Early maladaptive schemas (EMSs) are persistent dysfunctional beliefs that form in childhood and are thought to underlie chronic and recurring psychopathology. EMSs have been categorized into five...Show moreEarly maladaptive schemas (EMSs) are persistent dysfunctional beliefs that form in childhood and are thought to underlie chronic and recurring psychopathology. EMSs have been categorized into five broader schema domains. Transdiagnostic depressive symptoms entail depressive symptoms observed across various psychological disorders. We studied the relative contribution of the five EMS domains on transdiagnostic depressive symptoms in a cross-sectional within-subjects design. The sample consisted of students from Leiden University (N = 125) participating for course credit or monetary rewards, of which 91.2% were assigned the sex female at birth and 8.8% male (median age = 19, IQR = 2). Participants completed measures of the Young Schema Questionnaire 3 - short form (YSQ-S3) and the DSM-5 self-rated level 1 cross-cutting symptom measure – Adult (DSM-XC). Pearson correlations were inspected between each EMS domain and transdiagnostic depressive symptoms. A multiple regression analysis including the total scores of the five EMS domains as predictors was carried out. Individually, the EMS domains Disconnection & Rejection, Impaired Autonomy & Performance, Impaired Limits, Other-directedness, and Overvigilance & Inhibition were positively associated with transdiagnostic depressive symptoms (rs .451, .365, .289, .298, .345, p < .001), as hypothesized. The joint effect of the five EMS domains was positively associated with transdiagnostic depressive symptoms (Adj. R2 = .18, F(7, 117) = 4.88, p <.001). Interestingly, when holding the other domains constant, only the Disconnection & Rejection domain significantly predicted transdiagnostic depressive symptoms in the model (β = .44, 95% CI [.15, .74], p = .004). The domain groups the beliefs about expectations that one’s needs for security and stability will not be met predictably. Our findings suggest that each EMS domain is positively related to transdiagnostic depressive symptom severity in a university student population. The Disconnection & Rejection domain, relative to the other four domains, seems to uniquely contribute to transdiagnostic depressive symptoms. Future research could test whether identifying and changing the EMSs someone has in psychotherapy could reduce their transdiagnostic depressive symptoms across different psychological disorders. It remains a question if paying specific attention to the Disconnection & Rejection domain in psychotherapeutic treatment could improve the reduction of transdiagnostic depressive symptoms.Show less
Research master thesis | Psychology (research) (MSc)
closed access
Objective: The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is the gold standard to assess post-traumatic stress disorder (PTSD). Although the CAPS-5 was developed and validated in Western...Show moreObjective: The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is the gold standard to assess post-traumatic stress disorder (PTSD). Although the CAPS-5 was developed and validated in Western populations, many clinicians and researchers also use it to assess PTSD in non-Western refugee populations. In this study we investigated whether PTSD as assessed with the CAPS-5 has the same structure and meaning across trauma-exposed, treatment-seeking individuals with either a Dutch (i.e. Western) background or a non-Western refugee background. Method: We evaluated commonly accepted DSM-5 PTSD factor models and tested different levels of measurement invariance (configural and scalar invariance) in a clinical sample of non-Western refugee patients (N = 710) and Dutch patients (N = 1162) suffering from prolonged complaints of psychotrauma, using confirmatory factor analyses (CFA). Results: CFAs showed that the Hybrid model of PTSD fit the data best in the Dutch and non-Western refugee subsample, as well as in the combined sample, indicating that configural invariance was met. The model representing scalar invariance showed a worse fit compared to the model representing configural invariance, indicating that factor loadings and/or symptom severity differed between the subsamples. Further investigation showed that this result could mainly be attributed to non-Western refugee patients often manifesting higher scores on the CAPS-5 items than Dutch patients. Conclusions: Non-Western refugee patients showed a similar structure of DSM-5 PTSD symptoms as Dutch patients. Furthermore, the relative contribution of the majority of symptoms to its belonging symptom cluster was similar between non-Western refugee patients and Dutch patients. This meant that both groups understood these symptoms in the same way. However, non-Western refugee patients often manifested a higher symptom severity than Dutch patients.Show less
Research master thesis | Developmental Psychopathology in Education and Child Studies (research) (MSc)
closed access
