A high number (55-59%) of people with multiple sclerosis (MS) lose their job due to complex interactions between disease related factors, the working environment, job demands and personal factors....Show moreA high number (55-59%) of people with multiple sclerosis (MS) lose their job due to complex interactions between disease related factors, the working environment, job demands and personal factors. Identifying factors that will help provide a sustainable and healthy working life is essential. Our aim was to examine the association between cognitive fatigue and work functioning. The study included 225 individuals with relapsing-remitting MS in paid employment (>12 hours a week) (75.6 % female, median age: 42.5 years, median EDSS: 2.0). Five multiple regression analyses were conducted while accounting for known correlates (age, gender, education, duration of disease, MSrelated disability, job type) to examine the relationship between both subjective and objective measures of cognitive fatigue and work functioning in employees with MS. Secondly, a correlation analysis was conducted to examine the relationship between objective and subjective cognitive fatigue. Subjective cognitive fatigue is obtained by self-report questionnaires (Visual Analogue Scale (VAS)/Modified Fatigue Impact Scale (MFIS)) and objective cognitive fatigue is obtained by using a neuropsychological test, the Paced Auditory Serial Addition Test (PASAT). The outcome variables are (1) current work ability compared to lifetime's best measured by the Work Ability Index (WAI) and (2) work functioning measured by the 4 subscales of the Work Role Functioning Questionnaire-2 (WRFQ-2). No association was found between objective cognitive fatigue and work functioning. An explanation could be that objective and subjective measures are often only weakly correlated with each other. A lower subjective cognitive fatigue (MFIS: β = -.18, p = .041; VAS: β = -.39, p = < .001) was associated with better work ability. No association was found between subjective cognitive fatigue and the 4 subscales of the WRFQ-2 measuring work functioning. Lastly, no association was found between objective cognitive fatigue and subjective cognitive fatigue. In conclusion, subjective cognitive fatigue was associated with self-reported work ability in persons with relapsing-remitting MS with mild disability, while objective cognitive fatigue was not associated with self-reported work functioning. Further research should focus on objective measures of work functioning and other objective measures of cognitive fatigue.Show less
Introduction: Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders and has a major genetic heterogeneity. Comparing monogenetic causes of ASD can contribute to...Show moreIntroduction: Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders and has a major genetic heterogeneity. Comparing monogenetic causes of ASD can contribute to understanding its genetic aetiology. This study compares patients with fragile X syndrome (FXS) to patients with tuberous sclerosis complex (TSC) in terms of ASD severity and symptomatology to create an image of their ASD symptom profiles. This could lead to more focused diagnoses and specialized treatment for these patient groups. Methods: This study included children and adolescents (ages 1–18, mean age = 9.01 years) with FXS (n = 57, 80.7% males) or TSC (n = 105, 49.5% males). The second editions of the Autism Diagnostic Observation Scale and the Social Responsiveness Scale were used to assess ASD symptomatology. First, the prevalence of official ASD diagnoses among FXS and TSC patients was compared. Next, patients with an official diagnosis were compared in terms of (1) overall autism severity, (2) severity of problems within the restricted and repetitive behaviour (RRB) and social affect domains, and (3) more specific ASD symptoms such as ‘reciprocal communication’. Intelligence quotient (IQ; mean IQ = 58.08) was included as a predictor in the logistic regression and as a covariate in both between-group analyses of covariance and all multivariate analyses of covariance. Results: FXS patients are more likely to receive an official ASD diagnosis (χ2 = 4.081, p = .043). Higher IQ is related to less autism symptomatology (χ2 = 8.592, p = .003). Overall, ASD severity of patients with an official ASD diagnosis does not differ between the patient groups. The FXS patients with ASD exhibited more severe RRB (F = 8.21, p = .005). No significant difference was found for social affect or any specific symptoms. Conclusion: ASD prevalence is higher in children with FXS than in children with TSC, with FXS patients exhibiting more severe RRB. This study illustrates the relevance of comparing symptomatology in monogenetic causes of ASD, indicating that syndrome-symptom relationships can be found. This could lead to earlier intervention and focused treatment for these patients and contributes to research on the genetic aetiology of ASD.Show less
