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van Beek RJJ, Blankers M, Kleinjan M, Waldron J, Grabski M, Freeman T, Curran V, van der Pol P, van Laar M. Polydrug Use Typologies of Regular Ecstasy Users Visiting Electronic Dance Music Events: A Latent Class Analysis. Eur Addict Res 2023; 30:52-64. [PMID: 38154456 DOI: 10.1159/000534487] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/22/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION Polydrug use patterns among young adults using ecstasy vary, as well as their willingness to change them. Polydrug use patterns are likely associated with different adverse health outcomes. It is unknown whether polydrug use patterns of young adults who use ecstasy are similar in different countries. This study aims to identify and compare polydrug use patterns and willingness to change them of young adults that use ecstasy in the United Kingdom (UK) and the Netherlands (NL), two countries with a high prevalence of ecstasy use and a large electronic dance music (EDM) scene. METHODS The data from the online cross-sectional Electronic Music Scene Survey were used in a latent class analysis. The binary indicators used in the estimation were past-year substance use of 21 different substances. The sample consisted of young adult ecstasy users that regularly visit EDM events (age 18-34). RESULTS A total of 1,077 respondents from the UK (age M = 23.1) and 1,178 from the NL (age M = 23.7) that regularly visit EDM events were included in the analyses. In both countries, three polydrug use patterns of ecstasy users were identified based on Bayesian Information Criterion fit indices: a traditional polydrug use class (UK: 28%; NL: 40%), a stimulant and ketamine polydrug use class (UK: 48%; NL: 52%), and an extensive polydrug use class (UK: 24%; NL: 8%) characterized by substantial use of stimulants, depressant, and psychedelic substances. Overall, young adults that used ecstasy in the UK consumed 3,4-methylenedioxymeth-amphetamine (MDMA) more often as powder/crystalline and at higher dosages compared to young adults in the NL who preferred MDMA tablets. Regardless of polydrug class or country, most respondents indicated that they had the intention to reduce but not quit their use. CONCLUSION In both countries, structurally similar polydrug use patterns among young adults that use ecstasy were found, while the use frequencies of individual substances and preferred MDMA form varied between the countries.
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Affiliation(s)
| | - Matthijs Blankers
- Trimbos Institute, Utrecht, The Netherlands
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marloes Kleinjan
- Trimbos Institute, Utrecht, The Netherlands
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Jon Waldron
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Meryem Grabski
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Department of Psychology, Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
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de Jonge MC, Bukman AJ, Ter Bogt T, Onrust SA, Kleinjan M. What Do Young Adults Expect from the Recreational Use of Ecstasy (3,4-Methylenedioxymethamphetamine/Molly)? A Latent Class Analysis of a Convenience Sample of Dutch Young Adults. Eur Addict Res 2023:1-10. [PMID: 37271136 DOI: 10.1159/000530330] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/16/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION This study offers insights into Dutch young people's expected social and personal consequences of ecstasy use. Substance use expectancies are assumed to be an essential component in explaining substance use behaviour and, therefore, the development of effective substance use prevention and treatment strategies. METHOD Dutch young adults with an online interest in drug-related social media posts were targeted with an online survey about their use of alcohol and drugs. This resulted in a convenience sample (N = 4182, 73.4% female, Mage = 21.11), of which 35.5% had used ecstasy at least once in their life and 29.3% had used ecstasy last year. Latent class analyses were used to identify subgroups based on both positive and negative expectancies of ecstasy use. Cross-class differences were examined using multinomial logistic regression. RESULTS This study yielded four distinct classes: only negative expectancies (13.6%), high positive and negative expectancies (23.5%), low to moderate positive and negative expectancies (20.6%), and mostly positive expectancies (22.4%). These classes differed significantly in lifetime experience with ecstasy use, intention to use ecstasy, perception of harmfulness and availability, and social norms regarding the use of ecstasy. CONCLUSION Findings show that ecstasy use expectancies can be used to create meaningful classes of users and non-users, and that these classes are different enough to warrant varied prevention approaches. Expectancies young people have regarding the use of ecstasy are associated with various ecstasy use-related variables and should be taken into consideration when developing and implementing preventive interventions.
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Affiliation(s)
| | | | - Tom Ter Bogt
- Utrecht University, Interdisciplinary Social Science, Utrecht, The Netherlands
| | | | - Marloes Kleinjan
- Trimbos Institute, Utrecht, The Netherlands
- Utrecht University, Interdisciplinary Social Science, Utrecht, The Netherlands
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Zijlmans J, Tieskens JM, van Oers HA, Alrouh H, Luijten MAJ, de Groot R, van der Doelen D, Klip H, van der Lans RM, de Meyer R, van der Mheen M, Ruisch IH, van den Berg G, Bruining H, Buitelaar J, van der Rijken R, Hoekstra PJ, Kleinjan M, Lindauer RJL, Oostrom KJ, Staal W, Vermeiren R, Cornet R, Haverman L, Popma A, Bartels M, Polderman TJC. The effects of COVID-19 on child mental health: Biannual assessments up to April 2022 in a clinical and two general population samples. JCPP Adv 2023; 3:e12150. [PMID: 37753155 PMCID: PMC10519731 DOI: 10.1002/jcv2.12150] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/06/2023] [Indexed: 09/28/2023] Open
Abstract
Background The COVID-19 pandemic has had an acute impact on child mental and social health, but long-term effects are still unclear. We examined how child mental health has developed since the start of the COVID-19 pandemic up to 2 years into the pandemic (April 2022). Methods We included children (age 8-18) from two general population samples (N = 222-1333 per measurement and N = 2401-13,362 for pre-covid data) and one clinical sample receiving psychiatric care (N = 334-748). Behavioral questionnaire data were assessed five times from April 2020 till April 2022 and pre-pandemic data were available for both general population samples. We collected parent-reported data on internalizing and externalizing problems with the Brief Problem Monitor and self-reported data on Anxiety, Depressive symptoms, Sleep-related impairments, Anger, Global health, and Peer relations with the Patient-Reported Outcomes Measurement Information System (PROMIS®). Results In all samples, parents reported overall increased internalizing problems, but no increases in externalizing problems, in their children. Children from the general population self-reported increased mental health problems from before to during the pandemic on all six PROMIS domains, with generally worst scores in April 2021, and scores improving toward April 2022 but not to pre-pandemic norms. Children from the clinical sample reported increased mental health problems throughout the pandemic, with generally worst scores in April 2021 or April 2022 and no improvement. We found evidence of minor age effects and no sex effects. Conclusions Child mental health in the general population has deteriorated during the first phase of the COVID-19 pandemic, has improved since April 2021, but has not yet returned to pre-pandemic levels. Children in psychiatric care show worsening of mental health problems during the pandemic, which has not improved since. Changes in child mental health should be monitored comprehensively to inform health care and policy.
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Yang MJ, Brandon KO, Sutton SK, Kleinjan M, Sawyer LE, Brandon TH, Vinci C. Augmented reality as a novel approach for addiction treatment: development of a smoking cessation app. Ann Med 2022; 54:3096-3106. [PMID: 36345961 PMCID: PMC9648377 DOI: 10.1080/07853890.2022.2140451] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Augmented reality (AR) is a rapidly developing technology that has substantial potential as a novel approach for addiction treatment, including tobacco use. AR can facilitate the delivery of cue exposure therapy (CET) such that individuals can experience the treatment in their natural environments as viewed via a smartphone screen, addressing the limited generalizbility of extinction learning. Previously, our team developed a basic AR app for smoking cessation and demonstrated the necessary mechanisms for CET. Specifically, we showed that the AR smoking cues, compared to neutral cues, elicited substantial cue reactivity (i.e. increased urge) and that repeated exposure to the AR smoking cues reduced urge (i.e. extinction) in a laboratory setting. Here we report the next step in the systematic development of the AR app, in which we assessed the usability and acceptability of the app among daily smokers in their natural environments. METHOD Daily smokers (N = 23, 78.3% female, Mean Age = 43.4, Mean Cigarettes/Day = 14.9), not actively quitting, were instructed to use the AR app in locations and situations where they smoke (e.g. home, bar) at least 5 times per day over one week. The study is registered in clinicaltrials.gov (NCT04101422). RESULTS Results indicated high usability and acceptability. Most of the participants (73.9%) used the AR app on at least 5 days. Participants found the AR cues realistic and well-integrated in their natural environments. The AR app was perceived as easy to use (Mean = 4.1/5) and learn (mean of 2 days to learn). Overall satisfaction with the app was also high. Secondary analyses found that 56.5% reported reduced smoking, with an average 26% reduction in cigarettes per day at follow-up. CONCLUSIONS These findings set the stage for a randomized controlled trial testing the AR app as an adjuvant therapy for treating tobacco dependence, with potential applicability to other substances. KEY MESSAGEThis study found that the augmented reality (AR) smartphone application that utlized cue exposure treatment for smoking cessation was perceived as easy to use and learn in the natural, day-to-day environment of daily smokers. Findings set the stage for a larger clinical trial testing the AR app as an adjuvant therapy for treating tobacco dependence, with potential applicability to other addictive behaviors.
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Affiliation(s)
- Min-Jeong Yang
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.,Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Marloes Kleinjan
- Department of Child and Adolescent Health, Trimbos Institute, Utrecht, The Netherlands.,Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Leslie E Sawyer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Christine Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
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Yang MJ, Brandon KO, Sutton SK, Kleinjan M, Hernandez LM, Sawyer LE, Brandon TH, Vinci C. Augmented reality for extinction of cue-provoked urges to smoke: Proof of concept. Psychol Addict Behav 2022; 36:990-998. [PMID: 35834198 PMCID: PMC9771872 DOI: 10.1037/adb0000868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Cue-exposure therapy (CET) aims to extinguish conditioned cue reactivity (CR) to aid in smoking cessation. A key disadvantage of extant CET is its limited ability to generalize extinction to the real world. Our team developed a set of augmented reality smoking-related and neutral cues that can appear in real-time in smokers' natural environments as viewed through a smartphone screen. Prior to deployment as a clinical tool, the present study tested the ability of AR smoking cues to extinguish CR in a controlled laboratory study with an AR smartphone application developed for this project. We hypothesized that daily smokers who completed a single session of cue exposure with AR smoking cues (extinction condition) would demonstrate lower cue-provoked urge to smoke at posttest compared to those who viewed AR neutral cues (control condition). METHOD Daily smokers (N = 129, 46.5% female, Mage = 47.6, Mcigarettes/day = 19.1) in acute abstinence were randomized to either the extinction or control condition comprising 28 AR trials. RESULTS As hypothesized, we found a Time × Condition interaction indicating that posttest urge ratings were lower in the extinction condition than in the control condition (p = .034). A secondary hypothesis that participants in the extinction condition would show a longer latency to smoke when provided a cigarette was not supported. CONCLUSIONS These laboratory findings provide evidence supporting the potential clinical efficacy of AR cues for cue-exposure trials, setting the stage for testing in smokers' naturalistic environments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Min-Jeong Yang
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Karen O. Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Steven K. Sutton
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Marloes Kleinjan
- Department of Child and Adolescent Health, Trimbos Institute, Utrecht, The Netherlands
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Laura M. Hernandez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Leslie E. Sawyer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Thomas H. Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Christine Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
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Ruiter ELM, Molleman GRM, Kleinjan M, Kraiss JT, ten Klooster PM, van der Velden K, Engels RCME, Fransen GAJ. The effectiveness of a web-based Dutch parenting program to prevent overweight in children 9-13 years of age: Results of a two-armed cluster randomized controlled trial. PLoS One 2022; 17:e0276168. [PMID: 36269738 PMCID: PMC9586369 DOI: 10.1371/journal.pone.0276168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 08/30/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Although parental support is an important component in programs designed to prevent overweight in children, current programs pay remarkably little attention to the role of parenting. We therefore developed a web-based parenting program entitled "Making a healthy deal with your child". This e-learning program can be incorporated into existing overweight prevention programs. The aim of this study was to determine the effectiveness of this e-learning program. MATERIALS AND METHODS The effectiveness was examined in a two-armed cluster randomized controlled trial. The participants were 475 parent-child dyads of children 9-13 years of age in the Netherlands who participated in an existing schoolclass-based overweight prevention program. At the school grade level, parents were randomly assigned to either the intervention or the control condition. Measurements were taken from both parents and children at baseline, and 5 and 12 months after baseline. Primary outcomes included the child's dietary and sedentary behavior, and level of physical activity. Secondary outcomes included general parenting style, specific parenting practices, and parental self-efficacy. Linear mixed effects models and generalized linear mixed effects models were conducted in R. RESULTS Intention-to-treat analyses and completers only revealed no significant effects between the intervention and control condition on energy balance-related behaviors of the child and parenting skills after correction for multiple testing. The parents' mean satisfaction with the e-learning program (on a 10-point scale) was 7.0±1.1. CONCLUSIONS Although parents were generally satisfied with the parenting program, following this program had no significant beneficial effects regarding the children's energy balance-related behaviors or the parenting skills compared to the control condition. This program may be more beneficial if used by high-risk groups (e.g. parents of children with unhealthy energy balance-related behaviors and/or with overweight) compared to the general population, warranting further study.
