Background: Childhood emotional maltreatment by a primary caregiver is a key predictor for PTSD symptoms, yet limited research explores connections with specific symptoms, especially in children....Show moreBackground: Childhood emotional maltreatment by a primary caregiver is a key predictor for PTSD symptoms, yet limited research explores connections with specific symptoms, especially in children. Literature reports gender differences on emotional maltreatment and the experience of PTSD, so it is worth investigating the existence of differences when looking at separate symptoms. Objective: This study aims to investigate the correlation between childhood emotional maltreatment and PTSD symptomatology and identify gender differences in children and adolescents. Method: A sample of 237 children (mean age 15.5) with PTSD symptoms from a Dutch mental health institution (2012-2015) underwent assessment using anonymous questionnaires. Network analysis examined partial correlations between emotional abuse, neglect, intrusions, avoidance, arousal, and negative mood. Results: The network analysis showed a high correlation between emotional abuse and most PTSD symptoms. However, emotional neglect only exhibited a strong association with emotional abuse. Gender differences in how emotional maltreatment and PTSD symptoms interacted were found. Girls reported higher PTSD symptoms and emotional maltreatment than boys. Conclusions: This study highlights the important role of childhood emotional maltreatment in the development of PTSD, among children and adolescents. These results emphasize the need for the customization of PTSD treatment based on the type of maltreatment and gender.Show less
This thesis sought to investigate the relationships between treatment delays in bipolar disorder (BD) and cognitive impairments which characterize the disorder, measured both objectively and...Show moreThis thesis sought to investigate the relationships between treatment delays in bipolar disorder (BD) and cognitive impairments which characterize the disorder, measured both objectively and subjectively. Previous studies have established that a long delay occurs between the onset of mood symptoms in BD and the first form of treatment received, estimates ranging between 6 and 11 years. Cognitive impairments in the domains of executive functions, processing speed and memory were found to persist in BD patients even during euthymia. Such cognitive impairments burden BD patients, prevent them from regaining an appropriate level of general functioning and diminish their quality of life. Thus, in order to determine whether treatment delay impacts the cognitive impairments present in BD, 69 participants were followed over the course of one year, at three different time points. The participants took part in clinical interviews, and then were asked to complete multiple measures, such as the YMRS, the QIDS, four WAIS subscales (Block Design, Arithmetic, Information and Digit symbol), and the Cognition subscale of the WHODAS. The average treatment delay found in the current sample was 14.53 years. The results of the current study suggest that longer treatment delays did not significantly predict worse cognitive functioning in BD patients, either when measured subjectively, or when measured objectively.Show less
Suicidal ideation is more prevalent in people with Borderline Personality Disorder. Negative self-conscious emotions, such as shame and guilt, may be related to this relationship. In this study the...Show moreSuicidal ideation is more prevalent in people with Borderline Personality Disorder. Negative self-conscious emotions, such as shame and guilt, may be related to this relationship. In this study the relationship between suicidal ideation and borderline personality traits was explored. Shame and guilt were analysed as possible mediators. The Personality Assessment Inventory – Borderline Scale was used to assess borderline personality traits, and Ecological Momentary Assessment was used to gather data on suicidal ideation, guilt and shame four times a day, over the course of three weeks via an app. The sample consisted of (N = 82) adults with a history of a suicide attempt or moderate-to-severe suicidal ideation in the past year. The relationships were analysed using a parallel mediation model consisting of multiple multilevel regression analyses. All steps of the model showed significant relationships. The last step showed that instead of typical mediation, the model indicated suppression, because of an increase in the association between borderline personality traits and suicidal ideation when accounting for shame and guilt. More research is necessary to explore the possible cause of these findings.Show less
Social media has become a platform for sharing alcohol and other drug (AOD) recovery journeys, with #selflove as a prominent theme. This study explores the association of self- views, positive...Show moreSocial media has become a platform for sharing alcohol and other drug (AOD) recovery journeys, with #selflove as a prominent theme. This study explores the association of self- views, positive emotions, and social connections in the context of social media, particularly regarding #selflove and in AOD recovery. Specifically, social connections are examined as they are considered to be a relevant point of support during the recovery process. Positive emotions are examined, as employing a more positive outlook towards oneself is associated with a more positive self-view and a more sustained recovery process. The dataset comprises 902 posts from Instagram and Twitter in 2019 collected by Ziemer (2022). The present study addresses two research questions: (1) What is the association between positive and negative self-views in social media posts using chi-square analysis to identify a balanced self-view (discussing negative and positive self-views) during the recovery journey, (2) to what extent can positive self-view mentions be predicted through logistic regression, based on expressed connectedness with family/friends, the AOD recovery community, and positive emotions in the posts. Surprisingly, the results challenge the initial hypothesis of predominantly balanced self-views in these posts, as no association was found between mentioning positive and negative self-views within a single post. Contrary to expectations, mentioning positive self- views was not linked to references to connecting with others or positive emotions. Future research should employ more nuanced coding for emotions and social connections. Qualitative measures can help capture potential differences between sharing one's recovery journey online and the actual offline experience.Show less
