85 results on '"Mulkens S"'
Search Results
2. Body Dysmorphic Disorder
- Author
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Mulkens, S., Franken, I., Muris, P., Denys, D., Clinical Psychological Science, RS: FPN CPS III, and RS: FPN CPS II
- Published
- 2013
3. Sociale angststoornis
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Voncken, M.J., Mulkens, S., Dijk, C., Franken, I., Muris, P., Denys, D., Klinische Psychologie (Psychologie, FMG), Clinical Psychological Science, and RS: FPN CPS III
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- 2012
4. Psychometrie van body dysmorphic disorder
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Van Rood, Y.R., Mulkens, S, Bouman, T.K., Denys, D.A.J.P., Vulink, N.C.C., Clinical Psychological Science, RS: FPN CPS II, and Experimental Psychotherapy & Psychopathology
- Published
- 2011
5. Diagnostiek van body dysmorphic disorder
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Mulkens, S., Denys, D.A.J.P., Vulink, N.C.C., RS: FPN CPS II, and Section Eating Disorders and Obesity
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- 2011
6. Protocollaire behandeling van patiënten met een sociale-angststoornis: Taakconcentratietraining en cognitieve therapie
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Mulkens, S., Bögels, S., Keijsers, G.P.J., Minnen, A.V., Hoogduin, C.A.L., Clinical Psychological Science, and RS: FPN CPS II
- Published
- 2011
7. Cognitieve therapie bij eetstoornissen en obesitas
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Jansen, A.T.M., Mulkens, S., Bögels, S.M., Oppen, P.v., Clinical Psychological Science, and RS: FPN CPS II
- Abstract
In de dsm-iv (apa, 2000) worden drie verschillende eetstoornissen beschreven: bulimia nervosa, anorexia nervosa en eetstoornissen niet anderszins omschreven (eetstoornissen nao, waaronder ook de eetbuistoornis valt). Obesitas is geen eetstoornis volgens de dsm-iv en ook in de dsm-v – die in 2013 wordt verwacht – zal obesitas niet als eetstoornis opgenomen worden. Desondanks beschouwen wij obesitas als een gedragsprobleem dat in de ggz behandeld zou moeten worden (jansen e.a., 2009). Wie blijvend gewicht wil verliezen en daar weinig succes mee boekt, heeft veel baat bij de cognitieve technieken die in dit hoofdstuk beschreven worden. De hier beschreven cognitieve technieken kunnen dus bij elk eet- of gewichtsprobleem worden toegepast.
- Published
- 2011
8. From the Garden of Eden to the land of plenty Restriction of fruit and sweets intake leads to increased fruit and sweets consumption in children
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Jansen, E.L.G.M., Mulkens, S., Emond, Y., Jansen, A.T.M., RS: FPN CPS II, Clinical Psychological Science, and Health promotion
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digestive, oral, and skin physiology ,food and beverages ,humanities - Abstract
overweight is increasing rapidly in children, compelling researchers to seek for determinants of adverse food intake. In a previous experiment it was found that manipulating the restriction of attractive snacks increased the desirability and intake of these snacks. in the present study, we tested whether this paradoxical restricting effect is also seen in relatively less attractive but healthy food, i.e. fruit. Will fruit become More desirable through restriction, and will children eat more forbidden fruit than non-forbidden fruit? Two groups of young children were forbidden to eat fruits and sweets, respectively, whereas a control group was invited to eat everything. Desire for sweets remained high in the sweets-prohibition condition, whereas it decreased in the fruit-prohibition and no-prohibition conditions. No group differences were found regarding the desire for fruit, With respect to intake, children in both the fruit- and the sweets-prohibition condition consumed more of the formerly forbidden food during a taste session as compared to the no-prohibition condition. In addition, total food intake was higher in the two prohibition conditions than in the no-prohibition condition. These data indicate that the adverse effects of restriction apply to both attractive unhealthy and relatively less attractive but healthy food.
- Published
- 2008
9. Blij met je lijf? De invloed van sociale en temporele vergelijkingen op de lichaamswaardering en zelfwaardering van vrouwelijke cosmetische chirurgiepatienten
- Author
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Bos, A.E.R., Uleman, R., Mulkens, S., Muris, P., Mayer, B., Steenhuis, I.H.M., Velthuis, P., and Prevention and Public Health
- Published
- 2008
10. Protocollaire behandeling van boulimia nervosa en verwante eetstoornissen
- Author
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Jansen, A., Elgersma, H., Mulkens, S, Braet, C., Bögels, S., and Experimental Psychotherapy & Psychopathology
- Published
- 2008
11. Boulimia nervosa en verwante eetstoornissen
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Jansen, A.T.M., Elgersma, H., Mulkens, S., Braet, C., Bögels, S., Clinical Psychological Science, and RS: FPN CPS II
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- 2008
12. Changing self-esteem in children and adolescents: A roadmap for future interventions
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Bos, AER (Arjan), Muris, PEHM, Mulkens, S, Schaalma, H, and Department of Psychology, Education and Child Studies
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- 2006
13. Mooi, maar ontevreden, over psychische stoornissen en cosmetische chirurgie
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Mulkens, S., Kerzel, C., Merckelbach, H.L.G.J., Jansen, A.T.M., Clinical Psychological Science, RS: FPN CPS II, and RS: FPN CPS IV
- Published
- 2006
14. Psychopathology symptoms in a sample of female cosmetic surgery patients
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Mulkens, S. and Mulkens, S.
- Abstract
Objective: During the past decades, cosmetic surgery has become increasingly popular. People with certain psychopathology disorders, for example, body dysmorphic disorder (BDD), are dissatisfied with their physical appearance, and a significant number try to receive cosmetic medical treatment for their complaints. It seems relatively easy for them to receive this type of surgery, despite the fact that it has no or even adverse effects on the symptoms. The present study aimed to investigate the psychological condition and especially the presence of psychopathological symptoms such as BDD in cosmetic surgery patients. Methods: Questionnaires about body image dissatisfaction, symptoms of BDD and psychopathology in general and satisfaction about surgery were sent to patients who had been treated in a large cosmetic surgery clinic. Results: Of the patients who replied, 86% were pleased with the outcome of the cosmetic procedure. Further, 21-59% of these former patients scored higher on questionnaires of body image dissatisfaction and psychopathological symptoms than a norm group from the general population. When differentiating the group on the basis of BDD symptomatology, it appeared that the high BDD symptomatic group displayed significantly worse outcome on all measurements. That is, high BDD symptomatic patients were more dissatisfied about the result of surgery, exhibited higher levels of psychopathology, and had lower self-esteem than the low symptomatic BDD patients. Conclusion: These findings clearly suggest that the evaluation of the psychological condition and motivation of the candidate patient might be a valuable addition to the standard procedure in cosmetic medical treatment settings.
- Published
- 2012
15. Mirror gazing increases attractiveness in satisfied, but not in dissatisfied women; a model for body dysmorphic disorder?