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Affiliation(s)
- Emilie L. M. Ruiter
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, ELG 117, Radboud University Medical Center, HB Nijmegen, The Netherlands
- * E-mail:
| | - Gerard R. M. Molleman
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, ELG 117, Radboud University Medical Center, HB Nijmegen, The Netherlands
| | | | - Jannis T. Kraiss
- Department of Psychology, Health and Technology, University of Twente, AE Enschede, The Netherlands
| | - Peter M. ten Klooster
- Department of Psychology, Health and Technology, University of Twente, AE Enschede, The Netherlands
| | - Koos van der Velden
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, ELG 117, Radboud University Medical Center, HB Nijmegen, The Netherlands
| | | | - Gerdine A. J. Fransen
- Department of Primary and Community Care, Academic Collaborative Center AMPHI, Integrated Health Policy, ELG 117, Radboud University Medical Center, HB Nijmegen, The Netherlands
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Peeters M, Doornwaard S, Leijerzapf M, de Haas J, Efat A, Kleinjan M. Prestatiedruk en schoolstress bekeken vanuit verschillende perspectieven. Tijdschr Jeugdgezondheidsz 2022. [PMCID: PMC9483523 DOI: 10.1007/s12452-022-00289-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Jongeren ervaren de laatste jaren steeds meer schoolstress en druk door school. Om goed inzicht te krijgen in de factoren die ten grondslag liggen aan deze toename en mogelijk een schakel zijn voor verandering, is het van belang om dit maatschappelijke probleem vanuit verschillende perspectieven te bekijken. In dit onderzoek verbinden we wetenschappelijke kennis (systematisch literatuuronderzoek) met praktijk- en ervaringskennis van professionals, beleidsmedewerkers, ouders en jongeren (diepte-interviews, n = 60). De resultaten van dit onderzoek laten zien dat de beschermende factoren op verschillende niveaus (systeem, directe omgeving, individu) met elkaar interacteren. De maatschappij legt veel nadruk op resultaat en prestaties, wat invloed heeft op de verwachtingen van jongeren en ouders, en de inrichting van ons onderwijssysteem. Scholen kunnen jongeren ondersteunen bij hun ontwikkeling door aandacht te besteden aan bredere talentontwikkeling, alternatieve beoordelingsvormen, goed mentorschap en de sociaal-emotionele ontwikkeling. Om de ervaren schoolstress en druk door school te verminderen is het belangrijk om niet alleen het individu weerbaarder te maken, maar ook de directe omgeving en de school/maatschappij mee te nemen in preventieve maatregelen om schoolstress en ervaren druk te minderen.
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Affiliation(s)
- M. Peeters
- Interdisciplinaire Sociale Wetenschappen, Universiteit Utrecht, Utrecht, Nederland
| | - S. Doornwaard
- Interdisciplinaire Sociale Wetenschappen, Universiteit Utrecht, Utrecht, Nederland
| | - M. Leijerzapf
- Interdisciplinaire Sociale Wetenschappen, Universiteit Utrecht, Utrecht, Nederland
| | - J. de Haas
- Interdisciplinaire Sociale Wetenschappen, Universiteit Utrecht, Utrecht, Nederland
| | - A. Efat
- Nederlands Jeugdinstituut (NJi), Utrecht, Nederland
| | - M. Kleinjan
- Interdisciplinaire Sociale Wetenschappen, Universiteit Utrecht, Utrecht, Nederland
- Trimbos Instituut, Utrecht, Nederland
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Kleinjan M, Jansen DEMC, van den Essenburg M. The Need for a Data Ecosystem for Youth Mental Health in The Netherlands. Int J Environ Res Public Health 2022; 19:11499. [PMID: 36141777 PMCID: PMC9517201 DOI: 10.3390/ijerph191811499] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/30/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
The Netherlands is missing nationally representative data on child and adolescent mental health, e.g., on prevalence, course, and consequences of psychological disorders and mental health care utilization. Researchers and policy makers also lack a basic data infrastructure that is necessary to provide timely and reliable data crucial for benchmarking and informed decision making. In this article, we describe the necessity for a clear and well-organized overview of data on youth mental health and mental health care. We look back on three key moments in time to illustrate the breadth of the desire for data. Barriers in collecting structured, national data on a frequent basis are discussed, and several recommendations are provided of what is needed to move towards a data ecosystem that can help us to track the development and mental well-being of all children and youth and the impact of the care they receive.
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Affiliation(s)
- Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands
- Interdisciplinary Social Science, Youth Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
| | - Danielle E. M. C. Jansen
- Department of General Practice & Elderly Care Medicine, University Medical Centre Groningen, Hanzeplein 1, 9712 CP Groningen, The Netherlands
- Department of Sociology and Interuniversity Centre for Social Science Theory and Methodology (ICS), University of Groningen, Grote Rozenstraat 31, 9712 TG Groningen, The Netherlands
- Accare, University Centre for Child and Adolescent Psychiatry, Lübeckweg 2, 9723 HE Groningen, The Netherlands
| | - Maartje van den Essenburg
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands
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Tuijnman A, Kleinjan M, Olthof M, Hoogendoorn E, Granic I, Engels RC. A Game-Based School Program for Mental Health Literacy and Stigma on Depression (Moving Stories): Cluster Randomized Controlled Trial. JMIR Ment Health 2022; 9:e26615. [PMID: 35976200 PMCID: PMC9434393 DOI: 10.2196/26615] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/31/2021] [Accepted: 07/28/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Depressive symptoms are highly prevalent among adolescents in Western countries. However, although treatment for depressive symptoms is available, many adolescents do not seek help when they need it. Important barriers to help-seeking among adolescents include low mental health literacy and high stigma. Therefore, we have developed a game-based school program, Moving Stories, which combines mental health literacy training for depression with contact with someone with lived experience both in the digital and nondigital world. OBJECTIVE The aim of this study is to conduct a first test of the effectiveness of the newly developed game-based program, Moving Stories, using a cluster randomized controlled trial. METHODS A total of 185 adolescents participated, divided over 10 classes from 4 schools. Half of the classes were randomly selected to follow the Moving Stories program, whereas the other half were in the control group, where no intervention was provided. The adolescents filled out digital questionnaires at 4 time points, with questions on mental health literacy, stigma, depressive symptoms, and the program itself (before the program, after the program, 3-month follow-up, and 6-month follow-up). Using R (R Foundation for Statistical Computing), we ran linear mixed-effects models for all continuous outcome variables and generalized linear mixed-effects models for all binary outcome variables. RESULTS Compared with the control group, participants in the Moving Stories group improved after the program in personal stigma (b=-0.53, 95% CI -1.02 to -0.03; t179.16=-2.08; P=.04). Effects on personal stigma lasted over time (3-month follow-up: b=-0.57, 95% CI -1.11 to -0.03; t174.39=-2.07; P=.04). Most adolescents in the Moving Stories group participated in the introduction (97/99, 98%) and contact session (93/99, 94%), played the game for 4 or 5 days (83/99, 83%), and indicated that they would recommend the game to their peers (90/98, 92%). CONCLUSIONS The results of this study show the potential of Moving Stories as a stigma reduction program. With changes in the program to improve its effects on mental health literacy, Moving Stories could be implemented in schools to improve help-seeking in adolescents and reduce the negative consequences and burden of depressive symptoms. TRIAL REGISTRATION Dutch Trial Register NTR7033; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7033. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/11255.
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Affiliation(s)
- Anouk Tuijnman
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands.,Trimbos-institute, Utrecht, Netherlands
| | - Marloes Kleinjan
- Trimbos-institute, Utrecht, Netherlands.,Department of Interdisciplinary Social Sciences, Youth Studies, Utrecht University, Utrecht, Netherlands
| | - Merlijn Olthof
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands
| | | | - Isabela Granic
- Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | - Rutger Cme Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University, Rotterdam, Netherlands
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10
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Ruiter ELM, Fransen GAJ, Kleinjan M, van der Velden K, Molleman GRM, Engels RCME. The degree of consistency of applying parental dietary and sedentary behavior rules as indicators for overweight in children: a cross-sectional study. BMC Public Health 2022; 22:348. [PMID: 35180872 PMCID: PMC8855353 DOI: 10.1186/s12889-022-12742-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Review studies increasingly emphasize the importance of the role of parenting in interventions for preventing overweight in children. The aim of this study was to examine typologies regarding how consistently parents apply energy-balance related behavior rules, and the association between these typologies and socio-demographic characteristics, energy balance-related behaviors among school age children, and the prevalence of being overweight. METHODS For this cross-sectional study, we had access to a database managed by a Municipal Health Service Department in the Netherlands. In total, 4,865 parents with children 4-12 years of age participated in this survey and completed a standardized questionnaire. Parents classified their consistency of applying rules as "strict", "indulgent", or "no rules". Typologies were identified using latent class analyses. We used regression analyses to examine how the typologies differed with respect to the covariates socio-demographic characteristics, children's energy balance-related behaviors, and weight status. RESULTS We identified four stable, distinct parental typologies with respect to applying dietary and sedentary behavior rules. Overall, we found that parents who apply "overall strict EBRB rules" had the highest level of education and that their children practiced healthier behaviors compared to the children of parents in the other three classes. In addition, we found that parents who apply "indulgent dietary rules and no sedentary rules" had the lowest level of education and the highest percentage of non-Caucasians; in addition, their children 8-12 years of age had the highest likelihood of being overweight compared to children of parents with "no dietary rules". CONCLUSIONS Parents' consistency in applying rules regarding dietary and sedentary behaviors was associated with parents' level of education and ethnic background, as well as with children's dietary and sedentary behaviors and their likelihood of becoming overweight. Our results may contribute to helping make healthcare professionals aware that children of parents who do not apply sedentary behavior rules are more likely to become overweight, as well as the importance of encouraging parents to apply strict dietary and sedentary behavior rules. These results can serve as a starting point for developing effective strategies to prevent overweight among children.
