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
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
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
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
Previous studies on pro-environmentalism have highlighted the roles of friend’s pro environmental social norms and the experience of eco-anger as strong predictors of young adults’ pro...Show morePrevious studies on pro-environmentalism have highlighted the roles of friend’s pro environmental social norms and the experience of eco-anger as strong predictors of young adults’ pro-environmental behaviour (PEB). Substantial evidence supports the influential role of emotions, specifically eco-anger, in social influence processes within interpersonal relationships. While the unique effects of social norms and emotioanal responses on PEB are well-documented, the interaction between these factors, particularly in the context of environmental activism among adolescents and young adults, has not been explored. To address this gap, this study investigated the complex interplay between these factors, examining how friends’ pro-environmental social norms and eco-anger together influence young adults’ PEB. A sample of 216 young adults, aged 17-29 years, completed self-report questionnaires in a computer laboratory setting. Pro-environmental behaviour was measured using the Adolescents’ Environmental Behavior scale (AEB), friends' descriptive social norms through an adjusted version of the AEB scale, and self and friend’s eco-anger through self created scales. A moderation model was employed to test the main and interaction effects of friends’ social norms, self and friend’s eco-anger on PEB. Our findings revealed that both friends’ descriptive social norms (b = .27, t(210)= 5.65, p< .001, 95% CI [0.17, 0.36]) and self experienced eco-anger (b= .20, t(210)= 4.70, p < .001, 95% CI [0.12, 0.28]) were significant predictors of PEB. However, friends’ eco-anger did not significantly predict PEB, and the anticipated moderating effects of both self and friends’ eco-anger on the positive relationship between social norms and PEB were not supported. While the direct impact of friend’s social norms and self eco-anger was evident, the interaction between these factors did not enhance pro-environmental behavior as hypothesized. This suggests that eco-anger may drive proenvironmental actions through personal motivations rather than amplifying the effects of peer influence. Future studies should delve deeper into the nuances of these interactions, considering possible intermediate factors. The robust influence of friends’ social norms and eco-anger highlights the importance of leveraging both social networks and emotional engagement in designing effective pro-environmental campaigns and promoting sustainable behaviour.Show less
Problematic behaviour remains a problem within healthcare of individuals with dementia, especially as its patient group is set to expand. Problematic behaviour is often caused by pain and places a...Show moreProblematic behaviour remains a problem within healthcare of individuals with dementia, especially as its patient group is set to expand. Problematic behaviour is often caused by pain and places a heavy burden on both professional and family caregivers. Especially since family caregivers are often overlooked as a factor in care. This study therefore investigates the effectiveness of the STA OP! method (SOM), a stepwise approach to address problematic behaviour and pain in individuals with dementia, as well as how the efficacy of SOM is moderated by family involvement. The study, conducted within the CARED-4 project, utilizes a quasi-experimental longitudinal design with measurements at baseline, 3 months, and 6 months after implementing SOM. It included 84 residents with dementia from 10 Dutch nursing homes units paired with their family caregivers. Problematic behaviour was examined using the Neuropsychiatric Inventory Questionnaire (NPI-Q) and family involvement was examined through a tailored questionnaire. Analysis was performed with RM Anova for problematic behaviour and family involvement and a general linear model for the moderation of SOM by family involvement. Results indicated that SOM effectively reduces problematic behaviour overall (F(2,55) = 3.81, p = 0.028), after 3 months (Mean Difference = 5.47 SE= 1.97, p = 0.007), but not after 6 months (Mean Difference = 5.70 SE = 3.36, p = 0.095). Family involvement did not change overall (F(1.62,30) = 2.12, p = 0.138). Accordingly, family involvement did not moderate the impact of SOM on problematic behaviour (F(2) = 1.43, p = 0.243). Despite methodological challenges mainly due to missing data, the study takes a first step towards understanding how the effectiveness of SOM interacts with family involvement. So, although family involvement did not moderate a significant reduction in problematic behaviour, the efficacy of SOM has further been established.Show less
