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1. Goals

Author

Massey, Emma K., Gebhardt, W. A., Garnefski, N., and Levesque, Roger J. R., editor

Published
2018
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3. Moodpep: description and evaluation of an online self-help program for young adults with feelings of depression

Author

Garnefski, N. and Kraaij, V.

Abstract

There is a high prevalence of mental health problems in young adulthood. At the same time, these problems seem to be undertreated. Barriers to seeking help include: stigma, costs and time issues. eHealth interventions could be a promising solution. Moodpep was developed in 2019 as a guided online self-help program for young adults (18+) with depressive symptoms. It is based on Cognitive Behavioral Therapy and includes 8 lessons and 4 themes: activation, relaxation, changing negative cognitions, and goal attainment. The aims of the present article were: giving a detailed description of Moodpep and evaluating the program. The latter was done by analyzing pre-post data and studying participant satisfaction. In total, 31 participants started with the intervention of whom 23 completed it. The results showed that depressive symptoms significantly reduced after following the program, with large effect sizes. At post-test almost all participants scored in the categories of minimal or mild depression. In addition, program and coaching were valued by the participants. In conclusion, Moodpep could provide effective low-threshold help to young people; they could work on mental health at their own time and place, in relative anonymity, and against no or low costs.

Published
2023

4. Goals

Author

Massey, Emma K., Gebhardt, W. A., Garnefski, N., and Levesque, Roger J. R., editor

Published
2011
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5. Long-term effectiveness of an online self-help intervention for people with HIV and depressive symptoms

Author

Luenen, S. van, Garnefski, N., Spinhoven, P., and Kraaij, V.

Subjects
Infectious Diseases, Social Psychology, Depression, Public Health, Environmental and Occupational Health, HIV, Internet-based intervention, Telemedicine, Cognitive behavioral therapy
Abstract

The aim of this study was to investigate the long-term effectiveness (3–4 years later) of an online intervention that was previously found to effectively reduce depressive symptoms in people with HIV on the short term. Participants were people with HIV who had participated in the large RCT on the short-term effectiveness of the guided online intervention. The primary outcome measure was depressive symptoms [Patient Health Questionnaire-9 (PHQ-9)] and the secondary outcome measure was anxiety symptoms [Generalized Anxiety Disorder-2 (GAD-2) scale]. Forty-seven participants completed the long-term follow-up. PHQ-9 scores, previously found to have been significantly reduced on the short term, remained low on the long term. GAD-2 scores did not decrease significantly on the short term, however, on the long term, a significant decrease was found. The intervention may not only be effective in lowering depressive symptoms on the short term but also retain the results on the long term.Trial registration International Clinical Trials Registry Platform, NL8448, March 3, 2020.

Published
2022

6. Cost-effectiveness and cost-utility of an Acceptance and Commitment Therapy intervention vs. a Cognitive Behavioral Therapy intervention for older adults with anxiety symptoms: A randomized controlled trial

Author

Witlox, M., Kraaij, V., Garnefski, N., Bohlmeijer, E., Smit, F., Spinhoven, P., Epidemiology and Data Science, APH - Mental Health, and Psychology, Health & Technology

Subjects
Male, Economics, Cost-Benefit Analysis, Science, Cost-Effectiveness Analysis, Emotions, Social Sciences, Neuropsychiatric Disorders, Anxiety, Neuroses, Elderly, Health Economics, Mental Health and Psychiatry, Medicine and Health Sciences, Psychology, Adults, Humans, Single-Blind Method, Acceptance and Commitment Therapy, Aged, Netherlands, Multidisciplinary, Cognitive Behavioral Therapy, Biology and Life Sciences, Health Care Costs, Middle Aged, Anxiety Disorders, Economic Analysis, Psychotherapy, Health Care, Age Groups, People and Places, Medicine, Population Groupings, Female, Quality-Adjusted Life Years, Mental Health Therapies, Research Article
Abstract

