Research on suicidal ideation indicates the significant role of adverse childhood experiences (ACEs) and early parental attachment but fails to investigate risk potential in student populations....Show moreResearch on suicidal ideation indicates the significant role of adverse childhood experiences (ACEs) and early parental attachment but fails to investigate risk potential in student populations. This study aimed to research how adverse childhood experiences in a population of university students who report mood and stress problems are related to suicidal ideation and whether the relationship between adverse childhood experiences and suicidal ideation is moderated by attachment style. To target students at risk for suicidal ideation, purposive sampling was employed. An independent samples t-test with consecutive multiple regression (n= 234) showed that adverse childhood experiences, measured with the ACE questionnaire, predicted the presence and severity of suicidal ideation, measured by the BSSI. Consecutive ANCOVA showed that disorganized attachment to the mother and father, measured with the PBI, were found to predict suicidal ideation. Secure attachment was negatively associated with suicidal ideation, whereas for avoidant and anxious attachment there was no association found. A logistic regression analysis showed no moderation effect of insecure attachment styles in the relation between adverse childhood experiences and suicidal ideation. Gender, academic pressure, and nationality were controlled. Findings may be limited due to methodological and performance flaws. The results highlight the importance of early identification of adverse childhood experiences and disorganized attachment for intervention and prevention of later suicidal ideation amongst students.Show less
Victims who were involved in an accident are at risk of developing post-traumatic stress disorder (PTSD). Previous research showed that one-year PTSD, major depressive disorder (MDD), comorbid PTSD...Show moreVictims who were involved in an accident are at risk of developing post-traumatic stress disorder (PTSD). Previous research showed that one-year PTSD, major depressive disorder (MDD), comorbid PTSD-MDD symptom severity and new traumatic events are associated with long-term PTSD symptom severity. These different factors are often not included in research together and there are large differences in follow-up duration and study populations. The determination of predictors of PTSD is a prerequisite for efficient service delivery and prevention. Therefore, this study investigated the predictive value of 1-year PTSD, MDD, comorbid PTSD-MDD symptom severity and new traumatic events on 15-year PTSD symptom severity after traumatic injury. This study is a sub-project of Trauma TIPS, a prospective longitudinal cohort study. In this study n = 315 participants completed the online self-report questionnaires Impact of Event Scale - Revised (IES-R), Hospital Anxiety and Depression Scale (HADS) and Life Events Checklist for the DSM-5 (LEC-5). A multiple hierarchical regression analysis showed that higher 1-year PTSD, MDD and comorbid PTSD- MDD symptom severity significantly predicted higher 15-year PTSD symptom severity, unlike new traumatic events. These findings allow interventions to be developed to avert individual risk and may allow people with potential risk factors to be better monitored and treated in the future. This study partly replicated findings and revealed contradictions with previous research. Future research could focus on understanding the mechanism behind the association between 1-year PTSD, MDD and comorbid PTSD-MDD symptom severity and long-term PTSD symptom severity.Show less
Introduction. Longitudinal prospective studies are needed to identify risk factors for posttraumatic stress disorder (PTSD) symptoms 15 years after trauma, since cross-sectional findings do not...Show moreIntroduction. Longitudinal prospective studies are needed to identify risk factors for posttraumatic stress disorder (PTSD) symptoms 15 years after trauma, since cross-sectional findings do not inform how a possible pattern change as the clinical condition extends. Recently, thyroid hormones were in the top fifteen most relevant biochemical predictors for PTSD symptom trajectory within one year after trauma. Moreover, peritraumatic distress (PD) is highly associated with PTSD symptom severity. Nevertheless, most studies did not investigate the course of PTSD 15 years after a serious injury. This study hypothesized that higher thyroid functioning acutely after trauma, and higher PD predicted higher 15-year PTSD symptom severity, while the thyroid functioning mediated the relation between PD and 15-year PTSD symptom severity. Methods. This longitudinal prospective study examined 452 serious injury survivors. Blood samples were obtained acutely after trauma, and PD 23 days after trauma. PTSD symptom severity was assessed 15 years after trauma (M = 2.77, SD = 4.64), with the Clinician Administered PTSD Scale. Results. Multiple linear regression analyses showed that 15-year PTSD symptom severity was not predicted by the thyroid hormones and PD, and the thyroid hormones did not mediate the relation between PD and 15-year PTSD symptom severity. Discussion. Our study showed the importance of predicting 15-year PTSD symptoms, since understanding how and when these symptoms occur could be crucial for treatment and promising for risk identification at an early stage. More longitudinal studies are needed to understand why some people do, and others do not develop 15-year PTSD symptoms.Show less
