Attention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) are often co-morbid, and their prevalence is increased in the student...Show moreAttention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) are often co-morbid, and their prevalence is increased in the student population. The dynamics between self-regulation problems and ADHD, MDD, and GAD may reveal insights into the co-occurrence of the three disorders. The present study focused on psychological factors that support or threaten successful self-regulation. Using cross-sectional data, a network analysis was performed based on a sample of 902 students currently enrolled in higher education programs in the Netherlands. The analysis featured 17 commonly studied risk and protective factors associated with all three disorders. The network showed that irritability and impairments in daily functioning were shared problems between ADHD, MDD, and GAD. The network further suggested that impaired cognition and a propensity for procrastination are shared features of ADHD and MDD. ADHD and GAD did not share a direct relationship, diverging from previous assumptions. The findings highlight that the relationship between the disorders may depend on shared vulnerabilities and outcomes that act as bridges in the network. The study illustrates that psychological constructs need to be more clearly defined to move forward when researching co-morbidity beyond the level of symptoms.Show less
Research into Adverse Life Events (ALE) is rarely focused on students. ALE are a common experience among students and may have significant effects on mental health outcomes such as depression,...Show moreResearch into Adverse Life Events (ALE) is rarely focused on students. ALE are a common experience among students and may have significant effects on mental health outcomes such as depression, anxiety, stress, and lifetime depression. In this study we use multiple measures for ALE, which assess several types of ALE, including life trauma, childhood trauma, bullying, childhood adversities and negative life experiences. These outcomes are measured by the PHQ-9, GAD-7, PSS-10 and the LIDAS. This study investigated the relationships between ALE and these mental health outcomes, together with the predictive role of childhood trauma, negative life experiences, being bullied and childhood adversities by using multiple regression. In addition, we explored the role of gender as a control variable and conducted an exploratory network analysis. A multicohort study provided data from a sample of 449 Dutch higher education students who completed self-report measures of mental health outcomes and ALE experiences. The results showed that negative life events are significant predictors for all four mental health outcomes. Childhood trauma predicted depression, lifetime depression and stress, and life trauma were predictive of depression. Overall, these findings were supported by network analysis. They suggest that negative life events may be more impactful to current mental health than life trauma, and that both can have a lasting impact on the mental health of students. The implications and alternative explanations for these findings are discussed, together with suggestions for future research.Show less
The relationship between social media use and depression has been extensively studied but the current empirical evidence remains inconclusive. The present study aimed to explore how user specific...Show moreThe relationship between social media use and depression has been extensively studied but the current empirical evidence remains inconclusive. The present study aimed to explore how user specific characteristics, such as neuroticism, extraversion, and gender, are interconnected with social media use and symptoms of depression in a group-level cross-sectional network based on a student sample of young adults (18 to 30 years old). Participants (N = 430) filled in an online questionnaire measuring symptoms of depression, loneliness, social media use, neuroticism, extraversion, and stress. Regularized partial correlation networks were estimated to produce an aggregate network, and separate networks for men and women. The male and female network (n = 66 each) were compared in terms of structure and overall connectivity. Results showed that symptoms of depression and social media use were sparsely connected and if so, weakly positively related, but the relationship was not directly affected by either neuroticism or extraversion. No statistical differences were found between the male and female network. In sum, we found no evidence for personality and gender affecting the relationship between symptoms of depression and social media use. Future research could use temporal networks to discover potential causal relationships, specifically focusing on idiographic networks to reveal individual differences that would otherwise remain obscured.Show less
Research master thesis | Psychology (research) (MSc)
open access
