Background: Questionnaires for anxiety disorders come in different lengths, scales and with varying interpretation guidelines. This may hamper therapist-patient communication when discussing the...Show moreBackground: Questionnaires for anxiety disorders come in different lengths, scales and with varying interpretation guidelines. This may hamper therapist-patient communication when discussing the score and the interpretation of where a patient can be placed on a severity scale. Expressing scores on a standardized common metric can facilitate the communication between therapist and patient. This thesis aims for a method that enables an easier interpretation of scores and in addition produces scores with a normal distribution. Method: Using the data of four anxiety questionnaires, namely the Brief Scale for Anxiety (BSA), the PADUA Inventory Revised (PI-R), the Panic Appraisal Inventory (POL/PAI) and the Impact of Events Scale Revised (IES-R), theta-based T-scores were calculated with the Item-Response Theory and deployed as a basis for crosswalk tables to look up T-scores from raw scores. Based on these crosswalk tables, transformation formulas were established to calculate T-scores. To validate these, calculated T-scores were compared to theta-based T-scores. Results: Most of the calculated T-scores had a normal distribution and the correlations between both methods to arrive at the T-scores were significant, the highest correlation was found for the BSA and the IES-R. Discussion: Due to a significant correlation and a large sample size a new method to arrive at a common metric was established by linking every raw score on a T-score metric. This provides a way to facilitate the interpretation and discussion of outcome scores. Further, with this new method disorder severity can be calculated and looked up due to tangible cut-off scores.Show less
Background: Brua is an Afro-Caribbean set of spiritual beliefs found on the ABC Islands (Aruba, Bonaire, and Curaçao), which are part of the Dutch Antilles. Psychiatric patients from these islands...Show moreBackground: Brua is an Afro-Caribbean set of spiritual beliefs found on the ABC Islands (Aruba, Bonaire, and Curaçao), which are part of the Dutch Antilles. Psychiatric patients from these islands may believe that their mental health is influenced by Brua-related practices. It is therefore important that mental health professionals are knowledgeable of Brua, but it is not yet known to what extent they are. Goal: This study investigated the knowledge of Brua among psychologists, psychiatrists, and psychiatrists in training in The Netherlands. Methods: All psychologists, psychiatrists, and psychiatrists in training in the service of Parnassia Psychiatric Institute were contacted to fill out a tailor-made survey on knowledge of Brua. Sufficient knowledge of Brua was defined as a score of 6 or higher out of 10. Three potential predictors of knowledge of Brua were investigated, namely work experience, ethnicity, and inquiry into religious beliefs in the clinical practice. Results: Out of the 152 participants, 13.2% scored a sufficient score on knowledge of Brua. Work experience did not predict total score on the survey. There were too few participants of non-Caucasian ethnicities to investigate the relationship between ethnicity and knowledge of Brua. Practitioners who often inquired into religious beliefs in the clinical practice did not score higher than practitioners who sometimes inquired into religious beliefs. Conclusion: Knowledge of Brua among psychologists, psychiatrists, and psychiatrists in training in The Netherlands is limited. Informational or educational campaigns on how to assess the role of Brua in clinical practice are recommended.Show less
One-sided premature termination of the treatment may generate serious implications to patients and health system in general. Patients not recover fully or sufficiently to qualify for good end-state...Show moreOne-sided premature termination of the treatment may generate serious implications to patients and health system in general. Patients not recover fully or sufficiently to qualify for good end-state criteria; treatments that did not work or had to be repeated because of insufficient sessions attended increase waiting list times; early phases of treatment cost a considerable amount of money and resources. All this is likely to not pay off, since a larger number of sessions significantly correlates with improvement from PTSD and depression and an average number of sessions attended by early responders is between 6-7. The aim of this study is to investigate in which phase of the treatment do most of the dropouts occur, which patient and clinical factors are associated with the dropout and whether various types of treatment modality have different dropout rates. Sample contains 3084 patients getting treatment for post-traumatic stress disorder in Sinai center in Amsterdam. Bivariate regression analyses were conducted to examine relationship between demographic, clinical ant treatment variables in treatment dropouts and completers. Out of 3084 patients 2369 (76.8%) patients successfully completed the treatment, 715 (23.2%) dropped out, from those, 78 patients dropped out early. Contrary to predictions, more dropouts took place in later stages. Analysis showed that age was the only significant predictor variable of dropout.Show less
Although there are indications that parental anxiety is related to the development of anxiety among children, direct evidence for the specific mechanisms that underlie the parent-child transmission...Show moreAlthough there are indications that parental anxiety is related to the development of anxiety among children, direct evidence for the specific mechanisms that underlie the parent-child transmission of anxiety is limited. The interaction between anxious parents and their infant is a potentially important mechanism for the transmission of fear from the parent to the infant. This study aims to investigate the relationship between parental anxiety (mothers and fathers) and infants’ attention bias towards fearful faces (vs. happy faces). Both mothers (N = 155) and fathers (N = 74) were included in the study and parental anxiety was measured with the DASS questionnaire. Attention bias towards fearful faces (vs. happy faces) was measured with an eye-tracker in infants between 5 and 19 months old (N = 220; 112 girls, 108 boys). Results show that infants looked longer at fearful faces than at happy faces. However, no relation between parental anxiety and infants’ attention bias towards fearful faces was found. Moreover, the gender of the parent did not influence the relationship between parental anxiety and an infant’s attention bias. The findings do not support the notion that attention bias in infants is a mechanism that could explain the transmission of anxiety from parents to their children. Our study contributes to the literature about the transmission of anxiety from parents to their children and the role of infants’ attention bias in this transmission.Show less
Background: Translating scores to a common metric provides advantages that support the applied collaborative care model in the Netherlands. McCall's T-score is frequently used, and the optimal...Show moreBackground: Translating scores to a common metric provides advantages that support the applied collaborative care model in the Netherlands. McCall's T-score is frequently used, and the optimal approach to obtain this score is through Item Response Theory (IRT). However, IRT is complicated, requires dedicated software, and a large dataset. This study aimed to validate an alternative procedure to obtain T-scores from IRT. Methods: This study used data from an existing study, which comprised a population-based sample and a patient sample. We estimated the relation between raw scores and IRT-based T-scores with curve fitting and established conversion formulas to transform raw scores into calculated T-scores. We illustrated the process with raw scores from the Beck Depression Inventory, the Inventory of Depressive Symptomatology - Self Rated, and the Montgomery-Åsberg Depression Rating Scale. We performed a correlational analysis to assess the validity of the calculated T-scores. We also determined cut-off values using ROC analysis. Results: The curve-fitting procedure resulted in third-order polynomial regression equations to use as conversion formulas. The validity of calculated T-scores was supported by their high correlation with theta-based T-scores. ROC analysis provided cut-off values, which were comparable to the previous studies, using raw scale scores. Conclusion: The curve-fitting procedure yielded sufficiently valid calculated T-scores for all instruments in comparison to the theta-based T-scores from IRT. The resulting cut-off values demonstrated that calculated T-scores were able to distinguish patients from the general population. The practical use of the results is discussed.Show less
