The aim of this thesis was to study the link between hearing loss, language skills, and social functioning in deaf and hard of hearing (DHH) children. Sufficient language skills are an... Show moreThe aim of this thesis was to study the link between hearing loss, language skills, and social functioning in deaf and hard of hearing (DHH) children. Sufficient language skills are an essential prerequisite to develop appropriate communication skills, in order to join in conversations with others. Both their hearing loss and their diminished communication skills prevent DHH children from learning by observing their surroundings (incidental learning). As a result, DHH children showed more difficulty in understanding others’ thoughts and wishes (Theory of Mind or ToM). DHH teenagers reported to have difficulties with understanding others’ emotions and showed lower levels of prosocial behavior. Higher communication skills, but not language skills, were related to better ToM development and higher empathic abilities. Second, the role of early identification and intervention of hearing loss on the social-emotional development of DHH children was studied. This was illustrated in a longitudinal study showing that early cochlear implantation resulted in higher language and communication skills. In turn, these improved skills prevented the development of early signs of psychopathology. To conclude, this thesis shows that in order to stimulate the social-emotional development of DHH children, their opportunities for incidental learning have to be increased. Show less
Research on the prevalence, diagnostic and prognostic value for treatment of personality pathology – i.e., both personality disorders and problematic personality characteristics – was... Show more Research on the prevalence, diagnostic and prognostic value for treatment of personality pathology – i.e., both personality disorders and problematic personality characteristics – was carried out within a mainly Dutch forensic mental health setting. Issues such as (dis)simulation and unintentional self-deception limit the utility of self-report instruments within a pre-trial setting. Personality disorders and psychopathic traits in suspected offenders in the Netherlands often lead to court rulings of enforced psychiatric treatment – an internationally unique situation. A prospective study on the predictive value of personality disorder isolated factors that can affect enforced treatment length, such as crime type and comorbidity, that can be a focus for policy makers and forensic mental health experts. Caution is advised when using self-report instruments within the forensic context, especially in the absence of response bias scales and in the case of (legal) incentives for certain outcomes. There is urgent need for international standardization of instruments and terminology and a test battery that is specifically designed for and validated within forensic populations. An increase in (detail of) digital registration of patient, treatment and risk characteristics is necessary for meaningful scientific research, a better assessment of personality and risks, fewer incidents, lower recidivism and shorter treatment. Show less
The general aim of the studies in this dissertation is to provide more insight in the role of family characteristics, parent characteristics, and child characteristics in early child emotion... Show moreThe general aim of the studies in this dissertation is to provide more insight in the role of family characteristics, parent characteristics, and child characteristics in early child emotion socialization and children’s social-emotional development. In Chapter 2 the degree to which fathers and mothers elaborate on emotions with their daughters and sons is examined from toddlerhood to preschool age. In addition, the role of gender stereotypes in parents’ use of emotion talk is examined. Chapter 3 reports on the role of the gender combination of siblings on everyday (emotion-related) parent-child interactions. Chapter 4 focuses on the potential influence of the proportion of male siblings in fathers’ and mothers’ family of origin on their current gender-typed parenting characteristics, including parents’ gendered use of emotion talk. In addition to a direct relation between parents’ family background and their gender-typed parenting, an indirect effect through parents’ testosterone levels is tested. In Chapter 5 a mediation model is tested in which the link between parents’ psychopathology symptoms and preschoolers’ social-emotional functioning is mediated by the degree to which parents elaborate on negative emotions with their children. Finally, in Chapter 6 the main findings of these empirical studies are reviewed and integrated. Show less