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Affiliation(s)
- Emilie L M Ruiter
- Integrated Health Policy, Primary and Community Care, Academic Collaborative Center AMPHI, Radboud University Medical Center, ELG 117, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
| | - Gerdine A J Fransen
- Integrated Health Policy, Primary and Community Care, Academic Collaborative Center AMPHI, Radboud University Medical Center, ELG 117, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Marloes Kleinjan
- Trimbos Institute, P.O. Box 725, 3500 AS, Utrecht, the Netherlands.,Interdisciplinary Social Science, University Utrecht, P.O. Box 80.140, 3508 TC, Utrecht, the Netherlands
| | - Koos van der Velden
- Academic Collaborative Centre AMPHI, Primary and Community Care, Radboud University Medical Centre, ELG 117, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Gerard R M Molleman
- Integrated Health Policy, Primary and Community Care, Academic Collaborative Center AMPHI, Radboud University Medical Center, ELG 117, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Rutger C M E Engels
- Department of Psychology, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands
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11
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Abstract
Shortly after young adolescents initiate alcohol use, we investigated whether (1) drinking motives are associated with current alcohol use and binge drinking, (2) motives predict these alcohol outcomes 6 months later, and (3) alcohol outcomes predict motives 6 months later. Data on adolescents' drinking motives and alcohol use were drawn from a Dutch longitudinal 7-wave family study at the timepoint of alcohol use initiation (t0, N = 210, 51.4% male, Mage = 14.01 SD = 1.02) and 6 months later (t1, n = 88). Logistic and linear regressions were conducted. Results indicated that young adolescents mainly drink for social and enhancement motives rather than coping and conformity motives. Shortly after alcohol initiation, social motives were associated with alcohol use at t0 (OR = 1.52), enhancement motives with binge drinking at t0 (OR = 2.35), and coping motives with binge drinking at t0 (OR = 2.62) and at t1 (OR = 3.00). Conformity motives were inversely associated with binge drinking at t0 (OR = 0.42). Binge drinking predicted coping motives at t1 (B = 0.71, SE = -0.35), but no other associations among alcohol use, binge drinking, and drinking motives at t1 were found. Conclusively, this study shows that young adolescents drink to enjoy parties and to get drunk (social and enhancement motives) rather than to fit in (conformity motives). The study also indicates that shortly after alcohol initiation, alcohol to cope represents a reciprocal risk factor for binge drinking that may persist in the future, thus pointing to the importance of drinking motives for drinking behaviors among young adolescents. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Koen Smit
- Centre for Alcohol Policy Research, La Trobe University
| | - Carmen Voogt
- Behavioural Science Institute, Radboud University
| | - Roy Otten
- Behavioural Science Institute, Radboud University
| | - Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht University
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12
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van Keulen H, Voogt C, Kleinjan M, Kramer J, Andree R, van Empelen P. The development of a dynamically tailored mobile alcohol intervention entitled ‘What Do You Drink’ to reduce excessive drinking among Dutch lower educated (MBO) students aged 16 to 24 years: An Intervention Mapping approach (Preprint). JMIR Form Res 2022; 6:e36969. [PMID: 35969428 PMCID: PMC9412899 DOI: 10.2196/36969] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/04/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background The high prevalence and adverse consequences of excessive drinking among lower-educated adolescents and young adults are public concerns in the Netherlands. Evidence-based alcohol prevention programs targeting adolescents and young adults with a low educational background are sparse. Objective This study aimed to describe the planned process for the theory- and evidence-based development, implementation, and evaluation of a dynamically tailored mobile alcohol intervention, entitled What Do You Drink (WDYD), aimed at lower-educated students from secondary vocational education and training (Middelbaar Beroepsonderwijs in Dutch). Methods We used intervention mapping as the framework for the systematic development of WDYD. It consists of the following six steps: assessing needs (step 1), formulating intervention objectives (step 2), translating theoretical methods into practical applications (step 3), integrating these into a coherent program (step 4), anticipating future implementation and adoption (step 5), and developing an evaluation plan (step 6). Results Reducing excessive drinking among Dutch lower-educated students aged 16 to 24 years was defined as the desired behavioral outcome and subdivided into the following five program objectives: make the decision to reduce drinking, set realistic drinking goals, use effective strategies to achieve drinking goals, monitor own drinking behavior, and evaluate own drinking behavior and adjust goals. Risk awareness, motivation, social norms, and self-efficacy were identified as the most important and changeable individual determinants related to excessive drinking and, therefore, were incorporated into WDYD. Dynamic tailoring was selected as the basic intervention method for changing these determinants. A user-centered design strategy was used to enhance the fit of the intervention to the needs of students. The intervention was developed in 4 iterations, and the prototypes were subsequently tested with the students and refined. This resulted in a completely automated, standalone native app in which students received dynamically tailored feedback regarding their alcohol use and goal achievement via multiple sessions within 17 weeks based on diary data assessing their alcohol consumption, motivation, confidence, and mood. A randomized controlled trial with ecological momentary assessments will be used to examine the effects, use, and acceptability of the intervention. Conclusions The use of intervention mapping led to the development of an innovative, evidence-based intervention to reduce excessive alcohol consumption among lower-educated Dutch adolescents and young adults. Developing an intervention based on theory and empirical evidence enables researchers and program planners to identify and retain effective intervention elements and to translate the intervention to new populations and settings. This is important, as black boxes, or poorly described interventions, have long been a criticism of the eHealth field, and effective intervention elements across mobile health alcohol interventions are still largely unknown. Trial Registration Netherlands Trial Registry NTR6619; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6619
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Affiliation(s)
- Hilde van Keulen
- Department of Child Health, TNO (Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
| | - Carmen Voogt
- Trimbos Institute (Netherlands Institute for Mental Health and Addiction), Utrecht, Netherlands
| | - Marloes Kleinjan
- Trimbos Institute (Netherlands Institute for Mental Health and Addiction), Utrecht, Netherlands
- Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, Netherlands
| | - Jeannet Kramer
- Trimbos Institute (Netherlands Institute for Mental Health and Addiction), Utrecht, Netherlands
| | - Rosa Andree
- Trimbos Institute (Netherlands Institute for Mental Health and Addiction), Utrecht, Netherlands
| | - Pepijn van Empelen
- Department of Child Health, TNO (Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
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13
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Rombouts M, Duinhof EL, Kleinjan M, Kraiss JT, Shields-Zeeman L, Monshouwer K. A school-based program to prevent depressive symptoms and strengthen well-being among pre-vocational students (Happy Lessons): protocol for a cluster randomized controlled trial and implementation study. BMC Public Health 2022; 22:139. [PMID: 35057774 PMCID: PMC8772193 DOI: 10.1186/s12889-021-12321-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/26/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Depression is one of the leading causes of illness and disability among young people. In the Netherlands, one in twelve Dutch adolescents has experienced depression in the last 12 months. Pre-vocational students are at higher risk for elevated depressive symptoms. Effective interventions, especially for this risk group, are therefore needed to prevent the onset of depression or mitigate the adverse long-term effects of depression. The aim of this study is to examine the effectiveness and implementation of a school-based program Happy Lessons (HL), that aims to prevent depression and promote well-being among pre-vocational students.
Methods
A cluster randomized controlled trial (RCT) with students randomized to HL or to care as usual will be conducted. Pre-vocational students in their first or second year (aged 12 to 14) will participate in the study. Subjects in both conditions will complete assessments at baseline and at 3- and 6-months follow-up. The primary outcome will be depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D) at 6-months follow-up. Secondary outcomes are well-being using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) and life satisfaction (Cantril Ladder) measured at 6-months follow-up. Alongside the trial, an implementation study will be conducted to evaluate the implementation of HL, using both quantitative and qualitative methods (interviews, survey, and classroom observations).
Discussion
The results from both the RCT and implementation study will contribute to the limited evidence base on effective school-based interventions for the prevention of depression and promotion of well-being among pre-vocational adolescents. In addition, insights from the implementation study will aid identifying factors relevant for optimizing the future implementation and scale-up of HL to other schools and contexts.
Trial registration
This study was registered on 20 September 2021 in the Dutch Trial Register (NL9732).
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14
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de Jonge MC, Bukman AJ, van Leeuwen L, Onrust SA, Kleinjan M. Latent Classes of Substance Use in Young Adults - A Systematic Review. Subst Use Misuse 2022; 57:769-785. [PMID: 35188870 DOI: 10.1080/10826084.2022.2040029] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: This systematic review provides an overview of studies on latent classes related to the substance use among young adults (18-25 years). Identifying these classes helps to detect high-risk groups, setting a base for selective prevention.Methods: This systematic literature review included peer-reviewed studies (published up to February, 2021) that identified latent classes and investigated predictors of latent classes relating to the use of marijuana, alcohol and/or other substances within samples of young adults.Results: Twenty studies (sample sizes N = 171 to N = 21945) met the inclusion criteria. 14 studies identified 'low-level engagers', 'light alcohol and tobacco use', 'heavy alcohol and tobacco use' and 'heavy use/polysubstance use' classes. Four studies differentiated within the 'heavy/polysubstance' class and found 'traditional clubdrugs', 'hallucinogens' and 'wide-range illicit drugs' classes. Male gender and white race predicted membership of the 'heavy use/polysubstance use' class consistently across studies. Other predictors of polysubstance use that were consistent across studies were peer substance use, depressive symptoms, parental drinking and participating in an honor society.Conclusions: The investigated predictors of class membership provide insight into social settings and characteristics that predict heavy use or polysubstance use. They can contribute to the development of effective prevention interventions by allowing for a more targeted approach.
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Affiliation(s)
| | | | - Lonneke van Leeuwen
- Julius Center for Health Sciences and Primary Care Utrecht, Utrecht, The Netherlands
| | | | - Marloes Kleinjan
- Trimbos Institute, Utrecht, The Netherlands.,Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
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15
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Dieleman J, Sescousse G, Kleinjan M, Otten R, Luijten M. Investigating the association between smoking, environmental tobacco smoke exposure and reward-related brain activity in adolescent experimental smokers. Addict Biol 2022; 27:e13070. [PMID: 34263512 PMCID: PMC9285048 DOI: 10.1111/adb.13070] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/11/2021] [Accepted: 05/25/2021] [Indexed: 11/28/2022]
Abstract
Reduced anticipatory reward‐related activity, especially in the ventral striatum (VS), may underly adolescent vulnerability to develop nicotine dependence. It remains unclear whether nicotine uptake caused by environmental tobacco smoke (ETS) exposure, known to be associated with future smoking, might prompt similar changes in the brain's reward system, rendering adolescents vulnerable for development of nicotine dependence. To address this question, we tested whether current ETS exposure and monthly smoking are associated with VS hypoactivity for non‐drug rewards in experimental smoking adolescents. One‐hundred adolescents performed a monetary incentive delay task while brain activity was measured using fMRI. To test the hypothesized relationship, we used a variety of approaches: (1) a whole‐brain voxel‐wise approach, (2) an region‐of‐interest approach in the VS using frequentist and Bayesian statistics and (3) a small volume voxel‐wise approach across the complete striatum. The results converged in revealing no significant relationships between monthly smoking, ETS exposure and reward‐related brain activation across the brain or in the (ventral) striatum specifically. However, Bayesian statistics showed only anecdotal evidence for the null hypothesis in the VS, providing limited insight into the (non‐)existence of the hypothesized relationship. Based on these results, we speculate that blunted VS reward‐related activity might only occur after relatively high levels of exposure or might be associated with more long term effects of smoking. Future studies would benefit from even larger sample sizes to reliably distinguish between the null and alternative models, as well as more objective measures of (environmental) smoking via using devices such as silicone wristbands.
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Affiliation(s)
- Joyce Dieleman
- Department of Jeugd Trimbos Institute Utrecht Netherlands
- Behavioural Science Institute Radboud University Nijmegen Netherlands
| | | | - Marloes Kleinjan
- Department of Jeugd Trimbos Institute Utrecht Netherlands
- Interdisciplinary Social Sciences Utrecht University Netherlands
| | - Roy Otten
- Behavioural Science Institute Radboud University Nijmegen Netherlands
- Pluryn Research and Development Nijmegen Netherlands
- Arizona State University REACH Institute Tempe Arizona USA
| | - Maartje Luijten
- Behavioural Science Institute Radboud University Nijmegen Netherlands
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16
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Lensen JH, Stoltz SEMJ, Kleinjan M, Speckens AEM, Kraiss JT, Scholte RHJ. Mindfulness-based stress reduction intervention for elementary school teachers: a mixed method study. Trials 2021; 22:826. [PMID: 34802446 PMCID: PMC8607553 DOI: 10.1186/s13063-021-05804-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 11/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the Netherlands, more than half of the teachers working in primary education experience high levels of work stress. Compared to other professions, teachers are more likely to drop out from work and develop mental illnesses. Almost one in five even choose a new profession within 5 years after starting as a teacher. This indicates an urgent need for interventions to reduce stress levels in teachers. However, few evidence-based effective interventions targeting stress and work-related problems in the primary educational system are available. AIM In the current paper, we describe the protocol for a randomized controlled study (RCT) comparing an 8-week mindfulness-based stress reduction (MBSR) intervention with a wait list control condition in primary school teachers. We hypothesize that teachers who participate in the MBSR programme will report less stress (primary outcome) than those in the control group at post-test and at 3-month follow-up. We also expect a decrease in teachers' absenteeism and improvements of mental health, teacher skills, classroom climate quality and the pupil-teacher relationship (secondary outcomes). Finally, we hypothesize that self-compassion, mindfulness skills and emotion regulation skills could mediate effects. METHODS/DESIGN A mixed-method study will be conducted among N=155 Dutch primary school teachers (grade 1 to 6). The quantitative study will be an RCT, in which teachers will be randomly allocated to the MBSR or waiting list control condition. Trial participants will not be made actively aware of their condition. The data analysts will be blinded. Online questionnaires will be sent to teachers before and after the MBSR programme, and at 3-month follow-up. Information about absenteeism will be collected. In the qualitative part of the study, we will interview teachers to examine their perceived effects of MBSR on their teaching skills, the classroom climate quality and the pupil-teacher relationship. DISCUSSION This protocol paper describes a mixed-method study design with an RCT and a qualitative evaluation to evaluate an MBSR programme on perceived stress among primary school teachers. If the MBSR programme proves to be effective, it could be implemented as a programme to reduce stress and improve mental health and teaching outcomes in primary school teachers. TRIAL REGISTRATION Nederland Trial Register NL. Registered on 19 November 2019-retrospectively registered, https://www.trialregister.nl/trial/8171.
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Affiliation(s)
- J H Lensen
- Rotterdamse Vereniging Katholiek Onderwijs, Rotterdam, The Netherlands.
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
| | - S E M J Stoltz
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - M Kleinjan
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
- Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - A E M Speckens
- Faculty of Medical Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J T Kraiss
- Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands
| | - R H J Scholte
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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17
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Scheffers-van Schayck T, Hipple Walters B, Otten R, Kleinjan M. Implementation of a proactive referral tool for child healthcare professionals to encourage and facilitate parental smoking cessation in the Netherlands: a mixed-methods study. BMC Health Serv Res 2021; 21:973. [PMID: 34530809 PMCID: PMC8444610 DOI: 10.1186/s12913-021-06969-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 08/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background Recently, the parent-tailored telephone based smoking cessation counseling program ‘Smoke-free Parents’ was shown to be effective in helping parents to quit smoking. To implement this program in child healthcare settings in the Netherlands, the research team developed a proactive referral tool to refer parents to Smoke-free Parents. The aim of the present implementation study was to explore the facilitators, barriers, and suggestions for improvement in the implementation of this referral tool. Methods Child healthcare professionals (N = 68) were recruited via multiple strategies (e.g., social media, mailings, and word of mouth among healthcare professionals) and invited to complete two online (quantitative and qualitative) questionnaires and to participate in a telephone semi-structured qualitative interview between April 2017 and February 2019. In total, 65 child healthcare professionals were included in the analyses. After inductive coding, thematic analyses were performed on the qualitative data. Descriptive analyses were performed on the quantitative data. Results The data from both questionnaires and the telephone interview revealed that the majority of the child healthcare professionals (92.3 % female; average years of working as a healthcare professional: 23.0) found the Smoke-free Parents referral tool accessible and convenient to use. Yet there were several barriers that limited their use of the tool. The data revealed that one of the main barriers that healthcare professionals experienced was parental resistance to smoking cessation assistance. In addition, healthcare professionals noted that they experienced tension when motivating parents to quit smoking, as they were not the parent’s, but the child’s healthcare provider. Additionally, healthcare professionals reported being concerned about the lack of information about the costs of Smoke-free Parents, which limited professionals referring parents to the service. Conclusions Although healthcare professionals reported rather positive experiences with the Smoke-free Parents referral tool, the use of the tool was limited due to barriers. To increase the impact of the Smoke-free Parents telephone-based smoking cessation counseling program via child healthcare settings, it is important to overcome these barriers. Suggestions for improvement in the implementation of the referral tool in child healthcare settings are discussed.
