Saskia van Dorsselaer

The Netherlands Institute for Addiction Healthcare, Arnheim, Gelderland, Netherlands

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Publications (67)116.74 Total impact

  • Margreet Ten Have, Saskia van Dorsselaer, Ron de Graaf
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    ABSTRACT: This study examines the association of work and health-related characteristics with the intention to continue working after the age of 65 years. Data were from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative population survey, including 1854 employees aged 45-64 years; 29.0% reported the intention to continue working after 65 years. Lower education, more adverse psychosocial working conditions and any physical disorder were negatively associated with this intention. Mental disorders were not associated. These findings highlight the importance of favourable working conditions and good physical health in relation to employees' intention to continue working after 65 years.
    European journal of public health. 11/2014;
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    ABSTRACT: Background. Meta-analyses link childhood trauma to depression, mania, anxiety disorders, and psychosis. It is unclear, however, whether these outcomes truly represent distinct disorders following childhood trauma, or that childhood trauma is associated with admixtures of affective, psychotic, anxiety and manic psychopathology throughout life. Method. We used data from a representative general population sample (NEMESIS-2, n = 6646), of whom respectively 1577 and 1120 had a lifetime diagnosis of mood or anxiety disorder, as well as from a sample of patients with a diagnosis of schizophrenia (GROUP, n = 825). Multinomial logistic regression was used to assess whether childhood trauma was more strongly associated with isolated affective/psychotic/anxiety/manic symptoms than with their admixture. Results. In NEMESIS-2, largely comparable associations were found between childhood trauma and depression, mania, anxiety and psychosis. However, childhood trauma was considerably more strongly associated with their lifetime admixture. These results were confirmed in the patient samples, in which it was consistently found that patients with a history of childhood trauma were more likely to have a combination of multiple symptom domains compared to their non-traumatized counterparts. This pattern was also found in exposed individuals who did not meet criteria for a psychotic, affective or anxiety disorder and who did not seek help for subclinical psychopathology. Conclusions. Childhood trauma increases the likelihood of a specific admixture of affective, anxiety and psychotic symptoms cutting across traditional diagnostic boundaries, and this admixture may already be present in the earliest stages of psychopathology. These findings may have significant aetiological, pathophysiological, diagnostic and clinical repercussions.
    Psychological medicine. 10/2014;
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    ABSTRACT: To examine the association between baseline functional status and any emotional disorder at follow-up, after controlling for potential confounders. The effect modification of previous mental disorders and physical conditions was assessed.
    Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. 09/2014;
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    ABSTRACT: There is increasing interest on whether the current global economic uncertainties have an influence on the population's mental health. In this paper, we examined the association of negative socioeconomic changes, job loss and household income reductions with incident mental disorders. The moderating effect of gender was assessed.
    Journal of Epidemiology &amp Community Health 09/2014; · 3.39 Impact Factor
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    ABSTRACT: Despite evidence of the increased risk of psychotic disorders among ethnic minority adults, little is known about the effect of ethnic minority status to mild psychotic experiences among adolescents. This study investigated mild psychotic experiences in ethnic minority and majority adolescents in a Dutch representative general population sample, and tested the ethnic density effect in the classroom.
    Social Psychiatry and Psychiatric Epidemiology 08/2014; · 2.86 Impact Factor
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    ABSTRACT: Background: Different psychological models of trauma-induced psychosis have been postulated, often based on the observation of "specific" associations between particular types of childhood trauma (CT) and particular psychotic symptoms or the co-occurrence of delusions and hallucinations. However, the actual specificity of these associations remains to be tested. Methods: In 2 population-based studies with comparable methodology (Netherlands Mental Health Survey and Incidence Study-1 [NEMESIS-1] and NEMESIS-2, N = 13 722), trained interviewers assessed CT, psychotic symptoms, and other psychopathology. Specificity of associations was assessed with mixed-effects regression models with multiple outcomes, a statistical method suitable to examine specificity of associations in case of multiple correlated outcomes. Results: Associations with CT were strong and significant across the entire range of psychotic symptoms, without evidence for specificity in the relationship between particular trauma variables and particular psychotic experiences (PEs). Abuse and neglect were both associated with PEs (ORabuse: 2.12, P < .001; ORneglect: 1.96, P < .001), with no large or significant difference in effect size. Intention-to-harm experiences showed stronger associations with psychosis than CT without intent (χ(2) = 58.62, P < .001). Most trauma variables increased the likelihood of co-occurrence of delusions and hallucinations rather than either symptom in isolation. Discussion: Intention to harm is the key component linking childhood traumatic experiences to psychosis, most likely characterized by co-occurrence of hallucinations and delusions, indicating buildup of psychotic intensification, rather than specific psychotic symptoms in isolation. No evidence was found to support psychological theories regarding specific associations between particular types of CT and particular psychotic symptoms.
