The purpose of this study was threefold, namely (1) to differentiate between multiproblem familie... more The purpose of this study was threefold, namely (1) to differentiate between multiproblem families and control families on characteristics and processes within the family based on a theoretical framework, (2) to identify multiproblem families by establishing cutoff scores on various questionnaires, and (3) to categorize multiproblem families into subtypes by cluster analyses. Various questionnaires were administered to multiproblem families (n = 85) and control families (n = 150). Results showed that what we propose to refer to as multiproblem families present a broad range of problems on seven domains: (1) child factors, (2) parental factors, (3) childrearing problems (inadequate or inconsistent parenting), (4) family functioning problems, (5) contextual problems, (6) social network problems, and (7) mental health care problems. Further, reliable cutoff scores were established for various questionnaires. Finally, three types of families were found: (1) community-problem families, (2) multiproblem families, and (3) child-focused mild-problem families. This paper looks to advance an evidence-based definition and assessment of "multiproblem families" suggesting the possible value of defining and assessing multiproblem families in relation to these seven dimensions. Moreover, the classification of multiproblem families stresses the importance of providing tailored treatments.
The relation between maternal depressive symptoms and children's mental health problems has been ... more The relation between maternal depressive symptoms and children's mental health problems has been well established. However, prior studies have predominantly focused on maternal reports of children's mental health problems and on parenting behavior, as a broad and unilateral concept. This cross-sectional study examined specific observed mother-child interaction behaviors through which maternal depressive symptoms are assumed to affect children's mental health problems. We expected higher rates of maternal depressive symptoms to predict higher rates of children's mental health problems, and we expected this relation to be mediated by low maternal warmth and high maternal psychological control. The sample consisted of 111 mother-child dyads referred for treatment. The mother-child interaction behaviors were coded according to the observed mother-child interaction tasks. Children's mental health problems were assessed using both maternal reports and children's self-reports. As expected, the results showed that maternal depressive symptoms were strongly related to maternal reports of children's internalizing and externalizing mental health problems. Surprisingly, maternal depressive symptoms were unrelated to children's self-reported depressive symptoms. Furthermore, mother-child interactions did not mediate the relation between maternal depressive symptoms and child mental health problems. Maternal depressive symptoms were associated with high maternal warmth, and high psychological control was associated with high levels of mother-reported externalizing mental health problems in children. These results partially replicate previous findings but add to these by using observational methods and multiinformant data. The importance of using a multi-informant and multi-method approach in assessing children's mental health problems in clinical practice and research are discussed. Keywords Maternal depression Á Childhood depression Á Mother-child interaction Á Observations Á Internalizing and externalizing mental health problems
Background Informant discrepancies between mother and child have challenged the assessment, class... more Background Informant discrepancies between mother and child have challenged the assessment, classification, and treatment of childhood anxiety. Despite numerous studies on this matter, the implications and consequences for research and clinical practice remain unclear. Objective The present study aimed to obtain meaningful clinical information about informant discrepancies by examining mother-child agreement for anxiety subtypes, and by exploring mother-child discrepancies in relation to independent observer ratings of behavioral anxiety. Method The screen for child anxiety related emotional disorders was administered to 79 mothers and clinically referred anxious children aged 7-13 years. Mother-child dyads were observed during an anxiety-provoking task and independent observers rated children's observed anxiety. Results The findings indicated a high level of mother-child disagreement on reports of anxiety. There was variability in levels of agreement between subtypes of anxiety, with significantly stronger mother-child agreement for separation compared to other forms of anxiety. Observed proximity between the mother and child was positively associated with child-reported separation anxiety and children's observed anxious voice was negatively associated with child-reported panic disorder. Conclusions The results highlight the need to incorporate a multi-informant assessment of childhood anxiety in clinical practice and research, in particular for subtypes of anxiety problems that are characterized by less observable and more internally experienced components.
Background: Both depressive disorder and subclinical depressive symptoms during adolescence are a... more Background: Both depressive disorder and subclinical depressive symptoms during adolescence are a major public health concern. Therefore, it is important that depression is detected at an early stage and is treated preventively. Prevention based on the principles of Cognitive Behavioural Therapy (CBT) has proven to be the most effective, however research has mainly focused on the effectiveness of "prevention packages" consisting of multiple CBT-components, rather than on the distinct CBT-components. This study will evaluate the relative effectiveness of four core components of CBT (cognitive restructuring (CR), behavioural activation (BA), problem solving (PS) and relaxation (RE)). In addition the relative (cost-)effectiveness of four different sequences of these components will be evaluated: (1) CR-BARE -PS, (2) BA-CR-REPS , (3) PS-GA-CR-RE and (4) REPS -BA-CR. Methods: We will perform a non-blinded multisite cluster randomized prevention microtrial with four parallel conditions consisting of the four sequences. The four sequences of components will be offered in groups of high school students with elevated depressive symptoms. For each CBT-component a module of three sessions is developed. Assessments will be conducted at baseline, after each CBT-component, prior to each session, at post-intervention and at 6-month followup. Potential moderators and mediators will be evaluated exploratively to shed light on for whom the (sequences of) CBT-components are most effective and how effects are mediated. Discussion: The potential value of the study is insight in the relative effectiveness of the four most commonly used CBT-components and four different sequences, and possible moderators and mediators in the prevention of depression among adolescents. This knowledge can be used to optimize and personalize CBT-programs. Trial registration: The study is registered in the Dutch Trial Register (Trial NL5584 / NTR6176) on October 13, 2016.
