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Egan LA, Park HRP, Lam J, Gatt JM. Resilience to Stress and Adversity: A Narrative Review of the Role of Positive Affect. Psychol Res Behav Manag 2024; 17:2011-2038. [PMID: 38770188 PMCID: PMC11104260 DOI: 10.2147/prbm.s391403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/23/2024] [Indexed: 05/22/2024] Open
Abstract
The modern conception of mental health encompasses not only mental illness but also mental wellbeing, including positive emotional states and other forms of positive experience. Accordingly, research on resilience - that is, recovery or adaptation following adversity - has recently expanded to consider the roles of positive affect in the resilience process. To review this research, we performed a keyword search of all peer-reviewed journals within the American Psychological Association's PsycInfo database, retrieving all studies of positive affect in the context of resilience. These studies measured positive affect either as the outcome of the resilience process or as a resilience resource in its own right. With positive affect as the outcome, the literature suggests that various resilience resources can promote positive affect following a stressor, especially positive personality traits (eg, hope, optimism, self-compassion) and supportive interpersonal connections. With positive affect as a resilience resource, the literature suggests that higher levels of positive affect may protect individuals from the impact of stress on a number of outcomes, such as depression and trauma symptoms. In all, the reviewed research showcases a wide range of stressors, resources, and outcomes, and there are numerous openings for future discoveries in this promising area of inquiry.
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Affiliation(s)
- Luke A Egan
- Centre for Wellbeing, Resilience and Recovery, Neuroscience Research Australia, Randwick, NSW, Australia
| | - Haeme R P Park
- Centre for Wellbeing, Resilience and Recovery, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Psychology, University of New South Wales, Kensington, NSW, Australia
| | - Janine Lam
- Centre for Wellbeing, Resilience and Recovery, Neuroscience Research Australia, Randwick, NSW, Australia
| | - Justine M Gatt
- Centre for Wellbeing, Resilience and Recovery, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Psychology, University of New South Wales, Kensington, NSW, Australia
- Black Dog Institute, Randwick, NSW, Australia
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2
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Lassri D, Gewirtz-Meydan A, Nolte T. Transdiagnostic factors in the COVID-19 pandemic: Examining the role of childhood abuse and neglect in establishing latent profiles of risk and resilience. CHILD ABUSE & NEGLECT 2024:106808. [PMID: 38693009 DOI: 10.1016/j.chiabu.2024.106808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 04/01/2024] [Accepted: 04/18/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Ample studies have focused on the negative consequences of COVID-19 on mental well-being, but fewer have explored the specific role of childhood abuse and neglect in the context of risk and resilience during this unprecedented crisis. OBJECTIVE We aimed to identify distinct profiles of individuals based on their experiences of childhood abuse and neglect, coping strategies, and psycho-social transdiagnostic risk and protective factors, using a person-centered approach. PARTICIPANTS AND SETTING A convenience sample of 914 Israelis completed self-report questionnaires during the second wave of COVID-19. METHODS Latent Profile Analysis was employed based on levels of childhood abuse and neglect, coping strategies, and established factors underpinning risk and resilience in mental health: dissociation, self-criticism, self-efficacy, self-compassion, attachment insecurity, psychological resilience, mentalizing, distress disclosure, psychopathology, and relationship satisfaction. Profiles were compared in COVID-19-related distress and well-being using ANOVAs. RESULTS A four-profile solution was found to be optimal for describing individuals with different profiles of risk and resilience: "risk" (5.1 %)-individuals with meaningfully high levels of childhood abuse and neglect and dissociation; "vulnerable" (14.2 %)-individuals high in risk factors and low in protective factors; "moderately resilient" (47.6 %)-those with moderate levels of protective and risk factors; "highly resilient" (33.1 %)-individuals high in protective factors and low in risk factors; groups differed in mental well-being and COVID-19-related distress. CONCLUSIONS Results highlight the importance of childhood abuse and neglect in differentiating between the two distinct profiles of at-risk individuals. Implications for risk assessment and treatment in the context of potential traumatic stress are discussed.
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Affiliation(s)
- Dana Lassri
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel; Research Department of Clinical, Educational, and Health Psychology, University College London (UCL), United Kingdom.
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Israel. agewirtz-@univ.haifa.ac.il
| | - Tobias Nolte
- Research Department of Clinical, Educational, and Health Psychology, University College London (UCL), United Kingdom; Anna Freud, United Kingdom.
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3
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Cankardas S, Atak I, Simsek OF. Development and Validation of the Subjective Well-Being Resources Scale. THE JOURNAL OF PSYCHOLOGY 2024; 158:383-402. [PMID: 38442227 DOI: 10.1080/00223980.2024.2316063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/02/2024] [Indexed: 03/07/2024] Open
Abstract
Subjective well-being (SWB) is an important construct of positive psychology and it is known that these resources should be supported to prevent mental health disorders. However, there is no measurement tool to assess individual differences concerning SWB resources. The present study aims to develop a valid and reliable scale to measure SWB resources. For this aim, two studies were conducted. As a result, the five-factor (personal, religious, health, social, and external resources) construct explaining 45.3% of the variance was derived and validated with both exploratory and confirmatory factor analysis. The factors were related to mental health indicators and personality as expected. The internal consistency coefficient of the scale was .83), and the test re-test reliability was .88. As a result of the analysis, it is concluded that the Subjective Well-Being Resources Scale is valid and reliable and can be used to measure SWB resources.
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Meyer T, Sickinghe M, Matera V, Morina N. Comparison standards shape everyday judgments of low and high wellbeing in individuals with and without psychopathology: a diary-based investigation. Sci Rep 2024; 14:4063. [PMID: 38374170 PMCID: PMC10876573 DOI: 10.1038/s41598-024-54681-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/15/2024] [Indexed: 02/21/2024] Open
Abstract
People can easily rate and express their current levels of wellbeing, but the cognitive foundations for such judgments are poorly understood. We examined whether comparisons to varying standards underlie fluctuating wellbeing judgments within-person (i.e., throughout daily episodes) and between-person (i.e., high vs. low levels of psychopathology). Clinical and non-clinical participants recorded subjective affect for each distinct episode for one week. Participants briefly described current, best, and worst daily episodes, which we coded for presence and type of comparison standard (social, past temporal, criteria-based, counterfactual, prospective temporal, and dimensional). Participants also rated their engagement with these standards and the respective affective impact. During best episodes, participants reported more downward (vs. upward) comparisons that resulted in positive affective impact. In worst episodes, upward (vs. downward) comparisons were more frequent. In best and worst episodes, we most frequently identified past-temporal and criteria-based comparisons, respectively. The clinical group engaged more often with all potential standard types during worst daily episodes and was more negatively affected by comparative thoughts, amid consistently more negative affect levels across all episode types. Our data suggest that judgments of affect and wellbeing may indeed rely on comparative thinking, whereby certain standards may characterize states of negative affect and poor mental health.
