Wilma Vollebergh

Universiteit Utrecht, Utrecht, Utrecht, Netherlands

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Publications (102)298.56 Total impact

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    ABSTRACT: Background Alcohol consumption levels and alcohol use disorder (AUD) symptoms may serve as easily quantifiable markers for AUD relapse after remission and might help prevention workers identify at-risk individuals. We investigated the predictive value of alcohol consumption and AUD symptoms on relapse. Methods Data are from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). We selected 506 people in ≥12-month DSM-5 AUD remission at baseline and assessed their status at 3-year follow-up. AUD symptoms and drinking patterns were assessed using the Composite International Diagnostic Interview 3.0. Time since remission was assessed retrospectively at baseline and ranged from 1 to 48 years. Predictors for relapse were examined using Cox regression analysis. Results Cumulative AUD relapse rate was 5.6% at 5 years, 9.1% at 10 years and 12.0% at 20 years. Relapse was predicted by both medium [15-28/22-42 drinks weekly for women/men] and high [≥29/43] past alcohol intake, 6+ lifetime AUD symptoms, ‘impaired control over use’, and at-risk [≥8/15] current intake. The risk of relapse was especially high when medium or high past intake or 6+ lifetime symptoms coincided with current at-risk drinking. Conclusions Only a minority of people in DSM-5 AUD remission relapsed, but the risk of relapse increased substantially with the presence of at least one of the risk factors. Moreover, at-risk current drinking coupled with other risk factors substantially increased the likelihood of relapse. Therefore, current drinking may provide an adequate reference point for relapse prevention.
    Drug and alcohol dependence 01/2014; · 3.60 Impact Factor
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    ABSTRACT: To examine cross-national changes in frequent adolescent cannabis use (40+ times consumed over life-time at age 15) over time and relate these trends to societal wealth, family affluence and gender. Data from three cycles (2002, 2006, 2010) of the Health Behaviour in School-aged Children (HBSC) Study were used for cross-sectional and trend analyses of adolescent cannabis use. Representative surveys in 30 European and North American countries. A total of 160 606 15-year-old students. Respondents' life-time cannabis use, demographics, family affluence (FAS) and frequency of peer contacts were measured individually. Indicators of wealth (gross domestic product per capita, GDP) and perceived availability of cannabis were obtained from national public data bases. The frequency of life-time cannabis use decreased over time among adolescents in Europe and North America, particularly in western European countries and the United States (relative risk (RR) = 0.86: confidence interval (CI) 0.79-0.93). This trend was not observed consistently in rapidly developing countries in eastern, central and southern Europe. Over time (2002-10), cannabis use became: (i) less characteristic of high GDP countries in contrast to lower GDP countries (RR = 0.74: CI 0.57-0.95); (ii) less characteristic of youth from high FAS families in contrast to youth from low FAS families (RR = 0.83: CI 0.72-0.96); and (iii) characterized by an increasing gender gap, i.e. consumption was higher among males (RR 1.26: CI 1.04-1.53). Perceived availability of cannabis and peer contacts remained strong predictors of frequent cannabis use. Among 30 European and North American countries, cannabis use appears to have 'trickled down' over time, with developing countries taking on the former (heavier) use pattern of richer countries, and less affluent youth taking on the former (heavier) use pattern of more affluent youth. Cannabis use continues to be more common among adolescent males than females.