Geachte mevrouw Neefjes, Op 29 September 2016 heeft u bij ZonMw een subsidieaanvraag ingediend me... more Geachte mevrouw Neefjes, Op 29 September 2016 heeft u bij ZonMw een subsidieaanvraag ingediend met de titel: Doepressie blended; innovatief e-mental health programma voor klinisch depressieve adolescenten op maat! binnen de subsidieronde 'programmalijn 4b: kennisontwikkeling over digitale innovaties die de kwaliteit van zorg in het jeugdctomein verbeteren'. Met genoegen laat ik u weten dat de werkgroep van het programma Effectief werken in de jeugdsector een positief oordeel heeft over uw aanvraag. Dat betekent dat ZonMw u de subsidie zal toekennen. In deze brief leest u hoe ZonMw tot dit oordeel is gekomen en wat u moet doen voordat uw project van start kan gaan. Beoordeling Uw aanvraag is beoordeeld op relevantie voor deze oproep van het programma en op kwaliteit. Voor deze ronde van het program ma ontving ZonMw 20 subsidieaanvragen, waarvan er 9 wordt gehonoreerd. De beoordelingsprocedure was als volgt: Relevantie van de aanvraag De werkgroep van het programma Effectief werken in de jeugdsector heeft de relevantie van uw subsidieaanvraag voor deze oproep van het programma beoordeeld. Het eindoordeel over de relevantie van uw subsidieaanvraag voor het programma luidt: relevant. Hierbij zijn de volgende opmerkingen van belang: » De subsidieaanvraag voldoet aan de voorwaarden en doelstellingen van de subsidieoproep en de programmadoelstellingen. Kwaliteit van de aanvraag De werkgroep van het programma Effectief werken in de jeugdsector heeft ook een eindoordeel over de kwaliteit van uw subsidieaanvraag gegeven. Dit oordeel is gebaseerd op uw aanvraag, de beoordeling hiervan door referenten en uw reactie. Het eindoordeel over de kwaliteit van uw subsidieaanvraag luidt: goed. De werkgroep geeft de volgende argumenten voor het eindoordeel:. Met de aandachtspunten die de werkgroep u heeft meegegeven bij het positieve advies voor het uitwerken van het projectidee naar een subsidieaanvraag is over het algemeen goed rekening gehouden.
Geachte mevrouw Neefjes, Op 29 September 2016 heeft u bij ZonMw een subsidieaanvraag ingediend me... more Geachte mevrouw Neefjes, Op 29 September 2016 heeft u bij ZonMw een subsidieaanvraag ingediend met de titel: Doepressie blended; innovatief e-mental health programma voor klinisch depressieve adolescenten op maat! binnen de subsidieronde 'programmalijn 4b: kennisontwikkeling over digitale innovaties die de kwaliteit van zorg in het jeugdctomein verbeteren'. Met genoegen laat ik u weten dat de werkgroep van het programma Effectief werken in de jeugdsector een positief oordeel heeft over uw aanvraag. Dat betekent dat ZonMw u de subsidie zal toekennen. In deze brief leest u hoe ZonMw tot dit oordeel is gekomen en wat u moet doen voordat uw project van start kan gaan. Beoordeling Uw aanvraag is beoordeeld op relevantie voor deze oproep van het programma en op kwaliteit. Voor deze ronde van het program ma ontving ZonMw 20 subsidieaanvragen, waarvan er 9 wordt gehonoreerd. De beoordelingsprocedure was als volgt: Relevantie van de aanvraag De werkgroep van het programma Effectief werken in de jeugdsector heeft de relevantie van uw subsidieaanvraag voor deze oproep van het programma beoordeeld. Het eindoordeel over de relevantie van uw subsidieaanvraag voor het programma luidt: relevant. Hierbij zijn de volgende opmerkingen van belang: » De subsidieaanvraag voldoet aan de voorwaarden en doelstellingen van de subsidieoproep en de programmadoelstellingen. Kwaliteit van de aanvraag De werkgroep van het programma Effectief werken in de jeugdsector heeft ook een eindoordeel over de kwaliteit van uw subsidieaanvraag gegeven. Dit oordeel is gebaseerd op uw aanvraag, de beoordeling hiervan door referenten en uw reactie. Het eindoordeel over de kwaliteit van uw subsidieaanvraag luidt: goed. De werkgroep geeft de volgende argumenten voor het eindoordeel:. Met de aandachtspunten die de werkgroep u heeft meegegeven bij het positieve advies voor het uitwerken van het projectidee naar een subsidieaanvraag is over het algemeen goed rekening gehouden.
