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Deteriorated functioning is a part of the clinical-high risk (CHR) criteria for psychosis. Diminished social, educational and occupational functioning in the phase of late adolescence and early adulthood are associated with long-term social, economic and health consequences, which stresses the importance of early intervention to stimulate functioning. This pilot study examines the effectiveness and feasibility of the choose-get-keep model of Supported Education and Supported Employment (SEE) to improve educational and occupational functioning of individuals at CHR for a psychosis. A single blind randomized controlled pilot study combined SEE with treatment as usual (TAU) versus TAU among adolescents and early adults at CHR. School performance and job status as well as global functioning scales were assessed at twelve months. Of the 78 eligible participants, 20 individuals consented to participate in this study. At follow-up, participants in the intervention condition (n = 9) did not start an education more often than the participants in the control condition (n = 11) and the school results for both conditions were similar. However, in the intervention condition there were no school dropouts, more participants gained a job and worked longer hours. Two participants quit the intervention. This pilot study provides preliminary evidence that a SEE intervention is effective and feasible in sustaining and improving the level of both educational and occupational functioning of individuals at CHR for psychosis by supporting them in attaining, keeping and elaborating of their education or employment.

This dissertation examined the long-term outcomes after CSA on domains related to the transition to adulthood: relationships, parenthood, criminal careers, and income and employment. First, a systematic review was conducted of the literature on the effect of CSA on education, employment, offending, relationships, and parenting. From the literature it appears that, in general, CSA victims differ from non-victims not so much in that they less often fulfill adult roles, but that they experience lower quality of some of these roles. Findings also showed that CSA victims on average end up at lower educational levels than non-victims. Additionally, CSA victims appear more likely to be arrested in adulthood. CSA was also consistently found to be related to more partner violence, increased risk of divorce or separation, and teenage parenthood. Furthermore, CSA victims tend to have less positive experiences as a parent. In a first empirical study, the effect of CSA characteristics on family outcomes was studied. For that, a prospective study design was employed, with data on CSA gathered from court files. The outcomes were measured from register data, 30 years after the abuse. Overall, it was found that the relationship to the offender and the age at which the abuse happened, impacted outcomes more than the specific nature of the abuse. More specifically, it was found firstly that the younger victims were at the time of abuse, the less likely they were to marry. Abuse by a nuclear family member increased the odds of early marriage. Secondly, CSA victims abused by a nuclear family member were more than twice as likely to divorce compared to victims of abuse by a stranger. Thirdly, victims of CSA perpetrated by a nuclear family member were more likely to become a teenage parent than victims of other perpetrators. In a second empirical study, the effect of CSA victimization on recorded offending was studied. A number of pre-existing child, family, and environmental factors was controlled for by including not only a control group comprised of people from the general population of similar age and gender as the victims, but also a control group of same-sex siblings. Offending rates among victims were found to be the highest, followed by siblings, while rates of offending were lowest among random controls. Male victims did not differ in their offending behavior from their brothers, while female victims were only slightly more likely to offend than their sisters. CSA victims who offended committed all sorts of offenses, instead of ‘specializing’ in one type of crime such as sex offenses. In a third empirical study, the effect of CSA victimization on income, employment and social benefits was studied. CSA victims were found to have been less often employed than random controls, but not less than their siblings. Victims had lower quality employment than controls, but again not significantly lower than their siblings. Victims had lower incomes than random controls, as well as lower incomes than their siblings. Victims were more often recipients of incapacity benefits than both random controls and siblings. Regarding unemployment benefits none of the groups differed. Victims depended more often on subsistence benefits than random controls, as previous research found, but not more so than their siblings. This dissertation is scientifically relevant as it overcame some important shortcomings in previous research on CSA and the adaptation of adult roles. First, by employing a sibling design, which enabled us to partly control for shared pre-existing characteristics. Second, by using prospective data, with, third, an independent assessment of CSA victimization. Fourth, prospectively gathered officially registered objective data on adult role outcomes, with, fifth, no loss to follow-up.