    Addiction 11/2013; · 4.58 Impact Factor
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    ABSTRACT: Adolescents who attend special education for behavioural problems (SEB) and adolescents who live in a residential youth care institution (RYC) are characterised by behavioural disorders and problematic family backgrounds and have an increased risk for substance use. Though it is likely that the high rates of substance use in SEB/RYC settings might be inherent to the risk profile of these adolescents, little is known about the actual role the risk profile has in explaining substance use. The present study examined the extent to which the elevated risk of substance use in SEB/RYC can be explained by high levels of individual, family, and peer risk indicators that are known to characterise their risk profile. Self-report questionnaires from 531 adolescents in RYC (50 % male; mean age 14.7) and 603 adolescents in SEB (81 % male; mean age 14.1) were compared with information from 1,905 adolescents attending special education for students with learning disabilities (SEL) (56 % male; mean age 14.1). Results show that adolescents in SEB/RYC reported higher levels of daily smoking, weekly alcohol consumption, cannabis and hard drug use, as well as greater prevalence of individual, family and peer factors. Though individual, family and in particular peer risk indicators all explain some of the variance in substance use, the differences between adolescents in SEB/RYC compared with SEL remained significant and substantial, with the exception of heavy alcohol consumption. These findings suggest that deviant peer affiliation, in particular, plays a role in explaining high substance use levels in SEB/RYC and those factors relevant to the residential settings and special education schools might also contribute to substance use in these high-risk groups.
    European Child & Adolescent Psychiatry 09/2013; · 3.70 Impact Factor
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    ABSTRACT: Neighbourhood research hitherto has suggested that the neighbourhood in which youth grow up affects their educational achievement. However, the mechanisms though which the neighbourhood reaches these effects are still unclear. Family and individual characteristics seem important in explaining educational outcomes. We therefore propose two related mediating factors: parenting strategies and problematic behaviour. We test this mediation using the 2009 Health Behaviour in School-aged Children data for the Netherlands (N = 2683), in which adolescents are surveyed about their behaviour and relationships and, additionally, their parents are interviewed about their child and their parenting. These data are combined with data from Statistics Netherlands, which include neighbourhood-level information about real-estate value and ethnic variation of the neighbourhood population. The results show that the effects of the proportion of immigrant groups and the mean property values in the neighbourhood are unlikely to be mediated by parenting behaviours and problematic behaviour. The results also show that parents are likely to adapt their parenting behaviours to demographic neighbourhood characteristics. For example, parents in neighbourhoods with higher ethnic heterogeneity apply more protective parenting strategies.
    Environment and Planning A 09/2013; 45(9):2135-2153. · 1.89 Impact Factor
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    ABSTRACT: Although it seems intuitive that alcohol use disorders (AUDs) include excessive alcohol consumption (EAC), this notion is not well established. This study investigates to which degree EAC (defined as >14/21 drinks weekly for women/men and at least three 5+ drinking days per week) and AUD overlap and whether problematic alcohol use groups (EAC-only, AUD-only, and EAC + AUD) differ from each other and from nonproblematic alcohol users regarding sociodemographics, mental health problems, functioning, and service utilization. Data were derived from the Netherlands Mental Health Survey and Incidence Study-2, a population-based study including 5,443 current drinkers (aged 18 to 64) interviewed with the Composite International Diagnostic Interview 3.0. Both DSM-IV AUDs and a proxy of DSM-5 AUD are considered. Of the current drinkers, 3.8% reported 12-month EAC. Twelve-month prevalence of DSM-IV and DSM-5 AUD were 5.4 and 4.4%, respectively. Regarding DSM-IV, only 17.7% of subjects with AUD reported EAC and 25.3% of those with EAC had an AUD. Compared with nonproblematic alcohol users, the 3 groups of problematic alcohol use (EAC-only, AUD-only, and EAC + AUD) were more often associated with mental health problems, poorer functioning, and service utilization. There were few differences between EAC-only and AUD-only regarding these correlates. However, EAC + AUD had strongest associations with above-mentioned correlates compared with the other 3 groups. Compared with DSM-IV findings, DSM-5 AUDs had slightly larger overlap with EAC, but correlates were similarly associated with problematic alcohol use groups. Findings indicate limited overlap between EAC and AUD. Yet, both dimensions were similarly associated with other problems suggesting that both should be included in future epidemiological research to detect the total group of problematic alcohol users.