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Affiliation(s)
- Tessa Scheffers-van Schayck
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 735, 3500 AS, Utrecht, the Netherlands. .,Department of Interdisciplinary Social Science, Utrecht University, P.O. Box 80125, 3584 CS, Utrecht, the Netherlands.
| | - Bethany Hipple Walters
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 735, 3500 AS, Utrecht, the Netherlands.,Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, USA
| | - Roy Otten
- Clinical Developmental Psychology, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands
| | - Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 735, 3500 AS, Utrecht, the Netherlands.,Department of Interdisciplinary Social Science, Utrecht University, P.O. Box 80125, 3584 CS, Utrecht, the Netherlands
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18
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Nuyen J, Bos EH, de Jonge P, van Dorsselaer S, Tuithof M, Kleinjan M, de Graaf R, Ten Have M. Longitudinal bidirectional associations between internalizing mental disorders and cardiometabolic disorders in the general adult population. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1611-1621. [PMID: 33399884 DOI: 10.1007/s00127-020-02007-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE This prospective population-based study investigated whether having any internalizing mental disorder (INT) was associated with the presence and onset of any cardiometabolic disorder (CM) at 3-year follow-up; and vice versa. Furthermore, we examined whether observed associations differed when using longer time intervals of respectively 6 and 9 years. METHODS Data were used from the four waves (baseline and 3-, 6- and 9-year follow-up) of the Netherlands Mental Health Survey and Incidence Study-2, a prospective study of a representative cohort of adults. At each wave, the presence and first onset of INT (i.e. any mood or anxiety disorder) were assessed with the Composite International Diagnostic Interview 3.0; the presence and onset of CM (i.e. hypertension, diabetes, heart disease, and stroke) were based on self-report. Multilevel logistic autoregressive models were controlled for previous-wave INT and CM, respectively, and sociodemographic, clinical, and lifestyle covariates. RESULTS Having any INT predicted both the presence (OR 1.28, p = 0.029) and the onset (OR 1.46, p = 0.003) of any CM at the next wave (3-year intervals). Having any CM was not significantly related to the presence of any INT at 3-year follow-up, while its association with the first onset of any INT reached borderline significance (OR 1.64, p = 0.06), but only when examining 6-year intervals. CONCLUSIONS Our findings indicate that INTs increase the risk of both the presence and the onset of CMs in the short term, while CMs may increase the likelihood of the first onset of INTs in the longer term. Further research is needed to better understand the mechanisms underlying the observed associations.
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Affiliation(s)
- Jasper Nuyen
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands.
| | - Elisabeth H Bos
- Department of Developmental Psychology, Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Peter de Jonge
- Department of Developmental Psychology, Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Saskia van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | - Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | - Marloes Kleinjan
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
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19
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Brandon KO, Vinci C, Kleinjan M, Hernandez LM, Sawyer LE, Sutton SK, Brandon TH. Testing Augmented Reality for Eliciting Cue-Provoked Urges to Smoke: Toward Moving Cue-Exposure Into the Real World. Nicotine Tob Res 2021; 23:861-865. [PMID: 33277653 DOI: 10.1093/ntr/ntaa259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/03/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND Cue exposure for extinguishing conditioned urges to smoking cues has been promising in the laboratory, but difficult to implement in natural environments. The recent availability of augmented reality (AR) via smartphone provides an opportunity to overcome this limitation. Testing the ability of AR to elicit cue-provoked urges to smoke (ie, cue reactivity [CR]) is the first step to systemically testing the efficacy of AR for cue exposure therapy. OBJECTIVES To test CR to smoking-related AR cues compared to neutral AR cues, and compared to in vivo cues. METHODS A 2 × 2 within-subject design comparing cue content (smoking vs. neutral) and presentation modality (AR vs. in vivo) on urge response. Seventeen smokers viewed six smoking-related and six neutral cues via AR smartphone app and also six smoking and six neutral in vivo cues. Participants rated their urge to smoke and reality/co-existence of the cue. RESULTS Average urge to smoke was higher following smoking-related AR images (Median = 7.50) than neutral images (Median = 3.33) (Z = -3.44; p = .001; d = 1.37). Similarly, average urge ratings for in vivo smoking-related cues (Median = 8.12) were higher than for neutral cues (Median = 2.12) (Z = -3.44; p = .001; d = 1.64). Also, greater CR was observed for in vivo cues than for AR cues (Z = -2.67, p = .008; d = .36). AR cues were generally perceived as being realistic and well-integrated. CONCLUSIONS CR was demonstrated with very large effect sizes in response to AR smoking cues, although slightly smaller than with in vivo smoking cues. This satisfies the first criterion for the potential use of AR for exposure therapy. IMPLICATIONS This study introduces AR as a novel modality for presenting smoking-related stimuli to provoke cue reactivity, and ultimately to conduct extinction-based therapy. AR cues presented via a smartphone have the advantage over other modes of cue presentation (pictures, virtual reality, in vivo, etc.) of being easily transportable, affordable, and realistic, and they can be inserted in a smokers' natural environment rather than being limited to laboratory and clinic settings. These AR features may overcome the generalizability barriers of other methods, thus increasing clinical utility for cue exposure therapies.
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Affiliation(s)
- Karen O Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Psychology, University of South Florida, Tampa, FL
| | - Christine Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Oncologic Sciences, University of South Florida, Tampa, FL
| | - Marloes Kleinjan
- Department of Child and Adolescent Health, Trimbos Institute, Utrecht, The Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Laura M Hernandez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Leslie E Sawyer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Psychology, University of South Florida, Tampa, FL
| | - Steven K Sutton
- Department of Psychology, University of South Florida, Tampa, FL.,Department of Oncologic Sciences, University of South Florida, Tampa, FL.,Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.,Department of Psychology, University of South Florida, Tampa, FL.,Department of Oncologic Sciences, University of South Florida, Tampa, FL
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20
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Scheffers-van Schayck T, Wetter DW, Otten R, Engels RCME, Kleinjan M. Program uptake of a parent-tailored telephone smoking cessation counselling: An examination of recruitment approaches. Tob Prev Cessat 2021; 7:30. [PMID: 33907722 PMCID: PMC8066574 DOI: 10.18332/tpc/133019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Recently, a Dutch proactive parent-tailored telephone smoking cessation counselling program, Smoke-free Parents (SFP), was demonstrated to be effective in helping parents to quit smoking. This study aimed to examine the program’s uptake and the costs of two recruitment approaches (i.e. healthcare vs mass media) for SFP. In addition, parent’s barriers to participating in SFP and the characteristics of participating parents were assessed. METHODS As part of an effectiveness-implementation hybrid trial, 402 smoking parents were recruited via healthcare settings and mass media for an informal, proactive, and free phone call with a smoking cessation counsellor about SFP (the Netherlands, September 2016 – September 2018). Parents were asked whether they wanted to participate in SFP. If parents refused, reasons for decline and additional information (e.g. educational level) were collected. RESULTS Results revealed that 26.4% of the recruited parents participated in SFP. Although the program uptake of parents recruited via mass media was slightly, but not significantly, higher than via healthcare (27.3% vs 26.8%, p=0.92), the healthcare approach resulted in lower costs per participant (€99.62 vs €205.72). Smoking cessation counsellors were unable to reach almost one-third (32.7%) of the parents after they had agreed to be called about SFP. CONCLUSIONS The present study showed that more than a quarter of all recruited parents participated in SFP and that the mass media approach and healthcare approach can be used to recruit parents for SFP. To increase the number of parents participating in SFP, it is important to overcome the identified barriers that prevent parents from participating.
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Affiliation(s)
- Tessa Scheffers-van Schayck
- Epidemiology and Research Support, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, the Netherlands
| | - David W Wetter
- Center for Health Outcomes and Population Equity, Huntsman Cancer Institute, the University of Utah, Salt Lake City, United States
| | - Roy Otten
- Research and Development, Pluryn, Nijmegen, the Netherlands.,Department of Psychology, ASU REACH Institute, Arizona State University, Tempe, United States.,Developmental Psychopathology, Radboud University, Nijmegen, the Netherlands
| | | | - Marloes Kleinjan
- Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, the Netherlands.,Youth, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
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21
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Ten Have M, Tuithof M, van Dorsselaer S, Kleinjan M, Penninx BWJH, Batelaan NM, de Graaf R. Duration of anxiety disorder and its associated risk indicators: Results of a longitudinal study of the general population. Depress Anxiety 2021; 38:328-336. [PMID: 33107675 DOI: 10.1002/da.23103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/10/2020] [Accepted: 09/30/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Data on episode duration of anxiety disorders are required for informing patients and for disease management, but such data from population studies are lacking. METHODS Three-year longitudinal data were used from the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among the general adult population (N = 6646). Respondents with a new (first or recurrent) anxiety disorder were selected (n = 158). DSM-IV diagnoses were assessed with the Composite International Diagnostic Interview; the Life Chart Interview assessed episode duration and recovery rates. RESULTS Among those with anxiety disorder, median episode duration was 7.5 months and mean duration was 15.2 months. 38.8% had not recovered at 12 months and 30.1% not at 36 months. Longer duration was associated with older age, not having a paid job, higher neuroticism, more physical disorders, and worse physical functioning. CONCLUSIONS Also, in the general population, anxiety disorder has a rather chronic course. After 12 months the cumulative recovery rate flattened. To prevent and manage chronicity, timely treatment, and chronic disease management are required. The risk indicators found may help to identify individuals with an anxiety disorder at risk for chronicity.
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Affiliation(s)
- Margreet Ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marlous Tuithof
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marloes Kleinjan
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands.,Department of Interdisciplinary Social Sciences, Youth Studies, Utrecht University, Utrecht, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
| | - Neeltje M Batelaan
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
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22
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Boormans AJMG, Dieleman J, Kleinjan M, Otten R, Luijten M. Environmental Tobacco Smoke Exposure and Brain Functioning Associated with Smoking Cue-Reactivity and Inhibitory Control in Nonsmoking Adolescents. Eur Addict Res 2021; 27:341-350. [PMID: 33567443 PMCID: PMC8491477 DOI: 10.1159/000512891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/03/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Despite its well-established negative effects, environmental tobacco smoke (ETS) exposure remains highly prevalent worldwide. ETS exposure is associated with a wide range of physical and mental health-related problems among youth, including an increased likelihood to develop nicotine dependence. Up till now, neurocognitive effects of ETS exposure are largely unknown, while such effects could explain the role of ETS exposure in the development of nicotine dependence. Therefore, this preregistered study investigated the role of current ETS exposure in brain functioning associated with smoking cue-reactivity and inhibitory control. METHOD Concurrent with functional magnetic resonance imaging, nonsmoking adolescents aged 14-18 years (N = 51) performed a smoking cue-reactivity task, assessing brain functioning to smoking cues, and a Go/NoGo task measuring inhibitory control. ETS exposure was measured using a self-report questionnaire and biochemically verified. RESULTS No significant associations were observed between current ETS exposure and brain functioning associated with smoking cue-reactivity and inhibitory control. CONCLUSION These findings suggest that low-to-moderate levels of current ETS exposure are not associated with increased salience of smoking cues or deficits in inhibitory control in nonsmoking adolescents. Longitudinal research is needed to further clarify the exact effect of lifetime ETS exposure on brain functioning, as well as research focusing on the effects of higher levels of ETS exposure.
