This research aimed to comprehensively understand the demographics and characteristics of transgender and gender diverse (TGD) individuals seeking mental health care upon initiating gender...Show moreThis research aimed to comprehensively understand the demographics and characteristics of transgender and gender diverse (TGD) individuals seeking mental health care upon initiating gender-affirming care. Additionally, it focused on optimal integration of mental health care into gender-affirming care according to TGD individuals. Both were within the framework of an ongoing investigation at the Zaans Medical Centre. The quantitative data analysis consisted of intake questionnaire data of twenty-five TGD individuals, variables were derived from sections of the intake questionnaire. For the qualitative data analysis, seven semi-structured interviews were held with TGD individuals. The characteristics of TGD individuals consisted of self-reported psychological distress and well-being. Their relationship to requested mental health care intensity was studied through Spearman rank order correlations. The demographics included age, educational level, ethnicity, employment status, experienced income, and gender assigned at birth. Their association with requesting mental health care was explored through chi-square tests. A thematic analysis with semantic approach was performed to analyse the data. No significant correlations were found between demographic variables and mental health care requests at admission. The correlation between self-reported psychological distress and mental health care intensity was χ2 = -.003, p = .987, for self-reported psychological well-being and mental health care intensity χ2 = -.001, p = .997. Thematic analysis of interview data yielded three overarching themes: motives for seeking mental health care, recommendations for integrating mental health services into gender-affirming care, and desirable attributes of mental health care providers. Reasons for refraining from or seeking mental health care included experiencing psychological distress or good psychological well-being, experiences due to gender dysphoria, acceptance of themselves, and experienced lack of support. Suggestions for optimal mental health care integration were better and more provision of (mental) health care and travel distance to mental health care. Qualities of the ideal mental health care professional were having certain character traits such as being accepting and being specialized in TGD. Overall, this research emphasizes the importance of knowledgeability and empathetic and inclusive qualities in mental health care professionals in the treatment of TGD individuals suggesting its importance over mental health care professionals’ gender identity.Show less
Bachelor thesis | Cultural Anthropology and Development Sociology (BSc)
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The thesis "Shaping Tomorrow’s Cities: Exploring Human-Environment Relations for Social Sustainability" examines the diverse interactions between humans and their environments in relation to social...Show moreThe thesis "Shaping Tomorrow’s Cities: Exploring Human-Environment Relations for Social Sustainability" examines the diverse interactions between humans and their environments in relation to social sustainability within urban areas. I focus on marginalised groups whose experiences often diverge from mainstream perspectives. Through case studies such as the Minha Casa Minha Vida project in Brazil and Hyde Park in the United States, this thesis highlights how these communities infuse spaces with personal and collective memories, influencing their interactions with the environment. These studies suggest that standardised urban planning policies may overlook the lived realities of marginalised communities, leading to social sustainability initiatives that fall short of addressing their needs. By examining the complex social, historical, and economic factors that shape human-environment relations, the thesis proposes a reimagined approach to urban planning that could foster more inclusive, equitable and supportive urban spaces.Show less
Exposure therapy is an effective treatment for post-traumatic stress disorder (PTSD), yet a substantial number of patients fails to reach symptom relief. Therefore, a deeper understanding of the...Show moreExposure therapy is an effective treatment for post-traumatic stress disorder (PTSD), yet a substantial number of patients fails to reach symptom relief. Therefore, a deeper understanding of the underlying mechanisms may help improve the treatment. Inhibitory learning has been a recently developed approach, stating that new fear associations must be actively developed. One proposed strategy has been that of expectancy violation, in which threat expectancies are actively challenged during exposure. Actively experiencing a mismatch between expectancy and reality is supposed to benefit learning and thus improve exposure