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Versloot-Swildens MC, de Graaf H, Twisk JWR, Popma A, Nauta-Jansen LMC. Effectiveness of a Comprehensive School-Based Sex Education Program for Young Adolescents in the Netherlands. J Youth Adolesc 2024; 53:998-1014. [PMID: 38055133 DOI: 10.1007/s10964-023-01903-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/11/2023] [Indexed: 12/07/2023]
Abstract
Most sexual education programs traditionally focused on providing sexual information regarding the risks of sex. However, current studies on sexual behavior in youth show a need for truly comprehensive sex education approaches with a sex-positive focus on sexuality, that effectively improve sexual competence. Therefore, in the current study the effectiveness of "Love is…", a four lesson school-based program based on the Sexual Interactional Competence model and Attitude-Social-Influence-Self-Efficacy-model was studied. A cluster-randomized controlled trial on the effectiveness of "Love is…" was conducted in 2018-2020. The sample consisted of 1160 adolescents in grades 8 and 9 from nine schools in the Netherlands. The sample was 48% female, 34% Dutch/Caucasian, 41% none-religious and 50% higher educated. They were randomized at class level into a program group [n = 32 classes; 567 students (Mage = 13.74 (SD = 0.74))] and a control group [n = 31 classes; 593 students (Mage = 13.86 (SD = 0.73))]. Results showed that "Love is…" increased sexual knowledge, that adolescents in the program group showed less cyber victim blaming attitudes and increased in communications skills after the program. In conclusion, the current study shows that "Love is…" was effective not only on the knowledge level, but also regarding sexual attitudes and competences. However, due to the developmental process of sexuality, there is a necessity to continue lessons in following grades through booster sessions by reinforcing competences as communicating comfortably about sexuality.On 12 November 2019 the study design and hypotheses were registered in the Dutch Trial Registration, number NL8150. ( https://onderzoekmetmensen.nl/nl/trial/26676 ).
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Affiliation(s)
- M C Versloot-Swildens
- Department of Child and Adolescent Psychiatry Amsterdam UMC, Amsterdam, the Netherlands.
| | - H de Graaf
- Rutgers, Dutch Centre of Expertise on Sexual and Reproductive Health and Rights, Utrecht, the Netherlands
| | - J W R Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry Amsterdam UMC, Amsterdam, the Netherlands
| | - L M C Nauta-Jansen
- Department of Child and Adolescent Psychiatry Amsterdam UMC, Amsterdam, the Netherlands
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Swinkels LTA, Hoeve M, Ter Harmsel JF, Schoonmade LJ, Dekker JJM, Popma A, van der Pol TM. The effectiveness of social network interventions for psychiatric patients: A systematic review and meta-analysis. Clin Psychol Rev 2023; 104:102321. [PMID: 37499318 DOI: 10.1016/j.cpr.2023.102321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/12/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
Strengthening social networks is an important goal in mental health treatment. This study aimed to determine the effectiveness of social network interventions for psychiatric patients. A systematic review and meta-analysis was conducted comparing these interventions with control groups on social and mental health-related outcomes in psychiatric patients. PubMed, EMBASE.com, PsycInfo, Scopus, and IBSS were searched for studies until December 21, 2022. Three-level random effects models were used to obtain Cohen's d mean estimates on composite outcomes of social network and secondary mental health outcomes. Heterogeneity was examined with potential moderators. Thirty-three studies were included. Small-to-moderate effects of social network interventions were detected on positive social network (d = 0.115, p = 0.022) and support (d = 0.159; p = 0.007), general functioning (d = 0.127, p = 0.046), mental health treatment adherence (d = 0.332, p = 0.003), days substance use (d = 0.097, p = 0.004), and abstinence (d = 0.254, p = 0.004). Estimates of psychiatric functioning were higher in samples with more females. The quality of evidence was moderate-to-low. This evidence suggests that social network interventions can improve positive social networks, general functioning, mental health treatment adherence, and substance use in psychiatric patients receiving usual care. PROSPERO ID: CRD42019131959.