Background. Multiple sclerosis (MS) is a degenerative disease affecting the central nervous system. Symptoms include fatigue, worsening mobility, and cognitive impairment. Unemployment is common in...Show moreBackground. Multiple sclerosis (MS) is a degenerative disease affecting the central nervous system. Symptoms include fatigue, worsening mobility, and cognitive impairment. Unemployment is common in the MS-community. Within 10 years of disease onset 50-80% of MS-patients will be unemployed. Absenteeism often precedes unemployment. Work absenteeism has been associated with several physical and psychological factors in MS, such as fatigue, and use of maladaptive coping styles. Our aim is to investigate both fatigue and maladaptive coping as possible predictors for work absenteeism. To our knowledge coping and fatigue have not been investigated together with respect to work absenteeism in MS-patients. It is important to study absenteeism to prevent future unemployment as much as possible. Method. We investigated 269 employed MS-patients (age 21-63, Mage = 42.09, SDage = 9.39, 77.3% female) of which 47 had been absent within the last seven days. Participants completed questionnaires regarding fatigue (checklist for individual strength), coping style (coping inventory for stressful situations), and work absenteeism. We conducted three logistic regression analyses in which absenteeism was the dependent variable. Fatigue was investigated with subjective fatigue, motivation, concentration, and physical activity as predictors. Coping style was investigated with task-oriented, emotion-oriented, and avoidant coping as predictors. The last analysis investigated both fatigue and coping as predictors for absenteeism with all previous predictors mentioned. Results. A model in which multidimensional aspects of fatigue predict absenteeism was significant (X2(4) = 30.46, p < .001), fatigue, concentration, and physical activity were significant predictors of absenteeism (Bfatigue = 0.04, p = .036; Bconcentration = 0.07, p = .011, Bphysical_activity = -0.03, p = .032 respectively).Show less
Intergenerational research shows that children of parents with a mood disorder are at increased risk of developing a mood disorder themselves. Both risk as well as protective factors are believed...Show moreIntergenerational research shows that children of parents with a mood disorder are at increased risk of developing a mood disorder themselves. Both risk as well as protective factors are believed to influence the onset of the development of a mood disorder. Coping is believed to be a factor that is of importance when studying this. However, little is known about the mechanisms of coping strategies in this population. The objective of this study was to examine the associations between neuroticism and intelligence on the one hand and coping strategies on the other hand. Neuroticism is linked with higher emotional reactivity to stress and is therefore expected to influence coping. Additionally, the degree of problem-solving abilities which are of importance for adequately coping with stress, is a relevant element of intelligence. Therefore, relationships between neuroticism and intelligence and coping are expected to be found in the population under study. A total of 109 children of parents with a mood disorder who were between 13 and 25 years of age (mean: 19.24 ± 4.02, 69 females (58,7%)) were included in this study. Data of the Utrecht Coping List for Adolescents (UCL-A), the neuroticism items of the Big Five Inventory short form (BFI-xs) and subtests vocabulary and matrix reasoning from the Wechsler Intelligence Scale for Children-V (WISC-V) and Wechsler Adult Intelligence Scale IV (WAIS-IV) were used in the analyses. Seven multiple regression analyses were performed with each subscale of the UCL-A as outcome variable and neuroticism and intelligence as predictors, with age and sex as control variables. To correct for multiple testing a Bonferroni corrected p-value of .007 was used. The results of this study showed significant associations between neuroticism and active tackling (β = -.423, p <.001), passive response pattern (β =.716, p <.001), and reassuring thoughts (β = -.383, p <.001). Higher levels of neuroticism were related to less active tackling behavior and having fewer comforting thoughts in a stressful situation. Additionally, neuroticism was related to the use of more passive behavior during stress. No relations were found between estimated intelligence and coping. These findings highlight the relevance of a single personality feature in predicting some coping strategies in individuals at risk of developing a mood disorder. Prevention and intervention programs should focus on psychoeducation about mood disorders and coping and on tackling maladaptive coping strategies to bend these into adaptive strategies with the use of tips to correctly apply these strategies. For future research emotion regulation and emotional intelligence should be studied in relation to coping in at-risk offspring.Show less
