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Veerman LK, Fjermestad KW, Vatne TM, Sterkenburg PS, Derks SD, Brouwer-van Dijken AA, Willemen AM. Cultural applicability and desirability of 'Broodles': The first serious game intervention for siblings of children with disabilities. PEC Innov 2024; 4:100277. [PMID: 38590338 PMCID: PMC11000116 DOI: 10.1016/j.pecinn.2024.100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
Objective Serious games can serve as easily accessible interventions to support siblings of children with disabilities, who are at risk of developing mental health problems. The Dutch serious game 'Broodles' was developed for siblings aged 6-9 years. The current study aims to assess the cultural applicability, desirability, feasibility, and acceptability of 'Broodles' in Norway. Methods Norwegian siblings (N = 16) aged 6-13 years and parents (N = 12) of children with intellectual disabilities assessed the game. Their feedback data from interviews and questionnaires were sorted using a model of engagement factors in serious games. Results At pre-use, participants showed interest in the game, and after initial use the participants were overall positive about the format, content and objectives, including validation of emotions and recognition. The participants had suggestions for improved engagement and feasibility. Conclusion The game was found to be culturally applicable, desirable and acceptable, although Norwegian translation is necessary for further evaluation. Recommendations to enhance engagement were provided, including suggestions to play the game with parents or in a group. Innovation This initial assessment of the serious game Broodles in a non-Dutch setting shows promise for an innovative way of supporting siblings of children with disabilities.
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Affiliation(s)
- Linda K.M. Veerman
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
| | - Krister W. Fjermestad
- University of Oslo, Boks 1072 Blindern, 0316, Oslo, Norway
- Frambu Resource Center for Rare Disorders, Sandbakkveien 18, 1404, Siggerud, Norway
| | - Torun M. Vatne
- University of Oslo, Boks 1072 Blindern, 0316, Oslo, Norway
- Frambu Resource Center for Rare Disorders, Sandbakkveien 18, 1404, Siggerud, Norway
| | - Paula S. Sterkenburg
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
- Bartiméus, Oude Arnhemse Bovenweg 3, 3941 XM, Doorn, the Netherlands
| | - Suzanne D.M. Derks
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
| | | | - Agnes M. Willemen
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
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van Tuyll van Serooskerken JM, Willemen AM, Embregts PJ, Schuengel C. Parent-perceived autonomy-supportive experiences and basic psychological needs of people with complex support needs: Development and preliminary psychometric evaluation of two questionnaires. J Intellect Disabil 2024:17446295241237553. [PMID: 38488090 DOI: 10.1177/17446295241237553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Background: Understanding and supporting basic psychological needs of persons with complex support needs is important but difficult because of communicative challenges . We developed and tested questionnaires to obtain parents' perspectives on autonomy support and basic psychological needs of autonomy, competence, and relatedness. Method: Two parent-informant questionnaires were developed, administered, and subjected to psychometric property analyses. Participants were 63 Dutch parents of persons diagnosed with severe or profound intellectual and multiple disabilities. Results: Principal component analyses revealed a one-factor structure for the Parental Perceptions on Autonomy-Supportive Experiences questionnaire, while the Parental Perceptions on Basic Psychological Need Signals questionnaire yielded two-factors interpreted as Noticing Signals of Autonomy and Noticing Signals of Competence/Relatedness. Evidence for construct validity was found for both instruments. Conclusions: Preliminary evaluation of the new questionnaires is encouraging, but further validation with a larger sample size is warranted.
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Affiliation(s)
| | - Agnes M Willemen
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, The Netherlands
| | - Petri Jcm Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies, LEARN! Research Institute for Learning and Education, Vrije Universiteit Amsterdam, The Netherlands
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Derks SDM, Willemen AM, Wouda M, Sterkenburg PS. Effectiveness of the mentalisation-based serious game 'You & I' for adults with mild to borderline intellectual disabilities: A randomised controlled trial. J Appl Res Intellect Disabil 2024; 37:e13170. [PMID: 37916577 DOI: 10.1111/jar.13170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Mentalising and stress regulation pose challenges for adults with mild to borderline intellectual disabilities (MBID), emphasising the importance of an intervention program. The study examined the effectiveness and social validity of the serious game 'You & I' in enhancing mentalising and stress regulation among adults with MBID. METHOD A randomised controlled superiority trial with experimental and waitlist-control groups was conducted with 159 adults with MBID (Mage = 36) at baseline, post-test, and follow-up. Analyses investigated the effects on aspects of mentalising, stress regulation, and social validity. RESULTS The experimental group showed decreased stress from negative interpersonal relations, while the control group experienced increased stress (d = 0.26). There were no significant effects on mentalising, but positive user expectations and experiences were reported. CONCLUSIONS This initial study on 'You & I' provides limited evidence of its effectiveness for people with MBID, warranting further examination of the potential of serious games.
