Introduction: The COVID-19 pandemic has had a significant impact on individuals’ physical and mental well-being, particularly affecting their sleep patterns. However, prospective research on the...Show moreIntroduction: The COVID-19 pandemic has had a significant impact on individuals’ physical and mental well-being, particularly affecting their sleep patterns. However, prospective research on the specific effects of COVID-19 on sleep quality and rumination remains limited. The current study aims to fill this gap by investigating how the pandemic affects sleep quality and nighttime rumination in both adults and adolescents. It was hypothesised that COVID-19 would worsen sleep quality and increase nighttime rumination, particularly in adolescents. Methods: 101 participants (67 adults, 34 adolescents) were assessed using a within-betweensubjects design comparing two time periods (before and during COVID-19) across two age groups. Sleep quality was assessed daily by asking three questions that measured subjective sleep quality, sleep latency and wake after sleep onset. Nighttime rumination was quantified using self-reported rumination scores. Results: No significant differences in sleep quality or nighttime rumination were observed between the two periods for either age group. However, during the pandemic, adults experienced significantly worse sleep quality and increased nighttime rumination compared to adolescents. Additionally, nighttime rumination had a negative effect on sleep quality in both age groups. Conclusion: The study did not find statistically significant differences across time periods, but adults reported poorer sleep quality and higher levels of nighttime rumination during the pandemic compared to adolescents. These findings highlight the importance of further research to understand and address the psychological impact of global health crises in diverse populations.Show less
Earlier research showed that children who endure war are more at risk of developing trauma symptoms or PTSD. Trauma symptoms or PTSD can lead to significant disruptions in cognitive empathy and...Show moreEarlier research showed that children who endure war are more at risk of developing trauma symptoms or PTSD. Trauma symptoms or PTSD can lead to significant disruptions in cognitive empathy and high levels of anxiety. The aim of the current study is to look into the relationships between PTSD, cognitive empathy and anxiety in Syrian refugee children, and to test for gender differences. Participants were 33 Syrian refugee children aged 10-18. PTSD was measured using CPSS, cognitive empathy was measured using the EmQue-CA and the EDG (three social conditions were used: neutral individuals, victims and offenders of intentional pain) and anxiety was measured using the SCARED. Results showed that cognitive empathy did not affect Syrian refugee children in social situations. Secondly, anxiety did not affect cognitive empathy levels. Thirdly, anxiety did not affect cognitive empathy differently for boys and girls. Lastly, cognitive empathy is disrupted within Syrian refugee children with trauma symptoms or even PTSD. Suggesting that cognitive empathy is a predictor of PTSD. The findings of the current study could potentially be important for future faster treatment of trauma symptoms or even PTSD by using cognitive empathy levels as a predictive factor.Show less
Part of the origin of anxiety comes from genetic heredity and the rest is explained by environmental factors. Parental and family characteristics play an important role in the environmental factors...Show morePart of the origin of anxiety comes from genetic heredity and the rest is explained by environmental factors. Parental and family characteristics play an important role in the environmental factors of anxiety. Specific parenting styles are linked to childhood anxiety. Several studies showed that parental overprotection can be linked to anxiety in children. However, there are some inconsistent results between the different studies. This inconsistency may occur because previous studies looked at parents and children in general and possibly, this relationship is mainly important in specific groups of parents and children. Therefore, in this study we look at parents’ socioeconomic status and the gender of the child as a moderator for the link between parental overprotection and anxiety in children. This study was part of a larger research project named Cool Little Kids. We used the pre-intervention, baseline data of the Cool Little Kids project in which 170 parents participated. Parents filled out several questionnaires regarding parental overprotection, child anxiety and demographic characteristics. The results showed that there was no significant effect between overprotective parenting and childhood anxiety that is moderated by SES of the parents and gender of the child. However, the results did point at the expected directions, although they are too small to give significant results. This means that overprotective parenting may not be as important as we assumed. Results of this study must be considered with regard to several limitations. The sample size of this study is small, parents with low socioeconomic status are underrepresented and the study is based on cross-sectional data. Further studies might focus on other parental and environmental factors such as an authoritarian parenting style that may have a larger influence on childhood anxiety and the influence of parenting styles on childhood anxiety in same sex parent-child pairs.Show less
