Maarten Van Son - Academia.edu (original) (raw)

Papers by Maarten Van Son

European journal of psychotraumatology, 2011

Affect regulation is often compromised as a result of early life interpersonal traumatization and... more Affect regulation is often compromised as a result of early life interpersonal traumatization and disruption in caregiving relationships like in situations where the caretaker is emotionally, sexually or physically abusing the child. Prior studies suggest a clear relationship between early childhood attachment-related psychological trauma and affect dysregulation. We evaluated the relationship of retrospectively recalled childhood traumatization by primary caretaker(s) (TPC) and affect dysregulation in 472 adult psychiatric patients diagnosed with borderline personality disorder (BPD), somatoform disorder (SoD), both BPD and SoD, or disorders other than BPD or SoD, using the Bermond-Vorst Alexithymia Questionnaire, the self-report version of the Structured Interview for Disorders of Extreme Stress, the Self-rating Inventory for Posttraumatic Stress Disorder (SRIP) and the Traumatic Experiences Checklist. Almost two-thirds of participants reported having experienced childhood TPC, ra...

Psychological Trauma: Theory, Research, Practice, and Policy, 2013

ABSTRACT Potentially traumatizing experiences by a primary caregiver during childhood (TPC) may l... more ABSTRACT Potentially traumatizing experiences by a primary caregiver during childhood (TPC) may lead to affect dysregulation, which is a hallmark of borderline personality disorder (BPD) in adulthood. Path analyses with bootstrap confidence intervals were used to explore the relationships of TPC and under- and overregulation of affect to BPD symptoms. Almost 63% of a sample of 472 patients diagnosed with either BPD alone, comorbid BPD + somatoform disorder, or other mental disorder, reported childhood TPC. TPC and underregulation of affect were associated with severity of BPD symptoms, but overregulation was not. Underregulation of affect partially mediated the relationship between TPC and BPD symptoms. Study findings suggest that also addressing underregulation of affect as a sequela of TPC rather than as only on feature of BPD, may enhance treatment of BPD symptoms. Research is needed to determine if targeting overregulation of affect, next to TPC and underregulation of affect, enhances the efficacy of treatment for severe BPD symptoms with childhood TPC and with comorbid other mental disorders, especially somatoform disorder.

Psychopathology, 2013

To study difficulties in emotional functioning in two mental disorders that have been associated ... more To study difficulties in emotional functioning in two mental disorders that have been associated with difficulties in identifying and modulating emotions: borderline personality disorder (BPD) and somatoform disorder (SoD). In 472 psychiatric inpatients, difficulties in emotional functioning were measured using the Bermond-Vorst Alexithymia Questionnaire. Profiles of difficulties in emotional functioning were identified, suggesting that patients diagnosed with BPD with or without SoD were more likely to report difficulty identifying emotions and less likely to report reduced ability to fantasize or 'pensée opératoire' (externally oriented thinking) than patients diagnosed with SoD only and patients with mixed anxiety and affective disorders. SoD patients were more likely to report reduced ability to phantasize or pensée opératoire than difficulty identifying emotions. Patients with mixed anxiety and affective disorders were more likely to report reduced ability to experience...

