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Internalized HIV stigma is prevalent and research on internalized HIV stigma has increased during the past 10 years. The aim of this systematic review was to synthesize research on internalized HIV stigma and relationships with various health-related variables in order to better inform the development of interventions aimed at reducing internalized HIV stigma. We reviewed 176 studies with a quantitative design reporting correlates that were peer-reviewed, published in English before January 2021, drawn from PubMed, PSYCHINFO, Web of Science, EBSCO, and Scopus. Synthesis showed consistent associations between internalized stigma and negative psychological (e.g., depression, anxiety), social (e.g., lack of social support, discrimination, nondisclosure, and intersecting stigmas), and health (e.g., substance use, treatment nonadherence, negative clinical HIV outcomes) variables. We argue for a more socioecological approach to internalized stigma, with greater attention for intersectional stigmas, and more longitudinal research, if we are to effectively develop interventions that reduce internalized stigma.

Contains fulltext : 225520.pdf (Publisher’s version ) (Open Access) Effective treatments of highly prevalent stress-related outcomes such as depression and anxiety are understudied in adults with autism spectrum disorder (ASD). A randomized controlled trial with baseline, post-intervention, and 10-week follow-up, that explores the effects of animal assisted therapy (AAT) was conducted. In total, 53 adults with ASD with normal to high intelligence were randomized in an intervention (N = 27) versus waiting list control group (N = 26). The remarkable adherence to the therapy program by study participants and the program's clinically relevant effects indicate that AAT with dogs can be used to reduce perceived stress and symptoms of agoraphobia, and to improve social awareness and communication in adults with ASD with normal to high intelligence.

HIV-related stigmatization in employee selection procedures may be enacted through discrimination based on an applicant's HIV status. This study (N = 58) investigated to what extent applying an acknowledgment strategy in a job interview setting reduces HIV-related stigma, taking into account the applicants' personal responsibility and the perceivers' attitudes toward people living with HIV (PLWH). In an immersive virtual office, virtual applicants with HIV presented themselves as part of a job application procedure. Using a 2 (acknowledgment versus non-acknowledgment) x 2 (responsible versus not responsible for the onset of the HIV-infection) within-subjects design, we hypothesized that acknowledgment and onset responsibility would yield an interaction effect as well as separate main effects. We predicted that hearing virtual job applicants acknowledging their HIV status triggers higher evaluations, especially when applicants are not held personally responsible for their infection. In addition, we hypothesized that (between-subjects) positive implicit and explicit attitudes independently moderate the relationship between acknowledgment and applicant evaluation. We found that low-onset responsible applicants were more positively evaluated than high-onset responsible applicants (main effect of onset responsibility), F(1, 57) = 4.31, p = 0.04. This effect was irrespective of the applicants' status acknowledgment (no interaction effect). Acknowledgment did, however, produce higher evaluations when participants' explicit attitudes toward PLWH were more positive, F(1, 57) = 7.13, p = 0.01 (moderation effect of explicit attitudes). This study indicates that the more positive the explicit attitudes toward PLWH, the more positive the evaluations when hearing PLWH acknowledging their stigma. Theoretical and practical implications of these findings are discussed.

Being sexually aroused may be an important risk factor contributing to sexual decision making. Dual-process cognitive models, such as the reflective-impulsive model of Strack and Deutsch (2004), could be used to explain the effect of sexual arousal on intentions to use a condom. In this study, we investigated whether explicit and implicit attitudes toward condom use can predict intentions to use a condom when participants are sexually aroused and not aroused. In a within-subjects experimental design, male participants (N = 27) watched both a neutral and an erotic movie clip in counterbalanced order. After each clip, participants completed a questionnaire assessing their intentions to use a condom and explicit condom attitudes, followed by a wanting Implicit Association Test (IAT; Greenwald et al., 2003) and a liking IAT to assess their implicit attitudes to unsafe sex. In concordance with the reflective-impulsive model, we found that when participants were not sexually aroused, their intentions to use a condom were solely predicted by their explicit attitudes. However, when they were sexually aroused, intentions to use a condom were predicted by both explicit and implicit attitudes toward condom use.

Contains fulltext : 199253.pdf (Publisher’s version ) (Closed access) Research showed that more than 30% of patients with Posttraumatic Stress Disorder (PTSD) do not benefit from evidence-based treatments: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or Eye Movement Desensitization and Reprocessing (EMDR). These are patients with prolonged and multiple traumatization, with poor verbal memory, and patients with emotional over-modulation. Retelling traumatic experiences in detail is poorly tolerated by these patients and might be a reason for not starting or not completing the recommended treatments. Due to lack of evidence, no alternative treatments are recommended yet. Art therapy may offer an alternative and suitable treatment, because the nonverbal and experiential character of art therapy appears to be an appropriate approach to the often wordless and visual nature of traumatic memories. The objective of this pilot study was to test the acceptability, feasibility, and applicability of trauma-focused art therapy for adults with PTSD due to multiple and prolonged traumatization (patients with early childhood traumatization and refugees from different cultures). Another objective was to identify the preliminary effectiveness of art therapy. Results showed willingness to participate and adherence to treatment of patients. Therapists considered trauma-focused art therapy feasible and applicable and patients reported beneficial effects, such as more relaxation, externalization of memories and emotions into artwork, less intrusive thoughts of traumatic experiences and more confidence in the future. The preliminary findings on PTSD symptom severity showed a decrease of symptoms in some participants, and an increase of symptoms in other participants. Further research into the effectiveness of art therapy and PTSD is needed. 17 p.

Experiences of sexual prejudice threaten the quality of life and psychological well-being of sexual minority youth. The aim of this paper is to provide a comprehensive overview of how we developed a theory- and evidence-based sexual prejudice reduction program suitable for the Dutch high school context, guided by the intervention mapping approach (IM). In line with IM, six steps were followed: an initial needs assessment in which empirical, theoretical, and new data were gathered to acquire a thorough understanding of the problem (step 1); the formulation of program objectives for both students and teachers (step 2); the selection of theory-based methods and applications (step 3); program development (step 4); the provision of an adoption and implementation plan (step 5); and the development of an evaluation plan (step 6). In conclusion, developing a sexual prejudice reduction program for schools is a challenging but feasible process. IM is an effective tool for the systematic (theory- and evidence-driven) development of such a program.