- Author
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Mulkens, S. and Mulkens, S.
- Abstract
Body dysmorphic disorder is a severe disturbance in which the person is preoccupied with an imagined defect in appearance. It is unclear what causes and what maintains BDD, although it is assumed that patients are characterized by an increased self-focused attention. Since patients spend a lot of time examining their 'defect' in reflecting surfaces, it might well be that mirror gazing itself is an important maintaining factor for BDD, as it may lead to a loss of sense of proportions. If so, normal individuals' body evaluations are expected to decrease likewise after mirror exposure. In the present study, 50 female students watched both their own face in the mirror and a photograph of a neutral female face for 3.5 min. Before and after gazing, they rated the attractiveness of the faces. Results indicate that mirror exposure did not lead to decreased attractiveness in normal participants. However, when participants were divided into high and low satisfaction about appearance, highly satisfied individuals' evaluations of their own face improved, whereas low satisfied individuals' evaluations tended to decrease. For the other face, only the low satisfied individuals showed increased attractiveness scores at post-test. The results are explained by selective visual attention and are in line with recent findings in eating disordered women.
- Published
- 2009
16. Tackling childhood overweight. Treating parents exclusively is effective
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JANSEN, E., primary, MULKENS, S., additional, and JANSEN, A., additional
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- 2012
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17. Changing appearances: cosmetic surgery and body dysmorphic disorder
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Mulkens, S. and Mulkens, S.
- Abstract
Cosmetic surgery has become increasingly popular in the past 15 years, and even seems to be common practice. The overall picture communicates that people profit from these interventions. Generally, people wish to alter their appearance when they are dissatisfied about their body image and when appearance determines their self-esteem to a great extent. Body image disturbances, such as body dysmorphic disorder (bdd), are situated within the extreme dissatisfaction range. Bdd is a serious disorder which is characterised by a preoccupation with an imaginary defect in appearance or an excessive concern about a slight physical abnormality. Patients can be effectively treated with cognitive behavioural therapy or a serotonin reuptake inhibitor, but most of them are convinced that cosmetic surgery is the only answer. Surgery outcome is often disappointing, however. This article aims to summarise the literature about cosmetic surgery and bdd and argues that cosmetic surgery patients should be screened psychologically to detect whether they have bdd. Results of a pilot study are presented to underpin this claim. (netherlands journal of psychology, 62, 34-41.).
- Published
- 2006
18. Red, hot and scared? : inquiries into fear of blushing
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Mulkens, S., primary
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19. Fear of blushing: effects of task concentration training versus exposure in vivo on fear and physiology.
- Author
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Mulkens, S. and Mulkens, S.
- Abstract
Patients with fear of blushing as the predominant complaint (N = 31) were randomly assigned to (1) exposure in vivo (EXP), or (2) task concentration training (TCT), in order to test the effect of redirecting attention above exposure only. In addition, it was investigated whether treatment reduced actual blush behavior; therefore, physiological parameters of blushing were measured during two behavioral tests. Half of the patients served as waiting-list controls first. Assessments were held before and after treatment, at 6-weeks, and at 1-year follow-up. Both treatments appeared to be effective in reducing fear of blushing and realizing cognitive change, Yet, at posttest, TCT tended to produce better results with respect to fear of blushing. At 6-weeks follow-up, TCT produced significantly more cognitive change. At 1-year follow-up, patients further improved, while differential effects had disappeared, The reduction in fear of blushing was not paralleled by a reduction in actual blush behavior during the behavioral assessments. Thus, it seems that fear of blushing reflects a fearful preoccupation, irrespective of actual facial coloration.
- Published
- 2001
20. Realfit really works for obese adolescents: Post-test and 1-year follow-up of a multidisciplinary (CBT) group treatment for obese adolescents
- Author
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Mulkens, S., primary, Emond, Y., additional, and Nederkoorn, C., additional
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- 2008
- Full Text
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21. Do not eat the red food! Prohibition of snacks leads to their relatively higher consumption in children
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Jansen, E., primary, Mulkens, S., additional, and Jansen, A., additional
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- 2008
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22. Red, hot and scared? : inquiries into fear of blushing
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Mulkens, S. and Mulkens, S.
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- 2000
23. On being led into temptation: Counterregulation of food intake in unrestrained overweight children
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Jansen, A., primary, Theunissen, N., additional, Slechten, K., additional, Nederkoorn, C., additional, Mulkens, S., additional, and Boon, B., additional
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- 2002
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24. Vulnerability to interpretation bias in overweight children.
- Author
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Jansen A, Smeets T, Boon B, Nederkoorn C, Roefs A, and Mulkens S
- Abstract
Obese children are often liable to weight-related teasing, and in earlier studies this childhood teasing has been found to predict body dissatisfaction. Cognitive theory postulates that negative experiences are the source of interpretation biases, implicating that weight-related teasing might make obese children vulnerable to shape- and weight-related interpretation biases. In the present study, it was tested whether young overweight children show interpretation biases related to body weight/shape and self-esteem. A Situation Interpretation Test (SIT) was used to find out whether overweight children (n = 20) interpret neutral and negative ambiguous situations more often in terms of their concerns about body weight/shape and self-esteem than healthy controls (n = 16). The data show that 8- to 12-year-old overweight children indeed show interpretation biases, that is, they were more likely to endorse negative appearance and self-esteem-related interpretations of a neutral or negative event than normal-weight children. Also, the perceived threat value of these events was higher in the overweight group. Interpretation biases like this might increase and maintain body dissatisfaction and psychological distress. It is therefore argued that the vulnerability to the development of an interpretation bias emphasises the need to use cognitive strategies that tackle these biases in the treatment of overweight children. [ABSTRACT FROM AUTHOR]
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- 2007
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25. High blushing propensity: fearful preoccupation or facial coloration?
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Mulkens, S., Jong, P. J. De, and Boegels, S. M.
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- 1997
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26. Psychometrie van body dysmorphic disorder
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Rood, Y. R., Mulkens, S., and Theo Bouman
27. Feeding/Eating problems in children: Who does (not) benefit after behavior therapy? A retrospective chart review.
- Author
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Dumont E, Jansen A, Duker PC, Seys DM, Broers NJ, and Mulkens S
- Abstract
Background: Treating disordered feeding at a young age reduces risks of future feeding problems, but not all children profit equally; can we define predictors of a worse prognosis?, Objectives: In 252 children, with a mean age of 4; 7 years (SD = 3 years; range 5 months to 17; 10 years), who had undergone behavioral day treatment in the past, several variables were investigated, retrieved from initial consultation (t1) and re-assessed at follow-up (t2)., Method: Logistic regressions were carried out with sex, gastro-intestinal problems, refusal of the first nutrition, syndrome/intellectual disability, Down's syndrome, autism spectrum disorder, comorbidity of medical diseases (other than gastro-intestinal problems), restrictive caloric food intake and selective food intake, as the predictor variables from t1, and age-appropriate food intake at t2 as the dependent variable. The potential role of sensory processing problems was reviewed at t2., Results: About 73% had improved towards an age-appropriate food intake. Sex (boys), syndrome/intellectual disability, and a lack of varied nutritional intake at t1 were predictors of a worse prognosis. We found a small, but significant correlation between current selective eating patterns and general sensory processing problems., Conclusion: Feeding disordered children, especially boys, with intellectual disabilities or selective eating patterns are at risk for not achieving an age-adequate food intake at a later age, despite behavioral treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Dumont, Jansen, Duker, Seys, Broers and Mulkens.)