Both youth with a substance use disorder (SUD) and youth who have experienced adverse childhood experiences (ACEs) show heightened vulnerability to psychopathology. We aimed to quantify the risk of...Show moreBoth youth with a substance use disorder (SUD) and youth who have experienced adverse childhood experiences (ACEs) show heightened vulnerability to psychopathology. We aimed to quantify the risk of comorbid disorders in SUD youth with ACE-history. Additionally, we aimed to examine relations between ACEs, overall household experience, and general distress. We used cross-sectional YIT-study data from interviews with Dutch youth (aged 16-22) upon SUD treatment entry for cannabis, alcohol, or stimulant use. We measured ACE-types experienced up until 15 years of age, past-year DSM-5 disorders, general distress (DASS-21), and overall household experience rating. Logistic regressions quantified relations between ACE sum score and anxiety, depressive, behavior, and any disorder. Higher ACE sum scores related to increased risks for a(n) anxiety (OR = 1.12, highest odds = 2.84; χ2(1) = 6.71, p < .010; Nagelkerke R2 = 0.2), depressive (OR = 1.21, highest odds = 5.43; χ2(1) = 18.11, p < .001; Nagelkerke R2 = 0.6), behavior (OR = 1.20, highest odds = 5.24; χ2(1) = 17.41, p < .001; Nagelkerke R2 = 0.6), and any (OR = 1.25, highest odds = 7.58; χ2(1) = 17.26, p < .001; Nagelkerke R2 = 0.7) disorder. Exploratory analyses revealed that frequency of parental fighting, being hit/abused, getting belittled, emotional neglect, physical neglect, insufficient household income, long parental sickness, and overall household experience positively related to DASS-21. In a hierarchical regression analysis with all ACEs and overall household experience, only emotional neglect related to DASS-21 (B = 3.68, t(373) = 2.41, p = .017). Overall household experience did not improve the model (F(12) = 3.51, p < .001; R2change < .001). In hierarchical regression analyses containing ACE sum score and overall household experience, overall household experience was not uniquely related to DASS-21 (t = -0.22, p = .824; R2change < .01). In conclusion, ACEs relate to comorbid disorders in SUD youth. Our exploratory research suggests that ACE frequency might influence this relation, while overall household experience does not further explain this relation. Further research should investigate which ACE measures (a.o., type, frequency) strongly relate to SUDs and psychopathology and examine improved treatment options.Show less
Verbal information transmission has been proposed as one of the most influential fear learning pathways in the acquisition of social fears among children. Empirical studies have demonstrated that...Show moreVerbal information transmission has been proposed as one of the most influential fear learning pathways in the acquisition of social fears among children. Empirical studies have demonstrated that the content of parental verbal information regarding social situations plays a crucial role in shaping children’s development of social fear. Specifically, verbal threat (versus safety) information by the parent regarding novel stimuli significantly influenced children’s reported fear of the social scenario. The current study aims to further investigate whether such verbal threat and safety messages affect children's reported fear in social situations. Additionally, the study explores the potential moderating influence of parental social anxiety on this relationship, as evidence suggests that socially anxious parents convey more negative information regarding novel stimuli, thereby amplifying children's fear beliefs. A total of 69 children (mean age = 11.92 years; 38 girls) received standardized threat and safety information regarding a stranger from their primary caregivers. Subsequently, children engaged in three social tasks with each stranger and reported their fear beliefs about the stranger at the end of the social tasks. Results indicate significantly higher fear beliefs among children who received threat information compared to safety information regarding the stranger. However, parental social anxiety did not moderate the effects of negative verbal information on children’s reported fear beliefs. These findings underscore the role of negative verbal information transmission in children's acquisition of social fears while highlighting the complexity of factors within social anxiety that could contribute to the intergenerational transmission of these fears.Show less
The prevalence of overweight children in the Netherlands poses a threat to both mental and physical health. While genetic factors are important, the environment, particularly parental influence,...Show moreThe prevalence of overweight children in the Netherlands poses a threat to both mental and physical health. While genetic factors are important, the environment, particularly parental influence, also plays a significant role in the development of childhood overweight, as children of overweight parents are more often overweight. Parents pass on their genetic predispositions but also their learned eating behaviors to their children. This thesis explores how three different parental feeding styles moderate the intergenerational transmission of BMI between mothers and children: Restriction, Pressure to Eat, and Responsiveness to Child Fullness Cues. Participants were recruited through the Baby's First Bites project and were visited repeatedly at home. This study included 205 mother-child dyads, and children were assessed aged 36 months. Responsiveness to Child Fullness Cues and Pressure to Eat were assessed through observations, while Restriction was measured using the Infant Feeding Style Questionnaire. Both mothers and children were weighed at home and their BMIs were calculated using their height and age. The moderation analysis revealed a significant relationship between maternal and child BMI. Pressure to Eat acted as a negative moderator, with high levels of Pressure to Eat weakening the BMI relation between mothers and children. When analyzing the effect of gender, the full model was not significant for boys. However, for girls, Pressure to Eat remained a significant negative moderator, with high levels of Pressure to Eat weakening the BMI relation between mothers and children . These findings suggest that maternal BMI is a significant predictor of BMI in 36-month-old girls but not in boys, and that maternal Pressure to Eat moderates this relation. Intervention programs should consider these gender differences. However, due to the cross-sectional nature of this study, causal relationships cannot be inferred.Show less