Gerontopsychiatric nursing home residents are residents with a chronic mental condition (not dementia), in combination with one or more physical disorders. Psychiatric and behavioral problems are common within this population. The objective of this study is to examine these behaviors and their relationship to the level of both observed and self-rated well-being in the gerontopsychiatric population.Both gerontopsychiatric residents, and their primary formal caregiver in several nursing homes in The Netherlands were asked to participate in a structured interview concerning psychiatric and behavioral problems and resident well-being. Psychiatric and behavioral problems were measured with the Neuropsychiatric Inventory Questionnaire (NPI-Q) and the Cohen Mansfield Agitation Index (CMAI). Well-being was measured through the self-rated Laurens Well-being Inventory for Gerontopsychiatry (LWIG), and the observer rated Laurens Well-being Observations for Gerontopsychiatry (LWOG).A total of 126 residents participated in the study with ages varying from 42 to 90. Different types of chronic mental disorders such as schizophrenia spectrum disorder, bipolar disorders and personality disorders were prevalent in the population. Most psychiatric and behavioral problems are associated with lower observed and self-rated well-being. For irritability and affective problem behaviors the relationship with well-being was the most evident.In daily care practice the relationship between well-being and psychiatric and behavioral problems should be taken into account in care planning and treatment. To further explore the direction and details of this relationship, more research is needed.

The present study aimed to investigate associations of automatic and controlled cognition with sexual functioning, and moderation of these associations by working memory capacity in a community sample of heterosexual women (N = 65) and men (N = 51). Participants performed two single-target Implicit Association Tests (ST-IATs) to assess implicit liking and wanting of erotic stimuli. The Sexual Opinion Survey (SOS) was used to assess explicit liking of sex. The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) were used to assess sexual function. Working memory capacity was assessed using the Towers of Hanoi task and mood using the Hospital Anxiety and Depression Scale (HADS). In female participants, higher levels of sexual functioning co-occurred with stronger implicit associations of erotic stimuli with wanting, whereas implicit sex liking was unrelated to level of sexual functioning. In male participants, higher levels of sexual functioning co-occurred with lower implicit liking of erotic stimuli, whereas implicit sex wanting was unrelated to sexual functioning. Higher erotophilia scores were related to higher levels of sexual functioning in both women and men, but anxiety and depression symptoms were unrelated to sexual functioning. Working memory capacity did not moderate the associations between erotophilia and sexual functioning.

Doel: Een introductie van en rationale voor het inzetten van dieren in Geestelijke Gezondheidszorg.Methode: Een beknopte theoretische uiteenzetting wordt geïllustreerd met een case study bijeen cliënt met vroegkinderlijke traumatisering bij wie een psychodynamische psychotherapie ondersteund met het paard is ingezet.Conclusie: Het inzetten van experiëntiële interventies m.b.v. het paard kunnen helpen bij affectregulatie waarmee een volgende stap in de persoonsontwikkeling en psychotherapeutisch proces op gang kan worden gebracht.

Conceptual models of sexual functioning have suggested a major role for implicit cognitive processing in sexual functioning. The present study aimed to investigate implicit and explicit cognition in sexual functioning in women. Gynecological patients with (N = 38) and without self-reported sexual problems (N = 41) were compared. Participants performed two Single-Target Implicit Association Tests (ST-IAT), measuring the implicit association of visual erotic stimuli with attributes representing, respectively, valence and motivation. Participants also rated the erotic pictures that were shown in the ST-IATs on the dimensions of valence, attractiveness, and sexual excitement, to assess their explicit associations with these erotic stimuli. Participants completed the Female Sexual Functioning Index and the Female Sexual Distress Scale for continuous measures of sexual functioning, and the Hospital Anxiety and Depression Scale to assess depressive symptoms. Compared to nonsymptomatic women, women with sexual problems were found to show more negative implicit associations of erotic stimuli with wanting (implicit sexual motivation). Across both groups, stronger implicit associations of erotic stimuli with wanting predicted higher level of sexual functioning. More positive explicit ratings of erotic stimuli predicted lower level of sexual distress across both groups.

Background: Pelvic floor damage through vaginal birth exists in approximately half the women postpartum.Through this damage, complaints like urinary incontinence, faecal incontinence, flatus, pelvic organ prolapse,dyspareunia and pain in the pelvic floor area whilst sitting may occur. However, these complaints are also seen inwomen who do not encounter pelvic floor damage after childbirth, and in women who never experienced childbirth.Aim: The purpose of this study was to examine how far the extent of pelvic floor damage during a vaginal birth isresponsible for the development of pelvic floor complaints. Findings could help improve information for pregnantwomen, stimulate preventative measures before and at the time of birth and provide better-tailored care postpartum.Methods: This study was set up in a cross sectional design in The Netherlands. 379 women filled out an onlinequestionnaire. 239 women between the ages of 18 and 45 met the inclusion criteria. 177 parous women who had avaginal birth in the past two years and 62 nulliparous women were divided in five groups: no childbirth (controlgroup), no reported damage, episiotomy, 1st and 2nd degree, and 3rd and 4th degree perineal laceration. Six pelvicfloor complaints were investigated: urinary incontinence, faecal incontinence, flatus, pelvic organ prolapse,dyspareunia and pain in the pelvic floor area whilst sitting were subject of this study. It was expected that moresevere pelvic floor damage would result in more or more severe pelvic floor complaints. Hypotheses were testedusing multivariate analyses of variance, followed by contrast analysis.Results: Only dyspareunia occurs significantly more often after vaginal birth with 3rd and 4th degree perineallaceration in comparison with the control group. No significant differences between the five groups were found onurinary incontinence, faecal incontinence, pelvic organ prolapse and pain in the pelvic floor area whilst sitting.Conclusion: Dyspareunia is most likely to occur after vaginal birth with 3rd and 4th degree perineal lacerations

