Individual variation in mathematical skills can be ascribed to differences in cognitive ability, but also to students’ emotional experiences of mathematics, such as enjoyment and anxiety. The... Show moreIndividual variation in mathematical skills can be ascribed to differences in cognitive ability, but also to students’ emotional experiences of mathematics, such as enjoyment and anxiety. The current study investigated how the interplay of working memory with math anxiety and enjoyment explains mathematical performance in primary school students. We also explored whether these relations differed with the type of math test and students’ age. Using mixed effect models, we reanalyzed data from 4471 Dutch primary school students (grades 2–6) who had completed two computerized working memory tasks, had filled out a questionnaire on math emotions, and had completed two math tests: story problems and speeded arithmetic. Findings showed that working memory, anxiety, and enjoyment were linear (but not curvilinear) predictors of performance on both tests, while some relations were stronger for the math (story)-problem-solving test. Higher math anxiety negatively impacted performance more strongly for students with stronger working memory skills, but only on the arithmetic test. No interaction between working memory and enjoyment was found. The relation between math anxiety and math performance increased with grade level, but no other age-related changes were found. Interpretations and recommendations focus on situated views on learning and emotion. Show less
This thesis examines questions related to the prevalence of anxiety symptomatology and disorders in older adults, and compares two brief low-threshold psychological interventions (blended... Show moreThis thesis examines questions related to the prevalence of anxiety symptomatology and disorders in older adults, and compares two brief low-threshold psychological interventions (blended Acceptance and Commitment Therapy versus face-to-face Cognitive Behavioral Therapy) for older adults with anxiety symptoms in primary care. Show less
This thesis aimed to lay the foundation for a new set of Dutch mental health instruments to measure depression and anxiety in an efficient, reliable, valid, and responsive manner. More specifically... Show moreThis thesis aimed to lay the foundation for a new set of Dutch mental health instruments to measure depression and anxiety in an efficient, reliable, valid, and responsive manner. More specifically, the Dutch-Flemish PROMIS adult v1.0 item banks for Depression and Anxiety were psychometrically evaluated for computerized adaptive test (CAT) administration in the Dutch clinical and general population. CAT is a modern methodology that can be used to develop instruments that measure both efficiently and reliably as only the most appropriate questions are administered, and assessment terminates as soon as sufficient reliability is achieved. For the PROMIS CAT instruments, this was demonstrated in the thesis: measuring depression and anxiety in Dutch persons was highly efficient and reliable. Moreover, the CAT instruments were shown to measure depression and anxiety sufficiently responsive and valid as well. This even includes longitudinal validity, which has barely been studied for other Dutch mental health instruments. Overall, it was concluded that the new instruments are an improvement over available instruments. Therefore, using the PROMIS CAT instruments in clinical practice may lead to more efficient and reliable measurement that supports professionals and patients in evaluating patients' treatment. Show less
This dissertation describes the findings of six studies on mental health problems in the family context, specifically focusing on the associations with the parent-child relationship, parenting... Show moreThis dissertation describes the findings of six studies on mental health problems in the family context, specifically focusing on the associations with the parent-child relationship, parenting behaviors and experiences of childhood maltreatment. The aim is to better understand the risk factors, development and transmission of common psychological problems in order to contribute to prevention and treatment strategies for common psychological problems such as anxiety and depression.Overall, the findings underline the importance of the family context in the development and levels of mental health problems. In addition to the impact of one's own negative parenting experiences, including lack of warmth and experiences of emotional or physical abuse, negative parenting experiences of one's siblings are also associated with elevated anxiety and depressive symptom levels.We also found that externalizing problems of fathers and children have a negative impact on the parent-child interactions. In addition, we found that children with behavioral problems during early adolescence experience harsher parental discipline, even three years later.In the current treatment guidelines for common mental disorders, most therapies focus on the individual. An (additional) systemic approach and considering past and present family relationships in therapy, can be of additional value. For example, supporting families with interventions to improve the parent-child relationship can be helpful in the short and long term. Moreover, (early) treatment of psychological and behavioral problems of the parent or child might be beneficial for all family members. Show less