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Affiliation(s)
- Thomas Meyer
- Institute of Psychology, University of Münster, Münster, Germany.
| | - Marthe Sickinghe
- Institute of Psychology, University of Münster, Münster, Germany
| | - Vanessa Matera
- Institute of Psychology, University of Münster, Münster, Germany
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
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5
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Schürmann-Vengels J, Troche S, Victor PP, Teismann T, Willutzki U. Multidimensional Assessment of Strengths and Their Association With Mental Health in Psychotherapy Patients at the Beginning of Treatment. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e8041. [PMID: 37732153 PMCID: PMC10508254 DOI: 10.32872/cpe.8041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/07/2023] [Indexed: 09/22/2023] Open
Abstract
Background Modern concepts assume that mental health is not just the absence of mental illness but is also characterized by positive well-being. Recent findings indicated a less pronounced distinction of positive and negative mental health dimensions in clinical samples. Self-perceived strengths were associated with markers of mental health in healthy individuals. However, analyses of strengths and their association with different mental health variables in clinical populations are scarce. Method A cross-sectional design was conducted at a German outpatient training and research center. 274 patients before treatment (female: 66.4%, mean age = 42.53, SD = 13.34, range = 18-79) filled out the Witten Strengths and Resource Form (WIRF), a multidimensional self-report of strengths, as well as other instruments assessing positive and negative mental health variables. Data was analyzed with structural equation modeling and latent regression analyses. Results Confirmatory factor analysis of the WIRF showed good model fit for the assumed three-subscale solution. Regarding mental health, a one-factor model with positive and negative variables as opposite poles showed acceptable fit. A correlated dual-factor model was not appropriate for the data. All WIRF subscales significantly predicted unique parts of variance of the latent mental illness factor (p = .035 - p < .001). Conclusion The context-specific assessment of patients' strengths was confirmed and led to an information gain in the prediction of mental health. Results suggest that positive and negative facets of mental health are highly entwined in people with pronounced symptoms. The scientific and practical implications of these findings are discussed.
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Affiliation(s)
- Jan Schürmann-Vengels
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Stefan Troche
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Philipp Pascal Victor
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
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Liu Y, Yang X, Wu Y, Xu Y, Zhong Y, Yang S. The Relationship between Job Satisfaction and Depressive Symptoms among Chinese Adults Aged 35-60 Years: The Mediating Role of Subjective Well-Being and Life Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032023. [PMID: 36767389 PMCID: PMC9915934 DOI: 10.3390/ijerph20032023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 05/31/2023]
Abstract
The purpose of this study was to assess the serial multiple mediating effects of subjective well-being and life satisfaction between job satisfaction and depressive symptoms among Chinese adults aged 35-60 years. According to the 2018 China Family Panel Study (CFPS), we finally selected 10,609 respondents (5202 females, and 5407 males) aged 35-60 years old as samples for the study. Correlation analysis was carried out to examine the relationship among job satisfaction, subjective well-being, life satisfaction, and depressive symptoms. Linear regression models were established to analyze the relationship between job satisfaction and depressive symptoms. Serial multiple mediation analysis was conducted by the SPSS macro PROCESS program. The results suggested that job satisfaction was negatively correlated with depressive symptoms among Chinese adults aged 35-60 years. Subjective well-being and life satisfaction mediated the relationships between them, respectively. Furthermore, job satisfaction also had indirect impacts on depressive symptoms through the serial mediating effects of subjective well-being and life satisfaction. The findings revealed that increasing job satisfaction could decrease depressive symptoms through promoting subjective well-being and life satisfaction. The study may offer some meaningful implications for improving the mental health and reducing the risk of depressive symptoms among Chinese adults aged 35-60 years.
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Patients' symptoms and strengths as predictors of long-term outcomes of CBT for generalized anxiety disorder - A three-level, multi-predictor analysis. J Anxiety Disord 2022; 92:102635. [PMID: 36201995 DOI: 10.1016/j.janxdis.2022.102635] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 08/25/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022]
Abstract
Although cognitive behavioral therapy (CBT) is an effective treatment for generalized anxiety disorder (GAD), GAD often shows a chronic clinical course and common deterioration after treatment. Many trials have examined the efficacy of treatments in GAD, but little is known about intake predictors of long-term treatment outcomes. This study examined potential predictors of long-term treatment outcomes based on the individual's symptom severity and strengths (behavioral, cognitive, interpersonal) at intake. Long-term outcomes were defined as worry at six-month follow-up (six-m FU) and worry decrease from intake and post-treatment to six-m FU. Data from 137 CBT outpatients with a GAD diagnosis from two randomized clinical trials were analyzed using three-level hierarchical linear modeling. Results revealed that worrying decreased up to the six-m FU. In single-predictor models, intake symptom severity and strength measures predicted worry at the six-m FU. In multi-predictor models, only behavioral strengths remained a significant predictor. Worry decrease from intake to the six-m FU was only predicted by behavioral strengths. These findings provide relevant information about intake predictors of long-term outcomes after CBT for GAD and underscore the potential relevance of assessing patients' strengths for clinical practice.
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Osofsky H, Osofsky J, Saltzman LY, Lightfoot E, De King J, Hansel TC. Mechanisms of recovery: Community perceptions of change and growth following multiple disasters. Front Psychol 2022; 13:991770. [DOI: 10.3389/fpsyg.2022.991770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/06/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction and purposeThe geographic location of the Gulf South leaves communities in continuous threat, response, and recovery disaster cycles. Hurricane Katrina in 2005 provided an opportunity to study disaster mental health. Less than 5 years after the storm, many Hurricane Katrina survivors were impacted again by the Deepwater Horizon Gulf oil spill. Despite adversities impacting Gulf communities, over 90% of participants reported they were resilient. The purpose of this study was to improve the understanding of the mechanisms that contribute to strengths following adversity in communities affected by repeated disasters. Specifically, we focused on survivor perceptions of personal, spiritual, or community changes in efforts to describe community resilience and posttraumatic growth (PTG).MethodsParticipants were recruited through a quantitative survey and community flyers. Participants represented southeastern Louisiana, in areas impacted by hurricanes and the oil spill—for a total of five focus groups and 41 participants. Focus groups began by asking each participant to provide a brief overview of their disaster survival story and three additional guiding strengths-based questions. Data were transcribed using Dragon Speech Recognition software. A total of 963 unique responses were analyzed and coded.ResultsThe following themes were identified: connectedness (n = 259), coping (n = 94), spirituality (n = 60), adaptability (n = 47), and self-reliance (n = 23). Participants noted a growth mindset from the disasters and also acknowledged coinciding negative experiences (n = 154) associated with community change and loss, where subthemes included change in connectedness (n = 97), crime (n = 26), and feeling like an outsider (n = 31).Discussion and implicationsThese findings help scholars and mental health practitioners better understand the lived experiences of PTG in a community of survivors impacted by recurring traumatic experiences. In keeping with previous literature, PTG and negative experiences associated with trauma are not mutually exclusive, but occur simultaneously. Our results offer a holistic picture of coping with cumulative or repeated traumas and suggest that connectedness, coping, and spirituality provide important buffers to negative psychosocial outcomes.
