Patients with a personality disorder may experience stigmatization, sometimes even on a daily basis. However, research suggests that not everyone with a personality disorder experiences it in the...Show morePatients with a personality disorder may experience stigmatization, sometimes even on a daily basis. However, research suggests that not everyone with a personality disorder experiences it in the same way, and that the extent to which it is internalized is also different for different persons, depending on a number of possible variables. The aim of the current study is to investigate the role of some of these variables, i.e. that of the type of personality disorder and age. It also examines whether the age at which patients have first been diagnosed might influence the extent to which they internalize stigmatization. In total, 36 participants from two specialized outpatient clinics filled out four questionnaires on stigma, in a cross-sectional comparative study design. The results show that neither the type of personality disorder nor age play a role, and that the age at which someone receives a diagnosis of personality disorder does not predict whether stigma will be internalized. Although the present study has its limitations, such as a modest representation of the target group and low statistical power, it is of value because it focuses on the patients’ perspective and paves the way for further research on this topic.Show less
The prevalence of hallucinations and delusions in people with borderline personality disorder (BPD) is uncertain. Therefore this study aims to describe what is known about their lifetime prevalence...Show moreThe prevalence of hallucinations and delusions in people with borderline personality disorder (BPD) is uncertain. Therefore this study aims to describe what is known about their lifetime prevalence and phenomenological presentation, based on a systematic literature review and meta-analysis. Of the 2131 identified articles in which the abstract included the terms BPD and hallucination and/or delusion, 20 met my inclusion criteria (regarding 1747 patients in total). Based on these articles I calculated a lifetime prevalence of 27% for hallucinations and of 15% for delusions in people with BPD. Most common were auditory verbal hallucinations (lifetime prevalence = 29%) and persecutory delusions (lifetime prevalence = 10%). Due to the use of slightly different diagnostic criteria for BPD in some of the included studies, which were in turn due to changes made in subsequent versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), not all studies were equally well comparable. An implication for future research is the advice to conduct another literature review and meta-analysis five years from now with new studies using DSM-5 criteria. Another implication is the advice to assess the prevalence of hallucinations and delusions in a subgroup of people with BPD and an intellectual disability, since we found them to be most common in this group.Show less
Background: A large number of studies have been conducted on the topic of comorbid posttraumatic stress disorder (PTSD) in borderline personality disorder (BPD), however, there is hardly any...Show moreBackground: A large number of studies have been conducted on the topic of comorbid posttraumatic stress disorder (PTSD) in borderline personality disorder (BPD), however, there is hardly any research that examines the comorbidity rate of PTSD in non-BPD personality disorders (PDs). Knowledge about all clusters of PDs in terms of comorbid PTSD is needed in order to generate a more detailed clinical picture of PDs. Aims: This study is primarily designed to investigate the point-prevalence of comorbid PTSD in clinical practice and, in addition, to explore to what extent the point-prevalence of comorbid PTSD differs between BPD and non-BPD PD patients and gender. Secondly, this study also investigates whether the amount of comorbid disorders is predicted by BPD (versus non-BPD PDs), PTSD and/or gender. Methods: For this retrospective study, data of 183 PD patients was used. During the intake process, the PD diagnosis and comorbid psychiatric disorders were examined using The Structured Clinical Interview for DSM-V and The Mini International Neuropsychiatric Interview Plus. Results: The point-prevalence rates of comorbid PTSD in this non-BPD PD sample is 12.7% and in this BPD sample is 23.1%. Additionally, there was no difference in likelihood of comorbid PTSD in BPD and non-BPD PD patients and between gender. Furthermore, BPD (versus non-BPD PDs), PTSD and gender did not predict the amount of comorbid disorders. Conclusions and implications: The results indicate that in clinical practice, comorbid PTSD and other comorbid disorders might not be recognized so often and thus might be underdiagnosed in PD patients. Hence, there must be more sensitivity in clinical practice for the recognition of comorbid PTSD and other comorbid disorders in PD patients.Show less
Background: Verbal auditory hallucinations (VAH) are experienced by 46% of the patients with a borderline personality disorder (BPD). They may constitute a persistent source of distress. In...Show moreBackground: Verbal auditory hallucinations (VAH) are experienced by 46% of the patients with a borderline personality disorder (BPD). They may constitute a persistent source of distress. In patients with a schizophrenia spectrum disorder, the first choice of treatment for such hallucinations is antipsychotics. Since the effectiveness of these compounds in BPD is largely unknown, the current study focuses on the effectiveness of antipsychotics on VAH in patients with BPD. Method: Patients with BPD who experienced VAH were interviewed with the aid of the Psychotic Symptom Rating Scales – Auditory Hallucinations Rating Scale (PSYRATS - AHRS). To assess improvement over time a pre- and post-test was carried out. A logistic regression analysis was used to investigate the likelihood that receiving antipsychotics was predicted by the degree of suffering from VAH in patients with BPD at pre-test. A Wilcoxon signed rank test was used to investigate improvement over time in degree of suffering and general functioning. A Man-Whitney U test was used to investigate the expectation that patients with BPD and VAH who use antipsychotics experience a larger decrease in the degree of suffering from VAH than patients with BPD and VAH who do not use antipsychotics. Results: Among the 23 patients thus assessed, no improvement over time was found in the degree of suffering or in general functioning when using antipsychotics. Conclusion: Antipsychotics may not be effective in treating VAH in patients with BPD. Future research among a larger patient group may need to take into account the types of antipsychotic prescribed, dosages, and duration of treatment.Show less