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Affiliation(s)
- L T A Swinkels
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - M Hoeve
- Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, Netherlands
| | - J F Ter Harmsel
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - L J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - J J M Dekker
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV, Amsterdam, Netherlands; Department of Research and Quality of Care, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
| | - T M van der Pol
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Vlaardingenlaan 5, 1059 GL, Amsterdam, Netherlands; Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands; Department of Research and Quality of Care, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, Netherlands
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Leijdesdorff SMJ, Huijs CEM, Klaassen RMC, Popma A, van Amelsvoort TAMJ, Evers SMAA. Burden of mental health problems: quality of life and cost-of-illness in youth consulting Dutch walk-in youth health centres. J Ment Health 2023; 32:150-157. [PMID: 33086874 DOI: 10.1080/09638237.2020.1836555] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little is known about the burden of (sub-threshold) mental health problems in youth. AIM To examine the burden of mental health problems in terms of health-related quality of life (HRQoL) and cost-of-illness, for first visitors of the Dutch youth walk-in centres (@ease). METHOD A bottom-up, prevalence-based burden of disease study from a societal perspective. HRQoL was assessed through the EuroQoL (EQ-5D-5L), and cost-of-illness via items about truancy and health care utilization. RESULTS Participants (N = 80) showed a decreased HRQoL compared to the general population of Dutch youth. In the three months prior to their 1st attendance, participants skipped on average 4.11 days of school and had 1.03 health care visits, leading to total costs of €512.64 per person. Females had significantly higher health care costs and lower HRQoL. Health care use was lower in those not speaking the Dutch language. Living alone was a significant predictor of truancy (costs), and therefore total costs. CONCLUSIONS Mental health problems in youth consulting @ease have a considerable impact on the individual's HRQoL, and an economic impact on society, yet almost 75% is not receiving care. A lack of interventions in this critical period in life may have major lifelong consequences.
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Affiliation(s)
- S M J Leijdesdorff
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, The Netherlands
| | - C E M Huijs
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - R M C Klaassen
- Department of Child and Adolescent Psychiatry, Duivendrecht, The Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry, Duivendrecht, The Netherlands.,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - T A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, The Netherlands
| | - S M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Trimbos Institute Centre for Economic Evaluation and Machine Learning, Utrecht, the Netherlands
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Kaijadoe SPT, Klip H, de Weerd A, van Arragon EA, Nijhof KS, Popma A, Scholte RHJ. How do group workers respond to suicidal behavior? Experiences and perceptions of suicidal female adolescents residing in secure residential youth care in the Netherlands. PLoS One 2023; 18:e0283744. [PMID: 36996082 PMCID: PMC10062624 DOI: 10.1371/journal.pone.0283744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Adolescent suicidal behavior, including non-suicidal self-injury, is increasingly prevalent in Secure Residential Youth Care (SRYC) in the Netherlands. Group workers play a vital role in the well-being and functioning of adolescents in SRYC as they interact with adolescents on a daily basis. However, we have little understanding of how adolescents perceive group workers' responses to suicidal behavior and we lack knowledge about the impact of these responses on adolescents and the group climate. AIM The aim of this study is to explore (a) how adolescents value group workers responses towards suicidal behavior and (b) the impact of these responses on adolescents, as well as (c) on the group climate. The results can be used to develop care-policy to improve care for suicidal adolescents in SYRC. METHOD Eleven suicidal female adolescents residing in SRYC were interviewed. All adolescents had previously displayed suicidal behavior, including non-suicidal self-injury. Interviews were analyzed using grounded theory. CONCLUSION This study presents the perceptions of suicidal female adolescents residing in SRYC about group workers' responses on suicidal behavior. Adolescents prefer group workers who react responsive to suicidal behavior. Responsive care, trust and connectedness help adolescents disclose their suicidal thoughts. Participants criticize group workers who are non-responsive as being distant, and their relationship with these group workers lacked trust, communication, a sense of connection, or personal depth. All adolescents underline the devastating impact of involuntary seclusion, and stress the importance of being able to disclose without fear of coercive consequences. Findings indicate that non-responsive reactions contribute to an increase in suicidal distress as well as a closed group climate.