Providing behavioral treatment via online interventions allows greater ease of access and less stigma for migraineurs. However, online interventions for migraineurs are limited. Therefore, the aim...Show moreProviding behavioral treatment via online interventions allows greater ease of access and less stigma for migraineurs. However, online interventions for migraineurs are limited. Therefore, the aim of this study was to investigate the within person effects and outcomes of an online behavioral intervention. A single-case AB quasi-experimental design was utilized. Three Dutch-speaking participants, above the age of 18 with chronic migraines according to the ICHD3-beta, were recruited and allocated to care as usual and the intervention. Several questionnaires were completed: before the intervention (baseline), post-intervention (T2), six weeks after T2 (T3), and again three months after T2 (T4). Participants kept a headache diary daily before baseline and between baseline and T2 (intervention) to assess migraine frequency, severity, and duration. Ratings on these questionnaires were analyzed for clinically significant improvement (showing 30% improvement and 0.5 SD change using the normative sample SD) from baseline across time points. Improvement after intervention as compared to baseline was seen in pain, coping, physical and mental quality of life, locus of control, self-efficacy, migraine-related interference and distress, and illness cognitions for at least two participants. Migraine frequency, severity, and duration during baseline and intervention were analyzed using visual inspection, nonoverlap of all pairs (NAP), and Tau-U calculations. None of the NAP results were significant, however Tau-U results showed significant trend differences. Migraine frequency significantly increased for two participants (Tau-U = .67, p < .001; Tau U = .91, p < .001). Migraine severity significantly decreased for one participant (Tau-U = -.55, p = .01), but significantly increased for another participant (Tau-U = .98, p < .001). Migraine duration significantly decreased for one participant (Tau-U = -.49, p = .04), but significantly increased for another participant (Tau-U = .70, p < .001). No significant changes in migraine frequency, severity, nor duration were seen for one of the participants. While the methodological limitations of the current study made the results less valid, the results showed promise. Therefore, future studies could utilize a randomized control trial design to test feasibility and effectiveness of the intervention further and make it possible to generalize results to the greater patient population.Show less
Recent pension policy reforms in the Netherlands have resulted in the delayed retirement of older workers. Researchers are concerned that this increase in the retirement age will have a detrimental...Show moreRecent pension policy reforms in the Netherlands have resulted in the delayed retirement of older workers. Researchers are concerned that this increase in the retirement age will have a detrimental impact on the health of retirees. In light of this, it has become increasingly important to identify organisational strategies that both increase the longevity of employees and safeguard their post-retirement health. Flexible work arrangements are a potential HR policy that could achieve this. This study used data collected as part of the first and second wave of the Netherlands Interdisciplinary Demographic Pension Panel Survey. Out of 5312 total participants, 2421 retirees were included in this study (m=61, female= 45.9%). We used a conditional change regression analysis to examine the effect of perceived access to work-place flexibility, work-time flexibility and phased retirement during the work tenure on the change in pre- and post-retirement self-perceived health. We interpreted the results as the change effects on pre-retirement self-perceived health Wave 1 to post-retirement self-perceived health Wave 2. We defined effect size according to Cohen’s d (small= 0.2, medium=.05, and large= .08). Scores were coded in the current study so that a higher value indicated a better health status. Our results indicated that phased retirement was associated with a small positive effect on the change in pre- to post-retirement self-perceived health (Cohen’s d = .1719739, t(2456) = 2.08, p < .025). We did not find any evidence to suggest that work-time flexibility (Cohen’s d = -.0507841, t(2456) = -0.18, p < .05) or work-place flexibility (Cohen’s d =.0049062, t(2456) = 0.11 , p < .05) had a significant effect on the change in pre- to post-retirement self-perceived health. Future research should develop a more multilevel understanding of age-related HR policy by examining the impact of organisational climate. We recommend corporations looking to adapt to their ageing workforce should encourage flexible work arrangements that promote a smooth transition into retirement.Show less
