Psychopathy in 3D : using three dimensions to model psychopathic traits in youth

This dissertation aimed to study how to best conceptualize psychopathy in youth, to clarify the role of adolescents’ socioeconomic background in the manifestation of psychopathy, and validate the distinction between primary and secondary psychopathy. Psychopathy is a personality disorder characterized by a constellation of interpersonal, affective, and behavioral characteristics. In short, a bifactor model for psychopathy, examined with the Youth Psychopathic traits Inventory, was superior over other factor structures. That is, psychopathy is represented by a General Psychopathy factor related to all traits, and in addition, three Specific Dimensional factors. This bifactor model showed that the YPI was primarily unidimensional, and invariant for gender, ethnic background, and age. Moreover, socioeconomic status was not a simple risk factor for General Psychopathy, and in youth high on all three dimensions of psychopathic traits, a group with high levels of anxiety (i.e., secondary psychopathy) could be distinguished from a group with low levels of anxiety (i.e., primary psychopathy), with the former showing the most behavior problems. This group seems important targets for intervention and treatment programs. An important finding from these studies is that it is important to consider all three dimensions (i.e., interpersonal, affective, and behavioral) when studying psychopathy in youth. Development Psychopathology in context: clinical setting

To what extent does sociodemographic composition of the neighbourhood explain regional differences in demand of primary out-of-hours care:A multilevel study

Background:  In the Netherlands, primary out-of-hours (OOH) care is provided by large scale General Practitioner (GP) cooperatives. GP cooperatives can be contacted by patients living in the area surrounding the GP cooperative (catchment area) at hours when the patient's own general practice is closed. The frequency of primary OOH care use substantially differs between GP cooperative catchment areas. To enable a better match between supply and demand of OOH services, understanding of the factors associated with primary OOH care use is essential. The present study evaluated the contribution of sociodemographic composition of the neighbourhood in explaining differences in primary OOH care use between GP cooperative catchment areas. Methods:  Data about patients' contacts with primary OOH services (n = 1,668,047) were derived from routine electronic health records of 21 GP cooperatives participating in the NIVEL Primary Care Database in 2012. The study sample is representative for the Dutch population (for age and gender). Data were matched with sociodemographic characteristics (e.g. gender, age, low-income status, degree of urbanisation) on postcode level. Multilevel linear regression models included postcode level (first level), nested within GP cooperative catchment areas (second level). We investigated whether contacts in primary OOH care were associated with neighbourhood sociodemographic characteristics. Results:  The demand of primary OOH care was significantly higher in neighbourhoods with more women, low-income households, non-Western immigrants, neighbourhoods with a higher degree of urbanisation, and low neighbourhood socioeconomic status. Conversely, lower demand was associated with neighbourhoods with more 5 to 24 year old inhabitants. Sociodemographic neighbourhood characteristics explained a large part of the variation between GP cooperatives (R-squared ranging from 8% to 52%). Nevertheless, the multilevel models also showed that a considerable amount of variation in demand between GP cooperatives remained unexplained by sociodemographic characteristics, particularly regarding high-urgency contacts. Conclusions:  Although part of the variation between GP cooperatives could not be attributed to neighbourhood characteristics, the sociodemographic composition of the neighbourhood is a fair predictor of the demand of primary OOH care. Accordingly, this study provides a useful starting point for an improved planning of the supply of primary OOH care

Informal Caregivers of People with Dementia: Problems, Needs and Support in the Initial Stage and in Subsequent Stages of Dementia: A Questionnaire Survey

Objective: The ageing of the population is expected to lead to an increase in the prevalence of dementia. Providing support to informal caregivers is essential to promote their wellbeing and prevent serious caregiver burden. The aim of the study is to investigate whether differences occur between the initial and later stages of dementia in terms of (1) problems experienced by informal caregivers in the provision of care, (2) use of professional support by persons with dementia, (3) informal caregivers’ needs for additional professional support. Methods: The data were collected within the framework of the Dutch National Dementia Program, which was instigated in 2005 by the Dutch Ministry of Health, Welfare and Sport to improve integrated care for people with dementia and their informal caregivers. This paper is based on data of a questionnaire survey among 1494 informal caregivers, collected between September 2007 and December 2008. Results: Most informal caregivers (98-99%) experienced problems in caring for a person with dementia, irrespective of the stage of the illness process. In later stages, informal caregivers more often experienced problems in their social networks. Most dementia patients (87-94%) received ambulatory professional support. Conclusions: Since informal caregivers indicate a need for additional professional support in all stages of dementia, professional support should be provided during the entire illness process. Informal caregivers need advice on how to cope with symptoms of dementia, how to deal with behavior problems and receive more information about (early and advanced stages of) dementia and the supply of support. (aut. ref.

