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Biomedical subjects

W Vollebergh

Publications and source records attributed to W Vollebergh.

16 recordsLinked to original sources
PubMed2005

Internalizing and externalizing problems in adolescence: general and dimension-specific effects of familial loadings and preadolescent temperament traits.

BACKGROUND: We investigated the links between familial loading, preadolescent temperament, and internalizing and externalizing problems in adolescence, hereby distinguishing effects on maladjustment in general versus dimension-specific effects on either internalizing or externalizing problems. METHOD: In a population-based sample of 2230 preadolescents (10-11 years) familial loading (parental lifetime psychopathology) and offspring temperament were assessed at baseline by parent report, and offspring psychopathology at 2.5-years follow-up by self-report, teacher report and parent report. We used purified measures of temperament and psychopathology and partialled out shared variance between internalizing and externalizing problems. RESULTS: Familial loading of internalizing psychopathology predicted offspring internalizing but not externalizing problems, whereas familial loading of externalizing psychopathology predicted offspring externalizing but not internalizing problems. Both familial loadings were associated with Frustration, low Effortful Control, and Fear. Frustration acted as a general risk factor predicting severity of maladjustment; low Effortful Control and Fear acted as dimension-specific risk factors that predicted a particular type of psychopathology; whereas Shyness, High-Intensity Pleasure, and Affiliation acted as direction markers that steered the conditional probability of internalizing versus externalizing problems, in the event of maladjustment. Temperament traits mediated one-third of the association between familial loading and psychopathology. Findings were robust across different composite measures of psychopathology, and applied to girls as well as boys. CONCLUSIONS: With regard to familial loading and temperament, it is important to distinguish general risk factors (Frustration) from dimension-specific risk factors (familial loadings, Effortful Control, Fear), and direction markers that act as pathoplastic factors (Shyness, High-Intensity Pleasure, Affiliation) from both types of risk factors. About one-third of familial loading effects on psychopathology in early adolescence are mediated by temperament.

Adolescent↗
PubMed2005

Are apparent associations between parental representations and psychosis risk mediated by early trauma?

OBJECTIVE: It was investigated whether the reported association between representations of parental rearing style and psychosis does not represent a main effect, but instead is a proxy indicator of the true underlying risk factor of early trauma. METHOD: In a general population sample of 4045 individuals aged 18-64 years, first ever onset of positive psychotic symptoms at 3-year follow-up was assessed using the Composite International Diagnostic Interview and clinical interviews if indicated. Representations of parental rearing style were measured with the Parental Bonding Instrument (PBI). RESULTS: Lower baseline level of PBI parental care predicted onset of psychotic symptoms 2 years later. However, when trauma was included in the equation, a strong main effect of trauma emerged at the expense of the effect size of PBI low care. CONCLUSION: The results suggest that associations between representations of parental rearing style and psychosis may be an indicator of the effect of earlier exposure to childhood trauma.

Adolescent↗
PubMed2005

Early trauma may increase the risk for psychotic experiences by impacting on emotional response and perception of control.

OBJECTIVE: Exposure to early trauma may increase the risk of dysfunctional responses to anomalous psychotic experiences resulting in psychotic symptom formation. METHOD: In a three-wave longitudinal general population study, 4045 never-psychotic individuals exposed and non-exposed to trauma before the age of 16 years, according to baseline interview were interviewed for the onset of psychotic experiences 3 years later (T2). In 36 individuals with incident psychosis at T2, assessments were made, for each psychotic experience, of i) the amount of distress associated with and ii) the degree of coping and subjective control over the experience. RESULTS: In the 16 observations of an incident psychotic experience, in the absence of distress, the baseline rate of early trauma was low (6%), whereas it was much higher in the 21 observations of an incident psychotic experience with distress [43%; odds ratio=10.0, 95% confidence interval (CI): 1.04, 96.3; P=0.046]. Similarly, coping attempts in the context of early trauma was associated with less control (reduction of 2 points on a seven-point scale, 95% CI: -4.0, -0.07). CONCLUSION: Early experience of trauma may create lasting cognitive and affective vulnerabilities to develop clinical symptoms arising out of early, non-clinical psychotic experiences.

Adaptation, Psychological↗
PubMed2004

Is our concept of schizophrenia influenced by Berkson's bias?

