Skip to main content

Advertisement

SpringerLink
Log in

The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents (KiGGS): study design and methods

  • ORIGINAL CONTRIBUTION
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

The BELLA study on mental health and well-being in children and adolescents is the mental health module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The cross-sectional KiGGS survey collected comprehensive data on the health status of 17,641 children and adolescents, aged 0–17 years, living in Germany. The survey included physical examinations and tests, questionnaires filled in by parents and equivalent questionnaires for children aged 11 years or older. A computer-assisted personal interview was conducted by study physicians, and various laboratory tests, e.g. on blood and urine samples, were performed. The longitudinal BELLA study collected initial cross-sectional data from a representative KiGGS sub-sample of families with children aged 7–17 years. Of the 4,199 randomly selected families invited to participate in the BELLA study, 2,863 took part. A total of 48.5% of the participating children and adolescents were girls, 51.5% were boys. Within the BELLA study, trained interviewers conducted standardised telephone interviews with one parent and also the child, if it was at least 11 years old. Afterwards the families received additional questionnaires. The interviews and questionnaires included various standardised and ICD-10-oriented instruments examining overall mental health problems and associated burden, depression, anxiety, attention deficit-/hyperactivity and conduct disorders. Furthermore they covered a broad spectrum of aspects related to mental health and well-being, such as risk and protective factors and health-related quality of life. An analysis of the non-responders showed that the families who agreed to participate form a representative sample with respect to the German population. The sample deviated only slightly from the KiGGS sample structure regarding socioeconomic status and regarding parent-reported mental health problems. No such difference was observed for the children’s self-reported mental health. A weighting procedure was applied to correct for deviations from the sociodemographic and socioeconomic structure of the target population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Achenbach TM (1991) Manual for the Child Behavior Checklist/4–18 and 1991 Profile. University of Vermont, Department of Psychiatry, Burlington, VT

    Google Scholar 

  2. Achenbach TM (1991) Manual for the Youth Self-Report and 1991 Profile. University of Vermont, Department of Psychiatry, Burlington, VT

    Google Scholar 

  3. Antonovsky A (1987) Unraveling the mystery of health. Bass, San Francisco

    Google Scholar 

  4. Arbeitsgruppe Deutsche Child Behavior Checklist (1998) Elternfragebogen über das Verhalten von Kindern und Jugendlichen; deutsche Bearbeitung der Child Behavior Checklist (CBCL/4–18). Einführung und Anleitung zur Handauswertung, 2. Auflage mit deutschen Normen. Arbeitsgruppe Kinder-, Jugend- und Familiendiagnostik, Köln

  5. Asendorpf JB, Aken MAG v (1993) Self-Perception Profile for Children—deutsche Fassung (SPPC-D). Humboldt-University, Institute for Psychology, Berlin

  6. Bethell C, Read D, Stein RE, Blumberg SJ, Wells N, Newacheck PW (2002) Identifying children with special health care needs: development and evaluation of a short screening instrument. Ambul Pediatr 2:38–48

    Article  PubMed  Google Scholar 

  7. Bettge S, Ravens-Sieberer U (2003) Schutzfaktoren für die psychische Gesundheit von Kindern und Jugendlichen—empirische Ergebnisse zur Validierung eines Konzepts. Gesundheitswesen 65:167–172

    Article  CAS  PubMed  Google Scholar 

  8. Bettge S, Ravens-Sieberer U, Wietzker A, Hölling H (2002) Ein Methodenvergleich von Child Behavior Checklist and Strengths and Difficulties Questionnaire. Gesundheitswesen 64:119–124

    Article  Google Scholar 

  9. Birmaher B, Brent DA, Chiappetta L, Bridge Monga S, Baugher M (1999) Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry 38:1230–1236

    Article  CAS  PubMed  Google Scholar 

  10. Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, Kaufman J, Neer SM (1997) The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry 36:545–553

    Article  CAS  PubMed  Google Scholar 

  11. Brähler E, Klaghofer R (2001) Konstruktion und teststatistische Prüfung einer Kurzform der SCL-90-R. Zeitschrift für klinische Psychologie. Psychiatrie und Psychotherapie 49: 115–124

    Google Scholar 

  12. Conners CK (1973) Rating scales for use in drug studies with children. Pharmacotherapy of children (Special issue). Psychopharmacol Bull 9:24–29

    Google Scholar 

  13. Currie C, Samdal O, Boyce W, Smith R (eds) (2001) Health Behaviour in School-aged Children: a WHO Cross-National Study (HBSC), Research Protocol for the 2001/2002 Survey. Child and Adolescent Health Research Unit (CAHRU), University of Edinburgh

  14. Dölle R, Schaffrath Rosario A, Stolzenberg H (2007) The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): data management. Bundesgesund- heitsblatt Gesundheitsforschung Gesundheitsschutz 50:567–572

