Social withdrawal is an early and common feature of psychiatric disorders. Hypothalamic-pituitary-adrenal (HPA)-axis activation through increased salivary cortisol (sC) and sympathetic activation... Show moreSocial withdrawal is an early and common feature of psychiatric disorders. Hypothalamic-pituitary-adrenal (HPA)-axis activation through increased salivary cortisol (sC) and sympathetic activation through increased salivary alpha-amylase (sAA) may play a role. We aimed to study whether the link between increased sC and sAA on the one hand and depression on the other hand is mediated by social withdrawal. In this cross-sectional, observational study, sC and sAA measures were measured in seven saliva samples in 843 participants (231 psychiatric patients and 612 healthy controls). Social withdrawal was assessed through the Brief Symptom Inventory (BSI)-, the Short Form 36-, and the Dutch Dimensional Assessment of Personality Pathology social withdrawal subscales, and analyzed using linear regression and mediation analyses. On average, participants were 44.0 years old (SD = 12.8; 64.1% female). Basal and diurnal sAA were unrelated to any social withdrawal scale and depression. Certain sC measures were positively associated with the BSI social withdrawal subscale (i. e., area under the curve with respect to the increase, beta = 0.082, p = 0.02; evening sC value: beta = 0.110, p = 0.003; and mean sC value: beta = 0.097; p = 0.01). We found limited support for statistical mediation by social withdrawal (measured using a composite social withdrawal score) on the relationship between evening sC and depression. Thus, although we found no support for a role of basal and diurnal sAA in social withdrawal, HPAaxis activation may partly aggravate social withdrawal in depressive disorders. Show less
Bauduin, S.E.E.C.; Noorden, M.S. van; Werff, S.J.A. van der; Leeuw, M. de; Hemert, A.M. van; Wee, N.J.A. van der; Giltay, E.J. 2018
The main objective of this thesis is to describe the epidemiology of long term BZD use as well as its long term consequences. This thesis is structured into three sections: In section one, the... Show moreThe main objective of this thesis is to describe the epidemiology of long term BZD use as well as its long term consequences. This thesis is structured into three sections: In section one, the correlates of BZD use, new use, chronic use, inappropriate use, and BZD dependence severity are investigated. The possible influence of the prescribing physicians on patient BZD use is also considered. In section two, the focus is on the physiological consequences of long-term BZDs use on the HPA axis and the ANS. In section three, cognitive effects of BZDs in long-term users are addressed Show less
Colzato, L.S.; Does, A.J.W. van der; Kouwenhoven, C.; Elzinga, B.M.; Hommel, B. 2011
The thesis ‘Quality in home-based childcare: Impact and improvement’ consists of two studies. The general aim of the first study is to examine children’s stress levels and wellbeing, and the role... Show moreThe thesis ‘Quality in home-based childcare: Impact and improvement’ consists of two studies. The general aim of the first study is to examine children’s stress levels and wellbeing, and the role of caregiver stress and childcare quality. This first study is described in chapters 2, 3, and 4. Chapter 2 addresses the question whether children’s cortisol levels (and wellbeing) differ between contexts (childcare day or at home day) and setting (childcare homes and childcare centers), and associations with childcare quality are examined. Chapter 3 reports on caregivers’ cortisol levels (and perceived stress) between contexts (work day, non-work day) and setting (childcare homes and childcare centers). In addition, associations between caregiver stress and childcare quality are examined. Chapter 4 investigates associations between caregivers’ cortisol levels (and perceived stress) and children’s wellbeing and cortisol in home-based childcare. Also, children’s temperament is taken into account. In the second study, described in chapter 5, we test the effectiveness of the Video-feedback Intervention to promote Positive Parenting – Childcare (VIPP-CC) in enhancing childcare quality in home-based childcare. Show less
