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
Research master thesis | Developmental Psychopathology in Education and Child Studies (research) (MSc)
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Both youth with a substance use disorder (SUD) and youth who have experienced adverse childhood experiences (ACEs) show heightened vulnerability to psychopathology. We aimed to quantify the risk of...Show moreBoth youth with a substance use disorder (SUD) and youth who have experienced adverse childhood experiences (ACEs) show heightened vulnerability to psychopathology. We aimed to quantify the risk of comorbid disorders in SUD youth with ACE-history. Additionally, we aimed to examine relations between ACEs, overall household experience, and general distress. We used cross-sectional YIT-study data from interviews with Dutch youth (aged 16-22) upon SUD treatment entry for cannabis, alcohol, or stimulant use. We measured ACE-types experienced up until 15 years of age, past-year DSM-5 disorders, general distress (DASS-21), and overall household experience rating. Logistic regressions quantified relations between ACE sum score and anxiety, depressive, behavior, and any disorder. Higher ACE sum scores related to increased risks for a(n) anxiety (OR = 1.12, highest odds = 2.84; χ2(1) = 6.71, p < .010; Nagelkerke R2 = 0.2), depressive (OR = 1.21, highest odds = 5.43; χ2(1) = 18.11, p < .001; Nagelkerke R2 = 0.6), behavior (OR = 1.20, highest odds = 5.24; χ2(1) = 17.41, p < .001; Nagelkerke R2 = 0.6), and any (OR = 1.25, highest odds = 7.58; χ2(1) = 17.26, p < .001; Nagelkerke R2 = 0.7) disorder. Exploratory analyses revealed that frequency of parental fighting, being hit/abused, getting belittled, emotional neglect, physical neglect, insufficient household income, long parental sickness, and overall household experience positively related to DASS-21. In a hierarchical regression analysis with all ACEs and overall household experience, only emotional neglect related to DASS-21 (B = 3.68, t(373) = 2.41, p = .017). Overall household experience did not improve the model (F(12) = 3.51, p < .001; R2change < .001). In hierarchical regression analyses containing ACE sum score and overall household experience, overall household experience was not uniquely related to DASS-21 (t = -0.22, p = .824; R2change < .01). In conclusion, ACEs relate to comorbid disorders in SUD youth. Our exploratory research suggests that ACE frequency might influence this relation, while overall household experience does not further explain this relation. Further research should investigate which ACE measures (a.o., type, frequency) strongly relate to SUDs and psychopathology and examine improved treatment options.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
