311 research outputs found
Dionijs Huibert Burger, Sociologisch-economische geschiedenis van Indonesia
No full textLombard Denys. Dionijs Huibert Burger, Sociologisch-economische geschiedenis van Indonesia. In: Archipel, volume 19, 1980. pp. 315-317
Dionijs Huibert Burger, Sociologisch-economische geschiedenis van Indonesia
No full textLombard Denys. Dionijs Huibert Burger, Sociologisch-economische geschiedenis van Indonesia. In: Archipel, volume 19, 1980. pp. 315-317
Examining the link between socio-economic position and mental health in early adolescents
Full text linkMental health (MH) is fundamental to good quality of life and contributes to success in society. Healthy and confident children are more likely to turn out into healthy and confident adults. Adverse family situations such as low socio-economic position (SEP) may have negative consequences for child and adolescent MH. However, little is known about the link between low family SEP and MH. This thesis examined four aspects of this link: 1) the domain-specific link, 2) the mediation link, 3) the interaction link, and 4) the link with MH service use.
The link between low SEP and MH was found to be larger for the externalizing than internalizing problem domain and the SEP-MH relationship was partly mediated by environment-related life stressors, particularly for internalizing problems. Familial psychopathology and low SEP were independent and non-interacting risk factors for offspring MH problems. Finally, the true association between SEP and MH service use was obscured by severity of mental problems. Maternal education, independent of other indices of SEP and severity of MH problems, significantly predicted MH service use.
In conclusion, the effect of low family SEP on MH may be domain-specific, partly mediated by environment-related life stressors and the synergy between low SEP and parental psychopathology appear not to confer additional risks for mental problems in offspring. Further, failure to correct for severity of mental problems obscures the true association between SEP and MH service use in early adolescents. Finally, although the effects of SEP on MH may be relatively small, the negative SEP-MH association may be cumulative as suggested by previous studies. Since early adolescence is still at the beginning of the life-course, small SEP differences in early life may give rise to increasing differences later in the life. Therefore, interventions to ameliorate the negative effect of low SEP in families may be an important investment.
Stormy clouds in seventh heaven: A study on anxiety and depression around childbirth
Full text linkApproximately 10-15% of all women experience symptoms of anxiety or depression during the antenatal or postpartum period. Having elevated stress levels in the antenatal period has been associated with adverse outcomes in the child, but the mechanism behind this observation has not been found yet. Amongst the main risk factors for anxiety or depression in the antenatal or postpartum period are having a history of previous symptoms, traumatic events during childhood, recent major life events and specific personality traits. Chapters 2 and 3 of this thesis focus on the influence of traumatic events specifically during pregnancy, delivery or in the immediate postpartum period on the course of anxiety and depression in the antenatal and postpartum period. Screening for anxiety and depression during pregnancy is generally recommended by guidelines on antenatal and postpartum anxiety or depression, although antenatal screening tools that accurately predict an individual risk on symptoms in the postpartum period are not available yet. Chapters 4 and 5 of this thesis investigate whether two commonly used tools in screening for current symptomatology can be used in predicting later symptomatology. Treatment options for symptoms of anxiety or depression can be divided into pharmacological and non-pharmacological treatment. During the antenatal and breastfeeding period, women generally prefer non-pharmacological treatment, such as cognitive behavioral therapy. Outside pregnancy, this therapy has been proven to be successful in treating anxiety and depression. Chapter 6 focuses on a randomized controlled trial investigating the effect of cognitive behavioral therapy on pregnant women and their babies
Unhealthy behaviors during pregnancy : who continues to smoke and consume alcohol, and is treatment of anxiety and depressive symptoms effective?
Full text linkThis thesis investigated continued smoking and alcohol consumption during pregnancy, and treatment of anxiety and depressive symptoms during pregnancy using cognitive behavioral therapy. Data from a large prospective population-based cohort study and a randomized controlled trial were used. Regarding continued smoking and alcohol consumption during pregnancy, we studied associations with stressful events during pregnancy and personality. We found that the experienced severity of the following categories of stressful events are associated with continued alcohol consumption: ‘conflict with loved ones’, ‘crime related’, ‘pregnancy-specific’, and the total including all events. As for personality, we found that higher levels of openness to experience and lower levels of conscientiousness are associated with continued alcohol consumption. No associations were found with continued smoking during pregnancy. Furthermore, we studied the association of adverse pregnancy and delivery outcomes with postpartum smoking relapse, and found a positive association. Last, we investigated the effect of individual cognitive behavioral therapy on anxiety and depressive symptoms during pregnancy. We found no evidence for a beneficial effect of cognitive behavioral therapy, when compared to care as usual, among a group of pregnant women with subclinical anxiety and depressive symptoms and disorders that were not active help-seekers. Our findings raise new questions on the treatment of anxiety and depression symptoms during pregnancy. Our results suggest that more evidence is needed for which specific groups screening and treatment may be beneficial during pregnancy, including pregnant women with disorders
Pregnancy and Psychopathology
Full text linkFor a lot of people, because of the joy and happiness of a new life, pregnancy means being on cloud nine. The general population may not be aware that this does not apply to every woman. Psychopathology during and after pregnancy should not be underrated. For as much as 10-20% of all pregnant women, pregnancy results in black clouds, gathering over them. This thesis focuses on several aspects of psychopathology around pregnancy. In almost 8000 pregnant women, we investigated risk factors for anxiety and depression. Furthermore, we studied adverse effects of these psychiatric disorders both on breastfeeding and on the (unborn) child. Besides, we investigated the prevalence and severity of anxiety and depression among pregnant women in Nicaragua. We also studied the effects of psychotherapy on maternal symptoms, on perinatal outcomes, and on the development and behaviour of the child, compared to care as usual. Because we found no evidence for a positive effect on maternal symptoms and child development and behaviour and a possible adverse effect on perinatal outcomes, cognitive behavioural therapy should not be provided as treatment of subclinical antenatal psychopathology
Relapse prevention strategies for recurrent depression
Full text linkDepression is a recurrent disorder with a substantial disease burden for individuals and society. Given the high relapse/recurrence rates, especially for individuals with previous depressive episodes, relapse prevention is of paramount importance. This dissertation focused on current gaps in the knowledge of relapse prevention. We developed and validated a tool to predict relapse/recurrence risk for an individual and concluded that more studies are needed to enhance the performance before implementing it into clinical practice. We also explored beliefs about the causes of depression and recovery (i.e., causal beliefs) and whether they predicted antidepressant use in terms of adherence, dosage, and successful tapering antidepressants, which was not the case. In addition, we examined several relapse prevention strategies for individuals remitted from at least two depressive episodes. We found that adding Preventive Cognitive Therapy (PCT) to long-term antidepressants had positive effects on depressive relapse/recurrence over 24 months and was cost-effective compared to continuing antidepressants. Continuing antidepressants was not superior compared to PCT while tapering antidepressants but was cost-effective. Adding an internet-based version of PCT with minimal therapist support to Treatment As Usual (TAU) was neither effective nor cost-effective over 24 months compared to TAU alone. The most important clinical implications of the studies are that face-to-face PCT as started after recovery on antidepressants is recommended and that PCT might form an alternative for individuals with a wish to taper antidepressants, but that extra costs might be involved when tapering antidepressants
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