What do general practitioners know about ADHD? Attitudes and knowledge among first-contact gatekeepers: systematic narrative review

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common childhood disorder with international prevalence estimates of 5 % in childhood, yet significant evidence exists that far fewer children receive ADHD services. In many countries, ADHD is assessed and diagnosed in specialist mental health or neuro-developmental paediatric clinics, to which referral by General (Family) Practitioners (GPs) is required. In such ‘gatekeeper’ settings, where GPs act as a filter to diagnosis and treatment, GPs may either not recognise potential ADHD cases, or may be reluctant to refer. This study systematically reviews the literature regarding GPs’ views of ADHD in such settings. Methods: A search of nine major databases was conducted, with wide search parameters; 3776 records were initially retrieved. Studies were included if they were from settings where GPs are typically gatekeepers to ADHD services; if they addressed GPs’ ADHD attitudes and knowledge; if methods were clearly described; and if results for GPs were reported separately from those of other health professionals. Results: Few studies specifically addressed GP attitudes to ADHD. Only 11 papers (10 studies), spanning 2000–2010, met inclusion criteria, predominantly from the UK, Europe and Australia. As studies varied methodologically, findings are reported as a thematic narrative, under the following themes: Recognition rate; ADHD controversy (medicalisation, stigma, labelling); Causes of ADHD; GPs and ADHD diagnosis; GPs and ADHD treatment; GP ADHD training and sources of information; and Age, sex differences in knowledge and attitudes. Conclusions: Across times and settings, GPs practising in first-contact gatekeeper settings had mixed and often unhelpful attitudes regarding the validity of ADHD as a construct, the role of medication and how parenting contributed to presentation. A paucity of training was identified, alongside a reluctance of GPs to become involved in shared care practice. If access to services is to be improved for possible ADHD cases, there needs to be a focused and collaborative approach to training

De Landelijke Vegetatie Databank

De Landelijke Vegetatie Databank (LVD) is een gegevensbestand over de plantengroei van Nederland. In dit omvangrijke archief zijn ongeveer 500.000 recente en historische vegetatiebeschrijvingen, zogenaamde vegetatieopnamen, in geautomatiseerde vorm bijeengebracht. De gegevens weerspiegelen ruim vijfenzeventig jaar vegetatiekundig veldonderzoek en hebben betrekking op de gehele verscheidenheid van begroeiingstypen. Ze omvatten zowel aquatische als terrestrische begroeiingen, goed ontwikkelde plantengemeenschappen maar ook verarmde gemeenschappen. De waarnemingen betreffen zowel het cultuurlandschap als de halfnatuurlijke en natuurlijke landschappen, en ze bieden een omvattend beeld van de vegetatie in alle delen van ons land. Een toelichting over achtergronden, inventaris en toepassingen van de Landelijke Vegetatie Databank is vervat in de publicatie Schatten voor de natuur. De verplichtingen die voortkomen uit Europese afspraken met betrekking tot het internationale natuurbeleid, vormden de directe aanleiding voor het samenstellen van deze publicatie in opdracht van het Ministerie van Landbouw, Natuur en Voedselkwaliteit (LNV). De bedoelde Europese verplichtingen, kortweg aangeduid als Natura 2000, zijn in Nederland vervat in een aantal wettelijke taken die het behoud van de biodiversiteit in ons land moeten veiligstellen. Voor de uitvoering van deze taken bestaat een dringende behoefte aan gegevens over de desbetreffende natuurwaarden. Binnen de internationale verplichtingen nemen de Vogelrichtlijn en de Habitatrichtlijn (VHR), de twee pijlers van Natura 2000, een prominente plaats in. In het kader van deze richtlijnen moet het Ministerie van LNV periodiek rapporteren aan de Europese Commissie. In het jaar 2007 dient gerapporteerd te worden over de periode 2001-2006, waarbij in eerste instantie gevraagd wordt om de 'staat van instandhouding' van habitattypen en soorten te beoordelen, zeg maar de toestand waarin deze habitattypen en soorten in ons land verkeren. Wat de habitattypen betreft, wordt gebruik gemaakt van de vele vegetatiegegevens die in ons land in de loop van de tijd zijn verzameld

Socioeconomic status and psychopathic traits in a community sample of youth

The current study aims to address socioeconomic status (SES) as a moderating variable between psychopathic traits and conduct problems in a sample of 2432 Dutch adolescents (Mage = 14.50 years, SD = 1.67, 56%male). Both family and neighborhood SES were measured, with income as a proxy for the level of SES. There were small but significant positive correlations between the behavioral and interpersonal dimensions of psychopathy and family SES, a small but significant negative correlation between the affective dimension and neighborhood SES, and a small and significant positive correlation between neighborhood SES and the behavioral dimension of psychopathy. Results further showed that the relations between youth psychopathic traits were moderated by neither family SES nor neighborhood SES. The results suggest that the relations between psychopathic traits and conduct problems are equally strong for lower and higher SES youth. Taken together, these findings warrant the conclusions that SES does not play a role as a moderator in the relation between psychopathy and conduct problems.Development Psychopathology in context: clinical setting