Angststoornissen bij kinderen worden vaak geassocieerd met sociale problemen, schoolproblemen en ... more Angststoornissen bij kinderen worden vaak geassocieerd met sociale problemen, schoolproblemen en een verhoogd risico op andere stoornissen, zoals depressie en middelenmisbruik (Craske, 1997; Strauss et al., 1987; Strauss et al., 1988). Bovendien zijn angststoornissen vaak chronisch en zonder behandeling is de prognose slecht (Keller et al., 1992; Newman et al., 1996). Wereldwijd is de angststoornis een van de meest voorkomende vormen van psychische stoornissen bij kinderen. Internationale studies tonen prevalentiecijfers van 1,8 procent (Anderson et al., 1987) tot 25 procent (Kessler et al., 1994). In Nederland is een zes-maanden prevalentie van 23,5 procent gevonden bij adolescenten in de leeftijd van 13 tot 18 jaar. Als men kijkt naar de kinderen die vanwege hun angst daadwerkelijk problemen ondervinden in hun dagelijks leven, dan daalt het prevalentiecijfer naar 9,7 procent (Verhulst et al., 1997).
Depression is a major problem in youth mental health and identified as the leading cause of disab... more Depression is a major problem in youth mental health and identified as the leading cause of disability worldwide. There is ample research on the acute effects of treatment, with estimated small-to-moderate effect sizes. However, there is a lack of research on long-term outcomes. A total of 129 adolescents with clinical depression (82.2% female), aged 13-22 (M = 16.60, SD = 2.03), received blended CBT, face-to-face CBT or treatment as usual. Data were collected at 12 months after the intervention and compared between treatment conditions. Clinical diagnosis, depressive symptoms, suicide risk, internalizing symptoms and externalizing symptoms decreased significantly over time, from baseline to the 12-month follow-up, and also from post-treatment to the 12-month follow-up in all three conditions. Changes were not significantly different between conditions. At the long-term, improvements following the treatment continued. Due to the large amount of missing data and use of history control condition, our findings need to be interpreted with caution. However, we consider these findings as a clinical imperative. More evidence might contribute to convincing adolescents to start with therapy, knowing it has lasting effects. Further, especially for adolescents for whom it is not possible to receive face-to-face treatment, blended treatment might be a valuable alternative. Our findings might contribute to the implementation of blended CBT.
Background Previous research suggests that it is important to use parental reports when assessing... more Background Previous research suggests that it is important to use parental reports when assessing children's anxiety, but it remains unclear to what extent there are differences between mothers' and fathers' scores and whether these potential differences have any repercussions for the psychometric properties of the scale being used. Objective This study was conducted to investigate parental differences on the Parent version of the Screen for Child Anxiety Related Emotional Disorders-Revised (SCARED-RP), a rating scale for measuring child anxiety symptoms. The second aim was to reexamine the reliability and validity of the SCARED-RP, in light of these possible differences. Methods The SCARED-RP and the Child Behaviour Checklist (CBCL) were administered to parents of clinically anxious children (n = 81), and control children (n = 108). All children (n = 189) completed the SCARED-R. Results Significant correlations between mother and father reports were found within the clinically anxious sample. Mothers showed significantly more correspondence with their children in the control group than fathers. The SCARED-RP internal consistency on total scale was excellent (mothers: .94; fathers: .94) and moderate to good for all subscales (from .66 Situational-Environmental Phobia to .93 Animal Phobia). The SCARED-RP differentiated well between clinically anxious and control children (mother and father data). The concurrent validity was supported by strong correlations with the CBCL anxious-depressed scale. Conclusion Differences between mother and father reports suggest the importance of obtaining information from both parents separately. Furthermore, the SCARED-RP is a & Mélou Jansen
Journal of Clinical Child and Adolescent Psychology, Oct 13, 2021
OBJECTIVE Cognitive Behavioral Therapy (CBT) was dismantled into four modules of three sessions e... more OBJECTIVE Cognitive Behavioral Therapy (CBT) was dismantled into four modules of three sessions each: cognitive restructuring (Think), behavioral activation (Act), problem solving (Solve) and relaxation (Relax). We investigated the modules' relative effectiveness in indicated depression prevention for adolescents and examined variations in sequencing of these modules. METHOD We performed a pragmatic cluster-randomized microtrial with four parallel conditions: (1) Think-Act-Relax-Solve (n = 14 clusters, n = 81 participants); (2) Act-Think-Relax-Solve (n = 13, n = 69); (3) Solve-Act-Think-Relax (n = 13, n = 77); and (4) Relax-Solve-Act-Think (n = 12, n = 55). The sample consisted of 282 Dutch adolescents with elevated depressive symptoms (Mage = 13.8; 55.7% girls, 92.9% Dutch). In total 52 treatment groups were randomized as a cluster. Assessments were conducted at baseline, after each module and at 6-month follow-up with depressive symptoms as primary outcome. RESULTS None of the modules (Think, Act, Solve, Relax) was associated with a significant decrease in depressive symptoms after three sessions and no significant differences in effectiveness were found between the modules. All sequences of modules were associated with a significant decrease in depressive symptoms at post-intervention, except the sequence Relax-Solve-Act-Think. At 6-month follow-up, all sequences showed a significant decrease in depressive symptoms. No significant differences in effectiveness were found between the sequences at post-intervention and 6-month follow-up. CONCLUSIONS Regardless of the CBT technique provided, one module of three sessions may not be sufficient to reduce depressive symptoms. The sequence in which the CBT components cognitive restructuring, behavioral activation, problem solving and relaxation are offered, does not appear to significantly influence outcomes at post- intervention or 6-month follow-up. ABBREVIATIONS CDI-2:F: Children's Depression Inventory-2 Full-length version; CDI-2:S: Children's Depression Inventory-2 Short version; STARr: Solve, Think, Act, Relax and repeat.
