Social mindfulness

Lange, P.A.M. van [Promotor]Prooijen, J.W. van [Copromotor]Tybur, J.M. [Copromotor

The emerging role of BK virus in kidney transplantation

In summary, the studies in this thesis show that immunosuppression with tacrolimus carries a higher risk of BKPyV reactivation and pathology and that treatment with CsA or an mTOR inhibitor can then be considered. In addition, it is possible to differentiate between BKPyVAN and rejection with FACS and this method can be used to monitor the effectiveness of anti-rejection treatment or BKPyV-related treatment via immune profiles. BKPyV also has the potential to circumvent the immune system via viral miRNA, whereby the viral miRNAs largely follow the amount of viral DNA, but for which more research is needed to better understand complex expression differences of the miRNA during different phases of infection

Social Mindfulness and Psychosis: Neural response to socially mindful behavior in first-episode psychosis and patients at clinical high-risk

Background: Psychosis is characterized by problems in social functioning and trust, the assumed glue to positive social relations. But what helps building trust? A prime candidate could be social mindfulness: The ability and willingness to see and consider another person’s needs and wishes during social decision making. We investigated whether first-episode psychosis patients (FEP) and patients at clinical high-risk (CHR) show reduced social mindfulness, and examined the underlying neural mechanisms. Methods: Twenty FEP, 17 CHR and 46 healthy controls, aged 16-31, performed the social mindfulness task (SoMi) during fMRI scanning, spontaneously and after the instruction “to keep the other’s best interest in mind”. As first of two people, participants had to choose one out of four products, of which three were identical and one was unique, differing in a single aspect (e.g., color). Results: FEP tended to choose the unique item (unmindful choice) more often than controls. After instruction, all groups significantly increased the number of mindful choices compared to the spontaneous condition. FEP showed reduced activation of the caudate and medial prefrontal cortex (mPFC) during mindful, and of the anterior cingulate cortex (ACC), mPFC, and left dorso-lateral prefrontal cortex (dlPFC) during unmindful decisions. CHR showed reduced activation of the ACC compared to controls. Discussion: FEP showed a trend towards more unmindful choices. A similar increase of mindful choices after instruction indicated the ability for social mindfulness when prompted. Results suggested reduced sensitivity to the rewarding aspects of social mindfulness in FEP, and reduced consideration for the other player. FEP (and CHR to a lesser extent) might perceive unmindful choices as less incongruent with the automatic mindful responses than controls. Reduced socially mindful behavior in FEP may hinder the building of trust and cooperative interactions

People from lower social classes elicit greater prosociality:Compassion and deservingness matter

People are quick to form impressions of others’ social class, and likely adjust their behavior accordingly.If social class is linked to prosociality, as literature suggests, then an interaction partner’s class shouldaffect prosocial behavior, especially when costs or investments are low. We test this expectation usingsocial mindfulness (SoMi) and dictator games (DG) as complementary measures of prosociality. Wemanipulate target class by providing information regarding a target’s (a) position on a social classladder, and (b) family background. Three studies using laboratory and online approaches (Noverall =557) in two nations (the Netherlands [NL], the UK), featuring actual and hypothetical exchanges, revealthat lower class targets are met with greater prosociality than higher class targets, even when based oninformation about the targets’ parents (Study 3). The effect of target class was partially mediated bycompassion (Studies 2 and 3) and perceived deservingness of the target (Study 3). Implications andlimitations are discussed.Social decision makin

Implementing new routines in adult mental health care to identify and support children of mentally ill parents

BACKGROUND: Mental health problems are often transmitted from one generation to the next. This knowledge has led to changes in Norwegian legislation, making it mandatory to assess whether or not patients have children, and to provide necessary support for the children of mentally ill patients. The main purpose of this study was to evaluate the process of implementing new routines in adult mental health services to identify and support children of mentally ill parents. METHODS: The design was a pre-test post-test study. The sample (N = 219 at pre-test and N = 185 at post-test) included mental health professionals in the largest hospital in the region, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker’s knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. RESULTS: The results of this study indicated that some changes are taking place in clinical practice in terms of increased identification of children. Adult mental health services providing support for the children was however not fully implemented as a new practice. CONCLUSION: The main finding in this study is that the identification frequency had increased significantly according to self-reported data since the Family Assessment Form was implemented. The increase in self-reported identification behavior is however taking place very slowly. Three years after the legislation was changed to making it mandatory to assess whether or not patients have children, it was still not fully incorporated in the routines of the entire workforce. In terms of support for the families affected by parental mental illness, the changes are not yet significant

De nutritionele waardering van Natuphos-fytase in pluimveevoeders

Door fytase toe te voegen aan het voer, komt meer fosfor beschikbaar voor het dier. Bij vleeskuikens wordt door Gist-brocades geadviseerd dat 500 FTU overeenkomt met 1 g Monocalciumfosfaat (MCP-P). Voor leghennen is het advies dat 300 FTU overeenkomt met 1 g MCP-P