Anxiety disorders are among the most prevalent mental health disorders among children and adolescents, significantly impacting various aspects of their lives. Preventative measures are crucial in...Show moreAnxiety disorders are among the most prevalent mental health disorders among children and adolescents, significantly impacting various aspects of their lives. Preventative measures are crucial in reducing these disorders' incidence and negative outcomes. However, preliminary research on the mechanisms behind anxiety prevention programs is limited. This longitudinal study aimed to investigate a program designed to prevent anxiety development by targeting parents of behaviorally inhibited children, as they are at risk for anxiety. The research question was: What is the moderating effect of the gender of the child and the age of the parent in the mediating relationship of parental anxiety on the effectiveness of the Cool Little Kids (CLK) intervention on child anxiety post-intervention, compared to pre-intervention? A total of 76 parents and their inhibited children aged three to six years were included in this study. The study employed a randomized controlled trial (RCT) design to assign them to either the CLK parenting training or a book with general parenting tips. Child anxiety was measured using a condensed version of the Diagnostic Infant and Preschool Assessment (DIPA) interview administered to the parent, and parental anxiety was assessed using the State-Trate Anxiety Inventory (STAI) questionnaire. A moderated mediation analysis was conducted for separation anxiety, specific phobias, and social anxiety using the PROCESS plug-in for SPSS. The findings indicated that none of the moderated mediation models nor the individual pathways were significant. All hypotheses were rejected. No significant difference in child anxiety was found pre- to post-intervention in both the CLK intervention and active control condition, and parental anxiety does not mediate this relationship. Child gender and parental age did not significantly moderate the link between child and parental anxiety. Despite excelling in among others its preventive system-oriented approach and credibility, this study has several limitations that warrant further research to firmly conclude the role of parental anxiety in CLK’s effectiveness on child anxiety. Recommendations include employing a larger and more diverse sample and experimenting with different scoring methods for the DIPA interview.Show less
Background. The prevalence of metabolic syndrome is high in patients with depression or anxiety, which might explain the higher risk of cardiovascular mortality in this population. Symptoms of...Show moreBackground. The prevalence of metabolic syndrome is high in patients with depression or anxiety, which might explain the higher risk of cardiovascular mortality in this population. Symptoms of affective disorders can lead to changes in eating behaviors. However, poor diet quality seems implicated in underlying pathology of behavioral health disorders and could be a risk factor for developing depression and anxiety disorders. Objective. We aim to investigate the association between diet quality and metabolic syndrome in participants with and without anxiety and depressive disorders. Psychotropic medication, symptom severity, and lifestyle factors (i.e. physical activity, smoking, and alcohol use) are investigated as potential moderators. Methods. In the Netherlands Study of Depression and Anxiety (NESDA), the Mediterranean diet, the metabolic syndrome, physical activity, smoking, alcohol use, severity of symptoms, and medication were assessed among participants with depressive (n = 110), anxiety (n = 149), remitted disorders (n = 761), comorbid disorders (n = 110), and healthy controls (n = 295), in a cross-sectional design. Follow-up data from NESDA wave six is used, nine years after baseline measurement. Results. Participants (n = 1425) were on average 52.4 years old (SD = 13.13) of which 65.2% female. The association between diet quality and metabolic syndrome was the strongest for individuals with current depression (β = -.23 (CI: -.42 ; -.08); t = -2.87; p = .005), comorbid disorders (β = -.20 (CI: -.36 ; -.02); t = -2.22; p = .029), and remitted disorders (β = -.12 (CI: -.19 ; -.06); t = -3.85; p < .001). The association between diet quality and metabolic syndrome was not moderated by medication, symptom severity and lifestyle factors. Limitations. Results cannot be generalized to other cultures and the use of self-report scales could lead to a misclassification bias. Due to the cross-sectional design, it is impossible to provide evidence for temporal or causal relations. Conclusion. Low adherence to the Mediterranean diet is associated with a high score on metabolic syndrome for patients experiencing depression, comorbid depression and anxiety or remitted depression or anxiety. This association is not moderated by medication, symptom severity and lifestyle factors.Show less