Psychotic experiences (PEs) occur in up to 30% of children, usually subsiding during adolescence. The presence of PEs alone can lead to mental distress; additionally its persistence can have grave...Show morePsychotic experiences (PEs) occur in up to 30% of children, usually subsiding during adolescence. The presence of PEs alone can lead to mental distress; additionally its persistence can have grave consequences for the child’s development. Neighborhood characteristics are a promising new frontier for research on the development of PEs in childhood and adolescence. The main aim of this study was to investigate the relationship between neighborhood social cohesion, living conditions, objective and perceived safety, and PEs at age 14. The secondary aim was to investigate the relationship of the aforementioned neighborhood factors with the trajectory of PEs from age 10 to 14. We ran a specificity analysis using depressive symptoms to evaluate whether the associations were indicative of a link with general psychopathology or specific psychotic spectrum outcomes. We used the Generation R cohort data on self-reported hallucinations and delusions, and the Wijkprofiel Rotterdam on social, safety, and physical characteristics of the neighborhood. In our multilevel logistic regression analysis, we found no evidence for an association of any neighborhood factors with PEs at age 14. There were trends demonstrating the potential association between living conditions and two outcomes: remission of PEs at age 14, and severe depressive symptoms. However, neither association survived multiple testing correction. We discuss the need for further research to ascertain whether the associations apply to general psychopathology or psychotic spectrum outcomes. Furthermore, we propose the need to clarify new potential associations of neighborhood factors with PEs.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
The trait of narcissism had consistently been linked with social platforms’ perceived ubiquity and raising popularity. Narcissism is divided into the grandiose and vulnerable narcissism....Show moreThe trait of narcissism had consistently been linked with social platforms’ perceived ubiquity and raising popularity. Narcissism is divided into the grandiose and vulnerable narcissism. Accumulating research has investigated the association between grandiose narcissism with social media usage while vulnerable narcissism remains relatively understudied. Facebook and LinkedIn are two of the most widespread social platforms. Individuals engage into these platforms to create and maintain a personal and professional network and to promote their personal and professional achievements. The present study sought to investigate the association among grandiose and vulnerable narcissism with the emotional connection and social integration into Facebook and LinkedIn. A total sample of 117 Dutch-speaking participants (69.2% females, 30.7% males) with a mean age of 27.21 (SD=13.08) years were assessed online with the Grandiose Narcissistic Scale, the Hypersensitive Narcissistic Scale and the Social Media Use Integration Scale. Multiple regressions revealed that both narcissistic constructs significantly predict the emotional connection on Facebook, F (1, 108) =15.40, p<.001 and LinkedIn, F (1, 70) =10.86, p=.002. Higher grandiose scores were significantly associated with social integration into Facebook, F (1, 108) =9.89, p=.002, while vulnerable narcissism was a non-significant predictor. Social integration into LinkedIn was not significantly associated with narcissistic traits. The current findings suggest that both types of narcissists might feel emotionally connected to Facebook and LinkedIn to gain admiration and attention. Although only individuals with higher grandiose traits integrated Facebook into their social routines. Social integration into LinkedIn might be driven mainly by career purposes and not narcissistic motives.Show less
Background: Parental verbal communication of threat is regularly associated with (sub)clinical symptoms of anxiety in children. This experimental study aims to investigate the effect of parental...Show moreBackground: Parental verbal communication of threat is regularly associated with (sub)clinical symptoms of anxiety in children. This experimental study aims to investigate the effect of parental threatening and safe information about strangers on the fear and avoidance behavior of their child, in a non-clinical sample. It is also examined whether behavioral inhibition, parental social anxiety and their interaction lead to more socially anxious behavior of the child. Method: A sample of 68 children between 4 and 6 years old performed a social performance task in front of two strangers. Before the task, the parent was asked to transfer verbal threatening or safe information about the strangers to their child. After the task, the strangers interacted with the children separately from each other. Results: Exposure to verbal expression of threat about strangers did not change the anxious or avoidant behavior of children towards those strangers. However, the interaction of behavioral inhibition and parental social anxiety was significant, such that higher levels of behavioural inhibition in combination with less social anxiety in parents were significantly associated with more social anxiety towards the stranger about whom children receive safe information. Conclusion: Intergenerational transmission of social anxiety occurs when children who have a higher behavioral inhibition in combination with less socially anxious parents receive positive information about a stranger. It is concluded that the intergenerational transmission of social anxiety is dependent on multiple variables concerning the parents and the child.Show less
