Have preferences of girls changed almost 3 years after the much debated start of the HPV vaccination program in the Netherlands? A discrete choice experiment

Objectives: To assess how girls' preferences have changed almost 3 years after the much debated start of the human papillomavirus (HPV) vaccination program. Methods: A discrete choice experiment (DCE) was conducted among girls aged 11-15 years who were invited, or were not yet invited, to get vaccinated. A panel latent class model was used to determine girls' preferences for vaccination based on five characteristics: degree of protection against cervical cancer; duration of protection; risk of mild side-effects; age of vaccination; and the number of required doses of the vaccine. Results: The response rate was 85% (500/592). Most girls preferred vaccination at age 14 years (instead of at age 9 years) and a 2-dose scheme (instead of the current 3-dose scheme). Girls were willing to trade-off 7% (CI: 3.2% to 10.8%) of the degree of protection to have 10% less risk of mild side-effects, and 4% (CI: 1.2% to 5.9%) to receive 2 doses instead of 3 doses. Latent class analyses showed that there was preference heterogeneity among girls, i.e., higher educated girls and HPV vaccinated girls had a higher probability to opt for HPV vaccination at a higher age than lower educated girls or non-vaccinated girls. Conclusions: Three years after the start of HPV vaccination program the risk of mild side-effects and age at vaccination seem to have become less important. For the Dutch national immunization program, we recommend not to lower the current target age of 12 years. A 2-dose scheme may result in a higher uptake and we recommend that if this scheme is introduced, it needs to receive adequate publicity

Intranasal oxytocin enhances stress-protective effects of social support in women with negative childhood experiences during a virtual Trier Social Stress Test

Oxytocin is considered a biological mechanism underlying stress-protective effects of positive social interactions. It is assumed to underlie the women-specific tend-and-befriend response to stress, although few studies have tested this assertion with female samples. The aim of the present study was, therefore, to test whether oxytocin enhances stress-protective effects of social support during stress in women, taking into account the moderating role of childhood adversity. The sample consisted of 180 female undergraduate students who had reported on experiences of childhood abuse and how often their mother used love withdrawal as an insensitive disciplinary strategy. Women participated in a virtual version of the Trier Social Stress Test (TSST) and were randomly assigned to receive 24 IU oxytocin or a placebo and to receive support or no support from a female friend (sub-groups N = 45). Results showed that oxytocin reduced heart rate variability during the TSST in participants who received support, possibly indicating that oxytocin increases attention and stimulates a challenge motivational state in the presence of a friend. In addition, we found that, in the presence of a friend, oxytocin reduced state anxiety levels and cortisol levels after the TSST, but only in women with higher levels of adverse childhood experiences. Our findings may indicate that oxytocin is a neurobiological means to attain and benefit from social support under stressful circumstances, which may be particularly adaptive for women with a history of adversity. Thus, oxytocin may function as motivator for affiliative disposition during stress exposure in women with a history of childhood adversity. Results should be replicated in clinical samples

Gehechtheid, mentaliseren en autonomie bij anorexia nervosa en bulimia nervosa

BACKGROUND Attachment insecurity and difficulty with mentalization are common in patients with eating disorders and might be related to their symptoms and lack of autonomy. AIM To investigate the role of attachment and mentalization in the course of anorexia nervosa (an) and bulimia nervosa (bn). METHOD Patients with AN and BN were assessed at the start of treatment, and after 1 year and 1.5 years concerning attachment security and mentalization in relation to eating disorder and co-morbid symptoms and autonomy. The results at the start of treatment were compared to those of controls without an eating disorder. RESULTS Attachment insecurity and low level of mentalization were more prevalent in patients than in controls, and associated with borderline personality disorder and/or self-injurious behaviour. Attachment security increased after 1 year of treatment. Recovery from eating disorder after 1 year was related to higher level of mentalization and improvement of autonomy. Low pre-treatment level of mentalization predicted persistence of eating disorder until 1.5 years of follow-up. CONCLUSION Good mentalization is associated with recovery from eating disorder. More research on the effect of mentalization based treatment for patients with eating disorders, with or without borderline personality disorder, is recommended

Autonomy–Connectedness, Self-Construal, and Acculturation : Associations With Mental Health in a Multicultural Society

The present study investigated the associations between self-construal, acculturation, and autonomy–connectedness, as well as the relations between autonomy–connectedness and psychopathological symptoms, controlling for self-construal and acculturation. Participants were 1,209 Dutch individuals, of whom 693 (57.3%) were immigrants with a non-Western background. Results showed that an independent self-construal was positively associated with self-awareness and capacity for managing new situations, and was negatively associated with sensitivity to others (which are the three components of autonomy–connectedness). Moreover, an interdependent self-construal was negatively associated with self-awareness and capacity for managing new situations, and was positively associated with sensitivity to others. Importantly, the latter associations were similar for both Dutch natives and immigrants, and the associations between acculturation and autonomy–connectedness were small and nonsignificant. Autonomy–connectedness, after controlling for self-construal and acculturation, explained a large amount of additional variance in anxiety (12.7%) and depression (14.1), and a medium amount of additional variance in drive for thinness (3.7%) and bulimia (4.8%). Autonomy–connectedness, thus, seems to be an important construct for people with a Western background, as well as for immigrants with a non-Western background

Autonomy–Connectedness, Self-Construal, and Acculturation : Associations With Mental Health in a Multicultural Society

The present study investigated the associations between self-construal, acculturation, and autonomy–connectedness, as well as the relations between autonomy–connectedness and psychopathological symptoms, controlling for self-construal and acculturation. Participants were 1,209 Dutch individuals, of whom 693 (57.3%) were immigrants with a non-Western background. Results showed that an independent self-construal was positively associated with self-awareness and capacity for managing new situations, and was negatively associated with sensitivity to others (which are the three components of autonomy–connectedness). Moreover, an interdependent self-construal was negatively associated with self-awareness and capacity for managing new situations, and was positively associated with sensitivity to others. Importantly, the latter associations were similar for both Dutch natives and immigrants, and the associations between acculturation and autonomy–connectedness were small and nonsignificant. Autonomy–connectedness, after controlling for self-construal and acculturation, explained a large amount of additional variance in anxiety (12.7%) and depression (14.1), and a medium amount of additional variance in drive for thinness (3.7%) and bulimia (4.8%). Autonomy–connectedness, thus, seems to be an important construct for people with a Western background, as well as for immigrants with a non-Western background

The role of autonomy-connectedness in stress-modulating effects of social support in women: An experimental study using a virtual Trier Social Stress Test

Social support is associated with mental well-being and favorable therapy outcomes. As autonomy-connectedness, the capacity for self-governance in interpersonal context, may affect reliance on others, we investigated whether stress-modulating effects of social support are moderated by autonomy-connectedness. Ninety-seven undergraduates completed measures on autonomy-connectedness and trait social anxiety, and attended a laboratory session with a friend (support) or alone (control). All underwent a virtual Trier Social Stress Test and completed anxiety, cortisol and heart rate (variability) measures. Preregistered analyses revealed that social support reduced anxiety reactivity and delayed heart rate variability decreases, but not heart rate. Contrary to hypotheses, autonomy-connectedness did not predict stress-reactivity or interact with condition. Exploratory analyses suggested effects of social support on cortisol reactivity and indicated that reported support quality varied by trait anxiety and self-awareness. Our findings underline the stress-modulating effects of social support and suggest that social support can benefit individuals with varying levels of autonomy-connectedness