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- 2023
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28. Impact of COVID-19 Pandemic on Young Children With Feeding and Eating Problems and Disorders and Their Families.
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Krom H, van Mameren J, Remijn L, de Nennie K, Dumont E, van der Gaag E, van Leeuwen MCC, Mulkens S, Schakelaar C, and Kindermann A
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- Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Pandemics, Avoidant Restrictive Food Intake Disorder, COVID-19 epidemiology, Feeding and Eating Disorders epidemiology
- Abstract
Objectives: The incidence of feeding and eating problems and disorders (FEPD) in children increased during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to assess the impact of the COVID-19 pandemic on young children with FEPD and their parents., Methods: Cross-sectional survey: parents of children with FEPD (0-11 years) in the Netherlands completed an online questionnaire (January-April 2021). This questionnaire included 4 demographic questions (including criteria of pediatric feeding disorder [PFD] and/or avoidant/restrictive food intake disorder [ARFID]) and 11 questions related to experienced impact of the COVID-19 pandemic. Parental responses regarding children with FEPD (including PFD and ARFID) were compared with those of healthy controls (HCs)., Results: In total, 240 children (median age, 5.5 years; interquartile range [IQR], 3.5-7.9 years; 53.3% female) were included; 129 children with FEPD and 111 HC. Most children with FEPD fulfilled criteria for PFD (n = 119; 92.2%) and/or ARFID (n = 117; 90.7%). Parents of children with FEPD reported more stress (of their child [ P = 0.014] and parental stress [ P = 0.014]), worse eating by the child ( P < 0.001), more negative relations within the family ( P = 0.006), and less support from the environment ( P = 0.001) compared with parents of HC during the COVID-19 pandemic than before., Conclusions: It seems that the COVID-19 pandemic had great impact on young children with FEPD and their parents because parents of children with FEPD reported significantly more perceived stress within both the child and parents, more difficult eating behavior of the child, more negative behavior between family members, and less support from the environment as compared with HC., Competing Interests: Dr Mulkens’s Chair in “Feeding and eating disorders” is endowed and financially supported by SeysCentra (specialized treatment center for youth with avoidant/restrictive food intake disorder). The remaining authors report no conflicts of interest., (Copyright © 2022 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
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- 2022
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29. Feeding/Eating Problems in Children Who Refrained From Treatment in the Past: Who Did (Not) Recover?
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Dumont E, Jansen A, Duker PC, Seys DM, Broers NJ, and Mulkens S
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Background: Young children with disordered feeding may be at increased risk for problematic eating in the future. This retrospective study attempts to identify predictors of later feeding problems., Objectives: Children ( N = 236) with disordered feeding, who refrained from behavioral treatment after consultation at a tertiary treatment center for feeding and eating problems were followed-up after, on average, 6 years and 3 months (timepoint 2)., Method: Logistic regressions were carried out with characteristics taken at intake (timepoint 1)-sex, pre/dysmaturity, gastro-intestinal disease, history of age-adequate feeding, syndrome/developmental impairment, autism spectrum disorder, comorbidity, age, and several variables of a restrictive- and selective food intake-and duration between timepoint 1 and 2, as predictor variables, and age-appropriate food intake at t 2 as the dependent variable., Results: Despite improvement over time, 63% did not reach an age-adequate food intake at t 2. Predictors of age- in adequate food intake were: (a) older age; (b) sex (male), (c) longer duration between timepoint 1 and timepoint 2; (d) autism spectrum disorder; (e) selective texture choices and (f) lack of varied nutritional intake., Conclusion: This study shows that most untreated young children's feeding problems do not improve over years. Besides the advice to seek help at an early age, it seems especially recommended to treat (male) children with autism spectrum disorder and selective feeding patterns., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dumont, Jansen, Duker, Seys, Broers and Mulkens.)
- Published
- 2022
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30. Attitudes towards cosmetic surgery among women in China and the Netherlands.
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Wu Y, Alleva JM, Broers NJ, and Mulkens S
- Subjects
- Adult, Attitude, Body Image, China, Female, Humans, Netherlands, Surgery, Plastic
- Abstract
Around the world, an increasing number of people, predominantly women, are choosing to undergo cosmetic surgery-despite the associated health risks. This study aimed to promote a better cross-cultural understanding of the correlates and predictors of favorable attitudes toward cosmetic surgery among women in China (an Eastern country where cosmetic surgery is increasing most rapidly) and the Netherlands (a Western country). Questionnaire data were obtained from 763 adult women; 245 were Chinese women in China (Mage = 29.71), 265 were Chinese women in the Netherlands (Mage = 25.81), and 253 were Dutch women (Mage = 29.22). Facial appearance concerns and materialistic belief were significant predictors of favorable attitudes towards cosmetic surgery for all three cultural groups. Body appreciation was a significant positive predictor among Chinese women in both China and the Netherlands, whereas age and beauty-ideal internalization were significant positive predictors only among Chinese women in China. The findings and their implications are discussed with respect to the characteristics of Chinese culture that could explain the identified differences between Chinese and Dutch women., Competing Interests: The authors have declared that no competing interests exist.
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- 2022
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31. A Scoping Literature Review of the Relation between Nutrition and ASD Symptoms in Children.
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van der Wurff I, Oenema A, de Ruijter D, Vingerhoets C, van Amelsvoort T, Rutten B, Mulkens S, Köhler S, Schols A, and de Groot R
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- Child, Fatty Acids therapeutic use, Humans, Micronutrients therapeutic use, Nutritional Status, Autism Spectrum Disorder drug therapy, Autism Spectrum Disorder etiology
- Abstract
Autism spectrum disorder (ASD) is characterized by impairments in social interaction, communication skills, and repetitive and restrictive behaviors and interests. Even though there is a biological basis for an effect of specific nutrition factors on ASD symptoms and there is scientific literature available on this relationship, whether nutrition factors could play a role in ASD treatment is unclear. The goal of the current literature review was to summarize the available scientific literature on the relation between nutrition and autism spectrum disorder (ASD) symptoms in childhood, and to formulate practical dietary guidelines. A comprehensive search strategy including terms for ASD, nutrition factors (therapeutic diets, dietary patterns, specific food products, fatty acids and micronutrients) and childhood was developed and executed in six literature databases (Cinahl, Cochrane, Ovid Embase, PsycInfo, PubMed and Web of Science). Data from meta-analyses, systematic reviews and original studies were qualitatively summarized. A total of 5 meta-analyses, 29 systematic reviews and 27 original studies were retrieved that focused on therapeutic diets, specific food products, fatty acids and micronutrients and ASD symptoms during childhood. Results of the available studies were sparse and inconclusive, and hence, no firm conclusions could be drawn. There is currently insufficient evidence for a relation between nutrition and ASD symptoms in childhood, making it impossible to provide practical nutrition guidelines; more methodological sound research is needed.