This study aims to investigate relative age within primary school grades as a potential influential factor of perceived ADHD symptoms. It examines whether relatively younger pupils show more ADHD...Show moreThis study aims to investigate relative age within primary school grades as a potential influential factor of perceived ADHD symptoms. It examines whether relatively younger pupils show more ADHD symptoms than their classmates. The study is of cross-sectional design, using data of primary school children throughout the Netherlands. Participating children are in the age range of four to twelve years old, N = 168. To measure ADHD symptoms, the SNAP-IV (18) has been filled out by parents of the participating children. Relative age serves as the main predictor of this study. Simple linear regressions have been run on relative age (predictor) and ADHD symptoms (dependent). Analyses showed that relative age is no predictor of ADHD symptoms, implying that relative age is no influential factor in perceived ADHD symptoms. However, data screening pointed out that the sample of the current study might not be representative for the general population. Furthermore, the current research design worked with parental observations of ADHD symptoms, and not official ADHD diagnoses. Whether a child has had an ADHD diagnosis was unknown during this study. Incorporating this information in future research could potentially lead to a better understanding of the topic. All in all, the results of this study must be interpreted with care and future research is needed to (dis)prove the relation between relative age and ADHD symptoms.Show less
A social fear adolescents with and without a Social Anxiety Disorder experience very frequently is public speaking anxiety. The cognitions these adolescents have in public speaking situations play...Show moreA social fear adolescents with and without a Social Anxiety Disorder experience very frequently is public speaking anxiety. The cognitions these adolescents have in public speaking situations play an important role in the development and maintenance of their anxiety. Because of the impairments they experience in life, it is important to start treatment. The fact that only a small proportion of adolescents with social fears receive the focussed treatment they need, and that treatment outcomes are not optimal, is problematic. Blended care, the combination of face-to-face and online therapy, is a new type of treatment that appears to be promising for the treatment of mental health problems. This study aimed to research the feasibility of the blended care module ‘’Skills for Academic and Social Success’’ for treating adolescents with public speaking anxiety. Changes in cognitions and effects of comorbid depression were also explored. A total of 41 adolescents between 11 and 17 years, recruited from high schools in Leiden, The Netherlands, participated in this study. These adolescents followed the blended care module and were asked to, among others, fill out different self-report questionnaires on public speaking anxiety (PRPSA), cognitions (CATS-N/P) and depression (CDI-2) at four timepoints. The results show that the adolescents showed a decrease in public speaking anxiety during treatment. A higher level of anxiety at the start of the treatment was associated with a higher level afterwards, but also with greater, absolute improvements. Comorbid depression was also associated with a greater, absolute reduction in public speaking anxiety and there was a decrease in depression as well. The results also show that public speaking anxiety was negatively correlated with positive cognitions and positively with different types of negative cognitions. Some of these negative cognitions decreased during the treatment and were replaced with positive cognitions. However, there was almost no association between changes in cognitions and changes in public speaking anxiety. According to these findings, the blended care module appears to be feasible for the treatment of adolescents with public speaking anxiety, of which cognitions are part, and suitable for different levels of anxiety and for when comorbid depression is present.Show less
Childhood bullying victimization has been empirically established as a risk factor for insecure adult attachment as well as mental health issues such as anxiety and depression in adulthood. However...Show moreChildhood bullying victimization has been empirically established as a risk factor for insecure adult attachment as well as mental health issues such as anxiety and depression in adulthood. However, there is a lack of research exploring adult attachment styles as a mediator between bullying victimization in childhood and adult depressive and anxious symptoms. The present study investigated if the relationship between bullying victimization before the age of 18 and anxious and depressive symptoms in university students is mediated by adult attachment styles. Participants were part of a larger survey study of the Caring Universities Project. The sample included 3388 participants (university students) between the ages of 18 to 36, who filled out an online questionnaire testing for bullying victimization (RBQ), anxious symptoms (GAD-7), depressive symptoms (PHQ-9), and adult attachment styles (RQ). It was hypothesized that the relationship between bullying victimization and mental health is mediated by insecure attachment styles. A partially mediating effect of fearful and preoccupied attachment styles on the association between bullying victimization and anxious and depressive symptoms was established. A reason for the mediation effect of these two insecure attachment styles might be the underlying negative concept of the self that these attachment styles have in common. Limitations and implications of the findings are discussed.Show less
