Search

Contains fulltext : 306295.pdf (Publisher’s version ) (Open Access), PTEN hamartoma tumor syndrome (PHTS) might be associated with a distinct cognitive and psychological profile. However, previous studies are limited, predominantly based on small and pediatric cohorts, likely affected by selection bias, and show a broad range of findings. We aimed to characterize the neuropsychological functioning of adults with PHTS. A total of 40 participants, with intellectual disability as exclusion criterium, completed an extensive clinical neuropsychological assessment including cognitive tasks, questionnaires, and a clinical diagnostic interview. The cognitive tasks and questionnaire data were categorized as below and above average based on 1.5 SD. About 80% of participants showed an average level of intelligence. In addition, 30% and 24% of participants scored below average on immediate memory recall and speed of information processing, respectively. Furthermore, about 25% reported above average scores on the majority of the questionnaires, indicating psychological distress, signs of alexithymia, and cognitive complaints. Personality of participants was characterized by inflexibility, social withdrawal, and difficulties in recognizing and describing their own emotions. Adults with PHTS demonstrate a heterogeneous yet distinct neuropsychological profile that is characterized by slower information processing, psychological problems, and specific personality traits. These findings provide directions on how to optimize the care and daily lives of adults with PHTS., 15 mei 2024, 11 p.

21 januari 2023, Item does not contain fulltext, The maladaptive trait model of personality has gained popularity in the assessment of personality pathology. The Minnesota Multiphasic Personality Inventory (MMPI-2-RF) is a widely used instrument to measure maladaptive traits, by means of the Personality Psychopathology 5 (PSY-5-r) scales. Polarity of these maladaptive trait measures - whether these traits are unipolar or bipolar maladaptive - has not been empirically established in the literature. In a clinical sample (N = 275), we investigated content polarity of these traits in relation to 25 psychological symptoms, measured by the Patient Description Form. Hierarchical regression analyses were applied to compare linear and curvilinear models and determine optimal fit. The results provided evidence for content unipolarity of all five traits, with small exceptions. We conclude that, in practice, the MMPI-2-RF PSY-5-r scales do not assess the PSY-5 theoretical model as expected, such that the higher the score on these scales the more it is likely impairing or impacting daily functioning. Conceptual and clinical implications are discussed.

Radboud University, 15 februari 2023, Promotores : Egger, J.I.M., Heijden, P.T. van der Co-promotor : Derksen, J.J.L., Contains fulltext : 289338.pdf (Publisher’s version ) (Closed access), Psychopathological symptoms are complex and best measured in dimensional format, as research is showing more and more. In this thesis, the research shows that maladaptive personality traits are reliable over time, can be measured in a linear fashion with regard to other symptoms, that the structure of psychopathological symptoms can be reproduced if measured in a profile-format, that Autism Spectrum Disorder and Cluster C Personality Disorder symptoms don’t differ much in profile-format, and finally; that identity and psychopathological symptoms can be measured alongside each other using a comprehensive framework. These findings contribute to the idea that symptoms can be practically measured in profile and spectrum format, which is helpful for diagnosis and treatment. Moreover, in these studies, the Minnesota Multiphasic Personality Disorder-2-Restructured Form (MMPI-2-RF) was used, which is shown to be an adequate instrument for measuring these symptom profiles in the real world.

Item does not contain fulltext, Impulsive and aggressive behaviors along with intellectual disabilities often manifest in the context of genetic disorders and are a persisting challenge to professionals in the forensic psychiatric and psychological setting. The following chapter comprises an overview of relevant factors in the gene–context–behavior interaction such as monoamine oxidase A activity and specific epileptic phenomena. It presents several examples of monogenetic disorders with behaviors from the aggression spectrum and summarizes emerging strategies for treatment and clinical management thereof. The final part focuses on challenges and future developments in this field with relevance for the judicial and forensic systems. It is concluded that the relationship between a genetic syndrome and forensically relevant and/or violent behaviors should typically be addressed within a multidisciplinary framework that also includes the application of modern genetic techniques.

