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Biomedical subjects

Arnoud Arntz

Publications and source records attributed to Arnoud Arntz.

At least 19 recordsLinked to original sources
PubMed2006

On the links between self-discrepancies, rumination, metacognitions, and symptoms of depression in undergraduates.

The present study aimed to test the central components of Papageorgiou and Wells' (2003) non-clinical metacognitive model of rumination and depression that is grounded on the Self-Regulatory Executive Function (S-REF) model of emotional disorders [Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove, UK: Lawrence Erlbaum.]. A second aim of this study was to extend the non-clinical model with the concept of self-discrepancy in line with the S-REF model. Data of the current study were collected in a large sample of non-clinical Dutch undergraduates (N=196), who completed a battery of questionnaires including measures of rumination, positive and negative metacognitions, depressive symptoms, and self-discrepancy (i.e., actual-ideal, actual-ought, and actual-feared discrepancies). Hypothesized relationships among these variables were tested by means of structural equation modelling. Following some theoretically consistent modifications, the model was an adequate fit to the data. With respect to the second aim of the study, self-discrepancies were directly linked to symptoms of depression as well as indirectly via the cognitive processes involved in the metacognitive model of rumination and depression. Evidence was found for positive beliefs about rumination to partially mediate the relation between self-discrepancy and rumination. Clinical implications of the findings, including implementation of a metacognitive-focused cognitive therapy of depression, and suggestions for future research are discussed.

Adolescent↗
PubMed2006

Hypervigilance in patients with borderline personality disorder: specificity, automaticity, and predictors.

According to cognitive theory, an important factor in borderline personality disorder (BPD) is hypervigilance. The aim of the present study was to test whether BPD patients show schema-related biases, and to explore relations with childhood trauma, schemas, and BPD symptoms. Sixteen BPD patients were compared with 18 patients with a cluster C personality disorder, 16 patients with an axis I disorder, and 16 normal controls. An emotional Stroop task was applied with schema-related and unrelated, negative and positive, supra- and subliminal person-related stimuli. BPD patients showed hypervigilance for both negative and positive cues, but were specifically biased towards schema-related negative cues. Predictors were BPD schemas, childhood sexual traumas, and BPD anxiety symptoms. Both BPD and axis I disorder patients showed a trend for a bias for negative schema-related subliminal stimuli. More attention to hypervigilance in BPD is recommended for clinical practice.

Adult↗
PubMed2006

Responsibility and obsessive-compulsive disorder: an experimental test.

To test the causal status of responsibility in obsessive-compulsive disorder (OCD), an experiment was executed in which responsibility was experimentally manipulated. OCD patients, non-OCD anxiety controls, and non-patients executed a classification task in either a high or a low responsibility (LoRes) condition. Subjective ratings related to danger and responsibility indicated that the manipulation was successful. Subjective OCD-like experiences and checking behaviors were higher in OCD patients in the high responsibility (HiRes) condition than in all other groups. Although the checking subscale of the Padua Inventory correlated with subjective ratings in the OCD patients in the HiRes condition, it was not associated with checking behaviors. The results confirm the hypothesis that responsibility plays a causal role in OCD.

Adult↗
PubMed2006

On the measurement of rumination: a psychometric evaluation of the ruminative response scale and the rumination on sadness scale in undergraduates.

Rumination is considered a specific cognitive vulnerability factor that is thought to play a prominent role in the maintenance of depressive symptoms. The present study investigated the psychometric properties of two measures of rumination, the ruminative response scale (RRS) and the rumination on sadness scale (RSS) in undergraduates (N=331). A joint factor analysis yielded three factors, 'rumination on causes of sadness', 'symptom-based rumination', and 'rumination on sadness'. The internal consistency of the rumination factors was good and the test-retest stability over a 6-month period of time was moderate. Support was also found for the construct validity of the rumination factors. Finally, the 'rumination on the causes of sadness' factor was found to moderate the relation between depression measured at baseline and at 6-month follow-up. More specifically, baseline depression was a strong predictor of future depression but this was particularly true for high ruminating individuals. Implications of the results and directions for future research are provided.