Background A previous randomized controlled trial in older adults with anxiety symptoms found no differences between a brief blended Acceptance and Commitment Therapy (ACT) intervention and brief face-to-face Cognitive Behavior Therapy (CBT) regarding anxiety symptom severity at posttreatment and 12-month follow-up. A health-economic evaluation comparing these interventions has not yet been conducted. Objective This study examined the one-year cost-effectiveness and cost-utility of blended ACT compared to face-to-face CBT for older adults with anxiety symptoms. Methods The economic evaluation was embedded in a randomized controlled trial comparing blended ACT to CBT in 314 older adults with mild to moderately severe anxiety symptoms. Data were collected at baseline and 3, 6 and 12 months post baseline. For the cost-effectiveness analysis, treatment response was defined as a reliable improvement in anxiety symptom severity (measured with the Generalized Anxiety Disorder-7) between baseline and 12-month follow-up. To assess cost-utility, quality-adjusted life years (QALYs) were computed using EuroQol-5 Dimensions-5 Levels-5 utility scores. Analyses took the societal perspective, including both healthcare costs and productivity costs. Incremental cost-effectiveness ratios were calculated using 2500 bootstraps of seemingly unrelated regression equations of costs and effects. Sensitivity analyses were performed to assess the robustness of the findings. Results Differences between the blended ACT group and CBT group in treatment response and QALYs were statistically insignificant and clinically irrelevant. The ACT intervention was associated with an average per-participant cost reduction of €466 ($593) compared to CBT, which resulted from lower productivity costs in the blended ACT group. From a healthcare perspective, the ACT intervention was associated with higher costs (by €71 ($90)) than CBT. Conclusions The results do not indicate that from a health-economic perspective blended ACT should be preferred over CBT in the treatment of older adults with anxiety symptoms. The findings support a model of shared decision making, where clinicians and patients collaboratively decide on the preferred intervention, based on ethical-medical, practical and personal considerations. Trial registration Netherlands Trial Register: TRIAL NL6131 (NTR6270); https://www.trialregister.nl/trial/6131.

Published
2022

7. The Self-Compassionate Coping Measure (4 items): Psychometric features and relationships with depression and anxiety in adults

Author

Garnefski, N. and Kraaij, V.

Subjects
Coping (psychology), animal structures, Self, Construct validity, General Medicine, Mental health, Criterion validity, medicine, Anxiety, Internal validity, medicine.symptom, Psychology, Self-compassion, Clinical psychology
Abstract

Self-compassion refers to a positive, kind attitude of a person toward oneself when confronted with difficulties. A self-compassionate coping style may buffer against the development of psychological problems. Aim was to introduce a new, 4-item measure for Self-compassion and to test its psychometric properties. In addition, its relationships with Neff’s Self Compassion Scale (SCS) and with the HADS depression and anxiety scales were studied, in an adult general population sample. The results showed that the SCCM had a high reliability, confirming internal validity. In addition, the SCCM was strongly related to all subscales and total score of the SCS, suggesting construct validity. Finally, also strong relationships were found with symptoms of depression and anxiety, suggesting criterion validity. The SCCM might therefore be considered a valuable and reliable tool in the study of self-compassion associated with mental-health problems, while it also might provide us with targets for intervention.

Published
2019

8. The Behavioral Emotion Regulation Questionnaire: Development, psychometric properties and relationships with emotional problems and the Cognitive Emotion Regulation Questionnaire

Author

Kraaij, V. and Garnefski, N.

Subjects
Coping (psychology), education.field_of_study, Questionnaire, Emotion regulation, 05 social sciences, Population, 050109 social psychology, Cognition, Mental health, 050105 experimental psychology, Social support, Mood, Distraction, medicine, Anxiety, 0501 psychology and cognitive sciences, Coping, medicine.symptom, Psychology, education, General Psychology, Clinical psychology
Abstract

A new questionnaire, the Behavioral Emotion Regulation Questionnaire (BERQ) was developed. This questionnaire consists of 5 scales and assesses one's behavioral style or strategies of responding to stressful events to regulate emotions. It is the first questionnaire that measures behavioral coping only and complements the Cognitive Emotion Regulation Questionnaire (CERQ) which measures cognitive coping. In a sample of 457 adults from the general population the psychometric properties of the BERQ (measuring dispositional coping) and its relationship with well-being and the CERQ were examined. Principal component analyses supported the allocation of items to the subscales, with alphas of all scales being high. All BERQ scales correlated significantly with symptoms of depression and anxiety. Higher use of Seeking Distraction, Actively Approaching and Seeking Social Support was related to fewer depression and anxiety symptoms, suggesting these are more adaptive strategies. Higher use of Withdrawal and Ignoring was related to more depression and anxiety symptoms, suggesting these are less adaptive strategies. The BERQ and CERQ scales were mainly small to moderately correlated with each other. The results suggest that it is important to pay attention to behavioral coping in the development of intervention programs for mental health problems.

