This research aimed to comprehensively understand the demographics and characteristics of transgender and gender diverse (TGD) individuals seeking mental health care upon initiating gender...Show moreThis research aimed to comprehensively understand the demographics and characteristics of transgender and gender diverse (TGD) individuals seeking mental health care upon initiating gender-affirming care. Additionally, it focused on optimal integration of mental health care into gender-affirming care according to TGD individuals. Both were within the framework of an ongoing investigation at the Zaans Medical Centre. The quantitative data analysis consisted of intake questionnaire data of twenty-five TGD individuals, variables were derived from sections of the intake questionnaire. For the qualitative data analysis, seven semi-structured interviews were held with TGD individuals. The characteristics of TGD individuals consisted of self-reported psychological distress and well-being. Their relationship to requested mental health care intensity was studied through Spearman rank order correlations. The demographics included age, educational level, ethnicity, employment status, experienced income, and gender assigned at birth. Their association with requesting mental health care was explored through chi-square tests. A thematic analysis with semantic approach was performed to analyse the data. No significant correlations were found between demographic variables and mental health care requests at admission. The correlation between self-reported psychological distress and mental health care intensity was χ2 = -.003, p = .987, for self-reported psychological well-being and mental health care intensity χ2 = -.001, p = .997. Thematic analysis of interview data yielded three overarching themes: motives for seeking mental health care, recommendations for integrating mental health services into gender-affirming care, and desirable attributes of mental health care providers. Reasons for refraining from or seeking mental health care included experiencing psychological distress or good psychological well-being, experiences due to gender dysphoria, acceptance of themselves, and experienced lack of support. Suggestions for optimal mental health care integration were better and more provision of (mental) health care and travel distance to mental health care. Qualities of the ideal mental health care professional were having certain character traits such as being accepting and being specialized in TGD. Overall, this research emphasizes the importance of knowledgeability and empathetic and inclusive qualities in mental health care professionals in the treatment of TGD individuals suggesting its importance over mental health care professionals’ gender identity.Show less
Problematic behaviour remains a problem within healthcare of individuals with dementia, especially as its patient group is set to expand. Problematic behaviour is often caused by pain and places a...Show moreProblematic behaviour remains a problem within healthcare of individuals with dementia, especially as its patient group is set to expand. Problematic behaviour is often caused by pain and places a heavy burden on both professional and family caregivers. Especially since family caregivers are often overlooked as a factor in care. This study therefore investigates the effectiveness of the STA OP! method (SOM), a stepwise approach to address problematic behaviour and pain in individuals with dementia, as well as how the efficacy of SOM is moderated by family involvement. The study, conducted within the CARED-4 project, utilizes a quasi-experimental longitudinal design with measurements at baseline, 3 months, and 6 months after implementing SOM. It included 84 residents with dementia from 10 Dutch nursing homes units paired with their family caregivers. Problematic behaviour was examined using the Neuropsychiatric Inventory Questionnaire (NPI-Q) and family involvement was examined through a tailored questionnaire. Analysis was performed with RM Anova for problematic behaviour and family involvement and a general linear model for the moderation of SOM by family involvement. Results indicated that SOM effectively reduces problematic behaviour overall (F(2,55) = 3.81, p = 0.028), after 3 months (Mean Difference = 5.47 SE= 1.97, p = 0.007), but not after 6 months (Mean Difference = 5.70 SE = 3.36, p = 0.095). Family involvement did not change overall (F(1.62,30) = 2.12, p = 0.138). Accordingly, family involvement did not moderate the impact of SOM on problematic behaviour (F(2) = 1.43, p = 0.243). Despite methodological challenges mainly due to missing data, the study takes a first step towards understanding how the effectiveness of SOM interacts with family involvement. So, although family involvement did not moderate a significant reduction in problematic behaviour, the efficacy of SOM has further been established.Show less