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Affiliation(s)
| | - Joyce Dieleman
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands,Department of Child and Adolescent Mental Health, Trimbos Institute, Utrecht, The Netherlands
| | - Marloes Kleinjan
- Department of Child and Adolescent Mental Health, Trimbos Institute, Utrecht, The Netherlands,Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Roy Otten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands,*Maartje Luijten, Behavioural Science Institute, Radboud University, PO Box 9104, Montessorilaan 3, NL–6500 HE Nijmegen (The Netherlands),
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23
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Scheffers-van Schayck T, Mujcic A, Otten R, Engels R, Kleinjan M. The Effectiveness of Smoking Cessation Interventions Tailored to Smoking Parents of Children Aged 0–18 Years: A Meta-Analysis. Eur Addict Res 2021; 27:278-293. [PMID: 33311028 PMCID: PMC8315688 DOI: 10.1159/000511145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/03/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A meta-analysis was conducted to examine the effectiveness of smoking cessation interventions tailored to parents of children aged 0-18 years. METHODS A systematic search was carried out in PsycInfo, Embase, and PubMed in March 2020. A manual search of the reference lists of the included studies and systematic reviews related to the topic was also performed. Two authors independently screened the studies based on the following inclusion criteria: (1) effect studies with control groups that examine smoking cessation interventions tailored to parents of children (0-18 years), and (2) full-text original articles written in English and published between January 1990 and February 2020. In total, 18 studies were included in the analyses. The TiDieR checklist and the Cochrane Risk of Bias Tool 2.0 were used to extract data and to assess the risk of bias. Consensus among authors was reached at each stage. RESULTS Random-effects meta-analyses were performed. With a total number of 8,560 parents, the pooled relative risk was 1.62 (95% CI 1.38-1.90; p < 0.00001), showing a modest effect of the interventions on smoking cessation. Overall, 13.1% of the parents in the intervention conditions reported abstinence versus 8.4% of the parents in the control conditions. DISCUSSION/CONCLUSION Smoking cessation interventions tailored to parents are modestly effective. To increase the effectiveness and the impact of these interventions in terms of controlling tobacco use and public health, it is crucial for further research to explore how these interventions can be improved.
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Affiliation(s)
- Tessa Scheffers-van Schayck
- Epidemiology and Research Support, Trimbos Institute − Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands,*Tessa Scheffers-van Schayck, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Epidemiology and Research Support, Da Costakade 45, NL–3521 VS Utrecht (The Netherlands),
| | - Ajla Mujcic
- Drugs Monitoring and Policy, Trimbos Institute − Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands,Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Roy Otten
- Research and Development, Pluryn, Nijmegen, The Netherlands,Department of Psychology, ASU REACH Institute, Arizona State University, Tempe, Arizona, USA,Developmental Psychopathology, Radboud University, Nijmegen, The Netherlands
| | - Rutger Engels
- Executive Board, Erasmus University, Rotterdam, The Netherlands
| | - Marloes Kleinjan
- Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands,Youth, Trimbos Institute − Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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24
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van Benthem P, Spijkerman R, Blanken P, Kleinjan M, Vermeiren RRJM, Hendriks VM. [The therapeutic alliance as predictor in the treatment of young people]. Tijdschr Psychiatr 2021; 63:535-542. [PMID: 34523705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The quality of the therapeutic alliance is an important factor in the treatment of both adult and adolescent patients in psychiatry. Little is known about the importance of the therapeutic alliance among youths who seek help for their substance abuse problems in addiction treatment. AIM We investigated the importance of first treatment session therapeutic alliance for outcome in youth mental health and addiction treatment, considering both the youths' and therapists' perspective. METHOD 127 adolescents participated in a prospective clinical cohort study, with favorable or unfavorable treatment outcome after 4 months as primary outcome measure. At the end of the first treatment session, youths and their therapists were asked to rate the therapeutic alliance. RESULTS Youths' and therapists' perceptions about the therapeutic alliance at the start of treatment were predictive of treatment outcome at four months follow-up. In particular, the combined perspective on first-session alliance by both youths and therapists appeared a strong predictor for treatment outcome. If both youths and therapists rated the therapeutic alliance as weak, the percentage of youths showing a favorable treatment outcome was much lower (23%), than if youths and therapists rated the alliance as strong (70%). CONCLUSION The present study confirms the importance of a combined perspective on the therapeutic alliance for predicting treatment outcome among patients in youth mental health and addiction treatment.
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25
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Vinci C, Brandon KO, Kleinjan M, Hernandez LM, Sawyer LE, Haneke J, Sutton SK, Brandon TH. Augmented Reality for Smoking Cessation: Development and Usability Study. JMIR Mhealth Uhealth 2020; 8:e21643. [PMID: 33382377 PMCID: PMC7808889 DOI: 10.2196/21643] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/16/2020] [Accepted: 11/20/2020] [Indexed: 12/04/2022] Open
Abstract
Background The recent widespread availability of augmented reality via smartphone offers an opportunity to translate cue exposure therapy for smoking cessation from the laboratory to the real world. Despite significant reductions in the smoking rates in the last decade, approximately 13.7% of the adults in the United States continue to smoke. Smoking-related cue exposure has demonstrated promise as an adjuvant therapy in the laboratory, but practical limitations have prevented its success in the real world. Augmented reality technology presents an innovative approach to overcome these limitations. Objective The aim of this study was to develop a smartphone app that presents smoking-related augmented reality images for cue exposure. Smokers provided feedback on the images and reported on the perceived urge to smoke, qualities of reality/coexistence, and general feedback about quality and functioning. The feedback was used to refine the augmented reality images within the app. Methods In collaboration with an augmented reality design company, we developed 6 smoking-related images (cigarette, lighter, ashtray, lit cigarette in ashtray, etc) and 6 neutral images similar in size or complexity for comparison (pen, eraser, notebook, soda bottle with droplets, etc). Ten smokers completed a survey of demographic characteristics, smoking history and behavior, dependence on nicotine, motivation to quit smoking, and familiarity with augmented reality technology. Then, participants viewed each augmented reality image and provided ratings on 10-point Likert scales for urge to smoke and reality/coexistence of the image into the scene. Participants were also queried with open-ended questions regarding the features of the images. Results Of the 10 participants, 5 (50%) had experienced augmented reality prior to the laboratory visit, but only 4 of those 5 participants used augmented reality at least weekly. Although the sample was small (N=10), smokers reported significantly higher urge to smoke after viewing the smoking-related augmented reality images (median 4.58, SD 3.49) versus the neutral images (median 1.42, SD 3.01) (Z=–2.14, P=.03; d=0.70). The average reality and coexistence ratings of the images did not differ between smoking-related and neutral images (all P>.29). Augmented reality images were found on average to be realistic (mean [SD] score 6.49 [3.11]) and have good environmental coexistence (mean [SD] score 6.93 [3.04]) and user coexistence (mean [SD] score 6.38 [3.27]) on the 10-point scale. Participant interviews revealed some areas of excellence (eg, details of the lit cigarette) and areas for improvement (eg, stability of images, lighting). Conclusions All images were generally perceived as being realistic and well-integrated into the environment. However, the smoking augmented reality images produced higher urge to smoke than the neutral augmented reality images. In total, our findings support the potential utility of augmented reality for cue exposure therapy. Future directions and next steps are discussed.
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Affiliation(s)
- Christine Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, United States
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Marloes Kleinjan
- Trimbos Institute, Utrecht, Netherlands.,Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | - Laura M Hernandez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Leslie E Sawyer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
| | | | - Steven K Sutton
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States.,Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
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26
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Nuyen J, Tuithof M, de Graaf R, van Dorsselaer S, Kleinjan M, Have MT. The bidirectional relationship between loneliness and common mental disorders in adults: findings from a longitudinal population-based cohort study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1297-1310. [PMID: 31538206 DOI: 10.1007/s00127-019-01778-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 09/10/2019] [Indexed: 01/26/2023]
Abstract
PURPOSE Limited longitudinal population-based research exists on the bidirectional association between loneliness and common mental disorders (CMDs). Using 3-year follow-up data, this study examined whether loneliness among adults increases the risk for onset and persistence of mild-moderate or severe CMD; and whether mild-moderate or severe CMD is a risk factor for onset and persistence of loneliness. METHODS Data were used from the second ('baseline') and third (3-year follow-up) waves of the Netherlands Mental Health Survey and Incidence Study-2, a prospective study of a representative cohort of adults aged 18-64 years. Twelve-month CMDs and their severity were assessed with the Composite International Diagnostic Interview 3.0, and current loneliness using the De Jong Gierveld Loneliness Scale. Multivariate analyses were controlled for several potential confounders. RESULTS Loneliness predicted onset of severe CMD at follow-up in adults without CMDs at baseline, and increased risk for persistent severe CMD at follow-up in those with CMD at baseline. Conversely, severe CMD predicted onset of loneliness at follow-up in non-lonely adults at baseline, but was not associated with persistent loneliness at follow-up in lonely adults at baseline. Observed associations remained significant after controlling for perceived social support at baseline, except for the relationship between loneliness and persistent severe CMD. No longitudinal relationships were observed between loneliness and mild-moderate CMD. CONCLUSIONS Attention should be paid to loneliness, both in adults with and without CMD. Further research is needed to better understand the mechanisms underlying the observed associations between loneliness and CMDs to develop successful interventions.
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Affiliation(s)
- Jasper Nuyen
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands.
| | - Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | - Saskia van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
| | - Marloes Kleinjan
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, The Netherlands
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27
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Dieleman J, Kleinjan M, Otten R, van Schie HT, Heuvelmans V, Luijten M. Effects of environmental tobacco smoke exposure on brain functioning in never-smoking adolescents. Brain Behav 2020; 10:e01619. [PMID: 32608084 PMCID: PMC7428475 DOI: 10.1002/brb3.1619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Brain functioning, as indexed by event-related potentials (ERPs) representing smoking cue reactivity, inhibitory control, and reward processing, has been found to be compromised in smokers. However, whether environmental tobacco smoke (ETS) exposure in never smokers results in similar brain changes is unknown. This question is particularly relevant during adolescence, given ongoing brain maturation and a high risk of smoking initiation. The present study tested the associations between ETS exposure and ERPs reflecting cue reactivity (P3, LPP), inhibitory control (N2, P3), and reward processing (anticipation P3 (P3), feedback-related negativity (FRN)) among never-smoking adolescents. METHODS Eighty-four never-smoking adolescents (nonexposed = 32, exposed = 52) performed a smoking cue reactivity, a Go/NoGo, and a monetary incentive delay (MID) task while ERPs were measured. RESULTS Exposed and nonexposed groups did not differ in ERPs reflecting smoking cue reactivity, inhibitory control, and reward processing. A negative correlation between ETS exposure and the anticipatory P3 suggests reduced anticipatory reward sensitivity for nondrug rewards with increased levels of ETS exposure. However, since this effect was not consistent across analyses, no strong conclusions can be formulated. In the current study, few participants reported high levels of ETS exposure; therefore, further study is necessary. CONCLUSIONS Nevertheless, from this study, it can be concluded that low-to-moderate exposure to ETS during adolescence does not result in functional brain changes related to smoking cue reactivity, inhibitory control, and reward processing.
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Affiliation(s)
- Joyce Dieleman
- Department of Epidemiology and Research Support, Trimbos Institute, Utrecht, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Marloes Kleinjan
- Department of Epidemiology and Research Support, Trimbos Institute, Utrecht, The Netherlands.,Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Roy Otten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Pluryn, Nijmegen, the Netherlands.,Arizona State University, Tempe, AZ, USA
| | - Hein T van Schie
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Vivian Heuvelmans
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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Abstract
Augmented reality (AR) is a rapidly emerging technology that superimposes digital objects onto real-world scenes as viewed in real time through a smartphone, tablet, or headset. Whereas AR has been adopted for retail, entertainment, and professional training, it also has potential as a novel, mobile, and efficacious treatment modality for psychological disorders. In particular, extinction-based therapies (e.g., anxiety, substance use disorders) could utilize AR to present stimuli in natural environments, enhancing generalizability beyond the clinic. The limited psychological literature on AR has focused on the treatment of simple phobias. Here, with the goal of bringing this technology to the attention of clinicians and researchers, we describe AR, contrast it with virtual reality, review the theoretical foundation for extinction-based therapies, provide examples for the treatment of substance use disorders, and identify theoretical, practical, and implementation-based research questions.
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Affiliation(s)
- Christine Vinci
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Departments of Interdisciplinary Oncology and Psychology, University of South Florida, Tampa, FL, USA
| | - Karen O Brandon
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Marloes Kleinjan
- Trimbos Institute, Utrecht, Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, Netherlands
| | - Thomas H Brandon
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Departments of Interdisciplinary Oncology and Psychology, University of South Florida, Tampa, FL, USA
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29
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Smit K, Voogt C, Otten R, Kleinjan M, Kuntsche E. Alcohol expectancies change in early to middle adolescence as a function of the exposure to parental alcohol use. Drug Alcohol Depend 2020; 211:107938. [PMID: 32222262 DOI: 10.1016/j.drugalcdep.2020.107938] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/16/2020] [Accepted: 02/19/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The subjective effects of alcohol, i.e., alcohol expectancies (AE), are important predictors of alcohol use. This three-year longitudinal study examined: 1) the development of enhancement, social, coping, and conformity AE from age 10-16; 2) the association between parental alcohol use exposure and positive AE among adolescents and between exposure and changes in AE over the six month period and 3) the moderating effect of gender on the association between exposure and change in AE. METHODS A longitudinal study followed adolescents between 10-13-years old at baseline (N = 755; 45.6 % boys) in six months intervals for three years, resulting in seven measurements. RESULTS Adolescents most strongly endorsed enhancement AE. Social and coping AE dimensions positively increased over time. The estimated Multilevel Model of Change revealed that exposure to either fathers 'or mothers' alcohol use predicted an increase in social AE six months later (B = .129, SE = .032). Exposure to fathers' drinking predicted an increase in enhancement AE for boys (B = .075, SE = .031) but not for girls (B=-0.045, SE = .030). No associations between parental exposure and other AE dimensions were found. CONCLUSION The results add to previous studies in showing that the association between parental drinking behavior and offspring AE develops within short periods. Prevention should, therefore, include explicit guidelines for parents with respect to how their drinking behavior affect their offspring.
