Marion Spijkerman - Academia.edu (original) (raw)

Papers by Marion Spijkerman

BACKGROUND There is a need to regularly update the evidence base on the effectiveness of online m... more BACKGROUND There is a need to regularly update the evidence base on the effectiveness of online mindfulness-based interventions (MBIs), especially considering how fast this field is growing and developing. OBJECTIVE This study presents an updated meta-analysis of randomized controlled trials assessing the effects of online MBIs on mental health and the potential moderators of these effects. METHODS We conducted a systematic literature search in PsycINFO, PubMed, and Web of Science up to December 4, 2020, and included 97 trials, totaling 125 comparisons. Pre-to-post and pre-to-follow-up between-group effect sizes (Hedges g) were calculated for depression, anxiety, stress, well-being, and mindfulness using a random effects model. RESULTS The findings revealed statistically significant moderate pre-to-post effects on depression (g=0.34, 95% CI 0.18-0.50; P<.001), stress (g=0.44, 95% CI 0.32-0.55; P<.001), and mindfulness (g=0.40, 95% CI 0.30-0.50; P<.001) and small effects on ...

Een aanzienlijk deel van de Nederlandse bevolking krijgt op een zeker moment te maken met een chr... more Een aanzienlijk deel van de Nederlandse bevolking krijgt op een zeker moment te maken met een chronische ziekte. Hoewel klachtvermindering van groot belang is, verdient het welbevinden van deze groep eveneens aandacht. Hoe kunnen chronisch zieken binnen de beperkingen die hun ziekte met zich meebrengt, een plezierig, betekenisvol en betrokken leven (blijven) leiden? Het aanbod van de praktijkondersteuner van huisartsen voor de geestelijke gezondheidszorg (POH-GGZ) is op dit moment sterk in ontwikkeling. Dat biedt mogelijkheden voor positief psychologische interventies. In dit artikel worden de effecten en toepasbaarheid van de cursus Dit is jouw leven als blended care binnen de werksetting van de POH-GGZ besproken.

Studies investigating the effectiveness of compassion-focused therapy (CFT) are growing rapidly. ... more Studies investigating the effectiveness of compassion-focused therapy (CFT) are growing rapidly. As CFT is oriented toward helping people deal with internal processes of self-to-self-relating, having instruments to measure these processes is important. The 22-item Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS) has been found a useful measure. In the present study, a 14-item short form of the FSCRS (FSCRS-SF) suited to studies requiring brief measures was developed and tested in a Dutch community sample (N ϭ 363), and cross-validated in a sample consisting of participants in a study on the effectiveness of a guided self-help compassion training (N ϭ 243). Confirmatory factor analysis (CFA) indicated acceptable to good fit of the FSCRS-SF items to a three-factor model. Findings regarding internal consistency were inconsistent, with Study 1 showing adequate internal consistency for all subscale scores and Study 2 demonstrating satisfactory internal consistency only for the reassured self (RS) subscale score. Furthermore, the results showed that the FSCRS-SF subscale scores had adequate test-retest reliability and satisfactory convergent validity estimates with theoretically related constructs. In addition, the FSCRS-SF subscale scores were found to be sensitive to changes in self-to-self relating over time. Despite mixed findings regarding its reliability requiring further investigation, the FSCRS-SF offers a valid and sensitive measure which shows promise as a complimentary shorter version to the original FSCRS suited to nonclinical populations. Given that the FSCRS is increasingly used as a process and outcome measure, further research on this short form in nonclinical and clinical populations is warranted. Public Significance Statement The present study builds upon earlier findings regarding the psychometric properties of the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS) through developing and validating a short form. Despite mixed findings regarding its reliability requiring further investigation, the short form has adequate psychometric properties including structural validity, convergent validity and sensitivity to change, hence shows promise as a complimentary shorter version to the original FSCRS suited to nonclinical populations.

School Effectiveness and School Improvement

BACKGROUND Gamification is a promising strategy to increase the effectiveness of Web-based mental... more BACKGROUND Gamification is a promising strategy to increase the effectiveness of Web-based mental health interventions by enhancing engagement. However, because most studies focus on the longer term effects of gamification (eg, effectiveness or adherence at the end of the intervention period), there is limited insight into how gamification may enhance engagement. Research implies that gamification has a direct impact at the time of use of the intervention, which changes the experience of the users, and thereby motivates users. However, it is unclear what this direct impact of gamification might be and how it can be measured. OBJECTIVE The objective of this study was to explore the direct impact of gamification on behavioral, cognitive, and affective engagement in the context of a Web-based mental health intervention and to explore whether and how the different components of engagement are related. METHODS A pilot (n=19) and a real-life (n=75) randomized between-groups experiment was...