In multiple studies, the evening chronotype have been associated with poor sleep quality and other negative health outcomes. This study investigates the relationship between chronotype, sleep...Show moreIn multiple studies, the evening chronotype have been associated with poor sleep quality and other negative health outcomes. This study investigates the relationship between chronotype, sleep quality, total sleep time, and misalignment through five hypotheses. We hypothesized that a later chronotype would predict poorer sleep quality (H1), shorter total sleep time (H2), and higher misalignment (H3). Additionally, we predicted that higher misalignment would be linked with poor sleep quality (H4) and mediate the relationship between later chronotypes and sleep quality (H5). The study utilized the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and the Morningness-Eveningness Questionnaire (MEQ) for chronotype assessment. Misalignment was assessed using items from both the PSQI and MEQ. The findings supported all hypotheses except for the mediation role of misalignment. These results replicate previous findings on the impact of chronotype on sleep quality and contribute to the literature by employing subjective measures of misalignment and testing its potential mediator role. Future research should focus on improving the measurement of misalignment and exploring other potential mediators.Show less
Research shows that many students don’t have enough reading comprehension to understand texts. One way of improving students’ reading comprehension could be by providing feedback to students while...Show moreResearch shows that many students don’t have enough reading comprehension to understand texts. One way of improving students’ reading comprehension could be by providing feedback to students while they answer questions about a text. To use feedback efficiently in the future, it’s important to know how elaborate effective feedback should be. Considering this, the current study examined the relation between feedback and the use of reading strategies in general, and for the use of reading strategies while reading a text. Moreover, the relation between the amount of information provided in the feedback and the use of reading strategies was examined. Experimental data of 97 participants aged 10 and 11 years (52.6% boys, M = 10.45, SD = 0.52) was collected using questionnaires, namely the Metacognitive Awareness of Reading Strategies Inventory and the Task-Specific Strategy Self-Report. Participants were pre- and post-tested and had three intervention sessions. They were randomly assigned to a condition, namely no feedback, short feedback, or elaborate feedback. During the intervention sessions, participants had to read a text, and answer questions about the text. Depending on their condition, they either received feedback or not. If they did, the amount of information in the feedback differed. Every session ended with a questionnaire. Using SPSS, two repeated measures ANOVA were completed. According to the results, there was no relation between feedback and the use of reading strategies. Furthermore, no differences were found for the different amounts of information in feedback and the use of reading strategies. The biggest limitation of the current study was the lack of a motivational component in the used intervention. Therefore, future research should use motivation as part of the intervention to investigate if feedback could help in improving the use of reading strategies for youth aged 10 to 11.Show less
Insomnia is highly prevalent in patients with long-term medical conditions. Although fatigue is the most common daytime symptom of insomnia, it is still largely unknown which underlying components...Show moreInsomnia is highly prevalent in patients with long-term medical conditions. Although fatigue is the most common daytime symptom of insomnia, it is still largely unknown which underlying components are associated with fatigue in a broader population of insomnia patients. Previous literature stated that dysfunctional sleep-related beliefs (DSRB) and pre-sleep arousal (PSA) could explain the relationship between insomnia and fatigue. Additionally, subjective sleep characteristics, such as insomnia severity, number of nocturnal awakenings (NoA) and sleep efficiency might also be components of this relationship. This study aimed to investigate how these factors affect fatigue in a broad medical population with insomnia. It was hypothesized that more disturbed sleep-related psychological factors and subjective sleep characteristics were associated with increased fatigue. This cross-sectional study, derived from the ongoing TIMELAPSE study, consisted of 154 participants. Participants completed questionnaires assessing fatigue (Checklist Individual Strength-20), DSRB (Dysfunctional Beliefs and Attitudes about Sleep-16), PSA (Pre-Sleep Arousal Scale), and insomnia severity (Insomnia Severity Index). The Consensus Sleep Diary tracked NoA and sleep efficiency daily for one week. Two multiple regression analyses were performed to assess the relationship between sleep-related psychological factors (DSRB, PSA), subjective sleep characteristics (insomnia severity, NoA, sleep efficiency) and