Daan H. M. Creemers

The Role of Explicit and Implicit Self-Esteem in Peer Modeling of Palatable Food Intake: A Study on Social Media Interaction among Youngsters

Objective This experimental study investigated the impact of peers on palatable food intake of youngsters within a social media setting. To determine whether this effect was moderated by self-esteem, the present study examined the roles of global explicit self-esteem (ESE), body esteem (BE) and implicit self-esteem (ISE). Methods Participants (N = 118; 38.1% boys; M age 11.14±.79) were asked to play a computer game while they believed to interact online with a same-sex normal-weight remote confederate (i.e., instructed peer) who ate either nothing, a small or large amount of candy. Results Participants modeled the candy intake of peers via a social media interaction, but this was qualified by their self-esteem. Participants with higher ISE adjusted their candy intake to that of a peer more closely than those with lower ISE when the confederate ate nothing compared to when eating a modest (β = .26, p = .05) or considerable amount of candy (kcal) (β = .32, p = .001). In contrast, participants with lower BE modeled peer intake more than those with higher BE when eating nothing compared to a considerable amount of candy (kcal) (β = .21, p = .02); ESE did not moderate social modeling behavior. In addition, participants with higher discrepant or “damaged” self-esteem (i.e., high ISE and low ESE) modeled peer intake more when the peer ate nothing or a modest amount compared to a substantial amount of candy (kcal) (β = −.24, p = .004; β = −.26, p<.0001, respectively). Conclusion Youngsters conform to the amount of palatable food eaten by peers through social media interaction. Those with lower body esteem or damaged self-esteem may be more at risk to peer influences on food intake.

The effect of the video game Mindlight on anxiety symptoms in children with an Autism Spectrum Disorder

BackgroundIn the clinical setting, a large proportion of children with an autism spectrum disorder (ASD) experience anxiety symptoms. Because anxiety is an important cause of impairment for children with an ASD, it is necessary that effective anxiety interventions are implemented for these children. Recently, a serious game called Mindlight has been developed that is focused on decreasing anxiety in children. This approach is based on recent research suggesting that video games might be suitable as an intervention vehicle to enhance mental health in children. In the present study it will be investigated whether Mindlight is effective in decreasing (sub) clinical anxiety symptoms in children who are diagnosed with an ASD.Methods/DesignThe present study involves a randomized controlled trial (RCT) with two conditions (experimental versus control), in which it is investigated whether Mindlight is effective in decreasing (sub) clinical anxiety symptoms in children with an ASD. For this study, children of 8–16 years old with a diagnosis of an ASD and (sub) clinical anxiety symptoms will be randomly assigned to the experimental (N = 60) or the control (N = 60) condition. Children in the experimental condition will play Mindlight for one hour per week, for six consecutive weeks. Children in the control condition will play the puzzle game Triple Town, also for one hour per week and for six consecutive weeks. All children will complete assessments at baseline, post-intervention and 3-months follow-up. Furthermore, parents and teachers will also complete assessments at the same time points. The primary outcome will be child report of anxiety symptoms. Secondary outcomes will be parent report of child anxiety, child/parent report of depressive symptoms, and parent/teacher report of social functioning and behavior problems.DiscussionThis paper aims to describe a study that will examine the effect of the serious game Mindlight on (sub) clinical anxiety symptoms of children with an ASD in the age of 8–16 years old. It is expected that children in the experimental condition will show lower levels of anxiety symptoms at 3-months follow-up, compared to children in the control condition. If Mindlight turns out to be effective, it could be an important contribution to the already existing interventions for anxiety in children with an ASD. Mindlight could then be implemented as an evidence-based treatment for anxiety symptoms in children with an ASD in mental health institutes and special education schools.Trial registrationDutch Trial Register NTR5069. Registered 20 April 2015.

Damaged self-esteem is associated with internalizing problems

Implicit and explicit self-esteem are assumed to be important factors in understanding the onset and maintenance of psychological problems. The current study aims to examine the association between implicit and explicit self-esteem and their interaction with depressive symptoms, suicidal ideation, and loneliness. Specifically, the relationship between the size and the direction of the discrepancy between implicit and explicit self-esteem with depressive symptoms, suicidal ideation, and loneliness were examined. Participants were 95 young female adults (M = 21.2 years, SD = 1.88) enrolled in higher education. We administered the IAT to assess implicit self-esteem, and the Rosenberg self-esteem scale to measure explicit self-esteem while psychological problems were assessed through self-reports. Results showed that discrepancies between implicit and explicit self-esteem were positively associated with depressive symptoms, suicidal ideation, and loneliness. In addition, the direction of the discrepancy was specifically relevant: damaged self-esteem (i.e., high implicit self-esteem and low explicit self-esteem) was consistently associated with increased levels of depressive symptoms, suicidal ideation, and loneliness. In contrast, defensive or fragile self-esteem (i.e., low implicit and high explicit self-esteem) was solely associated with loneliness. These findings provide further support that specifically damaged self-esteem is an important vulnerability marker for depressive symptoms, suicidal ideation, and loneliness.