This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NH... more This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn.
Journal of Child Psychology and Psychiatry, Sep 8, 2021
Background: Subclinical depressive symptoms are highly prevalent among adolescents and are associ... more Background: Subclinical depressive symptoms are highly prevalent among adolescents and are associated with negative consequences, which may pose an economic burden for society. We conducted a prevalence-based cost-ofillness study using a societal perspective to investigate the cost-of-illness of subclinical depressive symptoms among adolescents. Methods: Using a bottom-up approach, cost questionnaires were assessed to measure costs from 237 Dutch families with an adolescent aged 11-18 with subclinical depressive symptoms (of which 34 met the criteria of a depressive disorder). The study is registered in the Dutch Trial Register (Trial NL5584/NTR6176; www.trialregister. nl/trial/5584). Results: Our calculations show that adolescents with subclinical depressive symptoms cost the Dutch society more than €42 million annually, expressed in costs related to depressive symptoms. Secondary analyses were performed to test the reliability and stability of the costs. When costs related to psychological problems were considered, the annual costs amounted to €67 million. The total societal costs related to physical problems amounted to approximately €126 million. All costs combined (depressive, psychological, behavioural and physical problems and other reasons) amounted to a €243 million. Total costs were highest for physical-related problems of the adolescent (52% of the total costs), followed by psychological (28%), depressive (17%) and behavioural problems (1%). Using an international prevalence rate, societal costs related to depressive symptoms resulted in €54 million a year. Conclusions: Cost-effective prevention programmes seem warranted given the high societal costs and risk of future costs as subclinical depressive symptoms could be a precursor of clinical depression later in life.
International Journal of Environmental Research and Public Health, Dec 24, 2019
Computerized and blended treatments seem to be an attractive treatment for adolescents as an alte... more Computerized and blended treatments seem to be an attractive treatment for adolescents as an alternative to face-to-face treatment, but mental health professionals seem hesitant to use these treatment modalities. This review provides an overview of factors contributing to and withholding from using computerized or blended treatment in routine care. Three databases were searched with terms related to (1) adolescents, (2) depression, (3) computerized or blended, and (4) treatment. Of the 33 articles identified, 10 focused on unguided computerized treatments, six on guided, two on blended, two compared unguided, blended-and face-to-face treatment to no treatment, and eight studies on games. Further, two articles that were focused on an online monitoring tool and three on intervention characteristics or preferred modes of help-seeking. Evidence for effectiveness, adherence, drop-out, and forming therapeutic relations were suspected to be barriers, but are no reason to reject computerized or blended treatment. Improvement in mental health literacy and the possibility to tailor the intervention are facilitators. However, adolescents' intention to seek help, acceptability of computerized treatment, symptom severity, time spent by therapist, and other facilities are identified as barriers and they need to be taken into account when using computerized or blended interventions. Nevertheless, computerized and blended are promising treatments for depressed youth.
European Journal of Developmental Psychology, May 9, 2016
Parenting is a multifaceted task and the way in which parents fulfill this task plays an importan... more Parenting is a multifaceted task and the way in which parents fulfill this task plays an important role in children's growth and development, especially in early childhood. Conceptualization and assessment of parenting behavior is elementary for research on child and family development and would fill a gap in clinical work, as there is a lack of questionnaires simultaneously assessing multiple parenting behaviors specific for early childhood. Therefore the Comprehensive Early Childhood Parenting Questionnaire (CECPAQ) was designed; a parent report measure of commonly occurring behaviors in five domains of parenting (i.e., support, stimulation, structure, harsh discipline, and positive discipline) central to early childhood. Data were collected from 1139 mothers and 526 fathers of 1-4 year-old children. Confirmatory factor analysis confirmed a five-factor structure (composed of 54 items). The five parenting domains were found to have good internal consistency and temporal stability. Preliminary evidence of validity of the CECPAQ was demonstrated by moderate relationships with measures of parental stress and child problem behavior. It is concluded that the CECPAQ is a promising measure of self-perceived parenting behavior for parents of 1-4 yearold children.
