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
Suicidal ideation is more prevalent in people with Borderline Personality Disorder. Negative self-conscious emotions, such as shame and guilt, may be related to this relationship. In this study the...Show moreSuicidal ideation is more prevalent in people with Borderline Personality Disorder. Negative self-conscious emotions, such as shame and guilt, may be related to this relationship. In this study the relationship between suicidal ideation and borderline personality traits was explored. Shame and guilt were analysed as possible mediators. The Personality Assessment Inventory – Borderline Scale was used to assess borderline personality traits, and Ecological Momentary Assessment was used to gather data on suicidal ideation, guilt and shame four times a day, over the course of three weeks via an app. The sample consisted of (N = 82) adults with a history of a suicide attempt or moderate-to-severe suicidal ideation in the past year. The relationships were analysed using a parallel mediation model consisting of multiple multilevel regression analyses. All steps of the model showed significant relationships. The last step showed that instead of typical mediation, the model indicated suppression, because of an increase in the association between borderline personality traits and suicidal ideation when accounting for shame and guilt. More research is necessary to explore the possible cause of these findings.Show less
This research aims to investigate the topology of the brain during reward processing and the influence of dopamine and norepinephrine on this network. So far, most research about reward processing...Show moreThis research aims to investigate the topology of the brain during reward processing and the influence of dopamine and norepinephrine on this network. So far, most research about reward processing has concentrated on specific brain areas and connections between particular regions, rather than the brain's organization and architecture. By investigating this organisation, gaps in our understanding of the brain architecture can be addressed, which could in turn lead to a better understanding of pathologies that disrupt the brain’s architecture. It is hypothesized that the brain will be more integrated during reward processing, and that increased dopamine and norepinephrine activity will result in a more integrated brain organisation. To test this prediction, the Global Efficiency (GE) of a total of 132 Regions of Interest (ROIs) and BOLD- activity of the Substantia Nigra/Ventral Tegmental Area (SN/VTA) and the Locus Coeruleus (LC) were obtained during a reward processing task, which 38 participants completed. During a functional magnetic resonance imaging (fMRI) scan, participants completed a reward- emotion recognition test. As predicted, in the reward condition, the paired t-test showed a higher GE in comparison to the no-reward condition in several nodes, mostly in the default mode network. These findings imply that the brain is more integrated when processing reward than when it is not processing reward. However, the catecholamines showed no significant correlation with this integration. Future research is needed to investigate the topology and influence of different catecholamines in more detail. The implications of these findings will be discussed.Show less
Background Alzheimer's dementia (AD) and mild cognitive impairment (MCI) are neurodegenerative conditions associated with cognitive decline. Previous research suggests that motor impairments are...Show moreBackground Alzheimer's dementia (AD) and mild cognitive impairment (MCI) are neurodegenerative conditions associated with cognitive decline. Previous research suggests that motor impairments are also present in individuals with MCI and AD. This thesis study aims to evaluate motor sequence learning abilities in patients with amnestic MCI (aMCI) and AD compared to healthy controls. This thesis study also explores the relationship between amyloid-β burden, a known biomarker for MCI and AD, and motor sequence learning to study whether such motor learning could also be a behavioral biomarker. This is because measuring amyloid-β is very costly and invasive, and thus the search for other biomarkers is important. Methods A cross-sectional design was employed, and participants included 28 AD patients, 33 aMCI patients, and 53 healthy controls. Motor sequence learning was assessed using a computerized task measuring reaction time and accuracy per trial, and with this information the rate and final amount of learning was calculated, i.e. how fast and how much information the participants are able to learn, respectively. Amyloid-β burden was measured using PET imaging, with higher burden reflecting more severity of the symptoms of aMCI and AD. Results The final amount of learning was not different amongst the groups, and the rate of learning was only significantly different between the AD and aMCI groups, with the AD groups showing a faster rate of learning. The AD and healthy control group did not, however, differ significantly in terms of rate of learning. The amount of amyloid-β in the brain was not associated with motor sequence learning abilities. Conclusion The findings suggest that motor sequence learning abilities are preserved in individuals with aMCI and AD, both in terms of how fast and how much they learn. In fact, patients with AD showed a faster rate of learning than patients with aMCI, although this was not found when comparing the AD patients with the healthy individuals. It is possible that this finding is because patients had more to learn by the end of the task than the aMCI group given that their memory is worse, and displayed a faster rate of learning due to this. This thesis study also suggests that motor sequence learning is not a behavioral biomarker for aMCI and AD. The search for less invasive and more easily measurable biomarkers continues to be imperative.Show less