Overcoming Clinician and Parent Ambivalence: General Practitioners' Support of Children of Parents With Physical or Mental Illness and/or Substance Abuse

Children who are next of kin to parents with physical or mental illness and/or substance abuse need access to mental health support and several cost-effective interventions are available. Because most parents in the target group often consult general practitioners (GPs), GPs may have a crucial role in identifying burdened children and ensuring their follow-up. However, this important topic has received little attention in clinical discussions and research. In response to the knowledge gap, we conducted the research project Burdened Children as Next of Kin and the General Practitioner. Four sub-studies have been completed and published: a sub-study with qualitative analysis of focus group interviews with GPs (paper 1), a qualitative analysis of focus group interviews with adolescents as next of kin (paper 2), and a qualitative analysis of individual interviews with parents with illness and/or substance abuse (paper 3). The results from these sub-studies were incorporated in a survey sent to members of a nationwide GP organization (paper 4). The aim of the present sub-study was to gain further knowledge about conditions for the encounters between GPs and parents with impairments to be supportive for the children as next of kin. The material of the present sub-study derived from the project's four previous sub-studies and comprised a secondary analysis of the four prior sub-studies. We conducted an overarching thematic analysis of these sub-studies' results sections. We searched for statements from the GPs, the adolescents, and the parents on their experiences and evaluations of the needs of the children and their families, and the possible ways of accommodating these needs in general practice. The analysis shows that both GPs and parents were ambivalent about addressing the topic of the patients' children during consultations. This was the case although the GPs were in a good position to identify these vulnerable children, and the parents were worried about their children's situations. Possible strategies for GPs to overcome this ambivalence can be to (1) strengthen their competence in the topic, (2) gradually build trusting relationships with parents, and (3) gradually gain contextual knowledge about the families' situations. GPs can do this by performing ordinary GP tasks and acknowledging the parents' efforts to give their children good daily lives

Improvements in the quality of the parent-child relationship following treatment with an integrated family approach

ObjectiveThis study investigated changes in the emotional availability of the parent and the child in the dyadic relationship, parental reflective functioning, and parental perception of the relationship with their child following treatment with an integrated family approach in adult and child mental health care services. The aim of the study was to investigate if an integrated family approach in treatment contributes to good practice in mental health care.BackgroundChildren of parents with a mental disorder are at increased risk for developing mental health problems themselves during lifetime. Infants are extremely vulnerable for environmental influences. Parents with mental disorders are at risk for mis-attuned behavior and non-optimal emotional availability. This increases the risk of adverse cascading effects on the parent-child relationship and child development. A secure parent-child relationship is an important protective factor against the intergenerational transmission of mental disorders. Although treatment of the parental mental disorder is important, it does not automatically change undesirable patterns in the parent-child relationship. Therefore, an integrated family approach to mental health treatment is recommended.MethodsThis study involved a mixed methods design using questionnaires, an observation instrument and semi-structured interviews. The variables examined were the quality of the parent-child interaction, the parental perspective on their relationship with the child, their problems with child upbringing, and on their parental reflective functioning. The clinical sample consisted of 50 patients with a variety of mental disorders and their young children.ResultsAfter finishing the integrated treatment the quality of the parent-child interaction had improved significantly. Likewise, we found a significant improvement in parental perception regarding the relationship with the child and the parental role. The majority of the parents interviewed showed that they were better able to mentalize about themselves, their child and their relationship with the child, but the data from the questionnaire showed mixed results regarding parents’ reflective functioning.ConclusionTreatment with an integrated family approach to mental health care in which the parental role of the patient, the young child, and the parent-child relationship are integrated in treatment, can be a valuable addition to the current practice of mental health care in which patients are commonly perceived as individuals

Family matters: infants, toddlers and preschoolers of parents affected by mental illness

Contains fulltext : 102540.pdf (publisher's version ) (Open Access)One in five young people in Australia, including infants, toddlers and preschoolers, lives in a family with a parent with a mental illness.1 Families affected by mental illness are more likely than other families to experience poverty and social isolation,2 and are more likely to have children taken into care.3 A combination of factors influences the child’s risk of psychopathology. These include psychosocial adversity, the child’s developmental status and age, genetics, family relationships, the severity and chronicity of parental psychiatric disorder, comorbidity, and the involvement of other carers in the child’s life. Not all children whose parents have mental health problems will experience difficulties themselves.4 Parental diagnosis itself does not confer risk, and many parents with severe depression, schizophrenia and other disorders are adequate caregivers.5 Rather, it is the severity and chronicity of psychopathology and the variation in parental personality, genetic characteristics, coping style and social circumstances that confer risk. Children’s characteristics, such as temperament and sex, can also influence the parent–child relationship and parenting behaviour.6 This article outlines the impact of three key mental health disorders on parenting and young offspring, and describes implications for practice