Research master thesis | Psychology (research) (MSc)
closed access
Mobile applications with a virtual coach providing real-time relapse-prevention support may be useful to aid smoking cessation as they are easily accessible, cost-effective, and can be utilized...Show moreMobile applications with a virtual coach providing real-time relapse-prevention support may be useful to aid smoking cessation as they are easily accessible, cost-effective, and can be utilized directly in situations where the risk of relapse is high. This study aimed to examine the effect of three types of relapse-prevention support on tobacco craving to inform the development of a mobile application with a virtual coach. The three types of support focused on (A) motivation and self-efficacy; (B) one’s future self and implementation intentions; and (C) identity-related positive self-talk. Secondly, the study aimed to explore how physical nicotine dependence related to the effect of relapse-prevention support on tobacco craving. A virtual reality experiment with a within-participant design was conducted where 25 participants intending to quit smoking were immersed in a virtual high-risk-of-smoking environment. The participants had four conversations in a randomized order with a concept version of a virtual coach on a simulated mobile phone: three conversations containing a type of relapse-prevention support and one neutral conversation. Physical nicotine dependence was measured at baseline and craving was measured after each conversation. Participants indicated that they would find it reasonably difficult to refrain from smoking in the VR environment and sense of presence was sufficient. Results indicated that the relapse-prevention support did not decrease craving compared to neutral contact with the coach. Furthermore, no association was found between physical nicotine dependence and effect of relapse-prevention support. These results stress the need for evaluations of effectiveness in order to inform the further development and improvement of the relapse prevention support prior to finalizing a mobile application with a virtual coach.Show less
Outcome expectations play a role in the functioning of people with different immune-mediated conditions, like Bechterew’s disease, and could strengthen or convey similar effects of regular long...Show moreOutcome expectations play a role in the functioning of people with different immune-mediated conditions, like Bechterew’s disease, and could strengthen or convey similar effects of regular long-term therapy. The Wim Hof Method has shown promising results with regards to its effect on clinical, autonomic and immune response to experimentally induced inflammation. The current study aims to investigate the relationship between generic (optimism/neuroticism) and specific outcome expectations (related to training effects on health) with the functioning of patients with Bechterew’s disease. In this proof-of-concept randomized controlled trial with a cross-sectional design, 24 patients were included, who followed an adapted version of the Wim Hof Method. During this intervention, a number of areas of functioning variables were included: quality of life, anxiety, depression, and disease activity. These were measured at baseline, week 4, week 8, and a follow-up meeting at week 24. When assessing the relationship between generic and specific treatment outcome expectations, it was found that, higher levels of neuroticism are related more positive specific outcome expectations (r = .414, p = .044). It was seen that better functioning in one area was associated with better functioning in some other areas (r = .434, p < .001, r = .836, p < .001). Regarding the influence of each treatment outcome expectation separately on the different areas of functioning, neuroticism was associated with higher disease activity before and after treatment, as well as more anxiety before treatment (r = .470, p = .018, r = .567, p = .05, r = .253, p = .05). Optimism and specific treatment outcome expectations were not significantly related to functioning. Also, when the influence of baseline functioning was assessed, only the levels of depression before treatment were predictive for depression after treatment (beta = .714, p = .027). When treatment outcome expectations were taken together, they were not significant predictors for functioning after treatment. This study provides limited indications for the importance of treatment outcome expectations for alternative treatment methods. However, neuroticism plays a role in worse functioning and could be used to predict treatment response, and its influence could be addressed through neuroticism management.Show less