Journal of Personality Disorders

Whereas several meta-analyses have shown that psychotherapy is effective for reducing borderline ... more Whereas several meta-analyses have shown that psychotherapy is effective for reducing borderline personality disorder (BPD) pathology, the overall impact of psychotherapy for BPD on quality of life (QoL) remains as yet unclear. Because impaired QoL is associated with poor long-term outcomes after therapy for BPD, this seems a timely and relevant issue. The authors conducted a systematic review and meta-analysis of randomized controlled trials of psychotherapies for adults diagnosed with BPD that reported results of QoL at posttreatment. Fourteen trials were included (1,370 individuals with BPD). Psychotherapies for BPD relative to control conditions showed significant effect sizes for QoL (Cohen's d = 0.31; 95% CI [0.18, 0.44]), and for BPD pathology (d = 0.43; 95% CI [0.23, 0.64]). The effect on QoL was not significantly moderated by the effect on BPD pathology. Psychotherapies for BPD have a positive effect on QoL of patients with BPD. However, more studies are needed to exami...

Psychology and Psychotherapy: Theory, Research and Practice

Objectives. The conceptual approach of compassion underlying compassion-focused therapy (CFT) is ... more Objectives. The conceptual approach of compassion underlying compassion-focused therapy (CFT) is based on theoretical rather than empirical grounds. The aim of the present study was to seek empirical support for components of compassion as outlined in the theoretical model underpinning CFT, and to explore which components, if any, matter most for improving well-being. Design. A sequential exploratory mixed methods design was employed. Methods. Alongside a randomized controlled trial (RCT), we systematically examined 625 emails sent by 87 RCT participants to five counsellors during the course of a wellbeing enhancing CFT self-help intervention, to identify theoretically based compassionate attributes and skills. Next, in a quantitative analysis, we compared participants who did and did not show clinically relevant improvement on well-being with regard to the occurrence of compassionate attributes and skills. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Frontiers in Psychology

Objective: The working mechanisms of compassion-focused therapy (CFT) remain understudied. Drawin... more Objective: The working mechanisms of compassion-focused therapy (CFT) remain understudied. Drawing on the theoretical model underlying CFT, we examined four putative working mechanisms-self-reassurance, self-criticism, positive/negative affect-in relation to changes in well-being and psychological distress. Methods: Data of a waitlist randomised controlled trial (N = 242) investigating the effectiveness of a self-help CFT-intervention in a non-clinical sample were analysed. Using single and multiple mediation models, we assessed if changes in self-reassurance, self-criticism and positive/negative affect during the intervention (3-month interval) mediated changes in well-being and depressive/anxiety symptoms from baseline to follow-up (6-month interval) compared to the waitlist condition. Results: For each outcome, single analyses revealed that the effects of CFT were significantly mediated by self-reassurance and self-criticism. The mediating role of affect differed across outcomes. In combined models, self-reassurance emerged as a significant mediator for well-being and anxiety symptoms. Additionally, positive and negative affect were found significant mediators of the effects on depressive and anxiety symptoms, respectively. Conclusion: This study provides preliminary empirical evidence that CFT operates through cultivating self-reassurance, reducing self-criticism and regulating positive and negative affect in a non-clinical sample. To advance the development of CFT, further exploration of therapeutic change processes and their interplay is needed.

Journal of Psychopathology and Behavioral Assessment

There is considerable evidence that self-criticism plays a major role in the vulnerability to and... more There is considerable evidence that self-criticism plays a major role in the vulnerability to and recovery from psychopathology. Methods to measure this process, and its change over time, are therefore important for research in psychopathology and wellbeing.

Psychological assessment, Jan 10, 2017

Journal of medical Internet research, Jan 4, 2017

Prevention of depression is important due to the substantial burden of disease associated with it... more Prevention of depression is important due to the substantial burden of disease associated with it. To this end, we developed a novel, brief, and low-threshold Web-based self-help approach for depressive complaints called complaint-directed mini-interventions (CDMIs). These CDMIs focus on highly prevalent complaints that are demonstrably associated with depression and have a substantial economic impact: stress, sleep problems, and worry. The aim was to evaluate the effectiveness of the Web-based self-help CDMIs in a sample of adults with mild-to-moderate depressive symptoms compared to a wait-list control group. A two-armed randomized controlled trial was conducted. An open recruitment strategy was used. Participants were randomized to either the Web-based CDMIs or the no-intervention wait-list control group. The CDMIs are online, unguided, self-help interventions, largely based on cognitive behavioral techniques, which consist of 3 to 4 modules with up to 6 exercises per module. Par...