Individuals with a lower socioeconomic status (SES) are at an increased risk for developing depressive symptoms. However, it has not been investigated whether this link is homogenous, or whether...Show moreIndividuals with a lower socioeconomic status (SES) are at an increased risk for developing depressive symptoms. However, it has not been investigated whether this link is homogenous, or whether specific depressive symptoms relate to SES differentially. In this thesis, I explored (1) which individual symptoms of depression are related to subjective social status (as a proxy for SES); (2) how specific indicators of SES are related to specific symptoms of depression; and (3) how the addition of stressors impacts the relations between SES indicators and depressive symptoms. I used data previously gathered from 448 students aged ≥18 at institutions of higher education in the Netherlands, as a part of the WARN-D study. Variables were assessed through a questionnaire that was administered online. I estimated three regularised partial correlation networks to explore shared variances among nine symptoms of depression, five indicators of SES, and seven stressors. The network analyses revealed that (1) subjective social status (as a proxy for SES) was negatively associated with guilt/worthlessness, depressed mood, anhedonia, trouble concentrating, and feeling tired, meaning that participants with higher scores on subjective social status had, on average, lower scores on these symptoms; (2) educational level (as one of multiple indicators of SES) was negatively associated with appetite disturbances, and the ability to get by financially was negatively associated with depressed mood, guilt/worthlessness, and appetite disturbances; (3) these associations diminished considerably or disappeared altogether when controlling for the stressor variables. Overall, all SES-depression associations were small in magnitude. The results suggest that patterns of depressive symptoms might differ between high-SES and low-SES individuals. Future research should explore the mechanisms behind these differences to guide prevention and intervention. My findings are consistent with previous research showing that symptom composite scores obscure important differences between individuals.Show less
Each year, roughly one in two children between the ages of 2 and 17 experience some type of childhood adversity (CA). Multiple studies have researched the relationship between CAs and a large set...Show moreEach year, roughly one in two children between the ages of 2 and 17 experience some type of childhood adversity (CA). Multiple studies have researched the relationship between CAs and a large set of mental disorders. However, less research has been done into the relationship between CAs and personality traits, even though links between life events and personality development are well established. In the current exploratory, cross-sectional study (N = 442), using a mixed-gender (N = 442) and female (N = 354) subset, it will be examined whether there are relations between personality traits, between CAs, between personality traits and CAs, and if there are differences between a mixed-gender and a female subset network. Participants are students enrolled at Dutch educational institutions between the ages of 18 and 53. Personality traits and CAs are measured with the Big Five Inventory-10 (BFI-10) and Big Five Inventory-44 (BFI-44), questionnaires adapted from the Caring Universities survey, and the Childhood Trauma Screener (CTQ), respectively. Subsequently, these questionnaires are analyzed using correlational and network analyses in SPSS and JASP, respectively. Overall, almost all CAs co-occur. Furthermore, higher neuroticism scores co-occurred with more sexual abuse and emotional neglect, and vice versa. In contrast, no relation was found between emotional abuse and personality traits. Finally, the association of personality traits and CAs are not stronger in the female subset network than in the mixed-gender network. Future research should use a more representative student sample, with longitudinal design, and evenly distributed gender subsets, to ensure generalizability and causality.Show less
Bullying is a phenomenon that is widespread in schools and workplace but is also occurring online in the form of cyberbullying. Previous studies have indicated that bullying is negatively related...Show moreBullying is a phenomenon that is widespread in schools and workplace but is also occurring online in the form of cyberbullying. Previous studies have indicated that bullying is negatively related to social support and self-esteem. Social support and self-esteem thus constitute protective factors in the relation to bullying. Further, it was expected that bullying will be positively related to the negative mental health outcomes loneliness, depression, anxiety, and suicidal ideation. To investigate the relations between bullying and social support, self-esteem, loneliness, depression, anxiety, and suicidal ideation the present study used the network approach to integrate all the variables and visualize their relations. The data was taken from the WARN-D project, where 453 participants aged between 18 and 53 (M = 22.7, SD = 4) filled out questionnaires about various mental health aspects including the seven variables used in the present study. Results show that the hypothesized positive relationships between bullying and mental health outcomes are present in the network. The same holds for the negative relationships between bullying and the protective factors. In conclusion, the present study provides an important framework for theory development and further use of the network approach in the field of bullying.Show less