The purpose of this study was threefold, namely (1) to differentiate between multiproblem familie... more The purpose of this study was threefold, namely (1) to differentiate between multiproblem families and control families on characteristics and processes within the family based on a theoretical framework, (2) to identify multiproblem families by establishing cutoff scores on various questionnaires, and (3) to categorize multiproblem families into subtypes by cluster analyses. Various questionnaires were administered to multiproblem families (n = 85) and control families (n = 150). Results showed that what we propose to refer to as multiproblem families present a broad range of problems on seven domains: (1) child factors, (2) parental factors, (3) childrearing problems (inadequate or inconsistent parenting), (4) family functioning problems, (5) contextual problems, (6) social network problems, and (7) mental health care problems. Further, reliable cutoff scores were established for various questionnaires. Finally, three types of families were found: (1) community-problem families, (2) multiproblem families, and (3) child-focused mild-problem families. This paper looks to advance an evidence-based definition and assessment of "multiproblem families" suggesting the possible value of defining and assessing multiproblem families in relation to these seven dimensions. Moreover, the classification of multiproblem families stresses the importance of providing tailored treatments.
The relation between maternal depressive symptoms and children's mental health problems has been ... more The relation between maternal depressive symptoms and children's mental health problems has been well established. However, prior studies have predominantly focused on maternal reports of children's mental health problems and on parenting behavior, as a broad and unilateral concept. This cross-sectional study examined specific observed mother-child interaction behaviors through which maternal depressive symptoms are assumed to affect children's mental health problems. We expected higher rates of maternal depressive symptoms to predict higher rates of children's mental health problems, and we expected this relation to be mediated by low maternal warmth and high maternal psychological control. The sample consisted of 111 mother-child dyads referred for treatment. The mother-child interaction behaviors were coded according to the observed mother-child interaction tasks. Children's mental health problems were assessed using both maternal reports and children's self-reports. As expected, the results showed that maternal depressive symptoms were strongly related to maternal reports of children's internalizing and externalizing mental health problems. Surprisingly, maternal depressive symptoms were unrelated to children's self-reported depressive symptoms. Furthermore, mother-child interactions did not mediate the relation between maternal depressive symptoms and child mental health problems. Maternal depressive symptoms were associated with high maternal warmth, and high psychological control was associated with high levels of mother-reported externalizing mental health problems in children. These results partially replicate previous findings but add to these by using observational methods and multiinformant data. The importance of using a multi-informant and multi-method approach in assessing children's mental health problems in clinical practice and research are discussed. Keywords Maternal depression Á Childhood depression Á Mother-child interaction Á Observations Á Internalizing and externalizing mental health problems
Background Informant discrepancies between mother and child have challenged the assessment, class... more Background Informant discrepancies between mother and child have challenged the assessment, classification, and treatment of childhood anxiety. Despite numerous studies on this matter, the implications and consequences for research and clinical practice remain unclear. Objective The present study aimed to obtain meaningful clinical information about informant discrepancies by examining mother-child agreement for anxiety subtypes, and by exploring mother-child discrepancies in relation to independent observer ratings of behavioral anxiety. Method The screen for child anxiety related emotional disorders was administered to 79 mothers and clinically referred anxious children aged 7-13 years. Mother-child dyads were observed during an anxiety-provoking task and independent observers rated children's observed anxiety. Results The findings indicated a high level of mother-child disagreement on reports of anxiety. There was variability in levels of agreement between subtypes of anxiety, with significantly stronger mother-child agreement for separation compared to other forms of anxiety. Observed proximity between the mother and child was positively associated with child-reported separation anxiety and children's observed anxious voice was negatively associated with child-reported panic disorder. Conclusions The results highlight the need to incorporate a multi-informant assessment of childhood anxiety in clinical practice and research, in particular for subtypes of anxiety problems that are characterized by less observable and more internally experienced components.
Background: Both depressive disorder and subclinical depressive symptoms during adolescence are a... more Background: Both depressive disorder and subclinical depressive symptoms during adolescence are a major public health concern. Therefore, it is important that depression is detected at an early stage and is treated preventively. Prevention based on the principles of Cognitive Behavioural Therapy (CBT) has proven to be the most effective, however research has mainly focused on the effectiveness of "prevention packages" consisting of multiple CBT-components, rather than on the distinct CBT-components. This study will evaluate the relative effectiveness of four core components of CBT (cognitive restructuring (CR), behavioural activation (BA), problem solving (PS) and relaxation (RE)). In addition the relative (cost-)effectiveness of four different sequences of these components will be evaluated: (1) CR-BARE -PS, (2) BA-CR-REPS , (3) PS-GA-CR-RE and (4) REPS -BA-CR. Methods: We will perform a non-blinded multisite cluster randomized prevention microtrial with four parallel conditions consisting of the four sequences. The four sequences of components will be offered in groups of high school students with elevated depressive symptoms. For each CBT-component a module of three sessions is developed. Assessments will be conducted at baseline, after each CBT-component, prior to each session, at post-intervention and at 6-month followup. Potential moderators and mediators will be evaluated exploratively to shed light on for whom the (sequences of) CBT-components are most effective and how effects are mediated. Discussion: The potential value of the study is insight in the relative effectiveness of the four most commonly used CBT-components and four different sequences, and possible moderators and mediators in the prevention of depression among adolescents. This knowledge can be used to optimize and personalize CBT-programs. Trial registration: The study is registered in the Dutch Trial Register (Trial NL5584 / NTR6176) on October 13, 2016.
