Let op het is Open Access maar met speciale Elsevier user rights, zie https://www.elsevier.com/about/policies/open-access-licenses/elsevier-user-license Background The presence of a comorbid borderline personality disorder (BPD) may be associated with an increase of suicidal behaviors in patients with depressive and anxiety disorders. The aim of this study is to examine the role of borderline personality traits on recurrent suicide attempts. Methods The Netherlands Study on Depression and Anxiety included 1838 respondents with lifetime depressive and/or anxiety disorders, of whom 309 reported at least one previous suicide attempt. A univariable negative binomial regression analysis was performed to examine the association between comorbid borderline personality traits and suicide attempts. Univariable and multivariable negative binomial regression analyses were performed to identify risk factors for the number of recurrent suicide attempts in four clusters (type and severity of axis-I disorders, BPD traits, determinants of suicide attempts and socio-demographics). Results In the total sample the suicide attempt rate ratio increased with 33% for every unit increase in BPD traits. A lifetime diagnosis of dysthymia and comorbid BPD traits, especially the symptoms anger and fights, were independently and significantly associated with recurrent suicide attempts in the final model (n=309). Limitations The screening of personality disorders was added to the NESDA assessments at the 4-year follow-up for the first time. Therefore we were not able to examine the influence of comorbid BPD traits on suicide attempts over time. Conclusions Persons with a lifetime diagnosis of dysthymia combined with borderline personality traits especially difficulties in coping with anger seemed to be at high risk for recurrent suicide attempts. For clinical practice, it is recommended to screen for comorbid borderline personality traits and to strengthen the patient's coping skills with regard to anger.
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Background: People with a personality disorder (PD) suffer from enduring inflexible patterns in cognitions and emotions, leading to significant subjective distress, affecting both self and interpersonal functioning. In clinical practice, Dance Movement Therapy (DMT) is provided to clients with a PD, and although research continuously confirms the value of DMT for many populations, to date, there is very limited information available on DMT and PD. For this study, a systematic literature review on DMT and PD was conducted to identify the content of the described DMT interventions and the main treatment themes to focus upon in DMT for PD. Methods: A systematic search was conducted across the following databases: EMBASE, MEDLINE, PubMed, WEB OF SCIENCE, PsycINFO/OVID, and SCOPUS following the PRISMA guidelines. The Critical Appraisal Skills Programme for qualitative studies was used to rank the quality of the articles. The Oxford Center for Evidence-based Medicine standards were applied to determine the hierarchical level of best evidence. Quantitative content analysis was used to identify the intervention components: intended therapeutic goals, therapeutic activities leading to these goals, and suggested therapeutic effects following from these activities. A thematic synthesis approach was applied to analyze and formulate overarching themes. Results: Among 421 extracted articles, four expert opinions met the inclusion criteria. Six overarching themes were found for DMT interventions for PD: self-regulation, interpersonal relationships, integration of self, processing experiences, cognition, and expression and symbolization in movement/dance. No systematic descriptions of DMT interventions for PD were identified. A full series of intervention components could be synthesized for the themes of self-regulation, interpersonal relationships, and cognition. The use of body-oriented approaches and cognitive strategies was in favor of dance-informed approaches. Conclusions: Dance movement therapists working with PD clients focus in their interventions on body-related experiences, non-verbal interpersonal relationships, and to a lesser extent, cognitive functioning. A methodological line for all intervention components was synthesized for the themes of self-regulation, interpersonal relationships, and cognition, of importance for developing systematic intervention descriptions. Future research could focus on practitioners’ expertise in applying DMT interventions for PD to develop systematic intervention descriptions and explore the suitability of the identified themes for clinical application. Clients’ experiences could offer essential insights on how DMT interventions could address PD pathology and specific PD categories.
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Background. Violent criminal offenders with personality disorders (PD’s) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs. Methods. We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms. Results. Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes – rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms – and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: F(5308) = 9.40, p < 0.001; unsupervised leave, treatment*- time: F(5472) = 3.45, p = 0.004), and showed faster improvements on PD scales (treatment*- time: t(1387) = −2.85, p = 0.005). Conclusions. These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community
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Purpose – Against the background of current leadership theory, this research paper analyses and compares the leadership approaches of two outstanding leaders: Daniel Vasella, chairman of the leading Swiss pharmaceutical organization Novartis and Ricardo Semler, owner of the Brazilian conglomerate Semco. In contrast to many rather abstract, unpractical and pointlessly theoretical papers on leadership this analysis provides a more applied view of leadership by means of the life history approach delivering insight into both leaders’ development and leader personality. Methodology/approach – First, this paper locates the ideas and practices associated with the term “leadership” as a concept through theories that have developed over time and shows how the practices of leading can be derived and understood through chosen theories. Based on this, the specific characteristics and career paths of both leaders are presented and compared so that a final analysis of their leadership approach can be done. The paper is based on secondary sources such as peer-reviewed business journals and literature on leadership. Information about both leaders and their approach to leadership is gathered mainly from published interviews with them. Additional information on Semler is taken from his autobiography. Conclusions – It is difficult to identify an “essence” of leadership, whether that takes the form of personality characteristics or traits, charisma, the ability to transform people or organizations or a brain function. All presented theories of leadership seem to have their raison d’être. Both Vasella and Semler apply a combination of different attitudes and behaviours that characterize their leadership style containing elements of transformational, charismatic, ethical, servant and authentic leadership.