    Alcoholism Clinical and Experimental Research 08/2013; · 3.42 Impact Factor
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    ABSTRACT: To establish the 3-year persistency rate of alcohol use disorder (AUD) and its predictors, and to examine drinking patterns of recently remitted persons. The Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2) surveyed a nationally representative sample of adults (aged 18-64) at baseline (response=65.1%) and 3-year follow-up (response=80.4%). People with AUD at baseline, as defined by DSM-5 (n=198). AUD, drinking patterns and mental disorders were assessed using the Composite International Diagnostic Interview 3.0. Other predictors were assessed with an additional questionnaire. Predictors of persistency were examined with univariable and multivariable logistic regression analyses. The AUD persistency rate was 29.5% (95% CI=20.0-39.0). In the multivariable model, the older (25-34 and 35-44) age groups had lower AUD persistency (odds ratio (OR)=0.05; p=.014 and OR=0.14; p=.028, respectively) than the youngest age group (18-24). A higher number of weekly drinks and a comorbid anxiety disorder predicted AUD persistency (OR=1.03; p=.043 and OR=4.56; p=.046, respectively). Furthermore, remission was associated with a reduction of 6 drinks per week between T0 and T1 . It should be noted however that 35.8% (95% CI=22.4-49.2) of persons in diagnostic remission still drank more than the recommended maximum (>7/14 drinks weekly for women/men). Only a minority of people in the Netherlands with alcohol use disorder (AUD) as defined by DSM-5 still have the disorder 3 years later. Factors that help identify people at risk of AUD persistence are: younger age, a higher number of weekly drinks and a comorbid anxiety disorder. A substantial number of people recently in diagnostic remission still drink above the maximum recommended level.
    Addiction 07/2013; · 4.58 Impact Factor
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    ABSTRACT: Background: Across Europe, tobacco use is more prevalent among secondary school students attending vocational tracks compared with students attending academic tracks. The purpose of the present study is to describe trends in social inequality in daily smoking among adolescents between 2002 and 2010 by addressing both absolute social inequality (prevalence difference between vocational and academic tracks) and relative social inequality (prevalence ratio) in seven European countries. Methods: Analyses were based on data from 15-year-olds who participated in the Health Behaviour in School-aged Children study in 2002, 2006 and 2010 in Belgium, Croatia, France, Germany, Hungary, Italy and The Netherlands (total N = 32 867). Results: Overall, daily smoking decreased between 2002 and 2010 in Belgium, France, Germany and The Netherlands, increased in Croatia and remained stable in Hungary and Italy. Considerable differences in daily smoking according to educational track existed in all countries. Absolute educational inequalities increased dramatically in Croatia and Italy, while relative inequalities showed a tendency to increase in all countries (significant in Belgium and The Netherlands). Conclusions: Conclusions on social inequality in adolescent smoking may appear differently when described by absolute and relative measures. Especially the large increase in absolute educational inequalities in daily smoking in Croatia and Italy are worrisome and warrant attention from the public health domain. The findings underline the need for appropriate smoking policies and interventions in vocational schools across Europe.
    The European Journal of Public Health 03/2013; · 2.52 Impact Factor
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    ABSTRACT: More physical activity is associated with fewer mental health problems among adolescents, but the underlying mechanisms are not clear. The aim of this article is to investigate whether the association between physical activity and mental health is mediated by body-weight perception (self-image) or the social aspects of participation in organized sports (social interaction). Data from 7,304 adolescents were drawn from the Dutch Health Behaviour in School-Aged Children survey. Logistic regression analyses showed that, compared with respondents who were physically active, inactive respondents were at higher risk for both internalizing (odds ratio [OR] = 1.52, p < .001) and externalizing (OR = 1.34, p < .05) problems. The inclusion of body-weight perception and sports-club membership variables reduced the strength of the association to an OR of 1.35 (p < .05) for internalizing problems and an OR of 1.20 (p = .132) for externalizing problems. This study found some support for the self-image and social interaction hypotheses and thereby confirms the importance of the psychological and sociological aspects of physical activity.
    Clinical Psychological Science. 01/2013; 1(1):67-74.
