There is a lack of reliable, repeatable, and non-invasive clinical endpoints when investigating treatments for intellectual disability (ID). The aim of this study is to explore a novel approach... Show moreThere is a lack of reliable, repeatable, and non-invasive clinical endpoints when investigating treatments for intellectual disability (ID). The aim of this study is to explore a novel approach towards developing new endpoints for neurodevelopmental disorders, in this case for ARID1B-related ID. In this study, twelve subjects with ARID1B-related ID and twelve age-matched controls were included in this observational case-control study. Subjects performed a battery of non-invasive neurobehavioral and neurophysiological assessments on two study days. Test domains included cognition, executive functioning, and eye tracking. Furthermore, several electrophysiological assessments were performed. Subjects wore a smartwatch (Withings (R) Steel HR) for 6 days. Tests were systematically assessed regarding tolerability, variability, repeatability, difference with control group, and correlation with traditional endpoints. Animal fluency, adaptive tracking, body sway, and smooth pursuit eye movements were assessed as fit-for-purpose regarding all criteria, while physical activity, heart rate, and sleep parameters show promise as well. The event-related potential waveform of the passive oddball and visual evoked potential tasks showed discriminatory ability, but EEG assessments were perceived as extremely burdensome. This approach successfully identified fit-for-purpose candidate endpoints for ARID1B-related ID and possibly for other neurodevelopmental disorders. Next, results could be replicated in different ID populations or the assessments could be included as exploratory endpoint in interventional trials in ARID1B-related ID. 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
Abbing, A.C.; De Sonneville, L.; Baars, E.; Bourne, D.; Swaab, H. 2019
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
Children become more active participants in parent-child interaction by the time they reach primary school age, during the transition from dependence to greater autonomy. Parent-child interaction... Show moreChildren become more active participants in parent-child interaction by the time they reach primary school age, during the transition from dependence to greater autonomy. Parent-child interaction can shape children’s neurocognitive development, yet little is known about the nature of this relation in school-aged children. In this dissertation the associations between parent-child interaction and four- to eight-year-old children’s attentional control, executive functioning , social cognition and reasoning skills were investigated. Furthermore, it was investigated whether parents can be educated to improve interactions with their child through a compact psycho-educational program. It can be concluded that parental supportive presence, intrusiveness and questioning style adaptive to both the age and needs of school-aged children were associated with children’s neurocognitive functioning. Educating parents to adaptively modify their parent-child interactions can positively influence their supportive presence, intrusiveness and questioning style, which in turn may benefit their child’s neurocognitive functioning. These findings suggest that educating parents can benefit children’s neurocognitive development and the aspects of parenting strategies investigated in this dissertation could be useful objectives. A compact school-based group program for parents may already have a meaningful impact in promoting aspects of parent-child interaction that have been shown to be associated with children’s neurocognitive development. Show less
Dingemans, A.E.; Vanhaelen, C.B.; Aardoom, J.J.; Furth, E.F. van 2019
Executive functions are a set of cognitive processes that are necessary for the cognitive control of behavior. They play a role in mediating self-control, self-regulation and decision-making. It... Show moreExecutive functions are a set of cognitive processes that are necessary for the cognitive control of behavior. They play a role in mediating self-control, self-regulation and decision-making. It has been suggested that the inability to control eating behavior in binge eating disorder (BED) may indicate deficits in executive functioning. This may be worsened by depressive symptoms. The aim of the present study was to compare executive functioning of patients with BED and no-to-mild depressive symptoms (n = 25), patients with BED and moderate-to-severe depressive symptoms (n = 66), and healthy controls (Body Mass Index <30) (n = 56), matched on age, educational level and gender. The participants were assessed by means of neuropsychological tests and questionnaires. The neuropsychological tests did not show significant differences in executive functioning between the groups. However, eating disorder psychopathology and depressive symptoms are associated with self-reported difficulties in executive functioning in daily life. A self-report questionnaire which evaluates the functional, real-world impact of executive dysfunction expressed in everyday activities seems to be more useful in this population than neuropsychological tests. This study highlights the importance of taking depressive symptoms into account when studying executive functioning in patients with (binge) eating disorders. Show less
Dingemans, A.E.; Vanhaelen, C.B.; Aardoom, J.J.; Van Furth, E.F. 2019