In recent years suicidal behavior has become more prevalent among students, especially in cases of depression. The Interpersonal Theory of Suicide has suggested that feelings of thwarted...Show moreIn recent years suicidal behavior has become more prevalent among students, especially in cases of depression. The Interpersonal Theory of Suicide has suggested that feelings of thwarted belongingness and burdensomeness can precede suicidal ideation. Both concepts are rooted deeply in the social world and research suggests that social support may alleviate these feelings offering a promising avenue of research for suicide prevention. The current study aims to explore the relationship between social support and suicidal ideation in the context of depressive symptoms among students by using a network analysis. A network of 11 nodes was computed using a Gaussian Graphical model. Nodes represented depressive symptoms (suicide ideation, low energy, sleep problems, weight/appetite changes, psychomotor changes, concentration problems, guilt, sadness and loneliness), perceived social support and objective social support. Participants (N = 453) were recruited as part of the WARN-D program and suicide ideation, level of social support and depressive symptoms were assessed using various questionnaires. Contrary to our expectation, no relationship was found between suicide ideation and social support or loneliness. Loneliness emerged as the most central node in the network. Guilt was found to have the most connections with other variables in the network. Further research is needed to clarify the role social support can play in preventing suicide ideation and in depression in general.Show less
Obsessive-compulsive disorder (OCD) commonly co-occurs with other psychiatric conditions. In recent years, network analysis has been employed to investigate the relationship between OCD and some of...Show moreObsessive-compulsive disorder (OCD) commonly co-occurs with other psychiatric conditions. In recent years, network analysis has been employed to investigate the relationship between OCD and some of its comorbidities. The objective of the current thesis was to explore the comorbidity network of OCD in relation to seven other psychiatric conditions, some of whose interactions with OCD have not been investigated by the former network analysis papers. The thesis made use of an open-source data which was collected from patients who registered to the Behavioural Health Partial (BHP) hospital program at McLean Hospital, Massachusetts between 30 November 2018–16 October 2019. The final sample consisted of 532 people. Their responses to four measures, namely Obsessive-Compulsive and Related Disorders Dimensional Scales, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Drug Alcohol Craving Scale were analysed using network analysis. In total, we estimated two regularized partial correlation networks. The first network consisted of eight nodes representing eight psychiatric conditions. Differing from the former network in one way, the second one represented OCD and depression at a symptom level. Network 1 showed that OCD was connected to all other obsessive-compulsive and related disorder (OCRD)’s and generalized anxiety disorder (GAD) but not to depression and drug alcohol craving. In this network, OCD was only linked to depression through other OCRD’s and GAD. Further, our results highlighted the importance of fatigue as it was one of the most central nodes in Network 2.Show less
Research master thesis | Psychology (research) (MSc)
open access
Death by suicide a global health problem, often preceded with the experience of suicidal ideation. Both depression and anxiety increase the risk of experiencing suicidal ideation. However, the...Show moreDeath by suicide a global health problem, often preceded with the experience of suicidal ideation. Both depression and anxiety increase the risk of experiencing suicidal ideation. However, the specific relations between symptoms of depression and anxiety on the one hand, and suicidal ideation on the other, remain unexplored. Therefore, we investigated these relations both at the cross-sectional (N = 2981) and the temporal level (N = 2596), with a follow-up time of 2 years. We included data from the NESDA study and controlled for the covariates age and gender. To do so, we used unregularized network models, each consisting of 21 nodes. In each network, 10 nodes represented depression items, 10 nodes represented anxiety items, and one node represented suicidal ideation. Results showed that the relation between suicidal ideation and depression was stronger than the relation between suicidal ideation and anxiety. This held true at the cross-sectional and temporal level. Overall, depression and anxiety symptoms at baseline explained about 15% of suicidal ideation at the cross-sectional level, and up to 13% at the temporal level. However, these percentages are not directly comparable, because only for the temporal analyses did we control for previous suicidal ideation. Results should be replicated and further investigated in order to be able to draw firm conclusions.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: Post-traumatic stress disorder (PTSD) has been associated with impairments across cognitive abilities. While some prior work suggests that the PTSD symptom domain of intrusion may be...Show moreBackground: Post-traumatic stress disorder (PTSD) has been associated with impairments across cognitive abilities. While some prior work suggests that the PTSD symptom domain of intrusion may be most strongly related to cognitive impairment, little is known about the relation of cognitive functioning with individual PTSD symptoms or other symptom domains, and the temporal stability of such relations. The current study addresses these questions. Methods: Data were analysed from 1,484 trauma-exposed U.S. military veterans (Mdn=65 years) who participated in the National Health and Resilience in Veterans Study (NHRVS). We estimated four regularised partial correlation networks of DSM-5 PTSD