Psychological Trauma: Theory, Research, Practice, and Policy, 2012

Clinical Psychology Review, 2006

To assess the empirical basis of prevalence and risk factors of childbirth-related posttraumatic ... more To assess the empirical basis of prevalence and risk factors of childbirth-related posttraumatic stress symptoms and PTSD in mothers, the relevant literature was critically reviewed. A MEDLINE and PSYCHLIT search using the key words bposttraumatic stressQ, bPTSDQ, bchildbirthQ and btraumatic deliveryQ was performed. The generated list of articles was supplemented by a review of their bibliographies. A total of 31 articles was selected. The primary inclusion criterion was report of posttraumatic stress symptoms or PTSD specifically related to childbirth. Case studies and quantitative studies on regular childbirth and childbirth by emergency cesarean section were identified. Consistency among studies was found with regard to development of posttraumatic stress symptoms as a consequence of traumatic delivery. Methodological issues concerning prevalence and risk factors were discussed. Case studies and quantitative studies confirm that childbirth may be experienced as so emotionally intense that it can lead to the development of posttraumatic stress symptoms or even a PTSD-profile. Among the identified risk factors were a history of psychological problems, trait anxiety, obstetric procedures, negative aspects in staff-mother contact, feelings of loss of control over the situation, and lack of partner support. The conclusion of the current review is twofold. First, traumatic reactions to childbirth are an important public health issue. Secondly, studying childbirth offers opportunity to prospectively study the development of posttraumatic stress reactions. D

Clinical Psychology Review, 2008

A meta-analysis was performed on the empirical literature which addressed the relationship of per... more A meta-analysis was performed on the empirical literature which addressed the relationship of peritraumatic dissociation to posttraumatic stress (PTS). Extensive literature searches were conducted to identify as many relevant studies as possible, and revealed 59 independent eligible studies. All studies were coded using a detailed code sheet that included effect measures, variables that indicated the methodological quality of the studies, and substantial variables that might theoretically affect the relationship between peritraumatic dissociation and PTS. A significant positive relation between peritraumatic dissociation and PTS was found. Differences in the methodological rigor between studiestime elapsed since peritraumatic dissociation, design, sample type, and study typesignificantly and sufficiently explained the variability in effect sizes between studies. Theoretical variables did not explain such variability. Although results underline earlier findings, due to designs of the reviewed studies no conclusions could be drawn as to causal relations between peritraumatic dissociation and PTS.

Clinical Psychology & Psychotherapy, 2005

Journal of Trauma & Dissociation, 2001

Journal of Trauma & Dissociation, 2005

The current study investigated the contributive role of perinatal dissociative and perinatal emot... more The current study investigated the contributive role of perinatal dissociative and perinatal emotional responses to the development of PTSD symptoms following childbirth. Method: Using a prospective, longitudinal design, 140 women were studied who were followed from the first week after delivery to three months postpartum. Results: Three women (2.1%) met criteria for PTSD and 21.4% reported a traumatic childbirth experience. Both perinatal negative emotional reactions and perinatal dissociative reactions were the predictors of PTSD symptoms at three months postpartum. The effect of perinatal dissociation, however, was partially mediated by perinatal emotional reactions. Conclusion: Posttraumatic stress disorder can be a consequence of the experience of childbirth. Women who reported high levels of negative emotions during and shortly after childbirth were more likely to develop Eelco Olde, Onno van der Hart and Maarten J.M. van Son are affiliated with the Department of Clinical Psychology,

European Psychiatry, 1996

Women with antibodies against the enzyme thyroid peroxidase [TPO-Ab; formerly microsomal antibodi... more Women with antibodies against the enzyme thyroid peroxidase [TPO-Ab; formerly microsomal antibodies (MsAb)] are at particular risk for developing postpartum thyroid dysfunction; the latter is significantly associated with postpartum depression. Although the negative effect of postpartum maternal depression on child development is well documented, the consequences of elevated titers of TPO-Ab during pregnancy and subsequent postpartum thyroid dysfunction on child development are not known. In a prospective study of a cohort of 293 pregnant women, the occurrence of TPO-Ab during gestation, thyroid dysfunction, and depression was investigated. Five years after delivery, child development was assessed in 230 children of the original cohort using the Dutch translation of the McCarthy Scales of Children&amp;amp;amp;amp;#39;s Abilities. Children of women with TPO-Ab during late gestation (n = 19, with normal thyroid function) had significantly lower scores (by t test) on the McCarthy Scales of Children&amp;amp;amp;amp;#39;s Abilities than antibody-negative women. The difference on the General Cognitive Scale, which reflects IQ scores, was substantial (10.5 points; t = 2.8; P = 0.005). After correction for possibly confounding variables, maternal TPO-Ab during gestation was found to be the most important factor related to the scores on the General Cognitive Scale (odds ratio = 10.5; 95% confidence interval = 3-34; P = 0.003). We conclude that children of pregnant women who had elevated titers of TPO-Ab but normal thyroid function are at risk for impaired development.