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Affiliation(s)
- Suzanne D M Derks
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Agnes M Willemen
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Mirjam Wouda
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Ons Tweede Thuis, Amstelveen, the Netherlands
| | - Paula S Sterkenburg
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Bartiméus, Doorn, the Netherlands
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Derks SDM, Willemen AM, Vrijmoeth C, Sterkenburg PS. Lessons learned from the adaptation of the Reflective Functioning Questionnaire (RFQ) for Dutch people with mild to borderline intellectual disabilities. PLoS One 2023; 18:e0287751. [PMID: 37368894 DOI: 10.1371/journal.pone.0287751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND People with mild to borderline intellectual disabilities (MBIDs) face challenges in social functioning, possibly as a result of limited mentalising abilities such as reflecting on the behaviour of themselves and others. Reflective functioning in people with MBIDs has not yet been investigated due to a lack of instruments. The Reflective Functioning Questionnaire (RFQ) is a seemingly easy adaptable, short self-report questionnaire. The aim of the present, explorative study was to adapt the RFQ for people with MBIDs and investigate the psychometric properties and correlations with other mentalising related constructs. The formulation of the items was adapted to the target group and items were added to broaden the scope towards reflection on both the self and other. METHOD Participants were 159 adults with MBIDs who completed a Dutch-translated and easy-to-read RFQ with five supplemental items, a questionnaire for autistic traits, a self-report questionnaire assessing perspective taking and two performance-based measures assessing emotion recognition and Theory of Mind. RESULTS Confirmatory factor analysis confirmed the factor structure of the RFQ and revealed a two-factor structure with a Self and Other subscale. Generally satisfactory internal consistency and test-retest reliability were found. Explorative results showed correlations of the RFQ-8 and RFQ subscales with autistic traits and between the RFQ Other and perspective taking. CONCLUSIONS This explorative study is the first testing psychometric properties of the RFQ as a self-report questionnaire for assessing reflective functioning in adults with MBIDs. This step is relevant in gaining more scientific knowledge on assessing mentalising in people with MBIDs.
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Affiliation(s)
- Suzanne D M Derks
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Agnes M Willemen
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cis Vrijmoeth
- Centre for Research and Innovation in Christian Mental Health Care, Hoevelaken, The Netherlands
| | - Paula S Sterkenburg
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Bartiméus, Doorn, The Netherlands
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Veerman LKM, Willemen AM, Derks SDM, Brouwer-van Dijken AAJ, Sterkenburg PS. The effectiveness of the serious game "Broodles" for siblings of children with intellectual disabilities and/or visual impairment: study protocol for a randomized controlled trial. Trials 2023; 24:336. [PMID: 37198687 DOI: 10.1186/s13063-023-07358-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/05/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Siblings of children with disabilities also need support. However, there are only a few evidence-based interventions for these siblings. The current study aims to assess the effectiveness of a newly developed serious game for young siblings of children with intellectual disability (ID) and/or visual impairment (VI). This serious game is hypothesized to improve sibling's quality of life, adjustment to their brother's or sister's disability, and multiple aspects of psychosocial well-being. METHODS The intervention consists of a serious game called "Broodles" (in Dutch: "Broedels") that helps children to recognize and deal with thoughts, feelings, and difficult situations. The game consists of eight 20-minute levels that all have the same structure with eight game elements. Each level addresses a domain of sibling quality of life and combines animations, mini-documentaries, fun mini-games, and multiple-choice questions. In addition to the game, siblings make a worksheet after playing each level. In order to support the child, the parents or caregivers receive a short brochure with information and tips. The effectiveness of the intervention will be investigated among a sample of 154 children aged 6-9 years and their parents or caregivers, using a two-arm parallel RCT design. The experimental group will play the serious game "Broodles" over a period of 4 weeks, whereas the control group will be placed on a waiting list. Assessments will take place at three time points: pre-test (week 1), post-test (week 5), and follow-up (weeks 12-14). At each timepoint, children and parents will complete several questionnaires on quality of life and different aspects of psychosocial well-being. In addition, children will make drawings to assess the sibling relationship. Next to that, parents and children will answer closed and open-ended questions about the sibling adjustment to their brother or sister's disability. Finally, parents and children will evaluate the serious game through closed and open-ended questions. DISCUSSION This study contributes to the knowledge about sibling interventions and serious games. Additionally, if the serious game is proven to be effective, it will be a readily available, easily accessible, and free of charge intervention for siblings. TRIAL REGISTRATION ClinicalTrials.gov, NCT05376007, registered prospectively on April 21, 2022.