Published
2019

10. Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual participant data

Author

Furukawa, T.A., Suganuma, A., Ostinelli, E.G., Andersson, G., Beevers, C.G., Shumake, J., Berger, T., Boele, F.W., Buntrock, C., Carlbring, P., Choi, I., Christensen, H., Mackinnon, A., Dahne, J., Huibers, M.J.H., Ebert, D.D., Farrer, L., Forand, N.R., Strunk, D.R., Ezawa, I.D., Forsell, E., Kaldo, V., Geraedts, A., Gilbody, S., Littlewood, E., Brabyn, S., Hadjistavropoulos, H.D., Schneider, L.H., Johansson, R., Kenter, R., Kivi, M., Björkelund, C., Kleiboer, A., Riper, H., Klein, J.P., Schröder, J., Meyer, B., Moritz, S., Bücker, L., Lintvedt, O., Johansson, P., Lundgren, J., Milgrom, J., Gemmill, A.W., Mohr, D.C., Montero-Marin, J., Garcia-Campayo, J., Nobis, S., Zarski, A.C., O'Moore, K., Williams, A.D., Newby, J.M., Perini, S., Phillips, R., Schneider, J., Pots, W., Pugh, N.E., Richards, D., Rosso, I.M., Rauch, S.L., Sheeber, L.B., Smith, J., Spek, V., Pop, V.J., Ünlü, B., van Bastelaar, K.M.P., van Luenen, S., Garnefski, N., Kraaij, V., Vernmark, K., Warmerdam, L., van Straten, A., Zagorscak, P., Knaevelsrud, C., Heinrich, M., Miguel, C., Cipriani, A., Efthimiou, O., Karyotaki, E., Cuijpers, P., Furukawa, T.A., Suganuma, A., Ostinelli, E.G., Andersson, G., Beevers, C.G., Shumake, J., Berger, T., Boele, F.W., Buntrock, C., Carlbring, P., Choi, I., Christensen, H., Mackinnon, A., Dahne, J., Huibers, M.J.H., Ebert, D.D., Farrer, L., Forand, N.R., Strunk, D.R., Ezawa, I.D., Forsell, E., Kaldo, V., Geraedts, A., Gilbody, S., Littlewood, E., Brabyn, S., Hadjistavropoulos, H.D., Schneider, L.H., Johansson, R., Kenter, R., Kivi, M., Björkelund, C., Kleiboer, A., Riper, H., Klein, J.P., Schröder, J., Meyer, B., Moritz, S., Bücker, L., Lintvedt, O., Johansson, P., Lundgren, J., Milgrom, J., Gemmill, A.W., Mohr, D.C., Montero-Marin, J., Garcia-Campayo, J., Nobis, S., Zarski, A.C., O'Moore, K., Williams, A.D., Newby, J.M., Perini, S., Phillips, R., Schneider, J., Pots, W., Pugh, N.E., Richards, D., Rosso, I.M., Rauch, S.L., Sheeber, L.B., Smith, J., Spek, V., Pop, V.J., Ünlü, B., van Bastelaar, K.M.P., van Luenen, S., Garnefski, N., Kraaij, V., Vernmark, K., Warmerdam, L., van Straten, A., Zagorscak, P., Knaevelsrud, C., Heinrich, M., Miguel, C., Cipriani, A., Efthimiou, O., Karyotaki, E., and Cuijpers, P.

Published
2021

11. Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual data

Author

Furukawa, TA, Suganuma, A, Ostinelli, EG, Andersson, G, Beevers, CG, Shumake, J, Berger, T, Boele, FW, Buntrock, C, Carlbring, P, Choi, I, Christensen, H, Mackinnon, A, Dahne, J, Huibers, MJH, Ebert, DD, Farrer, L, Forand, NR, Strunk, DR, Ezawa, ID, Forsell, E, Kaldo, V, Geraedts, A, Gilbody, S, Littlewood, E, Brabyn, S, Hadjistavropoulos, HD, Schneider, LH, Johansson, R, Kenter, R, Kivi, M, Bjorkelund, C, Kleiboer, A, Riper, H, Klein, JP, Schroder, J, Meyer, B, Moritz, S, Bucker, L, Lintvedt, O, Johansson, P, Lundgren, J, Milgrom, J, Gemmill, AW, Mohr, DC, Montero-Marin, J, Garcia-Campayo, J, Nobis, S, Zarski, A-C, O'Moore, K, Williams, AD, Newby, JM, Perini, S, Phillips, R, Schneider, J, Pots, W, Pugh, NE, Richards, D, Rosso, IM, Rauch, SL, Sheeber, LB, Smith, J, Spek, V, Pop, VJ, Unlu, B, van Bastelaar, KMP, van Luenen, S, Garnefski, N, Kraaij, V, Vernmark, K, Warmerdam, L, van Straten, A, Zagorscak, P, Knaevelsrud, C, Heinrich, M, Miguel, C, Cipriani, A, Efthimiou, O, Karyotaki, E, Cuijpers, P, Furukawa, TA, Suganuma, A, Ostinelli, EG, Andersson, G, Beevers, CG, Shumake, J, Berger, T, Boele, FW, Buntrock, C, Carlbring, P, Choi, I, Christensen, H, Mackinnon, A, Dahne, J, Huibers, MJH, Ebert, DD, Farrer, L, Forand, NR, Strunk, DR, Ezawa, ID, Forsell, E, Kaldo, V, Geraedts, A, Gilbody, S, Littlewood, E, Brabyn, S, Hadjistavropoulos, HD, Schneider, LH, Johansson, R, Kenter, R, Kivi, M, Bjorkelund, C, Kleiboer, A, Riper, H, Klein, JP, Schroder, J, Meyer, B, Moritz, S, Bucker, L, Lintvedt, O, Johansson, P, Lundgren, J, Milgrom, J, Gemmill, AW, Mohr, DC, Montero-Marin, J, Garcia-Campayo, J, Nobis, S, Zarski, A-C, O'Moore, K, Williams, AD, Newby, JM, Perini, S, Phillips, R, Schneider, J, Pots, W, Pugh, NE, Richards, D, Rosso, IM, Rauch, SL, Sheeber, LB, Smith, J, Spek, V, Pop, VJ, Unlu, B, van Bastelaar, KMP, van Luenen, S, Garnefski, N, Kraaij, V, Vernmark, K, Warmerdam, L, van Straten, A, Zagorscak, P, Knaevelsrud, C, Heinrich, M, Miguel, C, Cipriani, A, Efthimiou, O, Karyotaki, E, and Cuijpers, P