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- 2022
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32. Body image and acceptance of cosmetic surgery in China and the Netherlands: A qualitative study on cultural differences and similarities.
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Wu Y, Mulkens S, and Alleva JM
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- Adolescent, Adult, China, Female, Humans, Male, Middle Aged, Netherlands, Qualitative Research, Young Adult, Body Image psychology, Surgery, Plastic psychology
- Abstract
There is an established relationship between acceptance of cosmetic surgery and psychological factors, including body image. However, qualitative research among diverse cultural groups is needed to provide a more fine-grained understanding of the influences on women's attitudes towards cosmetic surgery. In this study, 20 Chinese and 20 Dutch women aged 18-50 years (M
Chinese = 34.20; MDutch = 34.70) participated in one-on-one semi-structured interviews. Data were analyzed using reflexive thematic analysis. We identified three themes that captured the factors that women perceived to foster favorable attitudes towards cosmetic surgery: (a) sociocultural pressures (e.g., normalization of cosmetic surgery, appearance-focused peers); (b) intrapersonal characteristics (e.g., beauty-ideal internalization, social comparison); and (c) benefits of beauty (e.g., attracting men, socioeconomic benefits). Conversely, two themes captured the factors perceived to reduce favorable attitudes towards cosmetic surgery: (a) intrapersonal characteristics (e.g., unconditional body acceptance, self-confidence); and (b) external considerations (e.g., health risks, financial costs). Overall, Chinese and Dutch participants shared many similarities in their opinions about what might affect cosmetic surgery consideration. The most striking cross-cultural differences concerned perceived socioeconomic benefits of beauty (mainly Chinese women) and women's conceptualization of body appreciation. This study may enable a more comprehensive understanding about the factors influencing Chinese and Dutch women's attitudes towards cosmetic surgery, and the nuances in these relationships across these cultures., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)- Published
- 2022
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33. The obsessive-compulsive spectrum: A network analysis.
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Dingemans AE, Volkmer SA, Mulkens S, Vuijk R, and van Rood YR
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- Compulsive Personality Disorder, Humans, Autism Spectrum Disorder complications, Body Dysmorphic Disorders, Feeding and Eating Disorders, Obsessive-Compulsive Disorder psychology
- Abstract
Several studies have shown that obsessive-compulsive disorder (OCD), eating disorders (ED), autism spectrum disorders (ASD) and body dysmorphic disorder (BDD) share obsessive-compulsive (OC) symptoms and often co-occur, which could be seen as indicative of a common etiological basis. In addition, they also appear to have similarities in executive functioning. The present study investigated disorder-specific symptoms and executive functioning as a possible joint factor in individuals with OCD (n=53), BDD (n=95), ED (n=171) and ASD (n=73), and in healthy controls (n=110). The participants completed online questionnaires measuring OCD, ED, ASD and BDD related symptoms as well as executive functioning. The clinical groups were first compared to the healthy controls. Subsequently, a network analysis was performed only with the OC-groups. This network approach assumes that psychopathological disorders are the result of causal symptom interactions. As expected, the healthy controls reported less severe symptoms compared to the OC patient groups. The network analysis suggested that the executive functioning skill set shifting/attention switching and the ASD symptoms, social and communication skills were the most central nodes in the model. Difficulty with cognitive flexibility and social factors are central in OC-spectrum disorders and may be perpetuating factors and thus a relevant focus of treatment., (Copyright © 2021. Published by Elsevier B.V.)
- Published
- 2022
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34. New developments in cognitive-behavioural therapy for eating disorders (CBT-ED).
- Author
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Mulkens S and Waller G
- Subjects
- Humans, Pandemics, SARS-CoV-2, COVID-19, Cognitive Behavioral Therapy, Feeding and Eating Disorders therapy
- Abstract
Purpose of Review: This review summarizes recent developments in cognitive-behavioural therapy for eating disorders (CBT-ED). More specifically, the past five years were covered, with the latest UK and Dutch guidelines for eating disorders as a starting benchmark, and with special consideration of the past 18 months., Recent Findings: The new research can be divided into findings that have: (1) reinforced our existing understanding of CBT-ED's models and impact; (2) advanced our understanding and the utility of CBT-ED, including its application for the 'new' disorder Avoidant/Restrictive Food Intake Disorder (ARFID); (3) suggested new directions, which require further exploration in clinical and research terms. These include learning from the circumstances of the COVID-19 pandemic., Summary: CBT-ED has developed substantially in the past 5 years, with consolidation of its existing evidence base, further support for real-life implementation, extension of methods used, and the development of new approaches for working with younger people - particularly in the form of treatments for ARFID. Over the past 18 months, even more promising changes in delivery occurred in response to the COVID19 pandemic, showing that we can adapt our methods in order to work effectively via remote means. Challenges remain regarding poor outcomes for anorexia nervosa., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
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35. A retrospective study of eating and psychosocial problems in patients with hepatic glycogen storage diseases and idiopathic ketotic hypoglycemia: Towards a standard set of patient-reported outcome measures.
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Venema A, Peeks F, de Bruijn-van der Veen M, de Boer F, Fokkert-Wilts MJ, Lubout CMA, Huskens B, Dumont E, Mulkens S, and Derks TGJ
- Abstract
There is a paucity in literature on eating and psychosocial problems in patients with hepatic glycogen storage disease (GSD) and idiopathic ketotic hypoglycemia (IKH), problems that can greatly affect quality of life. This is a monocentre, retrospective, observational mixed method study of patients with hepatic GSD or IKH treated at the Beatrix Children's Hospital Groningen, who had been referred to SeysCentra, a specialist centre for the treatment of eating problems. Additionally, a systematic literature review has been performed to identify instruments to quantify patient-reported outcome measures of psychosocial problems in hepatic GSD patients. Sixteen patients from 12 families were included with ages ranging between 3 and 24 years. Five out of sixteen patients were diagnosed with Avoidant/Restrictive Food Intake Disorder and six patients showed characteristics of this disorder. Fourteen patients experienced sleeping problems, and 11 out of 12 parent couples experienced stress about the illness of their child. We subsequently identified 26 instruments to quantify patient-reported outcome measures for GSD patients. This study demonstrates that GSD patients can develop Avoidant/Restrictive Food Intake Disorder influencing quality of life at multiple domains. The identification of instruments to assess psychosocial wellbeing is an important step towards a standard set of patient-reported outcome measures., Competing Interests: The authors declare no conflicts of interest., (© 2021 The Authors. JIMD Reports published by John Wiley & Sons Ltd on behalf of SSIEM.)