Insomnia is highly prevalent in patients with long-term medical conditions. Although fatigue is the most common daytime symptom of insomnia, it is still largely unknown which underlying components...Show moreInsomnia is highly prevalent in patients with long-term medical conditions. Although fatigue is the most common daytime symptom of insomnia, it is still largely unknown which underlying components are associated with fatigue in a broader population of insomnia patients. Previous literature stated that dysfunctional sleep-related beliefs (DSRB) and pre-sleep arousal (PSA) could explain the relationship between insomnia and fatigue. Additionally, subjective sleep characteristics, such as insomnia severity, number of nocturnal awakenings (NoA) and sleep efficiency might also be components of this relationship. This study aimed to investigate how these factors affect fatigue in a broad medical population with insomnia. It was hypothesized that more disturbed sleep-related psychological factors and subjective sleep characteristics were associated with increased fatigue. This cross-sectional study, derived from the ongoing TIMELAPSE study, consisted of 154 participants. Participants completed questionnaires assessing fatigue (Checklist Individual Strength-20), DSRB (Dysfunctional Beliefs and Attitudes about Sleep-16), PSA (Pre-Sleep Arousal Scale), and insomnia severity (Insomnia Severity Index). The Consensus Sleep Diary tracked NoA and sleep efficiency daily for one week. Two multiple regression analyses were performed to assess the relationship between sleep-related psychological factors (DSRB, PSA), subjective sleep characteristics (insomnia severity, NoA, sleep efficiency) and fatigue. Age, gender, and depression were included as controlling variables. Results showed that DSRB (β = .174, p = .027), PSA (β = -.160, p = .036), and insomnia severity (β = .243, p = .002) were factors associated with fatigue in insomnia patients. More severe DSRB and higher insomnia severity predicted elevated levels of fatigue. Contrary to expectations, PSA was negatively associated with fatigue. Lastly, NoA and sleep efficiency were not related to fatigue. This study uncovered connections between more severe DSRB, lower PSA, and higher insomnia severity that led to higher levels of fatigue. The current study suggests that improvements in DSRB and reducing insomnia severity may reduce fatigue of insomnia patients with long-term medical conditions. Sleep interventions should emphasize on challenging these DSRB. Future research is needed to examine the complex relationship between PSA and fatigue, as well as whether changes in DSRB during CBT-I treatment reduce fatigue symptoms in this population.Show less
The global prevalence of Alzheimer’s disease is expected to rise from 50 to 152 million cases by 2050 due to the limited availability of therapeutic and preventive strategies and ageing populations...Show moreThe global prevalence of Alzheimer’s disease is expected to rise from 50 to 152 million cases by 2050 due to the limited availability of therapeutic and preventive strategies and ageing populations. Although digital tools can address the growing gap between healthcare supply and demand, their implementation is difficult, and personal factors can influence individuals’ intention to use such tools. Thus, this study explores the relationship between various personal factors, as self-reported by healthy individuals (N = 507) who are part of a brain research registry, and their intention to use and promote using digital tools in the context of brain health and dementia. According to the hypothesis formulated for the research, higher financial scarcity, lower educational attainment, and lower employment status predict lower intention to use and promote digital tools for brain health. The study examined four distinct digital tools: (1) MijnBreincoach (a prevention tool), (2) cCog (a diagnostic tool), (3) ADappt (a patient- orchestrated care tool), and Neurokeys (a prediction tool). It was found that Neurokeys exhibited the highest score for intention to use but the lowest score for intention to promote. In addition, medium and high educational attainment predicted higher behavioral intention to use MijnBreincoach, while the most beneficial (i.e., most secure, stable, and safe) employment status predicted higher intention to promote MijnBreincoach and cCog. In conclusion, it is important to recognize differences in intention to use and promote different types of digital tools across potential users and the influence of personal characteristics on the intention to use and promote digital tools for brain health. During the development of a digital tool, it is recommended to consider which target audience would derive the greatest benefit from it and tailor it accordingly.Show less
This 3-wave study aims to examine the relationship between cognitive empathy (awareness and understanding of another’s emotion), affective empathy (experience of emotions consistent with those of...Show moreThis 3-wave study aims to examine the relationship between cognitive empathy (awareness and understanding of another’s emotion), affective empathy (experience of emotions consistent with those of the observed person), and self-perception of close friendships (one’s perception of the ability to form and maintain close friendships), both directly and indirectly through prosocial behavior (voluntary behavior intended to benefit another person) from late childhood to early adolescence. Participants were 127 adolescents aged between 10 and 14 years old who reported on their empathy, prosocial behavior, and self-perception of close friendships in three consecutive years, respectively. Simple mediation analyses revealed that cognitive and affective empathy did not have a significant positive effect on adolescents’ self-perception of close friendships two years later. Considering these findings, prosocial behavior was not found to be a mediator between adolescents’ cognitive or affective empathy and their self-perception of close friendships from late childhood to early adolescence. Moreover, cognitive and affective empathy did not significantly predict prosocial behavior one year later, whereas prosocial behavior did significantly predict the self-perception of adolescents’ close friendships one year later. These results underline the significance of developing tailored intervention programs targeting prosocial behavior to foster adolescents’ self-perception as close friends, a competence that is crucial during this developmental period considering the greater influence of peers.Show less