BACKGROUND: If both positive and negative dimensions of schizophrenia independently influence need for care, a higher estimate of the comorbidity between these dimensions is expected in clinical samples than would be the case if non-clinical cases were investigated (i.e. Berkson's bias). The present paper investigates whether positive and negative dimensions independently contribute to mental health care use in a general population sample. METHOD: A prospective cohort study was conducted, in which 7076 individuals were interviewed with the Composite International Diagnostic Interview Schedule at baseline and 1 and 3 years later. Lifetime positive and negative psychotic experiences (PPE, NPE) were assessed at baseline. Mental health care use (MHC) was assessed at baseline, and prospectively 1 and 3 years later. RESULTS: The rating of MHC was strongly associated with NPE and PPE, both retrospectively and prospectively and the effects of both variables remained strong and significant in the analyses with both variables included. CONCLUSIONS: These results, therefore, suggest that the concept of schizophrenia, as a unitary entity with high comorbidity between positive and negative dimensions, is in part the result of Berkson's bias.

Adolescent↗
PubMed2004

Dimensions of depression, mania and psychosis in the general population.

BACKGROUND: In order to investigate whether correlated but separable symptom dimensions that have been identified in clinical samples also have a distribution in the general population, the underlying structure of symptoms of depression, mania and psychosis was studied in a general population sample of 7072 individuals. METHOD: Data were obtained from the three measurements of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Symptoms of depression, mania and the positive symptoms of psychosis were assessed using the Composite International Diagnostic Interview. Confirmatory factor-analysis was used to test statistically the fit of hypothesized models of one, two, three or seven dimensions. RESULTS: The seven-dimensional model comprising core depression, sleep problems, suicidal thoughts, mania, paranoid delusions, first-rank delusions and hallucinations fitted the data best, whereas the unidimensional model obtained the poorest fit. This pattern of results could be replicated at both follow-up measurements. The results were similar for the subsamples with and without a lifetime DSM-III-R diagnosis. The seven dimensions were moderately to strongly correlated, with correlations ranging from 0.18 to 0.73 (mean 0.45). CONCLUSIONS: In the general population, seven correlated but separable dimensions of experiences exist that resemble dimensions of psychopathology seen in clinical samples with severe mental illness. The substantial correlations between these dimensions in clinical and non-clinical samples may suggest that there is aetiological overlap between the different dimensions regardless of level of severity and diagnosable disorder.

Adolescent↗
PubMed2004

Childhood abuse as a risk factor for psychotic experiences.

OBJECTIVE: To examine the hypothesis that individuals from the general population who report childhood abuse are at increased risk of developing positive psychotic symptoms. METHOD: Data were derived from a general population sample of 4045 subjects aged 18-64 years. First ever onset of positive psychotic symptoms at 2-year follow-up were assessed using the Composite International Diagnostic Interview and additional clinical interviews if necessary. Childhood abuse was assessed at baseline. RESULTS: Baseline reported childhood abuse predicted development of positive psychotic symptoms associated with need for care [odds ratio (OR) = 11.5, 95% CI 2.6-51.6]. This association remained after adjustment for demographic variables, reported risk factors and presence of any lifetime psychiatric diagnosis at baseline (OR = 7.3, 95% CI 1.1-49.0). CONCLUSION: The results suggest that early childhood trauma increases the risk for positive psychotic symptoms. This finding fits well with recent models that suggest that early adversities may lead to psychological and biological changes that increase psychosis vulnerability.

Adolescent↗
PubMed2004

Hallucinatory experiences and onset of psychotic disorder: evidence that the risk is mediated by delusion formation.

OBJECTIVE: To examine the hypothesis that the risk for onset of psychotic disorder in individuals with self-reported hallucinatory experiences (HE) would be higher in those who developed delusional ideation (DE) than in those who did not. METHOD: A population sample of 4673 individuals were interviewed with the Composite International Diagnostic Interview at baseline and 1 and 3 years later. At year 3, clinical re-interview took place to identify onset of psychotic disorder. RESULTS: Given the presence of HEs at baseline, the increase in risk of having the psychosis outcome at year 3 was much higher in those with DE at year 1 than in those without DE (risk difference between individuals with and without DE: 18.72%, 95% CI: 2.22-35.23, chi(2) = 4.94, df = 1, P = 0.026). CONCLUSION: The results are in line with current psychological theories stating that clinical outcome of psychosis-like experiences is related to the development of secondary beliefs and appraisals.

Adult↗
PubMed2004

Prevalence of bipolar disorder in the general population: a Reappraisal Study of the Netherlands Mental Health Survey and Incidence Study.