Background: No valid and reliable instrument exists to assess knowledge, skills, experience and attitudes pertaining to suicide prevention (SP) among healthcare professionals (HCPs) in training....Show moreBackground: No valid and reliable instrument exists to assess knowledge, skills, experience and attitudes pertaining to suicide prevention (SP) among healthcare professionals (HCPs) in training. Aim: This study intended to develop and test the psychometric properties of the Suicide Prevention Skills Inventory (SPSI). Methods: A literature review identified seven subscales and 76 items for the SPSI. Using a cross-sectional design, data was collected in a sample of Dutch undergraduate, graduate and postgraduate healthcare students (N = 439), partaking in the online survey. An Exploratory Factor Analysis was performed on the continuous scales; inter-item, item-total and Pearson correlations were calculated for the binary scales. Cronbach’s alphas were calculated for all subscales and the overall instrument. Results: A four subscale solution (Provider Competencies, Moral Attitude, Experience Making Contact and Personal Interest in SP Skills Training) with 35 items showed the most optimal fit, with items loading >.40 on factors and good inter-item and item-total correlations. Reliability for the individual subscales and total scale ranges from good to excellent (α = .72-.90). Due to poor reliability the subscale Factual Knowledge was excluded. Discussion: The four subscale SPSI shows a stable latent structure and good reliability. However, validity of the instrument is only confirmed once results have been replicated in a new and representative sample. Future applications of the SPSI include the assessment of learning effects among HCPs in training and provide insight into the level of SP expertise of graduated HCPs starting their career in the clinical fieldShow less
Background: Early studies show promising evidence for the feasibility and effectiveness of intensive Trauma-Focused Therapy (TFT) programs for patients with Posttraumatic Stress Disorder (PTSD)....Show moreBackground: Early studies show promising evidence for the feasibility and effectiveness of intensive Trauma-Focused Therapy (TFT) programs for patients with Posttraumatic Stress Disorder (PTSD). Little is known about the most effective treatment formats with regard to the therapy dose and frequency. The current study examines the effects of the High Intensive Trauma-focused Therapy (HITT) on the feasibility, tolerability, safety, and symptom outcomes. Methods: A Pragmatic Clinical Trial (PCT) was conducted with 16 treatment-resistant patients with PTSD who failed to respond sufficiently to previous treatment. The HITT treatment consisted of two five-day inpatient programs with Eye Movement Desensitization and Reprocessing, exposure, and trauma-sensitive yoga. Primary outcome was measured with the PCL-5 at the beginning and end of both HITT-weeks (T1 to T4). Clinically Significant Changes (CSC) and Reliable Change Indexes (RCI) were calculated. Results: No patients dropped out of treatment and no symptom exacerbations or adverse effects occurred. RCI and CSC from T1 to T4 showed that four patients recovered, two patients improved, and ten patients remained unchanged after treatment. The corresponding effect size on the PCL-5 between T1 and T4 was large (Cohen’s d = 0.88). Conclusions: Results demonstrated that the HITT-program was feasible, tolerable, and safe for all treatment-resistant patients and beneficial for six of these patients. Randomized controlled trials are needed to replicate these results and study the effectiveness of this treatment to further improve TFT formats. Also, future research is necessary to early select treatment-resistant patients who benefit from treatment to develop more cost- and time-effective treatments.Show less
Background: Suicidality is precipitated by a variety of mental vulnerabilities. There has been a dearth in knowledge about the interactions between psychological variables that can jeopardise...Show moreBackground: Suicidality is precipitated by a variety of mental vulnerabilities. There has been a dearth in knowledge about the interactions between psychological variables that can jeopardise university students into becoming suicidal. Aim: By exploring these interactions cross-sectionally using network analysis, this study sought to deduce risk profiles for student suicidality from 464 university students with self-reported mood and stress problems. Methods: Suicidality and clinical risk factors such as depression, anxiety, and posttraumatic stress were assessed using 13 self-report questionnaires. Interactions between those variables were analysed via connectivity and centrality indices in 114 and 74 participants identified at high risk for suicidal thoughts and suicidal attempts, respectively. Results: Symptoms of depression, posttraumatic stress, and anxiety displayed large interconnections in either centre. Perceived burdensomeness connected heavily with suicide thoughts and subjective symptoms of depression. Study-related stressors demonstrated centrality only at risk for suicide attempts. Conclusions: Suicide prevention programs for university students may benefit from targeting critical interactions between mental vulnerabilities for suicidality. Suicidal thoughts may be influenced especially by affecting perceived burdensomeness. Changes in depression may be crucial for achieving effects on perceived burdensomeness, posttraumatic stress, and anxiety.Show less