Abstract

BACKGROUND: Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom. METHODS: We did a systematic review and individual participant data component network meta-analysis (cNMA) of iCBT trials for depression. We searched PubMed, PsycINFO, Embase, and the Cochrane Library for randomised controlled trials (RCTs) published from database inception to Jan 1, 2019, that compared any form of iCBT against another or a control condition in the acute treatment of adults (aged ≥18 years) with depression. Studies with inpatients or patients with bipolar depression were excluded. We sought individual participant data from the original authors. When these data were unavailable, we used aggregate data. Two independent researchers identified the included components. The primary outcome was depression severity, expressed as incremental mean difference (iMD) in the Patient Health Questionnaire-9 (PHQ-9) scores when a component is added to a treatment. We developed a web app that estimates relative efficacies between any two combinations of components, given baseline patient characteristics. This study is registered in PROSPERO, CRD42018104683. FINDINGS: We identified 76 RCTs, including 48 trials contributing individual participant data (11 704 participants) and 28 trials with aggregate data (6474 participants). The participants' weighted mean age was 42·0 years and 12 406 (71%) of 17 521 reported were women. There was suggestive evidence that behavioural activation might be beneficial (iMD -1·83 [95% credible interval (CrI) -2·90 to -0·80]) and that relaxation might be harmful (1·20 [95% CrI 0·17 to 2·27]). Baseline severity emerged as the strongest prognostic factor for endpoint depression. Combining human and automated encouragement reduc

Published
2021

12. Cognitive coping and goal adjustment after first-time myocardial infarction: relationships with symptoms of depression

Author

Garnefski, N., Kraaij, V., Schroevers, M.J., Aarnink, J., van der Heijden, D.J., van Es, S.M., van Herpen, M., and Somsen, G.A.

Subjects
Heart attack -- Care and treatment, Heart attack -- Psychological aspects, Heart attack -- Research, Life skills -- Research, Depression, Mental -- Research, Cognition -- Physiological aspects, Cognition -- Demographic aspects, Cognition -- Research, Health, Psychology and mental health
Published
2009

15. Stress in Parents of a Child with Hemifacial Microsomia: The Role of Child Characteristics and Parental Coping Strategies.

Author

Ongkosuwito, E.M., Vlies, L. van der, Kraaij, V., Garnefski, N., Neck, H. van, Kuijpers-Jagtman, A.M., Hovius, S., Ongkosuwito, E.M., Vlies, L. van der, Kraaij, V., Garnefski, N., Neck, H. van, Kuijpers-Jagtman, A.M., and Hovius, S.