Tijdschrift voor gezondheidswetenschappen, 2015

SamenvattingDiabetes type 2 is een veelvoorkomende chronische ziekte. Er zijn verschillen in hoe ... more SamenvattingDiabetes type 2 is een veelvoorkomende chronische ziekte. Er zijn verschillen in hoe patiënten met deze ziekte en de lichamelijke, psychische en sociale gevolgen hiervan omgaan. Deze ‘mixed-methods’ studie beoogde te onderzoeken of er een relatie is tussen veerkracht en subjectief welbevinden onder 71 volwassenen met diabetes type 2. Patiënten werden gevraagd om een vragenlijst in te vullen over hun veerkracht en subjectief welbevinden (levenstevredenheid, positieve en negatieve emoties). Daarnaast zijn bij twaalf personen uit dezelfde populatie kwalitatieve interviews afgenomen om te exploreren welke factoren in de beleving van de patiënt van invloed zijn op veerkracht. De resultaten laten zien dat veerkracht positief samenhangt met levenstevredenheid en positieve emoties, en negatief samenhangt met negatieve emoties. Uit de interviews bleek dat positieve attitudes tegenover diabetes, ‘in control’ zijn, en positieve sociale relaties een belangrijke rol speelden bij veerkracht. Hoewel het er op lijkt dat veerkracht en subjectief welbevinden in diabetes type 2 patiënten met elkaar samenhangen, is aanvullend onderzoek nodig om te testen in hoeverre dit verband causaal is en om mediërende factoren in kaart te brengen.AbstractThe relationship between resilience and subjective wellbeing in adults with diabetes type 2 Diabetes type 2 is a common chronic illness. There are individual variations in how diabetes type 2 patients deal with their illness and the physical, mental and social limitations associated with it. This study aimed 1) to examine whether there is an association between resilience and subjective well-being in adults with diabetes type 2, and 2) to explore patient-reported factors associated with resilience. A mixed-methods cross-sectional design was used for this study. A questionnaire, including one resilience measure (Brief Resilience Scale) and two subjective well-being measures (Satisfaction With Life Scale, Positive and Negative Affect Schedule), was administered to 71 Dutch adults with diabetes type 2, twelve of whom subsequently participated in semi-structured interviews. Resilience was positively associated with life satisfaction and positive affect, and negatively associated with negative affect. The three major themes identified in the interviews were: positive attitudes towards diabetes, being in control, and supportive interactions. Although the findings suggest that there is a link between resilience and subjective well-being in adults with diabetes type 2, additional research is required to enable causal inference as well as to assess mediating factors.

