Clinical research

Selected publications

Research projects

Team

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The Department of Clinical Research of the Clinic for Psychiatry, Psychosomatics and Psychotherapy of Childhood and Adolescence at the University Hospital Frankfurt aims to improve the diagnosis of psychiatric disorders in children and adolescents, to develop novel therapeutic procedures and to test them in clinical studies. The research focuses on the following disorders/conditions: Autism spectrum disorders, conduct disorders and attention deficit hyperactivity disorder. In addition, selective mutism, anxiety and depressive disorders are also being researched in individual projects. The respective research questions include the development and test-theoretical verification of questionnaires and diagnostic instruments, the preparation of AWMF-S3 guidelines, the development of psychotherapy manuals as well as new therapy methods such as tDCS, sports or light therapy and their verification by means of randomised clinical studies, and developmental basic research to establish and verify the mechanisms therapy. In addition, neurobiological correlates of the above-mentioned diseases are researched in cooperation with the other working groups. Clinical research is funded by the BMBF, the DFG and the EU.

S-3 Guideline for the diagnosis of autism spectrum disorders in childhood and adolescence (Freitag et al., 2015): http://www.awmf.org/leitlinien/detail/ll/028-018.html

Latest articles

Bast, N., Mason, L., Freitag, C. M., Smith, T., Portugal, A. M., Poustka, L., . . . The EU-AIMS LEAP Group. (2020). Saccade dysmetria indicates attenuated visual exploration in autism spectrum disorder. Journal of Child Psychology and Psychiatry. doi:10.1111/jcpp.13267

Kitzerow, J., Hackbusch, M., Jensen, K., Kieser, M., Noterdaeme, M., Fröhlich, U., Taurines, R., Geißler, J., Wolff, N., Roessner, V., Bast, N., Teufel, K., Kim Z. & Freitag, C.M. (2020). Study protocol of the multi-centre, randomised controlled trial of the Frankfurt Early Intervention Programme A-FFIP versus early intervention as usual for toddlers and preschool children with Autism Spectrum Disorder (A-FFIP study). Trials, 21(1), 1-17.

Boxhoorn, S., Bast, N., Supèr, H., Polzer, L., Cholemkery, H. and Freitag, C.M. (2020). Pupil dilation during visuospatial orienting differentiates between autism spectrum disorder and attention-deficit/hyperactivity disorder. The Journal of Child Psychology and Psychiatry, 61: 614-624. doi:10.1111/jcpp.13179.

Bast, N., Banaschewski, T., Dziobek, I., Brandeis, D., Poustka, L., & Freitag, C. M. (2019). Pupil Dilation Progression Modulates Aberrant Social Cognition in Autism Spectrum Disorder. Autism Research, 12(11), 1680-1692.

Bast, N., Poustka, L., & Freitag, C. M. (2018). The locus coeruleus - norepinephrine system as pacemaker of attention - A developmental mechanism of derailed attentional function in autism spectrum disorder. European Journal of Neuroscience, 47(2), 115-125. http://onlinelibrary.wiley.com/doi/10.1111/ejn.13795/full

Freitag CM, Jensen K, Elsuni L, Sachse M, Herpertz-Dahlmann B, Schulte-Rüther M, Hänig S, von Gontard A, Poustka L, Schad-Hansjosten T, Wenzl C, Sinzig J, Taurines R, Geißler J, Kieser M, & Cholemkery H (2016). Group-based cognitive behavioural psychotherapy for children and adolescents with ASD: the randomized, multicentre, controlled SOSTA-net trial. Journal of Child Psychology and Psychiatry, 57(5):596-605. http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12509/full

Bernhard A, Martinelli A, Ackermann K, Saure D, Freitag CM (2016) Association of trauma, Posttraumatic Stress Disorder and Conduct Disorder: a systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews [Epub ahead of print] http://www.sciencedirect.com/science/article/pii/S0149763416303414

Current specialist books

Friday CM, Kitzerow J, Medda J, Soll S & Cholemkery H (2017) Autism spectrum disorders. Göttingen: Hogrefe.

Cholemkery H, Kitzerow J, Soll S & Freitag CM (2017). Guide Autism Spectrum Disorders. Göttingen: Hogrefe.

Devil K, Wilker C, Valerian J, Friday CM (2017). A-FFIP - Autism specific therapy in pre-school age. Berlin: Springer.

Schlitt S, Berndt K, Friday CM (2015). The Frankfurt Autism Parent Training (FAUT-E). Stuttgart: Cabbage.

Cholemkery H & Freitag CM (2014) Social competence training for children and young people with autism spectrum disorders. Weinheim: Beltz.

The list of the respective publications can be viewed via Researchgate or pubmed under the names of the respective researchers.