Abstract

01 augustus 2018, Contains fulltext : 196272.pdf (publisher's version ) (Closed access), OBJECTIVE: Examine stress levels of parents of children with hemifacial microsomia (HFM) and the relationship of parental stress to child characteristics and cognitive coping strategies. DESIGN: Prospective cross-sectional study. PARTICIPANTS AND SETTING: Parents with a child (age 3-19 years) with HFM (N = 31) were recruited through the Department of Orthodontics and the Craniofacial Center, Sophia-Erasmus Medical Center, Rotterdam, The Netherlands. Intervention and Outcome Measures: The adapted and shortened Dutch version of the parental stress index (NOSI-K) was used to measure parental stress, and the cognitive emotion-regulation questionnaire was used to measure cognitive coping strategies. Pearson correlations and a multiple regression analysis were performed. RESULTS: The hierarchical multiple regression analysis showed associations between increased parental stress and learning difficulties and use of acceptance as a coping strategy. This suggests that problems other than the characteristic visual appearance of the child's face in HFM have a greater influence on parental stress. CONCLUSIONS: Learning difficulties of the child with HFM and parental acceptance affect stress in parents with a child with HFM the most and are important in the search for a targeted tailoring of intervention for parents with high levels of parental stress.

Published
2018

16. Psychosocial interventions enhance HIV medication adherence: A systematic review and meta-analysis

Author

Spaan, P. (Pascalle), van Luenen, S. (Sanne), Garnefski, N. (Nadia), Kraaij, V. (Vivian), Spaan, P. (Pascalle), van Luenen, S. (Sanne), Garnefski, N. (Nadia), and Kraaij, V. (Vivian)

Abstract

About 40 per cent of people living with HIV do not sufficiently adhere to their medication regimen, which adversely affects their health. The current meta-analysis investigated the effect of psychosocial interventions on medication adherence in people living with HIV. Databases were systematically searched, resulting in 43 included randomized controlled trials. Study and intervention characteristics were investigated as moderators. The overall effect size indicates a small to moderate positive effect (Hedges’ g = 0.37) of psychosocial interventions on medication adherence in people living with HIV. No evidence for publication bias was found. This meta-analysis study concludes that various psychosocial interventions can improve medication adherence and thereby the health of people living with HIV.

Published
2018
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18. An Internet-based self-help intervention for people with HIV and depressive symptoms: study protocol for a randomized controlled trial

Author

Luenen, S. van, Kraaij, V., Spinhoven, P., and Garnefski, N.

Subjects
Counseling, Research design, Time Factors, 020205 medical informatics, medicine.medical_treatment, Medicine (miscellaneous), HIV Infections, 02 engineering and technology, Severity of Illness Index, Coaching, Self-help, law.invention, Study Protocol, Cognition, 0302 clinical medicine, Clinical Protocols, Randomized controlled trial, law, Adaptation, Psychological, 0202 electrical engineering, electronic engineering, information engineering, Pharmacology (medical), 030212 general & internal medicine, Netherlands, Depression, Self Efficacy, Cognitive behavioral therapy, Treatment Outcome, Research Design, Clinical psychology, medicine.medical_specialty, 03 medical and health sciences, Intervention (counseling), Severity of illness, medicine, Humans, Psychiatry, Psychiatric Status Rating Scales, Self-efficacy, Motivation, Internet, business.industry, HIV, Telephone, Self Care, Therapy, Computer-Assisted, Cognitive therapy, business
Abstract

Background Many people living with HIV suffer from depressive symptoms. In a previous pilot study, self-help cognitive behavioral therapy (in booklet format) was found to be effective in treating depressive symptoms in people with HIV. We developed an online self-help program in Dutch and English (based on the booklet) for people with HIV and depressive symptoms. Besides the main question regarding the effectiveness of the program aimed at lowering depressive symptoms, sub-questions will focus on the moderators of treatment success (for which patients is the program especially beneficial?) and the mechanisms of change underlying the treatment outcome (which mediators affect the outcome of treatment?). In this paper, the protocol of the study will be described. Methods/design The effectiveness of the program will be investigated by comparing the intervention group with a waiting list-control group in a randomized controlled design, by including a pretest and three post-tests. The self-help program contains four main components: activation, relaxation, changing maladaptive cognitions, and goal attainment. Participants with mild to moderate depressive symptoms will work on the program for 6 to 10 weeks, during which a coach will provide motivational support by telephone once a week. Participants in the control condition will receive weekly minimal support from a coach for 8 weeks, and after the second post-test, they can gain access to the self-help program. Depressive symptoms and possible mediators (e.g., activation, cognitive coping, self-efficacy, and goal adjustment) will be assessed by self-report three times during the intervention/waiting period and at the pretest and first post-test. Discussion The proposed study aims to evaluate the effectiveness of an online self-help intervention for people with HIV and depressive symptoms. If the intervention is shown to be effective, the program will be implemented. Consequently, many patients with HIV could be reached, and their psychological care may be improved. Trial registration Netherlands Trial Register: NTR5407 Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1292-6) contains supplementary material, which is available to authorized users.