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    ABSTRACT: In the present study precursors (risk behavior, parental self-efficacy and parental awareness) of parental worries about their child’s behavior during adolescence (12–16 years) were examined. To this end, a new measure of parental worries about the child’s involvement in risk behavior is developed. Second, the effect of parental worries on adolescents’ alcohol use was tested and third whether ineffective alcohol-specific parenting mediated this effect. Longitudinal data including four waves from 703 parent–adolescent (M age = 12.2 years, SD = 0.5) dyads were used to conduct latent path and growth analysis in Mplus. Results showed that parental awareness, confidence in the effectiveness of their parenting practices and adolescent risk behavior at age 12 related to higher levels of worries in parents. Furthermore, more parental worries predicted an increase in adolescents’ drinking (slope), yet worries did not predict the amount of drinking at age 12 (intercept). In addition, parental worries predicted less restrictive rule setting and a lower quality of communication. This ineffective parenting accounted for the effect of parental worries on adolescent alcohol use. In conclusion, this study demonstrated that worries about risk behavior of their child uniquely contribute to higher drinking rates due to less effective parenting. These findings implicate that alcohol interventions should provide parents with effective leads to tackle the drinking behavior in their children (e.g. strict rules about alcohol).
    Cognitive Therapy and Research 01/2013; · 1.70 Impact Factor
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    ABSTRACT: Previous research has provided considerable support for idea that increased parental support and control are strong determinants of lower prevalence levels of adolescent risk behavior. Much less is known on the association between specific parenting practices, such as concrete rules with respect to smoking and drinking and adolescent risk behavior. The present paper examined whether such concrete parental rules (1) have an effect on the targeted behaviors and (2) predict other, frequently co-occurring, risk behaviors (i.e., cannabis use and early sexual intercourse). These hypotheses were tested in a nationally representative sample of 12- to 16-year-old adolescents in the Netherlands. We found that both types of rules were associated with a lower prevalence of the targeted behaviors (i.e., smoking and drinking). In addition, independent of adolescent smoking and drinking behaviors, parental rules on smoking predicted a lower prevalence of cannabis use and early sexual intercourse, and parental rules on alcohol use also predicted a lower prevalence of early sexual intercourse. This study showed that concrete parental rule setting is more strongly related to lower levels of risk behaviors in adolescents compared to the more general parenting practices (i.e., support and control). Additionally, the effects of such rules do not only apply to the targeted behavior but extend to related behaviors as well. These findings are relevant to the public health domain and suggest that a single intervention program that addresses a limited number of concrete parenting practices, in combination with traditional support and control practices, may be effective in reducing risk behaviors in adolescence.
    Prevention Science 09/2012; · 2.63 Impact Factor
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    ABSTRACT: BACKGROUND: To compare the strength of the association between peer victimization at school and subjective health according to the disability or chronic illness (D/CI) status of students across countries. METHODS: This study used data from 55 030 students aged 11, 13 and 15 years from 11 countries participating in the 2005-06 Health Behaviour in School-aged Children survey. Self-completed questionnaires were administered in classrooms. Multivariate models of logistic regression (controlled for confounding factors and countries) were used to investigate differences in the association between peer victimization and poor subjective health according to the D/CI status. RESULTS: Overall, 13.5% of the students reported having been bullied at least two or three times a month. The percentage of victims was significantly higher among those reporting D/CI than among others in all countries studied. Victims of bullying were more likely to report poor self-rated health, low life satisfaction and multiple health complaints. However, there were no differences in the associations between peer victimization and subjective health indicators according to the D/CI status. CONCLUSIONS: In all countries studied, students reporting D/CI were more likely to report being victims of bullying. Victims of bullying reported more negative subjective health outcomes regardless of their D/CI status. Although inclusive education is currently a major topic of educational policies in most countries, additional efforts should be made to improve the quality of the integration of students with D/CI.
    The European Journal of Public Health 08/2012; · 2.52 Impact Factor
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    ABSTRACT: This study examines the social determinants of psychosomatic complaints in young adolescents. Using data from the Health Behaviour in School-aged Children (HBSC) study, psychosomatic complaints are studied in 98,773 adolescents (11- and 13-year-olds; 48% 11-year-olds, 52% 13-year-olds; 52% females, 48% males) from 34 European countries. Individual-level determinants, including family-, peer- and school-related factors as well as country-level determinants (Human Development Index [HDI]) are considered. In line with existing evidence, results revealed more psychosomatic complaints in young adolescents experiencing stress inducing familial-, peer- and school-related factors. Negative effects of poor friendships, negative class climate, school pressure, and high media use were more pronounced for girls. After controlling for these factors, a higher HDI was related to a lower risk for psychosomatic complaints. Gender-specific intervention programs should aim at improving the quality of relationships, especially among peers, to prevent psychosomatic complaints among young adolescents.