    Article  PubMed  Google Scholar 

  15. Donald CA, Ware JE (1984) The measurement of social support. Res Community Ment Health 4:325–370

    Google Scholar 

  16. Döpfner M, Steinhausen H-C, Coghill D, Dalsgaard S, Poole L, Ralston SJ, Rothenberger A, Study Group ADORE (2006) Cross-cultural reliability and validity of ADHD assessed by the ADHD Rating Scale in a pan-European study. Eur Child Adolesc Psychiatry 15(Suppl1):46–55

    Article  Google Scholar 

  17. Döpfner M, Lehmkuhl G (2000) Diagnostik-System für Psychische Störungen im Kindes- und Jugendalter nach ICD-10 und DSM-IV (DISYPS-KJ), 2nd edn. Huber, Bern

    Google Scholar 

  18. Faulstich ME, Carey MP, Ruggiero L, Enyart P, Gresham F (1986) Assessment of depression in childhood and adolescence: an evaluation of the Center for Epidemiological Studies Depression Scale for Children (CESDC). Am J Psychiatry 143:1024–1027

    CAS  PubMed  Google Scholar 

  19. Filipiak-Pittroff B, Wölke G (2007) External quality assurance in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Procedure and results. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:573–577

    Article  CAS  PubMed  Google Scholar 

  20. Franke G (1995) SCL-90-R. Die Symptom-Checkliste von Derogatis. Deutsche Version. Z Klin Psychol 26:77–79

    Google Scholar 

  21. Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586

    Article  CAS  PubMed  Google Scholar 

  22. Goodman R (1999) The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 40:791–799

    Article  CAS  PubMed  Google Scholar 

  23. Grob A, Lüthi R, Kaiser FG, Flammer A, Mackinnon A, Wearing AJ (1991) Berner Fragebogen zum Wohlbefinden Jugendlicher (BFW). Diagnostica 37:66–75

    Google Scholar 

  24. Kamtsiuris P, Bergmann KE, Dippelhofer A, Hölling H, Kurth BM, Thefeld W (2002) Der Pretest des Kinder- und Jugendgesundheitssurveys: Methodische Aspekte und Durchführung. Gesundheitswesen 64(Sonderheft 1):S99–S106

    Article  PubMed  Google Scholar 

  25. Kamtsiuris P, Lange M, Schaffrath Rosario A (2007) The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): sample design, response and nonresponse analysis. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:547–556

    Article  CAS  PubMed  Google Scholar 

  26. Kern R, Rasky E, Noack RH (1995) Indikatoren für Gesundheitsförderung in der Volksschule. Forschungsbericht 95/1. Karl-Franzens-Universität, Graz

    Google Scholar 

  27. Kurth B-M (2007) The German Health and Examination Survey for Children and Adolescents (KiGGS): an overview of ist planning, implementation and results taking into account aspects of quality management. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:533–546

    Article  PubMed  Google Scholar 

  28. Kurth B-M, Bergmann KE, Hölling H, Kahl H, Kamtsiuris P, Thefeld W (2002) Der bundesweite Kinder- und Jugendgesundheitssurvey: Das Gesamtkonzept. Gesundheitswesen 64:3–11

    Article  Google Scholar 

  29. Kurth B-M, Kamtsiuris P, Hölling H, Schlaud M, Dölle R, Ellert U, Kahl H, Knopf H, Lange M, Mensink GBM, Neuhauser H, Schaffrath Rosario A, Scheidt-Nave C, Schenk L, Schlack R, Stolzenberg H, Thamm M, Thierfelder W, Wolf U (2008) The challenge of comprehensively mapping children’s health in a nation-wide health survey: design of the German KiGGS-Study. BMC Public Health 8:196

    Article  PubMed  Google Scholar 

  30. Lange M, Kamtsiuris P, Lange C, Schaffrath Rosario A, Stolzenberg H, Lampert T (2007) Messung soziodemographischer Merkmale im Kinderund Jugendgesundheitssurvey (KiGGS) und ihre Bedeutung am Beispiel der Einschätzung des allgemeinen Gesundheitszustands. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:578–589

    Article  CAS  PubMed  Google Scholar 

  31. Masten AS, Hubbard JJ, Gest SD, Tellegen A, Garmezy N, Ramirez M (1999) Competence in the context of adversity: pathways to resilience and maladaptation from childhood to late adolescence. Dev Psychopathol 11:143–169

    Article  CAS  PubMed  Google Scholar 

  32. McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36). II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263

    Article  CAS  PubMed  Google Scholar 

  33. Morgan JF, Reid F, Lacey JH (1999) The SCOFF questionnaire: assessment of a new screening tool for eating disorders. Br Med J 319:1467–1468

    CAS  Google Scholar 

  34. Ravens-Sieberer U (2003) Der Kindl-R Fragebogen zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen—Revidierte Form. In: Schumacher JKA, Brähler E (eds) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden. Göttingen, Hogrefe, pp 184–188

    Google Scholar 

  35. Ravens-Sieberer U, KIDSCREEN the European Group (2006) The KIDSCREEN Questionnaires—Quality of life questionnaires for children and adolescents—handbook. Papst Science Publisher, Lengerich

    Google Scholar 

  36. Ravens-Sieberer U, Wille N, Bettge S, Erhart M (2007) Mental health of children and adolescents in Germany. Results from the BELLA study within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:871–878