Geachte mevrouw Neefjes, Op 29 September 2016 heeft u bij ZonMw een subsidieaanvraag ingediend me... more Geachte mevrouw Neefjes, Op 29 September 2016 heeft u bij ZonMw een subsidieaanvraag ingediend met de titel: Doepressie blended; innovatief e-mental health programma voor klinisch depressieve adolescenten op maat! binnen de subsidieronde 'programmalijn 4b: kennisontwikkeling over digitale innovaties die de kwaliteit van zorg in het jeugdctomein verbeteren'. Met genoegen laat ik u weten dat de werkgroep van het programma Effectief werken in de jeugdsector een positief oordeel heeft over uw aanvraag. Dat betekent dat ZonMw u de subsidie zal toekennen. In deze brief leest u hoe ZonMw tot dit oordeel is gekomen en wat u moet doen voordat uw project van start kan gaan. Beoordeling Uw aanvraag is beoordeeld op relevantie voor deze oproep van het programma en op kwaliteit. Voor deze ronde van het program ma ontving ZonMw 20 subsidieaanvragen, waarvan er 9 wordt gehonoreerd. De beoordelingsprocedure was als volgt: Relevantie van de aanvraag De werkgroep van het programma Effectief werken in de jeugdsector heeft de relevantie van uw subsidieaanvraag voor deze oproep van het programma beoordeeld. Het eindoordeel over de relevantie van uw subsidieaanvraag voor het programma luidt: relevant. Hierbij zijn de volgende opmerkingen van belang: » De subsidieaanvraag voldoet aan de voorwaarden en doelstellingen van de subsidieoproep en de programmadoelstellingen. Kwaliteit van de aanvraag De werkgroep van het programma Effectief werken in de jeugdsector heeft ook een eindoordeel over de kwaliteit van uw subsidieaanvraag gegeven. Dit oordeel is gebaseerd op uw aanvraag, de beoordeling hiervan door referenten en uw reactie. Het eindoordeel over de kwaliteit van uw subsidieaanvraag luidt: goed. De werkgroep geeft de volgende argumenten voor het eindoordeel:. Met de aandachtspunten die de werkgroep u heeft meegegeven bij het positieve advies voor het uitwerken van het projectidee naar een subsidieaanvraag is over het algemeen goed rekening gehouden.
Geachte mevrouw Neefjes, Op 29 September 2016 heeft u bij ZonMw een subsidieaanvraag ingediend me... more Geachte mevrouw Neefjes, Op 29 September 2016 heeft u bij ZonMw een subsidieaanvraag ingediend met de titel: Doepressie blended; innovatief e-mental health programma voor klinisch depressieve adolescenten op maat! binnen de subsidieronde 'programmalijn 4b: kennisontwikkeling over digitale innovaties die de kwaliteit van zorg in het jeugdctomein verbeteren'. Met genoegen laat ik u weten dat de werkgroep van het programma Effectief werken in de jeugdsector een positief oordeel heeft over uw aanvraag. Dat betekent dat ZonMw u de subsidie zal toekennen. In deze brief leest u hoe ZonMw tot dit oordeel is gekomen en wat u moet doen voordat uw project van start kan gaan. Beoordeling Uw aanvraag is beoordeeld op relevantie voor deze oproep van het programma en op kwaliteit. Voor deze ronde van het program ma ontving ZonMw 20 subsidieaanvragen, waarvan er 9 wordt gehonoreerd. De beoordelingsprocedure was als volgt: Relevantie van de aanvraag De werkgroep van het programma Effectief werken in de jeugdsector heeft de relevantie van uw subsidieaanvraag voor deze oproep van het programma beoordeeld. Het eindoordeel over de relevantie van uw subsidieaanvraag voor het programma luidt: relevant. Hierbij zijn de volgende opmerkingen van belang: » De subsidieaanvraag voldoet aan de voorwaarden en doelstellingen van de subsidieoproep en de programmadoelstellingen. Kwaliteit van de aanvraag De werkgroep van het programma Effectief werken in de jeugdsector heeft ook een eindoordeel over de kwaliteit van uw subsidieaanvraag gegeven. Dit oordeel is gebaseerd op uw aanvraag, de beoordeling hiervan door referenten en uw reactie. Het eindoordeel over de kwaliteit van uw subsidieaanvraag luidt: goed. De werkgroep geeft de volgende argumenten voor het eindoordeel:. Met de aandachtspunten die de werkgroep u heeft meegegeven bij het positieve advies voor het uitwerken van het projectidee naar een subsidieaanvraag is over het algemeen goed rekening gehouden.