Background: The observed link between positive psychotic experiences (PE) and psychosis spectrum disorder (PSD) may be stronger depending on concomitant presence of PE with other dimensions of psychopathology. We examined whether the effect of common risk factors for PSD on PE is additive and whether the impact of risk factors on the occurrence of PE depends on the co-occurrence of other symptom dimensions (affective dysregulation, negative symptoms, and cognitive alteration).Method: Data from the Netherlands Mental Health Survey and Incidence Study 2 were used. Risk factors included childhood adversity, cannabis use, urbanicity, foreign born, hearing impairment, and family history of affective disorders. Logistic regression models were applied to test (1) the additive effect of risk factors (4 levels) on PE and (2) the moderating effects of symptom dimensions on the association between risk factors (present/absent) and PE, using additive interaction, expressed as the interaction contrast ratio.Results: Risk factors were additive: the greater the number of risk factors, the greater the odds of PE. Furthermore, concomitant presence of the other symptom dimensions all increased the impact of risk factors on PE. After controlling for age, sex, and education, only affective dysregulation and negative symptoms remained significant moderators; only affective dysregulation remained a significant moderator if all dimensions were adjusted for each other.Conclusions: Risk factors may not be directly associated with PE but additively give rise to a multidimensional subthreshold state anticipating the multidimensional clinical syndrome. Early motivational and cognitive impairments in the context of PE may be reducible to affective dysregulation.

ObjectiveRecent research emphasizes the importance of habit in explaining patterns of energy intake and choices of consumption. However, the nature of the association between habit strength and snacking has not been explored for all types of between-meal snacks.DesignMultilevel linear techniques were used to: (i) examine the association between habit strength and moment-to-moment energy intake (kilocalories) from snacks in daily life; and (ii) determine whether gender, age, level of education and BMI moderate the association between habit strength and moment-to-moment energy intake from snacks. A smartphone application based on the experience sampling method was used to map momentary between-meal snack intake in the context of daily life. Demographics and habit strength were assessed with an online composite questionnaire.SettingThis research was performed in the Netherlands in the natural environment of participants’ daily life.SubjectsAdults (n 269) aged 20–50 years.ResultsHabit strength was significantly associated with moment-to-moment energy intake from between-meal snacks in daily life: the higher the strength of habit to snack between meals, the higher the amount of momentary energy intake from snacks. The association between habit strength and moment-to-moment energy intake from snacks was moderated by education level. Additional analyses showed that habit strength was significantly associated with moment-to-moment energy intake from between-meal snacks in the low to middle level of education group.ConclusionsIt is recommended to address habitual between-meal snacking in future interventions targeting low- to middle-educated individuals.

The present study examined the relation between juvenile delinquents’ responses to social problem situations and empathy in secure juvenile institutions. The sample consisted of 79 delinquent boys (62%) and 49 delinquent girls (38%), aged 12 to 19 years. Results showed problems with accepting authority to be negatively related to both affective and cognitive empathy. Inadequate coping with competition was negatively related to cognitive empathy, whereas problems with receiving or giving help were negatively related to affective empathy. The central role of authority problems suggests that group workers could influence adolescents’ empathy development by helping them to learn to cope with social problem situations.

The experience of emotional intimacy is assumed to play a particularly large role in maintaining sexual desire and partnered sexual activity in romantic relationships of longer duration. It is unclear whether the effect of intimacy on sexual contact between partners is direct or indirect, via its impact on sexual desire. Baumeister and Bratslavsky suggested that a certain increment in emotional intimacy causes a greater increment in sexual desire in men than in women. In the present study, we aimed to test the mediating role of sexual desire between perceived intimacy and sexual partner interaction and the gender effect as hypothesized by Baumeister and Bratslavsky. Experience sampling methodology in the participant’s natural environment was used. At 10 quasi-random moments per day, during 7 consecutive days, 134 participants reported their feelings of emotional intimacy, sexual desire, and sexual activity. The direct effect of intimacy on sexual partner interaction was not significant, but an indirect effect via sexual desire was observed. The strength of the association between intimacy and sexual desire diminished over time, from the strongest effect when intimacy, sexual desire, and sexual activity were measured simultaneously to a very small, but significant effect at an average time lag of 3 hr. At still larger time gaps, no effects were found. Men reported a higher average level of sexual desire than women, but the strength of the link between (increases in) intimacy and sexual desire was not different between the genders. The present findings suggest that in both male and female partners in romantic, long-term relationships, higher levels of intimacy are associated with higher sexual desire, which is, in turn, associated with higher odds for partnered sexual activity to occur. The temporal association of increasing intimacy and subsequent sexual desire appears not to be different in women and men.

INTRODUCTION: Effective treatment for cocaine use disorder should dampen hypersensitive cue-induced motivational processes and/or strengthen executive control. Using a randomized, double-blind, placebo-controlled intervention, the primary aim of this study was to investigate the effect of N-Acetylcysteine (NAC) and working memory (WM)-training to reduce cocaine use and craving and to improve inhibition assessed in the laboratory and during Ecological Momentary Assessment (EMA). The second aim was to examine correspondence between laboratory and EMA data.METHODS: Twenty-four of 38 cocaine-using men completed a 25-day intervention with 2400mg/day NAC or placebo and WM-training as well as two lab-visits assessing cocaine use, craving and inhibition (Stop Signal task). Additionally, cocaine use, craving and cognition (Stroop task) were assessed using EMA during treatment, with 26 participants completing 819 assessments.RESULTS: Cocaine problems according to the Drug Use Disorder Identification Test (DUDIT) decreased more after NAC than after placebo, and the proportion of cocaine-positive urines at lab-visit 2 was lower in the NAC group. No NAC effects were found on craving. For cocaine use and craving, results from the lab data were generally similar to EMA results. NAC also showed some effects on cognitive control: improved inhibition assessed with the Stop Signal task in the lab, and decreased classic Stroop performance during EMA. There were no significant effects of number of completed WM-training sessions.CONCLUSIONS: Overall this study revealed mixed findings regarding the treatment of cocaine use disorders with NAC and WM-training. The effect of NAC on inhibition should be further investigated.

Contains fulltext : 183787.pdf (Publisher’s version ) (Closed access) The distinction between mental health and mental illness has long been the subject of debate, especially in the last decade where there has been a shift in focus in mental health care from symptom reduction to the improvement of positive mental health. Art therapists have been influenced by this shift and in this study, we investigate: (1) whether art therapy improves mental health and/or reduces mental illness; and (2) what the relationship is between mental health and mental illness. We used secondary data (n = 74) from patients diagnosed with personality disorders from a pretest-posttest art therapy intervention, with 10 weeks in between the repeated measures. The indicators in the domains of mental health and mental illness we used were: symptom distress, flexibility, well-being, mindfulness, and schema modes. We used repeated measures ANOVA and effect sizes to examine the effects of art therapy and the Pearson correlation to examine the relationship between illness and health outcomes. Results indicated significant effects of art therapy in both domains. Furthermore, after creation of a single mental health and a mental illness score we found that the correlation between them was high. We conclude that art therapy both promotes mental health and reduces mental illness. The large correlation between these domains in patients with personality disorders suggests that we might be dealing with two sides of the same coin. 6 p.