symptoms at baseline (past month or lifetime) and cognitive functioning at baseline and three-year follow-up, respectively. Network comparison tests examined temporal stability, and sensitivity analyses the robustness of the associations. Results: Across network models, difficulty concentrating and trouble experiencing positive feelings consistently showed unique negative relations to cognitive functioning. Contrary to expectations, the symptom domains of alterations in arousal and reactivity, as well as cognition and mood were more strongly linked to cognitive functioning than the other two domains. Network structures and overall strength did not significantly differ between cross-sectional and longitudinal networks. Conclusion: Overall, we highlight the importance of links between PTSD symptoms and symptom domains on the one hand, and cognitive functioning on the other—relations obfuscated by modelling only PTSD diagnosis or sum score. Given that longitudinal processes between the two constructs appear to be present, we recommend monitoring of cognitive functioning and integrating it into clinical care of PTSD.Show less
Background. Anger is experienced in various mental disorders. Based on increased mental health problems in students and the adversity of the coronavirus pandemic, (1) the relations between anger,...Show moreBackground. Anger is experienced in various mental disorders. Based on increased mental health problems in students and the adversity of the coronavirus pandemic, (1) the relations between anger, depression, anxiety, stress, and being occupied with COVID-19 were explored. As traits predict interpersonal events and states identify events under situational control, it was investigated (2) if baseline trait anger predicted average state anger during a period of self-isolation to test if anger levels were determined by general tendencies, and (3) if trait and average state anger differed within and between men and women to test if the groups were affected differently by situational factors. Methods. (1) Ecological Momentary Assessment (EMA) data was collected from 79 undergraduates from Dutch universities, with surveys prompted via smartphone four times daily for 14 days. Contemporaneous, temporal, and between-subjects networks were computed. (2) In a multiple regression analysis, average EMA state anger was regressed on trait anger while controlling for gender, age, depression, anxiety, and stress. (3) A mixed-design analysis of covariance included standardized type of anger as a within-factor and gender as a between-factor while controlling for differences in mental health. Results. (1) Contemporaneously, anger was positively associated with irritability, feeling nervous and anhedonia. Temporally, anger and irritability positively predicted each other. Anger positively predicted difficulty to relax and itself. Between-subjects, anger was positively associated with irritability and feeling nervous but negatively with being occupied with COVID-19. (2) Trait anger did not significantly predict average EMA anger, whereas the covariate stress did. (3) Despite significantly lower trait anger compared to women, men displayed significantly increased average EMA anger in relation to their trait levels. Trait and average EMA anger did not differ within women. Conclusion. EMA anger was persistently related to stress, less likely to be the source or recipient of activation compared to other constructs, not strongly linked to trait, and increased in relation to trait levels only in the male group. Differences between our healthy participants and a clinical sample encourage an investigation of anger in phase transitions towards psychopathology and its potentially adaptive effects in healthy individuals.Show less
Background: It is well established that social contact is related to mental health. Previous research has shown that the quantity and quality of social interactions are associated with the...Show moreBackground: It is well established that social contact is related to mental health. Previous research has shown that the quantity and quality of social interactions are associated with the development, course and severity of mental disorders, such as anxiety and depression. Less is known about the psychological effects of social contact during a pandemic. Method: The current study investigates the dynamic associations among offline social interactions, depression, anxiety, and stress symptoms in undergraduates from a Dutch university (N=79; 75.95% female; MAge =20.37) during the COVID-19 pandemic. Ecological Momentary Assessment (EMA) was used for the data collection. A short online questionnaire was prompted via smartphone four times a day for two consecutive weeks. Multilevel vector autoregressive models were used for the network analysis and centrality indices were calculated. Results: We found significant dynamic associations among the duration of offline social contact and depression symptoms only. The absence of pleasure was associated with less offline social interactions, and vice versa. Having nothing to look forward to was predictive of less offline social contact three hours later. Social contact scored the lowest on centrality indices in our sample. Conclusion: Altogether, we found the duration of offline social contact to be partially related to mental health during the COVID-19 pandemic. Results, strengths and limitations are discussed. Examining the dynamic associations among mental health and social contact can provide novel insights into the development and maintenance of mental health issues.Show less