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Affiliation(s)
- Linda K M Veerman
- Department of Clinical Child and Family Studies; LEARN!; Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, Van der Boechorststraat 7, 1081 BT, the Netherlands.
| | - Agnes M Willemen
- Department of Clinical Child and Family Studies; LEARN!; Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, Van der Boechorststraat 7, 1081 BT, the Netherlands
| | - Suzanne D M Derks
- Department of Clinical Child and Family Studies; LEARN!; Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, Van der Boechorststraat 7, 1081 BT, the Netherlands
| | | | - Paula S Sterkenburg
- Department of Clinical Child and Family Studies; LEARN!; Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, Van der Boechorststraat 7, 1081 BT, the Netherlands
- Bartiméus, Doorn, Oude Arnhemse Bovenweg 3, 3941 XM, the Netherlands
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Heppe ECM, Willemen AM, Kef S, Schuengel C. Evaluation of a community-based mentoring program on psychosocial functioning of adolescents with a visual impairment: A randomized controlled trial. British Journal of Visual Impairment 2020. [DOI: 10.1177/0264619620935944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study evaluated the efficacy of a mentoring program on improving psychosocial functioning of young people with a visual impairment (VI). Furthermore, the impact of experimentally matching mentees to mentors with or without VI on youth outcomes was examined. A total of 76 adolescents with VI (15–22 year; 46% boys) were randomized into a yearlong mentoring program ( n = 51) or care-as-usual ( n = 25). Mentoring involved one-on-one activities within community settings. Psychosocial functioning was improved in all participants during the study ( d = 0.35–1.06); however, mentoring outperformed care-as-usual only for autonomy (95% CI: 0.003, 0.31; d = 0.44) and competence satisfaction (95% CI: 0.02, 0.34; d = 0.55), and not for the other six psychosocial outcomes ( d < 0.36). Matching similarity was not significantly related to the outcomes assessed. Mentoring was of limited benefit for psychosocial functioning of youth with VI. This trial is registered in the Netherlands Trial Register NTR4768.
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Affiliation(s)
| | | | - Sabina Kef
- Vrije Universiteit Amsterdam, The Netherlands
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Heppe ECM, Willemen AM, Kef S, Schuengel C. Improving social participation of adolescents with a visual impairment with community-based mentoring: results from a randomized controlled trial. Disabil Rehabil 2019; 42:3215-3226. [PMID: 31066313 DOI: 10.1080/09638288.2019.1589587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: The efficacy of a community-based mentoring program for adolescents with a visual impairment vs. care-as-usual was tested on social participation including satisfaction with social support.Materials and methods: Adolescents (15-22 years; 46% boys) were randomized to an intervention group with mentors with visual impairment (N = 25), an intervention group with mentors without visual impairment (N = 26), or care-as-usual (N = 25). One-on-one mentoring activities regarded school/work, leisure activities, and social relationships.Results and conclusions: Multilevel growth modelling revealed no effect of mentoring on changes in social participation compared to the care-as-usual group (participation [95% CI -0.30, 0.21, d = 0.1]; social participation composite [95% CI -0.24, 0.26, d = 0.24]). Mentees matched to mentors with visual impairments increased more on satisfaction with their social support compared to mentees matched to mentors without impairments and the care-as-usual group [95% CI 0.02, 0.49, d = 0.38]. Age, characteristics of the impairment, and number of match meetings were not associated with change in social participation during the mentoring program. This evaluation showed no benefit of mentoring for social participation of adolescents with a visual impairment. The value of mentors and mentees sharing the same disability needs further investigation. This trial is registered in the Netherlands Trial Register NTR4768.Implications for rehabilitationA community-based mentoring program resulted in no benefits for adolescents with a visual impairment on their social participation.A community-based mentoring program should not replace care-as-usual provided to young people with a visual impairment in the Netherlands. It could only be thought of as an additional service within rehabilitation.Matching mentees and mentors based on sharing the same disability could strengthen the effect of a community-based mentoring program. However, these benefits are rather small.Providing additional support for the social participation of young people with a visual impairment might be especially helpful for those with a progressive impairment and with comorbid problems.