Within evolutionary biology, life-history theory is used to explain cross-species differences in allocation strategies regarding reproduction, maturation, and survival. Behavioral scientists have recently begun to conceptualize such strategies as a within-species individual characteristic that is predictive of behavior. Although life history theory provides an important framework for behavioral scientists, the psychometric approach to life-history strategy measurement-as operationalized by K-factors-involves conceptual entanglements. We argue that current psychometric approaches attempting to identify K-factors are based on an unwarranted conflation of functional descriptions and proximate mechanisms-a conceptual mix-up that may generate unviable hypotheses and invites misinterpretation of empirical findings. The assumptions underlying generic psychometric methodology do not allow measurement of functionally defined variables; rather these methods are confined to Mayr's proximate causal realm. We therefore conclude that K-factor scales lack validity, and that life history strategy cannot be identified with psychometrics as usual. To align theory with methodology, suggestions for alternative methods and new avenues are proposed.

Background Insight in the influence of intelligence on the mastery of communication skills is important for improving the microcounselling method, an effective training programme for acquiring these skills. Method Participants were 323 bachelor psychology students. The participants׳ level of verbal, spatial and numerical intelligence was determined. Participants followed either a course in basic skills or a course in advanced skills. Their level of mastery of these skills was assessed with a video test. Results Both training programmes proved to be effective in training communication skills. As expected, numerical and spatial intelligence were no significant predictors for the mastery of these skills. Verbal intelligence did matter for the mastery of basic communication skills, but only when students are not acquainted with the use of these skills. Discussion Students profit from training these skills, regardless of their intelligence level.

Intersection accidents result in a significant proportion of road fatalities, and attention allocation likely plays a role. Attention allocation may depend on (limited) working memory (WM) capacity. Driving is often combined with tasks increasing WM load, consequently impairing attention orienting. This study (n = 22) investigated WM load effects on event-related potentials (ERPs) related to attention orienting. A simulated driving environment allowed continuous lane-keeping measurement. Participants were asked to orient attention covertly towards the side indicated by an arrow, and to respond only to moving cars appearing on the attended side by pressing a button. WM load was manipulated using a concurrent memory task. ERPs showed typical attentional modulation (cue: contralateral negativity, LDAP; car: N1, P1, SN, and P3) under low and high load conditions. With increased WM load, lane-keeping performance improved, while dual task performance degraded (memory task: increased error-rate; orienting task: increased false alarms, smaller P3). Practitioner Summary Intersection driver-support systems aim to improve traffic-safety and -flow. However, in-vehicle systems induce working memory (WM) load, increasing the tendency to yield. Traffic flow reduces if drivers stop at inappropriate times, reducing the effectiveness of systems. Consequently, driver-support systems could include WM load measurement during driving in the development phase.

Objectives: We evaluated factors predictive of the effect of internet-based cognitive behavioral therapy (CBT) in breast cancer survivors with a sexual dysfunction. Methods: Fifty-five women completed questionnaires assessing sexual functioning and distress at baseline and post-CBT. Results: Higher therapy compliance and better partner baseline sexual functioning predicted better post-CBT sexual functioning. Higher therapy compliance and higher partner relationship satisfaction predicted lower sexual distress. Therapy compliance, in turn, was predicted by active partner involvement in therapy and a stronger therapeutic relationship.Conclusions: To increase the effect of internet-based CBT, we recommend partner involvement in therapy and establishing a strong therapeutic relationship.

Contains fulltext : 194048.pdf (Publisher’s version ) (Open Access) Art therapy for people diagnosed with personality disorders (PD) cluster B/C seems valuable to explore dysfunctional patterns in managing emotions. Current art therapy interventions are based on practical beliefs or commonsense approaches, without a sound basis in research results. To increase the effectiveness of art therapy for this target group, a planned, systematic and theory-based approach is needed. The principles of Intervention Mapping were applied to guide the development, implementation, and planned evaluation of the art therapy intervention. Empirical findings, theoretical models, and clinical practice experience were combined to construct a programme tailored to the needs of the target group. A structured 10-session art therapy intervention programme for patients was developed, aimed at: experiencing a (more) stable and positive sense of self, being able to express and regulate emotions, understanding emotions, thoughts and behaviours, using improved social and problem solving skills. Implementation took place and evaluation of the intervention is being carried out. The systematically developed art therapy intervention seems to be promising for PD patients in learning to deal with their problems. The results of the evaluation study may contribute to the knowledge about the use of art therapy for PD problems. 11 p.

Objectives This study focused on lapse shortly after an attempt to quit smoking. Ecological momentary assessment (EMA) studies have mapped real-time situational factors that induce lapses in everyday life. However, the possible role of nonsmoking intention is disregarded in the dynamic context of daily life, whereas intention plays a key role in behavior change and shifts during smoking cessation. This study therefore aimed to capture the influence of intention on lapse, next to the known risk factors of negative affect, low self-efficacy, craving, positive outcome expectations towards smoking (POEs), being around smokers, and stress. It is hypothesized that scores on these factors shift during the day, especially shortly after quitting, which may induce lapse. Based on behavioral explanation models, intention is hypothesized to mediate the influence of the mentioned factors on lapse. Methods An EMA study was conducted among 49 self-quitters in the first week of smoking cessation. Results Generalized Linear Mixed Model regression analyses revealed that low nonsmoking intentions, low self-efficacy, and being around smokers (estimates were, respectively, -0.303, -0.331, and 2.083) predicted lapse. Nonsmoking intention partially mediated the influence of self-efficacy on lapse. Nonsmoking intention was predicted by not being around smokers, high self-efficacy, and low POEs (estimates were, respectively, -0.353, 0.293, and -0.072). Conclusions This small-scale EMA study confirms the importance of nonsmoking intention on lapse, next to self-efficacy and being around smokers. It adds insights into the mediating role of intention on the relationship between self-efficacy and lapse, and into the predictors of nonsmoking intention.