This dissertation examined the long-term outcomes after CSA on domains related to the transition to adulthood: relationships, parenthood, criminal careers, and income and employment. First, a systematic review was conducted of the literature on the effect of CSA on education, employment, offending, relationships, and parenting. From the literature it appears that, in general, CSA victims differ from non-victims not so much in that they less often fulfill adult roles, but that they experience lower quality of some of these roles. Findings also showed that CSA victims on average end up at lower educational levels than non-victims. Additionally, CSA victims appear more likely to be arrested in adulthood. CSA was also consistently found to be related to more partner violence, increased risk of divorce or separation, and teenage parenthood. Furthermore, CSA victims tend to have less positive experiences as a parent. In a first empirical study, the effect of CSA characteristics on family outcomes was studied. For that, a prospective study design was employed, with data on CSA gathered from court files. The outcomes were measured from register data, 30 years after the abuse. Overall, it was found that the relationship to the offender and the age at which the abuse happened, impacted outcomes more than the specific nature of the abuse. More specifically, it was found firstly that the younger victims were at the time of abuse, the less likely they were to marry. Abuse by a nuclear family member increased the odds of early marriage. Secondly, CSA victims abused by a nuclear family member were more than twice as likely to divorce compared to victims of abuse by a stranger. Thirdly, victims of CSA perpetrated by a nuclear family member were more likely to become a teenage parent than victims of other perpetrators. In a second empirical study, the effect of CSA victimization on recorded offending was studied. A number of pre-existing child, family, and environmental factors was controlled for by including not only a control group comprised of people from the general population of similar age and gender as the victims, but also a control group of same-sex siblings. Offending rates among victims were found to be the highest, followed by siblings, while rates of offending were lowest among random controls. Male victims did not differ in their offending behavior from their brothers, while female victims were only slightly more likely to offend than their sisters. CSA victims who offended committed all sorts of offenses, instead of ‘specializing’ in one type of crime such as sex offenses. In a third empirical study, the effect of CSA victimization on income, employment and social benefits was studied. CSA victims were found to have been less often employed than random controls, but not less than their siblings. Victims had lower quality employment than controls, but again not significantly lower than their siblings. Victims had lower incomes than random controls, as well as lower incomes than their siblings. Victims were more often recipients of incapacity benefits than both random controls and siblings. Regarding unemployment benefits none of the groups differed. Victims depended more often on subsistence benefits than random controls, as previous research found, but not more so than their siblings. This dissertation is scientifically relevant as it overcame some important shortcomings in previous research on CSA and the adaptation of adult roles. First, by employing a sibling design, which enabled us to partly control for shared pre-existing characteristics. Second, by using prospective data, with, third, an independent assessment of CSA victimization. Fourth, prospectively gathered officially registered objective data on adult role outcomes, with, fifth, no loss to follow-up.

This dissertation examined the long-term outcomes after CSA on domains related to the transition to adulthood: relationships, parenthood, criminal careers, and income and employment. First, a systematic review was conducted of the literature on the effect of CSA on education, employment, offending, relationships, and parenting. From the literature it appears that, in general, CSA victims differ from non-victims not so much in that they less often fulfill adult roles, but that they experience lower quality of some of these roles. Findings also showed that CSA victims on average end up at lower educational levels than non-victims. Additionally, CSA victims appear more likely to be arrested in adulthood. CSA was also consistently found to be related to more partner violence, increased risk of divorce or separation, and teenage parenthood. Furthermore, CSA victims tend to have less positive experiences as a parent. In a first empirical study, the effect of CSA characteristics on family outcomes was studied. For that, a prospective study design was employed, with data on CSA gathered from court files. The outcomes were measured from register data, 30 years after the abuse. Overall, it was found that the relationship to the offender and the age at which the abuse happened, impacted outcomes more than the specific nature of the abuse. More specifically, it was found firstly that the younger victims were at the time of abuse, the less likely they were to marry. Abuse by a nuclear family member increased the odds of early marriage. Secondly, CSA victims abused by a nuclear family member were more than twice as likely to divorce compared to victims of abuse by a stranger. Thirdly, victims of CSA perpetrated by a nuclear family member were more likely to become a teenage parent than victims of other perpetrators. In a second empirical study, the effect of CSA victimization on recorded offending was studied. A number of pre-existing child, family, and environmental factors was controlled for by including not only a control group comprised of people from the general population of similar age and gender as the victims, but also a control group of same-sex siblings. Offending rates among victims were found to be the highest, followed by siblings, while rates of offending were lowest among random controls. Male victims did not differ in their offending behavior from their brothers, while female victims were only slightly more likely to offend than their sisters. CSA victims who offended committed all sorts of offenses, instead of ‘specializing’ in one type of crime such as sex offenses. In a third empirical study, the effect of CSA victimization on income, employment and social benefits was studied. CSA victims were found to have been less often employed than random controls, but not less than their siblings. Victims had lower quality employment than controls, but again not significantly lower than their siblings. Victims had lower incomes than random controls, as well as lower incomes than their siblings. Victims were more often recipients of incapacity benefits than both random controls and siblings. Regarding unemployment benefits none of the groups differed. Victims depended more often on subsistence benefits than random controls, as previous research found, but not more so than their siblings. This dissertation is scientifically relevant as it overcame some important shortcomings in previous research on CSA and the adaptation of adult roles. First, by employing a sibling design, which enabled us to partly control for shared pre-existing characteristics. Second, by using prospective data, with, third, an independent assessment of CSA victimization. Fourth, prospectively gathered officially registered objective data on adult role outcomes, with, fifth, no loss to follow-up.