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Affiliation(s)
- Eline C M Heppe
- Faculty of Behavioural and Movement Sciences, Section of Clinical Child and Family Studies, Vrije Unviersiteit Amsterdam, Amsterdam, The Netherlands
| | - Agnes M Willemen
- Faculty of Behavioural and Movement Sciences, Section of Clinical Child and Family Studies, Vrije Unviersiteit Amsterdam, Amsterdam, The Netherlands
| | - Sabina Kef
- Faculty of Behavioural and Movement Sciences, Section of Clinical Child and Family Studies, Vrije Unviersiteit Amsterdam, Amsterdam, The Netherlands.,Bartimeus, Rehabilitation Centre for People with Visual Impairments, Zeist, The Netherlands
| | - Carlo Schuengel
- Faculty of Behavioural and Movement Sciences, Section of Clinical Child and Family Studies, Vrije Unviersiteit Amsterdam, Amsterdam, The Netherlands
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van Schalkwijk FJ, Blessinga AN, Willemen AM, Van Der Werf YD, Schuengel C. Social support moderates the effects of stress on sleep in adolescents. J Sleep Res 2015; 24:407-13. [PMID: 25824847 DOI: 10.1111/jsr.12298] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 03/06/2015] [Indexed: 11/27/2022]
Abstract
Academic expectations and demands become primary sources of stress during adolescence, negatively affecting sleep. To cope with stress, adolescents may turn to social support figures. The present study tested the extent of main and moderating effects of various sources of social support on the association between stress and sleep. Adolescents (n = 202, meanage 14.6 years, standard deviation = 0.71) reported on academic stress, sleep, and support using questionnaires during a low- and high-stress period, defined by the absence or presence of examinations, respectively. Inquiries were made regarding social support from parents, friends, and class supervisor. During both stress periods, academic stress was associated negatively with sleep quality and positively with sleep reduction. Social support increased sleep quality and lowered sleep reduction. In addition, social support moderated the effects of academic stress on sleep, thus improving sleep quality and lowering sleep reduction. Moderating effects were stronger during a period of high stress. The present study showed that adolescents can benefit from stress moderation through social support by improvements of sleep quality and sleep reduction. Such moderating effects should be taken into account when studying stress and sleep. Implications and recommendations based on these findings are discussed.
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Affiliation(s)
- Frank J van Schalkwijk
- Department of Clinical Child and Family Studies and LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, the Netherlands.,Department of Emotion and Cognition, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
| | - Agaath N Blessinga
- Department of Clinical Child and Family Studies and LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, the Netherlands
| | - Agnes M Willemen
- Department of Clinical Child and Family Studies and LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, the Netherlands
| | - Ysbrand D Van Der Werf
- Department of Emotion and Cognition, Netherlands Institute for Neuroscience, Amsterdam, the Netherlands.,Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies and LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, the Netherlands
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Overbeek MM, De Schipper JC, Willemen AM, Lamers-Winkelman F, Schuengel C. Mediators and Treatment Factors in Intervention for Children Exposed to Interparental Violence. J Clin Child Adolesc Psychol 2015; 46:411-427. [PMID: 25751123 DOI: 10.1080/15374416.2015.1012720] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Changes in children's emotion differentiation, coping skills, parenting stress, parental psychopathology, and parent-child interaction were explored as mediators of treatment factors in two selective preventive group interventions for children exposed to interparental violence (IPV) and their parents. One hundred thirty-four IPV-exposed children (ages 6-12 years, 52% boys) and their parents were randomized to an IPV-focused or common factors community-based group intervention and completed baseline, posttest, and follow-up assessments for posttraumatic stress (PTS). A multilevel model tested mediators that included children's ability to differentiate emotions and coping skills, parenting stress, parental psychopathology, and parent-child interactions. In both conditions, exposure to nonspecific factors, specific factors unrelated to IPV and trauma-specific intervention factors was coded from videotaped child and parent sessions. Improved parental mental health mediated the link between greater exposure to nonspecific treatment factors and decreases in PTS symptoms. In addition, an increase in emotion differentiation and a decrease in parenting stress were associated with a decrease in PTS symptoms. Greater exposure to trauma-specific factors in child sessions was associated with a small decrease in emotion differentiation, an increase in coping skills, and a decrease in PTS symptoms over time. Greater exposure to nonspecific treatment factors in child and parent sessions was associated with more positive parent-child interaction. Parental mental health appears to be an important mechanism of change that can be promoted through exposure to nonspecific factors in parent intervention. For children, the effect of greater exposure to trauma-specific factors in intervention is less clear and may not have clear benefits.
