Parental socialization refers to the process through which parents transmit values and beliefs to their children. During this process, children learn to understand the world and shape their social... Show moreParental socialization refers to the process through which parents transmit values and beliefs to their children. During this process, children learn to understand the world and shape their social functioning. The impact of parental socialization can vary across different cultures. My research focuses on family interactions within Chinese cultures, emphasizing the importance of cultural nuances when examining the role of parental behaviors in children's social development. The study utilized samples of Chinese children and their parents, employing various research methods, including observations, interviews, and questionnaires. The findings indicated that Chinese mothers' psychological control had a relatively minor negative effect on children's emotion regulation and social anxiety. Additionally, the research revealed racism and colorism among Chinese children, which were associated with mothers' color-evasive socialization behaviors. Chinese mothers did not avoid talking about racial appearance and cultural background, which contrasts with studies in White Western populations where most White mothers showed color evasion. Chinese mothers’ acknowledgement of shared culture predicted children’s positive attitudes towards their own racial ingroup with a darker skin tone. My research underscores the unique features of Chinese culture that play a pivotal role in shaping the nature and consequences of parental socialization on children's social functioning. It highlights that Western theories related to parenting and color-evasive socialization may need adaptation when applied to non-Western cultural contexts. Show less
Major Depressive Disorder (MDD) often is a recurrent and chronic disorder. We investigated the neurocognitive underpinnings of the incremental risk for poor disease course by exploring relations... Show moreMajor Depressive Disorder (MDD) often is a recurrent and chronic disorder. We investigated the neurocognitive underpinnings of the incremental risk for poor disease course by exploring relations between enduring depression and brain functioning during regulation of negative and positive emotions using cognitive reappraisal.We used fMRI-data from the longitudinal Netherlands Study of Depression and Anxiety acquired during an emotion regulation task in 77 individuals with MDD. Task-related brain activity was related to disease load, calculated from presence and severity of depression in the preceding nine years. Additionally, we explored task related brain-connectivity. Brain functioning in individuals with MDD was further compared to 35 controls to explore overlap between load-effects and general effects related to MDD history/presence.Disease load was not associated with changes in affect or with brain activity, but with connectivity between areas essential for processing, integrating and regulating emotional information during downregulation of negative emotions. Results did not overlap with general MDD-effects. Instead, MDD was generally associated with lower parietal activity during downregulation of negative emotions. During upregulation of positive emotions, disease load was related to connectivity between limbic regions (although driven by symptomatic state), and connectivity between frontal, insular and thalamic regions was lower in MDD (vs controls).Results suggest that previous depressive load relates to brain connectivity in relevant networks during downregulation of negative emotions. These abnormalities do not overlap with disease-general abnormalities and could foster an incremental vulnerability to recurrence or chronicity of MDD. Therefore, optimizing emotion regulation is a promising therapeutic target for improving long-term MDD course. Show less
This thesis had four main objectives:Predictors of Bipolar disorder (BD): Chapters 2 and 3 explored factors contributing to Bipolar Disorder's development and progression, considering both internal... Show moreThis thesis had four main objectives:Predictors of Bipolar disorder (BD): Chapters 2 and 3 explored factors contributing to Bipolar Disorder's development and progression, considering both internal and external influences.External Stressors: Chapter 4 investigated how external stressors, particularly the COVID-19 pandemic, impacted the stability of BD symptoms, highlighting the role of environmental factors.Symptom Interactions: Chapter 5 analyzed the complex interplay of mania and depressive symptoms in BD over time, enhancing our understanding of their evolution.Neurocognition and Brain Functioning: Chapter 6 reviewed long-term cognitive (dys)function and brain activity in BD patients, offering insights into the disorder's neural mechanisms.Overall, the thesis aimed to expand knowledge of BD, encompassing its predictors, the influence of external stressors, symptom dynamics, and neurocognitive aspects. This research contributes to better diagnosis and treatment strategies for individuals affected by BD. Show less
Spinhoven, P.; Hoogerwerf, E.; Giezen, A. van; Greeven, A. 2022
