Mental Health Care Institute

Ermelo, Netherlands

Mental Health Care Institute

Ermelo, Netherlands
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Kok J.S.,Mental Health Care Institute | Van Heuvelen M.J.G.,University of Groningen | Berg I.J.,Mental Health Care Institute | Scherder E.J.A.,VU University Amsterdam
BMC Geriatrics | Year: 2016

Background: Evidence shows that living in small scale homelike Special Care Units (SCU) has positive effects on behavioural and psychological symptoms of patients with dementia. Effects on cognitive functioning in relation to care facilities, however, are scarcely investigated. The purpose of this study is to gain more insight into the effects of living in small scale homelike Special Care Units, compared to regular SCU's, on the course of cognitive functioning in dementia. Methods: A group of 67 patients with dementia who moved from a regular SCU to a small scale homelike SCU and a group of 48 patients with dementia who stayed in a regular SCU participated in the study. Cognitive and behavioural functioning was assessed by means of a neuropsychological test battery and observation scales one month before (baseline), as well as 3 (post) and 6 months (follow-up) after relocation. Results: Comparing the post and follow-up measurement with the baseline measurement, no significant differences on separate measures of cognitive functioning between both groups were found. Additional analyses, however, on 'domain clusters' revealed that global cognitive functioning of the small scale homelike SCU group showed significantly less cognitive decline three months after the transfer (p < 0.05). Effect sizes (95 % CI) show a tendency for better aspects of cognition in favour of the homelike small scaled SCU group, i.e., visual memory, picture recognition, cognitive decline as observed by representatives and the clustered domains episodic memory and global cognitive functioning. Conclusions: While there is no significant longitudinal effect on the progression of cognitive decline comparing small scaled homelike SCU's with regular SCU's for patients with dementia, analyses on the domain clusters and effect sizes cautiously suggest differences in favour of the small scaled homelike SCU for different aspects of cognition. © 2016 Kok et al.


PubMed | University of Groningen, VU University Amsterdam and Mental Health Care Institute
Type: | Journal: BMC geriatrics | Year: 2016

Evidence shows that living in small scale homelike Special Care Units (SCU) has positive effects on behavioural and psychological symptoms of patients with dementia. Effects on cognitive functioning in relation to care facilities, however, are scarcely investigated. The purpose of this study is to gain more insight into the effects of living in small scale homelike Special Care Units, compared to regular SCUs, on the course of cognitive functioning in dementia.A group of 67 patients with dementia who moved from a regular SCU to a small scale homelike SCU and a group of 48 patients with dementia who stayed in a regular SCU participated in the study. Cognitive and behavioural functioning was assessed by means of a neuropsychological test battery and observation scales one month before (baseline), as well as 3 (post) and 6 months (follow-up) after relocation.Comparing the post and follow-up measurement with the baseline measurement, no significant differences on separate measures of cognitive functioning between both groups were found. Additional analyses, however, on domain clusters revealed that global cognitive functioning of the small scale homelike SCU group showed significantly less cognitive decline three months after the transfer (p<0.05). Effect sizes (95% CI) show a tendency for better aspects of cognition in favour of the homelike small scaled SCU group, i.e., visual memory, picture recognition, cognitive decline as observed by representatives and the clustered domains episodic memory and global cognitive functioning.While there is no significant longitudinal effect on the progression of cognitive decline comparing small scaled homelike SCUs with regular SCUs for patients with dementia, analyses on the domain clusters and effect sizes cautiously suggest differences in favour of the small scaled homelike SCU for different aspects of cognition.


Kok J.S.,Mental Health Care Institute | Berg I.J.,Mental Health Care Institute | Blankevoort G.C.G.,Mental Health Care Institute | Scherder E.J.A.,VU University Amsterdam
BMC Geriatrics | Year: 2017

Background: An enriched environment for residents with dementia may have a positive effect on the rest-activity rhythm. A small scaled homelike special care unit might be such an enriched environment. The present study shows whether the rest-activity rhythm of residents with moderate to severe dementia responds positively to a transfer from a regular Special Care Unit (SCU) to a small scaled homelike SCU. Methods: Initially, a group of 145 residents living in a regular SCU participated. Out of this group, 77 residents moved to a small scaled homelike SCU. This group was compared to the group of 68 residents that remained at the regular SCU. Rest-activity rhythm was assessed by means of actigraphy and observation scales before and after relocation. Results: No significant main effects nor significant interaction effects in intradaily and interdaily activity were found for the data of 38 residents in the small scaled homelike SCU and 20 residents of the regular SCU. The effect sizes, however, ranged from small to large. Conclusions: Considering the effect sizes, a new study with a larger number of participants is necessary before firm conclusions can be drawn. Trial registration: Current Controlled Trials ISRCTN11151241. registration date: 21-06-2017. Retrospectively registered. © 2017 The Author(s).