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9
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Wigman JTW, van der Tuin S, van den Berg D, Muller MK, Booij SH. Mental health, risk and protective factors at micro- and macro-levels across early at-risk stages for psychosis: The Mirorr study. Early Interv Psychiatry 2022; 17:478-494. [PMID: 36198658 DOI: 10.1111/eip.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 02/16/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The clinical staging model states that psychosis develops through subsequent stages of illness severity. To better understand what drives illness progression, more extensive comparison across clinical stages is needed. The current paper presents an in-depth characterization of individuals with different levels of risk for psychosis (i.e., different early clinical stages), using a multimethod approach of cross-sectional assessments and daily diary reports. METHODS Data came from the Mirorr study that includes N = 96 individuals, divided across four subgroups (n1 = 25, n2 = 27, n3 = 24, and n4 = 20). These subgroups, each with an increasing risk for psychosis, represent clinical stages 0-1b. Cross-sectional data and 90-day daily diary data on psychopathology, well-being, psychosocial functioning, risk and protective factors were statistically compared across subgroups (stages) and descriptively compared across domains and assessment methods. RESULTS Psychopathology increased across subgroups, although not always linearly and nuanced differences were seen between assessment methods. Well-being and functioning differed mostly between subgroup 1 and the other subgroups, suggesting differences between non-clinical and clinical populations. Risk and protective factors differed mostly between the two highest and lowest subgroups, especially regarding need of social support and coping, suggesting differences between those with and without substantial psychotic experiences. Subgroup 4 (stage 1b) reported especially high levels of daily positive and negative psychotic experiences. CONCLUSIONS Risk for psychosis exists in larger contexts of mental health and factors of risk and protection that differ across stages and assessment methods. Taking a broad, multi-method approach is an important next step to understand the complex development of youth mental health problems.
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Affiliation(s)
- Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Psychiatry, Rob Giel Onderzoekscentrum, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sara van der Tuin
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - David van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, The Netherlands.,Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Merel K Muller
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sanne H Booij
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands.,Center for Integrative Psychiatry, Lentis, Groningen, The Netherlands
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10
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Straka K, Blacketer AR, Martinez RL, Glover A, Winiarski DA, Karnik NS, Schueller SM, Zalta AK. Rates and correlates of well-being among youth experiencing homelessness. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3746-3759. [PMID: 35460583 PMCID: PMC9464689 DOI: 10.1002/jcop.22869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
Mental health concerns have been well studied among youth experiencing homelessness, yet few studies have explored factors that contribute to well-being in this population. The current cross-sectional study examined rates and correlates of well-being among youth experiencing homelessness. This is a descriptive, secondary analysis of the baseline data from a clinical intervention study. Ninety-nine youth (aged 16-25) who were experiencing homelessness were recruited in Chicago. Approximately 40% of the sample reported average or above average well-being relative to existing benchmarks. Having medical insurance, a mobile phone, and a history of more severe childhood trauma were unique cross-sectional predictors of worse well-being (all ps < 0.034). A significant portion of our sample experienced well-being. Having access to certain resources may be counterintuitive indicators of poorer well-being among youth experiencing homelessness, perhaps because they are indicators of greater need or increased social comparison among these youth.
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Affiliation(s)
- Kelci Straka
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Alexis R. Blacketer
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Ramona L. Martinez
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
| | - Angela Glover
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Dominika A. Winiarski
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Niranjan S. Karnik
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Stephen M. Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Alyson K. Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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11
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Mordeno IG, Gallemit IMJS, Bangcola BFB, Busaco JJJL, Tuto RT, Hall BJ. Parental migration status moderates the link between parent-child relationship and children's well-being through psychological distress. Psych J 2022; 11:922-935. [PMID: 35842842 DOI: 10.1002/pchj.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 05/23/2022] [Indexed: 11/06/2022]
Abstract
The effects of parental migration on the well-being of left-behind children (LBC) are varied. Several studies demonstrated that parental migration reduces children's psychological health but other research showed contradictory results. This study sought to clarify this issue by examining the mediating role of psychological distress and the moderating role of parental migration status in the association between the parent-child relationship and children's psychological distress. A total of 743 LBC and 688 non-LBC self-reported their parent-child relationship, psychological distress, and well-being. Findings showed that psychological distress mediated the association between parent-child relationship and children's well-being. This denotes that greater parent-child relationship results into lowered levels of psychological distress, and in turn, increases children's emotional, psychological, and social well-being. Moreover, the link between parent-child relationship and psychological distress was found to be contingent to parental migration status. Specifically, the negative association between parent-child relationship and psychological distress was especially strong among LBC in contrast to non- LBC. This implies that children with higher quality relationships with their parents tend to exhibit decreased severity of psychological distress symptoms, especially in children whose parents are working overseas. These results underscore the dynamic role of parent-child relationship in the well-being of LBC, and suggest ways to develop intervention programs that include cultivating skills in managing psychological distress and improving the emotional, psychological, and social well-being of LBC.