We explored workplace experiences of 10 health care providers with HIV in the Netherlands. We used semi-structured interviews to discuss motivations for disclosure and concealment, reactions to disclosures, the impact of reactions, and coping with negative reactions. Reasons for disclosure were wanting to share the secret, expecting positive responses, observing positive reactions to others, wanting to prevent negative reactions, and being advised to disclose. Reasons for concealment included fearing negative reactions, observing negative reactions, previous negative experiences, having been advised to conceal, and considering disclosure unnecessary. Positive reactions included seeing HIV as a nonissue; showing interest, support, and empathy; and maintaining confidentiality. Negative reactions included management wanting to inform employees, work restrictions, hiring difficulties, gossip, and hurtful comments, resulting in participants being upset, taken aback, angry, depressed, or feeling resignation. Participants coped by providing information, standing above the experience, attributing reactions to ignorance, seeking social support, or leaving their jobs.

Despite the use of art therapy in clinical practice, its appreciation and reported beneficial results, no instruments are available to measure specific effects of art therapy among patients with personality disorders cluster B/C in multidisciplinary treatment. In the present study, we described the development and psychometric evaluation of the Self‐expression and Emotion Regulation in Art Therapy Scale (SERATS). Structural validity (exploratory and confirmatory factor analysis), reliability, construct validity and sensitivity to change were examined using two independent databases (n = 335; n = 34) of patients diagnosed with personality disorders cluster B/C. This resulted in a nine‐item effect scale with a single factor with a high internal reliability and high test–retest reliability; it demonstrated discriminant validity and sensitivity to change. In conclusion, the SERATS is brief and content‐valid and offers objective and reliable information on self‐expression and emotion regulation in art therapy among patients with personality disorders cluster B/C. Although more research on construct validity is needed, the SERATS is a promising tool to be applied as an effect scale and as a monitoring tool during art therapy treatment. © 2017 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd

BackgroundThe experience sampling method (ESM) builds an intensive time series of experiences and contexts in the flow of daily life, typically consisting of around 70 reports, collected at 8-10 random time points per day over a period of up to 10 days.MethodsWith the advent of widespread smartphone use, ESM can be used in routine clinical practice. Multiple examples of ESM data collections across different patient groups and settings are shown and discussed, varying from an ESM evaluation of a 6-week randomized trial of mindfulness, to a twin study on emotion dynamics in daily life.ResultsResearch shows that ESM-based self-monitoring and feedback can enhance resilience by strengthening the capacity to use natural rewards. Personalized trajectories of starting or stopping medication can be more easily initiated and predicted if sensitive feedback data are available in real time. In addition, personalized trajectories of symptoms, cognitive abilities, symptoms impacting on other symptoms, the capacity of the dynamic system of mental health to bounce back from disturbance, and patterns of environmental reactivity yield uniquely personal data to support shared decision making and prediction in clinical practice. Finally, ESM makes it possible to develop insight into previous implicit patterns of thought, experience, and behavior, particularly if rapid personalized feedback is available.ConclusionsESM enhances clinical practice and research. It is empowering, providing co-ownership of the process of diagnosis, treatment evaluation, and routine outcome measurement. Blended care, based on a mix of face-to-face and ESM-based outside-the-office treatment, may reduce costs and improve outcomes.

The goal of this study was (1) to determine whether and how nursing home residents with dementia respond to the interactive art installation in general and (2) to identify whether responses change when the content type and, therefore, the nature of the interaction with the artwork changes. The interactive art installation ‘VENSTER’ evokes responses in nursing home residents with dementia, illustrating the potential of interactive artworks in the nursing home environment. Frequently observed responses were naming, recognizing or asking questions about depicted content and how the installation worked, physically gesturing towards or tapping on the screen and tapping or singing along to the music. It seemed content matters a lot. When VENSTER is to be used in routine care, the choice of a type of content is critical to the intended experience/usage in practice. In this study, recognition seemed to trigger memory and (in most cases) a verbal reaction, while indistinctness led to asking for more information. When (initially) coached by a care provider, residents actively engaged physically with the screen. Responses differed between content types, which makes it important to further explore different types of content and content as an interface to provide meaningful experiences for nursing home residents.\ud \ud \ud Implications for rehabilitation: \ud - VENSTER can facilitate different types of responses ranging from verbal reactions to active physical engagement. The choice of a type of content is critical to the intended experience/usage in practice.\ud \ud - Activating content seems suitable for use as a meaningful experience during the spare time in between existing activities or therapy.\ud \ud - Sessions with interactive content are short (avg. 30 mins) and intense and can therefore potentially be used as an activating therapy, activity or exercise.\ud \ud - In order to actively engage residents with dementia, the role of the care provider seems very important.

The Youth Anxiety Measure for DSM-5 (YAM-5) is a new self- and parent-report questionnaire to assess anxiety disorder symptoms in children and adolescents in terms of the contemporary classification system. International panels of childhood anxiety researchers and clinicians were used to construct a scale consisting of two parts: part one consists of 28 items and measures the major anxiety disorders including separation anxiety disorder, selective mutism, social anxiety disorder, panic disorder, and generalized anxiety disorder, whereas part two contains 22 items that focus on specific phobias and (given its overlap with situational phobias) agoraphobia. In general, the face validity of the new scale was good; most of its items were successfully linked to the intended anxiety disorders. Notable exceptions were the selective mutism items, which were frequently considered as symptoms of social anxiety disorder, and some specific phobia items especially of the natural environment, situational and other type, that were regularly assigned to an incorrect category. A preliminary investigation of the YAM-5 in non-clinical (N = 132) and clinically referred (N = 64) children and adolescents indicated that the measure was easy to complete by youngsters. In addition, support was found for the psychometric qualities of the measure: that is, the internal consistency was good for both parts, as well as for most of the subscales, the parent–child agreement appeared satisfactory, and there was also evidence for the validity of the scale. The YAM-5 holds promise as a tool for assessing anxiety disorder symptoms in children and adolescents.