    Article  CAS  PubMed  Google Scholar 

  37. Ravens-Sieberer U, Erhart M, Wille N, Bullinger M, BELLA study group (2008) Health-related quality of life in children and adolescents in Germany: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl1):148–156

    Google Scholar 

  38. Ravens-Sieberer U, Wille N, Erhart M, Bettge S, Wittchen H-U, Rothenberger A, Herpertz-Dahlmann B, Resch F, Hölling H, Bullinger M, Barkmann C, Schulte-Markwort M, Döpfner M as the BELLA study group (2008) Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey. Eur Child Adolesc Psychiatry 17(Suppl1):22–33

  39. Rueda GE, Diaz LA, Campo A, Barros JA, Avila GC, Orostegui LT, Osorio BC, Cadena Ldel P (2005) Validation of the SCOFF questionnaire for screening of eating disorders in university women. Biomedica 25:196–202

    PubMed  Google Scholar 

  40. Rueda GE, Diaz LA, Ortiz DP, Pinzon C, Rodriguez J, Cadena LP (2005) Validation of the SCOFF questionnaire for screening the eating behaviour disorders of adolescents in school. Aten Primaria 15:89–94

    Google Scholar 

  41. Schenk L, Ellert U, Neuhauser H (2007) Children and adolescents in Germany with a migration backround. Medical aspects in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:590–599

    Article  CAS  PubMed  Google Scholar 

  42. Schneewind K, Beckmann M, Hecht-Jackl A (1985) Familienklima-Skalen. Bericht. Institut für Psychologie—Persönlichkeitspsychologie und Psychodiagnostik der Ludwig Maximilians. Universität München, München

    Google Scholar 

  43. Schwarzer R, Jerusalem M (1999) Skalen zur Erfassung von Lehrer- und Schülermerkmalen. Dokumentation der psychometrischen Verfahren im Rahmen der Wissenschaftlichen Begleitung des Modellversuchs Selbstwirksame Schulen. Institut für Psychologie, Freie Universität Berlin, Berlin

    Google Scholar 

  44. Starfield B, Riley A, Ensminger M, Green B, Ryan S, Kim-Harris S, Johnston D, Vogel K (1994) Manual for the Child Health and Illness Profile-Adolescent Edition (CHIP-AETM). The Johns Hopkins University, Baltimore, MD

    Google Scholar 

  45. Stiensmeier-Pelster J, Schürmann M, Duda K (1989) Depressionsinventar für Kinder und Jugendliche. DIJK, Hogrefe, Göttingen

    Google Scholar 

  46. Ware JE, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey (SF-12): construction of scales and preliminary tests of reliability and validity. Med Care 32:220–233

    Article  Google Scholar 

  47. Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). Med Care 30:473–483

    Article  PubMed  Google Scholar 

  48. Wille N, Bettge S, Wittchen H-U, Ravens-Sieberer U, BELLA study group (2008) How impaired are children and adolescents by mental health problems? Results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl1): 42–51

    Google Scholar 

  49. Wille N, Bettge S, Ravens-Sieberer U, BELLA study group (2008) Risk and protective factors for children’s and adolescents’ mental health: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl1):133–147

    Google Scholar 

  50. Winkler J, Stolzenberg H (1999) Der Sozialschichtindex im Bundes-Gesundheitssurvey. Gesundheitswesen 61(Sonderheft 2):S178–S183

    PubMed  Google Scholar 

  51. World Health Organization (2003) Caring for children and adolescents with mental disorders: setting WHO directions. WHO, Geneva

    Google Scholar 

  52. World Health Organization (2005) Atlas: child and adolescent mental health resources: global concerns. WHO, Geneva

    Google Scholar 

Download references

Conflict of interest

All authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Dept. of Psychosomatics in Children and Adolescents, Center for Obstetrics and Paediatrics, University Clinic Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany

    Ulrike Ravens-Sieberer MPH

  2. Dept. of Epidemiology and Health Reporting, Robert Koch-Institute, Berlin, Germany

    Bärbel-Maria Kurth

Authors
  1. Ulrike Ravens-Sieberer MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bärbel-Maria Kurth
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

the KiGGS study group

BELLA study group

Corresponding author

Correspondence to Ulrike Ravens-Sieberer MPH.

Additional information

Members of the BELLA study group: Ulrike Ravens-Sieberer (Principal Investigator), Claus Barkmann, Susanne Bettge, Monika Bullinger, Manfred Döpfner, Michael Erhart, Beate Herpertz-Dahlmann, Heike Hölling, Franz Resch, Aribert Rothenberger, Michael Schulte-Markwort, Nora Wille, Hans-Ulrich Wittchen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ravens-Sieberer, U., Kurth, BM., the KiGGS study group. et al. The mental health module (BELLA study) within the German Health Interview and Examination Survey of Children and Adolescents (KiGGS): study design and methods. Eur Child Adolesc Psychiatry 17 (Suppl 1), 10–21 (2008). https://doi.org/10.1007/s00787-008-1002-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-008-1002-3

Keywords

Search

Navigation