Suicide attempts are a major global public health concern with wide-ranging tragic consequences. Trait anger has been shown to be a predictor of suicide attempts in past studies, with people higher...Show moreSuicide attempts are a major global public health concern with wide-ranging tragic consequences. Trait anger has been shown to be a predictor of suicide attempts in past studies, with people higher in trait anger having an increased risk of attempting suicide. Nevertheless, the underlying mechanisms as to why this relationship persists are still mostly unknown. The aim of this research was to investigate the prospective relationship between trait anger and suicide attempts. Based on the idea that frequent anger may harm social relationships, we proposed loneliness to mediate the relationship between trait anger and suicide attempts. The study design was longitudinal, and data was collected using ecological momentary assessment over a study period of one year. The sample consisted of participants with a history of suicide attempt or suicidal ideation (N = 65). Survival analysis was used to analyze the data. Against our predictions, higher trait anger was not related to an increased risk of attempting suicide. The hypothesized mediation effect of loneliness was also not significant. Possible reasons for this may be sample characteristics and our operationalizations of trait anger and loneliness. Nevertheless, our findings contribute to the literature on suicide attempts by utilizing comprehensive data collection and analysis methodologies as well as proposing important considerations for future research. Awareness of suicide attempts and corresponding prevention interventions are discussed.Show less
Anxiety is a prevalent mental health disorder among children and adolescents, affecting over 30% of individuals aged 13 to 18 years and can lead to significant long-term consequences if left...Show moreAnxiety is a prevalent mental health disorder among children and adolescents, affecting over 30% of individuals aged 13 to 18 years and can lead to significant long-term consequences if left untreated. Parental behaviour and mental health play pivotal roles in the development and persistence of childhood anxiety. One empirically supported preventative option is a group-based parenting intervention that is targeted to children with sub-clinical anxiety symptoms. Although this type of intervention focuses on reducing sub-clinical anxiety symptoms in children indirectly by working through the parents, some gains for the parents themselves have been hypothesised. In analogous research exploring universal group- based interventions and interventions for conduct disorder, parents have benefitted from these interventions themselves. Proposed mechanisms for this secondary effect include symptom reduction in the child and cognitive-behavioural changes in their parents, as parents may apply the techniques to themselves as well. Together, these lead to a reduction in stress in the wider family and parent marital relationship. Despite research into this mechanism in treatment of other disorders, there has been no such study directed at childhood anxiety specifically. Accordingly, the current systematic review and meta- analysis investigated the impact of targeted group-based parenting interventions on parental mental health in childhood anxiety prevention. It was predicted that results would mirror prior analogous research with the interventions positively impacting parental mental health. In January 2024, PsychInfo and relevant meta-analyses were searched for randomised controlled trials (RCTs) of targeted group-based parenting interventions for childhood anxiety. A total of 193 articles were screened by independent researchers, identifying 11 eligible studies. A mixed-effects model was used, and a moderation analysis was conducted to investigate potential sources of heterogeneity, exploring low- and high-intensity interventions. This did not account for the observed heterogeneity. While previous research indicated positive effects of these interventions on parental mental health, the current meta-analysis found no effect. Limitations, including variability in measures across studies and the absence of pre-existing psychopathology in parents, may account for the observed results. Future research should address these limitations, considering parental characteristics and extend the scope of the review by including additional databases in the literature search.Show less
Background:. This project investigates the effectiveness of a peer-led exposure therapy to help adolescents with mild-to-borderline intellectual disability (MBID) and a clinical level of anxiety...Show moreBackground:. This project investigates the effectiveness of a peer-led exposure therapy to help adolescents with mild-to-borderline intellectual disability (MBID) and a clinical level of anxiety symptoms. Focus groups were held to assess the implications of this mode of therapy. In this thesis the importance of matching between the peer and the adolescent as well as the possible characteristics to use during matching were assessed. Method: We assessed 40 stakeholders divided into three groups (15 therapists, 17 experienced experts and 8 parents of youth with MBID) by conducting 1 to 1.5 hour focus-groups or 45 minute individual interviews. Transcriptions were coded and afterwards both qualitatively (thematic analysis) and quantitatively analysed (chi-square tests and Fisher’s exact test). Results: Matching was found to be important by all groups, though therapists found it less important than the other stakeholders (3.2% of the transcription compared to 5.5% and 4.5%). Possible characteristics to match on were equal age, experiencing a connection, similar levels of social-emotional competence and same type of anxiety. The three stakeholder groups did not agree on how the characteristic intelligence should be implemented in the matching process. Conclusions: This study reveals the importance that is attributed to the process of matching between a peer and an adolescent with MBID and anxiety by the three stakeholder groups. Possible characteristics to match on are suggested.Show less