OBJECTIVE: The Netherlands Mental Health Survey and Incidence Study (NEMESIS) is a Dutch population study using a fully structured interview (Composite International Diagnostic Interview, CIDI), administered by trained interviewers. Based on all three assessments of NEMESIS, 2.4% of the respondents were identified with lifetime bipolar disorder (DSM-III-R). The primary aim of the study was to estimate the prevalence of bipolar disorder in the same population based on a semistructured interview administered by clinicians. METHOD: Seventy-four persons identified with a lifetime CIDI/DSM-III-R bipolar disorder and 40 persons with a major depressive disorder (MDD) were reinterviewed with the Structured Clinical Interview for DSM (SCID). RESULTS: Based on the SCID, 30 of 74 respondents with a CIDI/DSM-III-R bipolar disorder and eight of 40 respondents with MDD met DSM-IV criteria for bipolar disorder or cyclothymia, corresponding with an adjusted lifetime prevalence in these groups of 1% (95% CI: 0.7-1.3%) and 4.2% (95% CI: 1.6-6.9%) respectively. CONCLUSION: Compared with the SCID, the CIDI on the one hand overdiagnoses bipolar disorder but on the other hand underdiagnoses bipolar disorder.

Adolescent↗
PubMed2003

Self-reported psychotic experiences in the general population: a valid screening tool for DSM-III-R psychotic disorders?

OBJECTIVE: To examine the diagnostic value of self-reported psychotic-like experiences for DSM-III-R psychotic disorders. METHOD: A general population sample of 7076 subjects aged 18-64 years was interviewed with the Composite International Diagnostic Interview (CIDI) and, if there was evidence of psychotic experiences, the Structured Clinical Interview for DSM-III-R. RESULTS: The probability of having a psychotic disorder increased in a dose-response fashion with the level of self-reported psychotic experiences, but individual CIDI psychotic experience ratings had relatively low post-test probabilities (PPs) (range: 5.1-26.5%). However, limiting the sample to individuals who had been in contact with mental health services substantially improved PPs (range: 13.3-43.1%). CONCLUSION: Screening for psychosis in the population carries a high risk of stigmatization in false-positive cases and violation of the right 'not to know' in true-positive cases. However, in mental health care users, self-reported psychotic experiences may be a useful screening tool in individuals who have already developed help-seeking.

Adult↗
PubMed2003

Does educational background explain inequalities in care service use for mental health problems in the Dutch general population?

OBJECTIVE: To investigate whether (1) education predicts the use of care services for mental health problems, independently of mental disorder and functional impairment and (2) education modifies the association between mental disorder and service use. METHOD: Predictors of service use were recorded at baseline, and service use itself at 12-month follow-up, in a representative sample (N=7076) of the Dutch population, using the Composite International Diagnostic Interview. RESULTS: People with more education were less likely to use primary care but more likely to use mental health care. The effects on both types of care remained significant after adjustment for mental disorder and functional impairment. Lower education tended to strengthen the association between mood or anxiety disorder and primary care use. CONCLUSION: Further research on inequalities in service use will benefit from additional explanatory analyses and from the inclusion of sociopsychological variables, like cost-benefit considerations in decisions to use services.

Adolescent↗
PubMed2003

Upward trends in the use of community mental health and social work services in the Netherlands between 1979 and 1995: are particular sociodemographic groups responsible?

OBJECTIVE: We investigate 1) trends in use of community mental health care (CMHC) and community social work (CSW) by Dutch households in 1979-1995; 2) whether such trends can be explained by long-term relative changes in service use or in sizes of particular household categories. METHOD: Data was derived from the Facilities Use Surveys, cross-sectional population studies recording Dutch household characteristics and service use since 1979. A simulation technique was used to explain trends in service use. RESULTS: Use of CMHC and CSW virtually doubled in recent decades. Such trends are not explained by increasing relative service utilization in particular household categories, and only marginally by shifts in the relative sizes of such categories. They are attributable to growing rates of utilization throughout society. CONCLUSION: Trends in service use are explained by broad changes in help-seeking behaviour. Policymakers should act on these findings to narrow the persisting inequalities in service uptake.

Community Mental Health Services↗
PubMed2003

Discrimination and delusional ideation.

BACKGROUND: In the UK and The Netherlands, people with high rates of psychosis are chronically exposed to discrimination. AIMS: To test whether perceived discrimination is associated longitudinally with onset of psychosis. METHOD: A 3-year prospective study of cohorts with no history of psychosis and differential rates of reported discrimination on the basis of age, gender, disability, appearance, skin colour or ethnicity and sexual orientation was conducted in the Dutch general population (n=4076). The main outcome was onset of psychotic symptoms (delusions and hallucinations). RESULTS: The rate of delusional ideation was 0.5% (n=19) in those who did not report discrimination, 0.9% (n=4) in those who reported discrimination in one domain, and 2.7% (n=3) in those who reported discrimination in more than one domain (exact P=0.027). This association remained after adjustment for possible confounders. No association was found between baseline discrimination and onset of hallucinatory experiences. CONCLUSIONS: Perceived discrimination may induce delusional ideation and thus contribute to the high observed rates of psychotic disorder in exposed minority populations.

