Objective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH)...Show moreObjective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH). Secondary, it was aimed to identify the role of clinical characteristics in the effectiveness of the rehabilitation program. Methods. A longitudinal pilot intervention study was performed, with measurements before the start (T0), after three months (T1), and after six months (T2). Cognition was measured with the Montreal Cognitive Assessment, participation with the Impact on Participation and Autonomy questionnaire, and coping with the Utrecht Proactive Coping Competence Scale. Generalized Estimating Equation analyses were performed. Results. A total of 19 patients with SAH participated; 13 in the intervention group and 6 in the control group. For the intervention group, cognition improved between T0 and T2 and between T1 and T2. Participation declined between T0 and T1, but improved between T1 and T2. Proactive coping declined between T0 and T2 and between T1 and T2. Cognition of the control group did not change, but participation improved between T0 and T1 and proactive coping declined between T0 and T1. There was no significant difference between the control and intervention groups in improvements in cognition between T0 and T1 (p = 0.090). However, there was a significant difference between the control and intervention groups in changes in participation between T0 and T1 (p = 0.001) and in changes in coping between T0 and T1 (p < 0.001). The location of SAH played a role in the differences in participation, but not in cognition and coping. For treatment type and time since SAH, no significant effects were found. Conclusion. There was no effect of the rehabilitation program on cognition. The control group had a better participation level after three months and the intervention group worsened. The intervention group had a stable coping style after three months, whereas the control group declined in the use of proactive coping. Only the characteristic location of the aneurysm played a role in the participation level after three months, but not in cognition or coping. The other characteristics did not play a role in the changes. This study indicates that some long-term complaints can improve after the rehabilitation program, but more research is needed.Show less
Background: Studies on Selective Mutism (SM) often focused on young children rather than on adolescents. Emotion regulation difficulties likely play a role in the fear of speaking among children...Show moreBackground: Studies on Selective Mutism (SM) often focused on young children rather than on adolescents. Emotion regulation difficulties likely play a role in the fear of speaking among children with SM. Emotion regulation has been investigated in children and adolescents with anxiety disorders, but knowledge about emotion regulation among adolescents with SM is scarce. To fill this gap, the current mixed-methods study examined which emotion regulation strategies adolescents with SM use in anxiety-provoking situations. First, differences between adolescents with and without SM in the use of adaptive, maladaptive and external emotion regulation strategies were examined. Subsequently, it was investigated whether the use of emotion regulation strategies was related to and predicted SM symptoms in adolescents with SM. In addition, this study investigated in an exploratory qualitative way, which emotion regulation strategies adolescents themselves and parents of adolescents with SM reported in online focus groups. Methods: 33 adolescents with SM (SM-group) and 44 healthy adolescents (control group) were compared using the FEEL-KJ questionnaire on their use of different emotion regulation strategies. 79 parents filled in the Selective Mutism Questionnaire (SMQ) to confirm the SM diagnosis and to measure the severity of SM symptoms. Results: Adolescents with SM significantly used adaptive strategies less often and maladaptive strategies more often, compared to healthy adolescents. The adolescents with or without SM did not significantly differ from each other on external regulation strategies. In contrast, adaptive, maladaptive and external emotion regulation strategies did not relate to or predict the extent of SM symptoms in adolescents with SM. Quotes from the chat- and focus groups suggested that adolescents with SM use adaptive, maladaptive and external emotion regulation strategies, whereby withdrawal after freezing can be seen as an effective useful strategy for adolescents with SM. Conclusions: The results indicate emotion dysregulation among adolescents with SM. Limitations and strengths and suggestions of implications for treatment of adolescents with SM were discussed.Show less