This study aims to investigate the effects of exercise-intensity on divergent creativity. It is hypothesized that exercise of moderate and high intensity enhance creativity more effectively than...Show moreThis study aims to investigate the effects of exercise-intensity on divergent creativity. It is hypothesized that exercise of moderate and high intensity enhance creativity more effectively than exercise of lower intensity. The study also investigates if arousal, positive high-arousal affect, and negative high-arousal affect serve as intermediary variables in this relationship. Scarce previous research has suggested a relationship between exercise-intensity and creativity, but studies comparing different exercise-intensities on creativity and potential underlying mechanisms were lacking. To address this knowledge gap, this study compares different intensities, namely low-intensity (cycling at 55% of maximum heart rate), moderate-intensity (cycling at 70% of maximum heart rate), high-intensity (cycling at 85% of maximum heart rate) and a control group, on divergent creativity (i.e., number and uniqueness of creative ideas); And looks at affect and arousal as underlying mechanisms. Happy (positive), elated (positive), upset (negative), tense (negative) and stressed (negative) are used as indicators for high-arousal affect and feelings of wakefulness and alertness as indicators for arousal. Participants in this study completed two appointments, of which the first appointment consisted of a fitness test to measure participants’ maximum heart rate. During the second appointment, participants were randomly assigned to one of the four conditions and their affect and arousal were measured before and after the exercise or control task. Creativity was measured after the exercise or control task was completed. A Kruskal-Wallis Test showed that participants in the moderate-intensity and high-intensity exercise did not show higher creativity. Further, macro PROCESS model 4 revealed a significant effect of moderate-intensity and high-intensity exercise on arousal in comparison to low-intensity exercise and a significant effect of moderate-intensity exercise on positive high-arousal affect, in comparison to the control group. Other than this, the model revealed that none of the mediators significantly explained a relationship between exercise-intensity and creativity. This study thus suggests that exercise-intensity does not play a significant role in creativity enhancement, nor does arousal or high-arousal affect. However, future research is needed to confirm this for other modes of exercise, regular exercise instead of acute bouts of exercise and for different individual characteristics, such as age and gender.Show less
Transcranial magnetic stimulation (TMS) is a noninvasive neuromodulation technique showing promise in stroke rehabilitation, with evidence indicating significant enhancement in motor function of...Show moreTranscranial magnetic stimulation (TMS) is a noninvasive neuromodulation technique showing promise in stroke rehabilitation, with evidence indicating significant enhancement in motor function of the contralateral limb following treatment. While TMS appears promising for stroke rehabilitation, there is variability in the level of improvement individuals exhibit. This variability may be attributed to oscillatory neurophysiology, which refers to the rhythmic electrical activity of the brain. Therefore, this study investigated phase-dependent changes in cortical excitability after TMS among stroke patients in affected and unaffected hemispheres. We investigated motor-evoked and TMS-evoked potentials at four phases of the ongoing motor cortical mu rhythm (trough, peak, rising, falling) in both hemispheres (affected, unaffected). Participants comprised N=11 chronic subcortical stroke patients (6 female, mean ± std age: 58 y ± 11.4) with affected lateralized upper-limb impairment. Four blocks of 150 TMS pulses were applied on each hemisphere, targeting the primary motor hotspot of the first dorsal interosseus muscle of the contralateral hand. Participants watched nature videos during stimulation to maintain consistent attention levels. Cortical excitability was assessed by analyzing motor-evoked potentials (MEP) and TMS-evoked potentials (TEP). Results showed that motor responses (measured through MEP amplitudes) were significantly larger at the trough and rising phase compared to the peak phase. No significant differences were observed between the affected and unaffected hemispheres. TEP components, the brain signals in response to TMS, did not exhibit significant phase-dependent changes. While our findings showed a nonsignificant effect of stroke severity, exploratory correlation analyses presented a positive association between higher remaining movement function and enhanced phase-dependent responses to TMS. The findings build upon previous research indicating phase-dependent changes in cortical excitability for MEPs but not for TEPs. The larger MEP amplitudes during trough and rising phases suggest that TMS can be more effective at specific points of cortical activity. Further exploration is needed to assess the efficacy of phase-specific TMS interventions in clinical settings, potentially through larger-scale clinical trials with longitudinal designs and comparative effectiveness studies, aiming to evaluate functional outcomes and determine their impact on motor recovery.Show less