- Published
- 2021
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36. Cognitive-behavioral therapy in the time of coronavirus: Clinician tips for working with eating disorders via telehealth when face-to-face meetings are not possible.
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Waller G, Pugh M, Mulkens S, Moore E, Mountford VA, Carter J, Wicksteed A, Maharaj A, Wade TD, Wisniewski L, Farrell NR, Raykos B, Jorgensen S, Evans J, Thomas JJ, Osenk I, Paddock C, Bohrer B, Anderson K, Turner H, Hildebrandt T, Xanidis N, and Smit V
- Subjects
- Betacoronavirus, COVID-19, Cognitive Behavioral Therapy standards, Humans, Practice Guidelines as Topic, SARS-CoV-2, Telemedicine standards, Cognitive Behavioral Therapy methods, Coronavirus Infections prevention & control, Feeding and Eating Disorders therapy, Pandemics prevention & control, Pneumonia, Viral prevention & control, Telemedicine methods
- Abstract
Objective: The coronavirus pandemic has led to a dramatically different way of working for many therapists working with eating disorders, where telehealth has suddenly become the norm. However, many clinicians feel ill equipped to deliver therapy via telehealth, while adhering to evidence-based interventions. This article draws together clinician experiences of the issues that should be attended to, and how to address them within a telehealth framework., Method: Seventy clinical colleagues of the authors were emailed and invited to share their concerns online about how to deliver cognitive-behavioral therapy for eating disorders (CBT-ED) via telehealth, and how to adapt clinical practice to deal with the problems that they and others had encountered. After 96 hr, all the suggestions that had been shared by 22 clinicians were collated to provide timely advice for other clinicians., Results: A range of themes emerged from the online discussion. A large proportion were general clinical and practical domains (patient and therapist concerns about telehealth; technical issues in implementing telehealth; changes in the environment), but there were also specific considerations and clinical recommendations about the delivery of CBT-ED methods., Discussion: Through interaction and sharing of ideas, clinicians across the world produced a substantial number of recommendations about how to use telehealth to work with people with eating disorders while remaining on track with evidence-based practice. These are shared to assist clinicians over the period of changed practice., (© 2020 The Authors. International Journal of Eating Disorders published by Wiley Periodicals, Inc.)
- Published
- 2020
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37. Factor Analysis and Psychometric Properties of the Chinese Translation of the Acceptance of Cosmetic Surgery Scale.
- Author
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Wu Y, Alleva JM, and Mulkens S
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- Adult, China, Factor Analysis, Statistical, Female, Humans, Male, Reproducibility of Results, Body Image psychology, Health Knowledge, Attitudes, Practice, Psychometrics instrumentation, Psychometrics standards, Surgery, Plastic psychology
- Abstract
This paper describes a Chinese translation and validation of the Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005), a questionnaire for assessing attitudes towards cosmetic surgery. Chinese adults (335 women, 240 men; M
age = 33.65) completed the Chinese ACSS and - to investigate construct validity - measures of body appreciation, facial appearance concerns, sociocultural attitudes towards appearance (i.e., internalization of appearance ideals and appearance pressures), and demographics. Exploratory factor analysis revealed that the Chinese ACSS comprised two factors, which were invariant across sex, mirroring results among other non-Western samples. The Chinese ACSS also demonstrated good internal consistency (Cronbach's alphas > .90) and convergent validity via its positive associations with facial appearance concerns and overall sociocultural attitudes toward appearance. Chinese ACSS scores were higher among women, and were positively correlated with age among men. Chinese ACSS scores were not associated with body appreciation or other demographic factors. The ACSS seems to be a valid instrument for use in Chinese adults, and could bring more insight into attitudes toward cosmetic surgery from a cross-cultural perspective., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2020
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38. Body Contouring Surgery after Massive Weight Loss: Excess Skin, Body Satisfaction, and Qualification for Reimbursement in a Dutch Post-Bariatric Surgery Population.
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Monpellier VM, Antoniou EE, Mulkens S, Janssen IMC, Jansen ATM, and Mink van der Molen AB
- Subjects
- Adult, Body Contouring economics, Body Image, Dermatologic Surgical Procedures economics, Female, Humans, Male, Middle Aged, Netherlands, Personal Satisfaction, Prospective Studies, Quality of Life, Referral and Consultation statistics & numerical data, Reimbursement Mechanisms economics, Reimbursement Mechanisms statistics & numerical data, Surveys and Questionnaires, Treatment Outcome, Bariatric Surgery, Body Contouring methods, Dermatologic Surgical Procedures methods, Obesity, Morbid surgery, Weight Loss
- Abstract
Background: Body contouring surgery improves quality of life, weight loss, and body image after bariatric surgery. It is unclear why only a minority of the post-bariatric surgery population undergoes body contouring surgery. This study assesses overhanging skin, body satisfaction, and qualification for reimbursement of body contouring surgery in a Dutch post-bariatric surgery population., Methods: Post-bariatric patients were selected from a prospective database. Electronic questionnaires evaluated demographics, desire for body contouring surgery, excess skin, and satisfaction with their body., Results: A total of 590 patients were included: 368 patients (62.4 percent) desired body contouring surgery, 157 (26.6 percent) did not and 65 (11.0 percent) had undergone body contouring surgery. There were no significant differences between the groups regarding the percentage of patients who met the qualifications for reimbursement. Patients who desired body contouring surgery had more body parts affected by overhanging skin and more often rated the overhanging skin with a Pittsburgh Rating Scale grade 3 compared with patients without a desire to undergo body contouring surgery. The plastic surgeon was never consulted by 39.1 percent of the "desire" population; 44.1 percent of these patients met the weight criteria., Conclusions: Post-bariatric patients who desired body contouring surgery had more excess skin than patients without a desire and were less satisfied with their body. Almost half of these patients never consulted a plastic surgeon, partly because of incorrect assumptions regarding reimbursement. Plastic surgeons (together with bariatric teams) should better inform these patients about body contouring surgery possibilities.
- Published
- 2019
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39. A new cognitive behavior therapy for adolescents with avoidant/restrictive food intake disorder in a day treatment setting: A clinical case series.