Social anxiety disorder (SAD) is a prevalent disorder in adolescents. It manifests itself in avoidance of social situations, difficulties forming relationships and an overall increased impairment...Show moreSocial anxiety disorder (SAD) is a prevalent disorder in adolescents. It manifests itself in avoidance of social situations, difficulties forming relationships and an overall increased impairment in social functioning. In adulthood, individuals with SAD report an overall poorer quality of life. Intolerance of uncertainty (IU) and coping strategies have been associated with SAD in recent literature. However, information on this subject is scarce in adolescents. This study investigates the relationship between IU and traits of social anxiety (SA) in adolescents, incorporating age as a moderating variable and adaptive and maladaptive coping strategies as a mediating variable. Data on SA traits, IU and coping strategies was collected within a larger study from a non-clinical sample using questionnaires. This study included 233 participants (Mage = 18.6, SD = 3.3) of which 81% were female. Results of this study show a positive relationship between IU and SA traits. This positive relationship weakens with age during adolescence. Additionally, maladaptive coping strategies mediate the relationship between SA and IU, strengthening this relationship. These findings indicate IU, age and coping are important factors to be considered in relation to the development and maintenance of SAD. Future research should continue on this subject to provide additional practical implications for the prevention and treatment of SADShow less
Background: Quality of life (QoL) is an important aspect of disease management in patients with dementia. Yet, little is known about this from a patient’s perspective. The aim of this study is to...Show moreBackground: Quality of life (QoL) is an important aspect of disease management in patients with dementia. Yet, little is known about this from a patient’s perspective. The aim of this study is to gain insight in the QoL and instrumental activities of daily living (IADL) in patients with (early onset) dementia and to examine the possible relationships with openness to discuss concerns (ODC), perceived social support (PSS) and problem-focused coping. The main hypothesis tested if more ODC, PSS and a problem-focused coping strategy were related to higher QoL and IADL. Methods: We studied patients visiting the Amsterdam Alzheimer center for a screening-day, who consented to research in the ADC cohort. Of 206 patients visiting the clinic, 162 patients (35-82 years, M = 63.59, 63,6% male) completed an 88-item self-reported questionnaire. Patients were categorized by their cognitive diagnosis (SCD = 42 , AD = 48, other dementia = 33, psychiatric disorder = 20 or other neurological disorder = 19). Correlations and multiple linear regressions were performed to assess the relationships between QoL, IADL, and the social factors. In addition, we performed a linear regression to track down group differences. Tests with a p < .05 after correction for multiple testing using a False Discovery Rate (FDR), were considered significant. Results: The distribution of the QoL scores was widespread (range 0-96) with a low median (50). Correlations showed that both PSS (r = .41, p = 5.5×10-6), ODC (r = .17, p = .02) and problem-focused coping (r = .19, p =.02) correlated with higher QoL scores. For IADL (median = 15.3) this was, only true for the ODC (r = .22, p = .01). There were no differences found between patient groups. Conclusion: This study indicates that PSS, ODC and problem focused coping are related to higher QoL in patients with (early onset) dementia. There were no group differences, but the average QoL score was lower than expected. Improving patients’ psychosocial factors has the potential to optimize QoL in patients visiting a tertiary memory clinic.Show less
Although Social Anxiety is well-understood, the neural mechanisms behind this phenomenon are still under debate. Recent research suggests that Frontal Midline Theta power level expression seems...Show moreAlthough Social Anxiety is well-understood, the neural mechanisms behind this phenomenon are still under debate. Recent research suggests that Frontal Midline Theta power level expression seems indicative of the emotional processing of social evaluative feedback. However, it is still unclear what pattern this FM-theta expression follows in Socially Anxious individuals. The FM-theta power responses to social evaluative feedback in Rejection Sensitive people is not investigated thoroughly yet, although recent research points to a clear increase in FM-theta power in responses to unexpected rejection. In the current study, utilizing a social evaluative learning task, we tested whether the construct Rejection Sensitivity could influence the relationship between social anxiety and FM theta power expression in 12 female participants. Social feedback was provided by peers who provided positive social feedback in fixed numbers, creating Peer 1 who would provide positive social feedback in 85% of trials and Peer 4, who would provide positive social feedback in 15% of trials. We also examined which coping mechanisms are utilized more often in both Socially Anxious and Rejection Sensitive population (e.g. self-blaming, other blaming, catastrophizing, rumination, acceptance, refocusing, positive reappraisal, putting into perspective). Correlation analyses revealed a strong negative correlation between Rejection Sensitivity and FM-theta level expression in unexpected rejection by Peer 1, whereby lower FM-theta levels were associated with higher Rejection Sensitivity. A large, positive and significant correlation between receiving unexpected rejection and unexpected acceptance by Peer 4 was observed. Unfortunately, the