Search

This maniscript is submitted for publicationAbstractBackgroundIncreasingly more children return from ISIS’ Caliphate. They are considered potentially dangerous by their home countries, which might pose a challenge to their (re)integration. Based on experiences of Dutch children, now elderly, whose parents were members of the SS or NSB (a political party that collaborated with Nazi Germany) during WWII, this study explores and describes pitfalls and recommendations for the development and (re)integration of minor returnees from the Caliphate. Research questionsThe research questions were focussed on 1) participants’ experiences as children and as adults as a result of their background, 2) the effects of their experiences on their psychological well-being as children and as adults, 3) their coping responses, both during childhood and into adulthood, and (4) their recommendations on how to meet the needs of minor returnees. MethodsSemi-structured interviews were conducted with 17 Dutch adults, whose parents were members of the SS or NSB during WW II. The interview questions were based on re-occurring themes from literature, a codebook was generated and the verbatim transcribed interviews were scored using Atlas.ti 8. The results were analyzed and commonly reported codes were described, enriched with quotes from participants, and discussed. Results Participants reported social exclusion, being separated from their parents, and family secrecy as common experiences, with severe implications for their identity development, self-esteem, and family relationships. Their coping responses were active (e.g., searching information), avoiding (e.g., socially desirable behaviour) and using comforting thoughts. Participants’ main recommendations for minor returnees included: transparency within families about the past, an inclusive approach and respect for minor returnees’ loyalty to their parents. DiscussionIt is concluded that the experiences of the participants in this study may contribute to a better understanding of the developmental needs of minor returnees, which can help for successful (re)integration and for relevant policy making.

High levels of stress at work may have serious consequences for employee functioning and mental health. By providing employees with an easily accessible instrument to regularly evaluate stressors and resources, employee self-monitoring and guidance to support can be accommodated. We evaluated an online self-monitoring tool Brief Assessment of Stress and Energy (BASE). Through their organization, 139 railway emergency services employees were invited to complete BASE and six wellbeing measures. We assessed BASE in two ways: using multiple regression analysis (N = 102, 73.4%), as well as by telephone follow-up interviews during which experts and respondents evaluated the BASE outcome (N = 67, 65.7%). Explained variances of BASE on the six wellbeing measures ranged between 26.6% and 49.9%. Telephone interviews confirmed the BASE outcome. The results indicate that BASE is associated with several measures of wellbeing and accurately refers respondents to counseling. This study shows that BASE is a promising instrument to encourage employees to self-monitor stressors and resources and identify those who need counseling.

High quality mental health and psychosocial support (MHPSS) guidelines are indispensable for policy and practice to address the mental health consequences of disasters. This contribution complements a review that assessed the methodological quality of 13 MHPSS guidelines. We analyzed the content of the four highest-ranking guidelines and explored implications for disaster risk reduction (DRR). A qualitative explorative thematic analysis was conducted. The four guidelines proved largely similar, overlapping or at least complementary in their MHPSS definitions, stated purpose of the guidelines, user and target groups, terminology, and models used. Many recommended MHPSS measures and interventions were found in all of the guidelines and could be assigned to five categories: basic relief, information provision, emotional and social support, practical support, and health care. The guidelines stress the importance of monitoring needs and problems, evaluating the effect of service delivery, deliberate implementation and preparation, and investments in proper conditions and effective coordination across professions, agencies, and sectors. The MHPSS knowledge base embedded in the guidelines is comprehensive, coherent, and sufficiently universal to serve as the “overarching framework” considered missing yet vital for the integration of MHPSS approaches in DRR. Although application contexts differ geographically, this common ground should allow policymakers and practitioners globally to plan, implement, and evaluate MHPSS actions contributing to DRR, ideally together with target groups.

In 2007, the Inter-Agency Standing Committee (IASC) published its guidelines for mental health and psychosocial support (MHPSS) in emergency situations. This was one of the first sets of MHPSS guidelines, developed during the last decades, to aid policymakers and practitioners in the planning and implementation of disaster mental health risk reduction activities. However, the potential merit of MHPSS guidelines for this purpose is poorly understood. The objective of this study is to review available MHPSS guidelines in disaster settings and assess their methodological quality. MHPSS guidelines, frameworks, manuals and toolkits were selected via a systematic literature review as well as a search in the grey literature. A total of 13 MHPSS guidelines were assessed independently by 3–5 raters using the Appraisal of Guidelines for Research and Evaluation–Health Systems (AGREE-HS) instrument. Guideline quality scores varied substantially, ranging between 21.3 and 67.6 (range 0–100, M = 45.4), with four guidelines scoring above midpoint (50). Overall, guidelines scored highest (on a 1–7 scale) on topic (M = 5.3) and recommendations (M = 4.2), while implementability (M = 2.7) is arguably the area where most of the progress is to be made. Ideally, knowledge derived from scientific research aligns with the receptive contexts of policy and practice where risks are identified and mitigated.

