This retrospective cohort study aimed to investigate the influence of stress on atypical symptom amelioration to first-choice psychostimulant medication in individuals with attention deficit...Show moreThis retrospective cohort study aimed to investigate the influence of stress on atypical symptom amelioration to first-choice psychostimulant medication in individuals with attention deficit hyperactivity disorder (ADHD). Understanding the impact of stress on the effectiveness of psychostimulant medications is crucial, given the high prevalence of stress-related psychiatric comorbidity in ADHD and the potential stress effects on psychostimulant effectivity. It was hypothesized that cardiovascular stress and stress-related psychiatric comorbidity are related to atypical symptom amelioration and that these two characteristics are interrelated. Additionally, the effect of medication and time will be explored. A unique subset from the SOPHISTICATE cohort was analysed, comprising of 460 patients diagnosed with ADHD who exhibited atypical treatment response following first-choice medication registration and were switched to a second-choice medication within 3 weeks. The adult version of the Quantified Behavioral Test (QbTest), a computerized tool that quantifies the core symptoms of ADHD was used to determine baseline symptom severity and treatment response, i.e. QbActivity (QbAct); QbImpulsivity (QbImp); and QbInattention (QbIna). Patients were divided into groups based on stresscharacteristics, and linear mixed models were employed to examine the impact of stresscharacteristics, first-choice medication and time on symptom amelioration (i.e. QbTest score after first- or second-choice medication – QbTest score at baseline; ∆). The results reveal that stress-characteristics were not related to atypical symptom amelioration after first-choice medication. However, patients with stress related psychiatric comorbidity show more inattentive symptom amelioration after second-choice medication registration β=.21, SE=.10, 95% CI [.02, .41], p=.031. Importantly, the effect of time was significant for all three symptom domainssuggesting a role of time to enable a typical response, i.e. ∆QbAct (F(1,462) = 387.818, p < .001), ∆QbImp (F(1, 462) = 235.224, p < .001) and on ∆QbIna (F(1, 463) = 319.655, p = .242). Additionally it was found that baseline symptom severity confounds the medication effect for ∆QbImp and for ∆QbAct. In conclusion, the results indicate that stress characteristics nor medication is related to an atypical response pattern to first-choice medication. The current study did reveal an important role of time to enable a ‘typical’ response. Limitations of the study included the lack of a reference group, the possibility of random effects, and quality of the cardiovascular data. In conclusion, while the impact of stress on treatment response could not be definitively determined based on the available data, future research should explore the complex interplay between stress, psychiatric comorbidity, and medication types to optimize treatment strategies and improve outcomes for patientsShow less
Patients with bipolar disorder type I (BD-I) who consume alcohol, experience stronger than average negative effects from this consumption, as it leads to lower adherence to treatment and increased...Show morePatients with bipolar disorder type I (BD-I) who consume alcohol, experience stronger than average negative effects from this consumption, as it leads to lower adherence to treatment and increased suicide attempts. Independently, excessive alcohol consumption is associated with lower reward anticipation, which is a mechanism that helps making decisions that minimize harm. Using the concept of reward anticipation, this observational and crosssectional study, aimed to understand the relation between BD-I and alcohol consumption. Understanding this relation could eventually help improve treatment of alcohol related problems among BD-I patients. First is hypothesized that BD-I diagnosis is related to more alcohol consumption, second that lower reward anticipation is related to more alcohol consumption, and third that lower reward anticipation is stronger related to more alcohol consumption in BD-I patients than control participants. Reward anticipation was studied both objectively, with a Monetary Incentive Delay Task (MID), and subjectively, with the Positive Valence Systems Scale (PVSS-21). This created an opportunity to include a fourth hypothesis that the MID and the PVSS-21 are correlated. In collaboration with the Erasmus MC, participants completed online surveys and games to measure reward anticipation and alcohol consumption. The participants included 35 BD-I patients (20 female, Mage = 55.94, SDage = 11.17) and 15 control participants (6 female, Mage = 49.08, SDage = 13.35). First, no relation between BD-I diagnosis and alcohol consumption (OR = .87, 95%CI [.21, 3.59]) was found. Second, no relation between reward anticipation (ORMID = 1.20, 95%CI [.91, 1.57]; ORPVSS = 1.01, 95%CI [.97, 1.05]) and alcohol consumption was found. Third, no stronger relation between reward anticipation (ORMID = 1.20, 95%CI [.88, 1.63]; ORPVSS = 1.00, 95%CI [.99, 1.01]) and alcohol consumption for BD-I patients was found. Fourth, no correlation between scores MID and the PVSS-21 was found (r (50) = .18, p = .21). The results, conflicting with previous research, are likely influenced by the small amount of alcohol consumed by the participants. Making it difficult to make conclusions about the relation between BD-I diagnosis, reward anticipation and alcohol consumption. Further research is recommended with a larger group of participants with more age distribution.Show less
