Erik Schouten

The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: a meta-analytic review

This review examined evidence for some core predictions of the response styles theory (RST) concerning the relation between response styles and symptoms of depression and gender differences in the use of response styles in non-clinical children and adolescents. In summarizing the literature, effect sizes (pooled correlation coefficients) were calculated for cross-sectional and longitudinal studies. Stability of the obtained effect sizes was evaluated by means of a fail-safe N analysis. Results indicated that stable and significant effect sizes were found for rumination being associated with concurrent and future levels of depression. When controlling for baseline levels of depression, effect sizes for rumination and distraction were not stable, indicating that these findings should be interpreted with considerable caution. Finally, significant and stable effect sizes for gender differences in response styles were found only for rumination among adolescents. Taken together, the findings partly support the predictions of the response styles theory examined in this meta-analysis and may implicate that rumination is a cognitive vulnerability factor for depressive symptoms among adolescents.

Psychometric evaluation of the Dutch version of the Aggression Questionnaire

Confirmatory factor analyses were done in an attempt to replicate the factor structure of the Aggression Questionnaire constructed by Buss and Perry (1992) [Journal of Personality and Social Psychology, 63, 452-459] in a Dutch sample. The findings indicated that the Buss and Perry 4-factor model provided a poor fit to the full 29-item questionnaire. Although generally confirming the 4-factor structure, subsequent analyses revealed that a better fit was obtained by omitting 3 items (1 Verbal Aggression and 2 Hostility items). In general, the present findings are rather similar to previous research and emphasize the importance of assessing not only overall aggression but also its separate components.

Fear of movement/(re)injury predicting chronic disabling low back pain: a prospective inception cohort study

Study Design. Prospective inception cohort study. Objective. To investigate prospectively whether pain-related fear predicts future perceived disability and participation in patients with acute low back pain (LBP). Summary of Background Data. There are indications that fear of movement/(re)injury, as measured by the Tampa Scale for Kinesiophobia, is present early in an episode of LBP, and that it might be a predictor of future perceived disability and participation. Methods. A cohort of 555 patients with acute LBP included by general practitioners and physical therapists in primary care settings was followed for 6 months. Results. Results indicate that baseline fear of movement/(re)injury was predictive of future perceived disability and, to a lesser extent (and together with duration and radiation), of participation. Conclusions. The results suggest that interventions aimed at reducing pain-related fear in the acute stage of LBP might prevent restrictions of activity and participation because of pain, and might be a way of preventing the transition from acute to chronic LBP.

Providing universal access to antiretroviral therapy in Thyolo, Malawi through task shifting and decentralization of HIV/AIDS care.

Objective  To describe how district‐wide access to HIV/AIDS care was achieved and maintained in Thyolo District, Malawi.

Anxiety sensitivity in adolescents: Factor structure and relationships to trait anxiety and symptoms of anxiety disorders and depression

The current study examined the anxiety sensitivity construct in a large sample of normal Dutch adolescents aged 13-16 years (n=819). Children completed the Childhood Anxiety Sensitivity Index (CASI; Silverman, W. K., Fleisig, W., Rabian, B. & Peterson, R. A. (1991). Journal of Clinical Child Psychology, 20, 162-168) and measures of trait anxiety, anxiety disorder symptoms and depression. Results showed that (1) anxiety sensitivity as indexed by the CASI seems to be a hierarchically organized construct with one higher-order factor (i.e., anxiety sensitivity) and three or four lower-order factors, (2) anxiety sensitivity and trait anxiety were strongly correlated, (3) anxiety sensitivity was substantially connected to symptoms of anxiety disorders (in particular of panic disorder and agoraphobia) and depression, and (4) anxiety sensitivity and trait anxiety both accounted for unique proportions of the variance in anxiety disorder symptoms. Altogether these findings are in agreement with those of previous research in adult and child populations, and further support the notion that anxiety sensitivity should be viewed as an unique factor of anxiety vulnerability.