UNSTRUCTURED Most people who experience a potentially traumatic event (PTE) recover on their own. A small group of individuals develops psychological complaints, but this is often not detected in time or guidance to care is suboptimal. To identify these individuals and encourage them to seek help, a web-based self-help test called Mobile Insight in Risk, Resilience, and Online Referral (MIRROR) was developed. MIRROR takes an innovative approach since it integrates both negative and positive outcomes of PTEs and time since the event and provides direct feedback to the user. The goal of this study was to assess MIRROR’s use, examine its psychometric properties (factor structure, internal consistency, and convergent and divergent validity), and evaluate how well it classifies respondents into different outcome categories compared with reference measures. MIRROR was embedded in the website of Victim Support Netherlands so visitors could use it. We compared MIRROR’s outcomes to reference measures of PTSD symptoms (PTSD Checklist for DSM-5), depression, anxiety, stress (Depression Anxiety Stress Scale–21), psychological resilience (Resilience Evaluation Scale), and positive mental health (Mental Health Continuum Short Form). In 6 months, 1112 respondents completed MIRROR, of whom 663 also completed the reference measures. Results showed good internal consistency (interitem correlations range .24 to .55, corrected item-total correlations range .30 to .54, and Cronbach alpha coefficient range .62 to .68), and convergent and divergent validity (Pearson correlations range –.259 to .665). Exploratory and confirmatory factor analyses (EFA+CFA) yielded a 2-factor model with good model fit (CFA model fit indices: χ219=107.8, P

Introduction:The Western Pacific Region, comprised of 37 diverse countries and areas, is one of the world’s areas most prone to be affected by disaster. Seven of the top ten countries most at risk of a natural disaster are in this region. The Regional Agenda for Implementing the Mental Health Action Plan 2013-2020 in the Western Pacific identifies mental health in disasters and emergencies as a priority area and calls for a social movement for action on mental health and well-being. To increase understanding of and need for mental health and psychosocial support in emergency situations, regional guidelines are necessary. It is unclear to what degree international guidelines are applicable in this region.Aim:To synthesize the contents of available evidence-based guidelines and assess their potential to address the mental health and psychosocial needs of people in emergency settings in the Western Pacific Region.Methods:A systematic literature review of existing guidelines for mental health and psychosocial support in disasters and emergencies was conducted. Using the Appraisal of Guidelines for Research and Evaluation II instrument, the quality of each guideline was determined covering the following: (1.) scope and purpose, (2.) stakeholder involvement, (3.) rigor of development, (4.) clarity of presentation, (5.) applicability, and (6.) editorial independence.Results:The results provide an overview of the quality, number, and specificity of available guidelines. A framework was developed to categorize these guidelines on each stage of the disaster management cycle (prevention, preparedness, response, and recovery) while considering their guidance regarding coordination, monitoring, communication, human resources, and connection with regular health services.Discussion:The framework and its implications for further research and development are presented at the conference. We will specifically focus on the question, “What is needed to move from a reactive to a more proactive stance in policy and practice?”

Although most victims of disasters, terrorism, or other shocking events recover on their own, a sizable amount of these victims develops long-term disaster-related problems. These victims should receive timely and appro- priate psychosocial help. This article describes the development of guidelines on psychosocial interventions during the first 6 weeks after a major incident. Scientific literature, expert opinions, and consensus among relevant parties in the clinical field were used to formulate the recommendations. Early screening, a supportive context, early preventive and curative psychosocial interventions, and the organization of interventions are covered. The implications for the clinical field and future research are discussed. It is concluded that the international knowledge base provides valuable input for the development of national guidelines. However, the successful implementation of such guidelines can take place only if they are legitimated and accepted by local key actors and operational target groups. Their involvement during the development process is vital.

A recent development within burnout research is the shift to its conceptual opposite: work engagement. This study aimed to unravel the concepts of burnout and work engagement, and to determine their levels among dentists. A representative sample of 497 Dutch general dental practitioners was included (survey response rate of 59%), consisting of 372 men and 121 women (the gender of 4 dentists remained unknown). The hypothesized three-factor structure of work engagement (vigor, dedication, and absorption), as measured by the Utrecht Work Engagement Scale (UWES), was substantiated among dentists. It was also found that work engagement was related negatively to burnout, as measured by the Maslach Burnout Inventory (MBI). However, a model consisting of a reduced ('core') burnout factor and an 'enhanced' engagement factor (composed of the three original factors plus the burnout factor, personal accomplishment) showed the best fit. Overall burnout levels among dentists are low, and the levels of engagement indicate that dentists have a positive working attitude.