Een hogere score op Trait Mindfulness houdt verband met een beter welzijn. Psychologische flexibiliteit houdt ook een verband met een beter welzijn en met minder angst. Echter is niet bekend of een...Show moreEen hogere score op Trait Mindfulness houdt verband met een beter welzijn. Psychologische flexibiliteit houdt ook een verband met een beter welzijn en met minder angst. Echter is niet bekend of een hogere score op Trait Mindfulness ook een hogere score oplevert op psychologische flexibiliteit. Omdat studenten in de COVID- 19 tijd veel geïsoleerd hebben gezeten en veel angst hebben kunnen ontwikkelen, is het belangrijk dat naar een oplossing wordt gezocht om deze angst te verminderen. Het huidige onderzoek is een cross-sectioneel vragenlijstonderzoek en zal niet de oplossing geven, maar wel bijdragen aan de kennis wat tot een oplossing kan leiden. In dit onderzoek werd de relatie tussen Trait Mindfulness met flexibiliteit en angst voor negatieve evaluatie onderzocht. Aan dit onderzoek hebben 161 participanten, studerend aan het HBO of de Universiteit, meegedaan. Hogere scores op Trait Mindfulness hingen samen met hogere scores op flexibiliteit (r = -.76, p < .001), waarvan alle facetten van Trait Mindfulness, behalve ‘observeren’ significante voorspellers waren (F(4,156) = 125.17, p < .001, R2 = 0.762) en lagere scores op angst voor negatieve evaluatie (r = -.44, p < .001), waarvan de Trait Mindfulness- facetten ‘niet-oordelen’ en ‘non-reactief zijn’ significante voorspellers waren (F(2,158) = 36.30, p < .001, R2 = 0.315). Dit onderzoek toont aan dat Trait Mindfulness significant verband houdt met meer psychologische flexibiliteit en minder angst voor negatieve evaluatie. Met vervolgonderzoek kunnen er trainingen worden ontwikkeld om Trait Mindfulness onder studenten te verbeteren en hiermee ook psychologische flexibiliteit te verbeter en hiermee samen angst te verminderen.Show less
Placebos are a substance that do not have the qualities to create an effect on its own. Placebo effects are a well-known phenomenon in science and healthcare. However the positive effects of...Show morePlacebos are a substance that do not have the qualities to create an effect on its own. Placebo effects are a well-known phenomenon in science and healthcare. However the positive effects of placebo are not that well applied in healthcare. A reason for this may be that placebos are seen as a deception of a patient. When placebo is used to replace the actual medicine, then the acceptance to use this is very low with healthcare professionals (HP). However if the placebo is not a replacement but an addition to a working medicine the acceptability of HP’s is higher. The studies about the placebouse that have been done before are mostly focused on one type of placebo-use and do not make comparisons between different types of placebo-use. Another problem in placebo research is that the research of the placebo-effects are focused on one specialization, such as Cardiology. In this research the acceptability of eight types of placebo use within a specialization will be compared with each other, with the following research question: “To what extent does the acceptability of healthcare professionals for eight different types of placebo-use differ within their specializations in medical pediatrics?” The specializations in this research are, General pediatrics (HP’s work in a general healthcare department, or in four or more specializations), Cardiology and Neonatology. There are three RMA’s executed for answering this question. The results show that treatment-strengthening placebo music scores the highest acceptability, within all three specializations. Between the specializations there is no significant difference on acceptability (p = 0.984). This research has shown that HP’s have a high acceptability towards treatment-strengthening placebo-use.Show less
Placebos are a substance that do not have the qualities to create an effect on its own. Placebo effects are a well-known phenomenon in science and healthcare. However the positive effects of...Show morePlacebos are a substance that do not have the qualities to create an effect on its own. Placebo effects are a well-known phenomenon in science and healthcare. However the positive effects of placebo are not that well applied in healthcare. A reason for this may be that placebos are seen as a deception of a patient. When placebo is used to replace the actual medicine, then the acceptance to use this is very low with healthcare professionals (HP). However if the placebo is not a replacement but an addition to a working medicine the acceptability of HP’s is higher. The studies about the placebouse that have been done before are mostly focused on one type of placebo-use and do not make comparisons between different types of placebo-use. Another problem in placebo research is that the research of the placebo-effects are focused on one specialization, such as Cardiology. In this research the acceptability of eight types of placebo use within a specialization will be compared with each other, with the following research question: “To what extent does the acceptability of healthcare professionals for eight different types of placebo-use differ within their specializations in medical pediatrics?” The specializations in this research are, General pediatrics (HP’s work in a general healthcare department, or in four or more specializations), Cardiology and Neonatology. There are three RMA’s executed for answering this question. The results show that treatment-strengthening placebo music scores the highest acceptability, within all three specializations. Between the specializations there is no significant difference on acceptability (p = 0.984). This research has shown that HP’s have a high acceptability towards treatment-strengthening placebo-use.Show less
