Cilia Witteman

Radboud University | RU · Behavioural Science Institute

Background and objectives This study compared the effect of imagery rescripting focusing on self-compassion, imagery rescripting focusing on mastery, and a positive memory control condition on (1) emotional responses towards the memory (one day after), (2) changes in the believability of negative core beliefs, and dysfunctional eating behaviors (on...

Monitoring treatment progress by the use of standardized measures in individual therapy, also called feedback-informed treatment (FIT), has a small but significant effect on improving outcomes. Results of FIT in group therapy settings are mixed, possibly due to contextual factors. The goals of this study were to investigate the feasibility, accepta...

Background This study compared the effect of imagery rescripting (ImRs) of early autobiographical memories to ImRs of intrusive images and a no task control condition on eating disorder (ED) related core beliefs and ED symptoms in individuals at risk of developing an eating disorder. We qualitatively explored the content of ImRs scripts. Method Pa...

Therapists, including group therapists, can systematically gather feedback from patients about how their group members are responding to treatment. However, results of research on using feedback-informed group treatment (FIGT) are mixed, and the underlying mechanisms responsible for positive patient changes remain unclear. Therefore, the present qu...

This study aimed to assess the characteristics and content of intrusive images in patients with eating disorders, and test the relations between intrusive images, core beliefs and autobiographical memories. As an exploratory aim, patients with anorexia nervosa, bulimia nervosa and binge eating disorders were compared on the level of dissociation as...

Introduction: The present study sought a better understanding of the sources of client-perceived quality of the working alliance. Methods: At the end of psychotherapy sessions 3 and 5, 60 outpatient clients completed the Working Alliance Inventory-client form (WAI-c) and the Counselor Rating Form (CRF) measuring perceived therapists’ social power....

Background Despite the adverse impact diagnostic errors can have, clinical interviewing and decision-making in psychiatric practice have received relatively little empirical attention. When diagnosing patients, clinicians tend to fall back on a specific (heuristic) rule of thumb, the positive test strategy, a confirmatory approach that increases th...

We enquired into attitudes towards empirically supported treatments (ESTs), with an online questionnaire completed by 190 German and 400 Dutch therapists. Therapists had different attitudes, ranging from very negative to very positive. Two dimensions could describe these attitudes. A negative one: ESTs are thought to have a negative effect on the p...

Background Proponents of clinical case formulations argue that the causes and mechanisms contributing to and maintaining a patient's problems should be analysed and integrated into a case conceptualization, on which treatment planning ought to be based. Empirical evidence shows that an individualized treatment based on a case formulation is at leas...

Forensic firearm examination provides the court of law with information about the source of fired cartridge cases. We assessed the validity of source decisions of a computer-based method and of 73 firearm examiners who compared breechface and firing pin impressions of 48 comparison sets. We also compared the computer-based method's comparison score...

We argue that knowledge about the rationale for Bayes’ rule and about its proper application is a crucial tool for every clinician. We explain why such probabilistic reasoning is so important. We then acknowledge that the rule is quite abstract and may be difficult to use, and we offer a guideline to overcome this difficulty. We illustrate our text...

The rarity of general fingerprint patterns should be taken into account in the assessment of fingerprint evidence to provide a more complete assessment of fingerprint evidence than when only considering the minutiae. This should be done because, the rarer the corresponding pattern, the stronger the support for the hypothesis that the fingermark ste...

Objective Forensic judgments and their peer review are often the result of human assessment and are thus subjective and prone to bias. This study examined whether bias affects forensic peer review. Hypotheses We hypothesized that the probability of disagreement between two forensic examiners about the proposed conclusion would be higher with “blin...

Forensic firearm examiners compare the features in cartridge cases to provide a judgment addressing the question about their source: do they originate from one and the same or from two different firearms? In this article, the validity and reliability of these judgments is studied and compared to the outcomes of a computer-based method. The features...

The peak-end memory bias has been well documented for the retrospective evaluation of pain. It describes that the retrospective evaluation of pain is largely based on the discomfort experienced at the most intense point (peak) and at the end of the episode. This is notable because it means that longer episodes with a better ending can be remembered...

Objective: This study aims to investigate the effect of an integrated intervention of art activities and Qigong exercise on the well-being of older adults in nursing homes in Indonesia. Method: We employed a randomized controlled trial with 4 specific groups, i.e. art, Qigong, integration of art and Qigong, and control group. A total of 267 partici...

The aim of this study was to examine the characteristics and content of intrusive images in patients with different subtypes of eating disorders (EDs). Data were collected from 74 ED patients, 22 dieting and 29 non-dieting controls. Participants completed a set of self-report questionnaires. Intrusive images of ED patients were significantly more r...

Child welfare and child protection workers regularly make placement decisions in child abuse cases, but how they reach these decisions is not well understood. This study focuses on workers' rationales. The aim was to investigate the kinds of arguments provided in placement decisions and whether these arguments were predictors for the decision, in a...

