The past decades have shown a rise in skin cancer. This creates the need for prevention and efficient treatment. The most common skin cancer (melanoma) can only be treated when detected early. In...Show moreThe past decades have shown a rise in skin cancer. This creates the need for prevention and efficient treatment. The most common skin cancer (melanoma) can only be treated when detected early. In this thesis we propose a method of increasing awareness for people with a high risk of skin cancer as well as allowing for early detection. Skin cancer is hard to detect, even for experiences healthcare professionals. One of the signals of potential harm full lesions is change over time. We propose to develop an application with which changes in skin lesions can be identified early. By allowing patients to film their body with a mobile phone camera we aim to track the development of lesions. If a patient films their body regularly changes can be detected and the application can urge the patient to consult a dermatologist. In this thesis we explore the possibility of combining the frames of these films into an overview displaying the patients complete back or arm. Combining frames is called stitching. Different stitching techniques found in literature are explored and tested for effectiveness. The optimizations performed are reported and the final result is presented. The location of the different lesions on an overview of the body is needed to show the patient and the healthcare professional where potential harmful lesions are located on the body. This allows for further inspection at the dermatology department.Show less
Understanding the social world around us is important to function in today’s society. Gaining understanding can be achieved through cognitive empathy. In the current study, the main question ‘Is...Show moreUnderstanding the social world around us is important to function in today’s society. Gaining understanding can be achieved through cognitive empathy. In the current study, the main question ‘Is the effect of acute stress on the level of cognitive empathy in female students moderated by experienced childhood trauma?’ has been examined in 119 female students between 18 and 25 years old (M = 21.19, SD = 1.66). The relationship between acute stress, cognitive empathy and experienced childhood trauma has been examined with three sub-questions that focus on 1. the effect of acute stress on cognitive empathy, 2. the effect of subjective acute stress on the level of cognitive empathy and 3. Is the effect of acute stress on cognitive empathy moderated by experienced childhood trauma? These questions have been answered with an experimental study with a between-subjects design and a sequentially assigned stress or no stress manipulation provided by the Trier Social Stress Test (Kirschbaum et al., 1993). Before and during the manipulation acute stress has been measured with the Visual Analogue Scale (Freyd, 1923). Cognitive empathy has been measured with the Reading the Mind in the Eyes Test (Baron-Cohen et al., 2001) and the Childhood Trauma Questionnaire (Thombs et al., 2009) was used for measuring experienced childhood trauma. The current study shows no significant results for the main question and its sub-questions. This contributes to other studies who used the RMET to measure cognitive empathy and didn’t find any significant results, meaning they should use a different instrument in future research. In addition, it is important to re-examine the main research question using physiological measures of acute stress. This study contributes to the scientific knowledge of this moderation effect, but more research is needed to get a better understanding and help for people who experienced childhood trauma.Show less
Background: Childhood emotional maltreatment by a primary caregiver is a key predictor for PTSD symptoms, yet limited research explores connections with specific symptoms, especially in children....Show moreBackground: Childhood emotional maltreatment by a primary caregiver is a key predictor for PTSD symptoms, yet limited research explores connections with specific symptoms, especially in children. Literature reports gender differences on emotional maltreatment and the experience of PTSD, so it is worth investigating the existence of differences when looking at separate symptoms. Objective: This study aims to investigate the correlation between childhood emotional maltreatment and PTSD symptomatology and identify gender differences in children and adolescents. Method: A sample of 237 children (mean age 15.5) with PTSD symptoms from a Dutch mental health institution (2012-2015) underwent assessment using anonymous questionnaires. Network analysis examined partial correlations between emotional abuse, neglect, intrusions, avoidance, arousal, and negative mood. Results: The network analysis showed a high correlation between emotional abuse and most PTSD symptoms. However, emotional neglect only exhibited a strong association with emotional abuse. Gender differences in how emotional maltreatment and PTSD symptoms interacted were found. Girls reported higher PTSD symptoms and emotional maltreatment than boys. Conclusions: This study highlights the important role of childhood emotional maltreatment in the development of PTSD, among children and adolescents. These results emphasize the need for the customization of PTSD treatment based on the type of maltreatment and gender.Show less
