The occurrence of traumatic experiences in early life is associated with increased vulnerability to psychiatric disorders. The objective of this study is to integrate childhood trauma (CT) and...Show moreThe occurrence of traumatic experiences in early life is associated with increased vulnerability to psychiatric disorders. The objective of this study is to integrate childhood trauma (CT) and emotional eating (EE) with anxiety to show how implementing tailored treatment in standard therapy benefits overall health. This study is the first of its kind to investigate these variables. Three research questions are explored, all using regression analysis: first, is there an association between CT and EE in healthy controls (no diagnosis of anxiety or depression) and with diagnosed anxiety, second, what role does anxiety play in EE and what is the moderating effect of anxiety on CT and EE. The third investigates the five subtypes of childhood trauma (emotional, sexual, physical abuse, emotional and physical neglect) and its association with EE. The population was taken from the Netherlands Study of Depression and Anxiety (NESDA), a total of 1391 participants were included with either a lifetime diagnosed anxiety disorder or healthy controls. There was a significant positive association between CT and EE when controlled for anxiety. EE was higher in participants with an anxiety disorder relative to controls. Emotional abuse had the strongest association with EE, physical abuse had no significant association. The findings provide evidence that risk groups with childhood trauma and emotional eating would benefit from tailored interventions such as mindfulness, emotional regulation and dialectal behaviour therapy. Future research is recommended to investigate factors such as gender and depression to understand the extent of symptomology and ensure successful treatment.Show less
Background. The prevalence of metabolic syndrome is high in patients with depression or anxiety, which might explain the higher risk of cardiovascular mortality in this population. Symptoms of...Show moreBackground. The prevalence of metabolic syndrome is high in patients with depression or anxiety, which might explain the higher risk of cardiovascular mortality in this population. Symptoms of affective disorders can lead to changes in eating behaviors. However, poor diet quality seems implicated in underlying pathology of behavioral health disorders and could be a risk factor for developing depression and anxiety disorders. Objective. We aim to investigate the association between diet quality and metabolic syndrome in participants with and without anxiety and depressive disorders. Psychotropic medication, symptom severity, and lifestyle factors (i.e. physical activity, smoking, and alcohol use) are investigated as potential moderators. Methods. In the Netherlands Study of Depression and Anxiety (NESDA), the Mediterranean diet, the metabolic syndrome, physical activity, smoking, alcohol use, severity of symptoms, and medication were assessed among participants with depressive (n = 110), anxiety (n = 149), remitted disorders (n = 761), comorbid disorders (n = 110), and healthy controls (n = 295), in a cross-sectional design. Follow-up data from NESDA wave six is used, nine years after baseline measurement. Results. Participants (n = 1425) were on average 52.4 years old (SD = 13.13) of which 65.2% female. The association between diet quality and metabolic syndrome was the strongest for individuals with current depression (β = -.23 (CI: -.42 ; -.08); t = -2.87; p = .005), comorbid disorders (β = -.20 (CI: -.36 ; -.02); t = -2.22; p = .029), and remitted disorders (β = -.12 (CI: -.19 ; -.06); t = -3.85; p < .001). The association between diet quality and metabolic syndrome was not moderated by medication, symptom severity and lifestyle factors. Limitations. Results cannot be generalized to other cultures and the use of self-report scales could lead to a misclassification bias. Due to the cross-sectional design, it is impossible to provide evidence for temporal or causal relations. Conclusion. Low adherence to the Mediterranean diet is associated with a high score on metabolic syndrome for patients experiencing depression, comorbid depression and anxiety or remitted depression or anxiety. This association is not moderated by medication, symptom severity and lifestyle factors.Show less