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Affiliation(s)
- S P T Kaijadoe
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - H Klip
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - A de Weerd
- Experienced Expert, Student Psychology, Nijmegen, The Netherlands
| | - E A van Arragon
- Experienced Expert, Student Psychology, Nijmegen, The Netherlands
| | - K S Nijhof
- Pluryn, Nijmegen, The Netherlands
- Radboud University Nijmegen, Nijmegen, The Netherlands
| | - A Popma
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R H J Scholte
- Radboud University Nijmegen, Nijmegen, The Netherlands
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van de Koppel M, Mérelle SYM, Stikkelbroek YAJ, van der Heijden PT, Spijker J, Popma A, Creemers DHM. [Treatment plan for female adolescents in the grip of chronic suicidality]. Tijdschr Psychiatr 2022; 64:214-219. [PMID: 35506974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND A psychological autopsy study (Mérelle e.a. 2020) demonstrates a subgroup of female adolescents with chronic suicidal behavior and severe internalizing problems. AIM To describe characteristics of the suicidal process and the challenges experienced in providing mental health care for this subgroup. METHOD A case description and review of literature. RESULTS The persistent suicidal threat and the following despair of the patient and its parents are forcing care providers into an impasse: the primary focus of treatment is to guarantee the patient's safety, whereby the treatment of underlying problems is underexposed. Based on expert knowledge we make recommendations including autonomy-promoting treatment policy, treating suicidality as a transdiagnostic phenomenon, creating a multidisciplinary network of care providers and making chronic suicidality tolerable for care providers. CONCLUSION We propose preliminary practical recommendations in our quest for optimal mental health care for chronic suicidal adolescents.
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van Doorn M, Popma A, van Amelsvoort T, McEnery C, Gleeson JF, Ory FG, M. W. M. J, Alvarez-Jimenez M, Nieman DH. ENgage YOung people earlY (ENYOY): a mixed-method study design for a digital transdiagnostic clinical - and peer- moderated treatment platform for youth with beginning mental health complaints in the Netherlands. BMC Psychiatry 2021; 21:368. [PMID: 34301213 PMCID: PMC8299169 DOI: 10.1186/s12888-021-03315-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/07/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The onset of mental disorders typically occurs between the ages of 12 and 25, and the burden of mental health problems is the most consequential for this group. Indicated prevention interventions to target individuals with subclinical symptoms to prevent the transition to clinical levels of disorders, even leading to suicide, have shown to be effective. However, the threshold to seek help appears to be high. Digital interventions could offer a solution, especially during the Covid-19 pandemic. This implementation study will investigate the digital indicated prevention intervention ENgage YOung people Early (ENYOY), the Dutch version of the original Moderated Online Social Therapy Platform (MOST+) from Australia. In addition, the relationship between stress biomarkers, symptoms and outcome measures of youth using the platform will be investigated in this study. METHODS The MOST+ platform will be adapted, translated and developed for the situation in the Netherlands in collaboration with a Youth Panel. A prospective cohort of 125 young people (16-25 years) with beginning mental health complaints will be on the platform and followed for a year, of which 10 participants will have an additional smart watch and 10 participants will be asked to provide feedback about the platform. Data will be collected at baseline and after 3, 6 and 12 months. Outcome measures are Psychological Distress assessed with the Kessler Psychological Distress Scale (K10), Social and occupational functioning (measures by the SOFAS), positive mental health indicators measured by the Positive Health Instrument, stress biomarkers with a smart-watch, website journeys of visitors, and feedback of youth about the platform. It will be a mixed-method study design, containing qualitative and quantitative measures. DISCUSSION This trial will specifically address young people with emerging mental health complaints, and offers a new approach for treatment in the Netherlands. Considering the waiting lists in (child and adolescent)-psychiatry and the increase in suicides among youth, early low-threshold and non-stigmatizing help to support young people with emerging psychiatric symptoms is of crucial importance. Moreover, this project aims to bridge the gap between child and adolescent and adult psychiatry. TRIAL REGISTRATION Netherlands Trial Register ID NL8966 , retrospectively registered on the 19th of October 2020.
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Affiliation(s)
- M. van Doorn
- grid.509540.d0000 0004 6880 3010Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - A. Popma
- grid.509540.d0000 0004 6880 3010Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - T. van Amelsvoort
- grid.5012.60000 0001 0481 6099Department of Psychiatry and Neuropsychology Maastricht, Maastricht University, Maastricht, The Netherlands
| | - C. McEnery
- grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia ,grid.488501.0Orygen, Melbourne, Australia
| | - J. F. Gleeson
- grid.488501.0Orygen, Melbourne, Australia ,grid.411958.00000 0001 2194 1270Australian Catholic University, Melbourne, Australia
| | - F. G. Ory
- Buurtzorg Jong, Almelo, The Netherlands
| | - Jaspers M. W. M.