Objectives: The Stress Thermometer is an easily accessible Internet-based instrument for feedback on work stress and burnout. The aim of this paper is to describe the development of this instrument and to determine its applicability within the dental practice. Methods: The Stress Thermometer was made accessible to all members of the Dutch Dental Association, of which 77% of all Dutch dentists are members. Frequency of use was determined, and descriptive data was collected. Results: During an evaluation period of 5 months at least 12% of all possible respondents made use of the Stress Thermometer. Descriptive characteristics of the response group, as well as levels of burnout and work stress, corresponded with those found in the Dutch dentist population. However, some deviations were also present. Conclusions: Results indicate the applicability of the Stress Thermometer to a representative variety of dentists. Although the deviations found should not be ignored in future use, the Stress Thermometer was successful in reaching a population that is difficult to reach. It effectively calls attention to sensitive personal issues concerning work-related stress and burnout.

– Objectives: Differences between the sexes in the manifestation of burnout have been reported for different occupational groups. Although some gender-specific explanations for this finding have been forwarded, there is a paucity of studies in which the relation with other work-related gender differences is examined. The objective of this study was to analyze gender differences in burnout among dentists and to identify possible concomitant factors. Methods: Male (n = 411) and female (n = 81) Dutch dentists filled out the Dutch version of the Maslach Burnout Inventory (MBI) together with several health and work-related questionnaires. Results: Results showed male dentists to report a higher score on the depersonalization dimension of the MBI than did female dentists. No gender differences were found on the other dimensions (i.e. emotional exhaustion and personal accomplishment). Moreover, no gender-related differences in experienced work-stress or health-related aspects were found. It was found, however, that male dentists put in working hours and see more patients per week when compared to female dentists. Also, a difference in mean age was found. Our main finding was that the difference in depersonalization disappears when controlling for working hours and age. Conclusions: Gender differences in burnout among dentists do exist. However, our results indicate that underlying factors, such as working hours, have a profound effect on these differences. These results can have direct practical consequences, for instance, in distinguishing between groups concerning the way burnout scores should be interpreted.

Study/Objective To determine whether the chronic threat of exposure to mining-induced earthquakes in the northern part of the Netherlands, is accompanied by a higher prevalence of medically Unexplained Physical Symptoms (MUPS) and psychosocial problems. Background The Groningen natural gas field is among the largest in the world and uniquely located in a populated area. Decades of mining activities burdened the region with increased earthquake hazards, several times higher than 3.0 on the Richter scale (one 3.6, in 2012). Inhabitants were confronted with ground shaking, damaged houses, loss of livelihood, social unrest, and public anger towards the mining company and authorities. In 2013 future earthquakes with a magnitude over 5.0 were considered likely, contributing to lack of positive prospects and chronic stress: factors that are not beneficial from a public health perspective. Methods Data covering a five-year period (2011-2015), was extracted from electronic patient records of general practitioners. Two dependent variables were constructed: MUPS (physical symptoms clustered per organ system) and psychological and social problems (mood and anxiety disorders, suicide and problems in personal relations or work). Statistical analysis was conducted in steps to test differences in prevalence in health issues in the earthquake region and a comparison group; and to determine the predictive value of gender, age, socioeconomic status, and earthquake magnitude and depth, considering the cross-classified data structure with patients nested in general practices and postal codes. Results The results indicate whether the prevalence of MUPS and psychosocial problems was significantly higher in the earthquake region regardless of gender and age, after controlling for socio-economic status and earthquake magnitude and depth. Conclusion The health impact of chronic stress linked to earthquake-threat could be determined apart from other relevant explanatory factors.

The aim of the present study was to determine the long-term effects of a burnout-intervention program among Dutch dentists using a longitudinal design. Using the Maslach Burnout Inventory (Dutch version: MBI-NL), at the initial measurement in 1997 a 'burnout risk group' (n = 171) was identified. This group received feedback on their scores and was invited to participate in an intervention program. Of the total group. 19 dentists participated in an intervention program. After the end of the intervention program, 92 dentists (the 19 participants and a control group) responded to a post-intervention survey in 1998. These dentists were approached once more 1 yr later, and this time 78 dentists (84.8%) returned a questionnaire. While demonstrating an improvement on all subscales of the MBI-NL at the first post-test, results show that the program participants showed a relapse at the second post-test. Controls who took action on their own initiative, on the other hand, reported a beneficial effect in the long run. Finally, controls that did not take any preventive action showed little or no progress. Possible causes for these findings are discussed, including the influence of coping style. perceived control, confounding factors, demand characteristics, and the necessity of post-intervention follow-up.

