The present dissertation investigated adolescents’ overall stress and perceived stressors, the effectiveness of a universal psychoeducational program about stress, the Stress Lessons, and... Show moreThe present dissertation investigated adolescents’ overall stress and perceived stressors, the effectiveness of a universal psychoeducational program about stress, the Stress Lessons, and adolescents’ self-referral to a targeted school-based intervention. Another aim was to examine whether adolescents from different demographic groupings vary in their experience of stressors and the effect of psychoeducation. A large and heterogeneous sample was recruited from schools with variation in educational tracks and self-perceived ethnic backgrounds. The sample consisted of 1613 predominantly young adolescents with an average age of 13 years old. Most adolescents have to maneuver through a world of stressors, mostly related to the school environment, their health, and future uncertainty, while adolescents experience less stress from social pressure and financial pressure. Furthermore, our results indicate that the Stress Lessons were effective regarding improving adolescents’ knowledge about stress, but not in terms of stress levels. Finally, we found that adolescents who reported higher levels of test anxiety were generally more likely to show interest in an intervention targeting reduction of performance anxiety after the Stress Lessons. However, we did not find that adolescents with lower levels of social skills were more interested in an intervention targeting improvement of social skills. Show less
Sande, M.C.E. van de; Fekkes, M.; Diekstra, R.F.W.; Gravesteijn, C.; Kocken, P.L.; Reis, R. 2023
Social and Emotional Learning programs, designed to enhance adolescents' social and emotional skills, are implemented in schools worldwide. One of these programs is Skills4Life (S4L), for students... Show moreSocial and Emotional Learning programs, designed to enhance adolescents' social and emotional skills, are implemented in schools worldwide. One of these programs is Skills4Life (S4L), for students in Dutch secondary education. To strengthen this program and adapt it to students' needs, we conducted an exploratory study on their perspectives on their own social-emotional development, focusing on low-achieving students in prevoca-tional education.We interviewed eleven boys and eleven girls in five focus groups on (1) their general school life experiences, (2) their perceptions and experiences regarding interactions with peers, the problems they encountered in these interactions, and (3) the strategies and skills they used to solve these problems. Driven by findings in related studies initial thematic analyzes were extended using a three-step approach: an inductive, data-driven process of open coding; axial coding; and selective coding, using the social-emotional skills comprised in an often-used SEL framework as sensitizing concepts. Overall, students were satisfied with their relationships with classmates and teachers and their ability to manage their daily interaction struggles. Their reflections on their interactions indicate that the skills they preferred to use mirror the social-emotional skills taught in many school programs. However, they also indicated that they did not apply these skills in situations they experienced as unsafe and uncontrollable, e.g., bullying and harassment. The insights into adolescents' social-emotional skills perceptions and the problems they encountered with peers at school presented here can contribute to customizing school-based skills enhancement programs to their needs. Teacher training is required to help teachers gain insight into students' perspectives and to use this insight to implement SEL programs tailored to their needs. Show less
Pronk, S.; Berg, G. van den; Mulder, E.A.; Kuiper, C.; Stams, G.J.J.M.; Popma, A. 2023
Summery: This study examined the development of 74 adolescents (13 to 17 years old, 62% boys) after their placement in the non-residential alternative educational facility School2Care, including... Show moreSummery: This study examined the development of 74 adolescents (13 to 17 years old, 62% boys) after their placement in the non-residential alternative educational facility School2Care, including the prevention of secure residential placement. Findings: Results showed that 70% of the adolescents were not placed in a secure residential facility up until six months after leaving the educational facility. Adaptive emotion regulation strategies and feelings of empower-ment showed positive changes and parent-reported externalizing problems decreased. No improvements were found in adolescents' future-time perspective, family functioning and parenting stress. Differences in family functioning, treatment motivation and teacher-reported therapeutic alliances predicted secure residential placement. Applications: Findings of this study provide some preliminary evidence that School2Care can possibly contribute to positive outcomes, which should be tested in (quasi-)experimental research, but also show that further improvement of the intervention may be required. Show less
Beer, C.R.M. de; Nooteboom, L.A.; Domburgh, L. van; Vreugd, M. de; Schoones, J.W.; Vermeiren, R.R.J.M. 2022
