Research master thesis | Psychology (research) (MSc)
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Mobile applications with a virtual coach providing real-time relapse-prevention support may be useful to aid smoking cessation as they are easily accessible, cost-effective, and can be utilized...Show moreMobile applications with a virtual coach providing real-time relapse-prevention support may be useful to aid smoking cessation as they are easily accessible, cost-effective, and can be utilized directly in situations where the risk of relapse is high. This study aimed to examine the effect of three types of relapse-prevention support on tobacco craving to inform the development of a mobile application with a virtual coach. The three types of support focused on (A) motivation and self-efficacy; (B) one’s future self and implementation intentions; and (C) identity-related positive self-talk. Secondly, the study aimed to explore how physical nicotine dependence related to the effect of relapse-prevention support on tobacco craving. A virtual reality experiment with a within-participant design was conducted where 25 participants intending to quit smoking were immersed in a virtual high-risk-of-smoking environment. The participants had four conversations in a randomized order with a concept version of a virtual coach on a simulated mobile phone: three conversations containing a type of relapse-prevention support and one neutral conversation. Physical nicotine dependence was measured at baseline and craving was measured after each conversation. Participants indicated that they would find it reasonably difficult to refrain from smoking in the VR environment and sense of presence was sufficient. Results indicated that the relapse-prevention support did not decrease craving compared to neutral contact with the coach. Furthermore, no association was found between physical nicotine dependence and effect of relapse-prevention support. These results stress the need for evaluations of effectiveness in order to inform the further development and improvement of the relapse prevention support prior to finalizing a mobile application with a virtual coach.Show less
Outcome expectations play a role in the functioning of people with different immune-mediated conditions, like Bechterew’s disease, and could strengthen or convey similar effects of regular long...Show moreOutcome expectations play a role in the functioning of people with different immune-mediated conditions, like Bechterew’s disease, and could strengthen or convey similar effects of regular long-term therapy. The Wim Hof Method has shown promising results with regards to its effect on clinical, autonomic and immune response to experimentally induced inflammation. The current study aims to investigate the relationship between generic (optimism/neuroticism) and specific outcome expectations (related to training effects on health) with the functioning of patients with Bechterew’s disease. In this proof-of-concept randomized controlled trial with a cross-sectional design, 24 patients were included, who followed an adapted version of the Wim Hof Method. During this intervention, a number of areas of functioning variables were included: quality of life, anxiety, depression, and disease activity. These were measured at baseline, week 4, week 8, and a follow-up meeting at week 24. When assessing the relationship between generic and specific treatment outcome expectations, it was found that, higher levels of neuroticism are related more positive specific outcome expectations (r = .414, p = .044). It was seen that better functioning in one area was associated with better functioning in some other areas (r = .434, p < .001, r = .836, p < .001). Regarding the influence of each treatment outcome expectation separately on the different areas of functioning, neuroticism was associated with higher disease activity before and after treatment, as well as more anxiety before treatment (r = .470, p = .018, r = .567, p = .05, r = .253, p = .05). Optimism and specific treatment outcome expectations were not significantly related to functioning. Also, when the influence of baseline functioning was assessed, only the levels of depression before treatment were predictive for depression after treatment (beta = .714, p = .027). When treatment outcome expectations were taken together, they were not significant predictors for functioning after treatment. This study provides limited indications for the importance of treatment outcome expectations for alternative treatment methods. However, neuroticism plays a role in worse functioning and could be used to predict treatment response, and its influence could be addressed through neuroticism management.Show less
An effective way to reduce negative experiences such as stress, anxiety, and pain in hospitalized children is by implementing placebo applications. A placebo application is a procedure without...Show moreAn effective way to reduce negative experiences such as stress, anxiety, and pain in hospitalized children is by implementing placebo applications. A placebo application is a procedure without active elements that can elicit a positive treatment outcome. Despite its beneficial outcomes placebo applications are not frequently used in pediatric healthcare. Gaining insights in the opinions of healthcare providers on placebo applications will help to understand why placebo applications are not used frequently and offer suggestions to optimize usage. The aim of this cross-sectional observational study was to investigate whether the healthcare provider characteristics optimism, anxiety, and knowledge on placebos were associated with their opinions on the effectiveness, acceptability, and utilization of placebo applications. A differentiation is made between treatment-enhancing (e.g. music, Virtual Reality, comfort talk) and treatment-replacing (e.g. open treatment without active elements) placebo applications. Through an online questionnaire, data was collected from 121 healthcare providers (106 female, 15 male). Being more optimistic was negatively correlated with being less anxious (r = -0.43, p < 0.001). Multiple regression analyses showed that having more knowledge was associated with finding placebos applications more effective (β = 0.23, p = 0.012) and acceptable (β = 0.29, p = 0.001), but not with a higher utilization of placebo applications (p = 0.096). No significant associations were found of the amount of optimism and anxiety of healthcare providers with the opinions and use of placebo applications. Treatment-enhancing placebos applications were considered significantly more effective, acceptable, and utilized more often than treatment-replacing placebos (p-values < 0.001). The results of this study imply that more knowledge of placebos is associated with more positive opinions on placebo applications. The positive opinions and higher use of treatment-enhancing placebo applications indicate that implementing these in pediatric care is within reach. In this study, the reluctance to use placebos in pediatric care can be explained by the common assumption that placebo applications always replace the treatment, not knowing about the treatment-enhancing placebos that can be useful and ethically sound. It is recommended to offer education on treatment-enhancing and open treatment-replacing applications to examine if this increases use in pediatric care.Show less
