jeroen knipscheer
Utrecht University, Clinical and Health Psychology, Faculty Member
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achtergrond De toenemende culturele varieteit in de Nederlandse bevolking leidt tot hiaten in kennis en inzicht betreffende de aansluiting van de reguliere geestelijke gezondheidszorg op haar veranderende patientenpopulatie. doel Om de... more
achtergrond De toenemende culturele varieteit in de Nederlandse bevolking leidt tot hiaten in kennis en inzicht betreffende de aansluiting van de reguliere geestelijke gezondheidszorg op haar veranderende patientenpopulatie. doel Om de kennis te vergroten biedt dit artikel een overzicht van eerder gepubliceerde bevindingen over determinanten van gezondheidsproblemen, hulpzoekgedrag, hulpbehoeften en zorgwaardering bij migranten. methode Er werden steekproeven genomen uit de Surinaamse (n = 101), Marokkaanse (n = 51), Turkse (n= 63) en autochtoon Nederlandse (n = 59) ggz-populatie. De gegevens zijn verzameld aan de hand van meervoudige methodologie (semi-gestructureerde interviews en standaard vragenlijsten) en geanalyseerd met behulp van multivariate technieken. resultaten Wat gezondheidsverschillen betreft blijkt de interculturele varieteit binnen migrantengroepen doorgaans meer uitgesproken dan het verschil tussen migranten en autochtone Nederlanders. Tevens zijn socio-demografische factoren zoals opleidingsniveau en het hebben van betaald werk doorslaggevend voor de verschillen in gezondheidsproblemen en hulpzoekgedrag. Allochtone clienten hebben wel meer behoefte aan medicijnen dan autochtone patienten. De tevredenheid met de hulp is behoorlijk, maar een derde (overwegend meer Turken en Marokkanen) is ontevreden. conclusie De bevindingen van dit onderzoek onderstrepen de vervlechting van een sociaaleconomische achterstandspositie met culturele verschillen als verklaring van gezondheidsproblemen, hulpzoekgedrag en waardering van zorg door allochtonen. De hulpverlening dient op dit cluster van factoren te worden toegesneden.
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Research Interests: Cognitive Science, Mental Health, Ethnic minorities, Medicine, Multivariate Analysis, and 15 moreEmpathy, Humans, Female, Male, Netherlands, Mental Health Care, Ethnic Groups, Middle Aged, Outpatients, Adult, Empirical evidence, Ethnic Group, Ethnic Minorities, cultural characteristics, and Health Care Surveys
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Research Interests: Mental Health, Ghana, Acculturation, Medicine, Humans, and 15 moreFemale, Male, Psychological Intervention, Netherlands, Feeling, Immigrant, Health Status, Clinical Sciences, Middle Aged, Psychological Resilience, Psychological distress, Adult, Psychological Adaptation, Adverse effect, and Interviews as topic
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Abstract In Turkey, the large scale of internal displacement is caused by armed conflict that occurs because of the struggle of Kurds to obtain political recognition and rights in Turkey. As a result, many asylum requests were conducted... more
Abstract In Turkey, the large scale of internal displacement is caused by armed conflict that occurs because of the struggle of Kurds to obtain political recognition and rights in Turkey. As a result, many asylum requests were conducted in Europe and a massive wave of internal ...
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ObjectivesIn the present study, we examined relations between premigration, perimigration, and postmigration risk factors (i.e., potentially traumatic events [PTEs], postmigration living problems [PMLPs], stressful life events) and... more
ObjectivesIn the present study, we examined relations between premigration, perimigration, and postmigration risk factors (i.e., potentially traumatic events [PTEs], postmigration living problems [PMLPs], stressful life events) and psychological symptoms (i.e., anxiety/depression, posttraumatic stress) in Syrian emerging adults with refugee backgrounds; we also tested cultural identity conflict as a possible mediator of these relations. We expected that greater exposure to migration risk factors was associated with more psychological symptoms and that higher cultural identity conflict would contribute to these associations.MethodsWe used data from the first wave of Karakter, a longitudinal study of 158 Syrians with refugee backgrounds (69.0% men, age range 18–35). Participants completed a questionnaire assessing PTEs, PMLPs, stressful life events, cultural identity conflict, and symptoms of anxiety/depression and posttraumatic stress.ResultsCorrelational analyses indicated that more PTEs and stressful life events were related to higher levels of cultural identity conflict and more psychological symptoms. Furthermore, greater cultural identity conflict was associated with more psychological symptoms. We did not observe indirect effects of cultural identity conflict in the mediation analyses.ConclusionsResults suggest that postmigration stressors and cultural identity conflict are associated with psychological symptoms among Syrian emerging adults who have resettled in the Netherlands.
