Numerous lifestyle, cardiovascular, and psychosocial factors have been implicated in the development of cognitive decline and dementia. Using a person-centered approach, this study explored...Show moreNumerous lifestyle, cardiovascular, and psychosocial factors have been implicated in the development of cognitive decline and dementia. Using a person-centered approach, this study explored clustering of modifiable risk factors for cognitive decline and dementia and investigated how these clusters are associated with declines in cognition and with dementia risk. Here, cognitive decline was operationalized as declining information processing speed. The sample consisted of 3787 older adults (age 55-85) enrolled in the Longitudinal Aging Study Amsterdam. Latent class analysis was performed over a subset of 14 lifestyle, cardiovascular, and psychosocial risk factors to identify latent subgroups. Latent growth curve modelling associated membership in identified subgroups with trajectories of processing speed. Logistic regression associated group membership with incidence of probable dementia (n=2611). A four-class solution was deemed to optimally represent the sample. Next to a large group with no specific salient features (n=845, 75.1%), other groups reflected pronounced depressive symptoms (n=324, 8.6%), cardiometabolic risk (n=410, 10.8%), and high physical activity (n=208, 5.5%), respectively. Latent growth curve modeling suggested that declines in processing speed accelerated with age, but latent class membership did not seem to affect these declines. Compared to the normative group, the depressed group had lower initial levels of processing speed (β_intercept=-2.38; 95% CI=[-3.38, -1.37]; p<.001), but further trajectory differences between latent classes were not statistically significant at α=5%. No significant differences in odds of probable dementia between the normative and other groups were found. Thus, this study did not find evidence of an effect of membership in identified latent classes on the strength or rate of cognitive decline, nor dementia. To draw implications for clinical and political decision-making, future research could test the robustness of findings by replicating analyses in similar cohorts, examine the utility of other grouping structures, consider inclusion of alternative risk factors, and investigate auxiliary outcome measures of cognitive decline and dementia.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
Introduction As dementia prevalence increases, more individuals are becoming caregivers for family members with dementia. This role can negatively impact the caregiver's quality of life (QoL), even...Show moreIntroduction As dementia prevalence increases, more individuals are becoming caregivers for family members with dementia. This role can negatively impact the caregiver's quality of life (QoL), even when the person with dementia resides in a nursing home. This study aimed to identify factors influencing caregivers' well-being. We investigated whether the type and stage of dementia, the QoL of the person with dementia, and their interactions could predict the family caregiver's QoL. Methods This study included 205 elderly participants with dementia from 19 nursing homes and their family caregivers. It measured the type of dementia by using a physician’s diagnosis, stage of dementia using the Bedford Alzheimer Nursing Severity-Scale (BANS-S) ( M = 14.92, SD = 4.58), QoL of the person with dementia using the Quality of Life in Late-Stage Dementia (QUALID) scale (M = 22.88, SD = 7.96 ), and caregiver QoL using a scale question from the TOPICS-MDS questionnaire (M = 7.36 , SD = 1.18). A general linear model was employed to analyze the data. Results Neither the type of dementia (F(3, 189) = 0.62, p = 0.6030), stage of dementia (F(1, 189) = 0.871, p = 0.352), nor the QoL of the person with dementia (F(1, 189) = 0.225, p = 0.636) predicted the QoL of the family caregiver. Additionally, no interactions between these factors were significant predictors of the family caregiver’s QoL (Type x Stage; F(3, 189) = .264, p = .851) (Type x QoL); F(3, 189) =.548 , p =.650) (Stage x QoL; F(1, 189) = .388, p = .534) (Type x Stage x QoL; F(3, 189) =.149, p = .930). Discussion None of the characteristics nor their interactions were able to predict the caregiver's quality of life. These results contradict earlier research. Possible explanations are the violations of certain assumptions within the GLM, the methods that were used to measure the variables and the difference in care setting between this study and previous studies. Further investigation is needed to clarify these discrepancies and refine our understanding of factors affecting family caregivers' QoL.Show less
Monochorionic (MC) twins share a placenta, which leads to a heightened risk of developing medical complications. This study explored the impact of adverse intrauterine circumstances on the...Show moreMonochorionic (MC) twins share a placenta, which leads to a heightened risk of developing medical complications. This study explored the impact of adverse intrauterine circumstances on the temperament development of 6-month-old infants, focused on Twin-to-Twin Transfusion Syndrome (TTTS), Twin Anemia-Polycythemia Sequence (TAPS), and selective Fetal Growth Restriction (sFGR). The investigation measured temperament in terms of positive and negative affectivity. It was hypothesized that MC twins affected by TAPS and sFGR would display differential affectivity, with donors and smaller twins exhibiting lower positive affectivity and higher negative affectivity compared to their co-twins. For TTTS, no significant