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
DOCUMENT
Impact maken vinden PD-kandidaten Armand Odekerken, Jasmijn Ruijgrok en Jenny Zwijnenburg een van de belangrijkste redenen om aan het PD-traject mee te doen. Dat vertelden ze in een sessie tijdens de conferentie Onderzoek & Impact die Regieorgaan SIA en de Vereniging Hogescholen organiseerden op 3 juni 2024.
LINK
[ENG] "Processing Artistic and Design Research" gathers two PD candidates in a conversation about artistic and design research, the process of a research project in the context of a third cycle in education, and the links we can foster between research and practice. [NL] "Processing Artistic and Design Research" brengt twee PD-kandidaten samen in een gesprek over artistiek en ontwerpend onderzoek, het proces van een onderzoeksproject binnen de context van een derde cyclus in het onderwijs, en de verbanden die we kunnen leggen tussen onderzoek en praktijk.
LINK
Hogescholen starten in 2022 met een eigen doctoraatstraject: het Professional Doctorate. Daarmee introduceert het hbo een nieuwe beroepsopleiding waarmee het de grenzen in de beroepspraktijk wil verleggen. Kandidaten worden opgeleid tot hooggekwalificeerde professionals die leren te interveniëren in complexe vraagstukken zoals de energietransitie of de gezondheidszorg. Belangrijke en noodzakelijke toevoeging Hogescholen zien een doctoraatstraject in het hbo als een belangrijke en noodzakelijke toevoeging binnen het hoger onderwijs stelsel. Het Professional Doctorate (PD) maakt een doorlopende leerlijn van bachelor via master tot doctorate in de beroepskolom mogelijk, en wordt nauw verbonden met het overige hbo-onderwijs. Doel is dat hbo bachelor- en masterstudenten in hun onderwijs de vruchten plukken van het onderzoek van PD-kandidaten naar de laatste ontwikkelingen in de beroepspraktijk. Daarmee is de introductie van het professional doctorate ook een investering in de bredere aansluiting van het hbo op de arbeidsmarkt.
DOCUMENT
Sexual functioning is often impaired in patientswith Parkinson’s disease (PD) and may affect quality oflife of patients and their spouse. However, little is knownabout the practice patterns of neurologists with regard todiscussing sexuality in this field. The aim of this cross-sectional study was to evaluate to what extent neurologistsdiscuss sexuality with PD patients. A 22-item questionnairewas sent to 139 neurologists specializing in PD. The surveycontained questions about their attitudes, knowledge, andpractice patterns with respect to sexual dysfunction (SD) inpatients with PD. The response rate of the survey was66.9%. Most participants (56.8%) stated that they addresssexuality in less than half of their PD patients. High age ofpatients (42.0%), insufficient consultation time (37.5%),and a lack of patients’ initiative to raise the topic them-selves (36.4%) were frequently reported barriers towardsdiscussing sexuality. The majority of participants consid-ered that discussing sexuality is a responsibility that laywith neurologists (85.2%), nurses (73.9%), and patients(72.7%). One quarter of the neurologists reported to haveinsufficient or no knowledge on SD. The majority of par-ticipants regarded screening for SD important or slightlyimportant (85.2%). A large proportion of Dutch neurolo-gists specializing in PD do not routinely discuss sexualitywith their PD patients. Sexual healthcare in PD patientsmay benefit from time-efficient tools and agreements onwho is responsible for discussing SD. Furthermore, rec-ommendations in PD guidelines on screening and manag-ing SD should be adapted to fit everyday practicehttps://creativecommons.org/licenses/by/4.0/ CC BY 4.0https://creativecommons.org/licenses/by/4.0/
MULTIFILE
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.
DOCUMENT
Background: Recent research in the field of “Arts and Health” has demonstrated the beneficial impact of arts-based interventions on health and well-being across diverse populations. Recognizing their potential, especially in cases where conventional healthcare cannot address the multifaceted impact of conditions such as in Parkinson's disease (PD), our study advocates for an integrative approach in medical practice and neuroscience. We recommend incorporating learning environments from the design phase through long-term care. The arts offer a unique opportunity to create such environments. In this study, we specifically focus on individuals with PD, co-designing an intervention as a creative engagement learning environment and a PD-specific creative arts therapy. In this study, the narratives of those affected contribute as scientific knowledge, shaping care and increasing the intervention's relevance to participants' lives.
MULTIFILE
BACKGROUND: Although physical activity is beneficial for Parkinson's disease (PD) patients, many do not meet the recommended levels. The range of physical activity among sedentary PD patients is unknown, as are factors that determine this variability. Hence, we aimed to (1) assess daily physical activity in self-identified sedentary PD patients; (2) compare this with criteria of a daily physical activity guideline; and (3) identify determinants of daily physical activity. METHODS: Daily physical activity of 586 self-identified sedentary PD patients was measured with a tri-axial accelerometer for seven consecutive days. Physical fitness and demographic, disease-specific, and psychological characteristics were assessed. Daily physical activity was compared with the 30-min activity guideline. A linear mixed-effects model was estimated to identify determinants of daily physical activity. RESULTS: Accelerometer data of 467 patients who fulfilled all criteria revealed that >98% of their day was spent on sedentary to light-intensity activities. Eighty-two percent of the participants were 'physically inactive' (0 days/week of 30-min activity); 17% were 'semi-active' (1-4 days/week of 30-min activity). Age, gender, physical fitness, and scores on the Unified Parkinson's Disease Rating Scale explained 69% of the variability in daily physical activity. CONCLUSIONS: Performance-based measurements confirmed that most self-identified sedentary PD patients are 'physically inactive'. However, the variance in daily physical activity across subjects was considerable. Higher age, being female, and lower physical capacity were the most important determinants of reduced daily physical activity. Future therapeutic interventions should aim to improve daily physical activity in these high-risk patients, focusing specifically on modifiable risk factors.
LINK