Youth peer support workers (YPSWs) are young adults with lived experience of mental illness during childhood or adolescence who support young people receiving treatment in mental health services.... Show moreYouth peer support workers (YPSWs) are young adults with lived experience of mental illness during childhood or adolescence who support young people receiving treatment in mental health services. The contributions made by YPSWs are a promising development to facilitate consumer-centered and recovery-oriented care. Although the youth peer support workforce is expanding rapidly, structurally embedding YPSWs in practice is challenging. To overcome these challenges and thereby improve care for young people, insight into YPSW roles, barriers and facilitators for implementing and pursuing youth peer support (YPS) is a necessity. This systematic review examined the published literature to identify existing knowledge on YPSW roles in treatment settings, and the barriers and facilitators for implementing and pursuing YPS in practice. A total of 24 studies from a variety of youth serving contexts were included in this review. Thematic synthesis resulted in six YPSW roles and five themes with barriers and facilitators. The roles included the: engagement role, emotional support role, navigating and planning role, advocacy role, research role and the educational role. The themes explored the needs of YPSWs, experiences of YPSWs, relationships between service users and YPSWs, the collaboration process between YPSWs and non-peer staff, and organizational readiness. This review underlines that YPSWs likely are a valuable addition to numerous youth treatment contexts. Overall, the implementation of YPSWs is a multifaceted operation that requires careful planning. We recommend services to set clear and realistic expectations for YPSWs, to consider potential power imbalances between YPSWs and non-peer staff, to provide adequate resources to pursue YPS, and to approach the implementation of YPSWs with a growth mindset. Show less
Vries, I. de; Abeyta, S.; Lockwood, S.; Cuevas, C.A.; Rothman, E. 2022
Background: Parental donor kidney transplantation is the most common treatment option for children and adolescents with kidney failure. Emerging data from observational studies have reported... Show moreBackground: Parental donor kidney transplantation is the most common treatment option for children and adolescents with kidney failure. Emerging data from observational studies have reported improved short- and medium-term allograft outcomes in recipients of paternal compared to maternal donors. The INCEPTION study aims to identify potential differences in immunological compatibility between maternal and paternal donor kidneys and ascertain how this affects kidney allograft outcomes in children and adolescents with kidney failure.Methods: This longitudinal observational study will recruit kidney transplant recipients aged <= 18years who have received a parental donor kidney transplant across 4 countries (Australia, New Zealand, United Kingdom and the Netherlands) between 1990 and 2020. High resolution human leukocyte antigen (HLA) typing of both recipients and corresponding parental donors will be undertaken, to provide an in-depth assessment of immunological compatibility. The primary outcome is a composite of de novo donor-specific anti-HLA antibody (DSA), biopsy-proven acute rejection or allograft loss up to 60-months post-transplantation. Secondary outcomes are de novo DSA, biopsyproven acute rejection, acute or chronic antibody mediated rejection or Chronic Allograft Damage Index (CADI) score of > 1 on allograft biopsy post-transplant, allograft function, proteinuria and allograft loss. Using principal component analysis and Cox proportional hazards regression modelling, we will determine the associations between defined sets of immunological and clinical parameters that may identify risk stratification for the primary and secondary outcome measures among young people accepting a parental donor kidney for transplantation. This study design will allow us to specifically investigate the relative importance of accepting a maternal compared to paternal donor, for families deciding on the best option for donation.Discussion: The INCEPTION study findings will explore potentially differential immunological risks of maternal and paternal donor kidneys for transplantation among children and adolescents. Our study will provide the evidence base underpinning the selection of parental donor in order to achieve the best projected long-term kidney transplant and overall health outcomes for children and adolescents, a recognized vulnerable population. Show less
Moska, C.; Goudriaan, A.E.; Blanken, P.; Mheen, D. van de; Spijkerman, R.; Schellekens, A.; ... ; Hendriks, V. 2021
Background: Substance use disorders (SUDs) are prevalent in the general population, tend to follow a chronic course, are associated with many individual and social problems, and often have their... Show moreBackground: Substance use disorders (SUDs) are prevalent in the general population, tend to follow a chronic course, are associated with many individual and social problems, and often have their onset in adolescence. However, the knowledge base from prospective population surveys and treatment-outcome studies on the course of SUD in adolescents is limited at best. The present study aims to fill this gap and focuses on a subgroup that is particularly at risk for chronicity: adolescents in addiction treatment. We will investigate the rate of persistent SUD and its predictors longitudinally from adolescence to young adulthood among youth with DSM-5 SUD from the start of their addiction treatment to 2 and 4 years following treatment-entry. In addition to SUD, we will investigate the course of comorbid mental disorders, social functioning, and quality of life and their association with SUD over time.Methods/design: In a naturalistic, multi-center prospective cohort design, we will include youths (n = 420), who consecutively enter addiction treatment at ten participating organizations in the Netherlands. Inclusion is prestratified by treatment organization, to ensure a nationally representative sample. Eligible youths are 16 to 22 years old and seek help for a primary DSM-5 cannabis, alcohol, cocaine or