Background. Emergency department (ED) nurses are prone to develop burnout, however, they also tend to be engaged in their work. The goals of this study were twofold: (1) to establish the frequency...Show moreBackground. Emergency department (ED) nurses are prone to develop burnout, however, they also tend to be engaged in their work. The goals of this study were twofold: (1) to establish the frequency of ED nurses in four burnout - work engagement profiles, and (2) to investigate which work characteristics best separated the four burnout – work engagement profiles. Method. A cross-sectional study was done among 967 ED nurses working in one of 28 hospitals in the Netherlands (response rate 74%). The data was gathered using an online questionnaire. A frequency analysis and a descriptive discriminant analysis were performed. Two separate analyses were done for emotional exhaustion and depersonalization. Results. For emotional exhaustion, the engaged profile was most prevalent among the ED nurses in this sample, followed by the burnout, unengaged and engaged-burnout profiles. For depersonalization, the engaged profile was also most prevalent, followed by the burnout, engaged-burnout and unengaged profiles. Two functions were generated by the descriptive discriminant analysis: (1) the Job Demands-Resources (JDR) function and (2) the mastery function. The JDR function separated the burnout from the engaged profile. When nurses scored high on job demands and low on job resources, they were more likely to be in the burnout profile, and vice versa for the engaged profile. Work-time demands and autonomy were primarily responsible for group separation for burnout overall. For emotional exhaustion staffing was also primarily important, whereas for depersonalization, educational and developmental possibilities and (financial) appreciation were also primarily important for group separation. The mastery function separated the engaged-burnout from the unengaged profile. When nurses had educational and developmental possibilities, and experienced a higher frequency of emotionally demanding and conflict/aggression situations, they were more likely to be in the engaged-burnout profile, and vice versa for the unengaged profile. Conclusion. This study provided insight in the interplay between burnout, work engagement, job demands and job resources. This study shows the importance to improve the ED working environment as many nurses are burned out, and showed that ED nurses can be burned out and engaged simultaneously. The findings support the Job Demands-Resources Model, and show that enhancing job demands and job resources is important to facilitate engaged ED nurses.Show less
Abstract Young adulthood is the phase of life during which the most alcohol is consumed. This can have negative consequences and long-term effects. These effects might be explained by risk taking...Show moreAbstract Young adulthood is the phase of life during which the most alcohol is consumed. This can have negative consequences and long-term effects. These effects might be explained by risk taking behaviour. The association between risk taking behaviour and alcohol use has already been studied. However, to our knowledge, the relationship between alcohol use and the different domains of risk taking (health/safety, recreational, ethical, social and financial risks) has not been studied. Understanding these different contexts is essential to develop targeted interventions on the relationship between alcohol use and the specific domains to reduce excessive risk behaviours and alcohol use. Therefore, this research studies the extent to which risk taking in different domains is associated with, and predicts, alcohol use in young adults from 18 to 25 years old. The different domains of risk taking are measured by the Domain-Specific Risk Taking questionnaire and alcohol use is measured by the Alcohol Use Disorders Identification Test. This study was conducted cross-sectionally and longitudinally. The cross-sectional part consisted of 89 participants and studies the extent to which there is an association between risk taking in different domains and alcohol use. It is hypothesised that young adults who take risks in different domains also consume more alcohol. From the results, it can be concluded that young adults who consume alcohol are more likely to take health/safety risks, but they are less likely to take social risks. The longitudinal part consisted of 35 participants and studies the extent to which risk taking in different domains predicts alcohol use two years later. It is hypothesised that risk taking in different domains predicts alcohol use two years later. However, results show that risk taking is not predictive of alcohol use two years later. This result could be due to the small sample size of this study. Given these conclusions, it is important to continue with the interventions on health/safety risks and alcohol use and to target new interventions on social risks and alcohol use. In the future, this study could be repeated in other countries with an Eastern culture or in countries with different legal drinking ages.Show less