13 september 2023, Contains fulltext : 296421.pdf (Publisher’s version ) (Open Access), This case report aims to alert physicians to neuropsychological features and chromosomal variants that may underly resistant hypertension. We present a 35-year-old female patient with hypertensive crisis (BP 260/160 mmHg), initially treated with a combination of calcium antagonists, beta blockers, diuretics and angiotensin-converting enzyme (ACE)-inhibitors, though with little improvement. Cushing's syndrome, Conn's syndrome, and glucocorticoid receptor deficiency were ruled out. Multidisciplinary examination of medical history and (hetero)anamneses including psychosocial factors revealed mild dysmorphic body features, developmental delay, early diagnosis of autism spectrum disorder, a history of being bullied at school, little peer contact, learning disabilities, and special education. Neuropsychological assessment demonstrated below average to low average intelligence quotient, cognitive impairments, and psychopathology. Parallel genetic analyses revealed a rare 16p11.2 microdeletion syndrome. These concurrent examinations explained the patient's life-long high stress levels. After psychological treatment, with additional support at home, her blood pressure lowered to normal levels and antihypertensive drugs were no longer needed. Graphical Abstract, http://links.lww.com/HJH/C294

Contains fulltext : 297724.pdf (Publisher’s version ) (Open Access), (1) Background: chronic alcohol use is consistently associated with impaired executive functioning, but its profile across the spectrum from mild to major alcohol-related cognitive impairment is, to date, unclear. This study aims to compare executive performances of patients with alcohol-induced neurocognitive disorder, including Korsakoff's syndrome (KS), by using a computerized assessment battery allowing a fine-grained and precise neuropsychological assessment; (2) Methods: performances of 22 patients with alcohol-related cognitive impairment (ARCI) and 20 patients with KS were compared to those of 22 matched non-alcoholic controls. All participants were diagnosed in accordance with DSM-5-TR criteria and were at least six weeks abstinent from alcohol prior to assessment. Executive function was evaluated using four subtests of Cambridge Neuropsychological Test Automated Battery (CANTAB®); (3) Results: significant differences between groups were found on spatial working memory (updating), sustained attention and inhibitory control, set shifting, and planning. Healthy controls performed significantly better than both patient groups (Games-Howell post hoc; p < 0.05), but no differences in performance were found between the ARCI and KS group; (4) Conclusions: ARCI and KS patients showed significant executive impairments, most prominent in updating, set-shifting and general planning abilities. Findings suggest equivalent levels of executive function in ARCI and KS patients. Our results highlight executive function as a significant hallmark of alcohol-induced neurocognitive disorder and stipulate the importance of early assessment and evaluation of skills to guide treatment., 12 p.

Contains fulltext : 299357.pdf (Publisher’s version ) (Open Access), 5 p.

Contains fulltext : 299358.pdf (Publisher’s version ) (Open Access), 9 p.

Item does not contain fulltext

Contains fulltext : 299360.pdf (Publisher’s version ) (Closed access)

Item does not contain fulltext, Objective: Studies have reported inconsistent results regarding the extent to which neurocognitive recovery occurs in abstinent patients with alcohol use disorder (AUD). In addition to abstinence, other factors may have influenced this process and contributed to the inconsistencies. This review examines the factors investigated in this regard and describes the possible influence of each factor based on the evidence collected. Methodology: PubMed was systematically searched for articles published between January 2000 and July 2023. Longitudinal humane studies investigating neurocognitive recovery in abstinent adult AUD patients were included. Studies with a cross-sectional design were excluded, as were studies that did not classify AUD according to the DSM-IV or 5 criteria, only examined binge use, did not report neuropsychological outcomes or duration of abstinence, or where neurological disorders were present. Results: Sixteen categories of factors were distinguished from 31 full-text articles. Consistent patterns were found, indicating an association between neurocognitive recovery and the “smoking” and ‘brain volume” factors. Consistent patterns were also found indicating that there is no relationship with “quantities of alcohol used” and “education level.” A similar consistent pattern was also found for “polysubstance use”, “gender” and “verbal reading”, but the number of studies is considered limited. The association with “age” is studied frequently but with inconsistent findings. The remaining eight factors were regarded as understudied. Conclusion: The clearest patterns emerging from the evidence are a predominantly negative influence of smoking on neurocognitive recovery, associations between changes in brain area volume and neurocognitive recovery, and no association between neurocognitive recovery and the amount of alcohol consumed, as measured by self-report, nor with educational attainment. Future research on the understudied factors and factors with inc, 16 p.