Background. Research shows mixed results regarding executive functioning (EF) deficiencies in adolescent Anorexia Nervosa (AN), contrasting with established EF impairments in adult AN patients....Show moreBackground. Research shows mixed results regarding executive functioning (EF) deficiencies in adolescent Anorexia Nervosa (AN), contrasting with established EF impairments in adult AN patients. This study aimed to assess EF and its association with Body Mass Index (BMI) in adolescent girls with first-onset AN. Method. 79 AN patients were compared to 75 matched healthy controls (HC), all females aged 12-22. EF was assessed using the Central Coherence Index (CCI) of the Rey Complex Figure Test (RCFT) and the Behavior Rating Inventory of Executive Functioning (BRIEF). Standardized BMI scores (BMI-SDS) were used to determine the influence of BMI on EF. Measurements were taken at baseline (T1) and one-year follow-up (T2). Results. Total EF scores showed no differences between AN and HC at baseline or follow-up. Compared to HC, AN patients had significantly worse scores on the BRIEF subscales Flexibility (p < .001; p < .001), Emotion Regulation (p < .001; p = .006), and Initiative (p < .001; p = .006), and significantly better scores on Orderliness and Neatness (p = .002; p < .001). P-values represent T1 and T2 respectively. At baseline, AN patients scored significantly higher on the RCFT CCI (p = .009). There was no significant relation between BMI-SDS and EF. Conclusions. Compared to HC, AN patients had normal EF scores with mild weaknesses in set- shifting, emotion regulation, and initiating skills, and strengths in orderliness and neatness. Changes in EF were unaffected by BMI-SDS. This study enhances understanding of EF in adolescent AN patients, which can aid the development of treatment programs.Show less
Empathizing involves the understanding and responding to an individuals’ emotions, while systemizing refers to the understanding and the ability to predict systems. The topics of empathizing and...Show moreEmpathizing involves the understanding and responding to an individuals’ emotions, while systemizing refers to the understanding and the ability to predict systems. The topics of empathizing and systemizing have been studied in children and adults. However, as far as we are aware, no research has investigated these constructs in adolescence, whereas there is a lot of development that takes place during this period. Earlier studies found gender differences in systemizing and empathizing, with males scoring significantly higher on systemizing, while females scored significantly higher on empathizing. This study examined the current gap in research, by examining the relationship between empathizing and systemizing in adolescence and possible gender differences. We did this by estimating network models with partial correlations (Gaussian graphical model) and calculating bridge centrality which identified nodes. These nodes acted as important bridges between one or more communities (e.g., the relationship between understanding of empathizing and motoric systemizing), for both male and female participants. We utilized data from the empathizing and systemizing questionnaire in 6,644 adolescents (2574 males and 4070 females, aged 13-24 years old), which we obtained from the Open-Source Psychometrics Project. We found gender differences in the relationships between empathizing and systemizing nodes in the male and female networks. For instance, in the female network, a correlation was found between the subconstructs feeling of empathizing and natural systems, while in the male network no correlation was found between the two. Moreover, understanding of others’ feelings showed to be highly correlated with all subconstructs of systemizing in all three networks but was not correlated with other subconstructs of empathizing. This study provided a foundation for further exploration of how the constructs of empathizing and systemizing are related and could be used to help guide the design of gender-specific interventions aimed at enhancing both empathizing and systemizing skills in adolescence.Show less
This study examined the relationship between internalizing problem behavior and parental skills in children with sex chromosome trisomy (SCT). Focusing on children aged 1 to 7 years, it compared...Show moreThis study examined the relationship between internalizing problem behavior and parental skills in children with sex chromosome trisomy (SCT). Focusing on children aged 1 to 7 years, it compared them with typically developing peers. The hypothesis that children with SCT exhibit more internalizing problem behavior was confirmed; they scored significantly higher on anxious and withdrawn behavior. No significant difference was found in parental skills between parents of children with SCT and those of the control group, suggesting interventions for internalizing problem behavior may be universally applicable. Results indicate that only parental positive affect was significantly associated with internalizing problem behavior in children with SCT. This finding suggests that parents of children who exhibit a relatively high degree of internalizing problem behavior, may display more positive affect as an adaptive response to their children’s needs. No other parental skills were found to significantly contribute to the explanation of internalizing behavior. Factors other than parental skills, such as biological, psychological or environmental factors, may have a greater impact on the development of internalizing behavior in children with SCT. The study is limited by its cross-sectional nature and the selectivity of the sample, which may affect the generalizability of the results. Nevertheless, this research provides insight into the parenting skills of parents of children with SCT and offers an initial examination of the relationship between these skills and internalizing behavior in children with SCT. Additionally, it contributes to a better understanding of SCT in young children and underscores the importance of early identification and appropriate interventions to prevent more severe internalizing problems later in life.Show less