Visser H.A.,Mental Health Care Institute | Van Minnen A.,Radboud University Nijmegen | Van Megen H.,Mental Health Care Institute | Eikelenboom M.,VU University Amsterdam | And 4 more authors.
Journal of Clinical Psychiatry | Year: 2014

Background: Studies on the relationship between adverse childhood experiences (ACEs) and obsessivecompulsive disorder (OCD) symptom severity are scarce. Available studies leave a considerable degree of uncertainty. The present study examines the relationship between ACEs and symptom severity, chronicity, and comorbidity in a sample of patients with OCD. Method: Baseline data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study, in which 382 referred patients with DSM-IV-diagnosed OCD participated, were analyzed. ACEs (physical abuse, sexual abuse, witnessing interparental violence, maternal dysfunction, paternal dysfunction, and early separation from a parent) were measured using a structured interview. Data were collected between September 2005 and November 2009. Results: None of the ACEs were related to OCD symptom severity or chronicity, nor was there a doseresponse relationship between ACEs and OCD severity or chronicity, but results of linear regression analysis revealed that ACEs were related to comorbidity in patients with OCD (P <.001), in particular to comorbid affective disorders (P <.01), substance use disorders (P <.01), and eating disorders (P <.01), but not to comorbid anxiety disorders. Conclusions: Results of the study suggest that unlike in other psychiatric disorders, ACEs play no significant role in symptom severity and chronicity of OCD. This study was the first to reveal evidence for a relationship between ACEs and comorbidity in patients with OCD. Conclusions about trauma-relatedness of OCD based on studies finding higher trauma rates or severity among patients with OCD than among healthy controls, should be critically reconsidered, since presence of comorbidity might account for these differences. © Copyright 2014 Physicians Postgraduate Press, Inc.


Hofmeijer-Sevink M.K.,VU University Amsterdam | Hofmeijer-Sevink M.K.,Mental Health Care Institute | Van Oppen P.,VU University Amsterdam | Van Megen H.J.,Mental Health Care Institute | And 7 more authors.
Journal of Affective Disorders | Year: 2013

Background: This study describes lifetime and current rates of comorbidity, its onset and its consequences in a large clinical sample of patients with obsessive compulsive disorder (OCD). A wide range of risk factors and clinical characteristics were also examined to determine whether pure OCD is different from OCD with current comorbidity. Finally, the temporal sequencing of the disorders was examined. Method: Data were obtained from the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. A sample of 382 participants with current OCD (during the past month) was evaluated. Results: Current comorbidity occurred in 55%of patients with OCD, while 78%suffered from lifetime comorbidity. Comorbidity is associated with more severe OCD, anxiety and depressive symptoms and more negative consequences on daily life. Multiple comorbid disorders often precede OCD and influence both its course and severity. Childhood trauma and neuroticism are vulnerability factors for the development of multiple comorbid disorders in OCD. Limitations: It should be noted that causal inferences about the association between risk factors and OCD are precluded since our results were based on cross-sectional data. Conclusion: (Multiple) comorbidity in OCD is clinically relevant since it is associated with a specific pattern of vulnerability, with greater chronicity, with more severe OCD and more negative consequences on daily life. This indicates that the diagnosis and treatment of all comorbid disorders is clinically relevant, and clinicians should be especially aware of multiple disorders in cases of childhood trauma and high levels of neuroticism. Primary OCD has a different developmental and comorbidity pattern compared to secondary OCD. © 2013 Elsevier B.V. All rights reserved.