Background: This study aimed: (a) to examine the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for patients with a treatment-refractory anxiety disorders compared to Relapse... Show moreBackground: This study aimed: (a) to examine the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for patients with a treatment-refractory anxiety disorders compared to Relapse Prevention-Cognitive Behavioral Therapy (CBT-RP); and (b) to explore candidate mediating variables. Methods: We conducted a pragmatic randomized controlled trial comparing MBCT with CBT-RP in a group format for 136 outpatients with treatment-refractory DSM-IV defined anxiety disorder, who insufficiently responded to first-line psychological treatment. Results: At post-treatment, the MBCT group showed a significantly larger decrease in self-reported anxiety (Beck Anxiety Inventory), avoidance (Fear Questionnaire), difficulties in emotion regulation (Difficulties in Emotion Regulation Strategies), and worry (Penn State Worry Questionnaire), as well as a significantly larger increase in mindfulness skills (Five Facet Mindfulness Questionnaire). After a 6-month follow-up treatment gains were somewhat diminished. Effects of MBCT on anxiety at post-treatment did not prove to be mediated by mindfulness skills, difficulties in emotion regulation strategies, worry, or rumination (Rumination on Sadness Scales) at midtreatment. Conclusions: MBCT seems to be a promising intervention in routine clinical care for persons with an anxiety disorder who insufficiently responded to first-line psychological treatment. Future research in larger samples assessing long-term effects and using intensive longitudinal designs to identify possible working mechanisms is called for. Show less
Frey, V.; De Mulder, H.N.M.; Bekke M. ter; Struiksma M.E.; Berkum, J. J. A. van; Buskens, V. 2022
The current study investigates whether self-talk phrases can infuence behavior in Ultimatum Games. In our three self-talk treatments, participants were instructed to tell themselves (i) to keep... Show moreThe current study investigates whether self-talk phrases can infuence behavior in Ultimatum Games. In our three self-talk treatments, participants were instructed to tell themselves (i) to keep their own interests in mind, (ii) to also think of the other person, or (iii) to take some time to contemplate their decision. We investigate how such so-called experimenter-determined strategic self-talk phrases afect behavior and emotions in comparison to a control treatment without instructed self-talk. The results demonstrate that other-focused self-talk can nudge proposers towards fair behavior, as ofers were higher in this group than in the other conditions. For responders, self-talk tended to increase acceptance rates of unfair ofers as compared to the condition without self-talk. This efect is signifcant for both other-focused and contemplation-inducing self-talk but not for self-focused self-talk. In the selffocused condition, responders were most dissatisfed with unfair ofers. These fndings suggest that use of self-talk can increase acceptance rates in responders, and that focusing on personal interests can undermine this efect as it negatively impacts the responders’ emotional experience. In sum, our study shows that strategic selftalk interventions can be used to afect behavior in bargaining situations. Show less
Background and objectives: Emotion can be seen as the organizing process that coordinates response systems to deal effectively with challenges and opportunities. Synchronous change in subjective... Show moreBackground and objectives: Emotion can be seen as the organizing process that coordinates response systems to deal effectively with challenges and opportunities. Synchronous change in subjective and physiological reactivity is regarded as an indication of this organizing process. Synchrony is expected to increase with the intensity of emotional stimuli. Conversely, adaptive emotional functioning could be indicated by progressive synchrony upon increasing demands, and the magnitude of synchrony could be an indication of progress during therapy.Methods: We examined whether synchronous change in subjective and physiological reactivity over repeated exposures increased from watching a flight video through simulated flight to actual flight, and whether the magnitude of synchronous change predicted favourable short- and long-term treatment outcome within a group of 77 aviophobic participants during CBT.Results: Results did not show a relationship between the intensity of the phobic stimuli and the magnitude of synchronous change in subjective and physiological reactivity. Moreover, synchronous change across both response systems did not predict treatment outcome.Limitations: By design this study had no control group. Additional treatment or life events between end of treatment and 3-year follow-up were not assessed.Conclusion: The results provide only weak support for the functionalistic view that successful treatment of anxiety disorders is indicated by synchronous change in reactivity across emotional response systems. The relationship between these systems is likely to be affected by many intervening variables including higher order cognitive processes. 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