Anxiety disorders are highly prevalent in young children, underscoring the need for early prevention. To prevent anxiety disorders in young behaviourally inhibited children a parent-focused...Show moreAnxiety disorders are highly prevalent in young children, underscoring the need for early prevention. To prevent anxiety disorders in young behaviourally inhibited children a parent-focused prevention program called ‘Cool Little Kids’ has been developed. Previous research indicated that both parental engagement and parental anxiety can influence the effectiveness of such programs. Yet, research on the interplay between these factors is limited. Therefore, we investigated the mediating effect of engagement on the relationship between parental anxiety and the effectiveness of ‘Cool Little Kids’. The current study is part of the CLK research project performed by Leiden University. Participants were parents of behaviourally inhibited children between the ages of two and six (N = 42). Parents were interviewed before and after the training about the anxiety of the child, completed a questionnaire about their own anxiety, and were observed during the training to assess parental engagement. Mediation analyses were performed to investigate our hypotheses. No significant meditating effects between parental anxiety, parental engagement and the reduction of the child’s anxiety were found. However, results indicated that parental anxiety had a negative effect on the reduction of the child’s social anxiety. This suggests that CLK should possibly be adapted towards anxious parents of socially anxious children. Furthermore, parental engagement positively influenced the reduction of the child’s separation anxiety. This could be explained by the more central role of parents in separation anxiety but can also suggest that CLK is more suitable for reducing separation anxiety symptoms compared to symptoms of specific phobias and social anxiety and therefore needs adaptation. These results should be handled with care because the current study had several limitations, like a small sample, no control group and many analyses were performed without correction. So, extensive research is necessary to confirm our findings. In conclusion, our findings suggest that in general, parental anxiety and parental engagement do not influence the reduction of the child’s anxiety after CLK. Prevention programs such as CLK are essential to prevent anxiety disorders from occurring and therefore research is needed to improve the effectiveness of these programs.Show less
Background: The present study aimed to examine the interconnections between chronotype, sleep quality, alcohol consumption and mental health, and the role of sex (male and female) on these...Show moreBackground: The present study aimed to examine the interconnections between chronotype, sleep quality, alcohol consumption and mental health, and the role of sex (male and female) on these connections. Previous studies have shown that evening chronotype is connected to poorer sleep quality, higher alcohol consumption and worse mental health. Yet, there is limited research on the interactions between all these variables and on the role of sex differences. The current study hypothesized the mediating role of alcohol between sleep and mental health, and the moderating role of sex and mental health. Methods: Quantitative data of a big participant sample (N=2165) from the Netherlands Study of Depression and Anxiety (NESDA) was used. Participants derived from various settings and represented both healthy and clinical groups. Self-report measures were used, and mediation and moderation analyses were performed to test the hypotheses. Results: Alcohol was not found to mediate the relationship between sleep and mental health. Sex differences were found in anxiety and alcohol consumption, with women scoring higher in both. Sex also acted as a moderator between sleep quality and depression, and sleep quality and anxiety. Mental health status was found to affect chronotype and sleep quality, with healthy individuals being morning chronotypes more frequently and reporting higher sleep quality. Conclusions: The results of the current study contribute to our understanding of the interactions between sleep, alcohol and mental health, underlining the role of sex and mental health. This knowledge can be used in designing more personalized and multidimensional treatments, improving the quality of psychological care.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 study investigates the effectiveness of the 'i-Sleep & BioClock' digital cognitive-behavioral therapy intervention in reducing insomnia severity and anxiety symptoms among university...Show moreThis study investigates the effectiveness of the 'i-Sleep & BioClock' digital cognitive-behavioral therapy intervention in reducing insomnia severity and anxiety symptoms among university students with self-reported sleep problems. Utilizing a Single-Arm Open Pilot Trial design, 216 participants from Dutch universities, aged ≥ 16 years were included. Participants followed the intervention over five weeks and 64 participants answered the post-test questionnaire in week 7. Standardized questionnaires assessed insomnia severity (Insomnia Severity Index), anxiety symptoms (Generalized Anxiety Disorder 7-item scale), and chronotype (Munich Chronotype Questionnaire) at baseline and post-intervention. Results indicate significant reductions in insomnia severity and anxiety symptoms from baseline to post-intervention, with large and small to moderate effect sizes, respectively. Although the moderating role of chronotype was nonsignificant, findings suggest that individuals with intermediate chronotypes experienced the most significant change in insomnia symptoms. Limitations include the absence of a control group and a notable dropout rate. This study underscores the promising efficacy of digital interventions for addressing sleep and anxiety issues among university students, advocating for further research to optimize intervention strategies and enhance treatment outcomes.Show less