An effective way to reduce negative experiences such as stress, anxiety, and pain in hospitalized children is by implementing placebo applications. A placebo application is a procedure without...Show moreAn effective way to reduce negative experiences such as stress, anxiety, and pain in hospitalized children is by implementing placebo applications. A placebo application is a procedure without active elements that can elicit a positive treatment outcome. Despite its beneficial outcomes placebo applications are not frequently used in pediatric healthcare. Gaining insights in the opinions of healthcare providers on placebo applications will help to understand why placebo applications are not used frequently and offer suggestions to optimize usage. The aim of this cross-sectional observational study was to investigate whether the healthcare provider characteristics optimism, anxiety, and knowledge on placebos were associated with their opinions on the effectiveness, acceptability, and utilization of placebo applications. A differentiation is made between treatment-enhancing (e.g. music, Virtual Reality, comfort talk) and treatment-replacing (e.g. open treatment without active elements) placebo applications. Through an online questionnaire, data was collected from 121 healthcare providers (106 female, 15 male). Being more optimistic was negatively correlated with being less anxious (r = -0.43, p < 0.001). Multiple regression analyses showed that having more knowledge was associated with finding placebos applications more effective (β = 0.23, p = 0.012) and acceptable (β = 0.29, p = 0.001), but not with a higher utilization of placebo applications (p = 0.096). No significant associations were found of the amount of optimism and anxiety of healthcare providers with the opinions and use of placebo applications. Treatment-enhancing placebos applications were considered significantly more effective, acceptable, and utilized more often than treatment-replacing placebos (p-values < 0.001). The results of this study imply that more knowledge of placebos is associated with more positive opinions on placebo applications. The positive opinions and higher use of treatment-enhancing placebo applications indicate that implementing these in pediatric care is within reach. In this study, the reluctance to use placebos in pediatric care can be explained by the common assumption that placebo applications always replace the treatment, not knowing about the treatment-enhancing placebos that can be useful and ethically sound. It is recommended to offer education on treatment-enhancing and open treatment-replacing applications to examine if this increases use in pediatric care.Show less
Research master thesis | Psychology (research) (MSc)
closed access
Background: Between 10-15% of women have a pathological fear of childbirth. An expectation of fear might contribute to an actual fearful childbirth experience, which is known as a nocebo effect....Show moreBackground: Between 10-15% of women have a pathological fear of childbirth. An expectation of fear might contribute to an actual fearful childbirth experience, which is known as a nocebo effect. Likewise, positive thoughts about childbirth may lead to positive experiences, known as a placebo effect. Negative expectations surrounding childbirth mainly occurs in women who are known with anxiety and depression. As a result of these negative expectations, women could have a prolonged labor and obstetric complications which can evoke traumatic symptoms. The purpose of this study was to research whether there is a predictive association between positive or negative expectations surrounding childbirth and the experience of childbirth and whether this differs in women with or without psychiatric problems. This is relevant because most research on women’s expectations of childbirth are focused on fear of childbirth and its potential impact in medical aspects, whereas in this study the focus is on a broader expectation base, including positive expectations and also the subjective experience of childbirth. Methods: In this prospective study we included in total 150 women from both the Psychiatric Obstetric Pediatric (POP) outpatient clinics, a clinic for pregnant women with psychiatric vulnerability, and the general obstetric clinic, between January 2020 and January 2022. All participants filled in the Wijma Delivery Expectancy (version A at T1) and Experience (version B at T2) questionnaire after providing an informed consent. Also, all participants filled in the Hospital Anxiety and Depression scale (HADS) and the PTSS checklist for DSM-5 (PCL-5), to evaluate current psychiatric