• DFG-funded clinical study: Evaluation of the Frankfurt Early Intervention Programme (A-FFIP) - Autism specific therapy in preschool children
• Development of imitation and joint attention in children with autism spectrum disorder
• Pupillometry as an indicator of deviant attention processes in autism spectrum disorders
• Test theoretical investigation and standardisation of the Children's Communication Checklist-2 (CCC2), Repetitive Behavior Scale - Revised (RBS-R) and Aberrant Behavior Checklist (ABC)
• AWMF S3 Guideline for the therapy of autism spectrum disorders in childhood and adolescence
• BMBF-funded study: Systematic reviews of diagnostic tools for autism spectrum disorders
• EU-funded project MiND: Neurobiological causes and risk factors of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD)
• BMBF-funded study: ESCAdol for the therapy of chronic ADHD in adolescence
• EU-funded project CoCA. Sub-project CoCA-PROUD: Randomised controlled pilot study for the prevention of comorbid depression and obesity in attention deficit hyperactivity disorder (ADHD)
• EU-funded project FemNAT-CD: Research on social behaviour disorders
• Psychological and neurobiological bases of anxiety disorders in adolescents
•  Frankfurt Scale for Selective Mutism (FSSM)

The Frankfurt early intervention programme "A-FFIP" is based on the results of developmental psychological studies on speech, motor, cognitive and play development in healthy children and children with autism spectrum disorder (ASD). Empirically tested behaviour-therapeutic and practising procedures are applied. Developed to overcome the shortage of scientifically based and financially viable support approaches in Germany, the manualised A-FFIP is offered with an intensity of 2 hours per week. In this multi-centre study, the development of children with ASD is examined with regard to autism symptoms, cognition, language and social behaviour in the course of therapy (after 1 year), who were supported according to the A-FFIP approach and compared with the development of children with ASD who received other locally available support. The aim of this DFG-funded study is therefore to investigate the efficacy of the A-FFIP approach.

Further information: Ziyon.Kim[at]kgu.de

Current job advertisements:
PhD student / doctoral candidate in psychology

The skills of joint attention and imitation are central building blocks in early childhood development and influence the development of numerous other skills. Both Joint Attention and Imitation are often severely limited, especially in children with autism spectrum disorders. Until now, the parallel or consecutive development of differentiated aspects of joint attention and imitation in children with autism spectrum disorders has rarely been studied. The aim of the study is to take a closer look at and differentiate the interrelationships between the two abilities in longitudinal data on their developmental course.

Further information: Karoline.Teufel[at]kgu.de

Pupil size is also a good indicator of mental effort and general alertness. We can measure this measure easily and without intrusive elements even in infants by means of eye-tracking. Participants simply have to watch something, such as a film or another person. Recent studies show that abnormal pupil responses could be an early indicator of autism spectrum disorder (ASD). We are therefore working on making this measure useful in the early diagnosis of ASD by developing an innovative test battery to measure basal attention processes and are now validating it.

Further information: Nico.Bast[at]kgu.de

As the child and adolescent psychiatry department of the University Hospital, we are constantly striving to improve diagnostics. This also includes transferring questionnaires from the English-speaking world to Germany by translating them if necessary, but especially by evaluating and standardising them. We are currently doing this for three parent questionnaires also in the diagnosis of autism spectrum disorders: the Aberrant Behavior Checklist (ABC), the Children's Communication Checklist (CCC-2) and the Repetitive Behavior Scale-Revised (RBS-R).

Further information: Nico.Bast[at]kgu.de

Together with representatives of various professional societies and organisations from Germany, we are working in a steering group to prepare the second part of an S3 guideline on autism spectrum disorders across the entire age range. The work of the steering group is organised and managed from Frankfurt under the chairmanship of Prof. Freitag.

The S3 guideline on diagnostics has already been published by the Association of the Scientific Medical Societies (AWMF http://www.awmf.org/leitlinien/detail/ll/028-018.html). The second part, and thus action guideline for the treatment of autism spectrum disorders in Germany, is expected to be published in 2020.

Further information: Leonora.Vllasaliu[at]kgu.de

In recent decades, numerous diagnostic tools for autism spectrum disorders (ASD) have been developed, most of which consist of parental interviews or behavioural observations or a combination of both. Not all of them are equally well suited for the diagnostic process, some are only suited for certain sub- or age groups and others are only insufficiently investigated. We are therefore working on a systematic review, the aim of which is to provide a complete overview of all autism diagnostic instruments and their suitability. The methodology for this has already been published in the study protocol and can be viewed here: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD012036/abstract

Further information: Leonora.Vllasaliu[at]kgu.de

ADHD and ASD are long-term disorders in which the interaction of genetic factors, biochemical changes and neuropsychological factors play an important role. A high overlap of symptoms of both disorders suggests that certain risk factors could play a role in both disorders. Nevertheless, children and young people with ASD/ADHD usually need different treatment approaches according to their difficulties. The aim of the study is to identify overlaps and differences between children and young people with ASD and ADHD in order to improve diagnosis and individual treatment planning. To this end, neurocognitive profiles between ADHD and ADHD are analysed and correlated with healthy controls and clinical symptom profiles. Furthermore, we use a gaze-movement paradigm to record eye convergence as a possible biological marker for ADHD symptoms within and between the different groups.