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Affiliation(s)
- Koen Smit
- Centre for Alcohol Policy Research, La Trobe University, NR1 building, Melbourne, VIC 3086, Australia; Behavioural Science Institute, Radboud University, Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands; Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, the Netherlands.
| | - Carmen Voogt
- Behavioural Science Institute, Radboud University, Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands; Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, the Netherlands
| | - Roy Otten
- Behavioural Science Institute, Radboud University, Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands; Pluryn, Research & Development, P.O. Box 53, 6500 AB Nijmegen, the Netherlands; REACH Institute, Arizona State University, Phoenix, USA
| | - Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, the Netherlands; Utrecht University, Interdisciplinary Social Sciences, Youth Studies, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, NR1 building, Melbourne, VIC 3086, Australia; Behavioural Science Institute, Radboud University, Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands
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30
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Voogt C, Smit K, Kleinjan M, Otten R, Scheffers T, Kuntsche E. From Age 4 to 8, Children Become Increasingly Aware About Normative Situations for Adults to Consume Alcohol. Alcohol Alcohol 2020; 55:104-111. [PMID: 31825514 DOI: 10.1093/alcalc/agz093] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 01/19/2023] Open
Abstract
AIMS Limited cross-sectional studies have indicated that young children have some knowledge of the type of situations in which adults usually consume alcohol. However, it is unclear when and how this knowledge develops over time. This study tests the hypothesis that between the ages of 4 and 8, children become more knowledgeable about common drinking situations (e.g. 'partying') and uncommon situations (e.g. 'driving'). METHODS Data of two independent samples were used: a cross-sectional study (parents) and a three-wave longitudinal study (children). Parents and children were recruited via a convenience and random sampling strategy, respectively. To identify common, ambivalent, and uncommon drinking situations, parents (N = 158; 47% men) completed an online survey in which they indicated how common it is that any adult would drink alcohol in the 18 situations of the Dutch electronic appropriate beverage (eABT). Children (N = 329; 48.9% boys) completed the Dutch eABT to assess their knowledge of situations in which adults usually consume alcohol. RESULTS General linear model repeated measures with post-hoc pairwise comparisons showed that parents' perceptions of common, ambivalent, and uncommon situations in which adults consume alcohol predicted the initial level and the change over time in children's knowledge of adults' alcohol use in these situations. CONCLUSIONS Children aged 4-8 become increasingly knowledgeable about drinking norms in specific situations which implies that they know in what kind of situation alcohol consumption is a common human behavior. This knowledge may put them at risk for early alcohol initiation and frequent drinking later in life.
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Affiliation(s)
- Carmen Voogt
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Department Youth and Risky Behaviour, room 0.18, Da Costakade 45, 3521 VS Utrecht, The Netherlands, P.O. Box 725, 3500 AS Utrecht, The Netherlands.,Behavioural Science Institute, Department Developmental Psychopathology, Radboud University, Montessorilaan 3 6525 HR Nijmegen, The Netherlands, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands
| | - Koen Smit
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Department Youth and Risky Behaviour, room 0.18, Da Costakade 45, 3521 VS Utrecht, The Netherlands, P.O. Box 725, 3500 AS Utrecht, The Netherlands.,Behavioural Science Institute, Department Developmental Psychopathology, Radboud University, Montessorilaan 3 6525 HR Nijmegen, The Netherlands, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands.,Centre for Alcohol Policy Research, Building HS2, Level 5, La Trobe University, Bundoora Victoria 3086, Australia
| | - Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Department Youth and Risky Behaviour, room 0.18, Da Costakade 45, 3521 VS Utrecht, The Netherlands, P.O. Box 725, 3500 AS Utrecht, The Netherlands.,Department of General Social Sciences, Utrecht University, Heidelberglaan 1 3584 CS Utrecht, The Netherlands, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
| | - Roy Otten
- Behavioural Science Institute, Department Developmental Psychopathology, Radboud University, Montessorilaan 3 6525 HR Nijmegen, The Netherlands, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands.,Pluryn, Department Research Development, Industrieweg 50, 6541 TW Nijmegen, The Netherlands, P.O. Box 53 6500 AB Nijmegen, The Netherlands.,Psychology Department, The REACH Institute, Arizona State University, North Building 900 S. McAllister Ave., Room 205, P.O. Box 876005, Tempe, AZ 85287-6005, USA
| | - Tessa Scheffers
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Department Youth and Risky Behaviour, room 0.18, Da Costakade 45, 3521 VS Utrecht, The Netherlands, P.O. Box 725, 3500 AS Utrecht, The Netherlands
| | - Emmanuel Kuntsche
- Behavioural Science Institute, Department Developmental Psychopathology, Radboud University, Montessorilaan 3 6525 HR Nijmegen, The Netherlands, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands.,Centre for Alcohol Policy Research, Building HS2, Level 5, La Trobe University, Bundoora Victoria 3086, Australia
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van Benthem P, Spijkerman R, Blanken P, Kleinjan M, Vermeiren RRJM, Hendriks VM. A dual perspective on first-session therapeutic alliance: strong predictor of youth mental health and addiction treatment outcome. Eur Child Adolesc Psychiatry 2020; 29:1593-1601. [PMID: 32157389 PMCID: PMC7595997 DOI: 10.1007/s00787-020-01503-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 02/25/2020] [Indexed: 11/25/2022]
Abstract
We investigated the potential role of first-session therapeutic alliance ratings to serve as an early marker of treatment outcome in youth mental health and addiction treatment. The present study is among the first to incorporate both a youths' and a therapists' perspective of the therapeutic alliance in order to maximize predictive value of the alliance for treatment outcome. One hundred and twenty-seven adolescents participated in a multi-site prospective naturalistic clinical cohort study, with assessments at baseline and at 4 months post-baseline. Main outcome measure was favorable or unfavorable treatment outcome status at 4-month follow-up. Early therapeutic alliance had a medium and robust association with treatment outcome for youth' (b = 1.29) and therapist' (b = 1.12) perspectives and treatment setting. Based on the two alliance perspectives four subgroups were distinguished. Incorporating the alliance-ratings from both perspectives provided a stronger predictor of treatment outcome than using one perspective. Youth with a strong alliance according to both perspectives had an eightfold odds of favorable treatment outcome compared with youth with a weak alliance according to both perspectives. The association between therapeutic alliance and treatment outcome in youth mental health and addiction treatment may be substantially stronger than earlier assumed when both a youths' and therapists' perspective on alliance is considered.
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Affiliation(s)
- Patty van Benthem
- Parnassia Addiction Research Center (PARC), Brijder Addiction Care, Zoutkeetsingel 40, 2512 HN The Hague, The Netherlands
- Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Leiden, The Netherlands
| | - Renske Spijkerman
- Parnassia Addiction Research Center (PARC), Brijder Addiction Care, Zoutkeetsingel 40, 2512 HN The Hague, The Netherlands
| | - Peter Blanken
- Parnassia Addiction Research Center (PARC), Brijder Addiction Care, Zoutkeetsingel 40, 2512 HN The Hague, The Netherlands
| | - Marloes Kleinjan
- Epidemiology and Research Support, Trimbos Institute: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
- Department of Interdisciplinary Social Science, Youth Studies, Utrecht University, Utrecht, The Netherlands
| | - Robert R. J. M. Vermeiren
- Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Leiden, The Netherlands
- Youz, Parnassia Group, The Hague, The Netherlands
| | - Vincent M. Hendriks
- Parnassia Addiction Research Center (PARC), Brijder Addiction Care, Zoutkeetsingel 40, 2512 HN The Hague, The Netherlands
- Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Leiden, The Netherlands
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32
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Ruiter ELM, Fransen GAJ, Kleinjan M, Molleman GRM, van der Velden K, Engels RCME. Degree of consistency of parental dietary and sedentary behavior rules as indicators for overweight. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.276] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
To increase our understanding of the effect of parenting on the child’s likelihood of becoming overweight, we attempted to identify typologies based on how consistently parents apply dietary and sedentary behavior rules, and we examined whether these typologies are associated with energy balance-related behaviors in children and/or with the prevalence of overweight children.
Methods
Data were obtained from a cross-sectional survey of the Community Health Service in Nijmegen, the Netherlands in which a total of 4,865 parents of children aged 4-12 years participated. Data were collected using validated self-report questionnaires. To identify typologies based on how consistently parents apply dietary and sedentary behavior rules, we performed latent class analyses. We then performed regression analyses to examine the correlation between these typologies and socio-demographic characteristics, dietary and sedentary behaviors, and overweight.
Results
Latent class analyses revealed the existence of the following four distinct, stable classes/typologies; parents who have: (1) no dietary behavior rules, plus indulgent sedentary behavior rules; (2) indulgent dietary behavior rules, plus no sedentary behavior rules; (3) overall indulgent rules; (4) overall strict rules. Children of parents with overall strict rules (class 4) had significantly healthier dietary and sedentary behaviors compared to the children of parents in the other three classes. Children 8-12 years of age with parents in class 2 were the most likely to be overweight; compared to the children of parents in classes 1, 3, and 4, the parents in class 2 had the lowest level of education and the higher number of Turkish and Moroccan immigrants.
Conclusions
These results underscore the need for parents to establish strict rules for their children, particularly regarding sedentary behaviour in order to minimize the child’s likelihood of becoming overweight.
Key messages
The results underscore the need for parents to establish strict rules for their children, particularly regarding sedentary behaviour in order to minimize the child’s likelihood of becoming overweight. These results may contribute to making healthcare professionals aware that children of parents who do not apply sedentary behavior rules are more likely to become overweight.
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Affiliation(s)
- E L M Ruiter
- Academic Collaborative Center AMPHI, Radboudumc, Nijmegen, Netherlands
| | - G A J Fransen
- Academic Collaborative Center AMPHI, Radboudumc, Nijmegen, Netherlands
| | | | - G R M Molleman
- Academic Collaborative Center AMPHI, Radboudumc, Nijmegen, Netherlands
| | - K van der Velden
- Academic Collaborative Center AMPHI, Radboudumc, Nijmegen, Netherlands
| | - R C M E Engels
- Executive board, Erasmus University, Rotterdam, Netherlands
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Smit K, Voogt C, Otten R, Kleinjan M, Kuntsche E. Exposure to Parental Alcohol Use Rather Than Parental Drinking Shapes Offspring's Alcohol Expectancies. Alcohol Clin Exp Res 2019; 43:1967-1977. [DOI: 10.1111/acer.14139] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/18/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Koen Smit
- Behavioural Science Institute Radboud University, Nijmegen Nijmegen The Netherlands
- Trimbos Institute Netherlands Institute of Mental Health and Addiction Utrecht The Netherlands
| | - Carmen Voogt
- Behavioural Science Institute Radboud University, Nijmegen Nijmegen The Netherlands
- Trimbos Institute Netherlands Institute of Mental Health and Addiction Utrecht The Netherlands
| | - Roy Otten
- Behavioural Science Institute Radboud University, Nijmegen Nijmegen The Netherlands
- Research & Development Pluryn Nijmegen The Netherlands
- REACH Institute Arizona State University Phoenix Arizona
| | - Marloes Kleinjan
- Trimbos Institute Netherlands Institute of Mental Health and Addiction Utrecht The Netherlands
- Department of General Social Sciences Utrecht University Utrecht The Netherlands
| | - Emmanuel Kuntsche
- Behavioural Science Institute Radboud University, Nijmegen Nijmegen The Netherlands
- Centre for Alcohol Policy Research La Trobe University Melbourne VIC Australia
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34
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Ten Have M, de Graaf R, van Dorsselaer S, Tuithof M, Kleinjan M, Penninx BWJH. Childhood maltreatment, vulnerability characteristics and adult incident common mental disorders: 3-year longitudinal data among >10,000 adults in the general population. J Psychiatr Res 2019; 113:199-207. [PMID: 30986694 DOI: 10.1016/j.jpsychires.2019.03.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/28/2019] [Accepted: 03/29/2019] [Indexed: 01/07/2023]
Abstract
Childhood maltreatment (CM) is a strong predictor of incident (first-onset and recurrent) mental disorders in adulthood. However, less is known about underlying mechanisms and moderators of these associations. This study examines to what extent vulnerability characteristics (low social support, negative life events, parental psychopathology, neuroticism, history and comorbidity of mental and physical health) contribute to the impact of CM on adult psychopathology. Data from two general population cohorts - the first and second Netherlands Mental Health Survey and Incidence Studies - were combined into one dataset (N = 10,065). CM (emotional, psychological, physical or sexual abuse before the age of 16) and vulnerability characteristics were assessed with a structured face-to-face interview. First-onset and recurrent mental (mood, anxiety, substance use) disorders were assessed using the Composite International Diagnostic Interview. CM doubled the risk of developing a first-onset or recurrent mental disorder at three-year follow-up (OR = 2.08). CM was not only directly connected to incident mental disorders, but also indirectly through vulnerability characteristics. Several vulnerabilities, in particular low social support, parental psychopathology, prior mental disorders and neuroticism, moderated the relationship between CM and adult mental disorders, indicating that these vulnerability factors had a greater effect on incident mental disorders among people with childhood abuse. As not all adults with a history of CM develop mental disorders, these mediating and moderating risk factors might help identify adults with a history of maltreatment who could benefit from preventive interventions.