There are many instruments available to measure parental sensitivity, however each has its own limitations. In search of a more efficient instrument, an adapted mini-MBQS is proposed, in which...Show moreThere are many instruments available to measure parental sensitivity, however each has its own limitations. In search of a more efficient instrument, an adapted mini-MBQS is proposed, in which parents sort the cards instead of professionals. In this study, parent’s accuracy to report about their own parental sensitivity with this adapted Q-sort was explored. Additionally, it has been explored whether sex of the parent and parental reflective functioning influence parent’s accuracy on the Q-sort. To answer these questions, two online home visits were conducted with twenty parent-child pairs. During the home visits parent and child played together. Afterwards, the parent sorted the Q-sort about how sensitive s/he thought s/he was to the child during the play task. The play task was recorded and later coded on parental sensitivity with the Ainsworth Maternal Sensitivity Scale by a professional. Furthermore, parents filled in a questionnaire between the two online home visits, which contained questions about the family’s background and parental reflective functioning. The results from parent-reported and observed sensitivity were compared, which showed a positive, but weak and non-significant correlation of .22, suggesting a mismatch between parent’s own judgement and that of a professional about the level of sensitive parenting. Next, two ANCOVAs were conducted and showed that sex of the parent (F (1,16) < .01; p = .95) and parental reflective functioning (F (1,16) = .06; p = .81) did not moderate the relationship between observed and parent-reported sensitivity. From these results, it can be concluded that parents are not accurate when reporting about their parental sensitivity with the Q-sort. In addition, the results showed that gender or self-reported level of parental reflective functioning do not influence this accuracy. Therefore, it is not recommended to use the current form of the adapted MBQS as an instrument to measure parental sensitivity.Show less
Parental sensitivity refers to the degree to which parents are aware of their child’s signals, and respond quickly and appropriately to those signals. This parental sensitivity plays an important...Show moreParental sensitivity refers to the degree to which parents are aware of their child’s signals, and respond quickly and appropriately to those signals. This parental sensitivity plays an important role in raising children. In this study, correlations between sensitive parenting, parental self-confidence in raising children, child temperament and child age were investigated. Twenty-one parents participated in an online meeting in which they played for eight minutes with their 3-5 year-old child. Two to four weeks after the first meeting, parents participated in a second online meeting in which they also played for eight minutes with their child. After the first meeting, parents filled in a questionnaire about their sensitivity, their self-confidence in raising their child, and child temperament. The following questions were investigated: ‘are parental self-confidence in raising children and parental sensitivity correlated?’; ‘is child temperament or parental self-confidence in raising children more closely correlated with parental sensitivity?’; and ‘to what extent does child temperament affect the correlation between child age and parental sensitivity?’. Using a correlation, multiple regression and moderator analysis, no correlations were found. Parental sensitivity was not correlated to parental self-confidence in raising children, child temperament or child age. These results indicate that interventions for increasing parental sensitivity must not focus on parental self-confidence or child temperament, but for example on how parents can practice sensitive parenting or how parents can react sensitively when their child is angry.Show less
Teenagers spend a lot of time online, which may cause worry to their parents as the internet can bring a lot of risks. To protect their children from these dangers, parents might implement rules or...Show moreTeenagers spend a lot of time online, which may cause worry to their parents as the internet can bring a lot of risks. To protect their children from these dangers, parents might implement rules or restrictions of phone use for their teenagers. These restrictions can keep them away from risky apps or reduce their time online. However, it is unknown if these restrictions result in less encounters of dangerous situations. This study focusses specifically on exposure to sexual content online. The aim of this study is to find out if there is a relation between phone restrictions someone might have had while growing up and exposure to sexual online content. Participants were asked to anonymously fill in an online questionnaire about their online experiences and possible phone restrictions. Using this data, an ordinal regression analysis was used to examine the relation between the presence of phone restrictions and the exposure to sexual content online. In addition, this study looks if there is a relation between what type of restriction someone might have had and the type of online exposure to sexual content: unwanted exposure and wanted exposure for the participant. The results of this study have found no significant effect, implying there is no relationship between the presence of phone restrictions and exposure to online sexual content. Furthermore, no evidence was found to indicate a relationship between the type of restrictions and wanted exposure to online sexual content. Only a significant, positive relationship was found between a limited screen time and wanted exposure to online sexual content.Show less