Executive functions are a set of cognitive processes that are necessary for the cognitive control of behavior. They play a role in mediating self-control, self-regulation and decision-making. It... Show moreExecutive functions are a set of cognitive processes that are necessary for the cognitive control of behavior. They play a role in mediating self-control, self-regulation and decision-making. It has been suggested that the inability to control eating behavior in binge eating disorder (BED) may indicate deficits in executive functioning. This may be worsened by depressive symptoms. The aim of the present study was to compare executive functioning of patients with BED and no-to-mild depressive symptoms (n = 25), patients with BED and moderate-to-severe depressive symptoms (n = 66), and healthy controls (Body Mass Index <30) (n = 56), matched on age, educational level and gender. The participants were assessed by means of neuropsychological tests and questionnaires. The neuropsychological tests did not show significant differences in executive functioning between the groups. However, eating disorder psychopathology and depressive symptoms are associated with self-reported difficulties in executive functioning in daily life. A self-report questionnaire which evaluates the functional, real-world impact of executive dysfunction expressed in everyday activities seems to be more useful in this population than neuropsychological tests. This study highlights the importance of taking depressive symptoms into account when studying executive functioning in patients with (binge) eating disorders. Show less
Adolescence is characterized by considerable changes in cognitive and socio-emotional skills. There are considerable differences between adolescents with regards to the development of these skills.... Show moreAdolescence is characterized by considerable changes in cognitive and socio-emotional skills. There are considerable differences between adolescents with regards to the development of these skills. However, most studies examine adolescents’ average functioning, without taking into account this heterogeneity. The current study applies network analysis in order to examine heterogeneity of cognitive and socio-emotional functioning in adolescents on-track or delayed in their school progression. Data was collected at two time-points for on-track (n = 320) and delayed (n = 69) adolescents (Mage = 13.30 years, SDage = 0.77). Repeated measures ANOVA showed no significant differences between the groups in cognitive and socio-emotional functioning (p’s > 0.05). Network analysis revealed that executive functions play a key role in the network of cognitive, social, and emotional functioning. This is especially the case in the delayed group where executive functions are even more central, both at T1 (inhibition and shifting) and T2 (shifting). Subsequent community analysis revealed three profiles in both groups: a well-adapted and well-balanced group, a group with high levels of need for arousal and risk-taking, and a group with regulation problems. Compared to on-track adolescents, delayed adolescents showed even higher levels of risk-taking in the second profile and higher levels of executive function problems in the third profile at T1. These differences were leveled out at T2, indicating adolescents in the delayed group catch up with their peers. This study highlights the intricate balance between cognitive, social and emotional functioning in adolescents in relation to school performance and provides preliminary evidence of the importance of taking individual differences within groups into account. Show less
Dekkers, T.J.; Agelink van Rentergem, J.A.; Koole, A.; Van den Wildenberg, W.P.M.; Popma, A.; Bexkens, A.; ... ; Huizenga, H.M. 2017
Good parenting strategies can shape children’s neurocognitive development, yet little is known about the nature of this relation in school-aged children and whether this association shifts with age... Show moreGood parenting strategies can shape children’s neurocognitive development, yet little is known about the nature of this relation in school-aged children and whether this association shifts with age. We aimed to investigate the relation between parenting strategies observed during a home visit and children’s performance-based attentional control and executive functioning (N = 98, aged 4–8 years). Linear and curvilinear regression analyses showed that children of parents who were more supportive, were less intrusive, and asked more open-ended questions displayed better inhibitory control. In addition, children of parents who asked relatively more open-ended than closed-ended questions showed better performance on inhibition, working memory, and cognitive flexibility tasks. Curvilinear relations indicated the presence of an optimal amount of closed-ended and elaborative questions by parents—that is, not too few and not too many—which is linked to increased performance on attentional and inhibitory control in children. Higher parental intrusiveness and more frequent elaborative questioning were associated with decreased inhibitory control in younger children, whereas no such negative associations were present in older children. These results suggest that susceptibility to certain parenting strategies may shift with age. Our findings underscore the importance of adaptive parenting strategies to both the age and needs of school-aged children, which may positively affect their self-regulation skills. Show less
Ziermans, T.; Swaab, J.T.; Stockmann, A.; De Bruin, E.; Rijn, S. van 2017
Giftedness is often assessed by means of conventional (shortened) intelligence tests. These tests, however, are assumed to not always provide a picture of children’s potential for learning,... Show moreGiftedness is often assessed by means of conventional (shortened) intelligence tests. These tests, however, are assumed to not always provide a picture of children’s potential for learning, especially with regard to special populations. In the current dissertation, therefore, dynamic testing was utilized in order to investigate potential differences between gifted and average-ability children. Dynamic testing refers to a testing method in which training and feedback are integrated into the testing process. The main aims of this dissertation were to investigate potential differences between gifted and average-ability children with regard to their progression in analogy problem-solving, instructional needs during training, transfer of analogy problem-solving skills to analogy construction, as well as the roles that metacognition, cognitive flexibility and test anxiety potentially play in analogy problem-solving. The results showed that, in general, vis-à-vis their average-ability peers, gifted children showed higher initial scores on the tests, but showed similar progression after practice or training, equivalent instructional needs, and equivalent transfer success and effectiveness. Test anxiety and metacognition were, further, found to play a role in progression in analogy problem-solving, specifically with regard to training benefits. Lower scores of metacognition, and higher test anxiety scores were related to higher progression after training. Show less