success, yet results have been mixed. The aim of this study was to expose the mechanisms of expectancy violation by analyzing the types of expectancies experienced by PTSD patients. Furthermore, the effects of the strength of these expectancies and the extent to which they change in strength during exposure on treatment success was tested. In a clinical assay, participants (N = 60) were randomized across two groups, which both received exposure therapy. The experimental group’s exposure treatment was designed to enhance expectancy violation. In both groups, PTSD symptoms were measured at baseline and follow- up, and threat expectancies were measured right before and right after exposure. Results showed that both threat expectancies and PTSD symptoms reduced significantly. However, baseline expectancy strength did not have a significant effect on the amount of PTSD symptom reduction, both in the total and the experimental group. Furthermore, the amount of expectancy change did not predict PTSD symptom reduction either. A full ranking of expectancy types was provided.Show less
Depression is a leading cause of burden worldwide, disproportionately affecting women. Brooding rumination is a symptom and a risk factor for depression. The default mode network (DMN) is active...Show moreDepression is a leading cause of burden worldwide, disproportionately affecting women. Brooding rumination is a symptom and a risk factor for depression. The default mode network (DMN) is active during brooding rumination. Inadequate suppression of this network obstructs activation of the central executive network (CEN), essential for performing cognitively demanding tasks. While previous research linked DMN suppression to depression, this has not been investigated in a healthy population. This study examined potential gender differences in the time required to switch from the DMN to the CEN in a healthy sample. Additionally, it investigated whether switching time was positively related to brooding rumination and whether this relationship differed between genders. Lastly, it explored whether functional connectivity (FC) between the DMN and the subgenual anterior cingulate cortex (sgACC) was related to brooding rumination. Results indicated a faster DMN-CEN switch in men compared to women. No relationship was found between switching time and brooding rumination in either men or women. Lastly, brooding rumination showed no relationship with sgACC-DMN FC. This study proposes a slower DMN-CEN switch as a possible neural mechanism for higher rates of depression and relapse proneness in women compared to men. Moreover, it suggests that DMN suppression may not underlie brooding rumination as a risk factor for MDD. Researchers developing preventive measures for depression aimed at reducing brooding rumination may consider targeting other neural mechanisms than DMN suppression. Future research should explore these alternative neural mechanisms to support the development of preventive measures for the onset and relapse of depression.Show less
Bij het naleven van gedragsdoelen is een vorm van zelfregulatie van belang. Als deze zelfregulatie niet tot stand komt, spreken we van zelfregulatie falen. Hierbij hoort ook het ervaren van een...Show moreBij het naleven van gedragsdoelen is een vorm van zelfregulatie van belang. Als deze zelfregulatie niet tot stand komt, spreken we van zelfregulatie falen. Hierbij hoort ook het ervaren van een setback, een terugval in het naleven van een gedragsdoel. Om de kans op setbacks zo klein mogelijk te maken, moeten we begrijpen hoe individuen reageren op deze setbacks. In deze thesis wordt onderzoek gedaan naar het belang van gedragsdoelen en welke psychologische constructen invloed hebben of worden beïnvloed door het ervaren van een setback. Deze thesis onderzoekt daarnaast het verschil tussen approach-oriented en avoidoriented doelen in relatie tot subjectief succes bij gedragsverandering. Vanuit de literatuur werd verwacht dat doelen met betrekking tot fysieke gezondheid de belangrijkste gedragsdoelen waren. Daarnaast werd als hypothese gesteld dat approach-oriented doelen meer subjectief succes opleveren dan avoid-oriented doelen. Methoden. Met een steekproef van 167 participanten werden verschillende statistische analyses toegepast om antwoord te geven op de drie onderzoeksvragen. De resultaten duiden op een significant onderscheid tussen beide typen doelen, waarbij approach-oriented doelen aanzienlijk hogere gemiddelde scores op subjectief succes vertonen dan avoid-oriented doelen. In de context van de eerste onderzoeksvraag blijkt dat het verhogen of reguleren van wekelijkse sportactiviteiten het meest voorkomende doel is, terwijl het verhogen of reguleren van gezonde voeding het daaropvolgende meest gangbare doel is. De tweede onderzoeksvraag wijst op een algemene positieve perceptie van doelbereiking onder deelnemers, waarbij approach-oriented doelen, zoals het verhogen van gezonde voeding, meer succesvol lijken