Het Cool Little Kids (CLK) programma is een oudergericht interventieprogramma met als doel om angst en geïnhibeerd gedrag te verminderen bij jonge kinderen. Wanneer de ouders echter angstig van...Show moreHet Cool Little Kids (CLK) programma is een oudergericht interventieprogramma met als doel om angst en geïnhibeerd gedrag te verminderen bij jonge kinderen. Wanneer de ouders echter angstig van aard zijn, zou dit de effectiviteit van de interventie negatief kunnen beïnvloeden. Tot op heden beschrijft onderzoek echter tegenstrijdige resultaten, verzameld bij vooral oudere kinderen. De doelstelling van het hier gepresenteerde onderzoek was om (i) middels een paired samples T-toets te onderzoeken of de angstvermindering bij kinderen in de interventiegroep (n = 54) groter was dan die van de controlegroep (n = 38) en (ii) middels een moderatie-analyse te onderzoeken of de angst bij de ouder als moderator optreedt voor het verschil in angst bij de kinderen in de interventiegroep bij de voor- en nameting. Het verschil in angst bij het kind werd gemeten als verschilscore op de Preschool Anxiety Scale-Revised (PAS-R) en angst bij de ouder werd gemeten met de Spielberger State-Trait Anxiety Inventory (STAI). De resultaten ondersteunen de eerste hypothese (p = .033), maar niet de tweede (p = .436). In conclusie bleek het CLK programma effectief te zijn voor angstvermindering bij jonge, geïnhibeerde kinderen en lijkt een hogere angst bij de ouder geen negatieve invloed te hebben op deze effectiviteit. De resultaten worden besproken in relatie tot de huidige literatuur, limitaties van het onderzoek en maatschappelijke implicatiesShow less
Anxiety, a global health-related burden, is associated with preferential processing of threat, which is referred to as attention bias. Such bias is thought to be due to heightened attentional...Show moreAnxiety, a global health-related burden, is associated with preferential processing of threat, which is referred to as attention bias. Such bias is thought to be due to heightened attentional engagement to threat and/or difficulties in disengagement from threat, it can be altered through Attention Bias Modification (ABM) Training. Unfortunately, the predominantly used task in ABM training shows low effectiveness. Thus, this study aims to develop a new task that trains threat disengagement using a visual search task with emotionally valent faces. Thirty-four participants took part in an online experiment and completed a Go/ No-go-like Visual Search task designed to train disengagement from negative stimuli. Reaction time and accuracy were measured to examine the effect of the task while trait anxiety scores were gathered to examine the relationship between anxiety and attention bias. The results revealed no significant differences in threat disengagement as a function of training and no correlation between trait anxiety scores and threat disengagement. These findings may be attributable to the small sample size used or to the participants showing a lack of attention bias even before training commenced. Despite the study’s null findings, suggestions on how to improve the paradigm are presented and discussed to guide future studies to come up with an effective ABM training task.Show less
This thesis research investigates the indirect relationship between role conflict and sleep quality. It is investigated whether anxiety complaints have a mediating effect, and whether burnout has a...Show moreThis thesis research investigates the indirect relationship between role conflict and sleep quality. It is investigated whether anxiety complaints have a mediating effect, and whether burnout has a moderating effect. An association has been found in the literature for the relationship between role conflict and anxiety symptoms, as well as for anxiety symptoms and reduced sleep quality. In addition, it turned out that burnout has an effect on these three variables. Four online questionnaires were used for this study, which were completed over a period of three weeks. The results of this study showed no significant indirect effect, also burnout was not a significant moderator. However, a non-significant association was found between decreased sleep quality and role conflict. It is recommended that more research be done on this in the futureShow less