Adolescent↗
PubMed2006

Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy.

CONTEXT: Borderline personality disorder is a severe and chronic psychiatric condition, prevalent throughout health care settings. Only limited effects of current treatments have been documented. OBJECTIVE: To compare the effectiveness of schema-focused therapy (SFT) and psychodynamically based transference-focused psychotherapy (TFP) in patients with borderline personality disorder. DESIGN: A multicenter, randomized, 2-group design. SETTING: Four general community mental health centers. PARTICIPANTS: Eighty-eight patients with a Borderline Personality Disorder Severity Index, fourth version, score greater than a predetermined cutoff score. INTERVENTION: Three years of either SFT or TFP with sessions twice a week. MAIN OUTCOME MEASURES: Borderline Personality Disorder Severity Index, fourth version, score; quality of life; general psychopathologic dysfunction; and measures of SFT/TFP personality concepts. Patient assessments were made before randomization and then every 3 months for 3 years. RESULTS: Data on 44 SFT patients and 42 TFP patients were available. The sociodemographic and clinical characteristics of the groups were similar at baseline. Survival analyses revealed a higher dropout risk for TFP patients than for SFT patients (P = .01). Using an intention-to-treat approach, statistically and clinically significant improvements were found for both treatments on all measures after 1-, 2-, and 3-year treatment periods. After 3 years of treatment, survival analyses demonstrated that significantly more SFT patients recovered (relative risk = 2.18; P = .04) or showed reliable clinical improvement (relative risk = 2.33; P = .009) on the Borderline Personality Disorder Severity Index, fourth version. Robust analysis of covariance (ANCOVA) showed that they also improved more in general psychopathologic dysfunction and measures of SFT/TFP personality concepts (P<.001). Finally, SFT patients showed greater increases in quality of life than TFP patients (robust ANCOVAs, P=.03 and P<.001). CONCLUSIONS: Three years of SFT or TFP proved to be effective in reducing borderline personality disorder-specific and general psychopathologic dysfunction and measures of SFT/TFP concepts and in improving quality of life; SFT is more effective than TFP for all measures.

Ambulatory Care↗
PubMed2006

Dependent personality traits and information processing: assessing the interpretation of ambiguous information using the Thematic Apperception Test.

OBJECTIVES: This study was designed to investigate interpretation bias in people with dependent personality traits. METHOD: Eight Thematic Apperception Test (TAT) cards were administered to participants (N=56) who scored high or low on DSM-III-R dependent personality pathology. Two independent judges rated the TAT stories using a rating list based on the cognitive model of the dependent and paranoid personality disorder. RESULTS: Controlling for self-esteem, the dependent interpretation bias appeared to be specific for dependent personality pathology. SEM analysis supported a mediation model in which beliefs mediate the relationship between DSM-III-R traits and interpretation bias. CONCLUSIONS: The findings in this study support the hypothesis that people with dependent traits are characterized by a schema-related interpretation bias and that this bias is mediated by dependent beliefs.

Adult↗
PubMed2005

Emotional memory is perceptual.

In two experiments it was investigated which aspects of memory are influenced by emotion. Using a framework proposed by Roediger (American Psychologist 45 (1990) 1043-1056), two dimensions relevant for memory were distinguished the implicit-explicit distinction, and the perceptual versus conceptual distinction. In week 1, subjects viewed a series of slides accompanied with a spoken story in either of the two versions, a neutral version, or a version with an emotional mid-phase. In week 2, memory performance for the slides and story was assessed unexpectedly. A free recall test revealed superior memory in the emotional condition for the story's mid-phase stimuli as compared to the neutral condition, replicating earlier findings. Furthermore, memory performance was assessed using tests that systematically assessed all combinations of implicit versus explicit and perceptual versus conceptual memory. Subjects who had listened to the emotional story had superior perceptual memory, on both implicit and explicit level, compared to those who had listened to the neutral story. Conceptual memory was not superior in the emotional condition. The results suggest that emotion specifically promotes perceptual memory, probably by better encoding of perceptual aspects of emotional experiences. This might be related to the prominent position of perceptual memories in traumatic memory, manifest in intrusions, nightmares and reliving experiences.

