Secondary traumatization in partners and parents of Dutch peacekeeping soldiers.

This study examines secondary traumatization among 708 partners and 332 parents of Dutch peacekeepers (i.e., personnel who participated in military actions implemented by international organizations such as the United Nations). Partners or parents of peacekeepers with 4 levels of posttraumatic stress symptoms were compared on posttraumatic stress, health problems, the quality of the marital relationship, and social support. In comparison with partners of peacekeepers without posttraumatic stress disorder (PTSD) symptoms, partners of peacekeepers with PTSD symptoms reported more sleeping and somatic problems, reported more negative social support, and judged the marital relationship as less favorable. No significant differences were found for parents. Thus, peacekeepers' stress reactions were related to various problems of their partners. A systemic approach to the treatment of persons with PTSD appears appropriate

Samen beslissen met ROM als informatiebron:Kwalitatief onderzoek onder cliënten

Achtergrond Acht ggz-organisaties hebben in de periode 2019-2022 gewerkt aan de doorontwikkeling en implementatie van ‘Samen beslissen met routine outcome monitoring (ROM) als informatiebron’.Doel Inzicht krijgen in behoeften en ervaringen van cliënten met samen beslissen en ROM, en onderzoeken welke implementatieaanpak dit vraagt.Methode Exploratief, kwalitatief onderzoek bestaande uit semigestructureerde interviews en focusgroepen met cliënten (n = 101) in behandeling bij ggz-organisaties verspreid over Nederland.Resultaten Cliënten vonden samen beslissen belangrijk. Voor een goede toepassing vonden zij generieke aspecten (luisteren, vertrouwen, volledige informatie en gelijkwaardige inbreng) én maatwerk (aansluiten bij hulpvraag en bij elk besluit metacommunicatie over de rolverdeling tussen cliënten, naaste(n) en behandelaren, en wijze van informatievoorziening) van belang. Cliënten waardeerden ROM als informatiebron bij samen beslissen, mits vragenlijsten niet te lang waren, aansloten bij de problematiek en uitkomsten besproken werden.Conclusie Samen beslissen met ROM is in de ggz nog niet breed geïmplementeerd. Dit vraagt een blijvende stimulans en evaluatie ervan. De toepassing kan verbeteren door (na)scholing van behandelaren en ondersteuning van cliënten met betrokkenheid van naaste(n), ervaringsdeskundigen en psycho-educatie. Cliënten waarderen ROM als hulpmiddel bij samen beslissen; inzage in de eigen ROM is hierbij nuttig

Epidemiological study air disaster in Amsterdam (ESADA): study design

BACKGROUND: In 1992, a cargo aircraft crashed into apartment buildings in Amsterdam, killing 43 victims and destroying 266 apartments. In the aftermath there were speculations about the cause of the crash, potential exposures to hazardous materials due to the disaster and the health consequences. Starting in 2000, the Epidemiological Study Air Disaster in Amsterdam (ESADA) aimed to assess the long-term health effects of occupational exposure to this disaster on professional assistance workers. METHODS/DESIGN: Epidemiological study among all the exposed professional fire-fighters and police officers who performed disaster-related task(s), and hangar workers who sorted the wreckage of the aircraft, as well as reference groups of their non-exposed colleagues who did not perform any disaster-related tasks. The study took place, on average, 8.5 years after the disaster. Questionnaires were used to assess details on occupational exposure to the disaster. Health measures comprised laboratory assessments in urine, blood and saliva, as well as self-reported current health measures, including health-related quality of life, and various physical and psychological symptoms. DISCUSSION: In this paper we describe and discuss the design of the ESADA. The ESADA will provide additional scientific knowledge on the long-term health effects of technological disasters on professional workers

Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and DSM-5 diagnostic criteria for PTSD