Journal of Affective Disorders, 2003

Aim: The present study investigates both the antenatal prediction of the occurrence of depression... more Aim: The present study investigates both the antenatal prediction of the occurrence of depression during the first year postpartum and the course of depression in populations at different degrees of risk. Methods: In a population-based prospective study, 1618 women were screened during mid-pregnancy for risk factors with regard to depression. High-risk and low-risk women were identified, and depression (Research Diagnostic Criteria, RDC) was assessed at 32 weeks gestation and at 3, 6, and 12 months postpartum. Results: In the high-risk group (n = 97), 25% of the women were depressed during the first year postpartum compared to 6% of the low-risk women (n = 87). At 3 months postpartum, significantly more high-risk (17%) than low-risk women (1%) were depressed. While prevalence rates decreased after 3 months postpartum in the high-risk group, no significant fluctuations of prevalence rates were found in the low-risk group. Two risk factors were independently predictive of depression during the postpartum period: a personal history of depression, and high depressive symptomatology during mid-pregnancy. Conclusions: Women at high risk and low risk for depression during the early postpartum period can be detected during pregnancy. High-risk women were only at particular risk during the first 3 months postpartum. D

European Child & Adolescent Psychiatry, 2014

This study examines mother-and father-rated emotional and behaviour problems in and worries about... more This study examines mother-and father-rated emotional and behaviour problems in and worries about 0-to 5-year-old children at 3 and 12 months after a burn event and the relation with parental distress. Mothers (n = 150) and fathers (n = 125) representing 155 children participated in this study. Child emotional and behaviour problems and parental worries about the child were assessed with the Child Behavior Checklist at both time points. Parents' level of acute subjective distress was assessed within the first month after the burn event with the Impact of Event Scale. Mothers and fathers held comparable views of their child's emotional and behaviour problems, which were generally within the normal limits. Parents' own acute stress reactions were significantly related to parent-rated child behaviour problems at 3 and 12 months postburn. A substantial part of mothers' and fathers' worries about the child concerned physical and emotional aspects of the burn trauma, and potential future social problems. Parents with high acute stress scores more often reported burn-related concerns about their child at 3 and 12 months postburn. Health-care professionals should be informed that parents' distress in the subacute phase of their child's burn event may be related to subsequent worries about their child and to (parent-observed) child emotional and behaviour problems. The authors recommend a family perspective, with particular attention for the interplay between parents' distress and parent-reported child behaviour problems and worries, in each phase of paediatric burn care.

Journal of Child Psychology and Psychiatry, 1993

This article examines the concurrent validity of the Five-Minute Speech Sample (FMSS) as an index... more This article examines the concurrent validity of the Five-Minute Speech Sample (FMSS) as an index of Expressed Emotion in a Dutch sample of 84 parents of adolescents suffering from anorexia or bulimia nervosa. The Camberwell Family Interview (CFI), the criterion measure of EE, and the FMSS were conducted on the same day. The levels of Expressed Emotion in these families were low when compared with the EE ratings from the schizophrenia studies. The FMSS and CFI-EE ratings showed a limited degree of overlap. Whether the limited association between the two methods is due to the low levels of criticism in our sample, to cultural differences and/or to differences in the psychopathology under study remains unclear.