Alle psychologen hebben in hun opleiding de regel van Bayes geleerd, maar wat was die regel ook alweer? Was dat niet zo’n ingewikkelde formule? Ach ja, dat staat toch ver van de praktijk, kun je denken. Maar pas op, de regel van Bayes heeft juist alles met de praktijk te maken. Door de regel te negeren, kan een behandelaar de plank volkomen misslaa...

Objectives: To improve information for patients and to facilitate a vaccination coverage that is in line with the EU and World Health Organization goals, we aimed to quantify how vaccination and patient characteristics impact on influenza vaccination uptake of elderly people. Methods: An online discrete choice experiment (DCE) was conducted amon...

Visual art activities and physical exercise are both low-intensity and low-cost interventions. The present study aims to comprehensively describe published literature on the effectiveness of a combination of these interventions on well-being or quality of life (QoL) and mood of older adults. Embase, CINAHL, Ovid Medline (R), PsycINFO, and Web of Sc...

Background The LIRIK, an instrument for the assessment of child safety and risk, is designed to improve assessments by guiding professionals through a structured evaluation of relevant signs, risk factors, and protective factors. Objective We aimed to assess the interrater agreement and the predictive validity of professionals’ judgments made with...

Normative causal decision theories argue that people should use their causal knowledge in decision making. Based on these ideas, we argue that causal knowledge and reasoning may support and thereby potentially improve decision making based on expected outcomes, narratives, and even cues. We will summarize findings from empirical research, which ind...

Psychodiagnostische besluitvorming bevat een beschrijving van de moeilijkheden die clinici tegenkomen als zij oordelen en beslissingen nemen in het psychodiagnostisch proces. De theoretische achtergrond van beslissen in situaties als de klinische praktijk wordt beschreven en er wordt uitgelegd dat die situatie uitnodigt heuristieken en intuïtie te...

Objective: Perspective-taking difficulties have been demonstrated in autism and schizophrenia spectrum disorders, among other clinical presentations, and are traditionally examined from a Theory of Mind (ToM) point of view. Relational Frame Theory (RFT) offers a behavioural and contextual interpretation of perspective-taking, proposing that this ab...

This pilot study investigates the feasibility, acceptability and the effectiveness of social art activities for reducing symptoms of depression of Indonesian elderly people who live in a nursing home. Sixteen depressed elderly people with ages ranging from 65 to 85 years old were selected randomly in a nursing home to join 12 sessions of a-90 minut...

Several studies have demonstrated that in the mental health domain, experience does not always lead to better diagnostic decisions, suggesting that in clinical psychology experience-based intuition might actually not improve performance. The aim of the current study was to investigate differences in preferred reasoning styles of novice and experien...

This study investigated sex bias in the classification of borderline and narcissistic personality disorders. A sample of psychologists in training for a post-master degree (N = 180) read brief case histories (male or female version) and made DSM classification. To differentiate sex bias due to sex stereotyping or to base rate variation, we used dif...

Background: This study examines: (1) the prevalence of Non-Suicidal Self-Injury (NSSI) among Dutch and Belgian adolescents, (2) the associations between Big Five personality traits and NSSI engagement/versatility (i.e., number of NSSI methods), and (3) whether these associations are mediated by perceived stress and coping. Methods: A total of 946 F...

When adolescents live with a parent with mental illness, they often partly take over the parental role. Little is known about the consequences of this so-called parentification on the adolescents' internalizing and externalizing problems. This survey study examined this effect cross-sectionally and longitudinally in a sample of 118 adolescents livi...

Child welfare professionals regularly make crucial decisions that have a significant impact on children and their families. The present study presents the Judgments and Decision Processes in Context model (JUDPIC) and uses it to examine the relationships between three independent domains: case characteristic (mother's wish with regard to removal),...

ACHTERGROND Er is behoefte aan duidelijkheid over de aansluiting tussen de generalistische en de specialistische zorg op het gebied van psychiatrische problematiek. Onderzoekwijst uit dat huisartsen depressieve symptomen minder goed herkennen en de ernst ervan vaak onderschatten. Wij onderzochten op welke manier huisartsen en psychiaters tot hun oo...

Background Children of parents with mental illness have an elevated risk of developing a range of mental health and psychosocial problems. Yet many of these children remain mentally healthy. Objective The present study aimed to get insight into factors that protect these children from developing internalizing and externalizing problems. Methods...

We investigated the associations of bullying and victimization with non-suicidal self-injury (NSSI), as well as the mediating role of depressive mood in a sample of 785 adolescents. Further, we explored the moderating role of parental support in these associations. All participants completed questionnaires on bullying, victimization, NSSI, depressi...

