Psychotherapy necessarily involves a relationship between a therapist and a client. In examining this relationship, researchers address what is referred to as the therapeutic alliance. Contemporary...Show morePsychotherapy necessarily involves a relationship between a therapist and a client. In examining this relationship, researchers address what is referred to as the therapeutic alliance. Contemporary research established this alliance as an important common factor that has a significant effect on therapeutic outcomes. An alliance rupture is defined as a breakdown in agreement on therapeutic goals or tasks or of the therapeutic bond. Such ruptures are a near inevitable aspect of the therapeutic process. Distinct from existing meta-analyses which explored the relationship of rupture repairs on outcomes, the present research examines the effect that alliance ruptures themselves, identified through direct measures, have on therapeutic outcomes. Five studies were included in the meta-analysis (N = 366). A multilevel model was used to determine an aggregate effect size of ruptures on outcome across the included studies. In agreement with the paper’s hypothesis, the analysis showed a small but consistent positive relationship between ruptures and therapeutic outcomes where increased ruptures correlated with greater impairment in outcomes.Show less
The current study investigated the role of early maladaptive schema (EMS), particularly the schemas subjugation and self-sacrifice in mediating the relationship between adverse childhood...Show moreThe current study investigated the role of early maladaptive schema (EMS), particularly the schemas subjugation and self-sacrifice in mediating the relationship between adverse childhood experiences (ACE) and transdiagnostic somatic symptoms. Through convenience sampling, participants’ demographic data, EMS score (YSQ-3), ACE score (ACE questionnaire), and presence of transdiagnostic somatic symptoms (DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure) were measured. The total scores of subjugation and self-sacrifice, ACE, and transdiagnostic somatic symptoms were respectively summated, then analysed through mediation analysis. Participants were (N = 131) students of Leiden University from the age of 18 years old (M = 19, IQR = 2), comprising of 91.2% female and 8.8% male. Through the analysis, it was found that subjugation and self-sacrifice together significantly mediate the relationship between ACE and transdiagnostic somatic symptoms (b = .314, p = .003). The indirect effect was found to have mediated 55.6% (b = .175, p = .002) of the relationship. Moreover, exploratory analyses indicated that individually, subjugation and self-sacrifice also successfully mediated this relationship. This finding further strengthens the existing argument that following ACE, particular behavioral stress-response may lead to transdiagnostic somatic symptoms in later life. In this case, the schemas subjugation and self-sacrifice were found to be crucial in this relationship. Thus, providing a deeper look into the developmental trajectory of the ACE, EMS, and transdiagnostic domains and may aid clinicians in recognizing and targeting schemas related to transdiagnostic somatic symptoms.Show less
Objective. Neurofibromatosis type 1 (NF1) is a rare autosomal dominant single-gene disorder, primarily characterized by multiple (sub)cutaneous neurofibromas and café-au-lait macules. The cognitive...Show moreObjective. Neurofibromatosis type 1 (NF1) is a rare autosomal dominant single-gene disorder, primarily characterized by multiple (sub)cutaneous neurofibromas and café-au-lait macules. The cognitive profile of children with NF1 is hypothesised to be associated with deficits in three domains; visuospatial ability, executive function, learning and their interdependency. Between ages 11 and 15 years, an increase in PIQ was found in children with NF1. Because visuospatial abilities are strongly related to the level of PIQ as measured with the WISC-III-NL, the objective of this study was to find if improvement in visuospatial abilities in this course of age predicts this progress in PIQ. Methods. In a longitudinal design, 31 children with NF1 were assessed with the WISC-III-NL and a standardised battery of neuropsychological assessments at average age 11 and 15. In the statistical analyses the scores on the subtests of the WISC-III-NL constituting PIQ at age 11 and 15 were compared with paired t-tests and a repeated measures ANOVA. Next, five multivariable linear regression analyses were conducted with the increase in PIQ as the dependent variable and five neuropsychological constructs (visual and auditory attention, visuospatial ability, processing speed and fine motor skills) as the predictors. Results. Picture arrangement was the only WISC-III-NL subtest to increase between age 11 and 15, d = 1.04, p < .001. The repeated measures ANOVA resulted in a difference in improvement between the five WISC-III-NL subtest scores, p < .001. Visuospatial ability was the only neuropsychological construct that predicted the increase in PIQ, b = 1.22, p = .005. There was no