- grid.509540.d0000 0004 6880 3010Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - M. Alvarez-Jimenez
- grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia ,grid.488501.0Orygen, Melbourne, Australia
| | - D. H. Nieman
- grid.509540.d0000 0004 6880 3010Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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de Ruigh EL, Bouwmeester S, Popma A, Vermeiren RRJM, van Domburgh L, Jansen LMC. Using the biopsychosocial model for identifying subgroups of detained juveniles at different risk of re-offending in practice: a latent class regression analysis approach. Child Adolesc Psychiatry Ment Health 2021; 15:33. [PMID: 34158097 PMCID: PMC8218478 DOI: 10.1186/s13034-021-00379-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/01/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Juvenile delinquents constitute a heterogeneous group, which complicates decision-making based on risk assessment. Various psychosocial factors have been used to define clinically relevant subgroups of juvenile offenders, while neurobiological variables have not yet been integrated in this context. Moreover, translation of neurobiological group differences to individual risk assessment has proven difficult. We aimed to identify clinically relevant subgroups associated with differential youth offending outcomes, based on psychosocial and neurobiological characteristics, and to test whether the resulting model can be used for risk assessment of individual cases. METHODS A group of 223 detained juveniles from juvenile justice institutions was studied. Latent class regression analysis was used to detect subgroups associated with differential offending outcome (recidivism at 12 month follow-up). As a proof of principle, it was tested in a separate group of 76 participants whether individual cases could be assigned to the identified subgroups, using a prototype 'tool' for calculating class membership. RESULTS Three subgroups were identified: a 'high risk-externalizing' subgroup, a 'medium risk-adverse environment' subgroup, and a 'low risk-psychopathic traits' subgroup. Within these subgroups, both autonomic nervous system and neuroendocrinological measures added differentially to the prediction of subtypes of reoffending (no, non-violent, violent). The 'tool' for calculating class membership correctly assigned 92.1% of participants to a class and reoffending risk. CONCLUSIONS The LCRA approach appears to be a useful approach to integrate neurobiological and psychosocial risk factors to identify subgroups with different re-offending risk within juvenile justice institutions. This approach may be useful in the development of a biopsychosocial assessment tool and may eventually help clinicians to assign individuals to those subgroups and subsequently tailor intervention based on their re-offending risk.
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Affiliation(s)
- E L de Ruigh
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC -VUmc, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - S Bouwmeester
- Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC -VUmc, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - R R J M Vermeiren
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Oegstgeest, The Netherlands
| | - L van Domburgh
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC -VUmc, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
- Pluryn-Intermetzo, Lelystad, The Netherlands
| | - L M C Jansen
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC -VUmc, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands.
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Beekman ATF, Hillegers MHJ, De Backer L, Popma A, Dom G, Van HL. [Not Available]. Tijdschr Psychiatr 2021; 63:97-99. [PMID: 33620718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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van den Boogaard L, Popma A, van der Hoeven M, van den Boer M, Bokhorst P, Heerma A, van der Meer M, Steenmeijer J, van der Stegen B, Dekkers TJ. [Intensive home treatment (IHT): indication criteria for children and adolescents]. Tijdschr Psychiatr 2021; 63:175-180. [PMID: 33779971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Intensive home treatment (IHT) is an intervention that provides intensive psychiatric (crisis) care in the home environment. AIM To formulate indication criteria for IHT in children and adolescents, to improve assessment and to reduce the time needed for triage. METHOD The Delphi method was used to assess the opinion of experts on the indication for IHT in children and adolescents. In round 1, 18 employees of the IHT team of Levvel (Academic Centre for Child and Adolescent Psychiatry) list the indication criteria that they thought should be used to determine whether a patient belonged to the IHT target group. Open coding was used to analyze the responses and to derive statements that, in the following three rounds, were rated by the participants on their importance. RESULTS 33 statements were deemed important enough (> 80% consensus) to include in the final list. These statements concerned the aim, target group, treatment services, the role and responsibilities of the referrer and logistical issues. CONCLUSION The list with assessment indicators is a promising tool to help IHT teams working with children and adolescents improve and standardize their triage.