- Author
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Dumont E, Jansen A, Kroes D, de Haan E, and Mulkens S
- Subjects
- Adolescent, Child, Day Care, Medical, Diagnostic and Statistical Manual of Mental Disorders, Feeding and Eating Disorders psychology, Female, Humans, Retrospective Studies, Cognitive Behavioral Therapy methods, Feeding and Eating Disorders therapy
- Abstract
Objective: Avoidant/restrictive food intake disorder (ARFID) is a new diagnosis in the DSM-5 Feeding and Eating Disorders section, for which very limited treatment research has been carried out, yet. A new, 4-week exposure based cognitive behavioral therapy (CBT) day treatment, which integrated the inhibitory learning principles, was developed for adolescents with ARFID, and tested in the current study., Method: A nonconcurrent multiple baseline design was used in a clinical case series of eleven 10- to 18-year-old patients. After baseline, the 4-week CBT followed. Measurements of DSM-5 ARFID diagnosis, food neophobia and related measures such as body weight and length, were taken at baseline (t1), at the end of the 4-week intensive day treatment (t2) and 3 months after treatment (follow-up, t3). A food selectivity test, a 1-week food diary, and behavioral measures on food intake were also taken at baseline and at 3-month follow-up. Furthermore, continuous measurements of believability of dysfunctional cognitions, anxiety, and food acceptance were taken throughout the 4-weeks day treatment., Results: At follow-up, 10 out of 11 patients were in remission and had a healthy body weight and an average, age-adequate nutritional intake. For most patients, food neophobia scores decreased to a nonclinical range. The belief in dysfunctional cognitions and anxiety levels decreased during treatment., Discussion: This new exposure-based CBT for adolescents with ARFID seems promising. These results may be very useful for clinical practice and stimulate further development of effective CBT interventions in the area of ARFID., (© 2019 The Authors. International Journal of Eating Disorders published by Wiley Periodicals, Inc.)
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- 2019
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40. Body image dissatisfaction and depression in postbariatric patients is associated with less weight loss and a desire for body contouring surgery.
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Monpellier VM, Antoniou EE, Mulkens S, Janssen IMC, van der Molen ABM, and Jansen ATM
- Subjects
- Body Mass Index, Female, Humans, Male, Middle Aged, Obesity psychology, Obesity surgery, Patient Acceptance of Health Care psychology, Patient Satisfaction, Prospective Studies, Bariatric Surgery psychology, Body Contouring psychology, Body Dysmorphic Disorders psychology, Depression psychology, Postoperative Complications psychology
- Abstract
Background: Overhanging skin in postbariatric patients leads to a negative body image. In patients with obesity, negative body image is related to more depressive symptoms and a higher weight. This relationship might also be important in postbariatric patients, because improvement of body image via body contouring surgery (BCS) could lead to better weight loss results., Objectives: To evaluate the relationship between body image, depressive symptoms, and weight loss in a postbariatric population, focusing on desire for BCS., Setting: Outpatient clinic., Methods: One thousand twenty-four primary bariatric surgery patients were contacted, and 590 patients agreed to participate and filled in online questionnaires regarding body image (Body Shape Questionnaire and Multidimensional Body-Self Relations Questionnaire-Appearance Scales) and depression (Beck Depression Inventory-II). Differences between patients who had BCS, patients who desired BCS, and patients who did not desire BCS were studied. The mediating role of body image in the association between percentage total weight loss and depressive symptoms was assessed via a 2-mediator model., Results: There was a desire for BCS in 368 patients (62.4%); these patients had significantly lower scores on appearance evaluation and body image satisfaction scales and showed more depressive symptoms. Patients without a desire (n = 157, 26.6%) had lowest rates of depressive symptoms and a more positive body image. Sixty-five patients (11.0%) had undergone BCS. In the patients who desired BCS, percentage total weight loss was negatively affected by depressive symptoms via appearance evaluation and body-area satisfaction., Conclusions: There are striking differences regarding body image satisfaction and depressive symptoms when comparing postbariatric patients and without desire for BCS. Body image satisfaction is associated with less depressive symptoms in all postbariatric patients. In patients who desired BCS, body image is one of the mediators of the relationship between percentage total weight loss and depressive symptoms. Therefore, body image should be taken seriously and be part of outcome assessment in postbariatric patients., (Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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41. To deliver or not to deliver cognitive behavioral therapy for eating disorders: Replication and extension of our understanding of why therapists fail to do what they should do.
- Author
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Mulkens S, de Vos C, de Graaff A, and Waller G
- Subjects
- Feeding and Eating Disorders psychology, Female, Humans, Male, Treatment Outcome, Uncertainty, Clinical Decision-Making, Cognitive Behavioral Therapy, Feeding and Eating Disorders therapy, Psychotherapy
- Abstract
Objective: This study investigated the extent to which therapists fail to apply empirically supported treatments in a sample of clinicians in The Netherlands, delivering cognitive behavioral therapy for eating disorders (CBT-ED). It aimed to replicate previous findings, and to extend them by examining other potential intra-individual factors associated with the level of (non-)use of core CBT-ED techniques., Method: Participants were 139 clinicians (127 women; mean age 41.4 years, range = 24-64) who completed an online survey about the level of use of specific techniques, their beliefs (e.g., about the importance of the alliance and use of pretreatment motivational techniques), anxiety (Intolerance of Uncertainty Scale), and personality (Ten Item Personality Inventory)., Results: Despite some differences with Waller's (2012) findings, the present results continue to indicate that therapists are not reliably delivering the CBT-ED techniques that would be expected to provide the best treatment to their patients. This 'non-delivery' appears to be related to clinician anxiety, temporal factors, and clinicians' beliefs about the power of the therapeutic alliance in driving therapy outcomes., Discussion: Improving treatment delivery will involve working with clinicians' levels of anxiety, clarifying the lack of benefit of pre-therapy motivational enhancement work, and reminding clinicians that the therapeutic alliance is enhanced by behavioral change in CBT-ED, rather than the other way around., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2018
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42. Enhancing Executive Functions Among Dutch Elementary School Children Using the Train Your Mind Program: Protocol for a Cluster Randomized Trial.
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Bervoets J, Jonkman LM, Mulkens S, de Vries H, and Kok G
- Abstract
Background: Executive functions are higher cognitive control functions, which are essential to physical and psychological well-being, academic performance, and healthy social relationships. Executive functions can be trained, albeit without broad transfer, to this date. Broad transfer entails the translation of improved cognitive functions to daily life (behaviors). The intervention Train your Mind was designed to train executive functions among elementary school children aged 9 to 11 years, and obtain broad transfer in terms of enhanced physical activity, healthy eating, and socioemotional regulation., Objective: This paper aims to describe the cluster randomized trial to test the effectiveness of the Train your Mind intervention., Methods: Train your Mind was integrated into the existing school curriculum for 8 months (25 weeks excluding holidays). The effectiveness of the intervention was tested in a cluster randomized trial comprising 13 schools, 34 groups (school classes), and 800 children, using a battery of 6 computer tasks at pre- and postmeasurement. Each of the 3 core executive functions was measured by 2 tasks (Flanker and Go/No-Go; N-Back and Running Span; Attention Switching Task and Dots/Triangles). Moreover, we administered questionnaires that measure emotion-regulation, cognitive errors, physical activity, dietary habits, and the psycho-social determinants of diet and physical activity. Body mass index was also measured. Multilevel analyses will account for clustering at the school and group levels, and randomization took place at the school level., Results: Results are currently being analyzed., Conclusions: The main purpose of this study is to test Train your Mind's effectiveness in enhancing executive functions. Second, we investigate whether increased executive functions lead to improved physical activity and healthy eating. If found effective, executive function training could easily be integrated into school curricula everywhere, and as such, boost health, academic performance, and emotion-regulation of elementary school children, in a cost-effective manner., Trial Registration: Netherlands Trial Register NTR5804; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5804 (Archived by WebCite at http://www.webcitation.org/6z9twosJ8)., Registered Report Identifier: RR1-10.2196/7908., (©Joachim Bervoets, Lisa M Jonkman, Sandra Mulkens, Hein de Vries, Gerjo Kok. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 07.06.2018.)