BACKGROUND: Child maltreatment is a global health problem affecting children across the globe, that can result in serious impairments in later life, taking the form of serious psychological...Show moreBACKGROUND: Child maltreatment is a global health problem affecting children across the globe, that can result in serious impairments in later life, taking the form of serious psychological disorders or impoverished social skills. Empathy belongs to one of these fundamental skills. The current study aims to replicate previous findings that childhood maltreatment history is associated with lower empathy levels. Generally, research distinguishes between affective and cognitive empathy. Hence, this study explores possible differences in impact of child maltreatment history on cognitive versus affective empathy. METHOD: This cross-sectional design involved 218 healthy participants between 18 and 79 years of age. To assess child maltreatment, the Dutch version of the Childhood Trauma Questionnaire (CTQ) was used. The Interpersonal Reactivity Index (IRI) and the Multifaceted Empathy Test (MET) were used to assess both cognitive and affective empathy. The sample was divided into maltreated and non-maltreated participants, by applying cut-off scores, and where compared with multivariate ANOVAs on MET mean arousal level, MET total accuracy, perspective taking (PT), empathic concern (EC), fantasy (FS) and personal distress (PD). RESULTS: The present study failed to replicate previous findings of associations between child maltreatment and lowered empathy. Furthermore, a difference in impact on the two forms of empathy was not identified. However, after the exclusion of outliers, an indication was found for impaired cognitive empathy in individuals with maltreatment history. DISCUSSION: The present study shows that possible selective effects of child maltreatment on either cognitive or affective empathy may exist. Knowing how maltreatment differentially affects individuals in later adulthood, can help to optimize both prevention measures as well as treatments dealing with the consequence of child maltreatment, e.g. individual training focusing on either type of empathy. Limitations of the present study are discussed.Show less
Suicide is the second leading cause of death among university students. Insomnia symptoms have been established as a risk factor for suicidal ideation and feelings of thwarted belongingness have...Show moreSuicide is the second leading cause of death among university students. Insomnia symptoms have been established as a risk factor for suicidal ideation and feelings of thwarted belongingness have been proposed to explain the link between insomnia symptoms and suicidal ideation. The purpose of this study was to investigate the association between insomnia symptoms and suicidal ideation, with thwarted belongingness mediating the relationship, in a sample of Dutch university students. The study assessed participants crosssectionally (n = 218) and after six months (n = 83). Participants completed the Insomnia Severity Index, Beck Scale for Suicide Ideation, the Interpersonal Needs Questionnaire, Beck Depression Inventory, and the Beck Anxiety Inventory. Logistic regression and mediation analyses were conducted. Symptoms of depression and anxiety were controlled for. Crosssectionally, insomnia symptoms were significantly associated with suicidal ideation. When adjusting for symptoms of depression and anxiety, the association became nonsignificant and only symptoms of depression emerged as an independent predictor. Thwarted belongingness mediated the relationship between insomnia symptoms and suicidal ideation cross-sectionally. When depressive symptoms were controlled for, the mediation model became nonsignificant. Longitudinally, results suggested no predictive effect of insomnia symptoms on suicidal ideation and no mediation effect of thwarted belongingness on the relationship. The results did not support insomnia symptoms as an independent risk factor for suicidal ideation in university students, which underscores the need for more rigorous research to clarify this relationship for the future.Show less
Achtergrond: Professionals binnen de Geestelijke Gezondheidszorg in Nederland gebruiken Serious Games nog te weinig. Ondanks dat de effectiviteit van Serious Games gunstig blijken te zijn binnen de...Show moreAchtergrond: Professionals binnen de Geestelijke Gezondheidszorg in Nederland gebruiken Serious Games nog te weinig. Ondanks dat de effectiviteit van Serious Games gunstig blijken te zijn binnen de psychotherapie. Wat weerhoudt professionals om Serious Games in te zetten? Onderzocht werd wat de attitude was van de professionals ten opzichte van de belemmeringen voor henzelf of de cliënten in het gebruiken van Serious Games. Methode: Doormiddel van een online vragenlijst werden professionals binnen de Geestelijke Gezondheidszorg in Nederland, waarbij zij enige vorm van therapie geven aan cliënten, gevraagd naar hun attitudes omtrent Serious Games. Resultaten: Gebleken is dat bijna een kwart (23.3 procent) van de professionals Serious Games niet willen inzetten. De voornaamste reden hiervoor bleek het hebben van onvoldoende kennis in Serious Games en onvoldoende vertrouwen in de effectiviteit van Serious Games. Daarnaast weerhield het professionals om Serious Games te gebruiken voor cliënten met complexe problematieken. Conclusie/discussie: Omdat professionals aangeven te weinig kennis te hebben van Serious Games, wordt geadviseerd om trainingen te ontwerpen om professionals nog beter te informeren over het gebruik van Serious Games binnen de Geestelijke Gezondheidszorg in Nederland. Ook wordt geadviseerd nader onderzoek te doen naar de professionals met een negatieve attitude van Serious Games.Show less