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Ter Harmsel JF, Noordzij ML, Goudriaan AE, Dekker JJM, Swinkels LTA, van der Pol TM, Popma A. Biocueing and ambulatory biofeedback to enhance emotion regulation: A review of studies investigating non-psychiatric and psychiatric populations. Int J Psychophysiol 2020; 159:94-106. [PMID: 33248196 DOI: 10.1016/j.ijpsycho.2020.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Abstract
Over the last years, biofeedback applications are increasingly used to enhance interoceptive awareness and self-regulation, in psychiatry and beyond. These applications are used to strengthen emotion regulation skills by home training (ambulatory biofeedback) and real-time support in everyday life stressful situations (biocueing). Unfortunately, knowledge about the feasibility and effectivity of these applications is still scarce. Therefore, a systematic literature search was performed. In total, 30 studies (4 biocueing, 26 ambulatory biofeedback) were reviewed; 21 of these studies were conducted in non-psychiatric samples and 9 studies in psychiatric samples. Study characteristics, biofeedback characteristics, effectivity and feasibility outcomes were extracted. Despite the rapid advances in wearable technology, only a few biocueing studies were found. In the majority of the studies significant positive effects were found on self-reported (stress-related) psychological measures. Significant improvements on physiological measures were also reported, though these measures were used less frequently. Feasibility of the applications was often reported as sufficient, though not adequately assessed in most studies. Taken into account the small sample sizes and the limited quality of the majority of the studies in this recently emerging field, biocueing and ambulatory biofeedback interventions showed promising results. Future research is expected to be focusing on biocueing as a just-in-time adaptive intervention. To establish this research field, closer cooperation between research groups, use of more rigorous as well as individually tailored research designs and more valid feasibility and effectivity assessment are recommended.
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Affiliation(s)
- J F Ter Harmsel
- Inforsa, Forensic Mental Health Care, Amsterdam, the Netherlands; Amsterdam UMC, Department of Child and Adolescent Psychiatry and Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - M L Noordzij
- University of Twente, Department of Psychology, Health and Technology, Enschede, the Netherlands
| | - A E Goudriaan
- Arkin, Department of Research and Quality of Care, Amsterdam, the Netherlands; Amsterdam UMC, Department of Psychiatry, University of Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - J J M Dekker
- Arkin, Department of Research and Quality of Care, Amsterdam, the Netherlands; Vrije Universiteit Amsterdam, Faculty of Behavioral and Movement Sciences, Amsterdam, the Netherlands
| | - L T A Swinkels
- Inforsa, Forensic Mental Health Care, Amsterdam, the Netherlands; Amsterdam UMC, Department of Child and Adolescent Psychiatry and Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - T M van der Pol
- Inforsa, Forensic Mental Health Care, Amsterdam, the Netherlands; Amsterdam UMC, Department of Child and Adolescent Psychiatry and Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - A Popma
- Amsterdam UMC, Department of Child and Adolescent Psychiatry and Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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Van der Sluys ME, Zijlmans J, Popma A, Van der Laan PH, Scherder EJA, Marhe R. Neurocognitive predictors of treatment completion and daytime activities at follow-up in multiproblem young adults. Cogn Affect Behav Neurosci 2020; 20:1103-1121. [PMID: 32820418 PMCID: PMC7497488 DOI: 10.3758/s13415-020-00822-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Previous research has shown an association between cognitive control deficits and problematic behavior such as antisocial behavior and substance use, but little is known about the predictive value of cognitive control for treatment outcome. The current study tests whether selected markers of baseline cognitive control predict (1) treatment completion of a day treatment program involving a combination of approaches for multiproblem young adults and (2) daytime activities a year after the start of treatment, over and above psychological, social, and criminal characteristics. We assessed individual, neurobiological, and neurobehavioral measures, including functional brain activity during an inhibition task and two electroencephalographic measures of error processing in 127 male multiproblem young adults (age 18-27 years). We performed two hierarchical regression models to test the predictive power of cognitive control for treatment completion and daytime activities at follow-up. The overall models did not significantly predict treatment completion or daytime activities at follow-up. However, activity in the anterior cingulate cortex (ACC) during response inhibition, years of regular alcohol use, internalizing problems, and ethnicity were all significant individual predictors of daytime activity at follow-up. In conclusion, cognitive control could not predict treatment completion or daytime activities a year after the start of treatment over and above individual characteristics. However, results indicate a direct association between brain activity during response inhibition and participation in daytime activities, such as work or school, after treatment. As adequate baseline inhibitory control is associated with a positive outcome at follow-up, this suggests interventions targeting cognitive control might result in better outcomes at follow-up.