- Published
- 2018
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43. Correction: A Multifactorial Weight Reduction Programme for Children with Overweight and Asthma: A Randomized Controlled Trial.
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Willeboordse M, van de Kant KDG, Tan FES, Mulkens S, Schellings J, Crijns Y, van der Ploeg L, van Schayck CP, and Dompeling E
- Abstract
[This corrects the article DOI: 10.1371/journal.pone.0157158.].
- Published
- 2017
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44. Cosmetic Professionals' Awareness of Body Dysmorphic Disorder.
- Author
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Bouman TK, Mulkens S, and van der Lei B
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Self Report, Body Dysmorphic Disorders diagnosis, Dermatology, Health Knowledge, Attitudes, Practice, Practice Patterns, Physicians', Surgery, Plastic
- Abstract
Background: Preoccupation with a perceived appearance flaw is the main feature of body dysmorphic disorder. The majority of these patients seek and often receive some sort of cosmetic procedure, although this condition is considered to be a contraindication. This study evaluates cosmetic professionals' recognition of body dysmorphic disorder and the way they act on this., Method: Members of Dutch professional associations for aesthetic plastic surgery, dermatology, and cosmetic medicine received an online survey by means of their association's digital mailing lists; the survey was completed by 173 respondents., Results: Most participants indicated being more or less familiar with the diagnostic criteria and clinical picture of body dysmorphic disorder. Approximately two-thirds of the participants reported that they had encountered between one and five of these patients in their practice over the past year, a percentage that is significantly lower than the estimated prevalence of body dysmorphic disorder. The majority of professionals sometimes or often address body image problems during consultation, most of them collaborate with psychologists or psychiatrists when encountering a patient with body dysmorphic disorder, and approximately 70 percent had refused to perform a procedure in such a patient., Conclusions: Our results converge with those of previous studies, showing that most cosmetic professionals have some degree of awareness of body dysmorphic disorder, although the number they report encountering in clinical practice departs from prevalence figures. When a patient is identified as having body dysmorphic disorder, the professionals use this knowledge to guide their decision to perform a cosmetic procedure.
- Published
- 2017
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45. A Multifactorial Weight Reduction Programme for Children with Overweight and Asthma: A Randomized Controlled Trial.
- Author
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Willeboordse M, van de Kant KDG, Tan FE, Mulkens S, Schellings J, Crijns Y, Ploeg Lv, van Schayck CP, and Dompeling E
- Subjects
- Adolescent, Asthma pathology, Body Mass Index, Body Weight, Child, Female, Humans, Life Style, Lung pathology, Male, Overweight pathology, Quality of Life, Treatment Outcome, Asthma complications, Overweight complications, Overweight therapy, Weight Reduction Programs methods
- Abstract
Background: There is increasing evidence that obesity is related to asthma development and severity. However, it is largely unknown whether weight reduction can influence asthma management, especially in children., Objective: To determine the effects of a multifactorial weight reduction intervention on asthma management in overweight/obese children with (a high risk of developing) asthma., Methods: An 18-month weight-reduction randomized controlled trial was conducted in 87 children with overweight/obesity and asthma. Every six months, measurements of anthropometry, lung function, lifestyle parameters and inflammatory markers were assessed. Analyses were performed with linear mixed models for longitudinal analyses., Results: After 18 months, the body mass index-standard deviation score decreased by -0.14±0.29 points (p<0.01) in the intervention group and -0.12±0.34 points (p<0.01) in the control group. This change over time did not differ between groups (p>0.05). Asthma features (including asthma control and asthma-related quality of life) and lung function indices (static and dynamic) improved significantly over time in both groups. The FVC% predicted improved over time by 10.1 ± 8.7% in the intervention group (p<0.001), which was significantly greater than the 6.1 ± 8.4% in the control group (p<0.05)., Conclusions & Clinical Relevance: Clinically relevant improvements in body weight, lung function and asthma features were found in both the intervention and control group, although some effects were more pronounced in the intervention group (FVC, asthma control, and quality of life). This implies that a weight reduction intervention could be clinically beneficial for children with asthma., Trial Registration: ClinicalTrials.gov NCT00998413.
- Published
- 2016
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46. Mirror exposure to increase body satisfaction: Should we guide the focus of attention towards positively or negatively evaluated body parts?
- Author
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Jansen A, Voorwinde V, Hoebink Y, Rekkers M, Martijn C, and Mulkens S
- Subjects
- Adolescent, Adult, Female, Humans, Treatment Outcome, Young Adult, Attention physiology, Body Image psychology, Implosive Therapy methods, Personal Satisfaction, Visual Perception physiology
- Abstract
Background and Objectives: Though there is some evidence that body exposure increases body satisfaction, it is still unclear why exposure works and how attention should be guided during exposure. This pilot study manipulates the focus of attention during body exposure., Methods: Female participants high in body dissatisfaction were randomly assigned to an exposure intervention that exclusively focused on self-defined attractive (n = 11) or self-defined unattractive (n = 11) body parts. Both interventions consisted of five exposure sessions and homework. Outcome and process of change were studied., Results: Both types of exposure were equally effective and led to significant improvements in body satisfaction, body checking, body concerns, body avoidance and mood at post-test. Improvements for body satisfaction and mood were maintained at follow-up while body shape concerns and body checking still improved between post-test and follow-up. Body avoidance improvements were maintained for the positive exposure while the negative exposure tended to further decrease long-term body avoidance at follow-up.. The 'positive' exposure induced positive feelings during all exposure sessions while the 'negative' exposure initially induced a worsening of feelings but feelings started to improve after some sessions. The most unattractive body part was rated increasingly attractive in both conditions though this increase was significantly larger in the negative compared to the positive exposure condition., Limitations: The sample size was small and non-clinical., Conclusions: Both types of exposure might be effective and clinically useful. Negative exposure is emotionally hard but might be significantly more effective in increasing the perceived attractiveness of loathed body parts and in decreasing avoidance behavior., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2016
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47. Expectancy violation, reduction of food cue reactivity and less eating in the absence of hunger after one food cue exposure session for overweight and obese women.