Angststoornissen bij kinderen worden vaak geassocieerd met sociale problemen, schoolproblemen en ... more Angststoornissen bij kinderen worden vaak geassocieerd met sociale problemen, schoolproblemen en een verhoogd risico op andere stoornissen, zoals depressie en middelenmisbruik (Craske, 1997; Strauss et al., 1987; Strauss et al., 1988). Bovendien zijn angststoornissen vaak chronisch en zonder behandeling is de prognose slecht (Keller et al., 1992; Newman et al., 1996). Wereldwijd is de angststoornis een van de meest voorkomende vormen van psychische stoornissen bij kinderen. Internationale studies tonen prevalentiecijfers van 1,8 procent (Anderson et al., 1987) tot 25 procent (Kessler et al., 1994). In Nederland is een zes-maanden prevalentie van 23,5 procent gevonden bij adolescenten in de leeftijd van 13 tot 18 jaar. Als men kijkt naar de kinderen die vanwege hun angst daadwerkelijk problemen ondervinden in hun dagelijks leven, dan daalt het prevalentiecijfer naar 9,7 procent (Verhulst et al., 1997).
Depression is a major problem in youth mental health and identified as the leading cause of disab... more Depression is a major problem in youth mental health and identified as the leading cause of disability worldwide. There is ample research on the acute effects of treatment, with estimated small-to-moderate effect sizes. However, there is a lack of research on long-term outcomes. A total of 129 adolescents with clinical depression (82.2% female), aged 13-22 (M = 16.60, SD = 2.03), received blended CBT, face-to-face CBT or treatment as usual. Data were collected at 12 months after the intervention and compared between treatment conditions. Clinical diagnosis, depressive symptoms, suicide risk, internalizing symptoms and externalizing symptoms decreased significantly over time, from baseline to the 12-month follow-up, and also from post-treatment to the 12-month follow-up in all three conditions. Changes were not significantly different between conditions. At the long-term, improvements following the treatment continued. Due to the large amount of missing data and use of history control condition, our findings need to be interpreted with caution. However, we consider these findings as a clinical imperative. More evidence might contribute to convincing adolescents to start with therapy, knowing it has lasting effects. Further, especially for adolescents for whom it is not possible to receive face-to-face treatment, blended treatment might be a valuable alternative. Our findings might contribute to the implementation of blended CBT.
Background Previous research suggests that it is important to use parental reports when assessing... more Background Previous research suggests that it is important to use parental reports when assessing children's anxiety, but it remains unclear to what extent there are differences between mothers' and fathers' scores and whether these potential differences have any repercussions for the psychometric properties of the scale being used. Objective This study was conducted to investigate parental differences on the Parent version of the Screen for Child Anxiety Related Emotional Disorders-Revised (SCARED-RP), a rating scale for measuring child anxiety symptoms. The second aim was to reexamine the reliability and validity of the SCARED-RP, in light of these possible differences. Methods The SCARED-RP and the Child Behaviour Checklist (CBCL) were administered to parents of clinically anxious children (n = 81), and control children (n = 108). All children (n = 189) completed the SCARED-R. Results Significant correlations between mother and father reports were found within the clinically anxious sample. Mothers showed significantly more correspondence with their children in the control group than fathers. The SCARED-RP internal consistency on total scale was excellent (mothers: .94; fathers: .94) and moderate to good for all subscales (from .66 Situational-Environmental Phobia to .93 Animal Phobia). The SCARED-RP differentiated well between clinically anxious and control children (mother and father data). The concurrent validity was supported by strong correlations with the CBCL anxious-depressed scale. Conclusion Differences between mother and father reports suggest the importance of obtaining information from both parents separately. Furthermore, the SCARED-RP is a & Mélou Jansen
Journal of Clinical Child and Adolescent Psychology, Oct 13, 2021
OBJECTIVE Cognitive Behavioral Therapy (CBT) was dismantled into four modules of three sessions e... more OBJECTIVE Cognitive Behavioral Therapy (CBT) was dismantled into four modules of three sessions each: cognitive restructuring (Think), behavioral activation (Act), problem solving (Solve) and relaxation (Relax). We investigated the modules' relative effectiveness in indicated depression prevention for adolescents and examined variations in sequencing of these modules. METHOD We performed a pragmatic cluster-randomized microtrial with four parallel conditions: (1) Think-Act-Relax-Solve (n = 14 clusters, n = 81 participants); (2) Act-Think-Relax-Solve (n = 13, n = 69); (3) Solve-Act-Think-Relax (n = 13, n = 77); and (4) Relax-Solve-Act-Think (n = 12, n = 55). The sample consisted of 282 Dutch adolescents with elevated depressive symptoms (Mage = 13.8; 55.7% girls, 92.9% Dutch). In total 52 treatment groups were randomized as a cluster. Assessments were conducted at baseline, after each module and at 6-month follow-up with depressive symptoms as primary outcome. RESULTS None of the modules (Think, Act, Solve, Relax) was associated with a significant decrease in depressive symptoms after three sessions and no significant differences in effectiveness were found between the modules. All sequences of modules were associated with a significant decrease in depressive symptoms at post-intervention, except the sequence Relax-Solve-Act-Think. At 6-month follow-up, all sequences showed a significant decrease in depressive symptoms. No significant differences in effectiveness were found between the sequences at post-intervention and 6-month follow-up. CONCLUSIONS Regardless of the CBT technique provided, one module of three sessions may not be sufficient to reduce depressive symptoms. The sequence in which the CBT components cognitive restructuring, behavioral activation, problem solving and relaxation are offered, does not appear to significantly influence outcomes at post- intervention or 6-month follow-up. ABBREVIATIONS CDI-2:F: Children's Depression Inventory-2 Full-length version; CDI-2:S: Children's Depression Inventory-2 Short version; STARr: Solve, Think, Act, Relax and repeat.