Organisaties hebben op dit moment nog geen methode om de gezondheid van het IT Project Portfolio te meten. Deze studie brengt daar verandering in. Met behulp van in eerder wetenschappelijk onderzoek naar voren gekomen assessment criteria is een dashboard opgesteld. Daarbij is ook literatuuronderzoek gedaan naar onderliggende meetbare aspecten en structurele kenmerken en ontwerpeisen van een dashboard. De bruikbaarheid van het dashboard is binnen dit onderzoek getoetst aan de hand van een single case study. Respondenten hebben het dashboard ingevuld, in een plenaire sessie besproken en daarna zijn individuele interviews afgenomen. Geconcludeerd mag worden dat het samengestelde dashboard bruikbaar is als leidraad voor organisaties. Het is voor organisaties daarom aan te bevelen om vaker met behulp van dit dashboard de gezondheid van het ITPP in kaart te brengen.

Dit lespakket gaat over jongeren en jongvolwassenen met een chronische aandoening in het algemeen, maar ook meer specifiek gericht op lichamelijke beperkingen, en hun proces naar volwassenheid. Het begin van hun werkzame leven neemt hierbij een centrale plaats in.

In de residentiële jeugdzorg verblijven jongeren met complexe problemen die soms niet terug naar huis kunnen. Zij maken onder begeleiding een transitie door op weg naar volwassen- en zelfstandigheid. Uit internationaal onderzoek blijkt dat deze transitie naar volwassenheid vaak niet goed verloopt en dat deze jongeren een verhoogd risico lopen op sociale uitsluiting en marginalisering. Ook in Nederland blijkt dat de begeleiding die deze jongeren ontvangen onvoldoende aansluit op wat zij zelf ervaren nodig te hebben voor een zelfstandig leven. Op verzoek van organisaties uit de jeugdzorg is vanuit het perspectief van Disability Studies een instrument ontwikkeld, Mijn Pad. Dit instrument levert een bijdrage aan het exploratieproces van jongeren in hun ontwikkeling naar eigen regie en participatie.

In de residentiële jeugdzorg verblijven jongeren met complexe problemen die soms niet terug naar huis kunnen. Zij maken onder begeleiding een transitie door op weg naar volwassen- en zelfstandigheid. Uit internationaal onderzoek blijkt dat deze transitie naar volwassenheid vaak niet goed verloopt en dat deze jongeren een verhoogd risico lopen op sociale uitsluiting en marginalisering. Ook in Nederland blijkt dat de begeleiding die deze jongeren ontvangen onvoldoende aansluit op wat zij zelf ervaren nodig te hebben voor een zelfstandig leven. Op verzoek van organisaties uit de jeugdzorg is vanuit het perspectief van Disability Studies een instrument ontwikkeld, Mijn Pad. Dit instrument levert een bijdrage aan het exploratieproces van jongeren in hun ontwikkeling naar eigen regie en participatie.

Depressie is geassocieerd met beperkingen in het rolfunctioneren van zowel volwassenen als adolescenten. Hoewel veel studies de relatie tussen depressie en rolfunctioneren hebben besturdeerd, zijn er nog veel onduidelijkheden. Het is bijvoorbeeld onbekend of er factoren zijn die de relatie modereren en of er verschillen zijn tussen adolescente jongens en meisjes. Het doel van dit proefschrift is daarom de relatie dussen depressie en rolfunctioneren nader te bestuderen. Tijdens de adolescentie hebben we ons gefocused op het bestaan, de sterkte en de richting van de relatie tussen depressie en functioneren op school en in het sociale domein. Tijdens de volwassenheid hebben we ons gericht op het verklaren van heterogeniteit in rolfunctioneren van volwasenen met een depressie. De data was afkomstig van TRAILS en NESDA. De belangrijkste bevindingen van dit proefschrift laten zien dat er een sterke relatie is tussen depressie en rolfunctioneren in zowel adolescenten als volwassenen. Bij adolescenten gaan depressieve problemen vooraf aan beperkt rolfunctioneren, voornamelijk in het sociale domen. Daarnaast gaan beperkingen in het functioneren ook vooraf aan depressieve problemen. Bij depressieve volwassenen is de ernst van de depressieve symptomen de belangrijkse correlaat van beperkt rolfunctioneren. De ernst van depressieve symptomen en rolfunctioneren veranderen synchroon aan elkaar. Verschillende ziekte-, persoons-, en omgevingskenmerken beinvloeden de mate waarin de ernst van depressieve symptomen leidt tot beperkingen in rolfunctioneren. De resultaten beschrijven waarom beperkingen in het rolfunctioneren ontstaan bij de ene, maar niet bij de andere patient; en welke factoren de mate van beperkt rolfunctioneren bij een depressie verhogen of juist verlagen.

