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.; 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
This dissertation comprises an empirical study and a meta-analytical study on autonomic nervous system (ANS) functioning and attachment representations in maltreating parents. For the empirical... Show moreThis dissertation comprises an empirical study and a meta-analytical study on autonomic nervous system (ANS) functioning and attachment representations in maltreating parents. For the empirical study we recruited a sample of 45 mothers with substantiated abuse and neglect and 45 non-maltreating control mothers. Mothers listened to infant cry sounds of varying pitches while their heart rate, vagal tone, pre-ejection period, skin conductance, and salivary α-amylase were measured. Maltreating mothers showed a blunted ANS response to the cry sounds, as well as a lack of coherence between ANS components, compared to the non-maltreating group. During a second appointment we conducted the Adult Attachment Interview. More maltreating mothers had an Unresolved/disoriented (U/d) attachment representation and maltreating mothers showed lower coherence of mind. In turn, U/d attachment was associated with a decrease in skin conductance during an attachment-related computer paradigm, while coherence of mind was associated with higher skin conductance during the paradigm. A meta-analysis of 11 studies (N = 524)showed that (risk for) child maltreatment was associated with higher levels of baseline ANS activity, while a second meta-analysis (k = 11, N = 503) showed no differences in ANS stress reactivity between maltreating parents/at-risk adults and non-maltreating/low-risk comparison groups. Show less
Wat bepaalt de kwaliteit van gehechtheid? In een grootschalig onderzoek, Generation R, zijn de stresshuishouding en enkele kandidaatgenen van de kinderen onderzocht, en het gedrag van de ouder. De... Show moreWat bepaalt de kwaliteit van gehechtheid? In een grootschalig onderzoek, Generation R, zijn de stresshuishouding en enkele kandidaatgenen van de kinderen onderzocht, en het gedrag van de ouder. De gehechtheidsrelatie is de relatie tussen een kind en een ouder (of andere stabiele verzorger) die in het eerste levensjaar wordt opgebouwd. Veilig gehechte kinderen gebruiken hun ouder als veilige haven van waar ze de omgeving verkennen. Onveilig gehechte kinderen hebben hier moeite mee; zij kunnen niet de juiste balans vinden tussen contact met de ouder en het verkennen van de omgeving. Dit onderzoek laat zien dat onveilig gehechte kinderen heftiger op stress reageren dan veilig gehechte kinderen. Wanneer er sprake was van depressie in het leven van de moeder, leidt dit tot een verdere toename van stress bij de onveilig gehechte kinderen. Hetzelfde gold voor onveilig gehechte kinderen met een risico-gen dat verantwoordelijk is voor een minder goede stressregulatie. Verder vonden we dat sensitief opvoedgedrag van moeder leidde tot meer veilige gehechtheid, maar alleen wanneer het kind een bepaalde variant van een gen droeg dat van belang is bij het omgaan met stress. De resultaten laten de kwetsbaarheid en stressgevoeligheid van onveilig gehechte kinderen zien. Daarnaast kunnen we op basis van de huidige resultaten zeggen dat insensitief opvoedgedrag, depressie van moeder en genetische risico’s een rol spelen bij onveilige gehechtheid. De ontwikkeling van gehechtheid is complex, en het resultaat van het samenspel tussen biologische aspecten en de opvoedingsomgeving. Daarop moet toekomstig onderzoek dan ook gericht zijn. Show less
This thesis examined the development of adopted children to shed more light on the effects of deprivation on child development and the potential for catch-up and recovery after placement in the... Show moreThis thesis examined the development of adopted children to shed more light on the effects of deprivation on child development and the potential for catch-up and recovery after placement in the more advantageous environment of an adoptive family. In the first part of the thesis a meta-analysis is presented in which we compared adopted children’s attachment relationships with the normative attachment distribution of nonadopted children raised by their biological parents, and - as a comparison - we also compared the attachment distribution of foster children with the normative distribution. The second and third parts of the thesis focus on the development of former foster and post-institutionalized children, 11 to 16 months old at arrival, two and six months after their adoption from China. Several salient developmental domains were studied: attachment, cognitive and motor development, physical growth, stress regulation, and social-emotional behavior. Show less
Although institutional care jeopardizes children’s development, some studies suggest that well-functioning child-care institutions may offer children a better environment than their own... Show moreAlthough institutional care jeopardizes children’s development, some studies suggest that well-functioning child-care institutions may offer children a better environment than their own dysfunctional families. For the growing number of HIV-infected children who often live in underprivileged families or institutions, comparative studies on their care arrangements are crucial. In her dissertation Natasha Dobrova-Krol examined the impact of institutional care and HIV-infection on several developmental domains of more than 60 Ukrainian preschoolers. Physical growth, stress regulation, cognitive and social development, as well as organization of attachment and children’s indiscriminately friendly behavior were addressed in this study. Developmental outcomes of HIV-infected children reared in disadvantaged families were compared with the outcomes of children reared in institutions providing adequate medical and physical care. In search for possible risk and protective factors in the development of the children individual characteristics and various aspects of the rearing environment were explored. The findings of this study demonstrated that institutional rearing impeded the development of children in all domains. Both for children with and without HIV family care, even of compromised quality, was better than institutional care, even of good quality. HIV-infection was found to be associated with less favorable outcomes in physical growth and cognitive development. The negative impact of institutional care, however, was larger than the presence of HIV. In three out of six developmental domains that were examined, HIV-infected children reared in disadvantaged families showed significantly better results than both HIV-infected and uninfected children reared in institutions, and no difference was found in the other domains. The quality of the child-caregiver relationship had a larger impact on children’s physical growth and cognitive performance than either HIV-infection or the quality of the physical environment and thus represents an important intervention target. The study has important implications for intervention efforts in child-care institutions. Show less