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Affiliation(s)
- Imelu G Mordeno
- Department of Professional Education, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - I Marie Joy S Gallemit
- School of Graduate Studies, College of Education, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Bea Fatima B Bangcola
- Department of Psychology, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Jinky Joy Jessica L Busaco
- Department of Psychology, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Reignajean T Tuto
- Department of Psychology, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Brian J Hall
- Center for Global Health Equity, New York University Shanghai, Pudong New District, Shanghai, People's Republic of China.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Verhage V, Reijneveld SA, Wunderink C, Grietens H, Almansa J, Jansen DEMC. Care improves self-reported daily functioning of adolescents with emotional and behavioural problems. Eur Child Adolesc Psychiatry 2022; 31:1685-1693. [PMID: 34052910 PMCID: PMC9666343 DOI: 10.1007/s00787-021-01812-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 05/21/2021] [Indexed: 11/26/2022]
Abstract
Emotional and behavioural problems (EBP) have a negative impact on various life domains of adolescents. Receiving care for EBP may improve the functioning of adolescents with EBP, but evidence on long-term outcomes in real-life settings is lacking. We, therefore, investigated self-reported functioning in different life domains of adolescents with various EBP, and the role of care during a three-year period. We used data from the TAKECARE study, which consist of a care and community cohort. We followed adolescents aged 12 and over (n = 733) during 3 years over five assessment rounds. Using the Strengths and Difficulties Questionnaire, self-reported functioning was measured in four life domains: home life, friendships, classroom learning and leisure activities. We categorized the respondents into four groups: (1) adolescents without emotional and behavioural problems (n = 298); (2) adolescents with emotional problems (n = 192); (3) adolescents with behavioural problems (n = 80); and (4) adolescents with both emotional and behavioural problems (n = 163). The development of functioning over time was analyzed using longitudinal ordinal (probit) regression analyses. Adolescents with both emotional and behavioural problems reported poorer functioning at baseline in all domains and adolescents who received care reported poorer functioning at baseline compared to adolescents who did not receive care. Regarding the change in functioning during the 3 years, adolescents who received care showed improved functioning in all domains. We found improved functioning after care, even if the problems may not have been solved. Psychosocial care can contribute to the functioning of adolescents with EBP, which can have major effects on their future life.
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Affiliation(s)
- Vera Verhage
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- Centre of Expertise Healthy Ageing, Hanze University of Applied Sciences, Groningen, The Netherlands.
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Charlotte Wunderink
- Centre of Expertise Healthy Ageing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Lentis Psychiatric Institute Groningen, Groningen, The Netherlands
| | - Hans Grietens
- Faculty of Psychology and Educational Sciences, Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
| | - Josue Almansa
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Danielle E M C Jansen
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Sociology and Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands
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13
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Pet Ownership and Quality of Life: A Systematic Review of the Literature. Vet Sci 2021; 8:vetsci8120332. [PMID: 34941859 PMCID: PMC8705563 DOI: 10.3390/vetsci8120332] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022] Open
Abstract
Pet ownership is the most common form of human–animal interaction, and anecdotally, pet ownership can lead to improved physical and mental health for owners. However, scant research is available validating these claims. This study aimed to review the recent peer reviewed literature to better describe the body of knowledge surrounding the relationship between pet ownership and mental health. A literature search was conducted in May 2020 using two databases to identify articles that met inclusion/exclusion criteria. After title review, abstract review, and then full article review, 54 articles were included in the final analysis. Of the 54 studies, 18 were conducted in the general population, 15 were conducted in an older adult population, eight were conducted in children and adolescents, nine focused on people with chronic disease, and four examined a specific unique population. Forty-one of the studies were cross-sectional, 11 were prospective longitudinal cohorts, and two were other study designs. For each of the articles, the impact of pet ownership on the mental health of owners was divided into four categories: positive impact (n = 17), mixed impact (n = 19), no impact (n = 13), and negative impact (n = 5). Among the reviewed articles, there was much variation in population studied and study design, and these differences make direct comparison challenging. However, when focusing on the impact of pet ownership on mental health, the results were variable and not wholly supportive of the benefit of pets on mental health. Future research should use more consistent methods across broader populations and the development of a pet-ownership survey module for use in broad, population surveys would afford a better description of the true relationship of pet ownership and mental health.
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Riese H, von Klipstein L, Schoevers RA, van der Veen DC, Servaas MN. Personalized ESM monitoring and feedback to support psychological treatment for depression: a pragmatic randomized controlled trial (Therap-i). BMC Psychiatry 2021; 21:143. [PMID: 33691647 PMCID: PMC7945664 DOI: 10.1186/s12888-021-03123-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a highly prevalent mental disorder with large disease burden, high levels of relapse or persistence, and overall suboptimal outcomes of protocolized pharmacological and psychotherapeutic treatments. There is an urgent need to improve treatment effectiveness, possibly through systematic treatment personalization. In psychotherapeutic treatments this can be achieved by case conceptualization. To support this process, we developed the Therap-i module, which consists of personalized Experienced Sampling Methodology (ESM) and feedback. The Therap-i module is integrated into outpatient psychotherapeutic treatment as usual (TAU) for depression. The study aim is to investigate the efficacy of the Therap-i module in decreasing symptomatology in unresponsive or relapsing patients diagnosed with MDD. We hypothesize that the Therap-i module will contribute to TAU by i) decreasing depressive symptoms, and ii) improving general functioning, therapeutic working alliance, and illness perception. This paper provides details of the study rationale, aims, procedures, and a discussion on potential pitfalls and promises of the module. METHODS Patients diagnosed with MDD (n = 100) will enrol in a pragmatic two-armed randomized controlled trial. Randomization is stratified according to the patient's treatment resistance level assessed with the Dutch Method for quantification of Treatment Resistance in Depression (DM-TRD). All fill-out the Inventory of Depressive Symptomatology Self Report (IDS-SR), Outcome Questionnaire (OQ-45), Illness Perception Questionnaire Mental Health (IPQ-MH), and Work Alliance Inventory Self Report (WAI-SR). In the intervention arm, through close collaboration between patient, clinician, and researcher, a personalized ESM diary is developed based on the patient's case conceptualization. During the ESM monitoring period (8 weeks, 5 assessments/day), patients receive feedback three times, which is discussed among the abovementioned three parties. Both patients and clinicians will evaluate the Therap-i module. RESULTS Data collection is ongoing. DISCUSSION This is the first study in which personalized ESM and feedback is integrated in outpatient psychotherapeutic TAU for depression. The labour intensive procedure and methodological pitfalls are anticipated challenges and were taken into account when designing the study. When hypotheses are confirmed, the Therap-i module may advance treatment for depression by providing insights into personalized patterns driving or perpetuating depressive complaints. TRIAL REGISTRATION Trial NL7190 (NTR7381) , registered prospectively 03-08-2018.