Anxiety disorders are globally one of the most prevalent and disabling forms of psychopathology in adults and children. Having a parent with an anxiety disorder multiplies the risk of anxiety... Show moreAnxiety disorders are globally one of the most prevalent and disabling forms of psychopathology in adults and children. Having a parent with an anxiety disorder multiplies the risk of anxiety disorders in the ofspring, although the specifc mechanisms and processes that play a role in this intergenerational transmission remain largely unknown. According to information processing theories, threat-related biases in cognitive processing are a causal mechanism in the development and maintenance of anxiety. These theories propose that individuals with anxiety are more likely to cognitively process novel stimuli in their environment as threatening. Creswell and colleagues proposed a theoretical model that highlighted the role of these cognitive biases as a mechanism in the intergenerational transmission of anxiety (Creswell et al., in Hadwin, Field (eds) Information processing biases and anxiety: a developmental perspective, Wiley, pp 279–295, 2010). This model postulated signifcant associations between (1) parents’ and children’s threat-related cognitive biases (2) parents’ threatrelated cognitive biases in their own and their child’s environment, (3) parents’ threat-related cognitive biases and parenting behaviors that convey anxiety risk to the ofspring (e.g., modeling of fear, and verbal threat information transmission), and (4) parenting behaviors and child threat-related biases. This theoretical review collated the recent empirical work testing these four core hypotheses of the model. Building on the reviewed empirical work, an updated conceptual model focusing on threat-related attention and interpretation is proposed. This updated model incorporates the links between cognition and anxiety in parents and children and addresses the potential bidirectional nature of parent–child infuences. Show less
Struijs, S.Y.; Jong, P.J. de; Jeronimus, B.F.; Does, A.J.W. van der; Riese, H.; Spinhoven, P. 2021
ObjectivesTo explore possible working mechanisms of anxiety reduction in women with anxiety disorders, treated with art therapy (AT).MethodsA RCT comparing AT versus waiting list (WL) condition on... Show moreObjectivesTo explore possible working mechanisms of anxiety reduction in women with anxiety disorders, treated with art therapy (AT).MethodsA RCT comparing AT versus waiting list (WL) condition on aspects of self-regulation. Stress regulation (heart rate and heart rate variability) and executive functioning (daily behavioural and cognitive performance aspects of executive functioning (EF)) were evaluated in a pre-post design. Participants were women, aged 18–65 years with moderate to severe anxiety symptoms.ResultsEffectiveness of AT compared to WL was demonstrated in a higher resting HRV post treatment, improvements in aspects of self-reported daily EF (emotion control, working memory, plan/organize and task monitor), but not in cognitive performance of EF, stress responsiveness and down regulation of stress. The decrease in anxiety level was associated with improvements in self-reported daily EF.ConclusionsAT improves resting HRV and aspects of EF, the latter was associated with art therapy-related anxiety reduction Show less
It is common in life to not perform at the very top of our cognitive abilities. This phenomenon usually exacerbates when we are under high levels of stress and in people with psychiatric disorders.... Show moreIt is common in life to not perform at the very top of our cognitive abilities. This phenomenon usually exacerbates when we are under high levels of stress and in people with psychiatric disorders. Attention to negative information is considered to play a crucial role in the development and maintenance of these disorders, especially anxiety-related disorders. Attention to negative information is not necessarily bad as it is an evolutionary function to protect us from dangerous situations. However, it can be destructive when it occurs constantly or when we need to focus on an important task. There are many situations where we have to perform difficult cognitive tasks and we worry about our performance or other people’s evaluation. Trait cognitive control, the ability to control attention and maintain a goal-relevant behaviour, is suggested to play a key role in the relationships between anxiety/stress, attention to negative information, and cognitive performance. Yet, the evidence is limited and further investigation is needed. In the current thesis, the relations between anxiety/stress, attention to emotional information, and cognitive performance will be investigated in a multidisciplinary approach, synthesizing clinical and cognitive factors and neurobiological underpinnings, while focusing on the role of trait cognitive control. Show less
Abbing, A.C.; Baars, E.W.; Sonneville, L. de; Ponstein, A.S.; Swaab, H. 2019
Objectives: Art therapy (AT) as a treatment option for anxiety is regularly employed in clinical practice, but scientific evidence for its effectiveness is lacking, since this intervention has... Show moreObjectives: Art therapy (AT) as a treatment option for anxiety is regularly employed in clinical practice, but scientific evidence for its effectiveness is lacking, since this intervention has hardly been studied. The aim was to study the effectiveness of AT on anxiety in adult women. The specific type of AT studied was anthroposophic AT.Methods: A RCT comparing AT versus a waiting list (WL) condition on anxiety symptom severity, quality of life, and emotion regulation. Factors influencing treatment outcome were additionally explored. Participants were women, aged 18–65 years, diagnosed with generalized anxiety disorder, social anxiety disorder or panic disorder, with moderate to severe anxiety symptoms. The trial was registered in the Dutch Trial Registration (NL6661).Results: Fifty-nine women were included, of which 47 completed the trial. Both per-protocol and intention-to treat analyses demonstrated effectiveness of AT compared to WL, showing a reduction in anxiety, an increase in subjective quality of life (both with large effects) and an improvement in accessibility of emotion regulation strategies (medium effect). Treatment effects remained after 3 months follow-up. Improved acceptance of emotions and improved goal-oriented action are aspects of emotion regulation that are associated with the decrease in anxiety level.Conclusion: AT is effective in reducing anxiety symptoms, improving quality of life and aspects of emotion regulation. Future RCTs should use active controls (treatment as usual) and study cost-effectiveness. Show less