Abbing, A.C.; Baars, E.W.; Van Haastrecht, O.; Ponstein, A.S. 2019
Anxiety is a major problem for many individuals, causing impairment in daily life. Art therapy is often deployed and although positive results are communicated in clinical practice, its... Show moreAnxiety is a major problem for many individuals, causing impairment in daily life. Art therapy is often deployed and although positive results are communicated in clinical practice, its effectiveness and working mechanisms have hardly been studied. Therefore, it is important to systematically describe the intervention process and to detect the working mechanisms to be able to evaluate them. Narrative case studies help to understand the intervention in more depth. A typical case file was selected for case reporting according to scientific (CARE & CARE-AAT) guidelines, with the aim to explore the therapeutic elements that contributed to the reduction of anxiety. The report describes the intervention process of a 54-year-old female, suffering from anxiety since childhood and diagnosed with panic disorder, agoraphobia, claustrophobia and hypochondria. After 14 sessions of anthroposophic art therapy, reduction of anxiety was shown, as well as improvements of emotion regulation and executive functioning. The client indicated that she became more tolerant and accepting towards her anxiety. She noted a softened attitude towards herself and her complaints, even one year after art therapy. The course of treatment suggests that aspects of emotion regulation and executive functioning were addressed through implicit learning processes in different art therapy assignments. Show less
Children and adolescents with Autism Spectrum Disorder (ASD) often show comorbid emotional and behavior problems. The aim of this longitudinal study is to examine the relation between emotion... Show moreChildren and adolescents with Autism Spectrum Disorder (ASD) often show comorbid emotional and behavior problems. The aim of this longitudinal study is to examine the relation between emotion control (i.e., negative emotionality, emotion awareness, and worry/rumination) and the development of internalizing and externalizing problems. Boys with and without ASD (N = 157; age 9–15) were followed over a period of 1.5 years (3 waves). We found that baseline levels of worry/rumination was a specific predictor of later externalizing problems for boys with ASD. Furthermore, the developmental trajectory of worry/rumination predicted the development of internalizing and externalizing problems in both groups. Our findings suggest that worry/rumination may constitute a transdiagnostic factor underlying both internalizing and externalizing problems in boys with and without ASD. Show less
Children spend most of their days interacting with their social environment. Emotions form a large part of these interactions and vice versa social emotions become meaningful when interacting... Show moreChildren spend most of their days interacting with their social environment. Emotions form a large part of these interactions and vice versa social emotions become meaningful when interacting with others. Understanding the emotion processes that underlie successful social functioning is important, especially in children that experience difficulties in social-emotional functioning such as children with Autism Spectrum Disorders (ASD). These studies used a unique approach towards understanding the complex mechanisms that are involved in emotion processing, incorporating how emotions are perceived, experienced, regulated, and expressed. Sensitive and direct measures of emotion processing such as eyetracking and physiology revealed for the first time on a neurobiological level that children with ASD have difficulties emotionally resonating with others, use less efficient strategies to regulate their emotions, and provided evidence for a possible discordance between the expression and experience of emotions. The preschool years also presented with a possible window of opportunity; children with ASD do feel emotions when it comes to their own experiences and the development of social attention towards others might be prone to improvements during the preschool years. These findings are important to parents and professional and enhance the understanding of emotion processing during these very early years of life. Show less
Stoffels, M.; Nijs, M.; Spinhoven, P.; Mesbah, R.; Hagenaars, M.A. 2017
The empirical research in this thesis focused on individual differences in subjective- and physiological reactivity to flight-related stimuli. The results of these studies are mixed, making them... Show moreThe empirical research in this thesis focused on individual differences in subjective- and physiological reactivity to flight-related stimuli. The results of these studies are mixed, making them difficult to fit into existing theoretical models. The relationship between emotional response systems is likely affected by many intervening variables, including higher order cognitive processes. Pre-treatment individual differences in subjective distress reactivity and physiological reactivity to flight related stimuli, and pre-treatment use of cognitive coping strategies were not prognostic