There is growing evidence that impulsivity plays an important role in Eating Disorders (EDs), as it can negatively affect the illness’ development and the treatment success. The aim of this study...Show moreThere is growing evidence that impulsivity plays an important role in Eating Disorders (EDs), as it can negatively affect the illness’ development and the treatment success. The aim of this study is to examine whether there are differences in impulsivity between restricting subtype EDs, binge-eating/purging subtype EDs, and healthy controls using a neuropsychological assessment tool. It has been hypothesized that patients with a restricting ED had the lowest degree of impulsivity and patients with a binge-eating/purging ED the highest. Additionally, it was investigated if there is a correlation between the degree of impulsivity and the level of vitamin D in patients with an ED, whereby a negative correlation was expected. This study has a cross-sectional design with an observational nature. A total of 183 patients with an ED has participated in this study: 54 were patients with a restricting ED and 129 patients with a binge-eating/purging ED. The control group consisted of 45 participants. The sample size for the vitamin D analysis consisted out of 144 participants. The degree of impulsivity was determined by the Go/No-Go Task and the vitamin D level was determined by an analysis of a blood sample. To investigate the first hypothesis a MANOVA was performed. The second hypothesis was tested with the Pearson correlation coefficient. The MANOVA showed there was no significant effect of the group type on the degree of impulsivity, Λ = 0.967, p = 0.108. The Pearson correlations revealed a non-significant relation between a person's vitamin D level and the number of commission errors, r = 0.72, p = 0.172 or the vitamin D level and total reaction time, r = -0.05, p = 0.531. In conclusion, it would appear that there is no difference in the degree of impulsivity between the binge-eating/purging subtype, the restricting subtype, and the control group, and there is no relationship between a person's vitamin D level and impulsivity. It is critical that future studies using a combination of self-reports and neuropsychological assessment tasks examine the impact of ED subtypes on impulsivity. By investigating the possible function of vitamin D supplementation, novel treatment interventions that can target impulsivity from a clinical and physiological approach may be developed.Show less
Worldwide, 55 million people live with dementia, and this number is expected to double in the coming decades. The main care goal for people with dementia involves the improvement of Quality of Life...Show moreWorldwide, 55 million people live with dementia, and this number is expected to double in the coming decades. The main care goal for people with dementia involves the improvement of Quality of Life (QoL). Several studies have outlined the importance of activities in increasing QoL. Therefore, the present research explored activities in nursing homes that contributed to the QoL of residents with dementia. Additionally, the study investigated if actively mapping activity preferences of residents lead to better-fitting activities, which mapping methods best predict this, and whether informal caregivers score lower than healthcare professionals on how well they perceive activities to fit residents. In total, 103 healthcare professionals and 95 informal caregivers filled in an online survey. Results indicate that most activities provided in a nursing home tend to contribute strongly to the QoL of a resident with dementia. Additionally, residents who had their activities mapped were believed to engage in better fitting activities than those whose activities were not mapped. Specifically, mapping by means of direct conversation as well as by means of a book shows to positively predict activities to better fit to the residents. Furthermore, examining a possible disconnect between informal caregivers and healthcare professionals showed no difference in the extent to which they perceive activities to fit the residents. While this study outlines the importance of mapping activities to ensure activities fit the residents, it also reveals that—when it comes to contributing to QoL—the nature of the activity may not be as important as the participation in the activity.Show less