    The Journal of Early Adolescence 02/2012; 36:126-158. · 2.30 Impact Factor
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    ABSTRACT: Depression in adolescence is associated with long-term adverse consequences. The aim of the present study is to identify target groups at increased risk of developing depression in early adolescence, such that prevention is associated with the largest health benefit at population-level for the least effort. The analyses were conducted on data of the first (age range 10-12) and fourth (age range 17-20) wave of a population-based cohort study (N=1538). The Composite International Diagnostic Interview (CIDI) was used to assess onset of major depression in early adolescence. High-risk groups were identified using exposure rate, incidence rate and population attributable fraction. Prevention of depression onset in early adolescence is best targeted at children with one of the following risk profiles: a high body mass index in combination with (1) maternal depression (2) female gender, and (3) parental emotional rejection. Age of onset of depression was assessed retrospectively. Only a few risk indicators are needed to identify a relatively small group which accounts for a substantial percentage of the new cases of depression in early adolescence.
    Journal of affective disorders 02/2012; 138(3):287-94. · 3.76 Impact Factor
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    ABSTRACT: In deze studie is het middelengebruik van jongeren in de residentiële jeugdzorg en in het voortgezet speciaal onderwijs onderzocht. Het dagelijks gebruik van sigaretten, drinken van alcohol en ooit gebruik van cannabis en harddrugs van 531 jongeren in de residentiële jeugdzorg, 603 scholieren in de Rec-4 scholen van het voortgezet speciaal onderwijs, 916 scholieren in het praktijkonderwijs en 989 scholieren in het leerwegondersteunend onderwijs, is vergeleken met het gebruik in het regulier onderwijs (VMBO: 3792 scholieren, HAVO/VWO: 3154 scholieren). Resultaten laten zien dat het middelengebruik met name hoog is in de residentiële jeugdzorg en in het Rec-4. Zo is in de jeugdzorg 22% en in het Rec-4 16% van de 12-13 jarigen een dagelijks roker in vergelijking tot 2% in het VMBO. Achtergrondkenmerken (leeftijd, geslacht, etnische achtergrond en huwelijkse status ouders) verklaarden slechts gedeeltelijk verschillen in middelengebruik. De resultaten van deze studie hebben belangrijke implicaties voor het gezondheidsbeleid in de residentiële jeugdzorg en het speciaal onderwijs.
    Tijdschrift voor gezondheidswetenschappen. 02/2012; 90(5).
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    ABSTRACT: This study examines the social determinants of psychosomatic complaints in young adolescents. Using data from the Health Behaviour in School-aged Children (HBSC) study, psychosomatic complaints are studied in 98,773 adolescents (11- and 13-year-olds; 48% 11-year-olds, 52% 13-year-olds; 52% females, 48% males) from 34 European countries. Individual-level determinants, including family-, peer- and school-related factors as well as country-level determinants (Human Development Index [HDI]) are considered. In line with existing evidence, results revealed more psychosomatic complaints in young adolescents experiencing stress inducing familial-, peer- and school-related factors. Negative effects of poor friendships, negative class climate, school pressure, and high media use were more pronounced for girls. After controlling for these factors, a higher HDI was related to a lower risk for psychosomatic complaints. Gender-specific intervention programs should aim at improving the quality of relationships, especially among peers, to prevent psychosomatic complaints among young adolescents.