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... In de Amerikaanse literatuur (oa Pontoretto ea, 2001; Sue & Sue, 2003; Tseng, 1999) worden interculturele competenties veelal op drie domeinen onderscheiden: de eigen culturele achtergrond, de kijk op de wereld van de ander, en... more
... In de Amerikaanse literatuur (oa Pontoretto ea, 2001; Sue & Sue, 2003; Tseng, 1999) worden interculturele competenties veelal op drie domeinen onderscheiden: de eigen culturele achtergrond, de kijk op de wereld van de ander, en cultuurspecifieke interventiestrategieën. ...
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Research Interests: Humanities and Art
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Research Interests: Clinical Psychology, Depression, Quality of life, Ethnic minorities, Medicine, and 15 moreAffective Disorders, Europe, TURKISH, Psychological Intervention, Symptoms, Mental Health Care, Risk factors, Systematic review, Psychological distress, Ethnic Group, Risk Factors, Ethnic Minorities, labor migrants, Psychology and Cognitive Sciences, and Medical and Health Sciences
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How traumatic events (TEs) should be defined, and how specific TEs are for Post-traumatic Stress Disorder (PTSD) were examined in a general mental health care population. Three definitions of TEs were defined, according to the PTSD... more
How traumatic events (TEs) should be defined, and how specific TEs are for Post-traumatic Stress Disorder (PTSD) were examined in a general mental health care population. Three definitions of TEs were defined, according to the PTSD criteria of DSM-IV. Half of the sample reported any TE, with a high prevalence of TEs among non-PTSD disorders. Previous mental health care, female gender, and the likelihood of assigning PTSD were associated with more severe trauma definitions. Reexperiencing symptoms were especially common among mood disorders. The implications for treatment are discussed and an alternative, dimensional definition of trauma has been proposed.
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ABSTRACT Objective Using data from a randomized controlled trial on psychotherapy for posttraumatic stress disorder (PTSD) in older adults (aged >55), this study aimed at analysing the efficacy of two psychological interventions in... more
ABSTRACT Objective Using data from a randomized controlled trial on psychotherapy for posttraumatic stress disorder (PTSD) in older adults (aged >55), this study aimed at analysing the efficacy of two psychological interventions in terms of self-reported symptoms, comorbid psychopathology and resilience outcomes. Method Thirty-three outpatients (age 55–81) with PTSD were randomly assigned to eleven sessions of narrative exposure therapy or present-centered therapy. Self-reported symptom severity of PTSD, depression and general psychopathology, along with measures of resilience (self-efficacy, quality of life and posttraumatic growth cognitions), were target outcomes. Harvard Trauma Questionnaire, Beck Depression Inventory, Brief Symptom Inventory, General Efficacy Scale, World Health Organization Quality of Life Assessment and Meaning of War Scale (personal growth) were assessed pre-treatment, post-treatment and at four months follow-up. Because of variable inter-assessment intervals, a piecewise mixed effects growth model was used to investigate treatment effects. Results Neither post-treatment, nor at mean follow-up, between-group effects were found. At follow-up, significant medium to large within-group effect sizes were found in the NET-group for psychopathology (self-reported PTSD: Cohen’s d = 0.54, p < .01; depression: Cohen’s d = 0.51, p = .03; general psychopathology: Cohen’s d = 0.74, p = .001), but not so in the PCT-group. Resilience (self-efficacy, quality of life and personal growth cognitions) did not significantly change in either group. Conclusions In older adults with PTSD, the efficacy of NET extended beyond PTSD, reducing not only self-reported symptoms of PTSD but also comorbid depression and general psychopathology.