Published
2016

21. Zelfhulpprogramma's

Author

Kraaij, V., van Emmerik, A., Garnefski, N., Schadé, A., Boenink, A.D., Danner, S.A., and Klinische Psychologie (Psychologie, FMG)

Published
2010

27. Cognitive behaviour regulation strategies and emotional problems in early adolescents: The development of an instrument

Author

Garnefski, N., Rieffe, C.J., Jellesma, F., Meerum Terwogt, M., Kraaij, V., and Clinical Developmental Psychology

Abstract

The present study describes the development of the child version of the Cognitive Emotion Regulation Questionnaire (CERQ-k). Like the adult version of the CERQ, the CERQ-k measures nine cognitive emotion regulation strategies that children may use after having experienced negative life events. The original CERQ was considered suitable for adults and adolescents aged 12 and older. The CERQ-k was constructed for children of 9, 10 and 11 years of age. The present study describes some psychometric properties of the CERQ-k and relationships with measures of depression, fearfulness and worry among 717 primary school youngsters. Principal component analyses confirmed the allocation of most items to subscales, while Cronbach's alphas of most subscales exceeded 0.70. Cognitive emotion regulation strategies were found to be related to the reporting of symptoms of depression, fearfulness and worry, which provided some evidence for criterion-related validity. © 2006 Steinkopff Verlag.

Published
2007

35. Blended Acceptance and Commitment Therapy Versus Face-to-face Cognitive Behavioral Therapy for Older Adults With Anxiety Symptoms in Primary Care: Pragmatic Single-blind Cluster Randomized Trial

Author

Witlox, Maartje, Garnefski, Nadia, Kraaij, Vivian, de Waal, Margot W M, Smit, Filip, Bohlmeijer, Ernst, and Spinhoven, Philip

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

BackgroundAnxiety symptoms in older adults are prevalent and disabling but often go untreated. Most trials on psychological interventions for anxiety in later life have examined the effectiveness of face-to-face cognitive behavioral therapy (CBT). To bridge the current treatment gap, other treatment approaches and delivery formats should also be evaluated. ObjectiveThis study is the first to examine the effectiveness of a brief blended acceptance and commitment therapy (ACT) intervention for older adults with anxiety symptoms, compared with a face-to-face CBT intervention. MethodsAdults aged between 55-75 years (n=314) with mild to moderately severe anxiety symptoms were recruited from general practices and cluster randomized to either blended ACT or face-to-face CBT. Assessments were performed at baseline (T0), posttreatment (T1), and at 6- and 12-month follow-ups (T2 and T3, respectively). The primary outcome was anxiety symptom severity (Generalized Anxiety Disorder-7). Secondary outcomes were positive mental health, depression symptom severity, functional impairment, presence of Diagnostic and Statistical Manual of Mental Disorders V anxiety disorders, and treatment satisfaction. ResultsConditions did not differ significantly regarding changes in anxiety symptom severity during the study period (T0-T1: B=.18, P=.73; T1-T2: B=−.63, P=.26; T1-T3: B=−.33, P=.59). Large reductions in anxiety symptom severity (Cohen d≥0.96) were found in both conditions post treatment, and these were maintained at the 12-month follow-up. The rates of clinically significant changes in anxiety symptoms were also not different for the blended ACT group and CBT group (χ21=0.2, P=.68). Regarding secondary outcomes, long-term effects on positive mental health were significantly stronger in the blended ACT group (B=.27, P=.03, Cohen d=0.29), and treatment satisfaction was significantly higher for blended ACT than CBT (B=3.19, P

Published
2021
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41. Do cognitive coping and goal adjustment strategies used shortly after myocardial infarction predict depressive outcomes 1 year later?

Author

Garnefski N and Kraaji V

Abstract

RESEARCH OBJECTIVE: The aim of this study was to examine the extent to which cognitive and goal-related coping strategies used shortly after myocardial infarction predicted depressive outcomes 1 year later. SUBJECT AND METHODS: The sample consisted of 88 persons who had experienced a myocardial infarction 3 to 12 months before first data assessment. Cognitive coping and goal adjustment strategies were assessed at time 1 by the Cognitive Emotion Regulation Questionnaire and the Goal Obstruction Questionnaire, respectively. Depressive symptoms were assessed at both time 1 and time 2 by the Hospital Anxiety and Depression Scale. RESULTS AND CONCLUSIONS: The results showed that cognitive coping strategies (rumination, catastrophizing, and positive refocusing) and goal adjustment strategies predicted 39% of the variance in depressive symptoms at follow-up. In addition, little change in depressive symptom scores was observed after 1 year. The results with regard to the prospective relationships between coping and depressive symptoms provide important targets for intervention. [ABSTRACT FROM AUTHOR]

Published
2010
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42. Psychological intervention targets for people with visual impairments: the importance of cognitive coping and goal adjustment.