    The Journal of Early Adolescence 01/2012; 32(1):126-158. · 2.30 Impact Factor
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    ABSTRACT: Injury is a leading cause of mortality and morbidity among adolescents in developed countries. Jessor and Jessor’s Problem Behavior Theory suggests an association between risk behaviors (e.g., smoking, drunkenness, cannabis use, and sexual intercourse) and adolescent injury. The present study examined whether early engagement in risk behaviors would predict injury at age 15. It also examined whether such associations were consistent in strength across countries. Based on the data from the 2005-2006 Health Behaviour in School-aged Children (HBSC) survey, a multigroup logistic regression analysis was conducted. Our findings demonstrate a cross-national consistent association (with relative odds of injury rising to 1.85; 95% CI: 1.70-2.02). Based on the study findings, early engagement in risk behaviors was considered a marker for a trajectory that places adolescents at higher risk for physical injury, independent of their national context.
    The Journal of Early Adolescence 01/2012; 32(1):104-125. · 2.30 Impact Factor
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    ABSTRACT: Much is unclear about the association between attention-deficit/hyperactivity disorder (ADHD) and alcohol use (disorder). Research on this subject is hindered by the role of conduct disorder (CD). We investigate whether (1) childhood ADHD is associated with higher prevalence and earlier onset of alcohol initiation, regular alcohol use and alcohol use disorder (AUD) (2) CD mediates or modifies this association. Data were derived from the baseline assessment of the Netherlands Mental Health Survey and Incidence Study-2, a general population study. ADHD and CD were assessed among respondents aged 18-44 (n=3309). ADHD, CD, and alcohol use (disorder) were assessed using the Composite International Diagnostic Interview 3.0. Lifetime prevalence was 2.9% for ADHD, 5.6% for CD, 94.3% for alcohol initiation, 85.7% for regular alcohol use and 19.0% for AUD; mean ages of onset were 6.7, 11.5, 14.8, 16.7 and 19.2 years, respectively. After correction for gender and age, ADHD was associated with a higher prevalence of all three stages of alcohol use, but not with earlier onset of these stages. The association between ADHD and prevalence of AUD was fully explained by a mediating role of CD. CD did not modify the associations between ADHD and prevalence and onset of alcohol use (disorder). The mediating role of CD in the association between ADHD and AUD suggests a developmental pathway from ADHD to CD and subsequent AUD. Early interventions in children with ADHD may prevent CD and subsequent onset of AUD.
    Drug and alcohol dependence 11/2011; 123(1-3):115-21. · 3.60 Impact Factor
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    ABSTRACT: Adolescence is a critical period where many patterns of health and health behaviour are formed. The objective of this study was to investigate cross-national variation in the relationship between family affluence and adolescent life satisfaction, and the impact of national income and income inequality on this relationship. Data from the 2006 Health Behaviour in School-aged Children: WHO collaborative Study (N = 58,352 across 35 countries) were analysed using multilevel linear and logistic regression analyses for outcome measures life satisfaction score and binary high/low life satisfaction. National income and income inequality were associated with aggregated life satisfaction score and prevalence of high life satisfaction. Within-country socioeconomic inequalities in life satisfaction existed even after adjustment for family structure. This relationship was curvilinear and varied cross-nationally. Socioeconomic inequalities were greatest in poor countries and in countries with unequal income distribution. GDP (PPP US$) and Gini did not explain between country variance in socioeconomic inequalities in life satisfaction. The existence of, and variation in, within-country socioeconomic inequalities in adolescent life satisfaction highlights the importance of identifying and addressing mediating factors during this life stage.