Individuals diagnosed with a personality disorder (PD) are often confronted with a low quality of life (QoL) and high health costs, both important outcome variables among cost-effectiveness studies...Show moreIndividuals diagnosed with a personality disorder (PD) are often confronted with a low quality of life (QoL) and high health costs, both important outcome variables among cost-effectiveness studies. Several factors have been identified that are associated with a low QoL and high health costs in individuals diagnosed with a PD. The influence of trauma is unknown. It has been found that PDs are associated with both past trauma experiences and symptoms of posttraumatic stress disorder (PTSD) in their daily life. While several studies suggested that individuals with a Borderline PD (BPD) and comorbid PTSD suffer from a more impaired QoL compared to individuals with a single disorder, less is known about the effect of PTSD on PDs other than BPD and the relation between trauma severity and health costs. The current study investigates the effect of both childhood trauma and current PTSD symptoms on QoL and health costs in individuals diagnosed with a PD and the possible mediating role of QoL on the relationship between trauma and health costs. The sample consisted of 65 individuals, with a mean age of 38 (SD = 12.3), diagnosed with one or more PDs. Data was collected with several questionnaires (Childhood Trauma Questionnaire-Short Form, Posttraumatic Stress Disorder Checklist for DSM-5, Treatment Inventory of Costs in Patients with psychiatric disorders, and the Mental Health Quality of Life questionnaire). The results show that severity of current PTSD symptoms (t(58) = -4.19, p < .001) but not childhood trauma was related to a decreased QoL in individuals diagnosed with a PD. Both current PTSD symptoms and childhood trauma were not significantly related to health costs. QoL did not perform a mediating role on the relationship between trauma and health costs. To conclude, severe PTSD symptoms represent an additional deprivation for QoL among personality-disordered individuals in this sample. This conclusion is based on a relatively small sample, thus should be further investigated with a larger sample.Show less
Earlier research showed that children who endure war are more at risk of developing trauma symptoms or PTSD. Trauma symptoms or PTSD can lead to significant disruptions in cognitive empathy and...Show moreEarlier research showed that children who endure war are more at risk of developing trauma symptoms or PTSD. Trauma symptoms or PTSD can lead to significant disruptions in cognitive empathy and high levels of anxiety. The aim of the current study is to look into the relationships between PTSD, cognitive empathy and anxiety in Syrian refugee children, and to test for gender differences. Participants were 33 Syrian refugee children aged 10-18. PTSD was measured using CPSS, cognitive empathy was measured using the EmQue-CA and the EDG (three social conditions were used: neutral individuals, victims and offenders of intentional pain) and anxiety was measured using the SCARED. Results showed that cognitive empathy did not affect Syrian refugee children in social situations. Secondly, anxiety did not affect cognitive empathy levels. Thirdly, anxiety did not affect cognitive empathy differently for boys and girls. Lastly, cognitive empathy is disrupted within Syrian refugee children with trauma symptoms or even PTSD. Suggesting that cognitive empathy is a predictor of PTSD. The findings of the current study could potentially be important for future faster treatment of trauma symptoms or even PTSD by using cognitive empathy levels as a predictive factor.Show less
Childhood bullying victimization has been empirically established as a risk factor for insecure adult attachment as well as mental health issues such as anxiety and depression in adulthood. However...Show moreChildhood bullying victimization has been empirically established as a risk factor for insecure adult attachment as well as mental health issues such as anxiety and depression in adulthood. However, there is a lack of research exploring adult attachment styles as a mediator between bullying victimization in childhood and adult depressive and anxious symptoms. The present study investigated if the relationship between bullying victimization before the age of 18 and anxious and depressive symptoms in university students is mediated by adult attachment styles. Participants were part of a larger survey study of the Caring Universities Project. The sample included 3388 participants (university students) between the ages of 18 to 36, who filled out an online questionnaire testing for bullying victimization (RBQ), anxious symptoms (GAD-7), depressive symptoms (PHQ-9), and adult attachment styles (RQ). It was hypothesized that the relationship between bullying victimization and mental health is mediated by insecure attachment styles. A partially mediating effect of fearful and preoccupied attachment styles on the association between bullying victimization and anxious and depressive symptoms was established. A reason for the mediation effect of these two insecure attachment styles might be the underlying negative concept of the self that these attachment styles have in common. Limitations and implications of the findings are discussed.Show less
Background: This study on gut feelings investigates the correlation between microdiversity in the gut and cognitive reactivity in the brain with sex as a potential moderator. Research on potential...Show moreBackground: This study on gut feelings investigates the correlation between microdiversity in the gut and cognitive reactivity in the brain with sex as a potential moderator. Research on potential correlations and moderators is relevant to gain further insight into the networks involved in the gut-brain axis. The findings can influence treatment approaches in the field of clinical psychology to a greater focus on the gutbrain axis. Two hypotheses were examined: 1) a higher microdiversity in the gut is correlated with less emotion regulation difficulties, and 2) there are sex differences in the correlation between microdiversity and emotion regulation. Methods: This research was an observational between-subjects design with a total number of 75 participants. The primary outcome was the alpha score, assessed with the Shannon Index, which gives insight into individual microdiversity. The Difficulties in Emotion Regulation Scale was used to assess self-reported difficulties in emotion regulation to have insight into individual cognitive reactivity. Sex was conceptualised as the moderator variable. A correlational analysis for alpha scores and DERS scores was carried out, followed by a multiple regression analysis, which tested for a moderation with the variable sex. Results: There was no evidence for a negative correlation between high microdiversity and few emotion regulation difficulties. Sex did not have a significant moderation on this correlation either. Implications: Further research is needed on the gut-brain axis and sex differences in gut microdiversity and emotion regulation to adapt the treatment of stress-related disorders such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), or other anxiety-related disorders from a cognitive- to a more holistic approach.Show less