Since heterogeneity in depressed patients makes treatment decisions difficult and treatment often unsuccessful, we seek to identify certain subtypes of depression. 30 to 40% of depressed patients... Show moreSince heterogeneity in depressed patients makes treatment decisions difficult and treatment often unsuccessful, we seek to identify certain subtypes of depression. 30 to 40% of depressed patients have anger regulation problems; from irritability to anger attacks. What is the significance of anger in depression? Does it signify a subtype of depression? In the NESDA cohort, we compared a large sample of currently depressed patients with irritability to currently depressed patients without irritability. Irritable depressed patients had more symptoms of depression, more often had comorbid anxiety and had more often attempted suicide than non-irritable depressed patients. In a student sample, we investigated the role of the MAOA genotype and found that women with the high expression variant are possibly more vulnerable to anger or aggression during depression. Using acute tryptophan depletion we temporarily lowered serotonin in remitted depressed patients with and without anger regulation problems during their depression. We found no cognitive differences between the two groups, but the experiment did show us that depressed patients with anger regulation problems may be more serotonergically vulnerable. Further research is needed to elucidate best suited treatment strategies for anger regulation problems in depression Show less
Children with hearing loss are at risk for developing psychopathology, which has detrimental consequences for academic and psychosocial functioning. Therefore, the aims of this thesis were to... Show moreChildren with hearing loss are at risk for developing psychopathology, which has detrimental consequences for academic and psychosocial functioning. Therefore, the aims of this thesis were to objectify levels of psychopathology in hearing-impaired children, and to investigate the influence of various risk and protective factors on psychopathology. The first result of this large multi-center study was that children with hearing loss were more prone to developing psychopathology than their normally hearing counterparts. The second outcome entailed that cochlear implants recipients equaled to or outperformed children with hearing aids involving their levels of psychopathology. Moreover, for several psychopathological symptoms, children that received cochlear implants were comparable to normally hearing children, which is a very positive outcome for the cochlear implant children. Thirdly, several factors that impacted levels of psychopathology were identified. For example, children at mainstream schools using well-developed spoken language, have low risks for developing psychopathology. On the basis of this thesis, it was concluded that it is not the severity of hearing loss that contributes to the genesis of psychopathology, but many other factors. This necessitates clinicians to always consider the heterogeneity of the HI population, in order to improve personalized screening and treatment trajectories. Show less
The goal of this dissertation was to enhance our understanding about internalizing problems and peer relations in DHH youth (aged around 11 years). This was done along principles of the... Show moreThe goal of this dissertation was to enhance our understanding about internalizing problems and peer relations in DHH youth (aged around 11 years). This was done along principles of the developmental psychopathology framework in which DHH children were compared to their hearing counterparts and in which multiple (underlying) social-emotional factors were examined. Results showed that DHH youth reported equal levels of somatic complaints, but more depressive symptoms, lower friendship quality and some forms of victimization more than their hearing peers. Throughout the dissertation a recurring DHH-related characteristic causing variability within the DHH sample was type of education; DHH children in special education reported poorer outcomes than their DHH peers in mainstream education. Concerning the underlying factors, a key finding was that emotional functioning underlies the development of internalizing problems and peer relations in both DHH and hearing youth, while the influence of social factors caused a discrepancy between the two groups. For example, poor social understanding is related to depressive symptoms in DHH youth, while this relation is absent in the hearing sample. Peer relations and social understanding should receive focal attention in practice and future research with DHH youth. Show less
Child maltreatment is a global phenomenon affecting a significant number of the world’s children. The purpose of this study was to compare the prevalence of self-reported childhood maltreatment... Show moreChild maltreatment is a global phenomenon affecting a significant number of the world’s children. The purpose of this study was to compare the prevalence of self-reported childhood maltreatment among university students in Kenya, Zambia, and The Netherlands. We also sought to compare the psychopathological sequelae of child maltreatment in the three samples. In addition, we sought to find out whether PTSS mediated the association between child maltreatment and the psychopathological symptoms. The results of our study showed that neglect in childhood was the most prevalent of all forms of child maltreatment across the three samples. Physical abuse and sexual abuse was most prevalent in Kenya and Zambia while witnessing interparental violence was the least prevalent in the two samples. Child maltreatment was differentially associated with psychopathological symptoms in the three samples of our study. Notably, neglect was the most predictive of psychopathology symptoms. The cross-validation results of our study showed that there were no significant differences in the predictive patterns of PTSS from child maltreatment in the three samples. PTSS mediated the association between child maltreatment and psychopathology symptoms albeit differentially. The results of our study show that there is need to mitigate the prevalence and sequelae of child maltreatment. Show less
