In this thesis, we have studied the potential of the zebrafish larval model in studying the ECS, as a complementary model to the existing rodent models. More specifically, we have looked at the... Show moreIn this thesis, we have studied the potential of the zebrafish larval model in studying the ECS, as a complementary model to the existing rodent models. More specifically, we have looked at the role of the ECS in regulating locomotion and anxiety, and its interaction with the hypothalamic-pituitary-interrenal (HPI) axis, or stress axis. This study has provided us with an interesting animal model which allows for pharmacological screening of Cnr1 agonists, and their involvement in the CNS, as shown by a change in locomotion, anxiety-like behavior and HPI axis activity. The zebrafish larval model can be used as a complementary model to the existing rodent animal models, to study the ECS. The zebrafish larval model brings several interesting features, such as optical transparency and possibilities for high-throughput screening. Furthermore, a complete ECS is present, there is lack of endogenous activity, allowing for exogenous compound screening, and zebrafish data is generally in line with rodent literature. Since the ECS is involved in many diseases, more research of this system may result in the discovery of novel drugs and drug targets. Show less
This thesis describes the relation of fear of childbirth (FOC), measured pre- and postpartum, with the preferred and actual place and mode of giving birth and with the use of pharmacological pain... Show moreThis thesis describes the relation of fear of childbirth (FOC), measured pre- and postpartum, with the preferred and actual place and mode of giving birth and with the use of pharmacological pain relief during labour. The studies were embedded in the Dutch obstetric system, where midwives have an independent profession and where home birth is an accepted option for women with a low-risk pregnancy. The general finding, consistent across all studies in this thesis, is that the level of FOC in pregnancy was strongly related to, and predictive of the level of postpartum FOC. Furthermore, women with severe FOC during pregnancy were prone to preferring a hospital birth, having pharmacological pain relief during labour and requesting an elective Caesarean Section. Congruence between one’s own preference (of place or mode of giving birth) and the actual delivery situation was not related to the degree of postpartum FOC. Instead, predictors for high postpartum FOC were: being referred from midwifery-led care to obstetrician-led care, emergency Caesarean Section, and a poor condition of the new-born. For guiding women with severe FOC through pregnancy and childbirth, a close collaboration between the obstetric caregiver and a psychotherapist is advised. Show less
Art therapy is an often provided but little studied treatment option in mental health care.The effectiveness of art therapy in the treatment of anxiety was studied and its working mechanisms were... Show moreArt therapy is an often provided but little studied treatment option in mental health care.The effectiveness of art therapy in the treatment of anxiety was studied and its working mechanisms were explored. Outcomes of a randomised controlled trial (n=59) showed preliminary evidence of the effectiveness of art therapy. The treatment, consisting of three months of anthroposophic art therapy, showed major reduction of anxiety symptom severity in women, compared to a wait list condition. The therapy also improved quality of life and various aspects of self-regulation: higher HRV at rest (which may indicate an overall lower stress level), improvements in emotion regulation and improvements in daily executive functioning.The second part of this PhD research focused on case report methodology and the development of tools for research within this field, with and for therapists in clinical practice, and for education. A publication guideline for case reports was developed and positively evaluated in practice. An exemplary case report of a female client with anxiety was provided.The outcomes of this research support the indication of art therapy in the treatment of anxiety and justify further studying of the effectiveness and mechanisms of art therapy. Show less