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Affiliation(s)
- Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands.
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | | | - Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marloes Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands; Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
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van Leeuwen L, Onrust S, van den Putte B, Kleinjan M, Lemmers L, Engels RCME, Hermans RCJ. Cue-Reminders to Prevent Health-Risk Behaviors: A Systematic Review. Front Public Health 2019; 7:97. [PMID: 31134173 PMCID: PMC6524686 DOI: 10.3389/fpubh.2019.00097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/05/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction: It has been proposed that the use of cue-reminders may increase the effectiveness of interventions that aim to prevent health-risk behaviors (i.e., having unsafe sex, unhealthy dietary intake, lack of physical activity, and substance use). The aim of this systematic review was to explore whether there is evidence supporting this proposition, and to explore how cue-reminders are applied in health-risk behavior interventions to date. Method: We systemically reviewed (non-) randomized trials that examine differences in health-risk behaviors between an experimental group receiving an intervention with exposure to a cue-reminder and a control group receiving the intervention without such cue. Results: Six studies were eligible for inclusion. The studies differed in sample and research design, and how the cue-reminder was applied. One study demonstrated a positive and small effect, and one study found a negative medium effect of the cue-reminder. In the remaining studies, the effect sizes were positive but non-significant. Discussion: It is unclear whether complementing health-risk behavior interventions with cue-reminders increases the effectiveness of these interventions. Further investigation and experimentation into the efficiency and effectiveness of cue-reminders is needed before health-risk behavior interventions are complemented with cue-reminders.
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Affiliation(s)
- Lonneke van Leeuwen
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Simone Onrust
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Bas van den Putte
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.,Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | - Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, Netherlands
| | - Lex Lemmers
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
| | - Rutger C M E Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University, Rotterdam, Netherlands
| | - Roel C J Hermans
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
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Tuijnman A, Kleinjan M, Hoogendoorn E, Granic I, Engels RC. A Game-Based School Program for Mental Health Literacy and Stigma Regarding Depression (Moving Stories): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e11255. [PMID: 30869652 PMCID: PMC6437615 DOI: 10.2196/11255] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/31/2018] [Accepted: 11/10/2018] [Indexed: 12/19/2022] Open
Abstract
Background The prevalence of elevated depressive symptoms among youth in most western societies is high. Yet, most adolescents who are experiencing depressive symptoms do not seek help. Low mental health literacy, high stigma, and low social support have been shown to hinder help-seeking. A small number of interventions has been developed to target mental health literacy and stigma, but few focus on actual help-seeking and first aid behavior. We have developed a game-based school program called Moving Stories that targets mental health literacy, including knowledge and behavior, and stigma among adolescents, in regard to depression specifically. Objective Our aim is to describe the protocol for a study that will test the effectiveness of the program Moving Stories in a Dutch adolescent sample. We hypothesize that adolescents who participate in the program Moving Stories will have better mental health literacy and less stigma regarding depression compared to adolescents in the nonintervention control group at posttest and at 3- and 6-months follow-up. We also expect a positive change in actual help-seeking and first aid behavior at 3- and 6-months follow-up. Methods Moving Stories has been developed by a professional game design company in collaboration with researchers and relevant stakeholders. The effectiveness of Moving Stories will be tested through a randomized controlled trial with two conditions: Moving Stories versus control. Participants will fill in questionnaires at pretest, posttest, and 3- and 6-months follow-up. Our power analysis showed a required sample size of 180 adolescents. Results Four high schools have agreed to participate with a total of 10 classes. A total of 185 adolescents filled in the pretest questionnaire. The last of the follow-up data was collected in December 2018. Conclusions If Moving Stories proves to be effective, it could be implemented as a school-based program to target mental health literacy and stigma regarding depression; this could, in turn, improve early help-seeking in adolescents suffering from depression. Trial Registration Nederlands Trial Register NTR7033; https://www.trialregister.nl/trial/6855 International Registered Report Identifier (IRRID) DERR1-10.2196/11255
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Affiliation(s)
- Anouk Tuijnman
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Trimbos Institute, Utrecht, Netherlands
| | - Marloes Kleinjan
- Trimbos Institute, Utrecht, Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, Netherlands
| | | | - Isabela Granic
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Rutger Cme Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University, Rotterdam, Netherlands
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Ten Have M, de Graaf R, van Dorsselaer S, Tuithof M, Kleinjan M, Penninx BWJH. [Recurrence and chronicity of major depressive disorder in the general population: results from the Netherlands Mental Health Survey and Incidence Study-2]. Tijdschr Psychiatr 2019; 61:22-31. [PMID: 30640403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The naturalistic course of major depressive disorder (mdd) and risk indicators for recurrence and chronicity of mdd are best investigated using a psychiatric epidemiological population study without clear selection bias. However, such studies are scarce, thereby limiting clinical decision-making concerning the monitoring and maintenance of treatment.<br/> AIM: To present findings from the Netherlands Mental Health Survey and Incidence Study-2 (nemesis-2) regarding the recurrence and chronicity of mdd and associated risk indicators in the general population.<br/> METHOD: At baseline, two groups were selected to examine the recurrence and chronicity of mdd at follow-up. Diagnoses were assessed with the Composite International Diagnostic Interview (cidi) 3.0.<br/> RESULTS: Among respondents with remitted mdd (n = 746), the cumulative recurrence rate was 4.3% at 5 years, 13.4% at 10 years, and 27.1% at 20 years. Time to recurrence was predicted by vulnerability characteristics (childhood abuse, negative life events, parental psychopathology), physical health, functioning, clinical characteristics of depression (previous episodes, severity, medication use), psychiatric comorbidity and mental health use. Among respondents with current mdd (n = 242), 12% developed a chronic depressive episode over 6 years. The chronic course was predicted by risk indicators similar to those for recurrence, except for vulnerability characteristics and physical health.<br/> CONCLUSION: These risk indicators may help identify depressive patients requiring monitoring and who might benefit from preventive interventions or maintenance treatment.
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Scheffers-van Schayck T, Tuithof M, Otten R, Engels R, Kleinjan M. Smoking Behavior of Women Before, During, and after Pregnancy: Indicators of Smoking, Quitting, and Relapse. Eur Addict Res 2019; 25:132-144. [PMID: 30917383 PMCID: PMC6518863 DOI: 10.1159/000498988] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 02/15/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Smoking cessation during pregnancy and preventing relapse postpartum is a pivotal public health priority. OBJECTIVES This study examined the risk and protective indicators of women who (a) smoke before pregnancy, (b) smoke during the entire pregnancy, (c) successfully quit smoking during pregnancy, and (d) relapse postpartum. METHOD This paper reports secondary analyses of the Dutch population-based Monitor on Substance Use and Pregnancy (2016). A representative sample of mothers of young children (n = 1,858) completed questionnaires at youth health care centers. Bivariate and multivariate logistic regression analyses were conducted. RESULTS Main results showed that women's smoking around pregnancy was strongly associated with the partner's smoking status before pregnancy, partner's change in smoking during pregnancy, and partner's change in smoking postpartum. Women's educational level and cannabis use before pregnancy were also related with women's smoking before and during pregnancy. Women's intensity of alcohol use before pregnancy was ambiguously related with women's smoking before and during pregnancy. CONCLUSIONS One of the key findings of this study suggests that it is essential that partners quit smoking before pregnancy and do not smoke during pregnancy. If partners continue smoking during pregnancy, they should quit smoking postpartum. Health care professionals can play an important role in addressing partners' smoking and giving them evidence-based cessation support before, during, and after pregnancy.
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Affiliation(s)
- Tessa Scheffers-van Schayck
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Epidemiology and Research Support, Utrecht, The Netherlands,Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands,*Tessa Scheffers-van Schayck, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Epidemiology and Research Support, Da Costakade 45, Utrecht, 3521 VS (The Netherlands), E-Mail
| | - Marlous Tuithof
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Epidemiology and Research Support, Utrecht, The Netherlands
| | - Roy Otten
- Research and Development, Pluryn, Nijmegen, The Netherlands,ASU REACH Institute, Department of Psychology, Arizona State University, Tempe, Arizona, USA,Developmental Psychopathology, Radboud University, Nijmegen, The Netherlands
| | - Rutger Engels
- Executive Board, Erasmus University, Rotterdam, The Netherlands
| | - Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Epidemiology and Research Support, Utrecht, The Netherlands,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands
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Smit K, Otten R, Voogt C, Kleinjan M, Engels R, Kuntsche E. Exposure to drinking mediates the association between parental alcohol use and preteen alcohol use. Addict Behav 2018; 87:244-250. [PMID: 30096655 DOI: 10.1016/j.addbeh.2018.07.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/05/2018] [Accepted: 07/31/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the present study was to test the link between exposure to parental alcohol use (i.e., preteens seeing their parents drinking) and preteen's alcohol use. Specifically, this study aimed to (a) replicate the association between parental alcohol use and preteen alcohol use and (b) test whether alcohol use exposure mediated this association. METHOD Families were recruited from five regions in the Netherlands from 104 schools that agreed to participate. Preteens (N = 755, Mage = 11.27, SD = 0.56, 45.8% boys) and their mothers (N = 755) participated in the study. Preteens reported lifetime alcohol use and parental alcohol use exposure. Mothers reported on alcohol use for both parents. Structural Equation Modelling was used to assess direct and mediated paths between parental alcohol use, preteen's exposure to alcohol use and preteen alcohol use in one model. RESULTS Unexpectedly, father's alcohol use was negatively associated (β = -0.121, p = .012) and mother's alcohol use was not associated (β = 0.056, p = .215) with preteen's alcohol use. A positive indirect effect emerged through alcohol use exposure, showing that exposure to father's alcohol use mediated the association between parent's and preteen's alcohol use (β = 0.064, p = .001). This effect was absent for mother's alcohol use (β = 0.026, p = .264). Gender differences were non-significant. CONCLUSIONS Parental alcohol exposure positively mediated the association of parental alcohol use with preteen's alcohol use. These effects were found for both boys and girls and were most robust for father's drinking. The findings might provide clues for preventive action, for example, by emphasizing that exposure should be restricted to prevent preteen's alcohol use.
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Affiliation(s)
- Koen Smit
- Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands.
| | - Roy Otten
- Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Pluryn, Research & Development, P.O. Box 53, 6500 AB Nijmegen, The Netherlands; REACH Institute, Arizona State University, Phoenix, USA.
| | - Carmen Voogt
- Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands.
| | - Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands; Utrecht University, Department of General Social Sciences, P.O. Box 80140, 3508 TC Utrecht, The Netherlands.
| | - Rutger Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
| | - Emmanuel Kuntsche
- Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Centre for Alcohol Policy Research, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000, Australia.
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Tuithof M, Ten Have M, van Dorsselaer S, Kleinjan M, Beekman A, de Graaf R. Course of subthreshold depression into a depressive disorder and its risk factors. J Affect Disord 2018; 241:206-215. [PMID: 30130686 DOI: 10.1016/j.jad.2018.08.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/17/2018] [Accepted: 08/07/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Information on the natural course of subthreshold depression and risk factors for the development of a full-blown depressive disorder in the general population is scarce. This information is crucial to understand the development of depression and to advance indicated depression prevention. METHODS Using longitudinal data from a representative population-based study (the Netherlands Mental Health Survey and Incidence Study-2) we assessed 3-year course of subthreshold depression (depressive symptoms causing clinically significant distress for at least 2 weeks, or for 3 days per month for a year; n = 120), compared to an asymptomatic group (n = 4111) and a depressive disorder group (major depression or dysthymia; n = 294). Next, risk factors for the development of a depressive disorder among adults with subthreshold depression were determined. RESULTS Twelve percent of the subthreshold cases developed a full-blown depressive disorder during 3-year follow-up. Risk factors were lower social support, having recurrent short episodes of depressive symptomatology, remitted and current anxiety disorder, remitted substance use disorder, lifetime suicide thoughts, a chronic physical disorder and diminished mental and physical functioning. LIMITATIONS The number of subjects with subthreshold depression that developed a depressive disorder was small. This limits the possibility to detect significant risk factors. CONCLUSION Only a minority of the subthreshold cases developed a full-blown depressive disorder over three years. This shows that subthreshold depression does not, by itself, carry an a priori risk to warrant focusing indicated prevention. The identified risk factors could help to detect those subthreshold cases in whom depression prevention is economically and practically viable.