long-term temperamental differences between twins were anticipated. Additionally, it was expected that MC twins from uncomplicated pregnancies would show higher positive affectivity and lower negative affectivity compared to those with medical complications. Conducted as part of the TwinLIFE study, this research examined 103 MC twin pairs, a group naturally controlling for genetic and environmental confounders, thereby exploring the effects of these specific prenatal circumstances. The Infant Behavior Questionnaire-Revised Very Short Form (IBQ-R-VSF) was administered to assess temperament for each individual twin at 6 months of age. Results indicated no significant within-pair differences in temperamental development among medically complicated twins, as expected for TTTS, but contrary to expectations regarding TAPS and sFGR. These results indicate a sense of relief for parents with twins from complicated pregnancies, as they suggest no need for additional intervention to promote healthy development. Contrary to expectations, comparisons between twins from uncomplicated and complicated pregnancies revealed lower positive affectivity in the uncomplicated group. These findings could be explained by a potential influence of parental focus on positive reinforcement in children with complications in the context of the child's survival and well-being. These results highlight that intrauterine circumstances do not necessarily cause any substantial differences but suggest a complex interplay between parental interactions and temperamental expression, warranting further investigation into the long-term outcomes and support programs.Show less
Social anxiety can have a huge impact on adolescents’ lives, including emotional, social, and educational problems. The relationships between social anxiety, audience perception, and expressiveness...Show moreSocial anxiety can have a huge impact on adolescents’ lives, including emotional, social, and educational problems. The relationships between social anxiety, audience perception, and expressiveness are considered to play a role in the development of those problems, since they cause intense distress or even avoidance of social or performance situations. Effective treatment options are therefore important to prevent further problems. This study examined the relationship between social anxiety, audience perception, and expressiveness, and the feasibility of blended care. To examine this, 43 participants followed a 12 week blended care intervention consisting of psychoeducation, social skills training, cognitive restructuring techniques, exposure tasks, assertiveness training, and homework assignments. In addition, the Social Anxiety Scale for Adolescents, the Audience Perception Questionnaire, and the Speech Performance Observation Scale for Youth were administered before and after treatment. A mediation analysis was done to study whether audience perception mediated the relationship between social anxiety and expressiveness. To test whether blended care was feasible in reducing symptoms of social anxiety, and increase audience perception and expressiveness, multiple paired samples t-tests were performed. No significant relationships were found between social anxiety and audience perception (β = -.054, p = .40), between social anxiety and expressiveness (β = .005, p =.37), and between audience perception and expressiveness (β = -.009, p =.75). Logically, the whole mediation model was also not significant (β = .005, p =.45). Results from the paired samples t-tests showed significant differences for social anxiety (t(29) = 2.66, p = .013), lowering the mean scores from 56.8 to 50.6, and audience perception (t(28) = -4.00, p < .001), increasing the mean scores from -3.2 to -0,8. No significant differences were found for expressiveness (t(13) = .10, p = .92). The results show no relationships between social anxiety, audience perception, and expressiveness, which could be explained by the unfamiliarity of the concept of expressiveness, a different mediator that has influence on these variables, having a small sample size, or participants’ level of education. Further research is needed on both, to gain more insight in relationships affecting social anxiety in adolescents. The results did show the feasibility of blended care in reducing social anxiety and increasing audience perception. Using blended care is encouraged to provide more and better care to adolescents.Show less
Het aanleren van woordenschat aan NT2-leerlingen (leerlingen met Nederlands als tweede taal) in kleuterklassen is een cruciaal onderdeel voor de taalontwikkeling van de leerlingen en hun algehele...Show moreHet aanleren van woordenschat aan NT2-leerlingen (leerlingen met Nederlands als tweede taal) in kleuterklassen is een cruciaal onderdeel voor de taalontwikkeling van de leerlingen en hun algehele academisch succes. Echter is het effectief vormgeven van woordenschatonderwijs aan deze doelgroep een uitdaging voor basisscholen. Dit onderzoek richt zich op het identificeren van effectieve strategieën voor het geven van woordenschatonderwijs aan NT2-leerlingen in kleuterklassen alsmede onderzoek naar het gebruik van deze strategieën op een specifieke basisschool. Middels een literatuurstudie zijn er drie principes vastgesteld die bijdragen aan effectief woordenschatonderwijs: 1. Integreer de moedertaal in het onderwijs, 2. Verhoog de hoeveelheid verbale interactiemomenten 3. Werk met directe instructiemomenten. Uit semi-gestructureerde interviews met vijf werknemers van een basisschool die zich met het kleuteronderwijs bezighouden blijkt het volgende. Als eerste heeft de school de integratie van de eerste taal in haar onderwijs nog niet in grote mate geïmplementeerd. Daarnaast blijkt dat leerkrachten actief didactische impulsen geven om interactie tussen leerlingen te bevorderen. Ten slotte wordt vastgesteld dat de school bekend is met het concept van directe instructiemomenten, maar dat er niet altijd voldoende tijd beschikbaar is om dit toe te passen. Deze bevindingen bieden inzichten voor leerkrachten en ondersteunend personeel om woordenschat effectiever te implementeren voor NT2-leerlingen in kleuterklassen.Show less