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Affiliation(s)
- Mathilde M Overbeek
- a Department of Clinical Child and Family Studies and EMGO Institute for Health and Care Research , VU University
| | - J Clasien De Schipper
- a Department of Clinical Child and Family Studies and EMGO Institute for Health and Care Research , VU University
| | - Agnes M Willemen
- a Department of Clinical Child and Family Studies and EMGO Institute for Health and Care Research , VU University
| | - Francien Lamers-Winkelman
- a Department of Clinical Child and Family Studies and EMGO Institute for Health and Care Research , VU University
| | - Carlo Schuengel
- a Department of Clinical Child and Family Studies and EMGO Institute for Health and Care Research , VU University
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Pronk J, Goossens FA, Olthof T, De Mey L, Willemen AM. Children's intervention strategies in situations of victimization by bullying: social cognitions of outsiders versus defenders. J Sch Psychol 2013; 51:669-82. [PMID: 24295142 DOI: 10.1016/j.jsp.2013.09.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 09/04/2013] [Accepted: 09/09/2013] [Indexed: 10/26/2022]
Abstract
This study examined the social cognitions of outsiders and defenders about intervening in situations of victimization by bullying. Do outsiders and defenders behave differently in victimization situations because of differences in competence beliefs, or because of a selectivity effect in intervening? These issues were examined in a sample of 102 outsiders and 107 defenders who were classified into these bullying roles through a peer-nomination procedure out of a total sample of 761 10- to 14-year-old Dutch children. These children were presented with imaginary victimization events. They answered questions about their cognitions and self-efficacy beliefs about intervening in victimization situations and about handling such situations. Outsiders, compared to defenders, claimed to intervene indirectly in victimization situations rather than directly. Defenders, compared to outsiders, claimed to intervene directly in victimization situations rather than indirectly. Both outsiders and defenders claimed to be more likely to intervene when a friend was being victimized than when a neutral classmate was being victimized. Outsiders and defenders did not differ in their self-efficacy for indirect intervention, but only defenders claimed a high self-efficacy for direct intervention. Both outsiders and defenders claimed to benefit from direct help when they themselves are victimized, but only outsiders also reported to need indirect help. The results suggest that outsiders and defenders behave differently in victimization situations because of differences in competence beliefs rather than because of a selectivity effect. More generally, the results suggest that not only defenders but also outsiders have the intention to help children who are being bullied. However, outsiders' anti-bullying attempts are likely to be indirect and less firm than those of defenders.
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Affiliation(s)
- Jeroen Pronk
- Department of Educational Neuroscience, Faculty of Psychology and Education, VU University Amsterdam, The Netherlands; LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, The Netherlands.