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SummaryIn 1994, the Outline for Cultural Formulation (OCF) was included as a supplement to the DSM-IV. The OCF was developed as a tool to help care providers gain more insight in cultural factors which might be relevant while diagnosing... more
SummaryIn 1994, the Outline for Cultural Formulation (OCF) was included as a supplement to the DSM-IV. The OCF was developed as a tool to help care providers gain more insight in cultural factors which might be relevant while diagnosing mental problems of patients with cultural backgrounds that differ from the care provider´s. More than twenty years after publication, the query is justified whether the OCF actually serves the purpose it was intended for, and whether any adjustments are needed. By means of a literature search an answer is sought to these questions. The main conclusion is that reactions of professionals to the cultural formulation were positive and that it has managed to find its way into education, and, to a lesser extent, into clinical practice. However, evaluative and effect studies have been mostly lacking in the first period. Recent research has shown more favourable effects.
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BackgroundEvidence-based treatment and age-specific services are required to address the needs of trauma-affected older populations. Narrative exposure therapy (NET) may present an appropriate treatment approach for this population since... more
BackgroundEvidence-based treatment and age-specific services are required to address the needs of trauma-affected older populations. Narrative exposure therapy (NET) may present an appropriate treatment approach for this population since it provides prolonged exposure in a lifespan perspective. As yet, however, no trial on this intervention has been conducted with older adults from Western Europe.AimsExamining the efficacy of NET in a sample of older adults.MethodOut-patients with post-traumatic stress disorder (PTSD), aged 55 years and over, were randomly assigned to either 11 sessions of NET (n = 18) or 11 sessions of present-centred therapy (PCT) (n = 15) and assessed on the Clinician-Administered PTSD Scale (CAPS) pre-treatment, post-treatment and at follow-up. Total scores as well as symptom scores (re-experience, avoidance and hyperarousal) were evaluated.ResultsUsing a piecewise mixed-effects growth model, at post-treatment a medium between-treatment effect size for CAPS tota...
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The field of traumatic stress is often referred to as being in a state of controversy and lack of continuity. Throughout history, disputes repeatedly centered on defining the psychological consequences of severe adverse events and on... more
The field of traumatic stress is often referred to as being in a state of controversy and lack of continuity. Throughout history, disputes repeatedly centered on defining the psychological consequences of severe adverse events and on their causes. Even to this day this is current. To understand these controversies, an extensive historical literature review is presented of how mental consequences of trauma have been described in history, of the circumstances in which this took place, and of the disputes that have influenced the conceptualization of these mental responses. We found psychotrauma always being surrounded by controversy. Significant heterogeneity in symptom expression has been described over the centuries to this day. Some symptoms appeared steadily over many decades, but often each time period showed its own core symptoms. At syndrome level, we found an acute condition, one with longer duration, and a complex condition. Also here, definitions varied over the decades. Fin...
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... Furthermore, we thank Semiha Denktas, Caroline Geleijns, Astrid Kamperman, Kemal Inci, Suzan van den Boer, Carolien ten Brinke, Remco Neuteboom, Salima El Hamdi, and, in particular, Yusuf Mulayin for their contributions. ...
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Introduction: Torture survivors risk developing Posttraumatic Stress Disorder (PTSD) as well as other mental health problems. This clinical case study describes the impact of torture on two survivors who were treated for their PTSD with... more
Introduction: Torture survivors risk developing Posttraumatic Stress Disorder (PTSD) as well as other mental health problems. This clinical case study describes the impact of torture on two survivors who were treated for their PTSD with Narrative Exposure Therapy. Methods: The reports of the narratives of two torture survivors were qualitatively analyzed. It was hypothesized that torture yields overaccommodating cognitions, as well as mental defeat, which in turn, are related to severity of psychological complaints. Results: Both patients have experienced an accumulation of traumatic events. The psychological and physical torture they experienced lead to increased anticipation anxiety, loss of control and feelings of hopelessness, as well as overaccommodating cognitions regarding self and others. Conclusions: Cognitions, culture and beliefs, as well as issues of confidence and a more long-term perspective affect therapeutic work. Building trust, pacing the therapeutic process, and a...