Background: Researchers and clinicians within the field of trauma have to choose between different diagnostic descriptions of posttraumatic stress disorder (PTSD) in the DSM-5 and the proposed ICD-11. Several studies support different competing models of the PTSD structure according to both diagnostic systems; however, findings show that the choice of diagnostic systems can affect the estimated prevalence rates. Objectives: The present study aimed to investigate the potential impact of using a large (i.e. the DSM-5) compared to a small (i.e. the ICD-11) diagnostic description of PTSD. In other words, does the size of PTSD really matter? Methods: The aim was investigated by examining differences in diagnostic rates between the two diagnostic systems and independently examining the model fit of the competing DSM-5 and ICD-11 models of PTSD across three trauma samples: university students (N = 4213), chronic pain patients (N = 573), and military personnel (N = 118). Results: Diagnostic rates of PTSD were significantly lower according to the proposed ICD-11 criteria in the university sample, but no significant differences were found for chronic pain patients and military personnel. The proposed ICD-11 three-factor model provided the best fit of the tested ICD-11 models across all samples, whereas the DSM-5 seven-factor Hybrid model provided the best fit in the university and pain samples, and the DSM-5 six-factor Anhedonia model provided the best fit in the military sample of the tested DSM-5 models. Conclusions: The advantages and disadvantages of using a broad or narrow set of symptoms for PTSD can be debated, however, this study demonstrated that choice of diagnostic system may influence the estimated PTSD rates both qualitatively and quantitatively. In the current described diagnostic criteria only the ICD-11 model can reflect the configuration of symptoms satisfactorily. Thus, size does matter when assessing PTSD

Activating welfare recipients with health complaints: Reasons for failure of a cognitive training programme

Activating welfare recipients with health complaints: Reasons for failure of a cognitive training programme In western welfare states, a trend towards activation has led to the development of interventions aimed at welfare recipients with health complaints. Forms of coercion are increasingly applied within this activation policy. An example of this approach is the Dutch project Healthy to Work (HtW) which developed and evaluated an intervention combining an exercise program with cognitive training. Although HtW had been selected as an example of good practice, a randomized clinical trial did not show beneficial effects. This cognitive training programme based on rational-emotive therapy has not been studied separately as yet. Therefore, an in-depth qualitative study was conducted to examine reasons for failure. A purposive sample of six trainers were interviewed. The results indicated that trainers encountered problems with the heterogeneity of participants and different problems, expectations and labour market obstructions than expected beforehand. The mandatory nature of HtW had a negative effect on motivation of both participants and trainers. The discussion questions the assumption that coping style and cognitions of welfare recipients with health problems are the main obstacles to finding work, and the policy to ignore physical limitations of participants. We suggest that in this complex area of practice, improvement can be achieved by allowing trainers to adapt and learn during the process, while also reflecting on normative aspects, and by taking perspectives of welfare recipients themselves into account. Het activeren van uitkeringsgerechtigden met gezondheidsklachten: Oorzaken voor het falen van een cognitief trainingsprogramma Een groeiende nadruk op de activering van uitkeringsgerechtigden heeft in veel Westerse verzorgingsstaten geleid tot de ontwikkeling van interventies die gericht zijn op uitkeringsgerechtigden met gezondheidsklachten. Vormen van dwang, zoals verplichte participatie, worden meer en meer toegepast binnen dit activeringsbeleid. Een voorbeeld hiervan is het Nederlandse project “Gezond aan de Slag”, dat een interventie ontwikkelde en evalueerde waarin een fysiek trainingsprogramma gecombineerd wordt met cognitieve training. Hoewel HtW als “best practice” gold, liet een randomized trial geen positieve effecten van de interventie zien. Omdat het cognitieve trainingsprogramma, gebaseerd op rationeel-emotieve therapie, niet eerder afzonderlijk werd bestudeerd, werd een diepgaande kwalitatieve studie uitgevoerd. Getracht werd om de oorzaken van het falen van het programma in kaart te brengen. Zes, gericht geselecteerde, trainers werden geïnterviewd. De resultaten lieten zien dat de trainers problemen hadden met de heterogeniteit van de deelnemersgroep en op andere problemen, verwachtingen en arbeidsmarktobstakels stuitten dan vooraf verwacht. De verplichte aard van HtW had een negatief effect op de motivatie van zowel deelnemers als trainers. In de discussieparagraaf van dit artikel worden vraagtekens geplaatst bij de veronderstelling dat de coping stijl en cognities van uitkeringsgerechtigden met gezondheidsproblemen de belangrijkste hindernissen zijn voor het vinden van werk, en worden vraagtekens geplaatst bij het beleid om fysieke beperkingen van deelnemers te negeren. De auteurs suggereren dat met betrekking tot dit complexe praktijkprobleem, verbetering kan worden bereikt door aanpassen en leren van de interventie gedurende de toepassing daarvan toe te staan, en door expliciet te reflecteren op de normatieve aspecten van de interventie, en de perspectieven van de uitkeringsgerechtigden zelf