The current study examined to what extent the quality of the sibling relationship and the quality of the parent-child relationship is linked to aggressive behavior between siblings during conflicts...Show moreThe current study examined to what extent the quality of the sibling relationship and the quality of the parent-child relationship is linked to aggressive behavior between siblings during conflicts. In addition, it was examined whether the quality of the parent-child relationship would moderate the relation between the quality of the sibling relationship and aggressive behavior between siblings during conflict. These relations were examined with a sample of 26 families, of which two siblings aged 8-15 years old and one parent participated. The amount of aggressive behavior during conflicts between siblings, quality of the sibling relationship and the quality of the parent-child relationship were measured by questionnaires. The results of this study showed a negative relation between the sibling relationship quality and aggressive behavior during conflicts between siblings, a positive relation between the quality of the sibling relationship and the quality of the parent-child relationship and a negative relation between the quality of the parent-child relationship and aggressive behavior during conflicts between siblings. The quality of the parent-child relationship did not act as a moderator for the relationship between the quality of the sibling relationship and the degree of aggressive behavior in conflicts between siblings. These results indicate a possible indirect role of the parent-child relationship quality in the degree of aggressive behavior in conflicts between siblings.Show less
In a world of rising economic inequality, exploring factors that contribute to a more equal society is vital. The extent to which people are generous towards those around them can help reduce local...Show moreIn a world of rising economic inequality, exploring factors that contribute to a more equal society is vital. The extent to which people are generous towards those around them can help reduce local inequalities. While previous literature has established a link between economic mobility and preferences for redistribution, the impact on individual giving remains unclear. Therefore, this study examined the influence of economic mobility on giving behavior and whether meritocratic beliefs mediate this effect. The sample included 301 participants, predominantly from Global South countries. Participants were randomly assigned to ranks on a 5-rank ladder resembling socioeconomic classes and to conditions of low or high economic mobility. First, participants played a game in which they estimated the number of dots in a picture. Those with high economic mobility could earn 3 points, and those with low economic mobility could earn 1 point per round. In a dictator game, they could indicate how many points they want to give to reach rank. Results showed that the high economic mobility condition had significantly stronger meritocratic beliefs about the estimation game, aligning with the first hypothesis. However, contrary to the second hypothesis, participants in the high economic mobility condition gave significantly more to the ranks below them. Meritocratic beliefs about the estimation game did not mediate the effect. This suggests that inducing high economic mobility seems to increase generosity, particularly towards those with fewer resources. Policymakers and non-governmental organizations should promote high economic mobility to foster generosity in society.Show less
Autism spectrum disorder (ASD) is a developmental disorder that still holds many uncertainties regarding the etiology. In order to provide the most effective assistance to children with ASD,...Show moreAutism spectrum disorder (ASD) is a developmental disorder that still holds many uncertainties regarding the etiology. In order to provide the most effective assistance to children with ASD, understanding the cognitive foundation of this disorder is crucial. There are several theories on this subject, yet there is limited research delving deeper into the potential connections between these theories. This research focused on the Central Coherence Theory and the Executive Dysfunction Theory and investigated whether there is a relation between these factors in explaining ASD. For this purpose, the Rey-Osterrieth Complex Figure Task, Tower of Hanoi, Picture Span and Autism Spectrum Questionnaire were administered to 89 children aged between 8 and 11 from six different primary schools in the Netherlands. Correlation analyzes were conducted to examine whether performance on central coherence, planning, and working memory correlated with the level of ASD traits. Using the PROCESS Macro, a mediation analysis was conducted to investigate whether executive functions could mediate the relationship between central coherence and ASD characteristics. The results of this study indicated that neither central coherence nor planning nor working memory were associated with the number of ASD characteristics. Moreover, no mediating effect of planning or working memory could be found. The fact that the results were not in line with the expectations could possibly be related to the non-clinical sample used in the current study, among other things. Future research should continue to focus on further investigation into the relationship between central coherence and executive functions, carefully taking into account the heterogeneity of ASD.Show less