The primary aim of the NormQuest study described in this thesis was to generate evidencebased, reference values for 19 self-report and observational questionnaires. The focus was on questionnaires... Show moreThe primary aim of the NormQuest study described in this thesis was to generate evidencebased, reference values for 19 self-report and observational questionnaires. The focus was on questionnaires measuring mood, anxiety, and somatoform (MAS) disorders used in Routine Outcome Monitoring (ROM). The set of cut-off values of the ROM reference group (__healthy__) can be used in specialized mental health care by therapists to support the decision whether a patient is sufficiently recovered to be considered as a member of the healthy population, and no longer as a member of the patient population. These reference values are suitable as decision support for referral back to primary care physicians. Additionally, the set of the ROM patient group (__clinically ill__) cut-off values can be used by primary care physicians as decision support for referral to the specialized mental health care. To allow determination of cut-off points for skewed distributions, percentile scores were used. In addition, we assessed the discriminative power of the questionnaire scores by means of Receiver Operating Characteristics (ROC) analyses. Finally, we calculated reference values in separate strata of gender and age. The secondary aim of the NormQuest study concerned the need for the development of public domain questionnaires. In the NormQuest study, the generic Symptom Questionnaire-48 (SQ-48), aimed at broad applicability in patients with MAS disorders, was developed. Also, for the SQ-48 reference values were calculated Show less
Bet, P.M.; Hugtenburg, J.G.; Penninx, B.W.J.H.; Balkom, A. van; Nolen, W.A.; Hoogendijk, W.J.G. 2013
Research into the relation between psychopathology and etiological factors has not yet resulted in clear findings. One of the probable causes is that most researchers use the categorical DSM-IV... Show moreResearch into the relation between psychopathology and etiological factors has not yet resulted in clear findings. One of the probable causes is that most researchers use the categorical DSM-IV Classification of mental disorders. A dimensional system has several advantages compared to categorical systems: comorbidity, lack of diagnostic agreement and arbitrary nature of used boundaries are no longer a problem. Our aim was to develop a model with dimensions that can adequately describe patients with mood- and anxiety disorders. This project used data collected through Routine Outcome Monitoring (ROM), a monitoring system for patient care. First, we validated a Dutch adaptation of an instrument based on the tripartite model. Next, we formulated an extension of this model with 5 dimensions. Consequently we presented a second model with 6 dimensions: feelings of worthlessness, fatigue, somatic arousal, anxious apprehension, phobic fear and tension. We used several analysis techniques to create a valid and reliable dimensional model. Each individual factor and the total of factors can be regarded as unidimensional measurement scales. This model can describe the clinical state of patients more specifically than the tripartite model, and can be used in subsequent research into etiological factors of psychopathology (e.g. endophenotype, genotype, trauma's, personality). Show less
When a child is often scolded or threatened by his parents (emotional abuse) and /or when a child is structurally ignored or isolated by his parents (emotional neglect) we call this childhood... Show moreWhen a child is often scolded or threatened by his parents (emotional abuse) and /or when a child is structurally ignored or isolated by his parents (emotional neglect) we call this childhood emotional maltreatment (CEM). CEM is the most common form of child abuse, however, CEM is also the most hidden, underreported and least studied form of child abuse. An important reason for this may be because that the consequences of CEM are underestimated (e.g. __Sticks and Stones may break bones, but words will never hurt me__). However, this thesis shows that CEM is related with a persistent negative impact on cognition and the brain. We discovered that individuals that report CEM show differential structure and function of a brain area (the medial prefrontal cortex) that is crucial for role in responding to stress and thinking about yourself. Individuals with CEM also showed more activity in an area that signals threat (the amygdala) which may represent a persistent vigilance towards the detection of threat from others. These brain changes may underlie our other findings that individuals with CEM think more negatively about themselves and others. Negative thoughts can evoke negative thoughts and in new situations, which reinforces more negative memories. Due to this process, emotionally abused individuals may be more vulnerable to develop a depressive and/or anxiety disorder. Our findings warrant scientific and policital investments to increase societal awareness about the detrimental impact of CEM on cognition and the brain. Increased societal knowledge will hopefully lead to better awareness, reports, and subsequent interventions for individuals with CEM. Show less
Het boek is een biografie van Karl Abraham (1877-1925), de eerste psychoanalyticus van Duitsland, waar hij de psychoanalyse tot grote bloei heeft gebracht. Zijn klinisch-theoretische bijdragen... Show moreHet boek is een biografie van Karl Abraham (1877-1925), de eerste psychoanalyticus van Duitsland, waar hij de psychoanalyse tot grote bloei heeft gebracht. Zijn klinisch-theoretische bijdragen werden al snel klassiekers die veel invloed hebben gehad op de psychoanalytische theorievorming. Hij was de eerste die een psychoanalytische theorie over depressie ontwierp, enkele jaren voor Freuds 'Trauer und Melancholie' zou verschijnen. Abraham was de laatste jaren van zijn leven na Freud de belangrijkste analyticus van de psychoanalytische beweging, voorzitter van de IPA - International Psychoanalytic Association, voorzitter van de Berlijnse psychoanalytische vereniging en lid van het geheime comit_. Hij is betrokken geweest bij een aantal grote conflicten die zich in de beginjaren van de psychoanalyse hebben afgespeeld, waarbij postuum de schuld nogal eens naar hem is geschoven. Zo kon het gebeuren dat Abraham, tijdens zijn leven zo gewaardeerd, na zijn dood regelmatig werd verguisd. Show less