During this study, the decision-making process of ‘de Jeugdbeschermingstafel’ in complex divorce was examined. ‘De Jeugdbeschermingstafel’ from the Netherlands is a multidisciplinary meeting there...Show moreDuring this study, the decision-making process of ‘de Jeugdbeschermingstafel’ in complex divorce was examined. ‘De Jeugdbeschermingstafel’ from the Netherlands is a multidisciplinary meeting there professionals from various fields and parents come together to assess and discuss the well-being and safety of a child or young person who may be at risk. At ‘de Jeugdbeschermingstafel’, an assessment is conducted to determine the necessity of conducting a counsil investigation (‘raadsonderzoek’). It was examined whether this decision-making differs between families with a high or low socioeconomic status who are going through a complex divorce. The main question of study was: ‘To what extent is a complex divorce related to a custody investigation, and is this relationship moderated by the socioeconomic status of parents?’ To investigate this question a correlational research design was used. For this study, various research requests from ‘de Jeugdbeschermingstafel’ across the Netherlands were investigated. These research requests had been anonymized, read and coded. Seventy-one requests of investigations have been utilized. The distribution between complex divorce and non-complex divorce cases, as well as between socio-economic disadvantage and no socio-economic disadvantage could be improved. It was expected that a counseling investigation would be chosen more often for families going through complex divorce than for families without complex divorces, particularly in cases of high socioeconomic status, as these divorces tend to be more prolonged. Results showed that ‘de Jeugdbeschermingstafel’ does not indicate custody investigation more often for families with complex divorces, than it does in families without complex divorces. Furthermore, this relationship is not moderated by the socioeconomic status of families. However, due to the use of a small sample, this conclusion may be challenging to generalize to the broader population.Show less
Background. Traumatic Brain Injury (TBI) is one of the most common forms of Acquired Brain Injury (ABI), and has a high incidence rate across the world. Following TBI, many patients experience...Show moreBackground. Traumatic Brain Injury (TBI) is one of the most common forms of Acquired Brain Injury (ABI), and has a high incidence rate across the world. Following TBI, many patients experience cognitive complaints, as well as physical complaints about their health. Their general wellbeing can also be an issue. Fortunately, for most patients these complaints typically improve over time. This study investigates patients’ memory, concentration, energy, as well as general wellbeing, over time. Methods. Patients received questionnaires about their health and wellbeing every three months following hospital release, with the main goal to track their health and wellbeing after TBI. That data was used for this research. Energy, concentration, and memory were all measured by one question in the questionnaire. General wellbeing was measured by taking the average ratings of all questions on the questionnaire. Analyses were done with three and six questionnaires over time, using repeated measures ANOVAs. Descriptive statistics were used from the first questionnaire. Results. This study found that while patients rated all these measures on average positively, they still did not feel the same as before the injury, and most experienced hindrances in daily life. When looking at the ANOVAs with three questionnaires, there was a significant improvement on concentration, energy, as well as general wellbeing over time. For all of these, most improvement took place between the first and the second questionnaires. Memory did not change significantly over time. None of the ANOVAs with six questionnaires had any significant changes over time. Conclusion. This study shows that patients may suffer from long-lasting effects of TBI. It questions whether more should be done for these patients following hospital release, to alleviate symptoms. This study has limitations concerning selection bias and drop out.Show less
The Eurozone crisis is an example of how democratic regimes can be threatened under emergencies, and it revealed two contributing phenomena – the state of exception and technocracy. This thesis...Show moreThe Eurozone crisis is an example of how democratic regimes can be threatened under emergencies, and it revealed two contributing phenomena – the state of exception and technocracy. This thesis aims to understand the link between the two in the context of emergency politics, through the paradox of politics. This paradox, which can be traced back to Rousseau, brings to light an aporia in democratic politics, where we need good citizens to make good laws and good laws to make good citizens. This thesis starts by analysing each phenomenon individually and the way they threaten democracy. It then interprets them through the paradox of politics as arrangements meant to resolve that paradox, but infringing upon the ideal of democracy it subscribes to (inspired by the analysis of political theorist Bonnie Honig). Finally, it analyses the link between them and the potentials for the democratization of emergency politics. The main conclusions are 1) in emergency politics, technocracy and exception display a link of mutual reinforcement that infringes upon democratic politics (empirically and conceptually), and 2) the democratization of emergency politics requires not only a deexceptionalization of emergency (as suggested by Honig), but also a process of detechnocratization of democracy.Show less