Author

Garnefski N, Kraaij V, De Graaf M, and Karels L

Abstract

Purpose. This study represents, to our knowledge, the first examination of the joint influence of cognitive coping strategies and goal-related coping on depressive symptoms in people with severe visual impairments with the aim of finding targets for intervention. Method. In total, data of 67 individuals with visual impairments were assembled by telephone interviews. Depressive symptomatology, cognitive coping strategies, and goal-related coping processes were measured. Relationships between these variables were statistically analyzed by Pearson correlations and multiple regression analyses. Results. It was shown that a ruminative way of responding to visual impairments was related to more depressive symptoms among the study participants. In contrast, refocusing attention by seeking and re-engaging in alternative, meaningful goals was related to less depressive symptoms. Conclusions. On the basis of the results, it was concluded that both cognitive and goal-related coping could be important targets for intervention. Main components of treatment should include a combination of (1) teaching patients to decrease a ruminative way of thinking in response to their disabilities and (2) actively assisting patients in the search for and the reengagement in new personal goals, when existing goals are obstructed by their impairments. [ABSTRACT FROM AUTHOR]

Published
2010
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43. How do cancer patients manage unattainable personal goals and regulate their emotions?

Author

Schroevers M, Kraaij V, and Garnefski N

Abstract

OBJECTIVES: This article addressed the role of goal adjustment (i.e. disengagement from unattainable goals and reengagement in alternative goals) and cognitive emotion-regulation strategies (i.e. rumination, catastrophizing, positive refocusing) in cancer patients' psychological well-being. We expected that patients who are better able to disengage from unattainable goals, identify alternative goals, and regulate their emotions by positive refocusing and not engaging in rumination and catastrophizing would experience less negative and more positive affect. DESIGN: In this cross-sectional study, data were collected using a self-report questionnaire. METHODS: Cancer patients (N=108) were recruited on a psychoeducational meeting aimed to inform them about the illness and its consequences. To examine the relationships between goal adjustment, cognitive emotion-regulation strategies, and affect, Pearson correlations were calculated and regression analyses were performed. RESULTS: Regression analyses showed that reengaging in meaningful goals and focusing on pleasant issues were significantly associated with more positive affect. Focusing on pleasant issues was also significantly associated with less negative affect, whereas rumination and catastrophizing were significantly associated with more negative affect. CONCLUSIONS: Goal reengagement as well as cognitive emotion-regulation strategies seems to play an important role in cancer patients' psychological well-being. Health care professionals may assist patients in paying more attention to positive experiences in their daily life and in finding new meaningful goals. Techniques based on mindfulness may be used to assist cancer patients in decreasing the repetitive negative thinking about causes, meanings, and consequences of the illness and helping them to focus attention on the present moment. [ABSTRACT FROM AUTHOR]

Published
2008
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44. Cognitive coping, goal self-efficacy and personal growth in HIV-infected men who have sex with men.

Author

Kraaij V, Garnefski N, Schroevers MJ, van der Veek SM, Witlox R, and Maes S

Abstract

OBJECTIVE: The relationships between cognitive coping strategies, goal self-efficacy and personal growth were studied in HIV-positive men who have sex with men. METHODS: All members of a national organization for people living with HIV received a call for participation. The Cognitive Emotion Regulation Questionnaire, the Goal Obstruction Questionnaire and the Personal Growth Scale were filled out at home by 104 HIV-infected men. RESULTS: Thinking about joyful and pleasant issues instead of thinking about being HIV-positive, thinking about what steps to take and how to handle being HIV-positive, thoughts of attaching a positive meaning to being HIV-positive, thoughts of playing down the seriousness of being HIV-positive or emphasizing its relativity when compared to other events, thoughts of putting the blame of being HIV-positive on others (inversely) and the extent to which one considers oneself able to reengage in alternative meaningful goals were related to personal growth. CONCLUSION: The study showed that both cognitive coping strategies and goal self-efficacy were related to personal growth. The findings suggest that mainly positive ways to handle being HIV-infected are related to personal growth. PRACTICE IMPLICATIONS: These findings suggested that intervention programs for people with HIV should pay attention to cognitive coping strategies and goal self-efficacy. [ABSTRACT FROM AUTHOR]

Published
2008
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45. Cognitive emotion regulation strategies and emotional problems in 9-11-year-old children: the development of an instrument.