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Affiliation(s)
- M E Van der Sluys
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorstraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - J Zijlmans
- VU University Medical Center Department of Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - A Popma
- VU University Medical Center Department of Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
- Department of Criminal Law and Criminology, Leiden University, Steenschuur 25, 2311 ES, Leiden, The Netherlands
| | - P H Van der Laan
- Department of Criminal Law and Criminology, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands
- Netherlands Institute for the Study of Crime and Law Enforcement, De Boelelaan 1077, 1081 HV, Amsterdam, The Netherlands
| | - E J A Scherder
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorstraat 7, 1081 BT, Amsterdam, The Netherlands
| | - R Marhe
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorstraat 7, 1081 BT, Amsterdam, The Netherlands
- VU University Medical Center Department of Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
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12
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Swinkels LTA, van der Pol TM, Popma A, ter Harmsel JF, Dekker JJM. Improving mental wellbeing of forensic psychiatric outpatients through the addition of an informal social network intervention to treatment as usual: a randomized controlled trial. BMC Psychiatry 2020; 20:418. [PMID: 32842971 PMCID: PMC7446148 DOI: 10.1186/s12888-020-02819-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/12/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Forensic psychiatric patients often suffer from a multitude of severe psychiatric and social problems. Meanwhile multimodal evidence-based interventions are scarce and treatment effectiveness is in need of improvement. The main goal of forensic psychiatric treatment is to address psychiatric and social factors and thereby mitigate criminal behaviour. Notably, a supportive social network is an important protective factor for criminal behaviour. As such, improving a poor social network may decrease the risk of criminal recidivism. This study aims to examine the effectiveness of the addition of an informal social network intervention (FNC) to treatment as usual (TAU) among forensic psychiatric outpatients. METHODS In a mono-center randomized controlled clinical trial with two parallel groups, forensic psychiatric outpatients with social network-related problems (N = 105) will be allocated to either TAU + FNC or TAU alone. The informal social network intervention consists of a 12-month coaching intervention, performed by the forensic network coach (a volunteer trained by an informal care institute). Assessments will be conducted at baseline and 3 months, 6 months, 9 months, 12 months, and 18 months after baseline. The primary outcome variable is mental wellbeing. Psychiatric functioning, criminal recidivism, substance abuse, quality of life, social network, social support, loneliness and self-sufficiency are included as secondary outcomes. A variety of potential mediators and moderators of effectiveness will be explored. Additionally, a qualitative evaluation of effectiveness will be performed. DISCUSSION This study will contribute to the existing literature of forensic treatment effectiveness as it is the first RCT examining the effectiveness of adding a social network intervention in a forensic outpatient population. If effectiveness is shown, forensic mental health care could be optimized by collaborating with informal care or community initiatives aimed at improving a positive social network. In addition, results will provide insight regarding mediators and moderators of treatment effectiveness. TRIAL REGISTRATION This study is registered at the Netherlands Trial Register ( NTR7163 ). Date of registration: 16 april 2018.
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Affiliation(s)
- L. T. A. Swinkels
- Inforsa Forensic Mental Health Care, Vlaardingenlaan 5, 1059 GL Amsterdam, the Netherlands ,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - T. M. van der Pol
- Inforsa Forensic Mental Health Care, Vlaardingenlaan 5, 1059 GL Amsterdam, the Netherlands ,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - A. Popma
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - J. F. ter Harmsel
- Inforsa Forensic Mental Health Care, Vlaardingenlaan 5, 1059 GL Amsterdam, the Netherlands ,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - J. J. M. Dekker
- Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN Amsterdam, the Netherlands ,grid.12380.380000 0004 1754 9227Department of Clinical Psychology, VU University, Klaprozenweg 111, 1033 NN Amsterdam, the Netherlands
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13
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Zijlmans J, Bevaart F, van Duin L, Luijks M, Popma A, Marhe R. Error-related brain activity in relation to psychopathic traits in multi-problem young adults: An ERP study. Biol Psychol 2019; 144:46-53. [DOI: 10.1016/j.biopsycho.2019.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 02/04/2019] [Accepted: 03/26/2019] [Indexed: 10/27/2022]
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14
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Smeets KC, Oostermeijer S, Lappenschaar M, Cohn M, van der Meer JMJ, Popma A, Jansen LMC, Rommelse NNJ, Scheepers FE, Buitelaar JK. Are Proactive and Reactive Aggression Meaningful Distinctions in Adolescents? A Variable- and Person-Based Approach. J Abnorm Child Psychol 2017; 45:1-14. [PMID: 27113216 PMCID: PMC5219021 DOI: 10.1007/s10802-016-0149-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study was designed to examine whether proactive and reactive aggression are meaningful distinctions at the variable- and person-based level, and to determine their associated behavioral profiles. Data from 587 adolescents (mean age 15.6; 71.6 % male) from clinical samples of four different sites with differing levels of aggression problems were analyzed. A multi-level Latent Class Analysis (LCA) was conducted to identify classes of individuals (person-based) with similar aggression profiles based on factor scores (variable-based) of the Reactive Proactive Questionnaire (RPQ) scored by self-report. Associations were examined between aggression factors and classes, and externalizing and internalizing problem behavior scales by parent report (CBCL) and self-report (YSR). Factor-analyses yielded a three factor solution: 1) proactive aggression, 2) reactive aggression due to internal frustration, and 3) reactive aggression due to external provocation. All three factors showed moderate to high correlations. Four classes were detected that mainly differed quantitatively (no ‘proactive-only’ class present), yet also qualitatively when age was taken into account, with reactive aggression becoming more severe with age in the highest affected class yet diminishing with age in the other classes. Findings were robust across the four samples. Multiple regression analyses showed that ‘reactive aggression due to internal frustration’ was the strongest predictor of YSR and CBCL internalizing problems. However, results showed moderate to high overlap between all three factors. Aggressive behavior can be distinguished psychometrically into three factors in a clinical sample, with some differential associations. However, the clinical relevance of these findings is challenged by the person-based analysis showing proactive and reactive aggression are mainly driven by aggression severity.