Peritraumatic dissociation and posttraumatic stress after pregnancy loss: a prospective study

This study examined (1). predictors for peritraumatic dissociation, (2). its relations with acute and chronic symptoms of posttraumatic stress disorder (PTSD), and (3). pathways regarding these relations in response to pregnancy loss. In early pregnancy, about 1370 women volunteers completed questionnaires for neuroticism, control over emotions, dissociative tendencies, absorption, and prior life events. Of these, 126 subsequently experienced pregnancy loss and most of them completed measures 1 month (N = 118) and 4 months (N = 104) later. At 1 month, peritraumatic dissociation, memory of pregnancy loss (degree of fragmentation, sensory impressions, and emotional intensity), thought suppression, and PTSD symptoms were assessed, and at 4 months, PTSD symptoms were re-assessed. Peritraumatic dissociation was predicted by prior low control over emotions, dissociative tendencies, and lower education. It was not predicted by neuroticism, absorption, and prior life events. Peritraumatic dissociation was related to acute PTSD symptoms and LISREL analyses indicated that self-reported memory fragmentation and thought suppression of pregnancy loss mediated this relation. It also predicted chronic PTSD symptoms, and this relation was mediated by acute PTSD symptoms.

The role of evaluative learning and disgust sensitivity in the etiology and treatment of spider phobia

Abstract The role of disgust and contamination sensitivity in the development and treatment of spider phobia was examined. It was predicted that spider phobia high in disgust and contamination sensitivity have been more susceptible to evaluative conditioning processes and, as a result, less often report traumatic conditioning events and benefit less from exposure treatment than phobics low in disgust sensitivity ( Baeyens, Eelen, Crombez, & van den Bergh, 1992 ). As a group, spider phobics ( N = 46) were characterized by higher disgust sensitivity than nonphobic control subjects ( N = 28). However, phobics high in disgust sensitivity reported, if anything, more conditioning events than low digust sensitivity phobics. Treatment effects of exposure were evident in both self-report measures and the behavioral modality. These effects were comparable for high and low disgust sensitivity phobics. Remarkably, high and low disgust sensitivity phobics did not differ with regard to the perceived dirtiness of spiders. Even when the perceived dirtiness of spiders was used as a classifying variable, no differences in acquisition history or treatment outcome emerged between high and low groups. Thus, the findings lend no support to the views that traumatic conditioning events are rare and that exposure treatment is less successful in phobics who presumably have an evaluative learning background. The methodological limitations of the present study are discussed.

Outcome assessment of decentralization of antiretroviral therapy provision in a rural district of Malawi using an integrated primary care model

Objective  To assess the effect of decentralization (DC) of antiretroviral therapy (ART) provision in a rural district of Malawi using an integrated primary care model.

Threat perception abnormalities in children: the role of anxiety disorders symptoms, chronic anxiety, and state anxiety.

This study investigated the relative contribution of general (trait) anxiety and state anxiety to threat perception abnormalities in nonreferred children aged 8-13 years (N=299). Children were first asked to complete self-report measures of anxiety disorders symptoms and chronic anxiety. Next, they were individually interviewed using an ambiguous story paradigm from which a number of threat perception indexes were derived. Just before the interview started, children were asked to fill out a measure of state anxiety. Results showed that high levels of general anxiety (as indexed by anxiety disorders symptoms and chronic anxiety) were significantly related to increased threat perception and lower threat thresholds. High levels of state anxiety were also associated with increased threat perception and lower threat thresholds. Regression analyses indicated that general anxiety and state anxiety both accounted for a unique proportion of the variance in threat perception abnormalities, although the contribution of general anxiety was in most cases substantially larger than that of state anxiety. Finally, no support was found for the notion that threat perception abnormalities are the result of the conjoint influence of general anxiety and state anxiety.

Effects of Perceived Control on the Relationship between Perceived Parental Rearing Behaviors and Symptoms of Anxiety and Depression in Nonclinical Preadolescents.

This study examined mediational and moderational effects of perceived control on the relationship between perceived parental rearing behaviors and symptoms of anxiety and depression in a nonclinical sample of youths aged 11–14 years. Correlational analyses demonstrated that higher levels of negative parental rearing practices were associated with higher levels of anxiety and depression, which at the same time were related to lower levels of perceived control. Furthermore, no evidence was found for the presence of mediational effects of perceived control on the link between perceived parental rearing behaviors and symptoms of anxiety and depression. Finally, there was a moderational effect of perceived control on the link between anxious rearing and anxiety symptoms. While the presence of low perceived control and high anxious rearing yielded relatively high anxiety levels, it was especially the combination of high perceived control and low anxious rearing that clearly yielded the lowest anxiety levels.