This master thesis investigated how social motives (prosocial vs. pro-self) and communication medium (headphones vs. no headphones) affect group negotiation outcomes. The study used a 2x2 factorial...Show moreThis master thesis investigated how social motives (prosocial vs. pro-self) and communication medium (headphones vs. no headphones) affect group negotiation outcomes. The study used a 2x2 factorial design with 41 three-person groups (N = 123), who engaged in a structured negotiation task. Hypothesis 1 predicted that prosocial groups would achieve higher joint outcomes than pro-self groups, and results of an ANOVA supported this prediction. Hypotheses 2 and 3, predicting that structured communication, using headphones to manipulate turn-taking behaviour, would improve prosocial and reduce pro-self groups negotiation outcomes, respectively, were not supported by an ANOVA. This suggests that while prosocial motives significantly improve outcomes, structured communication alone does not. Future research should explore additional communication structuring methods and broader contexts to validate these findings.Show less
Sibling relationships are among the longest-lasting relationships in most individuals' lives and the majority of the Dutch population has at least one sibling. Sibling relationships are crucial, as...Show moreSibling relationships are among the longest-lasting relationships in most individuals' lives and the majority of the Dutch population has at least one sibling. Sibling relationships are crucial, as they offer daily opportunities for children to develop social skills. The quality of sibling relationships can be influenced by various factors, including adverse childhood experiences (ACEs), which include 10 types of possible traumatic experiences among which child abuse, neglect and household dysfunction. ACEs can negatively impact a child's social and emotional development, posing risks to their ability to form and maintain relationships and having a possibly negative effect on their mental health later on in life. Current research often only considers biological siblings while the step-sibling relationship was the fastest-growing type of sibling relationship in families with divorced parents between 1997 and 2017. Therefore, the current study aimed to investigate the association between ACEs and the quality of the relationship among both biological and step-siblings who have experienced parental divorce. Hundred young adults between the ages of 18 and 25 completed a questionnaire in which they answered questions about their relationship with their siblings and their ACEs. Multiple regression analyses revealed that ACEs were similarly associated with a lower quality of the sibling relationships for both biological and stepsiblings. Specifically, emotional abuse by a parent during childhood and having a parent with alcohol and/or drug problems during childhood were linked to lower quality of the sibling relationship, while other childhood experiences examined were not related to relationship quality. These results highlight the significance of improving sibling relationship quality, as these relationships may buffer the adverse impacts of traumatic experiences. Adopting a family-focused approach could reduce these negative impacts, addressing the shadow of the past that these experiences may cast on sibling relationships.Show less
Social network centrality is the social position of a person in a social network. The more friendships or social connections they have in the network, the higher the centrality. A low level of...Show moreSocial network centrality is the social position of a person in a social network. The more friendships or social connections they have in the network, the higher the centrality. A low level of social network centrality is often thought to be related to feelings of loneliness. Yet there is still a lot of discussion if this is also the case for children with Autism Spectrum Disorder (ASD). Thus, this study examined the level of loneliness as well as the level of social network centrality in children with ASD, compared to their peers without ASD, and the relation between these two aspects in special education settings. Children with ASD were expected to show a lower level of social network centrality than children without ASD. However it was expected that children with ASD would not feel lonelier than their peers without ASD. Thus, while it was expected that a lower level of centrality relates to a higher level of loneliness in children without ASD, this was not expected for children with ASD. This study compared a group of 47 children with ASD and a group of 52 children without ASD, aged from 8 to 13 years old (M= 10.806; SD = 1.266), in a special education primary school setting. Loneliness was measured with the Children’s Loneliness Scale, and the centrality was measured in a “Like to Play” measure and was based on the number of friendship nominations a child received. ANOVA showed that the children with ASD did not show a significantly lower level of social network centrality nor feel lonelier than their peers without ASD. A hierarchical regression showed no significant relations between social network centrality and the level of loneliness in the two groups. Based on the results of this study children with ASD in an inclusive environment might be more socially central and less lonely than expected.Show less