Depression and Anxiety Prevention Based on Cognitive Behavioral Therapy for At-Risk Adolescents: A Meta-Analytic Review

Depression and anxiety disorders are among the most common mental disorders during adolescence. During this life phase, the incidence of these clinical disorders rises dramatically, and even more adolescents suffer from symptoms of depression or anxiety that are just below the clinical threshold. Both clinical and subclinical levels of depression or anxiety symptoms are related to decreased functioning in various areas, such as social and academic functioning. Prevention of depression and anxiety in adolescents is therefore imperative. We conducted a meta-analytic review of the effects of school-based and community-based prevention programs that are based on cognitive behavioral therapy with the primary goal preventing depression, anxiety, or both in high risk adolescents. Articles were obtained by searching databases and hand searching reference lists of relevant articles and reviews. The selection process yielded 32 articles in the meta-analyses. One article reported on two studies and three articles reported on both depression and anxiety. This resulted in a total of 36 studies, 23 on depression and 13 on anxiety. For depression prevention aimed at high risk adolescents, meta-analysis showed a small effect of prevention programs directly after the intervention, but no effect at 3–6 months and at 12 months follow-up. For anxiety prevention aimed at high risk adolescents, no short-term effect was found, nor at 12 months follow-up. Three to six months after the preventive intervention, symptoms of anxiety were significantly decreased. Although effects on depression and anxiety symptoms were small and temporary, current findings cautiously suggest that depression and anxiety prevention programs based on CBT might have small effects on mental health of adolescents. However, it also indicates that there is still much to be gained for prevention programs. Current findings and possibilities for future research are discussed in order to further improve the effectiveness of targeted prevention on internalizing disorders.

Acute Stress Increases Implicit Depression and Decreases Implicit Self-Esteem

According to cognitive theories, internalizing problems are the result of the activation of dysfunctional attitudes (e.g., negative self-thoughts) in memory in response to stressful life events. Dual process models posit that associative and reflective cognitive processes may respond differently to stressful life events and may affect the development of psychopathology. According to these models, self-relevant stimuli activate both associative and reflective processes. However, previous research has focused mainly on reflective processes using explicit assessment instruments. The main aim of the present study was to examine the effect of acute stress on both associative and reflective cognitive processes by using implicit and explicit measures of self-esteem and depression. Participants were 95 university students (M = 23.3 years, SD = .37, 79 females). Implicit and explicit measures of self-esteem and depression were administered before and after a stress-induction procedure. The results showed that acute stress increased implicit depression (p < .01) and decreased implicit self-esteem (p < .05) but did not affect explicit measures of self-esteem and depression (p-values = .44). Together, these findings offer new insights into the relationship of stress with implicit and explicit attitudes and provide experimental support for dual process models.

The Association between Perceived Maternal and Paternal Psychopathology and Depression and Anxiety Symptoms in Adolescent Girls

Exposure to parental depression and anxiety is known to heighten the risk of internalizing symptoms and disorders in children and adolescents. Ample research has focused on the influence of maternal depression and anxiety, but the contribution of psychopathology in fathers remains unclear. We studied the relationships of perceived maternal and paternal psychopathology with adolescents’ depression and anxiety symptoms in a general population sample of 862 adolescent girls (age M = 12.39, SD = 0.79). Assessments included adolescents’ self-reports of their own depression and anxiety as well as their reports of maternal and paternal psychopathology. We found that perceived maternal and paternal psychopathology were both related to depression and anxiety symptoms in adolescent girls. A combination of higher maternal and paternal psychopathology was related to even higher levels of depression and anxiety in adolescent girls. Our findings showed that adolescents’ perceptions of their parents’ psychopathology are significantly related to their own emotional problems.