Background. There is a growing body of research indicating the importance of patient-reported outcome measures (PROMs) to evaluate quality of life. The health-related quality of life (HRQoL) is...Show moreBackground. There is a growing body of research indicating the importance of patient-reported outcome measures (PROMs) to evaluate quality of life. The health-related quality of life (HRQoL) is additionally of increasing interest when examining individuals with chronic conditions. PROMs can enhance patient care and monitor progress, possibly contributing to the improvement of HRQoL. The purpose of the current study was to compare the self-reported HRQoL of patients with amyotrophic lateral sclerosis (ALS) and patients who were three months post-stroke. Methods. A sample of n = 419 patients with ALS (66.1% male, mean age M = 65) and a sample of N = 360 patients with a stroke (60.3% male, mean age M = 70) completed the Patient-Reported Outcome Measurement Information System Global Health (PROMIS-10). Analyses were performed to compare the physical and mental HRQoL scores between the patient samples. Prior research has established Dutch reference norms for the PROMIS-10. Since the current study took place in the Netherlands, the results of the patient samples were also compared to the scores of the Dutch population. Additional analyses examined the influence of covariates such as age and sex. Results. The results showed that patients with a stroke reported significantly lower mental HRQoL than the general population, with a mean difference of T = -0.96 (p < .05). Patients in the ALS sample did not report significantly different mental HRQoL compared to stroke or the general population. Regarding physical HRQoL, ALS reported significantly lower scores than the stroke sample, with a mean difference of T = -2.69 (p < .001), as well as the general population (T = -5.71, p < .001). Age did not have a significant influence on the self-reported HRQoL. Finally, analyses revealed that the women (n = 285) of both patient populations reported lower physical and mental HRQoL than men, with mean differences of T = -2.11 (p < .001) and T = -1.47 (p = .015), respectively. Conclusion. Patients with ALS reported significantly lower physical HRQoL than patients who were three months post-stroke. There were no significant differences in the self-reported mental HRQoL. Compared to the general Dutch population, patients with ALS and patients with stroke both reported lower physical HRQoL, while patients with stroke also reported lower mental HRQoL. The findings of the current study provide support for the integration of HRQoL short-form measures such as PROMIS-10 into clinical care, to identify the need for intervention or for monitoring progress.Show less
Background: This study on gut feelings investigates the correlation between microdiversity in the gut and cognitive reactivity in the brain with sex as a potential moderator. Research on potential...Show moreBackground: This study on gut feelings investigates the correlation between microdiversity in the gut and cognitive reactivity in the brain with sex as a potential moderator. Research on potential correlations and moderators is relevant to gain further insight into the networks involved in the gut-brain axis. The findings can influence treatment approaches in the field of clinical psychology to a greater focus on the gutbrain axis. Two hypotheses were examined: 1) a higher microdiversity in the gut is correlated with less emotion regulation difficulties, and 2) there are sex differences in the correlation between microdiversity and emotion regulation. Methods: This research was an observational between-subjects design with a total number of 75 participants. The primary outcome was the alpha score, assessed with the Shannon Index, which gives insight into individual microdiversity. The Difficulties in Emotion Regulation Scale was used to assess self-reported difficulties in emotion regulation to have insight into individual cognitive reactivity. Sex was conceptualised as the moderator variable. A correlational analysis for alpha scores and DERS scores was carried out, followed by a multiple regression analysis, which tested for a moderation with the variable sex. Results: There was no evidence for a negative correlation between high microdiversity and few emotion regulation difficulties. Sex did not have a significant moderation on this correlation either. Implications: Further research is needed on the gut-brain axis and sex differences in gut microdiversity and emotion regulation to adapt the treatment of stress-related disorders such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), or other anxiety-related disorders from a cognitive- to a more holistic approach.Show less
This study explored cognitive function in patients with hypothyroidism who continue to experience complaints despite achieving biochemical euthyroidism with standard care. These subjective...Show moreThis study explored cognitive function in patients with hypothyroidism who continue to experience complaints despite achieving biochemical euthyroidism with standard care. These subjective complaints are related to fatigue and subjective feelings of cognitive difficulties. Although the link between untreated hypothyroidism and neurocognitive complaints has been thoroughly studied, there is limited data on such complaints among treated hypothyroid patients experiencing cognitive complaints, despite its clinical relevance in their care. This study evaluated whether patients with feelings of cognitive difficulties show objective cognitive deficits in attention, working memory, learning ability, executive function, and psychomotor speed. Additionally, the study investigated whether health-related quality of life (hr-QoL) could be predicted by objective overall neurocognitive function. The