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De publicatielijst bevat alle publicaties waar Berno van Meijel aan bijgedragen heeft
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In Haftanstalten und Maßregelvollzugskliniken sind Frauen in der Minderheit. Daher überrascht es nicht, dass die meisten Instrumente zur Einschätzung von Rückfallrisiken für Männer entwickelt und an ihnen erprobt wurden. Erst seit einigen Jahren hat man den Eigenschaften und Risikofaktoren straffälliger Frauen mehr Beachtung gezollt und untersucht, was für ihre Behandlung erforderlich ist. Untersuchungen zeigten, dass die standardmäßig angewandten Prognoseinstrumente zur Vorhersage gewalttätigen Handelns bei Frauen weniger brauchbare Ergebnisse lieferten als bei Männern. Um Risiken bei Frauen zu prognostizieren und entsprechende Interventionen zur Rückfallprävention zu entwickeln, bedarf es weiterer Forschung. Das ist nicht nur für die Frauen selbst und für die Gesellschaft entscheidend, sondern auch für den sozialen Kontext der Frauen, insbesondere für deren Kinder.
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Women and girls represent only a minority in the penitentiary system and in forensic mental health care. About 6%–10% of both prison and forensic psychiatric populations in Western countries comprise women (see for the most recent offi cial statistics in the UK w ww.gov. uk/government, in Canada w ww.statcan.gc.ca, and in the US w ww.bjs.gov) . However, there seems to be widespread agreement that in the past 20 years female offending has been on the rise, especially violent offending and particularly among young women ( Miller, Malone, and Dodge, 2010; M oretti, Catchpole, and Odgers, 2005) . Overall, a disproportionate growth of females entering the criminal justice system and forensic mental health care has been observed in many countries (for reviews, see Nicholls, Cruise, Greig, and Hinz, 2015; Odgers, Moretti, and Reppucci, 2005 ; Walmsley, 2015) . In addition, it should be noted that the ‘dark number’ for women is suggested to be bigger than for men. Offi cial prevalence rates of female offending might constitute an underestimation as women usually commit less reported offences, for example, domestic violence (N icholls, Greaves, Greig, and Moretti, 2015) . Furthermore, it has been found that – if apprehended – girls and women are treated more leniently by professionals and the criminal justice system. Generally, they receive lower prison sentences and are more often admitted to civil psychiatric institutions instead of receiving a prison sentence or mandatory forensic treatment after committing violence ( Javdani, Sadeh, and Verona, 2011 ; Jeffries, Fletcher, and Newbold, 2003 ). Hence, although female offenders compared to male offenders are a minority, female violence is a substantial problem that deserves more attention. Our understanding of female offenders is hindered by the general paucity of theoretical and empirical investigations of this population. In order to improve current treatment and assessment practices, our knowledge and understanding of female offenders should be enlarged and optimised (d e Vogel and Nicholls, 2016 ).
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Victim-offender contact has been studied extensively in prisons, but research on contact between victims and mentally disordered offenders in forensic mental health settings is lacking. Therefore, an exploratory study was conducted on contact between victims and offenders in four Dutch forensic psychiatric hospitals. These offenders have committed serious (sexually) violent offenses, for which they could not be held fully responsible due to severe psychopathology. During the mandatory treatment, it is possible for offenders and their victims to engage in contact with each other if both parties agree to this. To explore the conditions under which this contact is suitable, we interviewed 35 social workers about their experiences in 57 cases from four Dutch forensic psychiatric hospitals. Findings demonstrated that, according to the social workers, no type of offense or psychopathology were obvious exclusion criteria for victim-offender contact. Social workers described offenders' problem awareness, stable psychiatric condition, and ability to keep to agreements as important factors that enable victim-offender contact. Implications and suggestions for future research are provided.
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The adaptation of urbanised areas to climate change is currently one of the key challenges in the domain of urban policy. The diversity of environmental determinants requires the formulation of individual plans dedicated to the most significant local issues. This article serves as a methodic proposition for the stage of retrieving data (with the PESTEL and the Delphi method), systemic diagnosis (evaluation of risk and susceptibility), prognosis (goal trees, goal intensity map) and the formulation of urban adaptation plans. The suggested solution complies with the Polish guidelines for establishing adaptation plans. The proposed methodological approach guarantees the participation of various groups of stakeholders in the process of working on urban adaptation plans, which is in accordance with the current tendencies to strengthen the role of public participation in spatial management. https://doi.org/10.12911/22998993/81658
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Veel bedrijven stemmen hun communicatie en interactie met de consument af door te segmenteren op kanaalgebruik. In deze studie tonen wij aan dat een focus op kanalen maar zeer beperkt bruikbaar is. Deze beperking is een logisch gevolg van het feit dat de meeste consumenten meerdere kanalen gebruiken, het online kanaal ondertussen veel verschillende vormen kent en kanalen steeds meer integreren. Het vaak gemaakte onderscheid online en offline verliest hierdoor zijn relevantie. In deze studie lichten wij toe hoe wij verschillende navigatie-strategieën hebben geïdentificeerd die aangeven hoe consumenten hun weg vinden in het kanalenlandschap in de verschillende fasen rondom een aankoop. Door kanaalgebruik te verklaren vanuit deze navigatie-strategieën ontstaat een stabiel en eenduidige model dat organisaties zal helpen een effectieve multi-channel strategie te formuleren
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