- Author
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Schyns G, Roefs A, Mulkens S, and Jansen A
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- Adult, Energy Intake, Feeding Behavior physiology, Female, Food, Humans, Hunger physiology, Middle Aged, Motivation, Behavior Therapy methods, Cues, Feeding Behavior psychology, Obesity psychology, Obesity therapy, Overweight psychology
- Abstract
The present study investigated whether a single-session of food cue exposure for overweight women would decrease 'if CS then US' expectancies, cue reactivity and eating in the absence of hunger (EAH). EAH was measured in a behavioural paradigm that enabled to also investigate whether the cue exposure effects were specific for exposed foods or would generalise to food items that were not present during exposure. Overweight women were randomly assigned to either the cue exposure intervention or a control intervention that focused on body image. In line with the hypotheses, results showed that cue exposure induced a significant decrease in 'if CS then US' expectancies, in contrast to the control intervention. It was also found that, compared to the control intervention, desires to eat initially increased during cue exposure while gradual extinction was observed towards the end of the intervention. No extinction of increased salivation responses was found. Regarding EAH, the intake of the exposed food item was significantly less in the exposure condition than in the control condition, whereas total caloric food intake was not different between conditions, indicating that cue exposure was effective in reducing intake but did not generalise to the intake of other food items., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2016
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48. Long-term effects of the RealFit intervention on body composition, aerobic fitness, and behavior.
- Author
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Bartelink NH, Jansen MW, Kremers SP, Mulkens S, and Mujakovic S
- Subjects
- Adolescent, Body Composition, Body Mass Index, Female, Follow-Up Studies, Health Behavior, Health Promotion, Humans, Male, Netherlands epidemiology, Nutritional Status, Parents, Pediatric Obesity epidemiology, Pediatric Obesity psychology, Physical Fitness, Program Evaluation, Surveys and Questionnaires, Time Factors, Treatment Outcome, Waist Circumference, Weight Loss, Diet, Exercise, Pediatric Obesity prevention & control, Weight Reduction Programs
- Abstract
Background: RealFit is a 13-week weight reduction program for youth that focuses on nutrition, physical activity (PA), psychology, and parental participation. The short-term effectiveness of the RealFit intervention, in terms of body composition, aerobic fitness, and dietary and PA behavior, having been proven, the present study evaluated the long-term effects of the intervention., Methods: The study had a quasi-experimental design. Height, weight, waist circumference, aerobic fitness, and self-reported dietary and PA behavior were assessed at baseline (T(0)), immediately after the 13-week RealFit intervention (T(1)), after 5 months (T(2)), and 1 year (T(3)) of follow-up. A total of 86 adolescents participated in the intervention group. The control group (n=32) comprised overweight adolescents who did not receive any treatment., Results: One year after the RealFit intervention, significant decreases in BMI z-score (mean difference [MD]: -0.39) and waist circumference (MD, -3.24) were found. The comparison between the intervention and control groups, controlling for confounders, resulted in a significant difference (BMI z-score: -0.41; 95% confidence interval [CI]: -0.67 to -0.15; waist circumference: -8.07; 95% CI: -11.58 to -4.56). The results for dietary and PA behavior consistently showed favorable changes in the intervention group., Conclusions: The RealFit intervention appears to have significant favorable long-term effects on BMI z-score and waist circumference. These changes in body composition obviously represent changes in adolescents' energy balance-related behavior. Taking all results and limitations into account, it may cautiously be concluded that RealFit is an effective weight loss intervention.
- Published
- 2014
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49. Multifactorial intervention for children with asthma and overweight (Mikado): study design of a randomised controlled trial.
- Author
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Willeboordse M, van de Kant KD, de Laat MN, van Schayck OC, Mulkens S, and Dompeling E
- Subjects
- Adolescent, Asthma complications, Body Composition, Child, Exercise Test, Female, Humans, Life Style, Male, Obesity therapy, Overweight complications, Research Design, Respiratory Function Tests, Surveys and Questionnaires, Weight Loss, Asthma therapy, Overweight therapy, Weight Reduction Programs
- Abstract
Background: In children, the prevalence's of both obesity and asthma are disconcertingly high. Asthmatic children with obesity are characterised by less asthma control and a high need for asthma medication. As the obese asthmatic child is becoming more common in the clinical setting and the disease burden of the asthma-obesity phenotype is high, there is an increasing need for effective treatment in these children. In adults, weight reduction resulted in improved lung function, better asthma control and less need for asthma medication. In children this is hardly studied. The Mikado study aims to evaluate the effectiveness of a long term multifactorial weight reduction intervention, on asthma characteristics in children with asthma and a high body weight., Methods/design: The Mikado study is a two-armed, randomised controlled trial. In total, 104 participants will be recruited via online questionnaires, pulmonary paediatricians, the youth department of the Municipal Health Services and cohorts of existing studies. All participants will be aged 6-16 years, will have current asthma, a Body Mass Index in the overweight or obesity range, and no serious comorbidities (such as diabetes, heart diseases). Participants in the intervention arm will receive a multifactorial intervention of 18 months consisting of sessions concerning sports, parental involvement, individual counselling and lifestyle advices including dietary advices and cognitive behavioural therapy. The control group will receive usual care. The primary outcome variables will include Forced Expiratory Volume in one second and Body Mass Index - Standard Deviation Score. Secondary outcomes will include other lung function parameters (including dynamic and static lung function parameters), asthma control, asthma-specific quality of life, use of asthma medication and markers of systemic inflammation and airway inflammation., Discussion: In this randomised controlled trial we will study the potential of a multifactorial weight reduction intervention to improve asthma-related outcome measures in asthmatic children with overweight. Moreover, it will provide information about the underlying mechanisms in the relationship between asthma and a high body weight in children. These findings can contribute to optimal management programs and better clinical guidelines for children with asthma and overweight., Trial Registration: Clinicaltrial.gov NCT00998413.
- Published
- 2013
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50. Metacognitive therapy for body dysmorphic disorder patients in Iran: acceptability and proof of concept.
- Author
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Rabiei M, Mulkens S, Kalantari M, Molavi H, and Bahrami F
- Subjects
- Adolescent, Adult, Body Dysmorphic Disorders psychology, Female, Follow-Up Studies, Humans, Iran epidemiology, Male, Neuropsychological Tests, Patient Satisfaction, Psychiatric Status Rating Scales, Treatment Outcome, Young Adult, Body Dysmorphic Disorders rehabilitation, Cognitive Behavioral Therapy methods
- Abstract
The purpose of the present study was to determine the effect of metacognitive therapy (MCT) on symptoms of body dysmorphic disorder (BDD) and on symptoms of thought-fusion, by means of a wait-list controlled clinical trial. Participants were referred from dermatology and cosmetic surgery clinics in the city of Isfahan, Iran, and 20 patients were selected on the basis of DSM-IV-TR diagnostic criteria for BDD. They were randomly assigned to either the experimental or the wait-list control group. The Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS) and the Thought-Fusion Inventory (TFI) were used as the outcome measures. The experimental group received 8 weekly metacognitive intervention sessions. The control group was in the waiting-list until the end of the follow-up. Measures were taken at pre-test, post-test (after 2 months) and follow-up (after 6-months). The results of analysis of variance showed that MCT significantly reduced the symptoms of BDD and of thought-fusion, compared to the wait-list. Effects on both outcome measures were maintained at 6-months follow-up., (Copyright © 2011 Elsevier Ltd. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
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