Outcomes of a Randomized Controlled Trial on the Effectiveness of Depression and Anxiety Prevention for Adolescents with a High Familial Risk

A randomized controlled trail was conducted to examine the effectiveness of a depression and anxiety prevention program ‘Een Sprong Vooruit’ (A Leap Forward) among adolescent girls with a high familial risk (N = 142). The results showed neither effects of the prevention program directly after the intervention, nor at 6 or 12 months follow-up on depression and anxiety symptoms. Further, latent growth curve modeling (LGCM) was used to examine whether the growth functions for the intervention and the control condition were different. The slope representing the change in depression symptoms was not significantly different between the intervention and the control condition. For anxiety symptoms, the difference between slopes was also not significant. Based on these results, we suggested that these high-risk adolescent girls might benefit more from a more intensive prevention program.

Prevalence and risk factors of anxiety in a clinical Dutch sample of children with an autism spectrum disorder

Anxiety is highly prevalent in children with an autism spectrum disorder (ASD). However, there is inconsistency in studies investigating the prevalence and risk factors of anxiety in children with ASD. Therefore, the first aim of this study was to give an overview of the prevalence of anxiety symptoms in a clinical Dutch sample of children with ASD. The second aim was to investigate age, gender, ASD subtype, and IQ as potential risk factors for anxiety in this sample. In total, 172 children with ASD (age, 8–15 years) and their parents participated in this study. Specialized services in which children with ASD were recruited were two mental health institutes and one secondary special education school. The findings showed that more than 60% of the participating children with ASD had at least subclinical anxiety symptoms according to children. More than 80% of the children with ASD had at least subclinical anxiety symptoms according to parents. It was found that younger children and girls with ASD had more anxiety symptoms than older children and boys with ASD. Moreover, it was found that children with a higher performance (non-verbal) IQ and lower verbal IQ had more specific phobia symptoms. The findings suggest that in a clinical context, children with ASD have a high risk to have co-occurring anxiety symptoms, especially girls and younger children with ASD. Therefore, early prevention and treatment of anxiety in children with ASD who are most at risk is important.

De effectiviteit van een depressie preventie programma (‘Op Volle Kracht’) bij adolescente meisjes met verhoogde depressieve symptomen

Jonge adolescente meisjes met depressieve symptomen hebben een verhoogd risico om een depressie te ontwikkelen later in de adolescentie of in volwassenheid. Daarom is preventie in deze risicogroep belangrijk. Het doel van de huidige studie was het onderzoeken van het effect van de Cognitieve Gedrags Therapie (CGT) component van het depressie preventie programma ‘Op Volle Kracht’ (OVK) bij Nederlandse adolescente meisjes met verhoogde depressieve symptomen. In het totaal namen 102 adolescente meisjes (11-15 jaar) deel aan de huidige studie. De meisjes in de experimentele groep (n = 50) volgden de acht CGT-lessen van OVK en rapporteerden hun depressieve klachten één week voor de start van de lessen, na iedere les, na één maand follow-up en na zes maanden follow-up. De meisjes in de controle groep (n = 52) rapporteerden alleen hun depressieve klachten op dezelfde tijdsmomenten als de experimentele groep. Analyses lieten zien dat de afname van depressieve symptomen significant groter was voor de meisjes in de experimentele groep dan voor de meisjes in de controle groep, en dat de meisjes in de experimentele groep op de zes maanden follow-up significant minder depressieve symptomen hadden dan de meisjes in de controle groep. Deze bevindingen laten zien dat de CGT-component van OVK effectief is in het reduceren van depressieve symptomen.AbstractRandomized Controlled Trial Testing the Effectiveness of a Depression Prevention Program (‘Op Volle Kracht’) Among Adolescent Girls with Elevated Depressive SymptomsYoung adolescent girls with elevated depressive symptoms are at high risk to develop a depression during adolescence or adulthood. Therefore, prevention of depression in this high-risk group is important. The aim of the present study was to examine the effectiveness of the Cognitive Behavioural Therapy (CBT) component of the depression prevention program ‘Op Volle Kracht’ (OVK) among Dutch adolescent girls with elevated depressive symptoms. In total, 102 adolescent girls (11-15 years) participated in this study. The girls in the experimental group (n = 50) followed the eight CBT-lessons of OVK and reported depressive symptoms one week prior to the start of the lessons, after every lesson, at one-month and six-months follow-up. The girls in the control group (n = 52) exclusively reported depressive symptoms at the same time points. Latent Growth Curve Modeling showed that the decrease in depressive symptoms was significantly larger for the girls in the experimental group than for the girls in the control group. Furthermore, it was found that at six-months follow-up, the girls in the experimental group had significantly lower levels of depressive symptoms than the girls in the control group. These findings indicate that the CBT-component of OVK is effective in reducing depressive symptoms.