This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NH... more This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn.
Journal of Child Psychology and Psychiatry, Sep 8, 2021
Background: Subclinical depressive symptoms are highly prevalent among adolescents and are associ... more Background: Subclinical depressive symptoms are highly prevalent among adolescents and are associated with negative consequences, which may pose an economic burden for society. We conducted a prevalence-based cost-ofillness study using a societal perspective to investigate the cost-of-illness of subclinical depressive symptoms among adolescents. Methods: Using a bottom-up approach, cost questionnaires were assessed to measure costs from 237 Dutch families with an adolescent aged 11-18 with subclinical depressive symptoms (of which 34 met the criteria of a depressive disorder). The study is registered in the Dutch Trial Register (Trial NL5584/NTR6176; www.trialregister. nl/trial/5584). Results: Our calculations show that adolescents with subclinical depressive symptoms cost the Dutch society more than €42 million annually, expressed in costs related to depressive symptoms. Secondary analyses were performed to test the reliability and stability of the costs. When costs related to psychological problems were considered, the annual costs amounted to €67 million. The total societal costs related to physical problems amounted to approximately €126 million. All costs combined (depressive, psychological, behavioural and physical problems and other reasons) amounted to a €243 million. Total costs were highest for physical-related problems of the adolescent (52% of the total costs), followed by psychological (28%), depressive (17%) and behavioural problems (1%). Using an international prevalence rate, societal costs related to depressive symptoms resulted in €54 million a year. Conclusions: Cost-effective prevention programmes seem warranted given the high societal costs and risk of future costs as subclinical depressive symptoms could be a precursor of clinical depression later in life.
International Journal of Environmental Research and Public Health, Dec 24, 2019
Computerized and blended treatments seem to be an attractive treatment for adolescents as an alte... more Computerized and blended treatments seem to be an attractive treatment for adolescents as an alternative to face-to-face treatment, but mental health professionals seem hesitant to use these treatment modalities. This review provides an overview of factors contributing to and withholding from using computerized or blended treatment in routine care. Three databases were searched with terms related to (1) adolescents, (2) depression, (3) computerized or blended, and (4) treatment. Of the 33 articles identified, 10 focused on unguided computerized treatments, six on guided, two on blended, two compared unguided, blended-and face-to-face treatment to no treatment, and eight studies on games. Further, two articles that were focused on an online monitoring tool and three on intervention characteristics or preferred modes of help-seeking. Evidence for effectiveness, adherence, drop-out, and forming therapeutic relations were suspected to be barriers, but are no reason to reject computerized or blended treatment. Improvement in mental health literacy and the possibility to tailor the intervention are facilitators. However, adolescents' intention to seek help, acceptability of computerized treatment, symptom severity, time spent by therapist, and other facilities are identified as barriers and they need to be taken into account when using computerized or blended interventions. Nevertheless, computerized and blended are promising treatments for depressed youth.
European Journal of Developmental Psychology, May 9, 2016
Parenting is a multifaceted task and the way in which parents fulfill this task plays an importan... more Parenting is a multifaceted task and the way in which parents fulfill this task plays an important role in children's growth and development, especially in early childhood. Conceptualization and assessment of parenting behavior is elementary for research on child and family development and would fill a gap in clinical work, as there is a lack of questionnaires simultaneously assessing multiple parenting behaviors specific for early childhood. Therefore the Comprehensive Early Childhood Parenting Questionnaire (CECPAQ) was designed; a parent report measure of commonly occurring behaviors in five domains of parenting (i.e., support, stimulation, structure, harsh discipline, and positive discipline) central to early childhood. Data were collected from 1139 mothers and 526 fathers of 1-4 year-old children. Confirmatory factor analysis confirmed a five-factor structure (composed of 54 items). The five parenting domains were found to have good internal consistency and temporal stability. Preliminary evidence of validity of the CECPAQ was demonstrated by moderate relationships with measures of parental stress and child problem behavior. It is concluded that the CECPAQ is a promising measure of self-perceived parenting behavior for parents of 1-4 yearold children.
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Papers by Denise Bodden