Background: Patients with a psychotic disorder generally seem to have difficulties recovering, especially on functional and societal ground. Due to cognitive impairments and experienced stigma, the...Show moreBackground: Patients with a psychotic disorder generally seem to have difficulties recovering, especially on functional and societal ground. Due to cognitive impairments and experienced stigma, the psychosis population feel excluded from society as a result of discrimination. This study aimed to get a better insight of functional and societal recovery and their association amongst patients with a psychotic disorder. In addition, it was investigated whether degree of importance regarding social roles had a moderating effect on the association. Functional recovery lacked consensus on terminology and assessments, but this study used executive functioning as a point of reference. Societal recovery was described as counteracting the public stigma on mental illness and improving the position and rights of (ex-)clients within society. Methods: This study included 237 participants (18-65 years) with psychosis as their main diagnosis through Flexible Assertive Community Treatment teams or Early Intervention Psychosis teams in healthcare institutions throughout the Netherlands. Participants signed informed consent prior participating in the study. The study design was cross-sectional, where data at baseline was used for the analyses. The data was gathered through (self-reported) questionnaires that measured executive functioning (functional recovery), and satisfaction scores on fulfilling various social roles (societal recovery). Two multiple linear regression analyses were performed to assess whether the level of executive functioning was associated with satisfaction scores. A binary logistic regression was performed to assess executive functioning in employment. Results: No effects were found between self-reported executive functioning and satisfaction scores. The degree of importance regarding social roles was found to have a direct relationship with satisfaction scores. Surprisingly, self-reported executive functioning did not seem to be associated with employment. Conclusion: Functional and societal recovery were not related and degree of importance regarding social roles was directly related to societal recovery. Self-reported executive functioning did not differ amongst those who were employed and unemployed. A better consensus on terminology and measurements needs to be realized for functional and societal recovery to acquire a better assessment of the psychosis population. Further research should include a more diverse range of patients in the psychosis population for better generalizabilityShow less
Previous research has established the mediating role of aspects of emotion regulation in the effect of youth trauma on substance use. The purpose of this study was to investigate whether the use of...Show morePrevious research has established the mediating role of aspects of emotion regulation in the effect of youth trauma on substance use. The purpose of this study was to investigate whether the use of two emotion regulation strategies, cognitive reappraisal (CR) and expressive suppression (ES), mediate the effect of youth trauma severity on substance use severity. Sixty Dutch speaking participants (41 male) between the age of 21 and 63 years with a substance use disorder (SUD) and at least one comorbid psychiatric diagnosis were included. Participants completed self-report measures regarding youth trauma severity and emotion regulation strategies. A semi-structured interview was administered for substance use severity. We performed a mediation analysis using multiple regression analyses with youth trauma severity as independent variable, CR and ES as mediators and substance use severity as dependent variable. No significant effects of trauma severity on CR (b = -.03, t = -.37, p = .712) and of CR on substance use severity (b = .02, t = .54, p = .595) were found. Also, the effects of youth trauma severity on ES (b = -.07, t = -1.00, p = .322) and of ES on substance use severity (b = -.01, t = -.18, p = .854) were found to be non-significant. The completely standardized indirect effect of CR mediating the effect of youth trauma severity on substance use severity was calculated (ab = .01). The same was done for ES (ab = .00). Overall, the findings of this study suggested that CR and ES did not mediate the effect of youth trauma severity on substance use severity. The results did provide leads for future research like investigating the possibility of an inverted U relationship in the association of substance use and emotion regulation which may very well have influenced the results of this study. Additionally, future research should use objective measures administering the same time period and include subscales of youth trauma severity, more aspects of substance use severity and additional emotion regulation strategies in order to find potential associations which this study might have missed.Show less