Background: Previous studies found that patients with anorexia nervosa (AN) perform worse on executive functioning (EF) compared to healthy controls (HC’s). EF plays an important role in the...Show moreBackground: Previous studies found that patients with anorexia nervosa (AN) perform worse on executive functioning (EF) compared to healthy controls (HC’s). EF plays an important role in the regulation of behaviour in daily life. EF impairment can therefore lead to problems with functioning in daily life. Aims: The aim of this study was to investigate whether there is a difference between AN patients and HC’s in EF. In addition, it was investigated whether there is a correlation between EF, eating habits and BMI-SDS. The final aim of this study was to investigate whether EF improves in patients with AN after a one-year follow-up. In each case, the total EF scores and the scores on the 12 subscales of EF were examined. Methods: The study population consisted of 126 girls aged 12-22 years (M= 18.42; SD=2.35), 57 girls belonged to the AN group and 69 to the HC group (M age AN=17.98; M age HC= 18.84). The participants completed the Behaviour Rating Inventory of Executive Function (BRIEF), the Eating Disorder Examination (EDE) and the Body Mass Index (BMI) was calculated for the baseline measurements and for the follow-up one year later. Several independent-samples t-tests, linear regression analyses and a linear mixed model analysis were performed as analyses for the results. Results: No differences were found between the AN group and the HC’s with regard to total score of EF, but the AN group did show significantly lower flexibility (p< .001), emotion regulation (p< .001) and taking initiative (p= .001) compared to the HC. However, the AN group did report significantly more orderliness and neatness (p< .001) than the HC. BMI-SDS and eating habits were not associated with the total score of EF, even after adjusting for the confounders depression and age of onset. The subscales taking initiative (p= .029, inhibition (p= .006) and working memory (p= .010) turned out to be negatively associated with BMI-SDS and eating habits. Finally, there appeared to be no significant change in the total score of EF between the baseline measurement and the follow-up after one year for patients with AN. No significant change was found for the subscales either. Conclusion: AN patients showed impairment on certain subscales of EF, but the overall EF score was not different from the HC’s. The impairment found in subscales of EF did not change from baseline measurement after one year of follow-up. However, the participants in this study were all diagnosed with AN less than a year ago. Further research with a longer follow-up time is needed to find out whether this conclusion is the same for patients with chronic AN or patients who have recovered.Show less
Studies using event-related potential (ERP) suggests that the hippocampus, a medial temporal lobe (MTL) structure, can distinguish new and old stimuli. However, it remains unclear whether age...Show moreStudies using event-related potential (ERP) suggests that the hippocampus, a medial temporal lobe (MTL) structure, can distinguish new and old stimuli. However, it remains unclear whether age deficits in MTL processes contribute to age deficits in novelty processing. The present study aimed to investigate this knowledge gap and to confirm previous findings reported by Schomaker et al. (2021) regarding the role of the MTL in novelty detection and later processing. Twenty-one patients with epilepsy with unilateral MTL resection and twenty-four matched healthy controls performed an adapted visual novelty oddball task, with two streams of stimuli presented left and right of a fixation cross, while their electroencephalogram (EEG) was recorded. The participants had to respond to infrequent target stimuli while ignoring standard and novel stimuli. Novelty detection, indexed by the N2, was reduced by MTL resections, shown by a smaller N2 for patients compared to healthy controls. Novelty processing, indexed by the P3, was not reduced in patients, shown by a larger P3 for patients compared to healthy controls. However, this might be due to collapsing of data in the patient group, since resection side was outside the scope of this study. Target processing, indexed by the P3b, was unaffected by MTL resections: no differences were found between patients and healthy controls. These results suggest that MTL structures, including the hippocampus and the amygdala, play a role in novelty processing. In contrast, MTL structures do not play a role in target processing since this was unaffected by MTL resections.Show less
Objective: Cancer-related fatigue is defined as a persistent, subjective sense of tiredness related to cancer and cancer treatment that interferes with usual functioning. In addition to confirming...Show moreObjective: Cancer-related fatigue is defined as a persistent, subjective sense of tiredness related to cancer and cancer treatment that interferes with usual functioning. In addition to confirming the well-known presence of fatigue in patients with low-grade glioma (LGG), this study investigated whether patients suffered from cognitive impairment, and whether this cognitive impairment was related to the experienced fatigue. Method: Due to the exploratory nature of this study many outcome measures were investigated in order to map the possible factors related to experienced levels of fatigue. We therefore chose to perform