amphetamine use disorder. Assessments focus on lifetime and current substance use and SUD, non-SUD mental disorders, family history, life events, social functioning, treatment history, quality of life, chronic stress indicators (hair cortisol) and neuropsychological tests (computerized executive function tasks) and are conducted at baseline, end of treatment, and 2 and 4 years post-baseline. Baseline data and treatment data (type, intensity, duration) will be used to predict outcome - persistence of or desistance from SUD.Discussion: There are remarkably few prospective studies worldwide that investigated the course of SUD in adolescents in addiction treatment for longer than 1 year. We are confident that the Youth in Transition study will further our understanding of determinants and consequences of persistent SUD among high-risk adolescents during the critical transition from adolescence to young adulthood. Show less
In this thesis a literature review was conducted to map the results of earlier neuroimaging studies in minors who experienced childhood psychological trauma. Next, three different structural... Show moreIn this thesis a literature review was conducted to map the results of earlier neuroimaging studies in minors who experienced childhood psychological trauma. Next, three different structural neuroimaging techniques were employed to study the effects of childhood sexual trauma in youth .Main findings:1. Neuroimaging studies in traumatised children and adolescents are scarce and heterogeneous in design, in particular with regard to the sample studied and type of trauma.2. The results of structural neuroimaging studies in traumatised minors differ from those in adult populations, in particular with regard to findings on hippocampus and corpus callosum (CC).3. Paralleling the inconsistent findings on hippocampal volume reduction in traumatised minors, our VBM-study did not show differences between groups for hippocampal volume.4. VBM showed smaller volumes of key regions of the limbic system (ACC, amygdala) in the CSA-related PTSD group compared to controls.5. Adolescents with sexual abuse-related PTSD show no abnormalities in cortical thickness, in line with findings in adults. 6. Adolescents with CSA-related PTSD show less integrity of parts of the CC compared to healthy non-traumatised controls.7. Our structural neuroimaging studies showed limited associations with trauma symptomatology, in line with findings in studies in minors. Show less
Ozgen, H.; Spijkerman, R.; Noack, M.; Holtmann, M.; Schellekens, A.S.A.; Glind, G. van de; ... ; Hendriks, V. 2020
Background:Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also... Show moreBackground:Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not sufficient to justify robust treatment recommendations.Objective:The aim of the study was to obtain a consensus statement based on a combination of scientific data and clinical experience.Method:A modified Delphi study to reach consensus based upon the combination of scientific data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD.Results:After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n= 4), risk of developing SUD (n= 3), screening and diagnosis (n= 7), psychosocial treatment (n= 5), pharmacological treatment (n= 11), and complementary treatments (n= 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the first-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion.Conclusion:This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD. Show less
Pol, T.M. van der; Cohn, M.D.; Domburgh, L. van; Rigter, H.; Vermeiren, R.R.J.M. 2020
Background Earlier, we reported that multidimensional family therapy (MDFT) and cognitive behavioural therapy (CBT) decreased criminal offending in adolescents as measured with self-report in a... Show moreBackground Earlier, we reported that multidimensional family therapy (MDFT) and cognitive behavioural therapy (CBT) decreased criminal offending in adolescents as measured with self-report in a randomised controlled trial with 1-year follow-up. The present study tested if this effect could be confirmed using police arrest data. Methods Study participants were 109 adolescents who were recruited for the Dutch part of a transnational treatment trial. National police arrest records were analysed for 3 years before the adolescents entered treatment with MDFT or CBT and for 7 years after treatment entry. Results Police arrest rates rose in the 3 years preceding treatment and then dropped in both treatment groups to almost zero level during the follow-up period. Conclusions The results suggest that MDFT and CBT both strongly and durably decreased police arrest rates. However, this conclusion remains uncertain as crime rates concurrently decreased in the general population. Show less
AimsTo examine the association between UCP1, UCP2, and UCP3 gene polymorphisms with adiposity markers in European adolescents and to test if there were gene interactions with objectively measured... Show moreAimsTo examine the association between UCP1, UCP2, and UCP3 gene polymorphisms with adiposity markers in European adolescents and to test if there were gene interactions with objectively measured physical activity and adiposity.MethodsA cross-sectional study that involves 1.057 European adolescents (12-18years old) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study. A total of 18 polymorphisms in UCP1, UCP2, and UCP3 genes were genotyped. We measured weight, height, waist, and hip circumferences and triceps and subscapular skinfold thickness. Physical activity was objectively measured by accelerometry during 7days.ResultsThe C allele of the UCP1 rs6536991 polymorphism was associated with a lower risk of overweight (odds ratio [OR]: T/C+C/C vs T/T)=0.72; 95% confidence interval [CI]: 0.53-0.98; P=0.034; false discovery rate [FDR]=0.048). There was a significant interaction between UCP1 rs2071415 polymorphism and physical activity with waist-to-hip ratio (P=0.006; FDR=0.026). Adolescents who did not meet the physical activity recommendations (less than 60min/day of moderate to vigorous physical activity) and carrying the C/C genotype had higher waist-to-hip ratio (+ 0.067; 95% CI, 0.028-0.106; P=0.003), while no differences across genotypes were observed in adolescents meeting the recommendations.ConclusionsTwo UCP1 polymorphisms were associated with adiposity in European adolescents. Meeting the daily physical activity recommendations may overcome the effect of the UCP1 rs2071415 polymorphism on obesity-related traits. Show less