correlation between improvement in picture arrangement and improvement in visuospatial ability. Conclusions. Improvement in visuospatial ability appears to predict increase in PIQ in children with NF1 between age 11 and 15. Further investigation is required to determine if these findings are replicable in larger sample sizes. Additionally, there is further research needed to explore variances in the amount of improvement observed across different visuospatial tasks. It may be possible that progress in executive function effects improvement in some visuospatial tasks. Implications are that executive functioning must be taken into account when interpreting (visuospatial) results from neuropsychological assessments in children with NF1, both in science and in the clinic.Show less
While amnestic Mild Cognitive Impairment (aMCI) and Alzheimer’s disease (AD) are primarily defined by cognitive deficits, studies have demonstrated that motor impairments can precede cognitive...Show moreWhile amnestic Mild Cognitive Impairment (aMCI) and Alzheimer’s disease (AD) are primarily defined by cognitive deficits, studies have demonstrated that motor impairments can precede cognitive symptoms by several years in these conditions. However, it is uncertain if the ability to learn sequences of movements is also impaired in this population. Therefore, this study investigated whether aMCI and AD affect motor sequence learning abilities, and how such abilities are related to AD biomarkers. The sample included 33 individuals with aMCI, 28 with AD, and 52 healthy controls (HCs). All groups completed a motor task consisting of performing a sequence of button presses, alternated with random blocks. Reaction time, coefficient of variation, and learning rates were obtained from the task. Participants also completed a series of cognitive tests to assess memory, visuospatial abilities, processing speed, language, and attention. Additionally, the following biomarkers for AD were assessed: amyloid beta via PET imaging, hippocampal volume via structural MRI, and number of e4 alleles via APOE genotyping. ANOVAs showed that AD participants had longer and more variable reaction times, followed by aMCI individuals, and with HCs having the shorter and more consistent reaction times. No significant differences in sequence learning rate were observed between groups. Exploratory analyses revealed that aMCI/AD had significantly slower initial learning rate than HCs. Linear regressions showed associations of slower reaction times with smaller hippocampal volume, and of higher coefficients with higher amyloid deposition. Poisson regressions revealed no significant correlations between motor sequence learning and APOEe4 allele count. Akaike Information Criterion (AIC) results indicated that combining cognitive test with motor measures improves the prediction of AD biomarkers. Overall, AD and aMCI individuals showed impairments in general motor performance but relatively preserved motor sequence learning abilities, with some deficits in initial rate of learning. Moreover, statistical model comparison suggested that adding motor sequence learning measures to neuropsychological assessment tools enhanced the prediction of AD biomarkers. As such, future studies should explore the value of integrating motor sequence learning measures in the assessment and tracking of AD/aMCI.Show less
People in debt often avoid contacting their creditors, a behaviour likely driven by feelings of shame. In the Netherlands, around one million households face significant debt, leading to stress and...Show morePeople in debt often avoid contacting their creditors, a behaviour likely driven by feelings of shame. In the Netherlands, around one million households face significant debt, leading to stress and shame, which exacerbates financial problems by hindering communication with creditors. This study investigates the impact of building shame resilience on reducing avoidance behaviours among debtors. Enhancing shame resilience means increasing individuals' sense of control over their situation and reducing feelings of being trapped. These factors can empower debtors to confront their financial problems rather than avoid them. Thus, an experiment involving 308 participants with financial distress evaluated the effectiveness of different versions of the same creditor letter. These messages were adjusted to either increase a sense of control, reduce feelings of being trapped, or serve as a baseline with no specific emotional content. The study hypothesised that these adjustments would lead to greater willingness to contact creditors and that gender might moderate the impact. Results showed that messages enhancing control or reducing feelings of being trapped significantly increased participants' willingness to engage with creditors. Although the hypothesis regarding gender moderation was not supported overall, women responded more positively to messages reducing feelings of being trapped. These findings suggest that supportive communication strategies addressing emotional barriers like shame can facilitate better debt management. The study's implications for policy and creditor practices emphasise prioritising psychological well-being to enhance financial stability.Show less