descriptive statistical analyses. Fatigue and different subscales of fatigue (mental fatigue, physical fatigue, decreased motivation, decreased activity and general fatigue) were measured with the self-report Multidimensional Fatigue Inventory. In order to measure neuropsychological functioning all patients completed a battery of standardized neuropsychological tests selected to cover a broad range of cognitive functions, including attention and concentration, executive functioning, and memory. Mann-Whitney tests were used to compare severely fatigued patients to non-severely fatigued patients in order to analyse whether their performance on neuropsychological testing differed. In addition, we also examined whether severely fatigued patients differed from non-severely fatigued patients in characteristics, time post diagnosis, tumor location and treatment. These analyses were only performed for mental and physical fatigue. Results: Thirty-one adult patients (mean age, 44 years; 21 males [68%]) with a confirmed LGG and a mean time post diagnosis of 2.5 years were included in this study. Severe mental fatigue prevalence rates were reported by 17/31 (55%) patients, whereas 9/31 (29%) patients reported severe physical fatigue. Sixteen percent of the patients reported both severe mental and physical fatigue. Cognitive impairments (t-score < 40) were predominantly observed in the domain of attention and concentration (21.9%), and to a lesser extent in the domains of memory (15.8%) and executive functioning (10.3%). Significant differences (p < .05) between severely mental fatigued patients and non-severely mental fatigued patients were found on 4/14 (29%) cognitive tests. Concerning the physical fatigued patients and non-severely physical fatigued patients, significant differences (p < .05) were found on 2/14 (14%) cognitive tests. Conclusion: Our data demonstrated that LGG patients showed high levels of experienced fatigue, especially in the domain of mental fatigue, when compared to healthy individuals, which might partially be explained by impairment in cognitive functions, which where predominantly observed in the domain of attention and concentration. Additional research is needed to identify what other factors might cause increased levels of experienced fatigue in patients with LGG.Show less
Aim: This study aimed to determine whether qualitative assessment of the verbal fluency test could help in differentiating between the behavioral subtype of frontotemporal dementia (bvFTD) and the...Show moreAim: This study aimed to determine whether qualitative assessment of the verbal fluency test could help in differentiating between the behavioral subtype of frontotemporal dementia (bvFTD) and the three primary progressive aphasia variants, semantic (svPPA), non-fluent (nfvPPA) and logopenic (lvPPA). We examined differences in clustering of words, switching between strategies, lexical frequency, age of acquisition, neighborhood density and word length. Method: Patients diagnosed with bvFTD (N = 51) or PPA (27 svPPA, 25 nfvPPA, and 34 lvPPA) and a control group (N = 25) performed a semantic and letter fluency task. Clustering and switching were assessed by two independent raters. Lexical frequency, age of acquisition, neighborhood density and word length were derived from existing databases. Between-group differences were examined and diagnostic performance was assessed. Lastly, associations with memory, language, processing speed and executive functioning were examined. Results: Patients with bvFTD produced more words on semantic fluency, more clusters and larger total cluster size compared to svPPA. svPPA patients produced words with higher lexical frequency and lower age of acquisition on letter fluency compared to all groups. nfvPPA patients produced fewer words on letter fluency compared to svPPA patients, but had larger cluster sizes. lvPPA patients produced shorter words with a higher neighborhood density on letter fluency compared to bvFTD patients. The qualitative measures were successful in discriminating bvFTD patients from PPA patients and svPPA patients from lvPPA patietns and nfvPPA patients. Distinction between nfvPPA patients and lvPPA patients was significant only after adding total number of words. Lexical frequency, age of acquisition, neighborhood density and word length were positively related to language and semantic fluency. Conclusion: The differences found on the qualitative variables are in line with what is known about the type of impairments in each subtype of FTD. Our findings show the wealth of information that can be obtained from the verbal fluency test and its usefulness in discriminating between subtypes of FTD. Qualitative variables alone are insufficient in discriminating between lvPPA and nfvPPA, however together with the quantative measures differentiation is possible. This highlights the usefulness of extensive analysis of the verbal fluency test.Show less