Research master thesis | Psychology (research) (MSc)
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Background: Between 10-15% of women have a pathological fear of childbirth. An expectation of fear might contribute to an actual fearful childbirth experience, which is known as a nocebo effect....Show moreBackground: Between 10-15% of women have a pathological fear of childbirth. An expectation of fear might contribute to an actual fearful childbirth experience, which is known as a nocebo effect. Likewise, positive thoughts about childbirth may lead to positive experiences, known as a placebo effect. Negative expectations surrounding childbirth mainly occurs in women who are known with anxiety and depression. As a result of these negative expectations, women could have a prolonged labor and obstetric complications which can evoke traumatic symptoms. The purpose of this study was to research whether there is a predictive association between positive or negative expectations surrounding childbirth and the experience of childbirth and whether this differs in women with or without psychiatric problems. This is relevant because most research on women’s expectations of childbirth are focused on fear of childbirth and its potential impact in medical aspects, whereas in this study the focus is on a broader expectation base, including positive expectations and also the subjective experience of childbirth. Methods: In this prospective study we included in total 150 women from both the Psychiatric Obstetric Pediatric (POP) outpatient clinics, a clinic for pregnant women with psychiatric vulnerability, and the general obstetric clinic, between January 2020 and January 2022. All participants filled in the Wijma Delivery Expectancy (version A at T1) and Experience (version B at T2) questionnaire after providing an informed consent. Also, all participants filled in the Hospital Anxiety and Depression scale (HADS) and the PTSS checklist for DSM-5 (PCL-5), to evaluate current psychiatric complaints. Results: The expectation surrounding childbirth was a significant predictor for the childbirth experience after controlling for parity and pain relief, p <.001, whereas positive expectations are related to a positive childbirth experience (placebo effect) and negative expectations are related to a negative childbirth experience (nocebo effect). This was not different for women with or without psychiatric problems, p =.841. Conclusions: Women’s negative and positive expectations of childbirth are related to the childbirth experience, showing indications for both a nocebo and placebo effect. These results can be important for future experimental research to see whether changing the expectation of childbirth in a positive way, could improve the experience of childbirth.Show less
Placebo applications could be a positive addition next to regular treatment in the pediatric health care. Previous studies have mainly focused on placebo applications as a replacement of regular...Show morePlacebo applications could be a positive addition next to regular treatment in the pediatric health care. Previous studies have mainly focused on placebo applications as a replacement of regular treatment and focus on adults despite the promising results for using placebo effects in pediatric care. Pediatric health care professionals and parents’ knowledge and opinions about the use of placebo applications could be related to placebo use in pediatric healthcare. To examine differences in and associations between placebo knowledge and expected effectiveness of potential placebo applications between healthcare professions and parents, an online questionnaire was used in 150 pediatric health care professionals and 28 parents of children who have undergone a medical procedure or treatment in the past year. Professionals had more knowledge about placebo effects than parents (t(176 =3.146, p =.002), and a higher expected effectivity, (t(147)=3.59, p<.001) of placebo effects than parents. More knowledge about placebo effects was associated with higher expected effectivity in both groups, which did not significantly differ between the two groups (z=1.79, p=.073, r(127)=.18, p=.047 (professionals), r(18)=.57, p=.009 (parents). The current study showed that knowledge and opinions on placebo effects are lower in parents than healthcare professions but are related in both groups. Future research could examine whether educating pediatric healthcare professionals and parents on placebo effects in child healthcare leads to more favorable opinions about placebo applications in pediatric care, allowing a larger use of non-invasive optimization strategies within child healthcare.Show less
Research master thesis | Psychology (research) (MSc)
closed access
Background: Information processing impairments are frequently observed in posttraumatic stress disorder (PTSD). Yet, the neurobiological underpinnings of these impairments are not well understood....Show moreBackground: Information processing impairments are frequently observed in posttraumatic stress disorder (PTSD). Yet, the neurobiological underpinnings of these impairments are not well understood. Mismatch negativity (MMN) is an event-related potential (ERP) that is thought to represent early sensory change detection. Previous electro-encephalography (EEG) studies on MMN in PTSD have revealed inconsistent results, with findings of both enhanced and reduced MMN amplitudes. Objective: We aimed to extend previous MMN findings to trauma-affected refugees, a PTSD population that often presents with complex, chronic, and severe forms of PTSD. Methods: We examined amplitudes and latencies of MMN in 25 refugees with PTSD and 20 healthy refugee controls matched on age, sex, and country of origin. We employed an MMN paradigm with three types of sound deviants: frequency, duration, and frequency-duration combined. Furthermore, associations between MMN amplitudes and clinical scores of PTSD and functioning were examined. Results: There were no significant differences in MMN amplitudes or latencies in PTSD versus control participants, following any of the deviants. Exploratory analyses revealed a significant sex-by-group interaction effect on MMN following the frequency-duration combined deviant, with enhanced MMN amplitudes in women with PTSD compared with controls. This pattern of findings was not found for the other deviants. Significant associations were found between MMN amplitudes and clinical scores in women only. Conclusion: Our findings point towards sex-differences in the underlying mechanisms of PTSD in refugees, highlighting the need of considering sex in future MMN studies.Show less