Contains fulltext : 247691.pdf (Publisher’s version ) (Open Access), Klinefelter syndrome is a chromosomal disorder in which one extra X chromosome is present (47,XXY). Several other numeric variants of this syndrome are described that comprise one or more additional sex chromosomes such as 48,XXXY, 48,XXYY and 49,XXXXY. These rare conditions are often associated with increased risk for congenital malformations, additional medical problems, and a more complex psychological phenotype. Since 1963, apart from two infants, only four adult patients with a XXXYY pentasomy have been published as case report. The present paper critically reviews the existing literature and provides detailed assessments of a 25-year-old male with intellectual disability and autism. For the first time, this very rare pentasomy is now recorded using all information about developmental history as well as findings from genetic, somatic, endocrinological and neuropsychological examination. It is concluded that children born with abnormalities of the external genitalia should always be evaluated for genetic abnormalities in order to avoid unwanted delay of appropriately designed multidisciplinary medical and psychological treatment.

Contains fulltext : 237616.pdf (Publisher’s version ) (Open Access), Background: Social support represents a key factor in the development of post-traumatic stress disorder (PTSD). Social cognition - the ability to perceive, interpret, and respond to other people - is considered fundamental in making use of social support. Gaining knowledge on the link between PTSD and social cognition is therefore essential. Whilst social cognitive difficulties in patients with PTSD are documented, an understanding of which particular social cognitive processes might be affected more than others, is lacking. The current meta-analysis was therefore aimed to examine social cognitive functioning in four underlying social cognitive domains (mentalization, emotion recognition, social perception, and attributional style) in PTSD diagnosed patients versus controls. Methods: Meta-analyses were conducted on studies examining performance on at least one social cognitive domain in PTSD diagnosed patients compared to controls. Results: 19 studies were included, involving 565 patients and 641 controls. Relative to controls, the PTSD group scored lower on overall social cognitive functioning (SMD = -0.42), specifically on mentalization (SMD = -0.81) and social perception (SMD = -0.30), whilst the latter should be interpreted with caution as only one study was found pertaining to this domain. No emotion recognition and attributional style differences were found. Limitations: There was evidence of moderate heterogeneity in the results of the included studies for overall social cognition and attributional style. Conclusions: Findings indicate that social cognition represents a potential important clinical factor in PTSD and underscore the importance of differentiating between underlying social cognitive processes in research and treatment of PTSD.

Item does not contain fulltext, Cognitive difficulties are argued to be common in patients with Noonan syndrome spectrum disorders (NSSDs), but findings are based on studies in which patients with variants in PTPN11 (prevalence ~50%) were overrepresented. The current study, using a structured clinical approach, describes the cognitive phenotype and psychopathology of 100 patients (aged 6 to 61 years) with nine different gene variants in the Ras/MAPK pathway underlying NSSDs (PTPN11n = 61, PTPN11 Noonan syndrome with multiple lentigines n = 3, SOS1n = 14, KRASn = 7, LZTR1n = 5, RAF1n = 4, SHOC2n = 2, CBLn = 2, SOS2n = 2). After weighted assessment and bootstrapping of the results of individual neuropsychological assessments and measures of psychopathology, cognitive performances in most variant groups were within the ranges of expectation. IQs were significantly lower in patients with variants in PTPN11, KRAS, RAF1, and SHOC2, but no specific cognitive impairments were found. The performances of younger participants (<16 years of age) did not differ from those of adults. Alexithymia and internalizing problems were more frequent in patients with variants in PTPN11 and SOS1, while PTPN11 patients also showed higher levels of externalizing problems. These results stress the need to take intelligence into account when interpreting lower cognitive performances in individual neuropsychological assessments, which is crucial for an adequate understanding and guidance of patients with NSSDs.

24 november 2022, Contains fulltext : 284952.pdf (Publisher’s version ) (Open Access), Objectives: Executive functioning (EF) is a key topic in neuropsychology. A multitude of underlying processes and constructs have been suggested to explain EF, which are measured by at least as many different neuropsychological tests. However, these tests often refer to summary statistics to quantify the construct under study, failing to capture the dynamic nature of EF. An alternative to these summary statistics is a time-series approach that quantifies all the available temporal information. Methods: We used recurrence quantification analysis (RQA) to quantify the characteristics of any temporal pattern in random number generation data and we compared RQA to the traditional and static analysis of random number sequences. Results: The traditional measures yield inconsistent results with increasing sequences length, both for computer-generated and human-generated sequences, whereas the RQA measures do not. Conclusion: The results suggest that a time-series approach does a better job at modelling what is happening on different time-scales, and, therefore, is better at explaining how EF is changing in the course of the random number generation task. We argue that it is likely that these findings also apply to other neuropsychological EF tests, and that a time-series approach is an important addition to the study of EF.