Introduction: The aim of this study was to find out how to increase usage of serious games in mental healthcare through analyzing requirements for implementation of (former) patients. Methods: An...Show moreIntroduction: The aim of this study was to find out how to increase usage of serious games in mental healthcare through analyzing requirements for implementation of (former) patients. Methods: An online survey was conducted measuring (former) patients’ (n=82) attitudes towards usage of a serious game, requirements for implementation, and media usage. Attitude towards usage of a serious game groups, gender groups, and high and low frequency media usage groups were compared against each other on the requirements for implementation in categories of being necessary or not. All data was analyzed through a chi-square test in SPSS. Results: 75.6%(n=62) of the sample had a positive attitude towards the usage of a serious game. Patients with a positive attitude towards the usage of a serious game valued easy access and applicability(χ2 (1)=12.313, p<0.001), and entertainment of the game (χ2 (1)=5.22, p=.022) more than patients with a negative attitude towards the usage of a serious game. Women valued availability through insurance as significantly more necessary than men (χ2 (df(1)=5.838, p=.016). There were no differences between high and low media usage groups on their requirements for implementation. Discussion: Differences on requirements for implementation were found between genders, and patients with positive and negative attitudes towards usage of serious games. The main limitation of this study is that (former) patients were recruited through convenience sampling. Future studies should focus on experimenting whether implementing these requirements increase usage of a serious game in mental healthcare.Show less
Background: Despite increasing evidence for the effectiveness of Serious Games (SG), research and the implementation of such digital measures in mental health care lags behind. Insights into...Show moreBackground: Despite increasing evidence for the effectiveness of Serious Games (SG), research and the implementation of such digital measures in mental health care lags behind. Insights into attitudes and their influencing factors for professionals and clients of mental health care are assumed to facilitate the implementation and development of SG. Objective: This study aimed to gain a greater understanding of the attitudes of professionals and clients of mental health care towards SG and factors that influence (media usage, gaming experience) and moderate that relationship (age, gender). Method: A cross-sectional online survey with a quantitative study design was conducted with professionals (N = 166) and (former) clients of mental health care (N = 154). Two independent samples t-tests were conducted to study the influence of media usage and gaming experience on attitude towards SG, whereas four ANCOVAs were applied to examine the moderating effects of age and gender. Results: Media usage and gaming experience did not significantly influence the attitude towards SG in both samples. Also, age and gender did not significantly moderate the studied relationship. Conclusion: The factors media usage and gaming experience and the moderators age and gender do not contribute to a greater understanding of the attitude towards SG. Following these variables cannot facilitate the implementation and development of SG in mental health care. Based on the chosen sampling and measurement methods, the collected data was not considered representative of the studied population and statistical analysis were conducted with reduced power.Show less
Background: Serious games for mental health purposes is a young but rapidly growing concept, however, implementation in clinical practice lags behind. Knowing the characteristics and attitudes of...Show moreBackground: Serious games for mental health purposes is a young but rapidly growing concept, however, implementation in clinical practice lags behind. Knowing the characteristics and attitudes of the users, mental health professionals, will aid in seeking the optimal design and more efficient implementation. Objective: We wanted to gain more insight on what professionals want from the games, and if knowledge about games or practicing different therapeutic modalities is related to attitude on serious games. Method: We surveyed 123 MPHs via a cross-sectional online survey about technology usage, gaming knowledge, and attitudes towards serious games. Data were analysed using a t-test, chi-square test, exploratory factor analysis, and an ANOVA. Results: The results showed that overall interest to implement serious games with their own clients was high (75.6%), and perceived benefits outweighed perceived disadvantages, but current implementation rate was very low (.8%). The biggest reason for not wanting to use serious games was lack of knowledge (14.6%). Knowledge about gaming was significantly positively correlated to overall attitude, and with willingness to implement. There was no significant relationship between any specific therapeutic modality and the overall attitude towards serious games, which contradicts results from previous studies. Conclusion: Knowledge about games increases the attitude and willingness to try serious games with clients. Most mental health professionals reported to have beginner knowledge, thus educating them about (serious) gaming could help with implementation and adherence. More research is needed to map out why the professionals who are interested have not yet tried serious games. User-centred design (UCD) should be widely implemented when developing serious games for mental health purposes.Show less