The present study aimed to examine the way depressed adolescents experience their stressful life events, alongside their perceptions of parental support towards them. There was a sample of 115...Show moreThe present study aimed to examine the way depressed adolescents experience their stressful life events, alongside their perceptions of parental support towards them. There was a sample of 115 adolescents, and their parents (n = 214), including a group of depressed and a group of healthy control adolescents. Each adolescent was asked to write down two stressful events from his/her past and code the intensity of these events. After that, they were asked to discuss these events with their parents, and answer to three questions of the Parental Bonding (PB) questionnaire. Researchers also coded the intensity of the events. For our first hypothesis we conducted a multiple regression analysis to investigate whether depression constitutes a moderator variable between the adolescents’ codes of intensity towards their events and the researchers’ codes. For the second hypothesis we ran one-way ANCOVA to examine if there were any differences between the two groups in PB answers. Depression did not seem to moderate the relationship between the adolescents’ and the researchers’ intensity codes. However, separately, the researchers’ codes and the condition of the adolescents, depressed or not, proved to have statistically significant and positive main effects on the way the adolescents experienced their events. At the same time, the two groups also exhibited statistically significant differences on the PB. Considering these results, it is imperative to highlight the importance of including familial factors and the cultivation of resilience and coping skills towards stress into the intervention and prevention programs that address the adolescent depression.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
Abstract Social fears are highly prevalent, causing many functional limitations. Social fears in parents, transmitted via social learning, are one of the main risk factors contributing to the...Show moreAbstract Social fears are highly prevalent, causing many functional limitations. Social fears in parents, transmitted via social learning, are one of the main risk factors contributing to the development of social fears. This thesis is the first to investigate the effect of parental verbal expression of fear versus safety, in social situations, on child’s avoidance, in the developmental period where there is an increase in social fears, that is between 10-13 years of age. We additionally investigated whether parental social anxiety moderated the effect of parental verbal expression and child's avoidance. In the study, 76 children between 10 and 14 years old (M = 11.62) participated together with their parents. Both parents reported their social anxiety in online questionnaires. During a lab visit, only the primary caregivers provided their children with a fear and safety message about two strangers. The child was then confronted with the two strangers, during social tasks. The avoidant behavior was measured during the social performance task. Our findings revealed no significant difference in child’s avoidance towards the two strangers. In other words, when a parent verbally expressed fear about a stranger, the child did not show more avoidant behavior than when the parent verbally expressed safety. Also, the moderating role of parental social anxiety was not significant within this effect. We concluded that the parent's verbal information did not influence child’s avoidance, in the social situations constructed in this experiment. However, this thesis gave us insights in the intergenerational transmission of social fears and provided a baseline for future research investigating the influences of parental verbal expression of social fears on children's avoidance.Show less
Empathy is known as a multidimensional construct, and it is found to be highly important in parenting. Parents have been found to experience different empathic responses towards their children,...Show moreEmpathy is known as a multidimensional construct, and it is found to be highly important in parenting. Parents have been found to experience different empathic responses towards their children, including differences in emotional reactions, understanding their children’s feelings, and abilities in providing support and care in times of distress. Less is known about how parents’ mental well-being influences their levels of empathic distress towards their adolescent children. This study explored the relationship between parental well-being, specifically levels of anxiety and depression, and empathic distress experienced by parents in response to the suffering of their adolescent children. Additionally, the moderating influence of parental gender on this relationship was taken into account. A multiple linear regression analysis was employed. Significantly, maternal gender played a more prominent role in predicting empathic distress, regardless of the anxiety and depression scores. This highlights the notion that mothers and fathers may respond differently to empathic distress cues. These results emphasize the complexity of parental empathic distress and the multifaceted factors influencing its expression. This study contributes to the understanding of parental empathic responses and their connection to parental well-being and gender. These findings hold implications for mental health interventions aiding family dynamics, offering insights into gender roles, and how parents’ mental well-being is linked to their empathic responses.Show less