Adult↗
PubMed2005

The fallacy of ex-consequentia reasoning and the persistence of PTSD.

Many individuals experience psychological distress after a potentially traumatic event, but only a minority develops chronic posttraumatic stress disorder (PTSD). According to the cognitive model of Ehlers and Clark (Behaviour Research and Therapy 38 (2000) 319), chronic PTSD results from distorted beliefs about the trauma or its sequelae. Given the availability of disconfirming information, why do such distorted beliefs persist? A recent promising line of research focuses on the "ex-consequentia" reasoning fallacy: "if I feel anxiety, there must be danger". Ex-consequentia reasoning may start a vicious circle in which subjective fear responses are used to erroneously validate thoughts of impending doom, which intensifies distress, etc. In other words, false alarms are not recognized and irrational beliefs are maintained. We previously found that other anxiety patients (Behaviour Research and Therapy 33 (1995) 917) and PTSD patients (Behaviour Research and Therapy 39 (2001) 1139) show ex-consequentia reasoning, that is, they appear to believe that anxiety symptoms imply the presence of danger. Interestingly, this was not restricted to situations relevant to the individual's anxiety disorder. Tentative data suggest that ex-consequentia reasoning is causally involved in the persistence of PTSD and anxiety disorders. These are presented and possible underlying mechanisms are discussed.

Anxiety Disorders↗
PubMed2005

World assumptions and the role of trauma in borderline personality disorder.

The present study tested whether borderline personality disorder (BPD) is characterized by specific worldviews as hypothesized by cognitive models, using Janoff-Bulman's [(1989) Social Cognition, 7, 113-136] world assumptive model of negative effects of trauma. A second aim of this study was to investigate the role of trauma in the content of worldviews of BPD patients. Fifteen BPD patients, 14 patients with Cluster C personality disorders (PD), 19 patients with axis-I psychopathology and 21 non-patients filled out the World Assumptions Scale, the Personality Disorder Belief Questionnaire, a childhood trauma checklist (assessing physical, emotional and sexual abuse) and the BPD Checklist (severity of BPD psychopathology). BPD patients appear to view the world as malevolent and perceive less luck independent of trauma but dependent of BPD psychopathology. Furthermore, BPD patients have low self-worth and persist in specific beliefs independent of trauma or severity of BPD psychopathology. Pretzer's theory of BPD can be largely supported through Janoff-Bulman's world assumptive model. World assumptions of BPD patients can better be explained by the severity of BPD psychopathology than by the presence of trauma.

Adult↗
PubMed2005

Evaluations of emotional noninterpersonal situations by patients with borderline personality disorder.

According to cognitive models of borderline personality disorder (BPD), an important cause for the instability of patients with BPD is dichotomous thinking (DT). Object-relation theories assume that the similar phenomenon of splitting is central in BPD. Previous studies focusing on interpersonal situations found support for DT being prominent in BPD. The aim of this study was to investigate whether patients with BPD also make use of dichotomous and schema-specific evaluations in noninterpersonal situations. An experiment was designed in which a frustrating and rewarding situation was induced by computer games that subjects had to play. Participants evaluated both themselves and the games. Patients with BPD (n=24) were characterized by somewhat more extreme game evaluations in the emotionally negative situations than normal controls (n=25), participants with a cluster C (n=10) or an anti-social personality disorder (ASPD) (n=16). Patients with BPD appeared to be characterized best by a general negative evaluative style, more than by DT or splitting. ASPD participants showed a positivity bias in both conditions.

Adult↗
PubMed2005

An experimental test of the schema mode model of borderline personality disorder.