Author

Garnefski N, Rieffe C, Jellesma F, Terwogt MM, and Kraaij V

Abstract

The present study describes the development of the child version of the Cognitive Emotion Regulation Questionnaire (CERQ-k). Like the adult version of the CERQ, the CERQ-k measures nine cognitive emotion regulation strategies that children may use after having experienced negative life events. The original CERQ was considered suitable for adults and adolescents aged 12 and older. The CERQ-k was constructed for children of 9, 10 and 11 years of age. The present study describes some psychometric properties of the CERQ-k and relationships with measures of depression, fearfulness and worry among 717 primary school youngsters. Principal component analyses confirmed the allocation of most items to subscales, while Cronbach's alphas of most subscales exceeded 0.70. Cognitive emotion regulation strategies were found to be related to the reporting of symptoms of depression, fearfulness and worry, which provided some evidence for criterion-related validity. [ABSTRACT FROM AUTHOR]

Published
2007
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47. Addiction-risk and aggressive/criminal behaviour in adolescence: influence of family, school and peers.

Author

Garnefski, Okma, Garnefski, N, and Okma, S

Abstract

In this study, data from 2814 15- and 16-year-old secondary school students were analysed to investigate the collective influence of family, school and peers on behavioural problems in adolescence. Adolescents with addiction-risk and/or aggressive/criminal behaviour were compared to those who did not display such behaviour. Adolescents with behavioural problems were characterized by having a more negative perception of the environment with regard to most of the variables related with family, school and peers. Clearly behavioural problems are associated with problems in multiple environments. Some differences were found between boys and girls: multiple regression analyses showed that for boys, problems at school were the most important predictor of behavioural problem scores, while for girls, this applied to problems at home. [ABSTRACT FROM AUTHOR]

Published
1996
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49. Effects of a cognitive behavioral self-help program and a computerized structured writing intervention on depressed mood for HIV-infected people: a pilot randomized controlled trial.

Author

Kraaij V, van Emmerik A, Garnefski N, Schroevers MJ, Lo-Fo-Wong D, van Empelen P, Dusseldorp E, Witlox R, and Maes S

Abstract

OBJECTIVE: The aim of the present study was to examine whether low-resource, cost-effective intervention programs can be effective in improving depressed mood in people with HIV. The efficacy of a cognitive-behavioral self-help program (CBS) and a computerized structured writing intervention (SWI) were tested in a pilot randomized controlled trial. METHODS: Participants were members of a patient organization. They completed a pretest and posttest. The questionnaire included the HADS. Participants were randomly allocated to CBS (n=24), SWI (n=25) or a waiting list condition (WLC, n=24). To evaluate changes in the continuous outcome measure, a 3 x 2 (group x time) repeated measures ANCOVA was performed. Also, an ANCOVA was performed using change scores. RESULTS: Respondents who followed the CBS improved significantly compared to the WLC. However, for people in the SWI condition no significant improvement on depression was found. CONCLUSION: This pilot study suggests that a low-resource, cost-effective CBS program seems to be effective in reducing depressed mood in people living with HIV. PRACTICE IMPLICATIONS: Because self-help programs can be delivered through regular mail or the internet, a high number of people could be reached while overcoming geographical and social barriers to treatment. [ABSTRACT FROM AUTHOR]

Published
2010
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50. Living positive: eHealth for people with HIV and depressive symptoms

Author

Luenen, S. van, Spinhoven, P., Kraaij, V., Garnefski, N., Does, A.J.W. van der, Evers, A.W.M., Rooij, M.J. de, Riper, H., Wit, J.B.F. de, and Leiden University

Subjects
Depression, Moderator, Mediator, HIV, eHealth, Cost-effectiveness, Cognitive behavioural therapy, Coaching, Self-help, Online intervention
Abstract

This dissertation contains the results of an RCT into the effectiveness of an online self-help intervention for people living with HIV (PLWH) and depressive symptoms. Many PLWH suffer from depressive symptoms. Online interventions to treat depression may have benefits, such as less perceived stigma, a large reach and high accessibility. The online self-help intervention that we investigated is based on cognitive behavioral therapy and contains 4 components: stimulating activities, relaxation exercises, changing negative thoughts and goal attainment. Two meta-analyses were conducted and the results point to the effectiveness of psychosocial interventions for PLWH to improve depressive symptoms, anxiety symptoms, quality of life, psychological well-being, and medication adherence. The most important result of the RCT was that the intervention together with telephone coaching is effective in reducing depressive symptoms, compared to an attention-only control group. It was also found that the intervention may be effective for all PLWH, regardless of certain baseline characteristics. Furthermore, behavioral activation and goal reengagement were found to be mediators of the intervention effect. Also, the intervention is likely to be cost-effective compared to attention only. As eHealth interventions have benefits compared to face-to-face interventions, they should be more widely implemented in the mental healthcare for PLWH.

Published
2019

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