    Social Indicators Research 11/2011; 104(2):179-194. · 1.26 Impact Factor
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    ABSTRACT: In the Netherlands, youths of Moroccan origin account for a disproportionately large percentage of the population in juvenile justice institutions. Previous research showed that Moroccan adolescents in pre-trial arrest are characterized by less serious offending behavior (i.e., primarily property-based) and lower levels of mental health problems than native Dutch adolescents in pre-trial arrest. To date, little is known about the parent-child relationship of these adolescents. This study examines the mother-son relationships of Moroccan and native Dutch delinquent adolescents and their association with adolescent delinquency. In the present study, differences in the mother-son relationship characteristics between families of incarcerated (N = 129) and non-incarcerated (N = 324) adolescents were examined, and it was analyzed if these differences between incarcerated and non-incarcerated adolescents were the same for Moroccans and native Dutch. Data collection for the incarcerated sample took place from 2006 to 2008. Comparison data were used of interviews conducted with mothers originating from former larger studies in the general Dutch population. Latent Class Analysis was performed in order to identify types of mother-son relationship. Logistic regression analyses were used to identify the relationships between mother-son relationship types, incarceration and ethnicity. A three class model of mother-son relationship types was found: a low-conflict mother-son relationship type, a high-conflict mother-son relationship type, and a neglectful mother-son relationship type. Compared to the native Dutch adolescents, Moroccans (both in the incarcerated and non-incarcerated population) more often showed a neglectful mother-son relationship type. For Moroccans, no differences in mother-son relationship types were found between the incarcerated and non-incarcerated adolescents, whereas considerable differences occurred between the native Dutch incarcerated and non-incarcerated adolescents. Our findings indicate that mother-son relationship types of incarcerated Moroccan adolescents and non-incarcerated Moroccan adolescents are rather comparable. These findings are in line with previous studies which revealed the less problematic profile of Moroccan adolescents in pre-trial arrest in the Netherlands compared to native Dutch adolescents in pre-trial arrest.
    Child and Adolescent Psychiatry and Mental Health 06/2011; 5:23.
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    ABSTRACT: This study examined substance use rates and related background factors among adolescents in special education (SE) and in residential youth care institutions (RYC). Information on substance use from 531 adolescents in RYC, 603 adolescents in SE for students with behavioral problems (SEB) and 1,905 adolescents in SE for students with learning disabilities (SEL) was compared with information from 7,041 adolescents who attended mainstream education. Results show that substance use rates are particularly high among adolescents in RYC and in SEB. For example, 22% of the 12-13 years old in RYC and 16% in SEB was a daily smoker compared with 1% of their counterparts in mainstream education. Background factors, including age, ethnic background and family situation, partly explained the differences in substance use between mainstream education on the one hand and SE and RYC on the other hand, but differences between the groups remained substantial and significant. Several interaction effects were found in the relation between SE/RYC and substance use that were all in line with the risk paradox: some subgroups that are normally at lower risk for problem behavior are at higher risk when they are subjected to high-risk indicators. The elevated risk of substance use among adolescents in RYC/SE was in some cases particularly marked for those who would normally be at lower risk for substance use (girls in SEB for heavy alcohol drinking and cannabis use, ethnic minority adolescents and adolescents with a stable family situation in RYC for respectively heavy weekly alcohol drinking and daily use of tobacco). Results of this study have important implications for health education and intervention programs for adolescents in RYC and SE.
    European Child & Adolescent Psychiatry 06/2011; 20(6):311-9. · 3.70 Impact Factor

Publication Stats

3k Citations
298.56 Total Impact Points

Institutions

  • 2006–2014
    • Universiteit Utrecht
      • • Department of Interdisciplinary Social Science
      • • Faculty of Social and Behavioural Sciences
      • • Division of Clinical and Health Psychology
      Utrecht, Utrecht, Netherlands
  • 2004–2013
    • The Netherlands Institute for Addiction Healthcare
      Arnheim, Gelderland, Netherlands
    • Netherlands Institute for Space Research, Utrecht
      Utrecht, Utrecht, Netherlands
  • 2006–2011
    • Leiden University
      Leyden, South Holland, Netherlands
  • 2009
    • National Institutes of Health
      • Branch of Prevention Research (PR)
      Bethesda, MD, United States
  • 2001–2009
    • Maastricht University
      • MHeNS School for Mental Health and Neuroscience
      Maestricht, Limburg, Netherlands
  • 2007
    • University of Ulster
      • School of Psychology
      Belfast, NIR, United Kingdom
  • 2002–2007
    • Trimbos-instituut
      Utrecht, Utrecht, Netherlands
  • 2005
    • VU University Amsterdam
      Amsterdamo, North Holland, Netherlands
  • 2002–2004
    • University of Groningen
      • Department of Psychiatry
      Groningen, Province of Groningen, Netherlands