This research explores the interplay between social media usage, offline and online interactions, perceived social support, and depression levels among university students. Analyzing data from 430...Show moreThis research explores the interplay between social media usage, offline and online interactions, perceived social support, and depression levels among university students. Analyzing data from 430 participants, this cross-sectional study leverages the Patient Health Questionnaire-9 (PHQ-9) to assess depression symptoms and employs both multivariate and univariate linear regression analyses, as well as MANOVA and ANOVA tests, to understand the connections between online/offline social interactions, perceived social support, and depression. Key findings indicate a significant relationship between the level of perceived social support (β = -0.49, p < .001) and frequency of online interactions (β = 0.43, p < .05) with depression levels. Notably, individuals reporting higher levels of perceived social support tend to exhibit lower depression levels, while those with frequent online interactions often show higher depression levels. The study also identifies marked gender differences in social media use and depression, with females showing greater susceptibility. These results underscore a nuanced relationship between active/passive social media engagement, gender, and mental health. The research emphasizes the need for mental health strategies that consider individual differences, particularly focusing on the quality of social support and patterns of online engagement, to effectively address mental health concerns in young adults.Show less
In an era marked by escalating environmental challenges and the imperative to address climate change, this study explores the relationship between social mindfulness (SoMi) and environmental...Show moreIn an era marked by escalating environmental challenges and the imperative to address climate change, this study explores the relationship between social mindfulness (SoMi) and environmental concern (EC) on an individual level. It builds on previous research that identified correlations between SoMi and EC at a country level. This study hypothesizes a positive relationship between SoMi and EC, examining this relationship across three facets: attitude, intention, and behavior. Additionally, it investigates the connection between SoMi and concern for future generations. This study consists of a lab study with (N = 108). The results indicate a significant association between SoMi and environmentally concerned intentions, suggesting the significance of promoting social mindfulness to enhance pro- environmental intentions. However, no significant relationship was found between SoMi and EC across the facets of attitude, behavior, or concern for future generations. These non- significant findings align with recent studies emphasizing differences in the relationship between SoMi and EC at country level and individual level. Practical implications of this study include the development of educational programs to promote social mindfulness and enhance pro-environmental intentions. The study highlights the complexities of bridging the gap between intention and behavior in environmental concern and the need for future research to address this challenge comprehensively.Show less
Background: Intensified Prolonged Exposure (iPE) therapy has proven its efficacy in reducing PTSD symptoms. However, its effectiveness in naturalistic settings and underlying mechanisms of action...Show moreBackground: Intensified Prolonged Exposure (iPE) therapy has proven its efficacy in reducing PTSD symptoms. However, its effectiveness in naturalistic settings and underlying mechanisms of action are still under investigation. Objective: The current study investigates the effectiveness of iPE in reducing PTSD symptoms in a naturalistic setting. Additionally, the role of trauma-related maladaptive cognitions in predicting changes in PTSD symptoms was examined, thereby testing the cognitive model of PTSD. Methods: The study is based on anonymous data provided by the LUBEC mental health care facility in Leiden, following the iPE procedure outlined by Oprel et al. (2017). Patients with PTSD received 12 sessions of iPE administered over four weeks and two booster sessions at one-month intervals. Assessment of PTSD symptoms, including maladaptive cognitions, was conducted using the PCL-5 questionnaire at eight measurement time points: before the beginning of the treatment (baseline), during each of the four weeks of active treatment, after the two monthly booster sessions, and three months after the end of the treatment (end evaluation). Results: data of 58 participants was included in the study. The treatment resulted in a large improvement in PTSD symptoms, with 43.1% of the patients showing a clinically significant change in symptoms. Maladaptive trauma-related cognitions significantly decreased throughout the course of treatment. In contrast with expectations, preceding changes in maladaptive cognitions did not predict changes in PCL-5 score, while preceding changes in PCL-5 score predicted later changes in maladaptive cognitions. Conclusion: iPE is effective in reducing PTSD symptoms and maladaptive cognitions in a naturalistic setting. Preceding decrease in PTSD symptoms predicts a decrease in trauma-related cognitions; conversely, changes in cognitions do not impact later PTSD symptoms severity.Show less