Background: Internationally, several initiatives exist to describe standards for post-disaster psychosocial care. Objective: This study explored the level of consensus of experts within Europe on a set of recommendations on early psychosocial intervention after shocking events (Dutch guidelines), and to what degree these standards are implemented into mental health care practice. Methods: Two hundred and six (mental) health care professionals filled out a questionnaire to assess the extent to which they consider the guidelines’ scope and recommendations relevant and part of the regular practice in their own country. Forty-five European experts from 24 EU countries discussed the guidelines at an international seminar. Results: The data suggest overall agreement on the standards although many of the recommendations appear not (yet) to be embedded in everyday practice. Conclusions: Although large consensus exists on standards for early psychosocial care, a chasm between norms and practice appears to exist throughout the EU, stressing the general need for investments in guideline development and implementation. Keywords: Early psychosocial interventions; disaster; shocking events; psychological assessment; cross-cultural comparison (Published: 5 February 2013) Citation: European Journal of Psychotraumatology 2013, 4 : 19093 - http://dx.doi.org/10.3402/ejpt.v4i0.19093

Although most victims of disasters, terrorism, or other shocking events recover on their own, a sizable amount of these victims develops long-term disaster-related problems. These victims should receive timely and appropriate psychosocial help. This article describes the development of guidelines on psychosocial interventions during the first 6 weeks after a major incident. Scientific literature, expert opinions, and consensus among relevant parties in the clinical field were used to formulate the recommendations. Early screening, a supportive context, early preventive and curative psychosocial interventions, and the organization of interventions are covered. The implications for the clinical field and future research are discussed. It is concluded that the international knowledge base provides valuable input for the development of national guidelines. However, the successful implementation of such guidelines can take place only if they are legitimated and accepted by local key actors and operational target groups. Their involvement during the development process is vital.

Knowledge on the development of burnout among dentists is important for purposes of prevention and intervention. Using a two-wave longitudinal design, this study examined the chronological sequence of the three dimensions of the Maslach Burnout Inventory: emotional exhaustion; depersonalization; and personal accomplishment. Structural Equation Modelling was employed among a representative sample of Dutch dentists to examine the fit of several models proposed in earlier research. The results indicated that a model in which emotional exhaustion precedes depersonalization, which in turn precedes personal accomplishment, shows an adequate fit among dentists. However, an alternative model, in which personal accomplishment precedes emotional exhaustion, had an even better fit. In addition to the test of these a priori models, an ad hoc model was constructed that best fitted the current data. This model indicated emotional exhaustion to precede the development of depersonalization and personal accomplishment independently. Although not univocal, the results showed that emotional exhaustion should not be discarded as an early sign of burnout. This is in line with the view that emotional exhaustion can be considered as the key dimension of burnout.

Differences between the sexes in the manifestation of burnout have been reported for different occupational groups. Although some gender-specific explanations for this finding have been forwarded, there is a paucity of studies in which the relation with other work-related gender differences is examined. The objective of this study was to analyze gender differences in burnout among dentists and to identify possible concomitant factors.Male (n = 411) and female (n = 81) Dutch dentists filled out the Dutch version of the Maslach Burnout Inventory (MBI) together with several health and work-related questionnaires.Results showed male dentists to report a higher score on the depersonalization dimension of the MBI than did female dentists. No gender differences were found on the other dimensions (i.e. emotional exhaustion and personal accomplishment). Moreover, no gender-related differences in experienced work-stress or health-related aspects were found. It was found, however, that male dentists put in working hours and see more patients per week when compared to female dentists. Also, a difference in mean age was found. Our main finding was that the difference in depersonalization disappears when controlling for working hours and age.Gender differences in burnout among dentists do exist. However, our results indicate that underlying factors, such as working hours, have a profound effect on these differences. These results can have direct practical consequences, for instance, in distinguishing between groups concerning the way burnout scores should be interpreted.

Subjects, 292 Dutch psychology students answering negatively phrased Personal Accomplishment items, reported a more personally competent feeling than subjects answering positively phrased personal accomplishment items. The way of phrasing personal accomplishment items significantly affects the answers given.

Het restlesslegssyndroom (RLS) is een van de kleine kwalen in de huisarts­ge­nees­kunde. De prevalentie varieert in bevolkingsonderzoek tussen de 3 en 15%. Andere bevin­din­gen zijn dat RLS in een kwart van de gevallen gepaard gaat met ijzergebreksanemie en dat RLS en slaapstoornissen vaak samengaan. Deze gegevens zijn gebaseerd op epidemiologisch en klinisch onderzoek. Maar wat vinden we hiervan terug in de dagelijkse praktijk?

Het idee dat psychische klachten samenhangen met de seizoenen is wijd verbreid. In de herfst, als de blaadjes vallen, spelen bij veel mensen latente depressieve gevoelens meer en sterker op dan in andere seizoenen. Dat is tenminste het volksgeloof. In de literatuur zijn de meningen hierover verdeeld.