Introduction: The Locus Coeruleus (LC) is a small structure residing in the midbrain and is the primary source of Noradrenaline (NA) in the brain. The LC-NA system’s roles include focusing...Show moreIntroduction: The Locus Coeruleus (LC) is a small structure residing in the midbrain and is the primary source of Noradrenaline (NA) in the brain. The LC-NA system’s roles include focusing attention towards salient stimuli. Animal studies suggest that the LC-NA system plays a role in reward related functions, an aspect primarily attributed to the Ventral Tegmental Area (VTA) Dopamine (DA) system. Animal studies suggest that habituation of the LC to salient stimuli occurs rapidly. The Dorsal and Ventral attentional networks (DAN and VAN respectively) are other regions relevant in attentional focus. Thus, we hypothesise that the reward and salient stimuli will elicit higher responses in the LC compared to the control, the LC will habituate across trials, the DAN network will respond highest to reward, and the VAN highest to salience. Methods: Forty-five healthy participants were recruited to complete a reward-oddball task during fMRI scanning. Repeated Measures (RM)-ANOVAs assessed changes in BOLD levels in our regions of interest (LC, VTA, DAN, VAN) as participants responded to the different stimuli oddballs (reward, salient, no reward). Results: A main effect for stimulus type on LC activity was not found (p=.079). Activity in the LC did not significantly habituate (p=.469). The DAN had overall higher activation than the VAN and had higher activation to the reward oddball compared to the salient (p<.001). The VAN region also had higher activation to the reward compared to the salient condition (p<.001). Conclusion: Results suggest that the LC had a similar degree of activation to each stimulus. This may suggest that the LC responds to contextual saliency and may not account for how goal relevant a stimulus is. We did not find a statistically significant habituation across trials. This may suggest that habituation in humans happens at a slower/less extensive rate than rats. The DAN region had globally higher activation than the VAN, reflecting this region’s role in sustained and goal related attention. The lack of activation within the VAN may suggest an orientation response was not required during this task. Strengths, limitations, and directions for future research are discussed.Show less
Parkinson’s disease (PD) is a neurodegenerative disorder characterized primarily by motor symptoms due to the degeneration of dopaminergic neurons. However, non-motor symptoms such as cognitive...Show moreParkinson’s disease (PD) is a neurodegenerative disorder characterized primarily by motor symptoms due to the degeneration of dopaminergic neurons. However, non-motor symptoms such as cognitive decline are prevelant in up to 80% of PD patients. Multi-system degeneration and neurotransmitter decifiences are likely the cause. One of the systems implicated in PD-related cognitive decline is the cholinergic system but it remains unclear to what extent the system is affected and how it links to different disease stages. This retrospective cohort study explores the integrity of the cholinergic system in PD through the measurement of alpha reactivity using electroencephalography (EEG). EEG data from 191 participants, including 46 early-stage PD patients, 17 late-stage PD patients, and 128 healthy controls was analyzed. Alpha reactivity, measured as the difference in alpha power between eyes closed and eyes open conditions, was assessed via EEG. Cognition was assessed via the Mini-Mental State Exam (MMSE). Results revealed significantly reduced alpha reactivity in PD patients compared to healthy controls. ANCOVA analyses demonstrated reductions in alpha reactivity in both early-stage and late-stage PD groups when compared to healthy controls. However, no significant reduction in alpha reactivity was found between early and late-stage PD patients. These findings provide neurophysiological evidence of a reduction in alpha reactivity in PD patients, which could indicate a cholinergic dysfunction in PD, irrespective of disease stage. This study also highlights the potential utility of alpha reactivity as a biomarker for assessing disease severity.Show less
Given the profound environmental impact of single-use plastic packaging, this study addresses the influence of moral appeals and environmental attitudes regarding plastic-free consumer choices in...Show moreGiven the profound environmental impact of single-use plastic packaging, this study addresses the influence of moral appeals and environmental attitudes regarding plastic-free consumer choices in the UK. Utilizing an experimental between-subject design (N = 263), moral appeals were expected to influence plastic-free choices. Stronger pro-environmental attitudes were expected to increase plastic-free choices following an individualizing moral appeal, whereas weaker pro-environmental attitudes were expected to increase plastic-free choices following a binding appeal. Results did not support the hypotheses, as plastic-free choices did not differ between the moral appeal conditions and the control condition, and pro-environmental attitudes did not moderate this relationship. Surprisingly, the individualizing appeal prompted more plastic-free choices than the binding appeal. The roles of price, culture, and self-construal, as well as the partially failed manipulations, are discussed as possible explanations for the findings. In conclusion, using an individualizing moral appeal effectively promotes plastic-free purchasing behaviour in the UK.Show less