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Affiliation(s)
- H. Riese
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, Universitair Medisch Centrum Groningen, University of Groningen, P.O. Box 30.001 (CC72), 9700 RB Groningen, The Netherlands
| | - L. von Klipstein
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, Universitair Medisch Centrum Groningen, University of Groningen, P.O. Box 30.001 (CC72), 9700 RB Groningen, The Netherlands
| | - R. A. Schoevers
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, Universitair Medisch Centrum Groningen, University of Groningen, P.O. Box 30.001 (CC72), 9700 RB Groningen, The Netherlands
| | - D. C. van der Veen
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, Universitair Medisch Centrum Groningen, University of Groningen, P.O. Box 30.001 (CC72), 9700 RB Groningen, The Netherlands
| | - M. N. Servaas
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, Universitair Medisch Centrum Groningen, University of Groningen, P.O. Box 30.001 (CC72), 9700 RB Groningen, The Netherlands
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Implementation of a positive psychology group program in an inpatient eating disorders service: a pilot study. Eat Weight Disord 2021; 26:679-688. [PMID: 32350775 DOI: 10.1007/s40519-020-00908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/15/2020] [Indexed: 10/24/2022] Open
Abstract
CONTEXT Eating disorders (ED) are very difficult conditions to treat. Therefore, interventions in this field are shifting their main target towards the disorder's impact in quality of life, rather than ED symptomatology in itself. In this sense, a focus in the promotion of positive emotions and well-being is emerging to ameliorate the harmful effects caused by ED. However, evidence of the potential benefits of this type of interventions is still scarce. PURPOSE This study introduces a 4-week positive psychology group program specifically designed for ED patients' needs and to present data about feasibility and acceptability. METHOD Seven female inpatients of an eating disorder service aged from 13 to 38 years old attended the group. Measures of affect and optimistic thinking were taken before the program and after each session. RESULTS The program was very well rated by participants, and there was no attrition. Furthermore, possible benefits were found in terms of optimistic thinking at the end of the group program, and these benefits were noticeable, but non-significant, in the case of affect. CONCLUSIONS This study opens the door to conduct larger and controlled studies for testing interventions aimed at promoting positive emotions and well-being in ED populations. Thus, these interventions could support the efficacy of current treatments in order to improve patients' quality of life. LEVEL OF EVIDENCE Level IV, multiple time series analysis, with the intervention.
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Leung T, Rawana E, Klein R. Exploratory analysis of strength domains and association with subjective and psychological well-being among Canadian adolescents. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01407-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Xu W, Sun H, Zhu B, Yu X, Niu Y, Kou C, Li W. The prevalence of depressive symptoms and its determinants among adults in mainland China: Results from a national household survey. J Affect Disord 2021; 281:220-227. [PMID: 33333476 DOI: 10.1016/j.jad.2020.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/11/2020] [Accepted: 12/05/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Depression have become a widespread health concern in Chinese society. METHODS We analyzed the factors influencing the risk of depression among residents aged 16 and over using data from the 2016 China Family Panel Studies (CFPS), in which depression was measured using the Center for Epidemiologic Studies Depression (CES-D20) scale. A total of 26,464 individuals were sampled in a weighted manner to represent the entire country. Univariate and multivariate analysis were used to explore the risk factors for depression and the odds of depression in people with different characteristics. RESULTS A total of 76.6% of adult residents were mentally healthy. Females had higher rates of depression than males (OR=1.515). There was an "inverted U-shaped" distribution between age and risk of depression. Higher levels of education and better physiological health were associated with a lower risk of depression. Self-evaluated income and social status were not linearly related to the risk of depression but rather had a "U-shaped" distribution. For social capital, better social relationships and a higher level of social trust were associated with a lower risk of depression. Nonsmokers had a lower risk of depression than smokers (OR=0.818). LIMITATIONS All items were self-reported and some results depend on single item responses. This is a cross-sectional survey so that causative interpretations cannot be drawn. CONCLUSION These findings suggest potential public health measures whose efficacy needs to be tested and confirmed.
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Affiliation(s)
- Wen Xu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, 130021, China.
| | - Haiyan Sun
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, 130021, China.
| | - Bo Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China.
| | - Xiao Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China.
| | - Yaling Niu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China.
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China.
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, 130021, China.
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Kuranova A, Booij SH, Oldehinkel AJ, Wichers M, Jeronimus B, Wigman JTW. Reflections on psychological resilience: a comparison of three conceptually different operationalizations in predicting mental health. Eur J Psychotraumatol 2021; 12:1956802. [PMID: 34589174 PMCID: PMC8475143 DOI: 10.1080/20008198.2021.1956802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Psychological resilience refers to the ability to maintain mental health or recover quickly after stress. Despite the popularity of resilience research, there is no consensus understanding or operationalization of resilience. OBJECTIVE We plan to compare three indicators of resilience that each involve a different operationalization of the construct: a) General resilience or one's self-reported general ability to overcome adversities; b) Daily resilience as momentarily experienced ability to overcome adversities; and c) Recovery speed evident in the pattern of negative affect recovery after small adversities in daily life. These three indicators are constructed per person to investigate their cross-sectional associations, stability over time, and predictive validity regarding mental health. METHODS Data will be derived from the prospective MIRORR study that comprises 96 individuals at different levels of psychosis risk and contains both single-time assessed questionnaires and 90-days intensive longitudinal data collection at baseline (T0) and three yearly follow-up waves (T1-T3). General resilience is assessed using the Brief Resilience Scale (BRS) at baseline. Daily resilience is measured by averaging daily resilience scores across 90 days. For recovery speed, vector-autoregressive models with consecutive impulse response simulations will be applied to diary data on negative affect and daily stressors to calculate pattern of affect recovery. These indicators will be correlated concurrently (at T0) to assess their overlap and prospectively (between T0 and T1) to estimate their stability. Their predictive potential will be assessed by regression analysis with mental health (SCL-90) as an outcome, resilience indicators as predictors, and stressful life events as a moderator. CONCLUSION The comparison of different conceptualizations of psychological resilience can increase our understanding of its multifaceted nature and, in future, help improve diagnostic, prevention and intervention strategies aimed at increasing psychological resilience.
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Affiliation(s)
- Anna Kuranova
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands
| | - Sanne H Booij
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands.,Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, The Netherlands.,Center for Integrative Psychiatry, Lentis, Groningen, The Netherlands
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands
| | - Marieke Wichers
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands
| | - Bertus Jeronimus
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Johanna T W Wigman
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands.,Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, The Netherlands
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Examining Negative Emotional Symptoms and Psychological Wellbeing of Australian Sport Officials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218265. [PMID: 33182323 PMCID: PMC7664859 DOI: 10.3390/ijerph17218265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 11/29/2022]
Abstract
Sports officials are exposed to numerous performance and personal stressors, however little is known about their mental health and psychological wellbeing. This study investigated levels of mental health and psychological wellbeing of sports officials in Australia, and the demographic, officiating, and workplace factors associated with these outcomes. An online survey consisting of demographic and officiating questions, and measures of work engagement, mental health and psychological wellbeing was completed by 317 officials. A negative emotional symptoms score was computed. Associations between key demographic, officiating, and workplace factors with negative emotional symptoms and psychological wellbeing were assessed using univariate and multivariate analyses. Officials who were younger, not in a committed relationship, having lower levels of education, and less officiating experience reported higher levels of negative emotional symptoms, while males, older than 50 years, in a committed relationship and more officiating experience had higher levels of psychological wellbeing. The ability to self-manage workload and demonstrate professional autonomy were strongly associated with negative emotional symptoms and psychological wellbeing. Officials reported high negative emotional symptoms, but also high levels of psychological wellbeing. The ability to manage workload and to express professional autonomy are important determinants of mental health and wellbeing levels of sports officials.