The studies described in this thesis aim to provide a better understanding of the mechanisms that result in vulnerability to autism and ADHD symptomatology in individuals with the 22q11 deletion... Show moreThe studies described in this thesis aim to provide a better understanding of the mechanisms that result in vulnerability to autism and ADHD symptomatology in individuals with the 22q11 deletion syndrome (22q11DS). The objective of the current thesis was to investigate the association between neurocognitive functioning and severity of autism and ADHD symptomatology in individuals with 22q11DS. For this purpose intellectual functioning, executive functioning and social cognition were assessed in a sample of children and adolescents (aged 9-18.5 years) with 22q11DS. Our findings show that children and adolescents with 22q11DS present with severe impairments on various domains of neurocognitive functioning. Some of these impairments are associated with the variable expression of social behavioral problems within the syndrome, underlining the importance of monitoring the cognitive development within this population. This knowledge can be used as a starting point for the development and adjustment of preventive interventions and for treatments of children and adolescents with 22q11DS who are at risk of these developmental problems. For clinical practice and future research it is important to be aware of the role of both genetic factors and neurocognitive functioning in the presence and severity of behavioral problems in syndromes like 22q11DS. Show less
Liemburg, G.B.; Jahja, R.; Van Spronsen, F.J.; Sonneville, L.M.J. de; Van der Meere, J.J.; Bosch, A.M.; ... ; Huijbregts, S.C.J. 2015
Huntington's disease (HD) is a genetic neurodegenerative disease. Carriers of the HD gene without clinical symptoms of the disease can be identified and studied. The study of these premanifest... Show moreHuntington's disease (HD) is a genetic neurodegenerative disease. Carriers of the HD gene without clinical symptoms of the disease can be identified and studied. The study of these premanifest subjects is of importance for the understanding of preclinical disease progression and for the design of future clinical trials. HD is characterized by progressive decline in motor functioning, cognition and behaviour. The unwanted motor disturbances that patients experience are likely to be of influence on cognitive functioning, as cognitive tests almost always require a motoric response. In this thesis we investigated cognitive functioning in both premanifest HD gene carriers and HD patients by taking into account the motor disturbances that have been reported in both pre- and manifest phases of the disease. We also reports on the influence of time on cognition in HD by means of several longitudinal reports with follow-up periods as long as ten years. We found both carriers and patients deteriorate most on memory and executive functioning domains, with the latter being most sensitive in the premanifest phase. We have also found evidence for the presence of premanifest (cognitive) compensatory mechanisms. As expected, there is a substantial (negative) effect of motor functioning on cognition in HD. Show less
Core deficits in people with autisme spectrum disorders (ASD) are difficulties in adapting their behaviour to the social environment which hampers the possibilities to communicate adequately and to... Show moreCore deficits in people with autisme spectrum disorders (ASD) are difficulties in adapting their behaviour to the social environment which hampers the possibilities to communicate adequately and to have reciprocal relationships. These problems have a serious impact on functioning in their daily life. Since ASD are severe and lifelong conditions, it is relevant to examine how children with ASD develop troughout their life and to investigate which factors constitute an unfavourable contribution to their development. This thesis reveals that children with ASD are at specific risk of poor quality of life in adulthood when compared to children with other psychiatric disorders. Secondly, the impact of ASD on specific domains of intellectual functioning is different at different ages, implicating that re-evaluation of cognitive function during development of children with ASD is recommended during their life. Thirdly, children with ASD who are at risk of schizophrenia spectrum pathology, may show negative schizotypal symptoms, but also disorganized and positive symptoms in addition to ASD symptomatology. These symptoms of schizotypy appear to be associated with inhibition problems. We should be aware of inhibition problems in children with ASD because they may be indicators of high risk to schizophrenia spectrum pathology later in life. Show less
In this thesis the cognitive strengths and weaknesses have been examined. The results show impairment in advanced theory of mind. Furthermore, impairment was found in processing speed. The results... Show moreIn this thesis the cognitive strengths and weaknesses have been examined. The results show impairment in advanced theory of mind. Furthermore, impairment was found in processing speed. The results pointed to strengths in detailed information processing. No impairment was found in executive functioning Show less