main question about the influence of Rejection Sensitivity on the relationship between Social Anxiety and FM-theta power as a response to social evaluative feedback, could not be answered due to methodological issues related to a small sample size. These issues also led the analysis of coping mechanisms to be invalid and therefore no results are indicative as to which coping mechanisms are utilized more often. Finally, FM-theta band activity seems to be a servicing as a reactive error correcting mechanism, which might lead to clear responses in Rejection Sensitive people, but not necessary in Socially Anxious individuals, who suffer more from anticipating fears. Therefore, it seems somewhat unsure whether FM theta is completely suitable for the investigation of emotional processing within Socially Anxious people. It is advised for future studies to include a larger sample.Show less
This thesis seeks to explore the relation between psychological coping mechanisms and moral responsibility. It argues that there are three essential conditions guiding this relation: in order to be...Show moreThis thesis seeks to explore the relation between psychological coping mechanisms and moral responsibility. It argues that there are three essential conditions guiding this relation: in order to be morally responsible individuals must (1) be aware of a moral demand, (2) be aware of the morally relevant state of affairs, and (3) must to some degree have the physical and motivational ability to act upon this awareness. In specific, the view that motivational ability is an important factor in thinking about moral responsibility is defended in this thesis. Only by taking motivational ability into account, can we think about morality in a way that is both sufficiently realistic, while also satisfactorily idealistic.Show less
Master thesis | Theology and Religious Studies (Master)
open access
Comparing the effects of rehabilitation for drug and alcohol addiction from both religion-based and non-religion-based rehabilitation programs, specifically concerning relapse rates. The focus...Show moreComparing the effects of rehabilitation for drug and alcohol addiction from both religion-based and non-religion-based rehabilitation programs, specifically concerning relapse rates. The focus of religion-based programs will be Christian and all programs will be from the United States of America. Surrounding this is the “war on drugs” culture President Nixon waged in the 1970s and which has not been won yet; if anything, it has worsened in the last few decades. Concurrently, the laws regarding drug abuse have become harsher. The relationship between religion and health is fundamental to the discussion, and five specific relationships as defined by Hood, Hill, and Spilka will be applied to three selected studies. Hood et al’s relationships portray the core concepts of “self-control,” “coping,” and “emotion regulation” which are needed to deal with addiction and which rehabilitation is designed to provide tools to help with. The studies will cover a spectrum of religious rehabilitation, non-religious rehabilitation, and the “grey area” between. Pertinent questions for analysing these studies will be outlined and the results and their implications will be compared before ideas for further research are given.Show less
This study attempted to investigate the influence of frustration tolerance on the coping strategies of boys with disruptive behavior disorders (DBD). The participants were recruited in regular and...Show moreThis study attempted to investigate the influence of frustration tolerance on the coping strategies of boys with disruptive behavior disorders (DBD). The participants were recruited in regular and special primary schools in the Netherlands. Forty-one children with DBD were compared with a control group of thirty-eight children. The frustration tolerance is measured by using the 'Amsterdamse Neuropsychologische Taken; Delay Frustration' (ANT-DF). The coping strategy is measured by using questionnaires. To determine the emotion regulation, the 'Cognitive Emotion Regulation Questionnaire' (CERQ) is used. The coping strategies are analyzed by using the 'Behavioral Anger Response Questionnaire' (BARQ). Results show that boys with DBD do not differ in frustration tolerance compare to the control group. The effect of negative feedback results in more frustration for both groups. There is a difference between the DBD and control group in using the strategies 'avoidance' and 'diffusion'. Boys with DBD use less often these strategies compared with the control group. In addition, they do not avoid the stress situation but seek more often confrontation. Also, they focus on their anger. The DBD group is split into boys with a low frustration tolerance and boys with a high frustration tolerance because there was no difference between the DBD group and the control group. Of all strategies, DBD boys with a low frustration tolerance only use less often an avoidance coping strategy compared with the control group. Based on this study, it can be concluded that boys with DBD use other coping strategies compared with the control group. Specially boys with a low frustration tolerance, avoid stress situations less often and seek confrontation.Show less