Item does not contain fulltext, Relational frame theory (RFT) is a modern behavioral account of human language and cognition, which focuses on relations or propositions, rather than associations, as core explanatory constructs. In an attempt to measure such propositions, RFT researchers have developed the implicit relational assessment procedure (IRAP). It has been argued that the size of an IRAP effect may provide a metric for psychological inflexibility. The current study aimed to determine whether psychological inflexibility, as measured by the self-focused Natural Language-IRAP (NL-IRAP), would be higher in a clinical sample of individuals with a diagnosis of PTSD (N=29) when compared to a non-clinical sample. Subsequently, the study investigated whether the self-focused NL-IRAP could be used to predict the presence of a clinical diagnosis, using a ROC analysis. As predicted, higher levels of psychological inflexibility were observed for the clinical group. The self-focused NL-IRAP also correctly classified the presence of PTSD (AUC = 76%) with a sensitivity level of 79.3% and a specificity level of 59.2%.Overall, the use of the IRAP as a non-associative clinical measure appears promising.

Contains fulltext : 285039.pdf (Publisher’s version ) (Open Access), We applied a Bayesian Constraint-based Causal Discovery method (BCCD) to examine the hierarchical structure of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Restructured Clinical (RC) scales. Two different general psychopathology super spectra (p-factor) scales were extracted from (1) all RC scales and (2) all RC scales except the RCd (Demoralization) scale. These p-factor scales were included in separate models to investigate the structure of dimensions of psychopathology in a normative (n = 3,242) and clinical (n = 2,466) sample, as well as the combined normative/clinical sample (N = 5,708), by applying the BCCD algorithm to obtain a data-driven reconstruction of the internal hierarchical structure of the MMPI-2-RF. Research on the underlying structure of the MMPI-2-RF has clinical relevance as well as conceptual relevance in the context of the HiTOP model. Results demonstrated that the syndromes measured with the RC-scales - in presence of a p-factor - cluster into six spectra: internalizing, disinhibited-externalizing, antagonistic-externalizing, thought disorder, detachment, and somatoform. These results may support a super spectrum construct, as it was necessary for obtaining a bottom-up reconstruction of this six-spectrum structure. We found support for superiority of a broad super spectrum with additional variance over and above demoralization, as it resulted in the clearest structure (i.e., clustering of the RC scales). Furthermore, our results indicate independent support for the bifactor structure model of psychopathology.

Contains fulltext : 251272.pdf (Publisher’s version ) (Open Access), Background: Prader-Willi syndrome (PWS) is a potentially life threatening, genetic developmental disorder that requires lifelong medical treatment and behavioral management. PWS has a major impact on the patient's social environment. In this study, we have explored traumatic life events and symptoms of posttraumatic stress disorder (PTSD) in family members of individuals with PWS. We have also assessed quality of life in relation to trauma manifestations. In addition, we have evaluated demographic characteristics such as living setting of PWS patients as well as PWS symptom severity. Methods: Data of this observational study were obtained by means of the Life Events Checklist DMS-5, the Posttraumatic Stress Disorder Checklist DSM-5, the abbreviated World Health Organization Quality of Life questionnaire, the Lancashire Quality of Life Profile questionnaire, and a short demographic inventory. The study sample includes 98 adults aged 19 to 80 years (M = 49, SD = 15), who are relatives of 69 individuals with PWS aged 0 to 58 years (M = 19, SD = 13). Participants were recruited via the two Dutch patient associations PWS and the Dutch Digital Center of Expertise PWS. Results: Life time prevalence of traumatic events (93%) was higher in family members of PWS patients ("PWS relatives") than in the general Dutch population (81%). Of those who reported any traumatic event, almost half reported PWS-related events. The prevalence of probable PTSD was higher in PWS relatives (12.1%) than the general lifetime prevalence of PTSD (worldwide, and in the Netherlands 7.4%). Predominant trauma symptoms in PWS relatives were “negative changes in arousal and reactivity” and “negative changes in cognition and mood;” both significantly negatively related to quality of life. Symptom severity of PWS individuals, as well as the associated trauma symptom severity of their relatives increased with age of the PWS individual. The presence of trauma symptoms was less frequent among relatives of P