Background: Emotions mostly depend on the context in which they are experienced. Given how important emotions are for our social life and relationships, they need to be understood and adequately...Show moreBackground: Emotions mostly depend on the context in which they are experienced. Given how important emotions are for our social life and relationships, they need to be understood and adequately regulated. However, not all people can regulate their feeling appropriately. In more recent research, emotions have been studied within their social context and regarding the impact they have on interpersonal relationships. This study attempted to examine if one of the reasons why people cannot regulate their emotions in interpersonal contexts may depend on the severity of childhood trauma and if these associations may contribute to borderline personality disorder (BPD) symptoms. Methods: Data from N=196 participants were collected via an online survey where they completed questionnaires regarding traumatic childhood experiences, interpersonal emotion regulation techniques and a self-report regarding borderline personality disorder symptoms. Results: Multiple linear regression analyses revealed that there was a statistically significant correlation between childhood trauma severity and interpersonal emotion regulation, aligning with the first hypothesis. The associations with BPD symptoms were different for each interpersonal emotion regulation factor. Conclusion: The findings suggest that childhood trauma can have lasting effects on emotional regulation abilities in interpersonal contexts and contribute to the manifestation of BPD symptoms.Show less
Background: Previous studies have indicated a robust association between child maltreatment and a plethora of symptoms, such as somatic and PTSD symptoms. More specifically, sexual and emotional...Show moreBackground: Previous studies have indicated a robust association between child maltreatment and a plethora of symptoms, such as somatic and PTSD symptoms. More specifically, sexual and emotional abuse are linked to a higher likelihood of experiencing gastrointestinal symptoms. Furthermore, neglect and non-sexual abuse (emotional and physical abuse) have also been significantly associated with the re-experiencing and avoidance symptom clusters of PTSD. Objective: Subsequently, the purpose of this cross-sectional study was to examine the relationship between the different forms of child maltreatment, somatic, and PTSD symptoms; and to identify whether differences exist in individuals with a PTSD diagnosis versus those without a diagnosis. Methods: Data were collected from 237 participants (mean age 15.6 years, SD: 2.07) between February 2012 and April 2015. The participants completed the Childhood Trauma Questionnaire (CTQ), the Children’s Somatization Inventory (CSI-35), the Children’s Response to Trauma Inventory (CRTI), and the Children’s Depression Inventory (CDI), at baseline. Partial correlation networks were estimated from the baseline measure to investigate the association between child maltreatment, somatic, and PTSD symptoms. Results: Overall, emotional abuse emerged as the most central node within the network. Out of the five forms of child maltreatment, emotional abuse formed the strongest associations with gastrointestinal symptoms, and the avoidance symptom cluster of PTSD, while sexual abuse formed the strongest association with non-gastrointestinal symptoms. Among individuals with and without a PTSD diagnosis, discrepancies were present in regard to the interrelationships of child maltreatment, somatic, and PTSD symptoms. Conclusion: Consequently, individuals who experience emotional abuse may also experience other forms of maltreatment, thus, mental health professionals need to take into consideration that multiple forms of maltreatment are often present, and implement personalized interventions based on the forms of child maltreatment and the associated symptoms.Show less
The relationship between financial scarcity and persistence was examined using an online performance-based measure of persistence, the Anagram and Riddles task (ART). It was hypothesized that...Show moreThe relationship between financial scarcity and persistence was examined using an online performance-based measure of persistence, the Anagram and Riddles task (ART). It was hypothesized that feelings of financial scarcity leads to less persistence, measured by time spent on the hard and unsolvable anagrams and riddles. The Household Task was used to provoke feelings of financial scarcity in the experimental group and the scores on the PIFS were used to measure each person’s financial scarcity in real life. Results showed a marginally significant relationship between persistence time on unsolvable trials and the ‘PIFS’. This would suggest that people who experience more financial scarcity, show more persistency than people without financial scarcity when trying to solve the unsolvable. Possible explanations for the lack of other significant findings include uncontrolled settings and absence of personal motivation during the task.Show less