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Scholten L, Willemen AM, Last BF, Maurice-Stam H, van Dijk EM, Ensink E, Zandbelt N, van der Hoop-Mooij A, Schuengel C, Grootenhuis MA. Efficacy of psychosocial group intervention for children with chronic illness and their parents. Pediatrics 2013; 131:e1196-203. [PMID: 23478870 DOI: 10.1542/peds.2012-2222] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the efficacy of a cognitive-behavioral group intervention for children with chronic illnesses and to test the effect of an added parent component. METHODS Children (n = 194) and their parents participated in a multicenter randomized clinical trial comparing a child-only intervention and a parent-child intervention to a wait-list control group. Primary outcomes were parent- and self-reported internalizing and externalizing problems; secondary outcomes were child disease-related coping skills (information seeking, relaxation, social competence, medical compliance, and positive thinking). Assessments took place at baseline and at 6- and 12-month follow-ups. Intention-to-treat mixed-model analyses were performed to test the difference in change in outcomes. RESULTS The intervention had a positive effect on changes in parent-reported internalizing problems, child-reported externalizing problems, information seeking, social competence, and positive thinking. The additional effect of parental involvement was observed on parent-reported internalizing problems, child-reported externalizing problems, information seeking, and social competence. Illness severity and illness type did not moderate the effects. There were no intervention effects on child-reported internalizing problems, parent-reported externalizing problems, relaxation, or medical compliance. Of the families in the wait-list control group, 74% sought alternative psychological support during the intervention period. CONCLUSIONS This RCT supports the efficacy of a protocol-based group intervention for children with chronic illnesses and their parents. Adding a parental component to the intervention contributed to the persistence of the effects. Future research should focus on moderating and mediating effects of the intervention.
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Affiliation(s)
- Linde Scholten
- Psychosocial Department, Emma Children's Hospital Academic Medical Center, Meibergdreef 9, Room A3-241, 1105 AZ Amsterdam, Netherlands.
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Lamers-Winkelman F, Willemen AM, Visser M. Adverse childhood experiences of referred children exposed to intimate partner violence: consequences for their wellbeing. Child Abuse Negl 2012; 36:166-179. [PMID: 22280846 DOI: 10.1016/j.chiabu.2011.07.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 07/07/2011] [Accepted: 07/11/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE This study investigated the relationships among Adverse Childhood Experiences (ACEs) in a high risk clinical sample of Dutch children whose mothers were abused by an intimate partner, and the severity of behavioral and emotional problems and trauma symptoms. METHODS The study population comprised 208 children (M=7.81 years, SD=2.39, range 2-12) who were referred to mental health and welfare institutions after reported Intimate Partner Violence (IPV). At intake, caregivers, children, and teachers completed questionnaires on Adverse Childhood Experiences, behavior and emotional problems, and trauma symptoms. RESULTS The results showed that child witnesses of IPV were also exposed to other adverse experiences, such as abuse, household dysfunction and neglect. The mean number of ACEs was 5.08 (range 2-9). Twenty percent of the children in this sample experienced seven ACEs or more. The number of ACEs children were exposed to was unrelated to the level of emotional and behavioral problems, except for trauma related symptoms reported by parents. CONCLUSIONS This study shows that children who witnessed Intimate Partner Violence were also exposed to other adverse experiences. The results of this study may imply that in this high-risk clinical sample of children exposed to IPV, additional adverse experiences have a limited relationship to psychological outcomes. PRACTICE IMPLICATIONS A thorough assessment and inclusion of all Adverse Childhood Experiences is necessary for a comprehensive treatment program.
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Scholten L, Willemen AM, Grootenhuis MA, Maurice-Stam H, Schuengel C, Last BF. A cognitive behavioral based group intervention for children with a chronic illness and their parents: a multicentre randomized controlled trial. BMC Pediatr 2011; 11:65. [PMID: 21756299 PMCID: PMC3152519 DOI: 10.1186/1471-2431-11-65] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 07/14/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coping with a chronic illness (CI) challenges children's psychosocial functioning and wellbeing. Cognitive-behavioral intervention programs that focus on teaching the active use of coping strategies may prevent children with CI from developing psychosocial problems. Involvement of parents in the intervention program may enhance the use of learned coping strategies in daily life, especially on the long-term. The primary aim of the present study is to examine the effectiveness of a cognitive behavioral based group intervention (called 'Op Koers') 1 for children with CI and of a parallel intervention for their parents. A secondary objective is to investigate why and for whom this intervention works, in order to understand the underlying mechanisms of the intervention effect. METHODS/DESIGN This study is a multicentre randomized controlled trial. Participants are children (8 to 18 years of age) with a chronic illness, and their parents, recruited from seven participating hospitals in the Netherlands. Participants are randomly allocated to two intervention groups (the child intervention group and the child intervention combined with a parent program) and a wait-list control group. Primary outcomes are child psychosocial functioning, wellbeing and child disease related coping skills. Secondary outcomes are child quality of life, child general coping skills, child self-perception, parental stress, quality of parent-child interaction, and parental perceived vulnerability. Outcomes are evaluated at baseline, after 6 weeks of treatment, and at a 6 and 12-month follow-up period. The analyses will be performed on the basis of an intention-to-treat population. DISCUSSION This study evaluates the effectiveness of a group intervention improving psychosocial functioning in children with CI and their parents. If proven effective, the intervention will be implemented in clinical practice. Strengths and limitations of the study design are discussed. TRIAL REGISTRATION Current Controlled Trials ISRCTN60919570.