    Schizophrenia Bulletin 03/2014; 40 Suppl 2:S123-30. · 8.80 Impact Factor
  • M Tuithof, M Ten Have, S van Dorsselaer, R de Graaf
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    ABSTRACT: background Little is known about the prevalence and the consequences of attention-deficit hyperactivity disorder (ADHD) among adults in the general Dutch population. aim To ascertain the prevalence of ADHD in childhood and adulthood, to investigate characteristics associated with the prevalence and persistency of adhd and to draw a number of comparisons: to compare the functioning of adults with ADHD with that of people with a different mental disorder and to compare the extent to which these groups make use of treatment facilities. method Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), in which the occurrence of adhd was determined in a representative sample of the Dutch population (n = 3,309; aged 18-44). results 2.9% of the respondents had had ADHD in childhood, 70.0% of them still had the disorder in adulthood. An anxiety disorder before the age of 16 increased the risk of adhd persistency, whereas an impulse-control disorder decreased this risk. ADHD in adulthood was associated with lower socio-economic status, mental disorders, poor functioning and increased use of treatment facilities. ADHD adults and adults with an anxiety or substance use disorder showed very similar functional limitations and used treatment facilities to approximately the same extent. conclusion More than two-thirds of the adults who had had childhood adhd still had the disorder in adulthood. The consequences of this in terms of functioning and use of treatment facilities are substantial.
    Tijdschrift voor psychiatrie 01/2014; 56(1):10-19.
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    ABSTRACT: Objective Based on theoretical considerations and animal studies, mediation of ‘social defeat’ (SD) in the association between childhood trauma (CT) and psychosis was investigated. Method Trained interviewers administered a structured interview assessing CT, psychotic experiences and other psychopathology in 6646 participants in the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2). ResultsChildhood trauma was associated with psychotic experiences making up the extended psychosis phenotype (EPP), as well as with a diagnosis of psychotic disorder (PD). Similarly, CT was associated with a priori selected items indexing SD (discouraged, hopeless, worthless, loss of self-confidence, low self-esteem, better off dead, suicidal thoughts) and with a measure of affective dysregulation (AD), which in turn were also associated with psychosis. While SD and AD individually acted as mediators in the association between CT and EPP, only SD acted as a mediator in the association between CT and PD. Cannabis use did not mediate the association between CT and EPP or PD. Conclusion The present results suggest a developmental model implicating SD as an important mediator in the link between childhood adverse experiences and later development of psychotic experiences. The combined mediation by SD and AD is compatible with an ‘affective pathway’ to early psychosis.
    Acta Psychiatrica Scandinavica 11/2013; · 4.86 Impact Factor
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    M Ten Have, R de Graaf, J van Weeghel, S van Dorsselaer
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    ABSTRACT: Few studies have been published on the association between mental disorders and violence based on general population studies. Here we focus on different types of violence, adjusting for violent victimization and taking account of the limitations of previous population studies. Data were used from the first two waves of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face survey of the general population aged 18-64 years (n = 6646). Violence was differentiated into physical and psychological violence against intimate partner(s), children or any person(s) in general. DSM-IV diagnoses were assessed with the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0). Psychological violence occurs considerably more frequently than physical violence, but both showed almost identical associations with mental disorders. After adjustment for sociodemographic characteristics, most of the main categories of common mental disorders were associated with violence. The strongest associations were found for externalizing disorders (substance use, impulse-control, antisocial personality disorder). After additional adjustment for violent victimization, negative life events and social support, most diagnostic correlates lost their significance whereas substance use (in particular alcohol) disorders were still associated with most types of violence. The increased risk of violent offending among people with common mental disorders, other than substance use disorders, can be attributed to factors other than their mental illness.