Background and aims: Psychotic disorders (PD) are often accompanied by substance (ab)use. Recent studies demonstrated a connection between these conditions through a common neurocognitive...Show moreBackground and aims: Psychotic disorders (PD) are often accompanied by substance (ab)use. Recent studies demonstrated a connection between these conditions through a common neurocognitive dysfunction. This common dysfunction concerns the executive functions (EF). Through this way it affects both cognitive control and mechanisms of motivation/reward. An EF dysfunction is a core feature of both PD and substance (ab)use. Moreover, it is found to be present prior to the onset of both conditions. It is suggested that this common EF dysfunction highlights a vulnerability for comorbidity. Hence, this study investigated whether a common neurocognitive dysfunction is associated to the co-morbidity of substance (ab)use and PD. Investigating EF in co-morbidity is especially relevant for theories of aetiology, prevention and treatment. First, we examined whether poor EF predicts an increase in substance use in PD patients. Second, we examined whether poor EF, combined with substance use, predicts an increase in substance dependency. Methods: This crosssectional study included 90 patients diagnosed with PD (18-65 years). Data were obtained through self-report questionnaires that measured EF, substance use and -dependency. Three multiple linear regression analyses were calculated to evaluate whether EF scores predicted substance use; three moderated binary logistic regression analyses were calculated to evaluate whether EF scores, moderated by substance use, predicted substance dependency. Findings: Results showed that Initiative deficits predicted substance use (p=.01). Deficits of Emotional regulation (p=.04) and Working memory (p=.03), moderated by substance use, predicted a decrease of dependency. Conclusions: Our results partially confirmed that poor EF predicted substance use and -dependency in PD. It did not lend sufficient support for the idea that the co-morbidity of substance (ab)use and PD is associated with a common EF dysfunction. Nevertheless, results demonstrated a relation between EF and substance (ab)use, namely that PD patients use substances as a means of self-medication in order to cope with an EF dysfunction. It can be concluded that this self-medicative behaviour promotes the development of co-morbid substance (ab)use in PD. This study offers new insights into the selfmedication hypothesis. It demonstrated that, besides psychotic symptoms, an EF dysfunction induces self-medicative substance use in PD. Clinical implications may concern prevention techniques and treatment methods.Show less
Background: The cognitive and neuropsychiatric deficits present in patients with the behavioral variant of Frontotemporal dementia (bvFTD) impacts their functionality in the activities of daily...Show moreBackground: The cognitive and neuropsychiatric deficits present in patients with the behavioral variant of Frontotemporal dementia (bvFTD) impacts their functionality in the activities of daily living (ADLs). These activities are divided into advanced, instrumental, and basic domains, which begin to be undermined throughout the dementia progression. The detection of the cognitive and behavioral factors involved in the functional impairment of each ADLs domain is crucial for the implementation of suitable treatments. Methods: A retrospective cross-sectional study was conducted with 27 patients with bvFTD in its early stage (< 2 years of evolution) and 32 healthy controls. A neuropsychological assessment was carried out wherein measures of cognitive function, neuropsychiatric symptoms, and functionality were obtained. The informant- report Technology-Activities of daily living questionnaire was used to assess the percentage of functional impairment on advanced, instrumental, and basic ADLs. Therefore, higher percentages imply worse performance on ADL. To identify the best determinants for each ADLs domain, three separate standard multiple regression analyses were performed, considering each functional impairment as the dependent variable and executive function, social cognition, disinhibition, and apathy as independent variables. Results: For the basic ADLs, a model that explains 28.2% of the variability was found, in which apathy (β = 0.33, p = .02) and disinhibition (β = 0.29, p = .04) were significant predictors of functional impairment. Concerning instrumental ADLs, the model produced accounted for 58.8% of the functional variability, with apathy (β = 0.70, p < .001) and executive function (β = -0.30, p = .04) as the main contributors. Finally, in terms of advanced ADLs, the model found explains 52.9% of variance, wherein only apathy was a significant predictor (β = 0.69, p < .001). Furthermore, social cognition deficits did not show an influence on functional performance Conclusion: The results of this study show the strong influence of neuropsychiatric features such as apathy and disinhibition with the functional impairment of patients with bvFTD in its early stage. Apathy is the primary determinant of functioning for all the ADLs domains. These results could guide the planning of tailored interventions and quality of life improvement.Show less