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Kuranova A, Booij SH, de Jonge P, Jeronimus B, Lin A, Wardenaar KJ, Wichers M, Wigman JTW. Don't worry, be happy: Protective factors to buffer against distress associated with psychotic experiences. Schizophr Res 2020; 223:79-86. [PMID: 32473933 DOI: 10.1016/j.schres.2020.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 03/12/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Around 6-7% of the general population report psychotic experiences (PEs). Positive PEs (e.g. hearing voices) may increase the risk of development of psychotic disorder. An important predictor of the transition to a psychotic disorder is secondary distress associated with PEs. We examined the moderating effect of potential protective factors on this secondary distress. METHODS Data come from 2870 individuals of the HowNutsAreTheDutch study. PEs were assessed with the Community Assessment of Psychic Experience (CAPE) questionnaire and were divided into three subdomains ("Bizarre experiences", "Delusional ideations", and "Perceptual anomalies"). Protective factors explored were having a partner, having a pet, benevolent types of humor, optimism and the high levels of personality traits emotional stability (reversed neuroticism), extraversion, openness to experience, conscientiousness, and agreeableness. We examined whether these protective factors moderated (lowered) the association between frequency of PEs and PE-associated distress. RESULTS Due to low prevalence of perceptual anomalies in the sample, this domain was excluded from analysis. No moderating effects were observed of protective factors on the association between bizarre experiences and distress. Having a partner and high levels of optimism, self-enhancing humor, openness, extraversion and emotional stability moderated the association between delusional ideations and secondary distress, leading to lower levels of distress. CONCLUSIONS Several protective factors were found to moderate the association between frequency and secondary distress of delusional ideations, with high levels of the protective factors being associated with lower levels of distress. A focus on protective factors could be relevant for interventions and prevention strategies regarding psychotic phenomena.
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Affiliation(s)
- Anna Kuranova
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands.
| | - Sanne H Booij
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands; Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, the Netherlands; Center for Integrative Psychiatry, Lentis, Groningen, the Netherlands
| | - Peter de Jonge
- University of Groningen, Department of Developmental Psychology, Groningen, the Netherlands
| | - Bertus Jeronimus
- University of Groningen, Department of Developmental Psychology, Groningen, the Netherlands
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Australia
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands
| | - Marieke Wichers
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands
| | - Johanna T W Wigman
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands; Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, the Netherlands
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Jeronimus BF. Commentary: Contextualizing Neuroticism in the Hierarchical Taxonomy of Psychopathology. Front Psychiatry 2020; 11:175. [PMID: 32226947 PMCID: PMC7080961 DOI: 10.3389/fpsyt.2020.00175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 02/24/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bertus F. Jeronimus
- Department of Developmental Psychology, Faculty of Social and Behavioural Sciences, University of Groningen, Groningen, Netherlands
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Hiebler-Ragger M, Kamble SV, Aberer E, Unterrainer HF. The relationship between existential well-being and mood-related psychiatric burden in Indian young adults with attachment deficits: a cross-cultural validation study. BMC Psychol 2020; 8:21. [PMID: 32093787 PMCID: PMC7041092 DOI: 10.1186/s40359-020-0388-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 02/18/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Attachment and spirituality are thought to have deep evolutionary roots but are always interpreted within the framework of culture, religion and personal beliefs. While insecure attachment has been observed to be positively related with psychopathology, a positive mental health effect has often been described for spirituality. To examine the cross-cultural validation of previous research focused on Austrian young adults with Western socialization, we attempt to replicate our study examining the influence spirituality has on the connection between insecure attachment and mood-related psychiatric burden with Indian young adults. METHODS We investigated Avoidant (AV) and Anxious (AX) Attachment (ECR-RD), Religious (RWB) and Existential (EWB) Well-Being (MI-RSWB), and mood-related psychiatric burden (Anxiety, Depression, Somatization; BSI-18) in 443 (31% female) Indian young adults (age range: 18-30 years) with a Hindu upbringing. RESULTS Compared to young adults with a Roman Catholic upbringing in a Western socialization, Indian participants did not differ in AX and EWB but scored higher in mood-related psychiatric burden (eta2 = .04), AV (eta2 = .14), as well as RWB (eta2 = .28; all p < .01). As in previous research only AX (β = .40) positively predicted mood-related psychiatric burden (ΔR2 = .15, all p < .01), while EWB was an additional negative predictor (β = -.11, p < .05). CONCLUSIONS Our findings emphasize the universal importance of attachment and spirituality for mental health as well as the potential influence of socialization on their development. Furthermore, they underline that Existential Well-Being - including hope for a better future, forgiveness, and the experience of sense and meaning - appears to have a compensating effect on the relation between insecure attachment and impaired mental health.
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Affiliation(s)
- Michaela Hiebler-Ragger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, A-8036, Graz, Austria
- Center for Integrative Addiction Research (Grüner Kreis Society), Rudolfsplatz 9, A-1010, Vienna, Austria
| | - Shanmukh V Kamble
- Department of Psychology, Karnatak University, Pavate Nagar, Dharwad, Karnataka, 580003, India
| | - Elisabeth Aberer
- Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036, Graz, Austria
| | - Human Friedrich Unterrainer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, A-8036, Graz, Austria.
- Center for Integrative Addiction Research (Grüner Kreis Society), Rudolfsplatz 9, A-1010, Vienna, Austria.
- Department of Religious Studies, University of Vienna, Schenkenstraße 8-10/5th floor, A-1010, Vienna, Austria.