Item does not contain fulltext, Perceived Criticism is a transdiagnostic construct that captures the patients' perception of criticism. PC seems to be a reliable predictor of negative clinical outcomes concerning recurrence of symptoms or relapse in a broad range of stress-related psychiatric disorders and is thought to be related to underlying stress-related psychobiological vulnerabilities. Dialectical Behavior Therapy (DBT) is a treatment targeting these stress-related psychobiological vulnerabilities. In this pilot study we focus on the possible change in Perceived Criticism due to a (residential) DBT network training. This study follows a pre-post design where PC is recorded in 33 patients (mean age 25 years) and 61 relatives during 8 group sessions of a DBT network training, as part of a residential DBT program. The degree of perceived criticism is systematically assessed using the Perceived Criticism Measure, a two item self-report questionnaire that assesses mutual (perceived) criticism from patients and network members. Overall scores of the perceived criticism measure decrease significantly for both patients and relatives after following the DBT network training. More specific, item scores of both patients and relatives concerning how critical they are towards the other and how critical they thought the other was of them also decreased significantly after following the DBT network training. Findings suggest that a DBT network training as part of a residential DBT program may be instrumental in decreasing levels of perceived criticism. We recommend further exploration of Perceived Criticism as a possible moderator in effect size studies in randomized controlled clinical trials on DBT and in more fundamental research on the putative mechanisms of behavioural change such as improved perspective taking, and the evaluation of social cues.

Contains fulltext : 281795.pdf (Publisher’s version ) (Open Access)

Item does not contain fulltext, Introduction: Diagnostic exome sequencing has yielded over the past decades a great number of molecular diagnoses for genetic disorders in which both intellectual disability and epilepsy are present. One of these syndromes is myoclonic-atonic epilepsy (MAE) that is caused by pathogenic variants in the SLC6A1 gene located at 3p25.3. The most relevant clinical characteristics are intellectual disability, several forms of mostly treatment-resistant epilepsy starting at young age, serious disinhibitory behavioural problems, language impairment, higher pain tolerance, and symptoms from the autism spectrum, all in the absence of any consistent dysmorphism or malformation. Methods: After an overview of the literature, here, the developmental trajectory of a 55-year-old severely intellectually disabled male with therapy-resistant epilepsy and aggressive outburst is reported in detail, in whom no etiological diagnosis had been performed. Next to genetic, neurological, and neuropsychiatric examination, psychological assessment with validated instruments was performed. Results: Exome sequencing and targeted analysis of the patient and both his parents demonstrated a de novo missense variant in the SLC6A1 gene which was never before described in the literature nor in control databases. The phenotypical presentation of the patient with treatment-resistant epilepsy, especially absences and myoclonic seizures, as well as sleep disturbances and autism, corresponds with a diagnosis of MAE. Discussion: This case stresses that exome sequencing should be the first-tier diagnostic test for patients with unexplained neurodevelopmental disorders, regardless of their age, and that as yet the most suitable approach is the formation of an interdisciplinary team for treatment design and clinical management.

Item does not contain fulltext, De afgelopen decennia is de kennis over zeldzame ziekten en genetica toegenomen. Toch kent elke huisartsenpraktijk wel kinderen of volwassenen die nog niet gediagnosticeerd zijn met een zeldzame ziekte, terwijl ze daar wel baat bij kunnen hebben. Hoe vindt u bijvoorbeeld patiënten met het zeldzame Phelan-McDermidsyndroom? Deze patiënten hebben meestal een normaal uiterlijk en een onbegrepen ontwikkelingsachterstand. De diagnose wordt vaak pas laat gesteld, en gedrags- en belevingsproblemen worden niet (h)erkend. In dit soort gevallen kunt u een beroep doen op speciale expertisepoliklinieken van de universitaire ziekenhuizen. Deze hebben een geïndividualiseerd multidisciplinair begeleidingstraject opgezet om u te ondersteunen bij de diagnostiek, monitoring en behandeling.