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Affiliation(s)
- Linde Scholten
- Emma children's hospital Academic Medical Center Amsterdam, Psychosocial department, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Agnes M Willemen
- VU University Amsterdam, Department of Clinical Child and Family Studies, and EMGO Institute for Health and Care Research
| | - Martha A Grootenhuis
- Emma children's hospital Academic Medical Center Amsterdam, Psychosocial department, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Heleen Maurice-Stam
- Emma children's hospital Academic Medical Center Amsterdam, Psychosocial department, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Carlo Schuengel
- VU University Amsterdam, Department of Clinical Child and Family Studies, and EMGO Institute for Health and Care Research
| | - Bob F Last
- Emma children's hospital Academic Medical Center Amsterdam, Psychosocial department, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- VU University Amsterdam, Department of Clinical Child and Family Studies, and EMGO Institute for Health and Care Research
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Abstract
BACKGROUND Psychopathology in youth appears to be linked to deficits in regulating affective responses to stressful situations. In children, high-quality parental support facilitates affect regulation. However, in adolescence, the role of parent-child interaction in the regulation of affect is unclear. This study examined physiological reactivity to and recovery from stress in adolescents at risk for psychopathology, and their associations with internalising and externalising problems and parent-adolescent interactions. METHODS A total of 99 adolescents (M = 13.57 years, SD = 1.83) with a history of mental health problems underwent the Alarm Stress Task and were reunited with their primary caregiver after the stressor, while the physiological responses of the parasympathetic (respiratory sinus arrhythmia) and sympathetic (pre-ejection period) systems were measured. The quality of parent-adolescent interaction was determined from observations of secure-base seeking and providing during the task. Affect regulation was measured as physiological reactivity and recovery after the stressor. RESULTS Adolescents with high levels of externalising problems and low levels of secure-base support showed weaker parasympathetic reactivity and recovery. Higher level of adolescent secure-base seeking was associated with stronger sympathetic reactivity and recovery. CONCLUSIONS Secure-base interactions between parents and adolescents facilitate physiological regulation of stress, especially for adolescents with externalising symptomatology.
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Affiliation(s)
- Agnes M Willemen
- Department of Clinical Child and Family Studies, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands.
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Willemen AM, Koot HM, Ferdinand RF, Goossens FA, Schuengel C. Change in psychopathology in referred children: the role of life events and perceived stress. J Child Psychol Psychiatry 2008; 49:1175-83. [PMID: 18573146 DOI: 10.1111/j.1469-7610.2008.01925.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study examined the relation between stress and change in emotional and behavioural problems in children and adolescents referred for mental health services. METHOD At three waves across four years, children and their parents (N = 310, mean age at the first wave = 11.26 years, SD = 3.18) reported emotional and behavioural problems, as well as stressful life events (parent report) and perceived stress (child report). RESULTS Major life events before referral were associated with higher levels of parent-reported internalising and externalising problems at referral. Life events after referral were associated with a slower recovery from internalising problems. The associations between stressful life events and the course of parent- and self-reported problems were mediated by children's subjective feelings of stress. CONCLUSION Stressful life events appear to interfere with recovery from internalising problems in the years after referral through increasing the experience of stress in daily life.
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Affiliation(s)
- Agnes M Willemen
- PI Research, Duivendrecht, VU University Amsterdam, The Netherlands.
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Willemen AM, Goossens FA, Koot HM, Schuengel C. Physiological reactivity to stress and parental support: comparison of clinical and non-clinical adolescents. Clin Psychol Psychother 2008; 15:340-51. [DOI: 10.1002/cpp.578] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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