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Kuranova A, Booij SH, Menne-Lothmann C, Decoster J, van Winkel R, Delespaul P, De Hert M, Derom C, Thiery E, Rutten BPF, Jacobs N, van Os J, Wigman JTW, Wichers M. Measuring resilience prospectively as the speed of affect recovery in daily life: a complex systems perspective on mental health. BMC Med 2020; 18:36. [PMID: 32066437 PMCID: PMC7027206 DOI: 10.1186/s12916-020-1500-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 01/21/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION There is growing evidence that mental disorders behave like complex dynamic systems. Complex dynamic systems theory states that a slower recovery from small perturbations indicates a loss of resilience of a system. This study is the first to test whether the speed of recovery of affect states from small daily life perturbations predicts changes in psychopathological symptoms over 1 year in a group of adolescents at increased risk for mental disorders. METHODS We used data from 157 adolescents from the TWINSSCAN study. Course of psychopathology was operationalized as the 1-year change in the Symptom Checklist-90 sum score. Two groups were defined: one with stable and one with increasing symptom levels. Time-series data on momentary daily affect and daily unpleasant events were collected 10 times a day for 6 days at baseline. We modeled the time-lagged effect of daily unpleasant events on negative and positive affect after each unpleasant event experienced, to examine at which time point the impact of the events is no longer detectable. RESULTS There was a significant difference between groups in the effect of unpleasant events on negative affect 90 min after the events were reported. Stratified by group, in the Increase group, the effect of unpleasant events on both negative (B = 0.05, p < 0.01) and positive affect (B = - 0. 08, p < 0.01) was still detectable 90 min after the events, whereas in the Stable group this was not the case. CONCLUSION Findings cautiously suggest that adolescents who develop more symptoms in the following year may display a slower affect recovery from daily perturbations at baseline. This supports the notion that mental health may behave according to the laws of a complex dynamic system. Future research needs to examine whether these dynamic indicators of system resilience may prove valuable for personalized risk assessment in this field.
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Affiliation(s)
- Anna Kuranova
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands.
| | - Sanne H Booij
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
- Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, The Netherlands
- Center for Integrative Psychiatry, Lentis, Groningen, The Netherlands
| | - Claudia Menne-Lothmann
- Department of Psychiatry and Neuropsychology, School of mental health and neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Jeroen Decoster
- University Psychiatric Centre Sint-Kamillus, Bierbeek, Belgium
| | - Ruud van Winkel
- KU Leuven, Department of Neurosciences, Center for Public Health Psychiatry, UPC KU Leuven, Leuven, Belgium
- KU Leuven, Department of Neurosciences, Center for Clinical Psychiatry, UPC KU Leuven, Leuven, Belgium
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School of mental health and neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Mondriaan Mental Health Care, Heerlen, The Netherlands
| | - Marc De Hert
- KU Leuven, Department of Neurosciences, Center for Public Health Psychiatry, UPC KU Leuven, Leuven, Belgium
- KU Leuven, Department of Neurosciences, Center for Clinical Psychiatry, UPC KU Leuven, Leuven, Belgium
- Antwerp Health Law and Ethics Chair - AHLEC University Antwerpen, Antwerp, Belgium
| | - Catherine Derom
- Centre of Human Genetics, University Hospital Leuven, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Evert Thiery
- Department of Neurology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School of mental health and neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Nele Jacobs
- Department of Psychiatry and Neuropsychology, School of mental health and neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School of mental health and neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, UK
- Department Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Johanna T W Wigman
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
- Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, The Netherlands
| | - Marieke Wichers
- University of Groningen, University Medical Center Groningen, University Center Psychiatry (UCP) Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
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Goldbach N, Reif A, Preuss H, Röhm M, Straus E, Streicher E, Windmann S, Oertel V. The role of resources in the face of psychopathology. J Clin Psychol 2019; 76:406-422. [PMID: 31777087 DOI: 10.1002/jclp.22884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The current study compared resource realization and psychological distress in patients with different psychiatric diagnoses and healthy individuals and examined the moderating effect of intrapersonal resources (personal strengths) and interpersonal resources (relationships) on the association between incongruence (unsatisfactory realization of personal goals) and psychological distress. METHOD In total, 218 participants (45.87% female, mean age = 39.83 years) completed standardized questionnaires at one measurement point. RESULTS Healthy individuals (n = 56) reported the most resources, followed by patients with psychotic (n = 53), substance use (n = 53), and depressive disorders (n = 56). While patients with psychotic disorders benefited from intra- and interpersonal resources, patients with depression only benefitted from intrapersonal resources. Patients with substance use disorders did not benefit from resources at all. CONCLUSIONS Depending on the diagnosis, patients evaluated their level of resources differently and benefitted in different ways. The results suggest that within psychotherapy, it might be useful to strengthen resources, especially for patients with depressive and substance use disorders.
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Affiliation(s)
- Nele Goldbach
- Department of Psychiatry, Laboratory for Neuroimaging, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, Laboratory for Neuroimaging, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Hanna Preuss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mira Röhm
- Department of Psychiatry, Laboratory for Neuroimaging, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Eva Straus
- Department of Psychiatry, Laboratory for Neuroimaging, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Elisabeth Streicher
- Department of Psychiatry, Laboratory for Neuroimaging, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, Germany
| | - Sabine Windmann
- Department of Psychology, Cognitive Psychology II, Goethe University, Frankfurt, Germany
| | - Viola Oertel
- Department of Psychiatry, Laboratory for Neuroimaging, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, Germany
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Botes R, Vermeulen KM, Gerber AM, Ranchor AV, Buskens E. Health-related quality of life and well-being health state values among Dutch oldest old. Patient Prefer Adherence 2019; 13:721-728. [PMID: 31190754 PMCID: PMC6522649 DOI: 10.2147/ppa.s193171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/23/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Valuing hypothetical health states is a demanding personal process, since it involves the psychological evaluation of hypothetical health states. It seems plausible that elderly individuals will value hypothetical health states differently than the general population. It is, however, important to understand the psychological division that oldest old subgroups construct between acceptable and unacceptable health states. This information can produce important evidence regarding well-being and disability conceptualization. Objective: To investigate how Dutch oldest old, conceptualize health-related quality of life health states when compared to well-being health states. In addition, we aim to compare subgroups, based on dependency classification. Methods: Ninety-nine elderly living in the Groningen, Hoogeveen and Veendam areas of the Netherlands participated in the study. Respondents were classified into three groups based on dependency levels. The respondents were asked to value hypothetical health states, a generic preference-based HRQoL and a well-being instrument, using a visual analog scale. Results: All three groups ranked the same health states, from both questionnaires, below the average across the health states. The health-related quality of life health states was consistently ranked lower than the current well-being health states. Conclusions: Health state valuations performed by the oldest old indicate that conceptually, respondents view below average health-related and well-being health states as undesirable. The results indicated that the oldest old do view deficits in health-related health states as more important than deficits in well-being health states. Since the oldest old performed the valuations, focused interventions to improve below average health-related outcomes might be the most cost-effective way to increase oldest old well-being outcomes.