Advance care planning (ACP) is a process in which the patient expresses their wishes regarding future medical care in the presence of their family and health care provider. ACP is generally...Show moreAdvance care planning (ACP) is a process in which the patient expresses their wishes regarding future medical care in the presence of their family and health care provider. ACP is generally accepted in Western countries and has a positive effect on end-of-life care for people with dementia. However, culture affects expectations and preferences regarding end-of-life care and decision making. This study compared the acceptability of and preference for two types of ACP interventions for patients with dementia in health care providers from the Netherlands, the US and Japan. One intervention focused on concrete treatment orders in which the patient makes specific decisions. The other focused on what the patient finds important in life, resulting in global goals of care. A total of 125 participants were assessed by means of a structured interview and a questionnaire. Participants found both types of ACP acceptable, in general and per country. A multinomial logistic regression analysis indicated no significant difference in acceptability of the concrete or the global ACP approach between countries when adjusted for age and gender. However, age was a significant predictor of acceptability of the concrete ACP approach (2 (2, 123) = 6.32, p = .042), with older participants being less likely to find it acceptable compared to not finding it acceptable (W(8) = 5.50, p = 0.019). Participants preferred the global ACP approach for patients with dementia. A multinomial logistic regression analysis indicated no significant differences in preference between countries when adjusted for age and gender in general. However, Dutch participants were less likely to prefer the global ACP approach (W(8) = 5.18, p = .023). The relationship between country and preference was not influenced by whether participants most strongly considered what the patient with dementia wants for themselves, what the patient’s family wants or what they as the health care provider want for their patient when making medical decisions. ACP is generally regarded as an acceptable form of care for patients with dementia by health care providers across countries. Future research could more specifically determine which cultural or demographic aspects affect health care providers’ views on different ACP approaches.Show less
This thesis sought to investigate the relationships between treatment delays in bipolar disorder (BD) and cognitive impairments which characterize the disorder, measured both objectively and...Show moreThis thesis sought to investigate the relationships between treatment delays in bipolar disorder (BD) and cognitive impairments which characterize the disorder, measured both objectively and subjectively. Previous studies have established that a long delay occurs between the onset of mood symptoms in BD and the first form of treatment received, estimates ranging between 6 and 11 years. Cognitive impairments in the domains of executive functions, processing speed and memory were found to persist in BD patients even during euthymia. Such cognitive impairments burden BD patients, prevent them from regaining an appropriate level of general functioning and diminish their quality of life. Thus, in order to determine whether treatment delay impacts the cognitive impairments present in BD, 69 participants were followed over the course of one year, at three different time points. The participants took part in clinical interviews, and then were asked to complete multiple measures, such as the YMRS, the QIDS, four WAIS subscales (Block Design, Arithmetic, Information and Digit symbol), and the Cognition subscale of the WHODAS. The average treatment delay found in the current sample was 14.53 years. The results of the current study suggest that longer treatment delays did not significantly predict worse cognitive functioning in BD patients, either when measured subjectively, or when measured objectively.Show less
In the Netherlands, children are interrogated using the Dutch child interrogation method ‘the scenariomodel’. Surprisingly, this method does not consider the impact of children's personality traits...Show moreIn the Netherlands, children are interrogated using the Dutch child interrogation method ‘the scenariomodel’. Surprisingly, this method does not consider the impact of children's personality traits, despite literature indicating that these traits play a central role in their perspectives and can therefore influence the course of the interrogation and their testimony. This correlational study investigated the extent to which the personality trait 'shyness' plays a role in the course of the child interrogation according to the scenariomodel and in the quality of the witness statement. The research target group are children under the age of 12 who are victims of online sexual abuse. Participants (N = 23) underwent an ethically responsible simulation of online sexual abuse and a simulation of a child interrogation according to the scenariomodel. The transcripts of the interrogations were coded to first examine the quality of the testimony based on three indicators: accuracy of the statement, completeness of the statement and the amount of forensic information. And second to investigate the course of the interrogation based on the resistance that children show. Shyness was measured with a questionnaire. The study anticipated that shy children exhibit more resistance and provide lower quality testimonials due to their susceptibility to suggestiveness and social discomfort during interrogations. However, the results showed no significant correlations between shyness and the quality indicators of the testimony, nor between shyness and resistance. A mediating effect of resistance on the quality of the testimony was therefore also excluded. This suggests that the scenariomodel may be resistant to the negative influences of this personality trait and can be used without concern for interrogating shy children who have been victims of online sexual abuse. However, due to important limitations of the study, firm conclusions cannot be drawn and follow-up research is necessary.Show less