Contains fulltext : 240308.pdf (Publisher’s version ) (Open Access), Background: Apathy is an important neuropsychiatric symptom in alcohol-related cognitive impairment in general, and Korsakoff's syndrome in specific. However, research in patients with Korsakoff's syndrome on the multifaceted nature of apathy is lacking. Objectives: Aim of the current study was to examine behavioral, cognitive and emotional apathy in alcoholic Korsakoff patients, also investigating the association with overall cognitive and executive dysfunction. Methods: We studied 43 patients with Korsakoff's syndrome (mean age 60.9, SD=6.5, range 38-70) using the Apathy Evaluation Scale - Informant Version (AES-I) and also administered the Montreal Cognitive Assessment and the Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A) as a measure of daily executive problems. Results: In our sample, 76% of the Korsakoff patients were classified as being apathetic. AES-I scores correlated with overall cognitive function and were related to observer-rated daily executive problems. Discussion: Apathy is highly prevalent in Korsakoff patients and related to overall cognitive dysfunction and everyday executive problems. Our results stress the need to further examine underlying mechanisms of apathy in Korsakoff patients and the need for interventions aimed at reducing apathy.

Contains fulltext : 231873.pdf (Publisher’s version ) (Open Access), Current investigation focused on the criterion validity in a forensic sample of the Dutch language version of the Shedler-Westen Assessment Procedure (SWAP-200-NL), a personality assessment instrument completed by the examiner. We inquired into two areas: a) possible differences between a forensic and general mental health care population for SWAP-200-NL Personality Syndromes (PS) and Trait Dimensions (TD;N = 68), and b) explore criterion validity of SWAP-200-NL PS and TD scales for data from criminal records (N = 114). An ANOVA showed significantly higher scores for the forensic group on antisocial-psychopathic PS and psychopathy TD and lower scores on dysphoric, obsessional, high functioning depressive and avoidant PS than those for the general population. Furthermore, antisocial-psychopathic PS and psychopathy TD correlate negative with the age of first sentenced offence and positive with the number of sentenced offences in the past. Also, for the number of sentenced offences in probationary period we found significant mean differences for antisocial-psychopathic PS, and psychopathy and narcissistic TD. In contrast, criminal data showed inverse associations with scales representing obsessional, avoidant and depressive tendencies. In conclusion, present results support the differential diagnostic potential of the SWAP-200-NL and its clinical utility in forensic settings.

Contains fulltext : 234275.pdf (Publisher’s version ) (Open Access), The Random Number Generation (RNG) task has a long history in neuropsychology as an assessment procedure for executive functioning. In recent years, understanding of human (executive) behavior has gradually changed from reflecting a static to a dynamic process and this shift in thinking about behavior gives a new angle to interpret test results. However, this shift also asks for different methods to process random number sequences. The RNG task is suited for applying non-linear methods needed to uncover the underlying dynamics of random number generation. In the current article we present RandseqR: an R-package that combines the calculation of classic randomization measures and Recurrence Quantification Analysis. RandseqR is an easy to use, flexible and fast way to process random number sequences and readies the RNG task for current scientific and clinical use.

Contains fulltext : 219399.pdf (publisher's version ) (Open Access), The long-term stability of maladaptive personality traits in the general population has been under-investigated. The current study examined the longitudinal 20-year mean-level stability and rank-order consistency of five maladaptive personality traits - as measured with the Personality Psychopathology-5-r scales. Correlations and regression analysis were conducted to test both types of stability comparing raw scores of scale administrations in a general population sample in both 1992 and 2012 (N = 65). Repeated measures analysis of variance demonstrated significant mean-level stability of the PSY-5-r traits over 20 years. The PSY-5-r scales demonstrated significant rank-order consistency as evidenced by correlational analyses and reliability coefficients. The scales Aggressiveness-r (r = .73), Neuroticism/Negative Emotionality-r (r = .65), Introversion/Low Positive Emotionality-r (r = .63), and Disconstraint-r (r = .56), evidenced strong rank-order stability, whereas Psychoticism-r (r = .3) showed moderate rank-order consistency. The results of the present study indicate that maladaptive personality traits as measured with the PSY-5-r scales are relatively stable over 20 years in an adult community population.