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Affiliation(s)
- Riaan Botes
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, The Netherlands
- Correspondence: Riaan BotesDepartment of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen9700 RB, The NetherlandsTel +312 779 359 7351Email
| | - Karin M Vermeulen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, The Netherlands
| | - Anthonie M Gerber
- Department of Basic Medical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300, South Africa
| | - Adelita V Ranchor
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, 9700 AD, The Netherlands
| | - Erik Buskens
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB, The Netherlands
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Mendonca C, Shrivastava A, Pietschnig J. The effect of adaptive capacity, culture and employment status on happiness among married expatriate women residing in Dubai. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-9832-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Empathy is the ability to recognize and respond to the emotional states of other individuals. It is an important psychological process that facilitates navigating social interactions and maintaining relationships, which are important for well-being. Several psychological studies have identified difficulties in both self-report and performance-based measures of empathy in a range of psychiatric conditions. To date, no study has systematically investigated the genetic architecture of empathy using genome-wide association studies (GWAS). Here we report the results of the largest GWAS of empathy to date using a well-validated self-report measure of empathy, the Empathy Quotient (EQ), in 46,861 research participants from 23andMe, Inc. We identify 11 suggestive loci (P < 1 × 10-6), though none were significant at P < 2.5 × 10-8 after correcting for multiple testing. The most significant SNP was identified in the non-stratified analysis (rs4882760; P = 4.29 × 10-8), and is an intronic SNP in TMEM132C. The EQ had a modest but significant narrow-sense heritability (0.11 ± 0.014; P = 1.7 × 10-14). As predicted, based on earlier work, we confirmed a significant female advantage on the EQ (P < 2 × 10-16, Cohen's d = 0.65). We identified similar SNP heritability and high genetic correlation between the sexes. Also, as predicted, we identified a significant negative genetic correlation between autism and the EQ (rg = -0.27 ± 0.07, P = 1.63 × 10-4). We also identified a significant positive genetic correlation between the EQ and risk for schizophrenia (rg = 0.19 ± 0.04; P = 1.36 × 10-5), risk for anorexia nervosa (rg = 0.32 ± 0.09; P = 6 × 10-4), and extraversion (rg = 0.45 ± 0.08; 5.7 × 10-8). This is the first GWAS of self-reported empathy. The results suggest that the genetic variations associated with empathy also play a role in psychiatric conditions and psychological traits.
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Hiebler-Ragger M, Falthansl-Scheinecker J, Birnhuber G, Fink A, Unterrainer HF. Facets of Spirituality Diminish the Positive Relationship between Insecure Attachment and Mood Pathology in Young Adults. PLoS One 2016; 11:e0158069. [PMID: 27336471 PMCID: PMC4919040 DOI: 10.1371/journal.pone.0158069] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/09/2016] [Indexed: 11/20/2022] Open
Abstract
Traditionally, in attachment theory, secure attachment has been linked to parameters of mental health, while insecure attachment has been associated with parameters of psychopathology. Furthermore, spirituality and attachment to God have been discussed as corresponding to, or compensating for, primary attachment experiences. Accordingly, they may contribute to mental health or to mental illness. In this cross-sectional observational study, we investigate attachment styles (Avoidant and Anxious Attachment; ECR-RD), spirituality (Religious and Existential Well-Being; MI-RSWB), and mood pathology (Anxiety, Depression, Somatization; BSI-18) in 481 (76% female) young adults (age range: 18–30 years) who had a Roman Catholic upbringing. In accordance with previous research, we found insecure attachment to be associated with low levels of spirituality. Furthermore, insecure attachment and low levels of spirituality were associated with higher levels of mood pathology. In hierarchical regression analyses, only Anxious Attachment positively predicted all three dimensions of mood pathology while Existential Well-Being–but not Religious Well-Being–was an additional negative predictor for Depression. Our results underline that spirituality can correspond to the attachment style, or may also compensate for insecure attachment. Higher Existential Well-Being–comprised of facets such as hope for a better future, forgiveness and the experience of sense and meaning–seems to have an especially corrective effect on mood pathology, independent of attachment styles. Our findings emphasize the vital role of existential well-being in young adults’ affective functioning, which might be considered in prevention and treatment. Further research in clinical surroundings is recommended.
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Affiliation(s)
- Michaela Hiebler-Ragger
- University Clinic of Psychiatry, Medical University Graz, Graz, Austria
- Center for Integrative Addiction Research (Grüner Kreis Society), Vienna, Austria
| | | | | | - Andreas Fink
- Institute of Psychology, University of Graz, Graz, Austria
| | - Human Friedrich Unterrainer
- University Clinic of Psychiatry, Medical University Graz, Graz, Austria
- Center for Integrative Addiction Research (Grüner Kreis Society), Vienna, Austria
- Institute of Psychology, University of Graz, Graz, Austria
- * E-mail:
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Krieke LVD, Jeronimus BF, Blaauw FJ, Wanders RB, Emerencia AC, Schenk HM, Vos SD, Snippe E, Wichers M, Wigman JT, Bos EH, Wardenaar KJ, Jonge PD. HowNutsAreTheDutch (HoeGekIsNL): A crowdsourcing study of mental symptoms and strengths. Int J Methods Psychiatr Res 2016; 25:123-44. [PMID: 26395198 PMCID: PMC6877205 DOI: 10.1002/mpr.1495] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/10/2015] [Accepted: 08/17/2015] [Indexed: 12/28/2022] Open
Abstract
HowNutsAreTheDutch (Dutch: HoeGekIsNL) is a national crowdsourcing study designed to investigate multiple continuous mental health dimensions in a sample from the general population (n = 12,503). Its main objective is to create an empirically based representation of mental strengths and vulnerabilities, accounting for (i) dimensionality and heterogeneity, (ii) interactivity between symptoms and strengths, and (iii) intra-individual variability. To do so, HowNutsAreTheDutch (HND) makes use of an internet platform that allows participants to (a) compare themselves to other participants via cross-sectional questionnaires and (b) to monitor themselves three times a day for 30 days with an intensive longitudinal diary study via their smartphone. These data enable for personalized feedback to participants, a study of profiles of mental strengths and weaknesses, and zooming into the fine-grained level of dynamic relationships between variables over time. Measuring both psychiatric symptomatology and mental strengths and resources enables for an investigation of their interactions, which may underlie the wide variety of observed mental states in the population. The present paper describes the applied methods and technology, and presents the sample characteristics. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Lian Van Der Krieke
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Bertus F. Jeronimus
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Frank J. Blaauw
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
- University of GroningenJohann Bernoulli Institute for Mathematics and Computer Science, Distributed Systems GroupGroningenThe Netherlands
| | - Rob B.K. Wanders
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Ando C. Emerencia
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Hendrika M. Schenk
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Stijn De Vos
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Evelien Snippe
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Marieke Wichers
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Johanna T.W. Wigman
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Elisabeth H. Bos
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Klaas J. Wardenaar
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
| | - Peter De Jonge
- University of Groningen, University Medical Center GroningenDepartment of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE)GroningenThe Netherlands
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