Aim: In view of the serious negative consequences that shyness and anxious behavior can entail on children's quality of life, namely higher risks for internalizing problems, relationship...Show moreAim: In view of the serious negative consequences that shyness and anxious behavior can entail on children's quality of life, namely higher risks for internalizing problems, relationship difficulties, peer rejection and victimization, school adjustment issues, and poor academic success, we explored possible predictors. It was investigated whether parental stress, sleep disturbances, and physical activity predict shy behavior in five-year-old children. Methods: The study was based on the collected data from “The Cool Little Kids” project in collaboration with the "Jij en Je Gezondheid" study from the “Gemeentelijke Gezondheitsdiensten”. The survey had a cross-sectional design with a sample size of 4855 (51.66% girls), with a mean age of 5.1 (SD: 0.5, range from 4 to 7). The data was collected in the regions Amsterdam and Groningen in the years 2021 and 2022 through parental report questionnaires about the well-being of the children. Results: The study outcome supports the positive correlation of parental stress, sleep disturbances, and physical inactivity with shyness. However, the effect sizes of the model and the individual predictors are small. Conclusion: The obtained results underline the impact of parental stress and child habits on shyness. For an improved quality of life for children in their early and forthcoming life stages, the current focus on social anxiety disorders deserves an even shift to factors favoring shyness. This paper might serve as a guideline regarding the factors to be addressed considering future research and intervention programs for shy and anxious children.Show less
Research master thesis | Psychology (research) (MSc)
closed access
Observing emotions in others’ facial expressions is an important factor guiding social interaction. Observing others’ emotions elicits physiological arousal in the observer, which is reflected in...Show moreObserving emotions in others’ facial expressions is an important factor guiding social interaction. Observing others’ emotions elicits physiological arousal in the observer, which is reflected in increased pupil diameter (i.e., pupil dilation). The current study used pupil dilation as an index of physiological arousal to explore children’s responses to emotional facial expressions. More specifically, we investigated whether maternal symptoms of depression and/or anxiety were related to offspring’s pupil responses to negative (versus positive) facial displays irrespective of the child’s symptomology. A community sample of 87 mother- (M = 42.30, SD = 5.60, range = 27-57) child (M = 10.11, SD = 1.32, range = 7.2-12.9) dyads participated in the current study. Mothers and offspring reported on their depressive and anxiety symptoms via self-report questionnaires. Children’s pupil responses to angry, fearful, sad, and happy dynamic facial displays were measured during the dynamic emotions task using eye-tracking. Results revealed that maternal depressive symptoms were not related to child pupil responses to negative (versus positive) faces. Higher levels of maternal anxiety, however, were linked to stronger child pupil responses to fearful and sad faces than to happy faces. In turn, child pupil responses to angry (versus happy) faces did not statistically differ as a function of maternal anxiety. These findings persisted after accounting for the link between child anxiety symptoms and child pupil responses. Therefore, the way typically developing children react to negative versus positive emotional faces in later childhood appears to be related to maternal levels of anxiety, but not to maternal levels of depression. This points to the importance of exploring maternal anxiety symptoms as a potential risk factor for the development of negativity biases in offspring across the general population.Show less
The COVID-19 pandemic has affected everyone’s life since its outbreak, with the lockdown having a negative reputation on mental health. This study examined mental health levels of undergraduate...Show moreThe COVID-19 pandemic has affected everyone’s life since its outbreak, with the lockdown having a negative reputation on mental health. This study examined mental health levels of undergraduate students during and one year after the lockdown, with the expectation that they would experience more mental health problems. Mood and anxiety problems were assessed through an online questionnaire in two collection waves. The first wave was conducted between September and October 2020, after the first lockdown. The participants were reassessed one year later. The sample consisted of N = 478 undergraduates (mean age = 22,3; 55,6% female). A binary logistic regression revealed that during the lockdown, half of the students (50,8%) reported that the COVID-19 crisis had impacted their mood in a negative way. One year after the lockdown fewer students reported that the COVID-19 crisis had negatively impacted their mood (41,3%), F (1, 205) = 17.91, p < .001. Less than half of the students (38,9%) reported that the COVID-19 crisis had impacted their anxiety levels. One year after the lockdown 25,6% reported that the coronavirus had negatively impacted their anxiety levels, F (1, 206) = 7.49, p = .007. Previous mental health problems were associated with mood and anxiety problems in both waves. In contrast to preregistered hypotheses, experiencing mood and anxiety problems during the COVID-19 lockdown did not predict having more mood and anxiety problems one year after the COVID-19 lockdown. Undergraduate students were found to be largely resilient to the effects of lockdown measures on mental health.Show less