complaints. Results: The expectation surrounding childbirth was a significant predictor for the childbirth experience after controlling for parity and pain relief, p <.001, whereas positive expectations are related to a positive childbirth experience (placebo effect) and negative expectations are related to a negative childbirth experience (nocebo effect). This was not different for women with or without psychiatric problems, p =.841. Conclusions: Women’s negative and positive expectations of childbirth are related to the childbirth experience, showing indications for both a nocebo and placebo effect. These results can be important for future experimental research to see whether changing the expectation of childbirth in a positive way, could improve the experience of childbirth.Show less
Behandelversterkende en behandel-vervangende placebotoepassingen kunnen ingezet worden voor zowel acute als chronische aandoeningen bij volwassenen en kinderen. Behandelversterkende...Show moreBehandelversterkende en behandel-vervangende placebotoepassingen kunnen ingezet worden voor zowel acute als chronische aandoeningen bij volwassenen en kinderen. Behandelversterkende placebotoepassingen versterken een lopende medische behandeling terwijl behandel-vervangend een placebotoepassing is een op zichzelf staande behandeling. Om placebotoepassingen in te zetten in de pediatrische zorg is het belangrijk om te onderzoeken hoe ouders en zorgverleners tegenover placebotoepassingen staan. Ondanks een algemene positieve attitude is er nog weinig kennis over de acceptatie van placebotoepassingen onder ouders en zorgverleners en mogelijke verschillen tussen acute en chronische aandoeningen en behandelversterkende tegenover behandel-vervangende placebotoepassingen. In deze thesis is het verschil in acceptatie onderzocht van placebotoepassingen onder ouders en zorgverleners tussen pediatrische patiënten met een acute of chronische aandoening. Van 178 participanten waren er 28 ouders en 150 zorgverleners. Het onderzoek had een cross-sectioneel observationeel design. Bij geen van de acht placebotoepassingen was een verschil in acceptatie tussen acute en chronische aandoeningen. Onder zorgverleners werd de behandelversterkende (t(125) = -3.655, p < .001) en de behandel-vervangende (t(121) = -8.724, p < .001) placebotoepassing meer geaccepteerd voor chronische aandoeningen. Tot slot bleek dat er een significant verschil was tussen de acceptatie aan het begin en aan het eind van de vragenlijst bij zowel ouders als zorgverleners (t(19) = -2.949, p = .004; t(120) = -4.534, p < .001). Als er een vorm van misleiding gebruikt wordt bij de placebotoepassingen kan dit samengaan met een lagere acceptatie terwijl meer informatie over concrete placebotoepassingen samengaat met een hogere acceptatie van het inzetten ervan in de ziekenhuiszorg voor kinderen.Show less
Placebo applications could be a positive addition next to regular treatment in the pediatric health care. Previous studies have mainly focused on placebo applications as a replacement of regular...Show morePlacebo applications could be a positive addition next to regular treatment in the pediatric health care. Previous studies have mainly focused on placebo applications as a replacement of regular treatment and focus on adults despite the promising results for using placebo effects in pediatric care. Pediatric health care professionals and parents’ knowledge and opinions about the use of placebo applications could be related to placebo use in pediatric healthcare. To examine differences in and associations between placebo knowledge and expected effectiveness of potential placebo applications between healthcare professions and parents, an online questionnaire was used in 150 pediatric health care professionals and 28 parents of children who have undergone a medical procedure or treatment in the past year. Professionals had more knowledge about placebo effects than parents (t(176 =3.146, p =.002), and a higher expected effectivity, (t(147)=3.59, p<.001) of placebo effects than parents. More knowledge about placebo effects was associated with higher expected effectivity in both groups, which did not significantly differ between the two groups (z=1.79, p=.073, r(127)=.18, p=.047 (professionals), r(18)=.57, p=.009 (parents). The current study showed that knowledge and opinions on placebo effects are lower in parents than healthcare professions but are related in both groups. Future research could examine whether educating pediatric healthcare professionals and parents on placebo effects in child healthcare leads to more favorable opinions about placebo applications in pediatric care, allowing a larger use of non-invasive optimization strategies within child healthcare.Show less