dan avoid-oriented doelen, zoals het reduceren van alcoholinname. Echter tonen de resultaten aan dat deelnemers die zich richten op het verhogen of reguleren van sportactiviteiten zich over het algemeen niet significant succesvoller voelen dan degenen die zich concentreren op het verhogen of reguleren van gezonde voeding, Conclusie. De bevindingen suggereren dat het streven naar gewenste resultaten een verhoogd gevoel van succes teweegbrengt in vergelijking met het vermijden van ongewenste resultaten. Dit impliceert praktische implicaties voor interventies gericht op gedragsverandering, waarbij een nadruk op approach-oriented doelen een effectieve strategie lijkt te zijn. Echter wijst dit onderzoek op enkele beperkingen, zoals een beperkte steekproefomvang en de mogelijkheid van vertekening door zelfrapportage. Toekomstig onderzoek zou baat hebben bij een representatievere steekproef en longitudinale ontwerpen om een dieper inzicht te verschaffen in deze dynamiek.Show less
Eerdere studies hebben aangetoond dat er een relatie is tussen kritiek van ouders op het kind en externaliserend gedrag bij het kind. Om de negatieve gevolgen van externaliserend gedrag te...Show moreEerdere studies hebben aangetoond dat er een relatie is tussen kritiek van ouders op het kind en externaliserend gedrag bij het kind. Om de negatieve gevolgen van externaliserend gedrag te voorkomen, is het belangrijk om de mechanismen erachter beter te begrijpen. Het doel van dit onderzoek is om te kijken of deze relatie daadwerkelijk bestaat en of een laag zelfbeeld deze relatie versterkt. In een cross-sectioneel onderzoek met 80 kinderen en hun ouder(s), werden ouderlijke kritiek, het externaliseren van de kinderen en het zelfbeeld van de kinderen gemeten aan de hand van vragenlijsten en een interactietaak. De resultaten toonden dat er geen relatie is tussen kritiek van de ouders en externaliserend gedrag van het kind. Ook versterkte een laag zelfbeeld deze relatie niet. Het blijft echter nog de vraag op welke manier deze drie variabelen met elkaar in verband staan en of factoren zoals het geslacht van het kind of verschillen tussen de ouders hier iets mee te maken hebben. Onderzoek hiernaar zou meer duidelijkheid geven rondom dit vraagstuk.Show less
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)
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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
This study aims to investigate whether parental sensitivity is related to the level of correspondence within parent-child dyads in terms of the strategies that they use while monitoring animations...Show moreThis study aims to investigate whether parental sensitivity is related to the level of correspondence within parent-child dyads in terms of the strategies that they use while monitoring animations of social interactions. Higher levels of synchrony, or the level of correspondence in behavior between parents and their children, is related to better social and emotional developmental outcomes for the children. In total, 69 parents and their 12-months-old baby’s participated in an eye-tracking study, in which an animation was shown that depicted a situation, wherein a “baby figure” shows distress after it is separated from a “parent figure”. This so-called separation segment of the animation was followed by the so-called response segment, wherein either a reunion or further separation of the two characters was shown. Both the parental sensitivity during free-play and the relative fixation duration to the “parent figure” in regards to the “baby figure” were measured. Within this study, no relationship between parental sensitivity and the level of correspondence in monitoring strategies has been found. Moreover, there was no proof for the statement that overall the monitoring strategies of parents and their children correspond with each other while watching animations that depict a social interaction. The baby’s tend to look more at the “parent figure” than their parents do. The focus on the “parent figure” increased from the separation segment to the response segment, for both the parents and their baby’s, although this increase in fixation is bigger for the parents than for their baby’s. These results imply that further research into the possible precursors or influences on the correspondence of behaviors within parent-child dyads is necessary.Show less