Young has proposed a schema mode model of borderline personality disorder (BPD), hypothesizing that BPD patients tend to flip from 1 of 4 maladaptive schema modes to another. The present study is the first empirical test of this model, investigating whether these 4 modes are specific for BPD patients and whether BPD-relevant stress specifically increases one of the modes, the detached protector mode. Eighteen BPD patients, 18 cluster-C personality disorder (PD) patients and 18 non-patient controls (all women) filled out trait and state versions of a newly developed schema mode questionnaire, assessing cognitions, feelings and behaviors characteristic of 7 schema modes. Using a cross over design, subjects subsequently watched a neutral and a BPD-specific emotional movie fragment (order balanced). After watching each movie, subjects again filled out the schema mode questionnaire, state version. Trait as well as state versions indicated that BPD patients were indeed characterized by the hypothesized four maladaptive modes (Detached Protector, Punitive Parent, Abused/Abandoned Child, Angry/Impulsive Child). BPD patients were lowest on the Healthy Adult mode. The stress induction induced negative emotions in all groups, but the BPD group was unique in that the Detached Protector mode increased significantly more than in both control groups.

Adolescent↗
PubMed2005

Schema modes and childhood abuse in borderline and antisocial personality disorders.

Complex personality disorders (PDs) have been hypothesized to be characterized by alternating states of thinking, feeling and behavior, the so-called schema modes (Young, Klosko, & Weishaar (2003). Schema therapy: A practioner's guide. New York: Guilford). The present study tested the applicability of this model to borderline personality disorders (BPD) and antisocial personality disorders (APD), and related it to a presumed common etiological factor, childhood trauma. Sixteen patients with BPD, 16 patients with APD and 16 nonpatient controls (all 50% of both sexes) completed a Schema Mode Questionnaire assessing cognitions, feelings and behaviors characteristic of six schema modes. Participants were interviewed to retrace abusive sexual, physical and emotional events before the age of 18. BPD as well as APD participants were characterized by four maladaptive modes (Detached Protector, Punitive Parent, Abandoned/Abused Child and Angry Child). APD displayed most characteristics of the Bully/Attack mode, though not significantly different from BPD. The Healthy Adult mode was of low presence in BPD and of high presence in APD and the nonpatients. Frequency and severity of the three kinds of abuse were equally high in both PD groups, and significantly higher than in nonpatients.

Adolescent↗
PubMed2005

Pain patients in a randomized trial did not show a significant effect of a positive consultation.

OBJECTIVE: To examine whether telling symptomatic patients that they will soon be better shortens the duration of their illness. STUDY DESIGN AND SETTING: We repeated an earlier trial in general practice on this subject. All our patients were reassured that they probably had no serious underlying disease. We randomized 128 patients into two groups. Half of them got a clear diagnosis and were told that they would soon be better. The others heard from their general practitioners (GPs) that they probably had no serious underlying disease but that the GP did not know exactly what was wrong; these patients were advised to come back later if necessary. For 78 patients, study protocol was followed exactly. RESULT: Our trial could not show an effect. The Kaplan-Meier curves of patients with a positive and negative consultation ran nearly parallel. The hazard ratio in the total group was 0.97 (95% precision interval PI=0.69-1.41) and in the optimal subgroup 0.91 (95% PI=0.57-1.46). We still cannot rule out a modest placebo effect. CONCLUSION: Our finding contrasts with that of the earlier trial. We think that symptomatic patients mainly want to know that they do not have a serious problem. Often, they will miss the extra information that they get--and then they certainly cannot benefit from it.

Adult↗
PubMed2005

A longitudinal study on the predictive validity of the fear-avoidance model in low back pain.