Empathic Accuracy (EA) is an important skill in parenting. It promotes positive self- concept in adolescents and is a predictor for individual and family adjustment. Factors may influence parental...Show moreEmpathic Accuracy (EA) is an important skill in parenting. It promotes positive self- concept in adolescents and is a predictor for individual and family adjustment. Factors may influence parental EA, such as parental childhood maltreatment and parental or adolescent depression. Using a sample of 201 parents (55.2% mothers), this study measured with linear regression whether parental childhood maltreatment and parental depression contributed to parents misattributing their children’s negative emotions in the context of a conflict task. Adolescent depression was considered as a covariate. Parental childhood maltreatment, and depression of both adolescents and parents were measured using a self-report questionnaire. Parents (Mage = 49.31) and their adolescent child (Mage = 15.81) then participated in a video- recorded task, in which they were asked to solve a conflict. Afterwards, parents had to indicate how they thought their child was feeling on a 7-point Likert scale for positive and negative emotions during high affect moments in this task. The results suggested that parents who have experienced childhood maltreatment, but not parents who suffered from depression, tended to overestimate their children’s negative emotions during the conflict task, showing a negative bias. Additionally, when an adolescent was suffering from depression, parents tended to underestimate their negative emotions. These findings highlight that EA is an interactive process which may be influenced by different factors (e.g. parental childhood maltreatment, adolescent depression). This knowledge can make parents more aware of biases they might have towards the emotions of their children, and thereby improving their communicative and empathic skills.Show less
Patients with prolactinoma are often initially treated with dopamine agonists (DAs). Although in many cases effective, DAs can cause severe (psychological) side effects and sometimes require...Show morePatients with prolactinoma are often initially treated with dopamine agonists (DAs). Although in many cases effective, DAs can cause severe (psychological) side effects and sometimes require lifelong intake. Neurosurgical counseling offers an alternative treatment option. The current study investigated whether neurosurgical counseling leads to better outcomes than DA treatment regarding adverse mood symptoms, health-related quality of life (HRQoL), and disease burden in patients with prolactinoma. A preliminary analysis of the Prolactinoma Clinical Trial-study was conducted. Patients were included in a randomized controlled trial or the observational arm, receiving either neurosurgical counseling or DA treatment. Adverse mood symptoms (Hospital Anxiety and Depression Scale; HADS), HRQoL (Short-Form Health Survey; SF-36), and disease burden (Leiden Bothers and Needs Questionnaire; LBNQ) were measured at baseline and 12 months follow-up. Demographic and clinical variables were derived from electronic patient files. To investigate the effects of time, group, and time*group interaction, multivariate linear mixed models were performed on outcomes of the HADS, SF-36, and LBNQ, controlling for age, sex, and prolactin levels at baseline. Data were available for 71, 61, and 69 patients in the analysis on the HADS, SF-36, and LBNQ, respectively. A larger decline in anxiety symptoms was found in the group of neurosurgical counseling (time*group; B = -3.66 (95% CI [-5.85 – -1.47]), p = .001) compared to the DA group. Prolactin levels at baseline were predictive of more adverse mood symptoms, lower mental well-being, and more perceived bothers at 12 months follow-up (all p < .004). Neurosurgical counseling showed comparable effects to DA treatment in terms of HRQoL and disease burden but was superior at relieving anxiety symptoms. Furthermore, prolactin levels emerged as a more potent predictor of these outcomes than the choice of treatment. These findings may optimize treatment for patients with prolactinoma, addressing their mood, emotional well-being, and HRQoL.Show less
Decisions made at child protection sittings significantly impact the lives of children and their families. Therefore, it is crucial to investigate the factors influencing these decisions. Previous...Show moreDecisions made at child protection sittings significantly impact the lives of children and their families. Therefore, it is crucial to investigate the factors influencing these decisions. Previous research indicates that these decisions are not always made correctly and exhibit substantial variability. This study utilizes the Decision Making Ecology Model to analyse the influence of risk assessment tools and work experience on these decisions. Data were collected through a questionnaire and a case file study. The analyses show that the use of risk assessment tools has a significant impact on the decisions made. Work experience did not have a significant direct influence, but the use of risk assessment tools indirectly affected work experience, which in turn had a small effect on the final decisions.Show less