BackgroundProblem behavior of young children is generally not assessed with structured child interviews. This paper examined how information about problem behavior, obtained by structured interviews with six-year-old children, relates to DSM-disorders obtained from parents and to treatment referral.MethodsIn a population-based cohort, caregivers of 1084 young children (mean age 6.7 years) were interviewed with the DSM-based Diagnostic Interview Schedule-Young Child version (DISC-YC), and they scored the Child Behavior Checklist (CBCL). Children themselves were interviewed about problem behavior using the semi-structured Berkeley Puppet Interview (BPI). Information regarding treatment referral to mental health services was obtained by parent-reported questionnaire when children were on average eight years old.ResultsDSM-disorders and CBCL problems in the clinical range were cross-sectionally associated with higher levels of child self-reported problems. Associations were strongest in the externalizing domain (e.g. DISC-YC externalizing disorders with BPI externalizing scores: F(1, 416) = 19.39, P < 0.001; DISC-YC internalizing disorders with BPI internalizing scores: F(1, 312) = 3.75, P = 0.054). Moreover, higher BPI internalizing and externalizing problem scores predicted treatment referral two years later.ConclusionsWe conclude that systematically interviewing preschool and young elementary school-aged children should be an integral part of child assessment. This approach may contribute to a better understanding of child development and may predict future problems.

We explored 15 HIV-positive substance users’ experiences with health care alongside theperspectives of 14 health professionals. Substance users with HIV reported positive and negative experiences.Positive experiences included equal treatment, receiving social support and extra care, and good continuityof care. Negative experiences included being met with fear and apprehension, excessive or differentialprecautions, unnecessary referrals, outright care refusal, confidentiality breaches, and poor care provision.Health professionals reported limited experience caring for substance users with HIV. Most spoke generallyabout substance users, claiming that they can be difficult clients who are demanding, impatient,unpredictable, and untrustworthy. Also, health professionals indicated that substance users can be shoppersin search of unnecessary prescriptions or avoiders of health care. Efforts to improve interactions shouldencourage positive contact, and should focus on combating attributions of personal responsibility, creatingan awareness of behaviors that are stigmatizing, and improving knowledge of occupational risks for HIV.

AAI studies in the nursing home pose a specific set of challenges. In this article the practical and ethical issues encountered during a Dutch psychogeriatric nursing home AAI study are addressed with the aim of sharing our experiences for future researchers as well as AAI practitioners in general. In our study we compared three groups of clients with dementia who participated in group sessions of either visiting dog teams, visiting FurReal Friend robot animals, or visiting students (control group) and monitored the effect on social interaction and neuropsychiatric symptoms through video analysis and questionnaires. We encountered the following four categories of challenges during our study. Participant-related challenges include the legal implications of working with vulnerable patients, the practical implications of a progressive neurodegenerative disease with accompanying memory loss and behavioral problems, and the ethical implications of the use of robot animals for people with diminished cognitive functions. A very important challenge involves the selection of the participating dogs and ensuring animal welfare during the study. We partnered with a local university of applied sciences to help us successfully address these issues. The nursing home setting poses several practical challenges due to its inherent organizational structure, the high workload of nursing home staff, and an often suboptimal environment for a controlled randomized trial, especially when comparing nonpharmacological interventions. Balancing the desire for scientifically sound procedures with the practical limitations of a nursing home setting is often difficult and requires specific considerations.

Simple Summary This study investigates the synchrony in conversations (i.e., turn-taking) between a therapist and five children with Autism Spectrum Disorder during dolphin-assisted therapy. Videos of the first and last dolphin-assisted therapy sessions were analyzed with regard to turn-taking between the therapist and child in the presence of a dolphin. The results show that adequate turn-taking seemed to increase over time, but mainly for children who had reasonable verbal communication skills at the start of the therapy sessions. Abstract Synchronizing behaviors in interactions, such as during turn-taking, are often impaired in children with Autism Spectrum Disorder. Therapies that focus on turn-taking generally lead to increased social skills, less interruptions, and silent pauses, however a positive non-demanding environment is therefore thought to be beneficial. Such an environment can be achieved by incorporating animals into therapy. Our study was guided by the following research questions: (1) How can we characterize the interaction between child and therapist during dolphin-assisted therapy, with regard to synchrony in verbalizations (turn-taking) and (2) does synchrony change over the course of six sessions of therapy? To answer these questions, we performed a cross-recurrence quantification analysis on behavioral data of five children, to give a detailed view of the interaction between therapist and child in the context of dolphin-assisted therapy. We were able to detect synchrony (i.e., adequate turn-taking) in all dyads, although not all children improved equally. The differences might be explained by a delayed reaction time of some children, and their level of language development.

Regelmatig wordt door partijen buiten vaktherapie de vraag gesteld wat het unieke of onderscheidende is van vaktherapeutische interventies ten opzichte van interventies die strikt verbaal georiënteerd zijn. Door de zeven verschillende disciplines met daarbinnen een uiteenlopende set aan behandelmethoden en -perspectieven is het beantwoorden van die vraag geen sinecure. Voor een goede profilering van het vakgebied zou het heel wenselijk zijn om die vraag te kunnen beantwoorden en daar ook een theoretische onderbouwing bij te kunnen geven. In dit inleidende artikel wordt daartoe een poging gedaan, waarbij het handelings- en ervaringsgericht werken als focus wordt genomen. In een vervolgpublicatie zullen onderdelen van de theorie verder worden uitgewerkt.

Background: Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequently endorsed by, and (ii) cause less distress in Nigerian vs. Dutch and Norwegian students.Methods: Psychology students, aged 18 to 30 years, from universities in the Netherlands (n = 245), Nigeria (n = 478), and Norway (n = 162) were assessed cross-sectionally with regard to the frequency of subclinical positive psychotic experiences and related distress, using the Community Assessment of Psychic Experiences (CAPE-42). Multi-group confirmatory factor analysis and multivariate analysis of covariance were performed to assess measurement invariance of the positive symptom dimension (CAPE-Pos) and compare mean frequency and associated distress of positive psychotic experiences across study samples.Results: Only CAPE-Pos items pertaining to the dimensions ‘strange experiences’ and ‘paranoia’ met assumptions for (partial) measurement invariance. Frequencies of these experiences were higher in the Nigerian sample, compared to both the Dutch and Norwegian samples, which were similar. In addition, levelsof experience-related distress were similar or higher in the Nigerian sample compared to respectively the Dutch and Norwegian samples.Conclusion: Although positive psychotic experiences may be more commonly endorsed in non-Western societies, our findings do not support the notion that they represent a more benign, and hence less distressing aspect of human experience. Rather, the experience of psychotic phenomena may be just as, ifnot more, distressing in African than in European culture. However, observed differences in CAPE-Pos frequency and distress between samples from different cultural settings may partly reflect differences in the measure rather than in the latent trait. Future studies may therefore consider further cross-cultural adaptation of CAPE-42, in addition to explicitly examining cultural acceptance of psychotic phenomena, and environmental and other known risk factors for psychosis, when comparing and interpreting subclinical psychotic phenomena across cultural groups.