Radboud University, 19 maart 2021, Promotores : Egger, J.I.M., Vissers, C.T.W.M., Rinck, M., Contains fulltext : 230826.pdf (publisher's version ) (Open Access), Dit onderzoek biedt nader inzicht in zelfregulatie bij mensen met "Dubbel Diagnose" verwijzend naar een combinatie van verslaving met een andere psychische stoornis. Patiënten zijn onderzocht ter verkrijging van zowel rechtstreeks meetbare als indirect meetbare (bv. hersen-) informatie. Verder is een internationale zelfregulatie vragenlijst (Barkley Deficits in Executive Function Scale) vertaald en aangepast voor gebruik in de Nederlandstalige praktijk. Patiënten met Dubbel Diagnose voelen wel dat er emotie opkomt, maar begrijpen de reden ervan niet of minder goed en hebben moeite emoties te verwoorden en erop door te denken. Dit kan overspoeling door emoties en moeite met zelfregulatie tot gevolg hebben en leiden tot middelengebruik (patiënten kunnen zichzelf bijvoorbeeld minder remmen in de buurt van middelen). De sterke relaties tussen impulsiviteit en verslavingsgedrag naast zucht en verslavingsgedrag werden binnen dit onderzoek opnieuw bevestigd. Geadviseerd wordt in behandeling aandacht te besteden aan systematische training van stapsgewijs en doelgericht omgaan met (emotionele) situaties. English abstract: This dissertation offers a neuropsychological perspective on self-regulation in patients with Dual Diagnosis. The latter concerns the combination of a disorder in substance use and another mental disorder, which can influence health and overall daily life functioning. Both brain and neurobehavioral measures took place with patients and healthy controls. In addition, a self-regulation questionnaire (the Barkley Deficits in Executive Function Scale) was translated and adapted for use in Dutch health care settings. Patients with Dual Diagnosis do feel emotions arising; but, the cognitive analysis, verbalization of those emotions and self-regulation is problematic. This may trigger overarousal by emotions and more substance use. Furthermore, patients with Dual Diagnosis show inhibitory problems when confronted with substance related stimuli. The strong relation

Contains fulltext : 239409.pdf (Publisher’s version ) (Open Access), Background: Telepsychology is increasingly being implemented in mental health care. We conducted a scoping review on the best available research evidence regarding availability, efficacy and clinical utility of telepsychology in DBT. The review was performed using PRISMA-ScR guidelines. Our aim was to help DBT-therapists make empirically supported decisions about the use of telepsychology during and after the current pandemic and to anticipate the changing digital needs of patients and clinicians. Methods: A search was conducted in PubMed, Embase, PsycARTICLES and Web of Science. Search terms for telepsychology were included and combined with search terms that relate to DBT. Results: Our search and selection procedures resulted in 41 articles containing information on phone consultation, smartphone applications, internet delivered skills training, videoconferencing, virtual reality and computer- or video-assisted interventions in DBT. Conclusions: The majority of research about telepsychology in DBT has focused on the treatment mode of between-session contact. However, more trials using sophisticated empirical methodologies are needed. Quantitative data on the efficacy and utility of online and blended alternatives to standard (i.e. face-to-face) individual therapy, skills training and therapist consultation team were scarce. The studies that we found were designed to evaluate feasibility and usability. A permanent shift to videoconferencing or online training is therefore not warranted as long as face-to-face is an option. In all, there is an urgent need to compare standard DBT to online or blended DBT. Smartphone apps and virtual reality (VR) are experienced as an acceptable facilitator in access and implantation of DBT skills. In addition, we have to move forward on telepsychology applications by consulting our patients, younger peers and experts in adjacent fields if we want DBT to remain effective and relevant in the digital age.

Item does not contain fulltext, Introduction: Self-regulatory actions direct the achievement of life goals. Awareness of one's state is needed to adequately self-regulate one's life. Methods: The self-regulatory actions of (cognitive/emotional) self-awareness and (error-)monitoring were assessed in patients with Dual Diagnosis and healthy controls. A multi-method approach was applied. Results: Patients with Dual Diagnosis reported lower capacity to identify, verbalize and interpret emotions in a cognitive manner. Both groups reported experiencing arousal of emotions, but patients showed less cognitive elaboration on them and they reported more negatively labeled emotions. Patients with Dual Diagnosis signaled errors less adequately, but did not differ in the number of errors. Discussion: The abundance of negative emotions may overwhelm patients and trigger substance use to handle this negativity. Especially because they do in fact experience the arousal of emotions, but they find it harder to timely identify, interpret and verbalize these emotions. Training self-awareness and emotion regulation may be beneficial.