Background: Previous studies have shown that parental bonding (PB) is directly and in interaction with stressful events linked to mental health outcomes. Sexism affects many young women and is...Show moreBackground: Previous studies have shown that parental bonding (PB) is directly and in interaction with stressful events linked to mental health outcomes. Sexism affects many young women and is often associated with psychopathology. This research aimed to further investigate the relation between PB, sexual discrimination and mental health outcomes. Non-optimal maternal and paternal bonding styles and higher frequency of sexual discrimination were expected to be related to greater depressive and anxiety-related symptoms. Furthermore, PB was examined as a moderator on the sexism-symptomatology (depression and anxiety) links. Methods: In a cross-sectional study design, female university students (N = 186) self-reported perceived PB, sexist events, and symptoms of depression and anxiety. Results: Regression analyses revealed that compared to optimal PB, both maternal and paternal affectionless control and neglectful parenting significantly predicted depressive symptoms, whereas symptoms of anxiety were only significantly higher in paternal affectionless control profiles. Frequent sexual discrimination significantly predicted greater depression and anxiety symptomatology, and paternal but not maternal bonding moderated these relations. Non-optimal paternal bonding strengthened the relationships of sexism with symptoms of depression and anxiety, while for optimal paternal bonding, no significant link between sexism and depression was present. Conclusion: The findings indicate direct associations of both non-optimal PB and sexual discrimination with symptoms of depression and anxiety, and provide preliminary evidence that the sexism-symptomatology link might be more pronounced in non-optimal than optimal paternal bonding profiles. This study highlights the centrality of positive father-daughter relationships and sets implications for future research, parenting practices and intervention programs.Show less
Nineteenth-century London expanded tremendously due to British imperialism. The Britons were acquinted with new cultures and religions. Besides the benefits of the forming of London as metropolis,...Show moreNineteenth-century London expanded tremendously due to British imperialism. The Britons were acquinted with new cultures and religions. Besides the benefits of the forming of London as metropolis, the citizens experienced new anxieties. Urbanisation from immigrants led to xenophobia. The use of alcohol and opium rose and the city became even more divided wealth wise. Stevenson, Wilde and Stoker explore these Victorian anxiety.Show less
Research master thesis | Literary Studies (research) (MA)
open access
This research incorporates my analyses, based on close-readings, of cultural representations of the posthuman, each of which embodies different anxieties and power-relations. I depart from the...Show moreThis research incorporates my analyses, based on close-readings, of cultural representations of the posthuman, each of which embodies different anxieties and power-relations. I depart from the assumption that there are three dominant anxieties represented here: the fear of disembodiment; the fear of a loss of human uniqueness; and a fear of totalitarian control in relation to technology’s dehumanizing potential. By close-reading Mamoru Oshii’s Ghost in the Shell (1995) I address issues concerning the representation of the female cyborg as disembodied. Philip K. Dick’s Do Android’s Dream of Electric Sheep? (1968) and the novel’s adaptation into Ridley Scott’s film Blade Runner (1982) are analysed as challenging ideas about human nature and human uniqueness as based on more affective notions such as empathy. The analysis of the game We Happy Few (Compulsion Games, 2016) focuses on how the game thematises concerns about the dehumanizing potential of technologies in relation to notions of control and state-regulation. The aim of this research is to achieve a better understanding of the social and economic influences that shape different representations of humans and posthumans, and to demonstrate how definitions of what it means to be human are produced and represented in order to conceal their inherent fabricated, artificial character. I will demonstrate that fears and anxieties surrounding potential dystopic outcomes of human enhancement are all informed by (a fear of the loss of) power and control, and ideas of inequality and potential social disruption already present in society today.Show less