Recently, fear-avoidance models have been quite influential in understanding the transition from acute to chronic low back pain (LBP). Not only has pain-related fear been found to be associated with disability and increased pain severity, but also treatment focused at reducing pain-related fear has shown to successfully reduce disability levels. In spite of these developments, there is still a lack in well-designed prospective studies examining the role of pain-related fear in acute back pain. The aim of the current study was to prospectively test the assumption that pain-related fear in acute stages successfully predicts future disability. Subjects were primary care acute LBP patients consulting because of a new episode of LBP (<or=3 weeks). They completed questionnaires on background variables, fear-avoidance model variables and LBP outcome (Graded Chronic Pain Scale, GCPS) at baseline, 3, 6, and 12 months follow-up and at the end of the study. Two-hundred and twenty-two acute LBP patients were included, of whom 174 provided full follow-up information (78.4%). A backward ordinal regression analysis showed previous LBP history and pain intensity to be the most important predictors of end of study GCPS. Of the fear-avoidance model variables, only negative affect added to this model. Our results do not really support the longitudinal validity of the fear-avoidance model, but they do feed the discussion on the role of pain-related fear in early stages of LBP.

Adolescent↗
PubMed2005

Influences of beliefs and personality disorders on treatment outcome in anxiety patients.

The present study investigated the effects of personality disorders (PDs) and specific PD-related beliefs on the results of (cognitive-)behavioral therapy for anxiety disorders in a sample of 398 outpatients. The authors used a prospective design in which relationships between PD variables before treatment and outcome measures at posttest and follow-up were evaluated with multilevel analyses. People with PDs and PD-related beliefs reported higher symptom levels at outcome. However, these effects were not as strong as might be expected on the basis of prevailing clinical thought in this area. Dropout rates were not influenced by the presence of 1 or more PDs or PD-related beliefs. Results indicate that treatment of anxiety disorders in patients with concomitant one or more PDs is appropriate.

Adult↗
PubMed2005

Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study.

BACKGROUND: Post-traumatic stress disorder (PTSD) is the only psychiatric condition that requires a specific event to have occurred for its diagnosis. AIMS: To gather evidence from the adult general population on whether life events (e.g. divorce, unemployment) generate as many symptoms of post-traumatic stress as traumatic events (e.g. accidents, abuse). METHOD: Data on demographic characteristics and history of stressful events were collected through a written questionnaire sent to a random sample of 2997 adults. Respondents also filled out a PTSD symptom checklist, keeping in mind their worst event. Mean PTSD scores were compared, controlling for differences between the two groups. Differences in item scores and in the distribution of the total PTSD scores were analysed. RESULTS: Of the 1498 respondents, 832 were eligible for inclusion in our analysis. For events from the past 30 years the PTSD scores were higher after life events than after traumatic events; for earlier events the scores were the same for both types of events. These findings could not be explained by differences in demographics, history of stressful events, individual item scores, or the distribution of the total PTSD scores. CONCLUSIONS: Life events can generate at least as many PTSD symptoms as traumatic events. Our findings call for further studies on the specificity of traumatic events as a cause of PTSD.

Adult↗
PubMed2004

Beliefs in personality disorders: a test with the personality disorder belief questionnaire.

The hypothesis that each personality disorder (PD) is characterized by a specific set of beliefs was tested in a sample of 643 subjects, including non-patient controls, axis-I and axis-II patients, diagnosed with SCID-I and -II interviews. Beliefs of six PDs (avoidant, dependent, obsessive-compulsive, paranoid, histrionic, borderline) were assessed with the Personality Disorder Belief Questionnaire (PDBQ). Factor analyses supported the existence of six hypothesized sets of beliefs. Structural equation modeling (SEM) supported the hypothesis that each PD is characterized by a specific set of beliefs. Path coefficients were however in the medium range, suggesting that PDs are not solely determined by beliefs. Nevertheless, empirically derived cutoff scores of the six belief subscales were reasonably successful in classifying subjects, percentages ranging form 51% to 83%. It appeared that there was a monotonical increase in scores on each belief subscale from non-patient controls, to patients without any PD, to patients with PDs (other than the pertinent PD), to patients with the pertinent PD. This suggests that PD-related beliefs are at least partly associated with (personality) psychopathology in general. Another explanation is that many patients' position on the underlying dimensions is not high enough to lead to a DSM PD diagnosis, but high enough to lead to an elevated belief score.

Adult↗