Contains fulltext : 230169.pdf (publisher's version ) (Open Access), Objective: In Dual Disorders (DD), which involves the co-occurrence of a disorder in substance use and a mental disorder, recurrent struggles with addictive behavior are frequent. Neuropsychological knowledge concerning the profile of inhibitory control and the irresistible urge to use substances (craving) within the DD patient group may contribute to the prevention of this recurrent addictive behavior. Methods: Inhibitory control and craving were assessed in 25 patients with DD and 25 healthy controls (HC). Inhibitory control tasks (Go/No-go task and Stop Signal Task) were performed combined with brain measurements (Event Related Potentials) mapping inhibitory control. Moreover, implicit and explicit measures concerning craving were administered. Statistical DD and HC comparisons, correlational and regression analyses on exploratory base were conducted. Results: DD patients committed more inhibitory control errors than HC when confronted with (alcohol) consumption-related picture stimuli. Furthermore, patients with DD showed higher levels of implicit and explicit craving. The number of inhibitory control errors was positively related to levels of implicit and explicit craving. Moreover, explicit craving and impulsivity (as a dimension of inhibitory control) predicted the severity of addictive behavior. Event Related Potential analyses did not show differences in inhibitory control-associated brain activity between DD patients and HC; both groups showed reduction of P300 amplitudes in response to alcohol pictures. Conclusions: Impulsivity and craving are elevated in DD patients and show predictive value for the severity of addictive behavior. One's level of impulsive action tendency may trigger less effort to control (recurrent) substance use. The findings may contribute to existing DD treatment indications by the promotion of impulse control training via "stop-think-act" methods for DD patients.

Contains fulltext : 235059.pdf (Publisher’s version ) (Open Access), SATB2-associated syndrome (SAS) is a neurodevelopmental disorder caused by heterozygous pathogenic variants in the SATB2 gene, and is typically characterized by intellectual disability and severely impaired communication skills. The goal of this study was to contribute to the understanding of speech and language impairments in SAS, in the context of general developmental skills and cognitive and adaptive functioning. We performed detailed oral motor, speech and language profiling in combination with neuropsychological assessments in 23 individuals with a molecularly confirmed SAS diagnosis: 11 primarily verbal individuals and 12 primarily nonverbal individuals, independent of their ages. All individuals had severe receptive language delays. For all verbal individuals, we were able to define underlying speech conditions. While childhood apraxia of speech was most prevalent, oral motor problems appeared frequent as well and were more present in the nonverbal group than in the verbal group. For seven individuals, age-appropriate Wechsler indices could be derived, showing that the level of intellectual functioning of these individuals varied from moderate-mild ID to mild ID-borderline intellectual functioning. Assessments of adaptive functioning with the Vineland Screener showed relatively high scores on the domain 'daily functioning' and relatively low scores on the domain 'communication' in most individuals. Altogether, this study provides a detailed delineation of oral motor, speech and language skills and neuropsychological functioning in individuals with SAS, and can provide families and caregivers with information to guide diagnosis, management and treatment approaches.

Contains fulltext : 219563.pdf (publisher's version ) (Open Access), The Shedler-Westen Assessment Procedure (SWAP) is a Q-sort procedure for personality assessment. Empirical evidence for the psychometric qualities in the United States thus far is solid, but no such data exist for the Dutch language version. In this study we aim to investigate the higher order factor structure of the Personality Syndrome (PS) scales and Trait Dimension (TD) scales of the Dutch language version of the SWAP-200 (SWAP-200-NL) in a psychiatric outpatient sample (N = 282). For the TD scales Cronbach’s α is also calculated. Results show acceptable to good overall reliability (i.e., Cronbach’s α). Higher order factor analysis of the SWAP-200 (PS) reveals four maladaptive factors that resemble both the higher order personality traits conceptualized in section III of DSM-5 (APA, 2013), as well as the constructs identified by Widiger and Simonsen (2005) after integrating 18 alternative proposals for dimensional classification. Additionally, High-Functioning Depressive PS was most prevalent in our outpatient sample. While this PS is not described in DSM-5, it is discussed here as a possibly overlooked, clinically relevant construct. Finally, this study replicates previously identified higher order factors of the TD, adding to the instrument’s robustness.