What kinds of personal goals, aspirations and plans do Dutch youths consider important in their lives? And how does experience of setbacks when pursuing these goals and means of coping with these... Show moreWhat kinds of personal goals, aspirations and plans do Dutch youths consider important in their lives? And how does experience of setbacks when pursuing these goals and means of coping with these frustrations influence their psychological well-being and experience of headache? These are some of the main questions addressed in this research project by means of a series of questionnaire and diary studies among high-school students. Goals were most commonly reported in the area of interpersonal relationships, followed by health and body, their future, school, leisure and personal development. Importance of adolescent aspirations and thoughts and emotions related to these goals were shaped to a large extent by personal and contextual characteristics such as gender, age and ethnicity. Goal importance did not differ according to experience of headache, however, youths with weekly headache reported higher levels of frustration in personal goal pursuits compared to their headache-free peers. Frustration in pursuit of especially self and health goals was related to higher depressive symptoms and lower quality of life in a cross-sectional questionnaire study. Furthermore, frustration predicted next-day lower well-being and greater headache complaints in a prospective diary study. Moreover, dwelling on the negative aspects of the situation (catastrophizing), repetitive thoughts about the frustration (rumination) and the belief that one is unable to cope well with the setback predicted next-day poorer psychological well-being. This was one of the first studies to assess the contribution of self and emotion regulation factors to well-being and headache in adolescence and offers insights into possible targets for intervention with youths Show less
To fail or not to fail __ Clinical trials in depression investigates the causes of the high failure rate of clinical trials in depression research. Apart from the difficulties in the search for new... Show moreTo fail or not to fail __ Clinical trials in depression investigates the causes of the high failure rate of clinical trials in depression research. Apart from the difficulties in the search for new antidepressants during drug discovery, faulty clinical trial designs hinder their evaluation during drug development. This thesis focuses on three important aspects of clinical trials in depression: clinical endpoints, data analysis and trial design-related factors. Show less
In Chapter 2, results of a study are reported in which remitted depressed patients are compared to healthy controls to investigate possible residual cognitive impairments that persist into the... Show moreIn Chapter 2, results of a study are reported in which remitted depressed patients are compared to healthy controls to investigate possible residual cognitive impairments that persist into the euthymic phase. Chapter 3 will describe the effects of an alpha-lactalbumin enriched diet on cognitive performance in unmedicated recovered depressed patients and healthy controls. In Chapter 4 the effects of alpha-lactalbumin on mood and stress-induced cortisol response in unmedicated recovered depressed patients and healthy controls are reported. Chapter 5 describes the effects of low-dose and high-dose ATD on mood and neutral as well as emotional information processing in medicated remitted depressed patients. In Chapter 6, the effects of low-dose and high-dose tryptophan depletion on individual plasma tryptophan levels and the ratio tryptophan/LNAA will be discussed. In Chapter 7 the effects of ATD on heart rate variability in medicated remitted depressed patients are reported. A literature overview of studies investigating the effects of serotonin manipulations on emotional information processing and mood is given in Chapter 8. Also, evidence for a possible sequential link between serotonin induced changes in emotional information processing and mood is evaluated. Chapter 9 contains a summary and integration of the main findings, as well as methodological strengths and limitations, directions for future research and clinical implications of the findings reported in this thesis Show less
Arnold, Ingrid Antonette; Waal, Margaretha Wilhelmina Maria de 2006
De huisarts ziet veel patienten met onverklaarde lichamelijke klachten, vaak in combinatie met angst- en depressieve klachten. Dit proefschrift beschrijft de resultaten van een prevalentie studie... Show moreDe huisarts ziet veel patienten met onverklaarde lichamelijke klachten, vaak in combinatie met angst- en depressieve klachten. Dit proefschrift beschrijft de resultaten van een prevalentie studie met een prospectieve follow-up en een daarop volgende behandelstudie. De prevalentie van somatoforme stoornissen (DSM-IV) was 16,1%: één op de zes patienten die de huisarts bezoekt had tenminste zes maanden last van onverklaarde lichamelijk klachten met aanzienlijke beperkingen. De overlap met angst en depressie was substantieel en vergrootte de ernst van de ziektelast. Deze bevindingen onderstrepen het belang van een brede diagnostiek in de huisartspraktijk die zowel angst en depressie als somatoforme stoornissen omvat. Het aantal symptomen, zowel lichamelijk als psychisch, kan een nuttig instrument zijn bij het identificeren van de ernstigste patiënten. Het gegeven dat bijna driekwart van alle patiënten met een somatoforme stoornis langdurig klachten houdt impliceert een grote behoefte aan behandeling. In een gecontroleerde behandelstudie konden we echter niet aantonen dat een cognitief-gedragsmatige interventie volgens het gevolgenmodel door getrainde huisartsen effectiever was dan gebruikelijke zorg. Aangezien de behandelde patiënten vaak ernstige klachten hadden stellen de auteurs voor om een stapsgewijze behandelmethode te ontwikkelen zodat zowel kortdurende als chronische klachten goed aangepakt kunnen worden. Show less