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Affiliation(s)
- K C Smeets
- Karakter Child and Adolescent Psychiatry, Reinier Postlaan 12, 6525, GC, Nijmegen, Netherlands.
| | - S Oostermeijer
- Child and Adolescent Psychiatry, VU University Medical Center Amsterdam, Amsterdam, Netherlands
| | | | - M Cohn
- Child and Adolescent Psychiatry, VU University Medical Center Amsterdam, Amsterdam, Netherlands
| | - J M J van der Meer
- Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands
| | - A Popma
- Child and Adolescent Psychiatry, VU University Medical Center Amsterdam, Amsterdam, Netherlands
| | - L M C Jansen
- Child and Adolescent Psychiatry, VU University Medical Center Amsterdam, Amsterdam, Netherlands
| | - N N J Rommelse
- Karakter Child and Adolescent Psychiatry, Reinier Postlaan 12, 6525, GC, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Netherlands
| | - F E Scheepers
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, UMC Utrecht, Utrecht, Netherlands
| | - J K Buitelaar
- Karakter Child and Adolescent Psychiatry, Reinier Postlaan 12, 6525, GC, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands
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Bink M, van Boxtel GJM, Popma A, Bongers IL, Denissen AJM, van Nieuwenhuizen C. EEG theta and beta power spectra in adolescents with ADHD versus adolescents with ASD + ADHD. Eur Child Adolesc Psychiatry 2015; 24:873-86. [PMID: 25374034 DOI: 10.1007/s00787-014-0632-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 10/10/2014] [Indexed: 11/26/2022]
Abstract
Attention problems are common in youngsters with attention deficit hyperactivity disorder (ADHD) as well as in adolescents with combined autism spectrum disorder (ASD) and ADHD. However, it is unknown whether there is psychophysiological overlap and/or a difference in electroencephalogram (EEG) power spectra between ADHD and comorbid ASD and ADHD (ASD + ADHD), on and off stimulant medication. To explore potential differences and overlap, measures of theta and beta power in adolescents diagnosed with ADHD (n = 33) versus adolescents with combined ASD + ADHD (n = 20), categorized by stimulant medication use (57 % of the total sample), were compared. EEG measures were acquired in three conditions: (1) resting state, eyes closed (2) resting state, eyes open and (3) during an oddball task. In addition, performance on the d2 attention test was analyzed. Adolescents with ADHD displayed more absolute theta activity than adolescents with ASD + ADHD during the eyes open and task conditions, independent of stimulant medication use. In addition, only the adolescents with ADHD showed an association between diminished attention test performance and increased theta in the eyes open condition. Results of the current study suggest that although there is behavioral overlap between ADHD characteristics in adolescents with ADHD and adolescents with combined ASD + ADHD, the underlying psychophysiological mechanisms may be different. Adolescents with ASD + ADHD exhibited fewer of the EEG physiological signs usually associated with ADHD, although there was an overlap in attentional problems between the groups. This may indicate that treatments developed for ADHD work differently in some adolescents with ASD + ADHD and adolescents with ADHD only.