<雑録>歐洲哲學現今ノ趨勢

textabstractThe Assessment of Daily Activity Performance (ADAP) test has been developed to measure the physical capacity of older adults to carry out instrumental activities of daily living (ADL). The present study explores the option to create a less time-consuming short version of the ADAP that can be completed in the individual's home environment and that imposes less of a physical burden. Data from 141 independently living women aged 70 and older were analyzed using principal components analysis (PCA). PCA identified two factors, on which 10 of the original 21 items had loaded sufficiently to be eligible for inclusion in a short version. The ADAP short version is considerably shorter than the original test and provides a good representation of the constructs being measured. More research is necessary to develop a short version of the ADAP that is easily applicable in the home environment of older adult

Utility of the impact of event scale in screening for posttraumatic stress disorder

This study assesses the optimal cut-off point for the Impact of Event Scale and compares its screening properties with those of the Self-rating Inventory for Posttraumatic Stress Disorder among war-related trauma victims. 74 patients with war-related trauma were administered the Impact of Event Scale and the Self-rating Inventory for Posttraumatic Stress Disorder, followed 1 wk. later by the Clinician-administered PTSD Scale. Receiver operating characteristic analysis indicated for the Impact of Event Scale a sensitivity of .77 and a specificity of .51 at a cut-off value of 36. For the Self-rating Inventory for Posttraumatic Stress Disorder a sensitivity of .86 and a specificity of .69 were found at a cut-off value of 52. The authors conclude that careful use of the Impact of Event Scale as a screening measure for Posttraumatic Stress Disorder is warrante

Dimensionality of the posttraumatic stress response among police officers and fire fighters: An evaluation of two self-report scales

Confirmatory factor analyses were done to assess the dimensionality of the stress response in a sample of police officers and fire fighters (n = 1168) involved in the 1992 air disaster in Amsterdam. The confirmatory factor analyses were applied to the responses on two psychometrically different instruments, i.e., the Self-Rating Inventory for Posttraumatic Stress Disorder (SRIP) and the Impact of Event Scale (IES). The previously found distinction between (active) avoidance and numbing in samples highly affected by posttraumatic stress disorder appears to be applicable to the stress response of a less affected sample. For the SRIP, a five-factor structure (i.e., intrusion, avoidance, hyperarousal, emotional numbing and sleep disturbance) appeared to fit slightly better than the four-factor structures from previous findings. For the IES, our results replicated findings of a four-dimensional structure (i.e., intrusion, avoidance, numbing and sleep disturbance) underlying the posttraumatic stress response. The factors of the best-fitting structure of both instruments proved reliable. Due to the psychometric properties of the two instruments, the relationship between similar factors in both instruments was only low to moderate. Compared with the IES, factors of the SRIP were, however, less discriminative from other symptoms of psychopathology. Replication in different traumatized or community samples is recommended