fatigue. Age, gender, and depression were included as controlling variables. Results showed that DSRB (β = .174, p = .027), PSA (β = -.160, p = .036), and insomnia severity (β = .243, p = .002) were factors associated with fatigue in insomnia patients. More severe DSRB and higher insomnia severity predicted elevated levels of fatigue. Contrary to expectations, PSA was negatively associated with fatigue. Lastly, NoA and sleep efficiency were not related to fatigue. This study uncovered connections between more severe DSRB, lower PSA, and higher insomnia severity that led to higher levels of fatigue. The current study suggests that improvements in DSRB and reducing insomnia severity may reduce fatigue of insomnia patients with long-term medical conditions. Sleep interventions should emphasize on challenging these DSRB. Future research is needed to examine the complex relationship between PSA and fatigue, as well as whether changes in DSRB during CBT-I treatment reduce fatigue symptoms in this population.Show less
This Dutch study examined whether having a mentally ill family member influences adolescent psychosocial health and resilience, focusing on social support, assertiveness, and parental relation...Show moreThis Dutch study examined whether having a mentally ill family member influences adolescent psychosocial health and resilience, focusing on social support, assertiveness, and parental relation quality. A total of 421 adolescents with a mentally ill family member (target group) were compared to 9504 adolescents without familial mental illness (control group), using data from the Youth Health Monitor, conducted by the Dutch Public Health Service Gelderland North East (GGD GNE) based on ANCOVA and linear regression (n=9925; 51.4% girls; mean age=14.2). Results revealed that social support did not show group differences, but the target groups scored lower on assertiveness and parental relation quality. Moreover, parental relationship quality emerged as a positive moderator on adolescent psychosocial health. These findings highlight potential targets for future interventions aimed at enhancing parental relationships and assertiveness skills to improve the psychosocial health of adolescents with a mentally ill family member.Show less
Climate change is a serious threat to the future ecological environment, and household behaviors contribute significantly to greenhouse gas emissions. Engaging young people in sustainable household...Show moreClimate change is a serious threat to the future ecological environment, and household behaviors contribute significantly to greenhouse gas emissions. Engaging young people in sustainable household behaviors is crucial to reduce their carbon footprints. Therefore, this study aimed to investigate whether young adults’ perceived need for autonomy, relatedness, and competence vary across different living situations (Deci & Ryan, 2000) and if these needs, in turn, promote their motivation to perform pro-environmental behavior (PEB). The hypothesis was that students living in peer co-residentials experience higher levels of these needs, leading to increased PEB. Methods: This observational and cross-sectional study was part of the Horizons research project. The participants included students (N = 214), aged 16 to 26. The Needs-satisfaction Scale (Sheldon et al., 2001) was used to measure perceived autonomy, relatedness and competence for PEB. A modified version of the Behavior-based Environmental Attitude Scale for adolescents (Kaiser et al., 2007) was used to assess PEB. Living situations were categorized as peer co-residentials, parental homes, and other households. One-way ANOVAs were performed to analyse the levels of the needs across the household types. A between-subject ANCOVA was performed to analyse the main effects of household, autonomy, relatedness and competence on PEB, including interaction effects. Results: No significant differences were found in the levels of perceived needs across the household types, p >. 05. Similarly, no main effects on PEB were identified, p >. 05. However, a significant interaction effect between perceived competence and household type on PEB was observed, F(3, 204) = 4.55, p < .001. Regression analysis revealed an interaction between perceived competence and PEB within in parental households, F(1, 74) = 4.39, p = .04, with competence having a significant and positive effect on PEB, b = .77, t(75) = 2.09, p < .001. Conclusion: Within parental homes, students who perceived more competence while performing PEB were more inclined to engage in PEB. Except for this effect, the findings revealed no significant differences in perceived needs or levels of PEB across household types. This study highlights that young adults’ perceived competence in parental homes plays a role in their environmental engagement. Future research may explore how parent-child relationships continue to shape young adult’s perceived needs after they move out. Understanding these dynamics can inform programs aimed at engaging young adults’ pro-environmental behavior, leading to reduced household carbon footprints over time.Show less