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Affiliation(s)
- Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | | | - Marloes Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Utrecht University, Utrecht, The Netherlands
| | | | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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41
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Ten Have M, de Graaf R, van Dorsselaer S, Tuithof M, Kleinjan M, Penninx BWJH. Recurrence and chronicity of major depressive disorder and their risk indicators in a population cohort. Acta Psychiatr Scand 2018; 137:503-515. [PMID: 29577236 DOI: 10.1111/acps.12874] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The naturalistic course of major depressive disorder (MDD) and risk indicators for recurrence and chronicity are best studied using a population sample without clear selection bias. However, such studies are scarce. This limits clinical decision-making concerning monitoring and maintenance treatment. METHOD Data were used from the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among a representative adult population. Two groups at baseline were selected to study recurrence and chronicity of MDD at follow-up. Diagnoses were assessed with the Composite International Diagnostic Interview 3.0. RESULTS Among remitted MDD cases (n = 746), the cumulative recurrence rate was 4.3% at 5 years, 13.4% at 10 years and 27.1% at 20 years. Time to recurrence was predicted by vulnerability characteristics (childhood abuse, negative life events, parental psychopathology), physical health, functioning, clinical characteristics of depression (previous episodes, severity, medication use), psychiatric comorbidity and mental health use. Among current MDD cases (n = 242), 12% developed a chronic depressive episode over 6 years. Chronic course was predicted by similar risk indicators as recurrence, except for vulnerability characteristics and physical health. CONCLUSION These risk indicators may help to identify patients requiring monitoring and who could benefit from preventive interventions or maintenance treatment.
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Affiliation(s)
- M Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - M Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - M Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
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42
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Poppelaars M, Lichtwarck-Aschoff A, Kleinjan M, Granic I. The impact of explicit mental health messages in video games on players’ motivation and affect. Computers in Human Behavior 2018. [DOI: 10.1016/j.chb.2018.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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43
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Smit K, Voogt C, Hiemstra M, Kleinjan M, Otten R, Kuntsche E. Development of alcohol expectancies and early alcohol use in children and adolescents: A systematic review. Clin Psychol Rev 2018; 60:136-146. [DOI: 10.1016/j.cpr.2018.02.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 01/26/2018] [Accepted: 02/02/2018] [Indexed: 01/11/2023]
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44
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Stikkelbroek Y, Bodden DHM, Kleinjan M, Reijnders M, van Baar AL. Correction: Adolescent Depression and Negative Life Events, the Mediating Role of Cognitive Emotion Regulation. PLoS One 2018; 13:e0192300. [PMID: 29381743 PMCID: PMC5790292 DOI: 10.1371/journal.pone.0192300] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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45
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Scheffers-van Schayck T, Otten R, Engels R, Kleinjan M. Evaluation and Implementation of a Proactive Telephone Smoking Cessation Counseling for Parents: A Study Protocol of an Effectiveness Implementation Hybrid Design. Int J Environ Res Public Health 2018; 15:E97. [PMID: 30720774 PMCID: PMC5800196 DOI: 10.3390/ijerph15010097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 12/22/2017] [Accepted: 01/04/2018] [Indexed: 02/01/2023]
Abstract
Detrimental health consequences of smoking for both parents and children stress the importance for parents to quit. A Dutch efficacy trial supported the efficacy of proactive telephone counseling on parents. Still, how this program would function in "real world" conditions and how parents could be optimally reached is unclear. Therefore, this study will use an innovative method to examine the recruitment success of two implementation approaches (i.e., via a healthcare approach and a mass media approach) to test the (cost)effectiveness of the program. A two-arm randomized controlled trial and an implementation study (i.e., process evaluation) are conducted. Parents (N = 158) will be randomly assigned to the intervention (i.e., telephone counseling) or control conditions (i.e., self-help brochure). Primary outcome measure is 7-day point prevalence abstinence at three months post-intervention. Qualitative and quantitative research methods are used for the process evaluation. We expect that parents in the intervention condition have higher cessation rates than parents in the control condition. We also expect that the recruitment of parents via (youth) health care services is a more promising implementation approach compared to mass media. Results will have implications for the effectiveness of a proactive telephone counseling and provide directions for its successful implementation.
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Affiliation(s)
- Tessa Scheffers-van Schayck
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands.
- Department of Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands.
| | - Roy Otten
- Department of Research and Development, Pluryn, P.O. Box 53, 6500 AB Nijmegen, The Netherlands.
- ASU REACH Institute, Department of Psychology, Arizona State University, P.O. Box 876005, Tempe, AZ 85287-6005, USA.
| | - Rutger Engels
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands.
- Department of Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands.
| | - Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands.
- Department of Cultural Diversity & Youth, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands.
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46
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Ten Have M, Penninx BWJH, Tuithof M, van Dorsselaer S, Kleinjan M, Spijker J, de Graaf R. [New numbers on the duration of major and minor depressive episodes in the general population; results from NEMESIS-2]. Tijdschr Psychiatr 2018; 60:364-373. [PMID: 29943793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Relatively little research has been conducted that can reliably be used by psychiatrists, psychologists and general practitioners to estimate the recovery time of their patients suffering from depression. The treatment guideline for depression submits that half of those with mdd will recover within three months.<br /> AIM: To present the findings from nemesis-2 (the Netherlands Mental Health Survey and Incidence Study-2) on both the duration of depressive episodes in the general population and associated risk indicators.<br /> METHOD: The respondents that had developed a depressive episode between the first two follow-up assessments were selected; 286 with a clinical depression according to dsm-iv criteria (mdd) and 107 with a subclinical depression (MinDD). The episode duration was assessed with the Life Chart Interview.<br /> RESULTS: Half of the patients with mdd recovered within 6 months and 12% had not recovered after 3 years. The mean duration for mdd was 10.7 months. Better physical and mental health before depression onset predicted shorter duration. Longer duration was associated with comorbid dysthymia or anxiety disorder. In comparison, the median duration of MinDD was half the length of mdd (3 months), whereas the mean duration (8.7 months), the percentage that had not recovered after 3 years (10%) and risk indicators for episode duration hardly differed.<br /> CONCLUSION: In the guideline for depression it is assumed that half of those with mdd will recover within three months. Our study, however, found the median duration of mdd to be twice as long. Consequently, only a short period without active treatment can be justified. This paper also concludes that MinDD cannot be regarded as a transient, self-limiting mood state.
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47
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van Starrenburg MLA, Kuijpers RCMW, Kleinjan M, Hutschemaekers GJM, Engels RCME. Effectiveness of a Cognitive Behavioral Therapy-Based Indicated Prevention Program for Children with Elevated Anxiety Levels: a Randomized Controlled Trial. Prev Sci 2017; 18:31-39. [PMID: 27822663 PMCID: PMC5236072 DOI: 10.1007/s11121-016-0725-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Childhood anxiety is a problem not only because of its negative consequences on the well-being of children but also because of its adverse effects on society and its role in mental disorders later in life. Adequate prevention might be the key in tackling this problem. The effectiveness of Coping Cat, as an indicated CBT-based prevention program in Dutch primary school children, was assessed by means of a randomized controlled trial. In total, 141 children aged 7–13 with elevated levels of anxiety and their mothers were included and randomly assigned to an intervention group and a waiting list control group. After screening, all participants completed baseline, post-intervention, and 3-month follow-up assessments. The results showed that Coping Cat, as an indicated prevention program, reduces children’s self-reported anxiety symptoms, with Cohen’s effect size d of 0.66 at the 3-month follow-up. A moderating effect was found for baseline anxiety level; specifically, children with high levels of baseline anxiety who received the Coping Cat program had lower anxiety levels at follow-up compared to children with high levels of anxiety in the control condition. No moderating effects of gender or age were found. An unexpected decline in anxiety levels from screening to pre-assessment was found in both groups, and this decline was stronger in the experimental group. These promising results warrant the implementation of Coping Cat as an indicated prevention program.
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Affiliation(s)
- Manon L A van Starrenburg
- Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands. .,Ambulatorium KJJ, Toernooiveld 5, Postbus 6909, 6503 GK, Nijmegen, The Netherlands.
| | - Rowella C M W Kuijpers
- Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands.,Ambulatorium KJJ, Toernooiveld 5, Postbus 6909, 6503 GK, Nijmegen, The Netherlands
| | | | - Giel J M Hutschemaekers
- Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands.,Pro Persona, Tarweweg 2, 6534 AM, Nijmegen, The Netherlands
| | - Rutger C M E Engels
- Trimbos, Da Costakade 45, 3521 VS, Utrecht, The Netherlands.,Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
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48
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Ten Have M, Penninx BWJH, Tuithof M, van Dorsselaer S, Kleinjan M, Spijker J, de Graaf R. Duration of major and minor depressive episodes and associated risk indicators in a psychiatric epidemiological cohort study of the general population. Acta Psychiatr Scand 2017; 136:300-312. [PMID: 28512767 DOI: 10.1111/acps.12753] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Hardly any studies exist on the duration of major depressive disorder (MDD) and factors that explain variations in episode duration that lack biases. This limits clinical decision-making and leaves patients wondering when they will recover. METHOD Data were used from the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among a nationally representative adult population. Respondents with a newly originated depressive episode were selected: 286 MDD and 107 minor depressive disorder (MinDD) cases. DSM-IV diagnoses were assessed with the Composite International Diagnostic Interview 3.0 and episode duration with the Life Chart Interview. RESULTS Among MDD cases, median episode duration was 6 months, mean duration was 10.7 months, and 12% had not recovered at 36 months. Longer duration was associated with comorbid dysthymia, anxiety disorder, psychotropic medication use (i.e. antidepressants or benzodiazepines prescribed by a mental health professional), mental health care use and suicidal behaviour. Better physical and mental functioning before depression onset predicted shorter duration. Among MinDD cases, shorter median duration (3 months) but similar mean duration (8.7 months), risk of chronicity (10% not recovered at 36 months) and risk indicators for episode duration were found. CONCLUSION As the risk of chronicity was similar for MDD and MinDD, MinDD cannot be dismissed as a merely brief mood state.
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Affiliation(s)
- M Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - B W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - M Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - S van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - M Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - J Spijker
- Radboud University, Nijmegen, the Netherlands
| | - R de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
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49
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Tuithof M, Ten Have M, Beekman A, van Dorsselaer S, Kleinjan M, Schaufeli W, de Graaf R. The interplay between emotional exhaustion, common mental disorders, functioning and health care use in the working population. J Psychosom Res 2017; 100:8-14. [PMID: 28789797 DOI: 10.1016/j.jpsychores.2017.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Previous research established that emotional exhaustion - the often assumed core dimension of burnout - diminishes job-related functioning, but knowledge of its association with functioning and health care utilization is largely lacking. Moreover, as exhaustion frequently co-occurs with mood and anxiety disorders (i.e. common mental disorders (CMD)), the question should be addressed whether these associations hold after adjustment for CMD, and whether CMD intensifies the burden of exhaustion. METHODS Cross-sectional data was used from 2902 workers included in the third wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face survey. Exhaustion was assessed with the exhaustion scale of the Maslach Burnout Inventory; work loss (including presenteeism and absenteeism) with the WHO Disability Assessment Schedule; and general functioning with the 36-item Short Form. Health care use is defined as ≥1 general or mental health care contact for mental health problems. Confounders included sociodemographics, job characteristics, CMD, and physical health. The Composite International Diagnostic Interview assessed CMD. RESULTS Mild and severe exhaustion occurred in 14.9% and 2.3% of the workers, respectively, and was significantly associated with work loss, impaired emotional, physical and social functioning, and health care use, even after adjustment for confounders. Co-occurrence of CMD strengthened the association between exhaustion and work loss as well as impaired emotional and social functioning. CONCLUSIONS Exhaustion is uniquely associated with work loss, impaired functioning and health care use. Moreover, co-occurring CMD intensified impairments in functioning. This stresses the need for clinical attention to the exhaustion dimension of burnout.
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Affiliation(s)
- Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | | | | | - Marloes Kleinjan
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | - Wilmar Schaufeli
- Utrecht University, Utrecht, The Netherlands; KU Leuven, Leuven, Belgium.
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
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Voogt C, Otten R, Kleinjan M, Engels R, Kuntsche E. Alcohol-Related Knowledge and Alcohol-Related Norms in 4- to 6-Year-Olds-Evidence from the Dutch Electronic Appropriate Beverage Task. Alcohol Clin Exp Res 2017; 41:1637-1647. [DOI: 10.1111/acer.13452] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 07/11/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Carmen Voogt
- Behavioral Science Institute; Radboud University; Nijmegen the Netherlands
- Trimbos Institute; Netherlands Institute of Mental Health and Addiction; Utrecht the Netherlands
| | - Roy Otten
- Behavioral Science Institute; Radboud University; Nijmegen the Netherlands
- Pluryn, Research & Development; Nijmegen the Netherlands
- Psychology Department; The REACH Institute; Arizona State University; Tempe Arizona
| | - Marloes Kleinjan
- Trimbos Institute; Netherlands Institute of Mental Health and Addiction; Utrecht the Netherlands
| | - Rutger Engels
- Trimbos Institute; Netherlands Institute of Mental Health and Addiction; Utrecht the Netherlands
- Department of General Social Sciences; Utrecht University; Utrecht the Netherlands
| | - Emmanuel Kuntsche
- Behavioral Science Institute; Radboud University; Nijmegen the Netherlands
- Centre for Alcohol Policy Research; La Trobe University; Melbourne Victoria Australia
- Institute of Psychology; Eötvös Loránd University; Budapest Hungary
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