Adolescent↗
PubMed2002

Combined effect of mental disorder and low social support on care service use for mental health problems in the Dutch general population.

BACKGROUND: People with a mental disorder have high rates of service utilization for emotional or addiction problems. Little is known about the role of functional impairments and low social support in such service use. This article investigates: (1) whether the presence of multiple functional impairments mediates the link between mental disorder and service use; and (2) whether social support modifies that association. METHODS: Data were derived from the Netherlands Mental Health Survey and Incidence Study, NEMESIS, a prospective general population study. Predictors of service use (mental disorder; functional impairments; social support) were recorded in the second wave of the study, and service use in the third wave. RESULTS: Persons with a DSM-III-R disorder and persons with multiple functional impairments were three to seven times as likely to use primary or mental health care. People with low perceived social support were two to three times as likely to use them, and living alone increased the likelihood by 30% to 80%. The effect of mental disorder on service use was mediated by multiple functional impairments. In people with a mental disorder, low levels of social support intensified mental health service use. CONCLUSION: Service utilization by people with mental problems can be better understood through a model incorporating: (1) independent effects of mental disorder, functional impairments and social support on service use; (2) a mediating effect of multiple functional impairments on the link between mental disorder and service use; and (3) interaction effects of mental disorder and low social support on service use.

Adolescent↗
PubMed2001

Prevalence of psychotic disorder and community level of psychotic symptoms: an urban-rural comparison.

BACKGROUND: Urban and rural populations have different rates of psychotic illness. If psychosis exists as a continuous phenotype in nature, urban-rural population differences in the rate of psychotic disorder should be accompanied by similar differences in the rate of abnormal mental states characterized by psychotic or psychosislike symptoms. METHODS: A random sample of 7076 individuals aged 18 to 64 years were interviewed by trained lay interviewers with the Composite International Diagnostic Interview. Approximately half of those with evidence of psychosis according to the Composite International Diagnostic Interview were additionally interviewed by clinicians. We investigated associations between a 5-level urbanicity rating and (1) any DSM-III-R diagnosis of psychotic disorder (sample prevalence, 1.5%), (2) any rating of hallucinations and/or delusions (sample prevalence, 4.2%), and (3) any rating of psychotic or psychosislike symptoms (sample prevalence, 17.5%). RESULTS: Level of urbanicity was associated not only with DSM-III-R psychotic disorder (adjusted odds ratio [OR] over 5 levels, 1.47; 95% confidence interval [CI], 1.25-1.72), but also, independently, with any rating of delusion and/or hallucination (adjusted OR, 1.28; 95% CI, 1.17-1.40; clinician-assessed psychotic symptoms only: OR, 1.30; 95% CI, 1.03-1.64) and any rating of psychosislike symptom (adjusted OR, 1.18; 95% CI, 1.13-1.24). Psychotic symptoms were strongly and independently associated with psychotic disorder, regardless of the level of urbanization. CONCLUSIONS: Community level of psychotic and psychosislike symptoms may be inextricably linked to the prevalence of psychotic disorder. The prevalence of abnormal mental states that facilitate development to overt psychotic illness increases progressively with level of urbanization.

Adolescent↗
PubMed2001

Predictors of incident care service utilisation for mental health problems in the Dutch general population.

BACKGROUND: The determinants of first-time ('incident') use of primary care and mental health care services for mental health problems have not been previously investigated. Such information is needed to identify new client groups and to gain a better understanding of causal factors. METHOD: Data were derived from the Netherlands Mental Health Survey and Incidence Study, NEMESIS, a prospective general population study of adults. Potential predictors of care use (psychiatric disorders, burden of illness, sociodemographic characteristics) were recorded in the first wave of the study, and the utilisation of care services in the second wave. Psychiatric diagnoses were based on the Composite International Diagnostic Interview (CIDI) 1.1. RESULTS: Six of the ten indicators linked to the frequent utilisation of care were found not to be associated with incident use: higher age, lower income, living alone, paid employment, mood disorders and anxiety disorders. Four other indicators showed associations with both frequent and incident use: female gender, higher numbers of restricted activity days, poorer social functioning and unmet care needs. Two predictors of incident use only were lower educational attainment and being in treatment for a somatic disorder. CONCLUSION: New clients who come to primary health care or mental health care services with mental health problems are found in all age groups. They are more likely to be women, to have less education, to be in treatment for a somatic disorder and to have functional problems related to their mental health problems.

Acute Disease↗