Background: the vascular hypothesis of apathy suggests a link between vascular factors like cerebral small vessel disease (CSVD) and apathy symptoms, through lesions in the brain’s reward network....Show moreBackground: the vascular hypothesis of apathy suggests a link between vascular factors like cerebral small vessel disease (CSVD) and apathy symptoms, through lesions in the brain’s reward network. Previous studies found a cross-sectional association between lower blood pressure (BP) and symptoms of apathy in older persons with more CSVD, potentially through reduced cerebral blood flow (CBF). However, longitudinal research on these associations is lacking. This thesis investigated whether structural and dynamic vascular factors are associated with apathy symptoms over time in older persons. Methods: this longitudinal cohort study used participants of the Discontinuation of ANtihypertensive Treatment in the Elderly (DANTE)-Leiden, community-dwelling older persons on antihypertensive treatment with mild cognitive deficits. BP was measured at baseline and apathy was assessed with the Apathy Scale at baseline and after four years of follow-up (n=178). Additionally, a baseline MRI sub-study (n=109) was conducted to measure CSVD and CBF. Results: the mean age of the sample was 80 years (SD 4) and 63% was female. No significant association was found between the summary CSVD scores (β(95% CI)=0.018(-1.089-1.125), p=.975) or its separate features; WMH (β(95%CI)=0.012(-0.011-0.035), p=.318), CMB (β(95%CI)=-0.017(-0.605-0.572), p=.956), lacunar infarctions (β(95% CI)=-0.413(-1.266-0.440), p=.339), and a change in Apathy Scale score. Additionally, no significant association was found between the dynamic vascular factors; CBF (β(95% CI)=-0.029(-0.152-0.094), p=.640), systolic BP (β(95% CI)=-0.019(-0.056-0.018), p=.310) and diastolic BP (β(95%CI) =-0.029(-0.099-0.042), p=.425), and change in Apathy Scale score. The multiple linear regression model, incorporating all the structural and dynamic vascular parameters, was not significant (F(7,90)=1.32 , p=.250, R2=.093). Conclusions: in older persons with mild cognitive deficits, structural and dynamic vascular factors were not associated with apathy symptoms over time, in contrast to previous cross-sectional studies. Our findings did not support the vascular apathy hypothesis. Other factors, such as lifestyle, might confound the cross-sectional association between vascular factors and apathy. This study highlights the importance of further research into vascular factors and apathy, which acknowledge our limitations, or into other possible mechanisms for apathy.Show less
Aim: Effective self-management is essential for managing chronic kidney disease (CKD) and can enhance patients’ functioning and wellbeing. This study aims to examine the relationship between...Show moreAim: Effective self-management is essential for managing chronic kidney disease (CKD) and can enhance patients’ functioning and wellbeing. This study aims to examine the relationship between illness perceptions and self-management behaviors of CKD patients, as to whether illness perceptions are associated with improvements in self-management behaviors over time. Method: A randomized controlled trial was conducted to test an online self-management program with 121 participants, the majority of whom had received a kidney transplant (65.3%). Illness perceptions (helplessness, acceptance, emotional response, timeline and perceived control) were assessed using the ICQ and B-IPQ. Baseline self-management behaviors (medication adherence, healthy diet, physical activity, weight maintenance, and non-smoking) were measured with the PPPQ-self-management and the reported improvements or deterioration with regard to patients self-selected self-management goals with the PPPQ-self-management improvements at 6-months follow-up. Regression analyses were performed to examine the relationship between illness perceptions and self-management behaviors at baseline, as well as between illness perceptions at baseline and the reported improvements in self-management goals at 6-months follow-up. Analysis were controlled for the confounding variables gender, comorbidities, kidney transplantation, and participation in the E-GOAL study. Results: Helplessness showed a significant relationship with the reported self-management improvements at 6-months follow-up (R2= .040, β = -.20, p = .036), which remained significant after controlling for confounders. Patients who experienced greater helplessness at baseline reported smaller improvements in their self-management goals at 6- months follow-up. Conclusion: Helplessness was found to be significantly related to self- management improvements, yet no other significant relationships were found between the other illness perceptions and the self-management behaviors or their improvements in CKD patients. These findings suggest that addressing feelings of helplessness in self-management programs may be crucial, as it can interfere with self-management improvements. Healthcare providers could assess patients’ levels of helplessness and incorporate psychological interventions into self-management programs to reduce these feelings and support patients in improving their self-management behaviors, ultimately leading to better overall patient wellbeing.Show less