    Psychological Medicine 09/2013; · 5.59 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: OBJECTIVE This study examined lifetime treatment contact and delays in treatment seeking, including rates for receipt of helpful treatment, after the onset of specific mental disorders and evaluated factors that predicted treatment seeking and delays in treatment seeking. METHODS Data were from the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative, face-to-face survey of the general population aged 18-64 (N=6,646). DSM-IV diagnoses, treatment contact, and respondents' perception of treatment helpfulness were assessed with the Composite International Diagnostic Interview 3.0. RESULTS The proportion of respondents with lifetime mental disorders who made lifetime treatment contact ranged from 6.5% to 56.5% for substance use disorders and from 75.3% to 91.4% for mood disorders. Delays in initial treatment contact varied among persons with mood disorders (median=0 years), substance use disorders (0-4 years), impulse-control disorders (4-8 years), and anxiety disorders (0-19 years). The proportion of respondents who received helpful treatment ranged from 33.5% for substance use disorders to 69.5% for mood disorders. Men, older cohorts, and respondents with younger age at onset of the disorder generally were more likely to have no lifetime treatment contact, to have longer treatment delay, and to have not received helpful treatment. CONCLUSIONS There was substantial variation in lifetime treatment contact and delays in initial treatment contact by mental disorder. Lifetime treatment contact, delays in treatment seeking, and receipt of helpful treatment did not vary by educational level.
    Psychiatric services (Washington, D.C.) 07/2013; · 2.81 Impact Factor
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    ABSTRACT: In prospective psychiatric epidemiological studies, attrition at follow-up can be selective, and can bias the research findings. Therefore, knowledge of predictors of attrition and of its different types (noncontact, refusal, inability to participate) is of importance. By means of (multinomial) logistic regression analyses, predictors of attrition were studied in the first 3-year follow-up of the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2), a prospective psychiatric epidemiological study among 6646 subjects of the general population aged 18-64years. Baseline sociodemographic characteristics, physical health, mental disorders and their clinical characteristics, and experience with the previous interview were studied as predictors of attrition and of its different types. The attrition rate at follow-up was 20.2%. Refusal (14.2%) was more common than noncontact (4.6%) and inability to participate (1.4%). Compared to respondents, nonrespondents were more often younger, lower educated, unemployed and born outside the Netherlands. A less positive experience with the baseline interview and shorter interview duration also predicted attrition. Any 12-month mental disorder, the categories and separate mental disorders, and their clinical characteristics, were not significantly associated with attrition, after controlling for sociodemographics. Sociodemographic predictors and experience with the baseline interview differed between the three types of attrition, but these types were also hardly or not associated with previous mental disorders. The authors conclude that bias due to selective attrition was limited to sociodemographics and experience with the baseline interview. Mental health status at baseline was not of influence, possibly due to the large time investment to persuade respondents to re-participate and to find them in case of noncontact or removal to an unknown address. During follow-up waves of future prospective studies it is important to implement an intensive recruitment period with special efforts among young adults and the lower educated.
    Comprehensive psychiatry 06/2013; · 2.08 Impact Factor
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    ABSTRACT: BACKGROUND: Ethnic minority position is associated with increased risk for psychotic outcomes, which may be mediated by experiences of social exclusion, defeat and discrimination. Sexual minorities are subject to similar stressors. The aim of this study is to examine whether sexual minorities are at increased risk for psychotic symptoms and to explore mediating pathways. Method A cross-sectional survey was performed assessing cumulative incidence of psychotic symptoms with the Composite International Diagnostic Interview in two separate random general population samples (NEMESIS-1 and NEMESIS-2). Participants were sexually active and aged 18���64 years (n��=��5927, n��=��5308). Being lesbian, gay or bisexual (LGB) was defined as having sexual relations with at least one same-sex partner during the past year. Lifetime experience of any psychotic symptom was analysed using logistic regression, adjusted for gender, educational level, urbanicity, foreign-born parents, living without a partner, cannabis use and other drug use. RESULTS: The rate of any psychotic symptom was elevated in the LGB population as compared with the heterosexual population both in NEMESIS-1 [odds ratio (OR) 2.56, 95% confidence interval (CI) 1.71���3.84] and NEMESIS-2 (OR 2.30, 95% CI 1.42���3.71). Childhood trauma, bullying and experience of discrimination partly mediated the association. CONCLUSIONS: The finding that LGB orientation is associated with psychotic symptoms adds to the growing body of literature linking minority status with psychosis and other mental health problems, and suggests that exposure to minority stress represents an important mechanism.