Clinical Psychology Review, 2013

In order to inform clinical practice, we reviewed the empirical literature on emotional, behavior... more In order to inform clinical practice, we reviewed the empirical literature on emotional, behavioral and social outcomes in children with burns and their families published between 1989 and 2011. A systematic search of the literature yielded 75 articles. Qualitative synthesis of the results showed that child anxiety, traumatic stress reactions, and behavioral problems were considerably prevalent in the first months after the burn event. Among parents, high rates of posttraumatic stress, depressive symptoms, and guilt feelings were found. Cross-sectional studies, often performed many years after the injury, suggest that some children experience long-term psychological problems, such as anxiety, depression, and difficulties with social functioning. However, there was little evidence that behavior in general, self-esteem, or body image were impaired in the total population of children with a history of burns. Long-term family outcome studies suggest that psychological problems persist in a substantial subgroup of parents. Child peritraumatic factors anxiety and pain, parental posttrauma psychological reactions, and family functioning were the most consistently reported factors associated with child outcome. More recent studies have demonstrated that burn severity may have an indirect effect on child postburn psychosocial outcome. Clinical implications, methodological strengths and limitations of the reviewed studies, and directions for future research are discussed.

Journal of Affective Disorders, 2004

Background: Patient preferences have been associated with a positive effect of depression treatme... more Background: Patient preferences have been associated with a positive effect of depression treatment. Little is known about patient preferences in at-risk samples. The aim of this study was to examine the role of patient preference for counselling in the occurrence of postpartum depression in high-risk women. Method: We conducted a prospective 1-year follow up study in two hospitals and four midwifery practices in The Netherlands. Participants were 90 pregnant women at high risk for postpartum depression: 45 high-risk women who preferred no counselling, 45 high-risk women who preferred counselling. Both groups received care as usual. The main outcome measure was clinical depression (Research Diagnostic Criteria) at 3, 6, and 12 months postpartum. Results: Point-prevalence rates of clinical depression were significantly higher in high-risk women who preferred counselling compared with high-risk women who did not prefer counselling (24% versus 9%, P=0.048; 19% versus 5%, P=0.048, at 3 and 6 months postpartum, respectively). No significant difference was found at 12 months postpartum. Across the first-year postpartum, high-risk women who preferred counselling were at seven-fold increased risk for clinical depression (OR=7.7, 95% CI 1.7-33.8, P=0.007). Conclusions: Patient preference for counselling is an important predictor of postpartum depression in pregnant women at high risk for postpartum depression. Patient preferences may reflect validly a perceived need for intervention in high-risk women. This finding emphasises the need to take patient preference for counselling into account as an important variable to identify a high-risk population. D

Psychosomatic Medicine, 2005

Objective: Personality has been associated with clinical depression in general. However, few stud... more Objective: Personality has been associated with clinical depression in general. However, few studies have investigated personality in relation to postpartum depression, and these studies reported inconclusive findings. Therefore, the present study focused on neuroticism and introversion in the prediction of postpartum depression. Method: In a population-based prospective study, women were screened during mid-pregnancy on standard risk factors for depression. In a group of randomly selected women (n ϭ 277), neuroticism and introversion were measured at 32 weeks gestation. Clinical depression (Research Diagnostic Criteria) and depressive symptoms (Edinburgh Postnatal Depression Scale) were measured at 32 weeks gestation and at 3, 6, and 12 months postpartum. Results: High neuroticism was associated with an increased risk of clinical depression and depressive symptoms during the postpartum period. The combination of high neuroticism and high introversion was the only independent predictor of clinical depression across the first year postpartum (odds ratios: 3.08, 4.64, and 6.83 at 3, 6, and 12 months postpartum, respectively, p Ͻ .05-.01), even when controlling for clinical depression during pregnancy. History of depression was the only other independent predictor during the early but not during the late postpartum. Inclusion of personality not only significantly improved the detection of women at increased depression risk but also the identification of women with an extremely low depression risk. Conclusions: Personality may be an important and stable determinant of postpartum depression. The combination of high neuroticism and high introversion considerably improved the risk estimates for clinical depression across the first year postpartum.

American journal of epidemiology, Jan 8, 2015