Placebo-toepassingen in de pediatrie zijn schaars onderzocht en de kijk daarop vanuit zorgverleners is een belangrijke invalshoek. In deze studie is onderzocht welke kenmerken van placebo...Show morePlacebo-toepassingen in de pediatrie zijn schaars onderzocht en de kijk daarop vanuit zorgverleners is een belangrijke invalshoek. In deze studie is onderzocht welke kenmerken van placebo-toepassingen (behandelversterkend/behandelvervangend), het ziektebeeld (acuut/chronisch, oncologisch/cardiologisch/migraine), het kind (leeftijd en sekse) en de zorgverlener (kennis en gebruik van placebo-toepassingen) samenhangen met de acceptatie door drie typen zorgverleners (artsen/verpleegkundigen/medisch psychologen) van placebo-toepassingen in de medische pediatrische zorg. Een online vragenlijst is afgenomen onder 62 pediatrisch zorgverleners. De placebo-kennis van de zorgverleners was groot (M = 6.31; SD = 0.71), met een hogere kennis bij artsen dan verpleegkundigen (p = .04). De typen zorgverleners verschilden niet (p-waarden ≥ .07) in hun gemiddeld hoge acceptabiliteit (M = 8.23; SD = 1.09) en gebruik (M = 7.42; SD = 1.77) van behandelversterkende placebo-toepassingen. Bij een relatief laag gemiddeld gebruik van behandelvervangende placebo-toepassingen (M =2.23; SD = 2.63) gebruikten psychologen dit meer dan artsen (p = .04). Voor geen van de zorgverleners hing placebo-kennis en gebruik van placebo-toepassingen samen met acceptabiliteit (p-waarden ≥ .11). Behandelversterkende placebo-toepassingen werden voor alle ziekte- en kindkenmerken acceptabeler gevonden dan behandelvervangende placebo-toepassingen (p-waardes < .001). Placebo-toepassingen werden als acceptabeler gezien voor chronische versus acute patiënten (p < .001), migraine versus oncologische/cardiologische aandoening (p < .001) en meisjes versus jongens (p = .01). Concluderend laten deze voorlopige data in een kleine steekproef zorgverleners zien dat het type placebo-toepassing en ziekte- en kindkenmerken een verschil kunnen maken in acceptabiliteit. In vervolgonderzoek zou de redenatie van de zorgverleners achter dit verschil in acceptabiliteit kunnen worden onderzocht.Show less
Alopecia Areata (AA) is an autoimmune disease affecting the hair follicles resulting in irregular hair loss. The severity and unpredictability of the condition could lead to feelings of...Show moreAlopecia Areata (AA) is an autoimmune disease affecting the hair follicles resulting in irregular hair loss. The severity and unpredictability of the condition could lead to feelings of helplessness and lack of control, resulting in a decreasing quality of life. Until now no disease-specific psychological interventions exist for patients with AA. Therefore this study looked into potential contributing factors that could be implemented to improve the disease-specific quality of life of patients with AA. A questionnaire on demographic and disease-related factors was sent to Dutch Alopecia Association members. A total of 271 participants were placed in one of four subgroups based on their combination of high vs low objective and subjective AA severity; all subgroups contained ≥ 37 participants. Results showed that diseasespecific quality of life was highest in patients with a mild subjective AA condition, regardless the objective severity of the condition. Potential contributing factors related to a lower disease-specific quality of life for patients with AA were more stigmatization, fear of negative evaluation, and helplessness, and less acceptance; no major differences in contributing factors between the subgroups were found. This study signifies the importance of subjective over objective disease severity related to disease-specific quality of life in patients with AA. More research is needed on the causal relationship between disease-specific quality of life and these factors. Nevertheless, the results of this study suggest that subjective severity of AA, stigmatization, helplessness, fear of negative evaluation, and acceptance could be considered as potential contributing factors to disease-specific quality of life.Show less
The aim of the present study was to explore how directional cues (arrows appearing next to the picture of food), the healthiness of the food items and the selfesteem of the participants influence...Show moreThe aim of the present study was to explore how directional cues (arrows appearing next to the picture of food), the healthiness of the food items and the selfesteem of the participants influence the choice of food items. In order to find out the role of these factors, we recruited participants through the crowdsourcing website Amazon Mechanical Turk. The participants completed a series of tasks: rating the desirability of food items, choosing between food items, and filling out questionnaires. The data were analyzed relying on Repeated Measures ANOVA and Pearson correlations, using SPSS, and on Bayesfactor analysis, using JASP. The most important positive finding is that there is an interaction effect between the factors of healthiness and cue, indicating that if the food is healthy then cues have a significant positive impact on choice. The degree of self-esteem and the healthiness of food (processed or unprocessed) are unrelated to food choice. The relevance of cues under certain conditions is a factor that health campaigns should take into consideration.Show less