Depressie is geassocieerd met beperkingen in het rolfunctioneren van zowel volwassenen als adolescenten. Hoewel veel studies de relatie tussen depressie en rolfunctioneren hebben besturdeerd, zijn er nog veel onduidelijkheden. Het is bijvoorbeeld onbekend of er factoren zijn die de relatie modereren en of er verschillen zijn tussen adolescente jongens en meisjes. Het doel van dit proefschrift is daarom de relatie dussen depressie en rolfunctioneren nader te bestuderen. Tijdens de adolescentie hebben we ons gefocused op het bestaan, de sterkte en de richting van de relatie tussen depressie en functioneren op school en in het sociale domein. Tijdens de volwassenheid hebben we ons gericht op het verklaren van heterogeniteit in rolfunctioneren van volwasenen met een depressie. De data was afkomstig van TRAILS en NESDA. De belangrijkste bevindingen van dit proefschrift laten zien dat er een sterke relatie is tussen depressie en rolfunctioneren in zowel adolescenten als volwassenen. Bij adolescenten gaan depressieve problemen vooraf aan beperkt rolfunctioneren, voornamelijk in het sociale domen. Daarnaast gaan beperkingen in het functioneren ook vooraf aan depressieve problemen. Bij depressieve volwassenen is de ernst van de depressieve symptomen de belangrijkse correlaat van beperkt rolfunctioneren. De ernst van depressieve symptomen en rolfunctioneren veranderen synchroon aan elkaar. Verschillende ziekte-, persoons-, en omgevingskenmerken beinvloeden de mate waarin de ernst van depressieve symptomen leidt tot beperkingen in rolfunctioneren. De resultaten beschrijven waarom beperkingen in het rolfunctioneren ontstaan bij de ene, maar niet bij de andere patient; en welke factoren de mate van beperkt rolfunctioneren bij een depressie verhogen of juist verlagen.

Depressie is geassocieerd met beperkingen in het rolfunctioneren van zowel volwassenen als adolescenten. Hoewel veel studies de relatie tussen depressie en rolfunctioneren hebben besturdeerd, zijn er nog veel onduidelijkheden. Het is bijvoorbeeld onbekend of er factoren zijn die de relatie modereren en of er verschillen zijn tussen adolescente jongens en meisjes. Het doel van dit proefschrift is daarom de relatie dussen depressie en rolfunctioneren nader te bestuderen. Tijdens de adolescentie hebben we ons gefocused op het bestaan, de sterkte en de richting van de relatie tussen depressie en functioneren op school en in het sociale domein. Tijdens de volwassenheid hebben we ons gericht op het verklaren van heterogeniteit in rolfunctioneren van volwasenen met een depressie. De data was afkomstig van TRAILS en NESDA. De belangrijkste bevindingen van dit proefschrift laten zien dat er een sterke relatie is tussen depressie en rolfunctioneren in zowel adolescenten als volwassenen. Bij adolescenten gaan depressieve problemen vooraf aan beperkt rolfunctioneren, voornamelijk in het sociale domen. Daarnaast gaan beperkingen in het functioneren ook vooraf aan depressieve problemen. Bij depressieve volwassenen is de ernst van de depressieve symptomen de belangrijkse correlaat van beperkt rolfunctioneren. De ernst van depressieve symptomen en rolfunctioneren veranderen synchroon aan elkaar. Verschillende ziekte-, persoons-, en omgevingskenmerken beinvloeden de mate waarin de ernst van depressieve symptomen leidt tot beperkingen in rolfunctioneren. De resultaten beschrijven waarom beperkingen in het rolfunctioneren ontstaan bij de ene, maar niet bij de andere patient; en welke factoren de mate van beperkt rolfunctioneren bij een depressie verhogen of juist verlagen.