of short- and long-term post-treatment clinical course. In the course of therapy, individual reactivity became more strongly related to treatment outcome. The magnitude of change in the use of maladaptive coping strategies during therapy was indicative of long-term persistence of flight anxiety and long-term flying behaviour. Subjective distress reactivity, pre-exposure and during actual flight, was prognostic for short- and long-term treatment outcomes. Adding measurements of physiological reactivity improved the prediction of treatment outcome. The magnitude of synchronous change in subjective and physiological reactivity did not increase with higher intensity of phobic stimuli, and was not related to outcome. Subjective and physiological measurements of fear activation provided partly independent information. Prognosis for clinical course of aviophobia therefore could benefit from including physiological reactivity measurements. Show less
Insight in the underlying mechanisms of sexual motivation is essential to understand disorders in sexual desire and such understanding may be helpful in the development of new and effective... Show moreInsight in the underlying mechanisms of sexual motivation is essential to understand disorders in sexual desire and such understanding may be helpful in the development of new and effective psychological and pharmacological interventions, since empirically validated treatments are lacking for female sexual interest/arousal disorder as well as hypersexuality and related disorders. Because much sexual behaviour is thought to be acquired through learning, and given the specific hypothesis that classical conditioning plays an etiological role in the development of sexual dysfunction, research in the area of classical conditioning of human sexual arousal is warranted. In the first part of this thesis, experimental studies on sexual conditioning and extinction are described. Further insights in human sexual motivation and behaviour require looking more closely at the pathway of information between stimulus and response and considering how these processes are embedded within other (higher-level) processes and higher order brain structures such as frontal regions, known to be involved in emotional processing and regulation. The second part of this thesis describes studies on the influence of emotion regulation strategies on the expectation of sexual reward, and one fMRI study on the influence of acute-stress on deliberate emotion regulation during the processing of sexual stimuli. Show less
Kersten, L.; Präzlich, M.; Mannstadt, S.; Ackermann, K.; Kohls, G.; Oldenhof, H.; ... ; Stadler, C. 2016
Background: In Europe, the number of females exhibiting oppositional defiant disorder (ODD) and conduct disorder (CD) is growing. Many of these females live in youth welfare institutions.... Show moreBackground: In Europe, the number of females exhibiting oppositional defiant disorder (ODD) and conduct disorder (CD) is growing. Many of these females live in youth welfare institutions. Consequently, there is a great need for evidence-based interventions within youth welfare settings. A recently developed approach targeting the specific needs of girls with ODD and CD in residential care is START NOW. The aim of this group-based behavioural skills training programme is to specifically enhance emotional regulation capacities to enable females with CD or ODD to appropriately deal with daily-life demands. It is intended to enhance psychosocial adjustment and well-being as well as reduce oppositional and aggressive behaviour. We present the study protocol (version 4.1; 10 February 2016) of the FemNAT-CD intervention trial titled 'Group-Based Treatment of Adolescent Female Conduct Disorders: The Central Role of Emotion Regulation'. Methods/design: The study is a prospective, confirmatory, cluster-randomised, parallel-group, multi-centre, randomised controlled trial with 128 institutionalised female adolescents who fulfil the diagnostic criteria of ODD and/or CD. Institutions/wards will be randomised either to provide the 12-week skills training as an add-on intervention or to provide treatment as usual. Once the first cycle is completed, each institution will run a second cycle with the opposite condition. Primary endpoints are the pre-post change in number of CD/ODD symptoms as assessed by a standardised, semi-structured psychiatric interview (Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime, CD/ODD section) between baseline and the end of intervention, as well as between baseline and a 3-month follow-up point. Secondary objectives include pre-post change in CD/ODD-related outcome measures, most notably emotional regulation on a behavioural and neurobiological level after completion of START NOW compared with treatment as usual. Discussion: To our knowledge, this study is the first to date to systematically investigate the effectiveness of an adapted integrative psychosocial intervention designed for female adolescents with ODD and CD in youth welfare settings. Trial registration: German Clinical Trials Register (DRKS) identifier: DRKS00007524. Registered on 18 December 2015 and with the World Health Organisation International Clinical Trials Registry Platform. Show less