An SCT is a genetic disorder in which children are born with an extra sex chromosome that arises during pregnancy. Even though SCTs are one of the most common chromosome duplications, many people...Show moreAn SCT is a genetic disorder in which children are born with an extra sex chromosome that arises during pregnancy. Even though SCTs are one of the most common chromosome duplications, many people with SCTs go undiagnosed due to a lack of evidence or visible symptoms. Previous studies showed that the neurocognitive functioning, especially executive functions and social cognition of children with SCT differ from those of children without SCT. However, that research focuses mostly on older children, so there was a need for knowledge of the development of children under 4 years with an SCT. Research also showed that ADHD symptoms in children with an SCT increased as these children got older and that there are differences in social-emotional development between boys and girls. This study examined which factors influence the difference in social-emotional development between children with and without SCT. Social-emotional development is about the social and emotional skills that children acquire to communicate and deal with emotions. Differences between SCT and no SCT and between boys and girls as well as the influence of age on social-emotional development were examined. The sample of this study is part of a larger ongoing project investigating development in different domains of children with an SCT. The total score on the Ages & Stages Questionnaires was used to measure social-emotional development. This research shows that there is a significant difference in social-emotional development between children with and without an SCT. Specifically, children with an SCT grow into a deficit as they get older. It could not be shown that gender has an influence. The recommendation is to perform more research towards the early diagnosis of SCTs in children in order to be able to intervene at a young age. This will prevent them from growing into deficit when they get older.Show less
Research implies that stroke rehabilitation might benefit from music as an add-on in physical therapy. Nevertheless, it is still not widely used and researched. This research aims to examine if...Show moreResearch implies that stroke rehabilitation might benefit from music as an add-on in physical therapy. Nevertheless, it is still not widely used and researched. This research aims to examine if sonification, translating movement into sound, or rhythmic auditory stimulation (RAS) of movement, using background music, shows a greater learning process while playing the Pizzicato game. As both have shown to be a profitable add-on, the current research question is, “Which auditory-motor training method is most suitable for stroke rehabilitation?”. Here, we predict that sonification will show a greater learning increase over RAS, while a combination of the two exceeds all the conditions. 75 participants were randomly assigned over four conditions to play the Pizzicato game. The results arising from a 1x4 ANOVA show a lack of overall significant effects, even though significant effects are seen in sonification, and RAS compared to no sound. Concluding sonification and RAS can possibly enhance motor learning performance, while a combination of the auditory stimuli could result in a cognitive overload. Sonification or RAS could cautiously be implemented in stroke rehabilitation only if it is to increase enjoyability in rehabilitation.Show less
This thesis looks into the effects of horizontal inequalities on civilian victimisation during civil wars. The contribution of this paper is two-fold. First, it gave an extensive overview of...Show moreThis thesis looks into the effects of horizontal inequalities on civilian victimisation during civil wars. The contribution of this paper is two-fold. First, it gave an extensive overview of relevant research from numerous fields, which were subsequently combined into one overarching theoretical framework. Secondly, a preliminary empirical analysis was conducted using multiple linear regression (OLS) models to test the resulting expectations - that horizontal inequalities (economic and political) are likely positively related to civilian victimisation during civil wars. The analysis came back with mixed results, and at best limited and indirect support for the expected positive link between horizontal inequality and civilian victimisation.Show less