The theoretical background of the life-span sequelae of exposure to interpersonal psychological trauma (emotional or physical neglect or abuse or sexual abuse) in childhood, particularly when a primary caretaker is involved, and its assessment and treatment possibilities in a 100% online environment are outlined. These sequelae may be understood as a complex variant of PTSD (CPTSD) or a complicated array of overlapping mental and personality disorders or as transdiagnostic symptoms. However, disorders of extreme stress not otherwise specified (DESNOS) constitute a distinct syndrome of potential clinical utility. In childhood, adolescence, and young adulthood (YA), these symptoms seem encompassed by developmental trauma disorder (DTD). Affect dysregulation, identity alterations, and relational impairment are central features of DESNOS/DTD/CPTSD and can also be understood as trans-diagnostic symptom clusters. More and more people use smartphone apps in daily life. Therefore we started our 100% online treatments in patients’ environments and at their convenience (need driven). Our digitally enriched outpatient clinics (DOCs) using smartphone apps for videoconferencing psychotherapy (VCP) and personal data monitoring aim to augment established evidence-based treatment protocols. Also, they facilitate continuously gathering real-time sensor- and self-reported data that improve ecological validity of selfreports and monitoring for course of treatment and relapse prevention.

The Sexual Self-Consciousness Scale (SSCS) aims to measure individual variability with regard to the propensity to become self-conscious in sexual situations. Self-focused attention has been found to have impeding effects on genital sexual responsiveness, presumably because it also reduces processing capacity (Meston, 2006). Experimentally induced self-focus was found to interact with the personality trait of sexual self-consciousness in their effect on genital arousal (Meston, 2006; van Lankveld & Bergh, 2008; van Lankveld, van den Hout, & Schouten, 2004). Subjective experience of sexual excitement was not affected in these studies. Sexual self-consciousness may thus constitute a vulnerability factor for the development of sexual dysfunction.

Driving is a complex, goal-directed task. ASD can be related to impairments in executive functioning (EF), which may interfere with driving. This study aimed to investigate (1) if 16 young novice drivers with ASD exhibited a divergent performance on EF tests compared to 18 neurotypical peers, (2) if ASD participants exhibited a divergent driving performance compared to their neurotypical peers, and (3) if differences in driving performance would be related by the performance on the EF tasks. All participants completed a driving simulator scenario and computer-task battery. Driving error classification allowed the selection of several driving measures (e.g., collisions, speeding). Three EF tasks measuring working memory (WM), attention, and response inhibition were included. Results indicated lower WM and attention performance of the ASD participants compared to the control group, whereas response inhibition was similar across groups. Furthermore, the current study demonstrated that people with ASD can be considered as capable drivers once they have learned how to drive, that it is important to take different types of hazards into account, and that EF performance is related to driving performance. This relation may be different for drivers with and without ASD. Moreover, the relation may depend on the specific EFs and driving parameters under investigation. Future research could focus on the very early phases of driving education, and include additional driving and EF measures. (C) 2019 Elsevier Ltd. All rights reserved.

Autisme en aandachtstekortstoornis met hyperactiviteit (ADHD) zijn stoornissen die steeds vaker gesteld worden. Symptoomoverlap en vertekeningen in de diagnostische criteria maken het moeilijk om beide diagnoses op basis van het gedrag van elkaar te onderscheiden. De vraag in deze studie is of er onderscheid gemaakt kan worden op basis van de intelligentie, gemeten met de Wechsler Adult Intelligence Scale (Nederlandse vierde editie, WAIS-IV-NL). In een multicenter onderzoek werden de WAIS scores van volwassenen met autisme of ADHD met elkaar vergeleken. Beide groepen bleken niet van elkaar te verschillen op het totale intelligentiequotiënt (IQ) en de vier indices van de WAIS. Wel scoorden volwassenen met ADHD hoger op de subtests ‘figuur samenstellen’ en ‘symbool zoeken’, dan de volwassenen met autisme. De verschillen waren echter klein.

As part of a larger, randomized controlled trial, we evaluated longitudinally the sexual functioning and relationship satisfaction of 69 partners of breast cancer (BC) survivors who received Internet-based cognitive behavioral therapy (CBT) for sexual dysfunction. The findings suggest that Internet-based CBT positively affects the partners' immediate post-CBT and longer-term overall sexual satisfaction, sexual intimacy, and sexual relationship satisfaction. No sustained changes in other areas of sexual functioning were observed. Our CBT program was focused primarily on the sexual health of the BC survivors. We recommend that future programs include more psychoeducational and behavioral elements targeted at the partners.

Contains fulltext : 200606.pdf (Publisher’s version ) (Open Access) Background: Childhood peer victimization is a stressful life experience associated with long-lasting adverse psychological consequences. While there is some evidence that victimization is associated with alterations in brain function, little is known about effects on brain structure. This study explored the relationships between childhood peer victimization, cortisol, and adolescent ventrolateral prefrontal cortex (vlPFC) structure in a sample of healthy children. Methods: A total of 50 (M-age = 9.29 years at baseline) children participated in this longitudinal study. We examined whether diurnal cortisol levels (assessed at baseline) moderated the link between children's self-reported peer victimization (assessed at baseline) and vlPFC surface area, gray matter volume, and thickness 5 years later. Results: For boys, cortisol levels moderated the association between victimization and brain structure. For boys with a low daily cortisol output (assessed as area under the curve; AUC), high victimization was associated with a smaller right vlPFC surface area, and for boys with a high AUC, high victimization was associated with a larger right vlPFC surface area. In addition, for boys with a steeper diurnal slope, high victimization was associated with a smaller right vlPFC surface area, and for boys with a low flatter diurnal slope, high victimization was associated with a larger right vlPFC surface area. Conclusion: These results indicate the differential influence of cortisol on the relationship between victimization and brain structure. Findings suggest that victimization may have differential effects on brain development in boys who are more versus less biologically sensitive to stress. 9 p.

