Projects

The following projects are currently ongoing at the research department of the University Hospital of Child and Adolescent Psychiatry and Psychotherapy

AtR!Sk (dt. Ambulatorium für Risikoverhalten und Selbstschädigung) at the University Hospital for Child and Adolescent Psychiatry and Psychotherapy in Bern is a specialized outpatient service for adolescents (aged 12-17 years) with risk-taking and self-harm behavior, aiming to early identify and intervene in those potentially developing borderline personality disorder (early detection and intervention). All patients of the service are invited to take part in the AtR!Sk cohort study. The study aims are examining the correlates and prognostic factors of risk-taking and self-harm behavior and personality pathology in help-seeking adolescents. In addition, individual predictors of treatment response are examined. The findings will inform early detection and treatment of adolescents with borderline personality disorder features. The study is conducted in collaboration with the Department of Child and Adolescent Psychiatry, University Hospital Heidelberg, Germany.

Suicide is the second most common cause of death in adolescents and young adults and almost 10% of the adolescent normal population report a suicide attempt at some point. In order to inform and facilitate accurate and personalized risk assessment of suicidal ideation and behavior in clinical practice, efforts to identify specific risk factors have been made, but recent research found prediction to still be only marginally above chance. Therefore, using new approaches to examine such behavior is key. The goal of the current study is to apply Ecological Momentary Assessment and Digital Phenotyping in an at-risk group of adolescents, as well as their parents and therapists, to identify proximal short-term predictors of suicide attempts and suicidal crises. The study is conducted in collaboration with the Department of Psychology, University of Oregon, Eugene, USA.

Interpersonal difficulties are a hallmark of BPD. Affected individuals often report about intense and instable interpersonal relationships, which result in emotional distress and difficulties in various life domains. The current study aims at elucidating the cognitive and neurophysiological mechanisms underlying the oscillating character of interpersonal relationships in adolescents with BPD features. This is done by examining the formation and updating of beliefs about the character of other people, using a novel game-theoretical paradigm and a hierarchical Bayesian computational model. In addition, the model-inferred perceptual and learning biases are correlated with neuroimaging data. The study is conducted in collaboration with the Department of Economics, University of Zurich and the University Hospital for Psychiatry and Psychotherapy Bern.

The aim of this project is to evaluate a home treatment approach for children with acute mental disorders who require intensive therapy. Replacing inpatient treatment, which is commonly used for these patients in German-speaking countries, the young patients in AT_HOME are treated with high frequency in their own homes by a team of child and youth psychiatrists, psychologists, special nurses and pedagogues. The study is conceptualized as a randomized controlled trial comparing AT_HOME to regular inpatient treatment. The primary endpoint is the level of psychosocial functioning at 6 months follow-up after discharge from treatment.

The psychotherapeutic process is on the one hand driven by evidence-based psychotherapeutic interventions that address specific symptoms or maintenance mechanisms of mental disorders and on the other hand by specific common factors such as the therapeutic alliance and expectations regarding treatment outcome. This project aims at developing and applying an instrument that continuously monitors the psychotherapeutic process in terms of outcome ratings (e.g. changes in psychosocial functioning level during treatment) and session ratings (process variables, e.g. therapeutic alliance). The aim is to investigate how the psychotherapeutic process is influenced by common therapeutic process factors in adolescents with different mental disorders.

NSSI describes the intentional, self-directed act of injuring one’s own body tissue (i.e., by cutting) without suicidal intent and for purposes not socially sanctioned. Adolescents predominantly engage in NSSI to regulate stress and negative affect. Disentangling potential neurobiological mechanisms underlying NSSI, our research focuses on the hypothalamic–pituitary–adrenal (HPA) axis and the autonomic nervous system (ANS), linking stress- and emotion-regulation. The present study aims to test in an experimental trial, if pain compared to a no-pain condition following stress induction specifically alters neurobiological measures and subjective reports of stress experience in adolescents with NSSI compared to a healthy control group. The project will enhance our understanding of the psychological and neurobiological mechanisms underlying stress-relief following NSSI, the emergence of the behavior and its maintenance. If supported by empirical evidence, findings may lead to new treatment targets in NSSI. This study is funded by the Swiss National Science Foundation (SNSF), and conducted in close collaboration with the AG Koenig at our institution.

Glucocorticoids (GC) in supranormal dosing have been used for decades in the treatment of paediatric patients with acute lymphoblastic leukaemias and lymphomas. Besides their positive anti-tumoral effects, GC also have side effects on the emotional perception and behavior of children. We aim to detect and characterize the effects of GC treatment on emotional regulation in paediatric patients and correlate this to biological parameters. We will investigate patients undergoing a minimum 15-day therapy with GC before, during and after treatment (within-subject design) with psychological measures, analysis of hormonal reaction patterns in saliva, urine and blood and GC receptor genetics. The study is conducted in collaboration with the Department of Pediatric Oncology and Hematology of the Inselspital Bern.