Introduction: There is a concerning rise in childhood overweight rates. Higher intake of vegetables appears to aid in preventing overweight. Since food preferences form before the age of 2,...Show moreIntroduction: There is a concerning rise in childhood overweight rates. Higher intake of vegetables appears to aid in preventing overweight. Since food preferences form before the age of 2, understanding factors influencing children's vegetable intake is crucial. Parental vegetable intake predicts children's vegetable intake, but research on the mother-child relationship in this context is limited, especially regarding young children under the age of 2. This study examines the relationship between maternal and child vegetable intake among children aged 11 to 14 months, exploring the potential moderating roles of maternal body mass index (BMI) and exclusive breastfeeding. Method: Data were drawn from the "Baby's First Bites" study, involving 240 mother-child pairs from the Netherlands, with 121 pairs included in this analysis. Children's vegetable intake was measured using Compl-eat, while mothers' vegetable intake was measured using the Food Frequency Questionnaires (FFQ). One multiple regression and two moderation analyses were conducted, with the mother's education level included as control variable. Results: Results indicated no significant association between maternal and child vegetable intake. Moderation analyses revealed that neither maternal BMI nor exclusive breastfeeding moderated this relationship. Even after accounting for the mothers' educational levels, the results remained unchanged. Discussion: These results are contrary to the hypotheses. Possible explanations for these findings include the young age of the children in this study, which may prevent them from applying modeling as a possible working mechanism between maternal and child vegetable intake. Also, methodological limitations such as the use of Compl-eat and the limited duration of exclusive breastfeeding could explain the lack of an observed association. Future research could investigate whether altering methodologies reveals a previously unnoticed association between mothers' and children's vegetable intake, and explore the underlying mechanisms of this relationship to clarify the effectiveness of increasing mothers' vegetable intake as a preventive measure against childhood overweight.Show less
Research master thesis | Developmental Psychopathology in Education and Child Studies (research) (MSc)
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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
Tien procent van de bevolking van 16 jaar en ouder meldt in de afgelopen vijf jaar slachtoffer te zijn geweest van een of meerdere vormen van dwingende controle als vorm van huiselijk geweld (CBS,...Show moreTien procent van de bevolking van 16 jaar en ouder meldt in de afgelopen vijf jaar slachtoffer te zijn geweest van een of meerdere vormen van dwingende controle als vorm van huiselijk geweld (CBS, 2023). Het is een vorm van huiselijk geweld waar nog relatief weinig over bekend is. Daarom is de organisatie Enver bezig met het opstellen van een nieuw protocol voor het werken met deze problematiek. In dit adviesrapport staat beschreven wat de kennis over dwingende controle is binnen Enver en wat de behoeften zijn van medewerkers in het verbeteren van de kennis en de aanpak. Hierbij is gezocht in reeds bestaande literatuur naar de definitie, de mogelijke gevolgen en waarop gelet moet worden bij het signaleren van dwingende controle. Daarnaast is onderzocht welke kennis de medewerkers van Enver al hebben en waar eventuele behoeften liggen, door middel van een vragenlijst die is verspreid onder de medewerkers van Enver. Uit de resultaten van de literatuur komt naar voren dat er verschillende definities worden gehanteerd voor dwingende controle. De definitie van Stark (2007) is het meest passend. Hierin definieert Stark dwingende controle als een strategische reeks onderdrukkend gedrag die verder gaat dan fysiek geweld. Daarnaast zijn in het literatuuronderzoek ook resultaten gevonden over de signalering van dwingende controle. Hieruit is een helder dader- en slachtoffer profiel naar voren gekomen. Verder blijkt in de literatuur geen consensus te zijn over concrete richtlijnen van signalering van dwingende controle. Wel zijn twee recente gidsen (Instrumenten Voor Opsporing van Dwingende Controle, z.d.), een gespreksinstrument (DASH; Myhill & Hohl, 2019) en een training voor professionals gevonden (Geweldspatroon van Dwingende Controle in (Ex-)Partnerrelaties - het Verschil Tussen Wat Er Gebeurt op het Toneel en in de Coulissen | RINO Groep Utrecht, z.d). Als laatste is uit de literatuur gebleken dat er verschillende negatieve gevolgen zijn op persoonlijke en relationele vlakken voor partners. Ook kunnen er gevolgen zijn voor een kind. Uit het empirisch onderzoek blijkt dat, als er gekeken wordt naar de afdelingen, ‘gedragswetenschappers’ de hoogste score behalen en deze significant hoger scoren dan de ‘jeugdhulpverleners’. Verder is naar voren gekomen dat op het cluster gevolgen beter wordt gescoord dan op de clusters signaleren en gedragskenmerken. Wat betreft de behoeften blijkt dat medewerkers behoefte hebben aan duidelijke richtlijnen binnen de organisatie over hoe te handelen in het geval van dwingende controle. Het advies voor Enver is om richtlijnen op te stellen voor gepaste hulpverlening na signalering van dwingende controle en eventuele bijscholing voor afdelingen te overwegen.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