Further information: Sara.Boxhoorn[at]kgu.de

ADHD is often a chronic mental disorder that is very stressful in everyday life. Many adolescents have been suffering from the disease for years, and most of them also suffer from comorbid diseases such as a disorder of social behaviour or emotional problems. Many of those affected have already attempted several treatments without sufficient success. This study http://www.esca-life.org/was-ist-escalife/escadol deals with the therapy of such chronic activity and attention deficit disorders that have not been sufficiently improved by previous treatments. A new individually modifiable therapy programme, consisting of ten therapy modules to choose from, was developed by the University Hospital of Würzburg and is to be evaluated in this project in various centres, including the University Hospital Frankfurt www.esca-life.org/escadol/universitaetsklinikum-frankfurt-am-main.

Further information: Nadine.Friedrich[at]kgu.de

This international research project aims to better understand the physiopathological mechanisms behind Attention Deficit Hyperactivity Disorder (ADHD) and the diseases associated with it, thereby opening new avenues for the prevention and treatment of ADHD. The risk of depression and obesity is significantly increased for adolescent patients with (ADHD). The subproject CoCA-PROUD under the direction of Prof. Dr. Freitag investigates in a randomised controlled pilot study (phase IIa) the efficacy and feasibility of two novel non-pharmacological therapy programmes (light and movement therapy) for the prevention of depression and obesity in adolescents and young adults with ADHD. This also includes the use of a smartphone app, which is intended to support the affected persons in implementing the therapeutic measures in their daily life.

Further information: Jutta.Mayer[at]kgu.de

Our clinic is currently conducting a Europe-wide study to investigate disorders of social behaviour in girls. Special focus of this study is on emotion processing, neurobiology and therapy of conduct disorders (CD). This disorder can have a negative influence on the development and well-being of affected children and adolescents as well as their families, caregivers and teachers. However, previous research has mostly focused on the investigation of causes, course and treatment options in boys with CD. Although CD is more common in boys than in girls, about one to three percent of girls also suffer from it, and the number of girls with CD has increases significantly in Western societies such as the EU in recent years. A total of 17 research institutes from eight EU countries are participating in this large-scale study. The aim of the study is to gain a better understanding of social behaviour disorders and to identify possible differences between boys and girls with CD and healthy control subjects in order to develop improved treatment options.

Further information: Anka.Bernhard[at]kgu.de

Anxiety disorders are among the most common mental illnesses in childhood and adolescence. Within the framework of our study "Psychological and neurobiological bases of anxiety disorders in adolescents" we investigate factors that influence the development as well as the (partial) inpatient therapeutic success of anxiety disorders and school absenteeism on a psychological, molecular biological and neurophysiological level. The aim of the study is to contribute to the improvement of the knowledge of disorders and to achieve an optimisation of diagnostic procedures, differential indication and treatment. For this purpose, a detailed examination of symptoms (questionnaires, computer procedures), an EEG examination and blood samples are taken.

Further information: Lisa.Kroemer[at]kgu.de

The Frankfurt Scale for Selective Mutism (FSSM) was developed by Dr. Angelika Gensthaler. The FSSM is available in three versions for preschool children aged 3-7 years (FSSM 3-7), school-aged children aged 6-11 years (FSSM 6-11) and adolescents aged 12-18 years (FSSM 12-18).

This and further information is available for you in the download section

Further information: Angelica.Gensthaler[at]kgu.de

EU-funded project "Autism Innovative Medicine Studies-2-Trials - AIMS-2-Trials" (Innovative Medicines Initiative 2 under Joint Undertaking under grant agreement No. 777394 receives support from the European Union's Horizon 2020 research and innovation programme, EFPIA, Simons Foundation, Autism Speaks, and Autistica; Prof. C. M. Freitag, Site Principal Investigator)

EU-funded project "Neurobiology and therapy of social behaviour disorders in girls: The central role of emotion processing - FemNAT-CD" (European Union's Seventh Framework Programme grant agreement no. 602407 ; Prof. C. M. Freitag, coordinator)

EU-funded project "Comorbid conditions of attention deficit/ hyperactive disorders - CoCA" (European Union's Horizon 2020 under grant agreement no. 667302; Prof. C. M. Freitag, WP5-lead)

EU-funded project " Mastering skills in the training network for attention deficit hyperactivity and autism spectrum disorders- MiND" (European Union's Horizon 2020 under grant agreement no. 643051; Prof. C. M. Freitag)

DFG-funded project "Multicentre, randomized controlled trial of the Frankfurt Early Intervention Program for toddlers and preschool children with Autism Spectrum Disorder - A-FFIP" (DFG under grant agreement no. FR 2069/8-1; Prof. C. M. Freitag)

BMBF-funded project "Network ESCA-Life in the Research Network for Mental Diseases - Clinical study on evidence-based, step-by-step care of ADHD through individualised short-term therapy in adolescents (ESCAadol)" (grant agreement no. 01EE1408C - Prof. Dr. Romanos, University Hospital Würzburg)