In de huidige studie is het seksverslavingsmodel van hyperseksualiteit als uitgangspunt genomen om de associaties te onderzoeken tussen de generieke kenmerken van verslaving en de hulpbehoefte bij problemen met hyperseksualiteit. We richtten ons daarbij vooral op de verslavingskenmerken Tolerantie (steeds meer seks willen) en Ontwenning (onrust na stoppen van het seksuele gedrag) die zelden zijn onderzocht in de context van seksverslaving. Daarnaast onderzochten we ook de associaties tussen Orgasmefrequentie en problemen met hyperseksualiteit; met betrekking tot deze associaties laat eerder onderzoek tegenstrijdige resultaten zien. Op basis van de aan ons beschikbaar gestelde data van 33.160 volledig ingevulde online zelftests is een exploratieve multinomiale regressieanalyse uitgevoerd waarbij onderzocht werd welke verslavingskenmerken de hulpbehoefte voor seksverslaving typeren. De afhankelijke variabele van de analyse was Hulpbehoefte, bestaande uit drie categorieën: 1) geen hulpbehoefte; 2) wil hulp; en 3) heeft hulp. In tegenstelling tot wat het seksverslavingsmodel voorspelt, wezen het ervaren van Tolerantie en het hebben van een hogere Orgasmefrequentie juist op minder behoefte aan hulp. Wel in overeenstemming met het seksverslavingsmodel was dat, naarmate men meer Ontwenning ervoer, de kans groter was dat dat men hulp had of wilde. De uitkomsten van de huidige exploratieve studie laten zien dat Ontwenning een belangrijke indicator kan zijn van seksverslaving, iets wat in vervolgonderzoek nader onderzocht dient te worden. Theoretische implicaties van de resultaten voor het seksverslavingsmodel en suggesties voor vervolgonderzoek worden besproken.

The need for meaningful activities that enhance engagement is very important among persons with dementia (PWDs), both for PWDs still living at home, as well as for PWDs admitted to a nursing home (NH). In this study, we systematically registered behaviours related to engagement in a group animal-assisted activity (AAA) intervention for 21 PWDs in NHs and among 28 home-dwelling PWDs attending a day care centre. The participants interacted with a dog and its handler for 30 minutes, twice a week for 12 weeks. Video-recordings were carried out early (week 2) and late (week 10) during the intervention period and behaviours were categorized by the use of an ethogram. AAA seems to create engagement in PWDs, and might be a suitable and health promoting intervention for both NH residents and participants of a day care centre. Degree of dementia should be considered when planning individual or group based AAA.

Purpose The purpose of this paper is to describe whether and how groups of nursing home residents respond to the interactive device “the CRDL”. The CRDL can translate touches between people into sounds. It recognises the type of touch and adjusts the produced sound accordingly. Design/methodology/approach This was as an observational explorative study. Responses were coded and analysed using an existing theoretical framework. Findings The CRDL creates an atmosphere of playfulness and curiosity. It lowers the threshold to touch, provides an incentive to touch and encourages experimentation with different types of touches on arms and hands. The sounds the CRDL produces sometimes trigger memories and provide themes to start and support conversation. Involving a (large) group of nursing home residents to interact with the CRDL is challenging. Research limitations/implications In order to more fully understand the potential of the CRDL, its use should be studied in different group and individual sessions and the effects of tailored content, adjusted to individual preferences and/or stages of cognition should be explored. Finally, the effects of using the CRDL on the general wellbeing of nursing home residents should be studied. Practical implications The CRDL can help caregivers to use touch to make contact with (groups of their) residents. A session should be guided by an experienced caregiver. Some familiarisation and practice with the CRDL are recommended and a quiet environment is advised. Originality/value This paper demonstrates the potential of interactive objects, such as the CRDL, in the nursing home.

STUDY QUESTION To what extent are endometriosis and its related physical and mental symptoms associated with the perceived level of sexual functioning in women and their male partners? SUMMARY ANSWER Dyspareunia and depressive symptoms are associated with impaired sexual functioning in women with endometriosis, whereas sexual functioning in their male partners is not affected. WHAT IS KNOWN ALREADY Women with endometriosis suffer from more dyspareunia, lower sexual functioning, and lower quality of life. In qualitative studies, partners of women with endometriosis report that endometriosis affected their quality of life and produced relational distress. STUDY DESIGN SIZE, DURATION In this cross-sectional study, sexual functioning in women with endometriosis (n = 83) and their partners (n = 74) was compared with sexual functioning in a control group of women attending the outpatient department for issues related to contraception (n = 40), and their partners (n = 26). PARTICIPANTS/MATERIALS, SETTING, METHODS Women and partners were recruited in the Maastricht University Medical Centre (MUMC) and the VieCuri Medical Centre Venlo between June 2011 and December 2012. All participants were asked to complete a set of online questionnaires. MAIN RESULTS AND THE ROLE OF CHANCE Response rates were 59.3% (83/140) for women with endometriosis and 52.3% (74/140) for their partners. Response rates in the control group were respectively 43.2% and 27.4% (41/95 and 27/95), of whom 40 women and 26 partners could be included in the study. Women with endometriosis as compared with the control group, reported significantly more frequent pain during intercourse (53% versus 15%, P

The present paper gives an overview of the methodology and results of the first decade of research into Internet-based interventions for women’s sexual dysfunction. The interventions, retrieved in a literature search, were mostly well grounded on common theoretical models of sexual dysfunction and psychological disorders, and most ingredients of the interventions were theory-informed. Most interventions offered Web-based therapeutic content within a more or less preprogrammed structure. Most of these also offered prescheduled and/or participant-initiated contact with a sexual health care professional. Comparative effect studies showed improvements in sexual functioning as well as relational functioning at the point of termination of the intervention period. Improvements at posttreatment were generally maintained for several months after termination of the active intervention period. The results of this review seem to warrant further development of Internet-based interventions for women’s sexual dysfunctions.