cognitive domains were measured in patients with hypothyroidism and subjective complaints despite normalized levels of thyroid-stimulating hormone (TSH) (N = 17) using several standardized tests and compared to normative data with one sample t-tests. To measure hr-QoL, a widely used thyroid patient-reported questionnaire was used. Subsequently, a linear regression analysis was conducted to determine the predictive relationship between objective cognitive function on hr-QoL. Patients showed significantly lower test scores on the domains of working memory (p < .001, Cohen’s d = .69) and memory and learning (p = .008, Cohen’s d = .77). The total composite score of the objective test measures was not a determinant of hr-QoL (p = .963, R² = 0.00). The observed memory deficiencies emphasize the importance of addressing subjective cognitive complaints, while the absence of significant deficiencies in the other domains highlights the complexity of the relationship between subjective and objective neurocognitive measures. Additionally, this study did not find a predictive relationship between cognitive test scores and hr-QoL, which calls for future investigation into individual cognitive domains or other explanations for the lower hr-QoL of this patient group. This is the first study that distinguished the patient group experiencing subjective neurocognitive complaints from the overall group of patients with hypothyroidism. Consequently, this research contributes valuable insights to enhance future care in managing neurocognitive symptoms, particularly for the subgroup that frequently discusses such concerns with their healthcare provider.Show less
Objective: Multiple Sclerosis (MS) is a chronic neurological disorder characterized by a wide range of symptoms, of which physical and cognitive impairments are prominent. Cognitive functioning in...Show moreObjective: Multiple Sclerosis (MS) is a chronic neurological disorder characterized by a wide range of symptoms, of which physical and cognitive impairments are prominent. Cognitive functioning in MS has received increasing attention due to its significant impact on quality of life. However, the exact relationship between physical functioning and cognitive functioning in people with MS (PwMS) remains insufficiently understood. This study aimed to explore the predictive value of physical outcome measures on cognitive functioning. Furthermore, the influence of disease severity and anxiety and depression on the relationship between physical outcome measures and cognitive functioning is explored. Methods: Conducted as part of the ‘Don’t be late!’ project, this study included 23 PwMS (Mean age = 46.63, SD = 11.13; 60.9 % female). Physical functioning was assessed using balance, walking speed, grip strength, dexterity and endurance. Furthermore, cognitive functioning was assessed using the Minimal Assessment of Cognitive Functions in MS and disease severity and anxiety and depression were measured using the Expanded Disability Status Scale and the Hospital Anxiety and Depression Scale, respectively. Multiple regression analyses were performed to determine the predictive value of physical functioning on cognitive functioning. Mediation analyses were performed with disease severity and anxiety and depression as mediating factors. Results: No significant model for the predictive value of physical outcome measures on cognitive functioning was found (p = .117). Furthermore, the study found no significant mediating effects of disease severity (p = .979) or anxiety and depression (p = .633) on this relationship. Due to missing values on the Paced Auditory Serial Addition Test (PASAT), a post-hoc analysis was conducted. Significant effects were found for the predictive value of balance (p = .016), dexterity (p = .045) and walking speed (p = .008) on cognitive functioning. Conclusion: The study identified significant links between balance, dexterity, walking speed, and cognitive functioning in PwMS. It faced limitations including a small sample size and its cross-sectional nature. Despite these limitations, this study suggests that the interplay between physical and cognitive domains in MS is multifaceted and warrants more nuance investigation.Show less
This research was performed to see how useful dynamic testing of reading and writing would be for children with and without dyslexia and to explore the relationship between dynamic testing of...Show moreThis research was performed to see how useful dynamic testing of reading and writing would be for children with and without dyslexia and to explore the relationship between dynamic testing of reading and writing and intelligence, specifically fluid and crystallised intelligence. To research this, this research had an experimental pretest-training-posttest design with two groups—dyslexic and non-dyslexic—as well as two conditions—training and no-training. The participants were children in primary school between the ages of 7 and 9. The study consisted of two sessions: a preliminary investigation and a dynamic test. The dynamic test used was the EPALE-NL. It consists of four subtests: phonemic awareness, prosodic awareness, sounds and verbs, and context words. A significant difference was found between the group that was trained and the group that was not trained, in specific for the subtest prosodic awareness, with the trained group showing more improvement in accuracy. For the performance on the posttest by the dyslexic group and non-dyslexic group, no significant difference was found between the groups. No significant relationship was found between the gain score and fluid and crystallised intelligence. Dynamic testing of reading and writing has shown potential to be used in the classroom for its previously discovered benefits, as well as its ability to teach both dyslexics and non-dyslexics of varying intelligence.Show less