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Affiliation(s)
- M Bink
- Scientific Center for Care and Welfare (Tranzo), Tilburg University, PO Box 90153 (T425), 5000 LE, Tilburg, The Netherlands,
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Popma A. [Examining the developing brain in Dutch child and adolescent psychiatry]. Tijdschr Psychiatr 2015; 57:871-875. [PMID: 26727561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Research on the developing brain in children and adolescents is delivering new insights into the underlying mechanisms of childhood psychiatric disorders. AIM To provide important information about the role that departments of Dutch child and adolescent psychiatry are playing in this international field that is expanding rapidly. METHOD This article provides an overview of recent, mainly Dutch neuro-imaging studies on the developing brain. RESULTS A large number of studies from Dutch research centers have greatly increased our knowledge about normal and abnormal brain development in relation to the development of psychiatric disorders. CONCLUSION Neuro-developmental research can help us to understand the underlying mechanisms of developing psychiatric disorders. This is likely to lead to new preventive measures and to more effective treatment in the future. Policy-makers should therefore commit a larger proportion of their neuroscience research budgets to neurodevelopmental studies in children.
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Vermeiren R, Colins OF, Popma A, Mulder E. [Forensic child, adolescent and transitional psychiatry]. Tijdschr Psychiatr 2015; 57:881-885. [PMID: 26727563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Over the past 20 years there has been a marked increase in research relating to forensic child and adolescent psychiatry. AIM To review briefly and reflect on this research. METHOD First of all, we describe the characteristics of forensic psychiatry and consider the consequences of this type of psychiatry for research in forensic settings. Secondly, we highlight several lines of research; these range from neurobiology to the prevalence of psychiatric disorders in persons who have committed specific types of offences. RESULTS A majority of young people who have been in contact with the law appeared to have a psychiatric disorder, especially behavioural disorders, ADHD and substance abuse. However, also anxiety and depressive disorders were found in 10-20% of all delinquent young people. Particularly the existence of more than one disorder showed a connection between the nature and the severity of the delinquent behaviour and the disfunctioning of the adolescent. Current research focuses on stress and HPA axis of young people in relation to proactive and reactive aggression. CONCLUSION In the past decades research in forensic child and adolescent psychiatry has taken an enormous flight. One of the challenges for the future will be translating the results of the research into practice.
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Platje E, Vermeiren RRJM, Raine A, Doreleijers TAH, Keijsers LGMT, Branje SJT, Popma A, van Lier PAC, Koot HM, Meeus WHJ, Jansen LMC. A longitudinal biosocial study of cortisol and peer influence on the development of adolescent antisocial behavior. Psychoneuroendocrinology 2013; 38:2770-9. [PMID: 23927935 DOI: 10.1016/j.psyneuen.2013.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 11/25/2022]
Abstract
It is increasingly recognized that in order to understand the complex phenomenon of antisocial behavior, interrelations between biological and social risk factors should be taken into account. In the current study, this biosocial approach was applied to examine the mediating role of deviant peers in longitudinal associations linking the level of hypothalamic-pituitary-adrenal (HPA) axis activity to aggression and rule-breaking. Participants were 425 boys and girls from the general population, who were assessed yearly at ages 15, 16, and 17. As a measure of HPA axis activity, cortisol was assessed at awakening, 30, and 60 min later (the cortisol awakening response, CAR). Participants, as well as their best friend, reported on their own aggressive and rule-breaking behavior, thereby allowing to assess bidirectional influences within friendships. Aggression was only predicted by a decreased cortisol level at awakening, and not by aggressive behavior of their friend. Decreased levels of cortisol at awakening predicted adolescents' rule-breaking, which subsequently predicted increased rule-breaking of their best friend. The latter was only found for adolescents who changed friends, as compared to adolescents with the same friend in every year. Gender differences were not found. These findings suggest that interrelations between biological and social risk factors are different for the development of aggression versus rule-breaking. Furthermore, decreased levels of HPA axis activity may represent a susceptibility to selecting deviant peers.
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Affiliation(s)
- E Platje
- VU University Medical Center, Department of Child and Adolescent Psychiatry, Amsterdam, The Netherlands.
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Bink M, Popma A, Bongers IL, van Boxtel GJM, Denissen A, van Nieuwenhuizen C. Cardiac Reactivity and Stimulant Use in Adolescents with Autism Spectrum Disorders with Comorbid ADHD Versus ADHD. J Autism Dev Disord 2013; 45:481-94. [DOI: 10.1007/s10803-013-1929-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Popma A. Regional Medical Programs; mountain states. Postgrad Med 1970; 48:299-302. [PMID: 5460374 DOI: 10.1080/00325481.1970.11693573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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