    Psychological Medicine 05/2013; · 5.59 Impact Factor
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    ABSTRACT: BACKGROUND: Prospective studies measuring first-incidence of DSM-IV mood, anxiety and substance use disorders in the general population are rare. We assessed these incidence rates in the Dutch population; and identified baseline sociodemographic, physical and psychopathological variables, and negative changes in sociodemographics and physical health between baseline and follow-up, as determinants of first-onset main categories of disorders. METHOD: Data are from NEMESIS-2, a representative face-to-face survey including 5303 subjects aged 18-64 interviewed twice (2007-2009; 2010-2012) with the CIDI3.0. RESULTS: In three years, 8.86% of adults without prior psychopathology experienced any mental disorder, corresponding with 3.09 cases per 100 person-years. Incidence was highest for anxiety (1.69 per 100 person-years) and mood disorder (1.65), and lowest for substance use disorder (0.97). For the separate disorders, incidence was highest for major depression (1.58), specific phobia (0.79) and alcohol abuse (0.73). For mood and anxiety disorder, incidence rate was higher among women and for substance use disorder it was higher among men. Age was inversely related to all disorder categories. Changes in sociodemographics, like no longer living with a partner and decrease in income, were stronger determinants than the corresponding sociodemographics. Incident mood disorder was predicted by baseline anxiety and substance use disorder, incident anxiety disorder by mood and substance use disorder, and incident substance use disorder by adultADHD. LIMITATIONS: Validity of lifetime diagnoses can be questioned because of difficulty of accurate recall. Only determinants of categories of disorders were studied, due to low numbers of incident cases of most separate disorders. CONCLUSION: First-onset of mental disorders in a 3-year period is not an uncommon phenomenon. Results about determinants of incident disorders are important for prevention and early intervention initiatives aimed at reducing burden of mental disorders.
    Journal of Affective Disorders 02/2013; · 3.76 Impact Factor
  • Margreet Ten Have, Saskia van Dorsselaer, Ron de Graaf
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    ABSTRACT: BACKGROUND: To report lifetime prevalences of suicidal ideation, plans and attempts, as well as risk factors for first onset suicidal behaviours and for the transition from ideation to first onset plan or attempt. METHODS: Data were used from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative survey among the general population aged 18-64 years (N=6646; response rate=65.1%). Face-to-face interviews were administered between November 2007 and July 2009. Suicidal behaviours and DSM-IV mental disorders were assessed using the Composite International Diagnostic Interview 3.0. RESULTS: The lifetime prevalence of suicidal ideation, plan and attempt was 8.3%, 3.0% and 2.2%, respectively. Among ideators, the probability of ever making an attempt was 26.8%. 76.5% of transitions from ideation to attempt occurred within the first year after ideation onset. Risk factors for suicidal behaviours included being female, younger, less educated, having had childhood trauma and a prior mental disorder. The strongest risk factors for the transition from ideation to first onset attempt were characteristics of prior suicidal behaviours, such as an early age of ideation onset and prior plans. LIMITATIONS: Data were based on retrospective self-reports of mental disorders and suicidal behaviours. CONCLUSIONS: It is important that health professionals verify suicide plans of their patients with suicidal ideas. They should also discuss the way their patients deal with problems and the kind of help they need, because a substantial proportion of (first) attempts was not intended to kill oneself. Preventive measures are best offered within the first year after ideation onset.
    Journal of Affective Disorders 11/2012; · 3.76 Impact Factor
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    ABSTRACT: To estimate work loss days due to absenteeism and presenteeism associated with commonly occurring mental and physical disorders. In a nationally representative face-to-face survey (Netherlands Mental Health Survey and Incidence Study-2) including 4,715 workers, the presence of 13 mental and 10 chronic physical disorders was assessed using the Composite International Diagnostic Interview 3.0 and a physical disorder checklist. Questions about absent days due to illness and days of reduced quantitative and qualitative functioning while at work were based on the WHO Disability Assessment Schedule. Total work loss days were defined as the sum of the days of these three types of loss, where days of reduced functioning were counted as half. Both individual and population-level effects of disorders on work loss were studied, taking comorbidity into account. Any mental disorder was associated with 10.5 additional absent days, 8.0 days of reduced-qualitative functioning and 12.0 total work loss days. For any physical disorder, the number of days was 10.7, 3.5 and 11.3, respectively. Adjusted for comorbidity, drug abuse, bipolar disorder, major depression, digestive disorders and panic disorder were associated with the highest number of additional total work loss days. At population-level, major depression, chronic back pain, respiratory disorders, drug abuse and digestive disorders contributed the most. Annual total work loss costs per million workers were estimated at 360 million for any mental disorder; and 706 million for any physical disorder. Policies designed to lessen the impact of commonly occurring disorders on workers will contribute to a reduction in absenteeism and presenteeism. As the indirect costs of (mental) disorders are much higher than their medical costs, prevention and treatment of these conditions may be cost-effective.
    Social Psychiatry 03/2012; 47(11):1873-83. · 2.05 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).