Tijdschrift voor gezondheidswetenschappen, 2014

ABSTRACT Onderzoek laat zien dat het bereik van depressiepreventie aanzienlijk achterblijft bij b... more ABSTRACT Onderzoek laat zien dat het bereik van depressiepreventie aanzienlijk achterblijft bij bevolkingsgroepen met een lagere sociaal-economische status (SES). Dit heeft geleid tot de ontwikkeling van een alternatief concept: klachtgerichte miniinterventies (KMIs). In dit artikel beschrijven we de uitkomsten van drie KMIs gericht op achtereenvolgens slapen, stress en piekeren. Verder identificeren we subgroepen van de Nederlandse bevolking die potentieel baat hebben bij deze interventies met speciale aandacht voor groepen met een lagere SES. In een totale onderzoekspopulatie van 135 volwassenen die hebben deelgenomen aan één van de drie KMIs, is tweemaal een vragenlijst afgenomen om niveaus van welbevinden, depressie, angst, slaapklachten, stress en piekeren te meten, één voor aanvang en één drie maanden na de start van de cursus. Alle interventies laten verbeteringen zien op de specifieke klachten waarop zij gericht zijn (slaap-, stress- of piekerklachten). Een afname van depressieve klachten en stress werd geobserveerd bij alle cursussen. De data tonen verder demografische verschillen in de impact van de interventies gebaseerd op geslacht, opleiding, leeftijd en het hebben van een betaalde baan. Voorzichtig concluderen we dat KMIs kunnen bijdragen aan het verminderen en voorkomen van depressie, ook onder lage SES groepen. Op basis van de resultaten van deze pilot verdient het aanbeveling om een gerandomiseerde gecontroleerde trial uit te voeren om te testen in hoeverre de gemeten effecten daadwerkelijk toegeschreven kunnen worden aan de interventies. Abstract Are complaint-directed mini-interventions for sleeping, stress and worrying an enrichment for depression prevention? Results of a one-group pretest-posttest study Research indicates that depression prevention reaches fewer people in lower socio-economic groups as compared to higher socio-economic groups. This gave rise to the development of an alternative concept: complaint-directed miniinterventions. In a pilot with a one-group pretest-posttest design, we examined the outcomes of three complaint-directed mini-interventions aimed at sleeping, stress and worrying. Furthermore, we identified subgroups who potentially benefit from these interventions with a special interest in groups with a low socio-economic status (SES). In a total sample of 135 Dutch adults who participated in one of the three interventions, levels of well-being, depression, anxiety, sleeping problems, stress and worrying were measured at baseline and at three-month follow-up. All three interventions yielded significant improvements on the specific complaints they aimed at (sleeping, stress or worrying). A reduction of levels of depression and stress was observed in all interventions. Moreover, the data indicate demographic variations in the impact of the interventions based on sex, education, age and having paid employment. Carefully, we conclude that complaint-directed mini-interventions have the potential to contribute to depression prevention, also among low SES populations. It is recommended to conduct a randomised controlled trial to examine to what extent these effects can be attributed to the interventions.

Tijdschrift voor gezondheidswetenschappen, 2013

Via het programma PreventieKracht Thuiszorg en de opvolger PreventieKracht dicht bij huis financi... more Via het programma PreventieKracht Thuiszorg en de opvolger PreventieKracht dicht bij huis financierde ZonMw tussen 2007 tot en met 2012 de uitvoering van preventieplannen van lokale samenwerkende partijen. Voorwaarde was dat een thuiszorgorganisatie betrokken was bij de uitvoering van de preventieplannen. Het Trimbos-instituut heeft de resultaten van 2009, 2010 en 2011 geanalyseerd. Welke typen organisaties werkten samen bij de uitvoering van welke interventies en activiteiten en met welk bereik? In dit artikel wordt de stand van zaken opgemaakt.

Journal of Medical Internet Research

Background: Gamification is a promising strategy to increase the effectiveness of Web-based menta... more Background: Gamification is a promising strategy to increase the effectiveness of Web-based mental health interventions by enhancing engagement. However, because most studies focus on the longer term effects of gamification (eg, effectiveness or adherence at the end of the intervention period), there is limited insight into how gamification may enhance engagement. Research implies that gamification has a direct impact at the time of use of the intervention, which changes the experience of the users, and thereby motivates users. However, it is unclear what this direct impact of gamification might be and how it can be measured. Objective: The objective of this study was to explore the direct impact of gamification on behavioral, cognitive, and affective engagement in the context of a Web-based mental health intervention and to explore whether and how the different components of engagement are related. Methods: A pilot (n=19) and a real-life (n=75) randomized between-groups experiment was carried out, where participants used a gamified or nongamified version of the same Web-based well-being intervention for a single session. Participants (68%, 64/94 female, mean age 23 years) were asked to use the intervention in one session for research purposes. Gamification elements included a map as visualization of the different lessons, a virtual guide, and badges. Later, behavioral, cognitive, and affective engagement were measured. Results: The pilot experiment showed no differences between the gamified and nongamified intervention. However, in the real-life experiment, participants in the gamified intervention scored higher on cognitive engagement, that is, involvement (P=.02) and some elements of affective engagement, that is, flow as a combination of cognitive and affective engagement (P=.049), and the emotions "interest" (P=.03) and "inspiration" (P=.009). Furthermore, the effect of gamification on cognitive engagement was mediated by the influence of gamification on specific positive emotions. Conclusions: The gamified intervention seemed to be able to increase cognitive engagement and the combination of cognitive and affective engagement but not behavioral and affective engagement alone. However, positive emotions seem to play an important role in mediating the effect of gamification on engagement. In conclusion, we cannot say that gamification "works" but that the design of an intervention, in this case, gamification, can have an impact on how participants experience the intervention.