Creemers D.H.M.,Mental Health Care Institute | Creemers D.H.M.,Radboud University Nijmegen | Scholte R.H.J.,Radboud University Nijmegen | Engels R.C.M.E.,Radboud University Nijmegen | And 2 more authors.
Journal of Behavior Therapy and Experimental Psychiatry | Year: 2012

The aim of the present study was to examine whether explicit and implicit self-esteem, the interaction between these two constructs, and their discrepancy are associated with depressive symptoms, suicidal ideation, and loneliness. Participants were 95 young female adults (M = 21.2 years, SD = 1.88) enrolled in higher education. We administered the Name Letter Task to measure implicit self-esteem, and the Rosenberg self-esteem scale to assess explicit self-esteem. The results indicated that explicit but not implicit self-esteem was negatively associated with depressive symptoms, suicidal ideation, and loneliness. The interaction of implicit and explicit self-esteem was associated with suicidal ideation, indicating that participants with high implicit self-esteem combined with a low explicit self-esteem showed more suicidal ideation. Furthermore, the size of the discrepancy between implicit and explicit self-esteem was positively associated with depressive symptoms, suicidal ideation, and loneliness. In addition, results showed that the direction of the discrepancy is an important: damaged self-esteem (high implicit self-esteem combined with low explicit self-esteem) was consistently associated with increased levels of depressive symptoms, suicidal ideation, and loneliness, while defensive or fragile self-esteem (high explicit and low implicit self-esteem) was not. Together, these findings provide new insights into the relationship of implicit and explicit self-esteem with depressive symptoms, suicidal ideation, and loneliness. © 2011 Elsevier Ltd. All rights reserved.


Leeuwis F.H.,VU University Amsterdam | Koot H.M.,VU University Amsterdam | Creemers D.H.M.,Radboud University Nijmegen | Creemers D.H.M.,Mental Health Care Institute | van Lier P.A.C.,VU University Amsterdam
Journal of Abnormal Child Psychology | Year: 2015

Discrepancies between implicit and explicit self-esteem have been linked with internalizing problems among mainly adolescents and adults. Longitudinal research on this association in children is lacking. This study examined the longitudinal link between self-esteem discrepancies and the development of internalizing problems in children. It furthermore examined the possible mediating role of self-esteem discrepancies in the longitudinal link between experiences of peer victimization and internalizing problems development. Children (N = 330, Mage = 11.2 year; 52.5 % female) were followed over grades five (age 11 years) and six (age 12 years). Self-report measures were used annually to test for victimization and internalizing problems. Implicit self-esteem was assessed using an implicit association test, while explicit self-esteem was assessed via self-reports. Self-esteem discrepancies represented the difference between implicit and explicit self-esteem. Results showed that victimization was associated with increases in damaged self-esteem (higher levels of implicit than explicit self-esteem. Additionally, damaged self-esteem at age 11 years predicted an increase in internalizing problems in children over ages 11 to 12 years. Furthermore, damaged self-esteem mediated the relationship between age 11 years victimization and the development of internalizing problems. No impact of fragile self-esteem (lower levels of implicit than explicit self-esteem) on internalizing problems was found. The results thus underscore that, as found in adolescent and adult samples, damaged self-esteem is a predictor of increases in childhood internalizing problems. Moreover, damaged self-esteem might explain why children who are victimized develop internalizing problems. Implications are discussed. © 2014, Springer Science+Business Media New York.


PubMed | Mental Health Care Institute
Type: Journal Article | Journal: Journal of behavior therapy and experimental psychiatry | Year: 2011

The aim of the present study was to examine whether explicit and implicit self-esteem, the interaction between these two constructs, and their discrepancy are associated with depressive symptoms, suicidal ideation, and loneliness. Participants were 95 young female adults (M=21.2 years, SD=1.88) enrolled in higher education. We administered the Name Letter Task to measure implicit self-esteem, and the Rosenberg self-esteem scale to assess explicit self-esteem. The results indicated that explicit but not implicit self-esteem was negatively associated with depressive symptoms, suicidal ideation, and loneliness. The interaction of implicit and explicit self-esteem was associated with suicidal ideation, indicating that participants with high implicit self-esteem combined with a low explicit self-esteem showed more suicidal ideation. Furthermore, the size of the discrepancy between implicit and explicit self-esteem was positively associated with depressive symptoms, suicidal ideation, and loneliness. In addition, results showed that the direction of the discrepancy is an important: damaged self-esteem (high implicit self-esteem combined with low explicit self-esteem) was consistently associated with increased levels of depressive symptoms, suicidal ideation, and loneliness, while defensive or fragile self-esteem (high explicit and low implicit self-esteem) was not. Together, these findings provide new insights into the relationship of implicit and explicit self-esteem with depressive symptoms, suicidal ideation, and loneliness.

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