The ratio between frontal resting state EEG power in the theta and beta frequency bands (theta/beta ratio, TBR) was first associated with attention deficit hyperactivity disorder (ADHD) and later... Show moreThe ratio between frontal resting state EEG power in the theta and beta frequency bands (theta/beta ratio, TBR) was first associated with attention deficit hyperactivity disorder (ADHD) and later linked to various psychological functions and cognitive/emotional processes that rely on executive cognitive control. The aim of this thesis was to further investigate TBR as a potentially useful marker for executive/attentional control, particularly when studying threat selective attention and uncontrolled thoughts. It was found that high TBR was associated with more attention to mild than high threat and low threat-interference in visual-spatial tasks containing emotional information. TBR was also negatively related to self-reported attentional control. Frontal TBR was moreover significantly higher during uncontrolled thought compared to controlled thought and this effect was also found for functional connectivity of the ‘executive control network’, which was also correlated to the controlled versus uncontrolled thought effect on TBR. However, no evidence was found to suggest that TBR can be manipulated using Neurofeedback training. These findings provide clear indications of the neuropsychological functional nature of TBR and further support the notion that TBR reflects connectivity in brain networks involved in executive control processes. Show less
Witlox, M.; Kraaij, V.; Garnefski, N.; De Waal, M.W.M.; Smit, F.; Hoencamp, E.; ... ; Spinhoven, P. 2018
Anxiety is among the most prevalent and disabling mental health problems in older adults. Few older adults with mild to moderately severe anxiety symptoms receive adequate interventions, putting... Show moreAnxiety is among the most prevalent and disabling mental health problems in older adults. Few older adults with mild to moderately severe anxiety symptoms receive adequate interventions, putting them at risk for developing anxiety disorders, depression, and various somatic problems. Effective, low-threshold interventions should be developed. Blended care, in which a web-based intervention is combined with a limited amount of face-to-face contacts with a mental healthcare counselor at the general practice, is a promising option. The online self-help intervention “Living to the Full”—an Acceptance and Commitment Therapy (ACT) intervention—has been proven to reduce depression and anxiety in several patient groups, but has not yet been investigated in older adults. The aim of this study is to evaluate the (cost-)effectiveness of a blended form of “Living to the Full” in reducing anxiety symptoms in adults aged 55 to 75 years. Furthermore, moderators and mediators of the treatment effect are investigated. Show less
Spinhoven, P.; Van Hemert, A.M.; Penninx, B.W.J.H. 2017
This thesis aimed to investigate the neurobiological mechanisms of adolescent onset depression and anxiety disorders. A longitudinal fMRI study design was used that included both task related brain... Show moreThis thesis aimed to investigate the neurobiological mechanisms of adolescent onset depression and anxiety disorders. A longitudinal fMRI study design was used that included both task related brain activation and resting state functional connectivity. All participants were scanned three times in a six-month period. In between scan sessions the adolescents from the clinical group received treatment as usual. Adolescents from the control group were scanned within the same time interval but did not receive treatment. During a scan session several MRI parameters were collected including task based fMRI (emotional face processing task) and resting state fMRI. We also administered several questionnaires about derpession and anxiety symptomatology. It was demonstrated that adolescents with depressive and anxiety disorders show differentiating patterns of amygdala reactivity and connectivity compared to a healthy control group. Furthermore, using a dimensional approach and taking individual differences in self-reported depression and anxiety symptoms into account highlighted the role of self-reported anxiety symptoms in amygdala reactivity during emotional faces processing. These findings indicate that the amygdala indeed is an important region involved in emotional face processing and that focusing on this region can provide further insights in the development and persistence of depressive and anxiety disorders in adolescents. Show less
Broekhof, R.; Rius-Ottenheim, N.; Spinhoven, P.; Van der Mast, R.C.; Penninx, B.W.J.H.; Zitman, F.G.; Giltay, E.J. 2015
The present thesis concentrates on predictors and outcomes of occupational stress in emergency (ER-) nurses, working in in-hospital emergency wards, ambulance services and fast rescue teams. More... Show moreThe present thesis concentrates on predictors and outcomes of occupational stress in emergency (ER-) nurses, working in in-hospital emergency wards, ambulance services and fast rescue teams. More specifically, this thesis focuses on the relationships between (1) demographic factors, (2) exposure to traumatic events, (3) job characteristics, (4) organizational variables, (5) coping strategies and (5) goal orientation as potential determinants of (a) job satisfaction, (b) turnover intention, (c) burnout, (d) work engagement, (e) post-traumatic stress symptoms (f) fatigue and (g) other somatic complaints. The first part of this chapter gives an overview of the main results of the different studies, followed by an attempt to integrate all these results from a theoretical and methodological point of view, resulting in a set of practical recommendations and directions for future research Show less