  • R de Graaf, M Ten Have, C van Gool, S van Dorsselaer
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    ABSTRACT: Little is known about the prevalence and trends of mental disorders in the Dutch population. To present the prevalences of lifetime and 12-month DSM-IV mood disorders, anxiety disorders, and substance use disorders and impulse-control disorders reported in NEMESIS-2 (Netherlands Mental Health Survey and Incidence Study), and to compare the 12-month prevalence of mood disorders, anxiety disorders and substance use disorders with estimates from the first study (NEMESIS-1). Between November 2007 and July 2009, face-to-face interviews were conducted among 6646 subjects aged 18-64 by means of the Composite International Diagnostic Interview 3.0. Trends in mental disorders were examined with these data and NEMESIS-1 data from 1996 (n = 7076). The lifetime prevalence in NEMESIS-2 was 20.2% for mood disorder, 19.6% for anxiety disorder, 19.1% for substance use disorder and 9.2% for impulse-control or behaviour disorder. For the 12-month disorders, the prevalences were 6.1%, 10.1%, 5.6% and 2.1%, respectively. Between 1996 and 2007-2009, there was no change in the 12-month prevalence of anxiety disorder and substance use disorder. The 12-month prevalence of mood disorder decreased slightly but was no longer significant after differences in the sociodemographic variables between the two studies had been taken into account. This study shows that in the Netherlands mental disorders occur fairly frequently. Over about a decade, no clear change was found in the mental health status of the population.
    Tijdschrift voor psychiatrie 01/2012; 54(1):27-38.
  • Ron de Graaf, Margreet Ten Have, Saskia van Dorsselaer
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    ABSTRACT: The longitudinal epidemiological population study NEMESIS-2 (Netherlands Mental Health Survey and Incidence Study-2) replicates the first study conducted from 1996 to 1999, and expands it by adding new subjects such as impulse-control disorders. To describe the aims and design of nemesis -2, particularly of its first round of measurements, to provide up-to-date figures on prevalence, incidence, course and consequences of mental disorders and associated factors, and to study trends in the mental health of the population aged 18-64 years and the use these people make of psychiatric services. Face-to-face interviews were conducted (November 2007-July 2009) by means of the Composite International Diagnostic Interview 3.0. The response was 65.1% (n = 6646). Respondents were reasonably representative for the population, but young persons were somewhat underrepresented. Two follow-up rounds of measurements are planned with three-year intervals between the rounds. The second round of measurements began in November 2010. A qualitatively good dataset was built up. This will allow several mental health topics to be studied in the future.
    Tijdschrift voor psychiatrie 01/2012; 54(1):17-26.
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    ABSTRACT: Rates of self-reported psychotic experiences (SRPEs) in general population samples are high; however the reliability against interview-based assessments and the clinical significance of false-positive (FP) ratings remain unclear. Design: The second Netherlands Mental Health Survey and Incidence Study-2, a general population study. Trained lay interviewers administered a structured interview assessing psychopathology and psychosocial characteristics in 6646 participants. Participants with at least one SRPE (N = 1084) were reassessed by clinical telephone interview. Thirty-six percent of participants with SRPEs were confirmed by clinical interview as true positive (TP). SPREs not confirmed by clinical interview (FP group) generated less help-seeking behavior and occurred less frequently compared with TP experiences (TP group). However, compared with controls without psychotic experiences, the FP group more often displayed mood disorder (relative risk [RR] 1.7, 1.4-2.2), substance use disorder (RR 2.0, 1.6-2.6), cannabis use (RR 1.5, 1.2-1.9), higher levels of neuroticism (RR 1.8, 1.5-2.2), affective dysregulation, and social dysfunction. The FP group also experienced more sexual (RR 2.0, 1.5-2.8) and psychological childhood trauma (RR 2.1, 1.7-2.6) as well as peer victimization (RR 1.5, 1.2-2.0) and recent life events (RR 2.0, 1.6-2.4) than controls without psychotic experiences. Differences between the FP group and the TP group across these domains were much smaller and less conclusive. SRPEs not confirmed by clinical interview may represent the softest expression of an extended psychosis phenotype that is phenotypically continuous with clinical psychosis but discontinuous in need for care.
    Schizophrenia Bulletin 09/2011; 38(2):231-8. · 8.80 Impact Factor

Publication Stats

590 Citations
116.74 Total Impact Points

Institutions

  • 2004–2014
    • The Netherlands Institute for Addiction Healthcare
      Arnheim, Gelderland, Netherlands
  • 2004–2012
    • Trimbos-instituut
      Utrecht, Utrecht, Netherlands
  • 2009
    • Universiteit Utrecht
      • Faculty of Social and Behavioural Sciences
      Utrecht, Provincie Utrecht, Netherlands