The most difficult target group in mental health care for youth, is recognizable from social debates: An alarming example of a suicide or severe non-suicidal self-injury illustrates the... Show moreThe most difficult target group in mental health care for youth, is recognizable from social debates: An alarming example of a suicide or severe non-suicidal self-injury illustrates the vulnerability of these adolescents and underlines a powerless society. Notably, this target group is often excluded from scientific research. Hauber attributes this exclusion on the many psychiatric problems young people face and a rigid classification system. Theoretical models do not accommodate overlapping problems, despite the most serious conditions being characterized by such an overlap. Hauber described the need for a dimensional classification system to enable care providers to assess serious problems, such as an overlap of personality disorder, insecure attachment and non-suicidal self-injury. The influences of puberty, attachment insecurity and the adolescent’s social dynamics should be included in such a model. By having young people reflect in writing on their treatment, relevant information can be obtained to tailor personalized care, and drop-out can be minimized. New developments suggest improving resilience and connection with others, rather than just reducing symptoms. Hauber's research similarly showed the importance of connecting with others to grow emotionally in adolescence. This is a challenge in modern society, with loneliness being the highest mortality risk for humans. Show less
Adolescents with delinquency and cannabis abuse, primarily boys, are predisposed to a variety of comorbid psychiatric psychopathology and form an intricate subgroup which is difficult to treat ... Show more Adolescents with delinquency and cannabis abuse, primarily boys, are predisposed to a variety of comorbid psychiatric psychopathology and form an intricate subgroup which is difficult to treat (Merikangas et al., 2010; Zahn-Waxler, Shirtcliff, & Marceau, 2008). Systemic treatments are considered the type of treatment which renders the most promising results in addressing the complex taxonomy of adolescents’ problem behaviours (Carr, 2009; Von Sydow, Retzlaff, Beher, Haun, & Schweitzer,2013; Waldron & Turner, 2008). Clinicians working with this group of adolescents have to deal, on a daily basis, with serious issues and have to make difficult decisions, impacting the adolescent, his/her family, and society as a whole. For the forensic research field, comprehending and grasping the complexity of these adolescents, which could generate insights and practical advises leading to improvement of care, is a tough and demanding task. This dissertation tries to inform clinical and research practice by providing insight and knowledge concerning: the common elements of systemic treatment, the effectiveness of Multidimensional Family Therapy (MDFT), and the predictive value on treatment outcome of baseline characteristics of the adolescent. This to better understand systemic treatments and to be better able to match a treatment with the individual adolescent’s psycho-social make-up. Show less
Pol, T.M. van der; Hendriks, V.; Rigter, H.; Cohn, M.D.; Doreleijers, T.A.H.; Domburgh, L. van; Vermeiren, R.R.J.M. 2018
Background: Substance use and delinquency are considered to be mutual risk factors. Previous studies have shown that multidimensional family therapy (MDFT) is effective in tackling both conditions... Show moreBackground: Substance use and delinquency are considered to be mutual risk factors. Previous studies have shown that multidimensional family therapy (MDFT) is effective in tackling both conditions on the short term. The current study examines the long-term effects of MDFT on criminal offending.Methods: 109 adolescents with cannabis use disorder and comorbid problem behavior were randomly assigned to either MDFT or cognitive behavioral therapy (CBT). Police arrest data were collected for 6 years: 3 years prior to and 3 years after treatment entry. Using survival analysis and repeated measure General Linear Models (rmGLM), the two treatment groups were compared on number of arrests, type of offence, and severity of offence. Moderator analyses looking at age, disruptive behavior disorders, history of crimes, family functioning, and (severe) cannabis use were conducted (rmGLM).Results: While police arrest rates increased in the 3 years before treatment, the rates decreased substantially after the start of both treatments. No differences were found between the treatment groups with respect to either time to first offence from the start of the treatment or changes in frequency or severity of offending over time. A treatment effect trend favoring MDFT was found for property offending in the subgroup of adolescents with high baseline-severity of cannabis use.Conclusions: Across a follow-up period of 3 years, MDFT and CBT were similarly effective in reducing delinquency in adolescents with a cannabis use disorder. Show less