This study investigates decision making in mental health care. Specifically, it compares the diagnostic decision outcomes (i.e., the quality of diagnoses) and the diagnostic decision process (i.e., pre-decisional information acquisition patterns) of novice and experienced clinical psychologists. Participants' eye movements were recorded while they...

In this article, the authors report a study into the Dutch probation service about the question whether structured decision making about case management plans does or does not improve the quality of these plans, and subsequently improves the effectiveness of offender supervision. Two samples of nearly 300 case management plans each were compared. I...

Heuristics and biased judgments in clinical diagnostic processes Debiasing strategies In clinical practice a multitude of judgments and decisions are made about, and on behalf of, clients. To be able to do so adequately despite time pressure and other constraints, clinicians rely on heuristics that can potentially result in biased judgments. In a p...

Background Practitioners investigating cases of suspected child maltreatment often disagree whether a child is subject to or at risk of abuse or neglect in the family and, if so, what to do about such abuse or neglect. Structured decision-making is considered to be a solution to the problem of subjective judgments and decisions. Objective This stud...

The child is a major stakeholder in the decision whether to continue placement in foster care or to reunify her or him with the biological family. This study investigated whether Dutch social workers are influenced by the child’s wish in their recommendations about reunification. Data were gathered from 120 child welfare professionals and 120 stude...

In de klinische praktijk wordt veel geoordeeld en beslist over en voor cliënten. Om dat ondanks tijdsdruk te kunnen doen, gebruiken clinici heuristieken, die mogelijk tot vertekeningen leiden. In deze bijdrage beschrijven wij de belangrijkste heuristieken en de consequenties van hun gebruik. In een volgende bijdrage wordt een overzicht gegeven van...

Exploring three perspectives on differences between general practitioners (GP) and psychiatrists in clinical decision making about depressed patients. The gold standard perspective focuses on differences in decisions (output) as a result of lack of expertise, the input perspective relates differences to different information use and to other roles,...

This study presents a cross-sectional examination of the age-related executive changes in a sample of adults with a history of psychiatric illness using the Cambridge Neuropsychological Test Automated Battery. A total of 406 patients, aged 18 to 72 years old, completed executive function tests of working memory, strategic planning, and set shifting...

Reliability in decision making about intervention plans is a necessary condition for evidence-based probation work and equal treatment of offenders. Structuring decision making can improve agreement between clinical decision makers. In a former study however, we found that in Dutch probation practice structured risk and needs assessment did not res...

The present study uses a relational frame approach (Hayes, Barnes-Holmes, and Roche, 2001) to perspective taking for individuals suffering from social anxiety disorder (SAD). Perspective taking is conceptualized as the ability to relate events in accordance with the deictic frames of I-You, Here-There, and Now-Then. We hypothesized that the systema...

Dit boek bevat een leidraad voor het uit­voe­ren van psychodiagnostisch onderzoek in de klinische praktijk. Het geeft inzicht in hoe verschillende stappen in het psy­cho­diag­nos­tisch onderzoeksproces op een goede manier uitgevoerd kunnen worden. Psychodiagnostiek bevat een inleiding over het uitvoeren van psychodiagnostisch onderzoek, met paragra...

In mental health care, clinicians’ treatment decisions are expected to be based on the formulation (i.e., exploration of the causing and maintaining mechanisms) of the client’s problems. Previous research showed two things: clinicians’ case formulations mainly contain descriptive information instead of explanatory information and it is unclear to w...

The present study investigated whether diagnostic anchors, that is: diagnoses suggested in referral letters, influence judgments made by clinical psychologists with different levels of experience. Moderately experienced clinicians (N = 98) and very experienced clinicians (n = 126) were randomly assigned to reading a referral letter suggesting eithe...

Medication adherence for daily preventive asthma medication is especially low during adolescence. In the present study, we aimed to test whether Type D personality (both as a category and with its constituent components (negative affectivity: NA and social inhibition: SI) separately and in interaction) predicts medication adherence of early adolesc...

Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent-child interaction and family environment. This cross-sectional questionnaire...

Background Child welfare professionals regularly make crucial decisions that have a significant impact on children and their families. The present study utilizes the Judgments and Decision Processes in Context model (JUDPIC) to examine the relationships between three independent factors: case characteristic (mother's wish with regard to removal), p...

Gestructureerde besluitvorming wordt beschouwd als een mogelijke oplossing voor de grote subjectiviteit in beoordelingen en beslissingen over kinderen in een (potentieel) onveilige opvoedingssituatie. In deze vignetstudie is onderzocht in hoeverre een werkwijze voor gestructureerde besluitvorming, orba, leidt tot meer overeenstemming tussen medewer...

There is convincing evidence that structuring decision making leads to better decisions. Comparing structured and unstructured professional decisions on a wide variety of topics in medicine, psychology or social welfare, it was found that structured decisions were as good as and often better than unstructured decisions. This can be explained by the...

Introducing instruments to structure risk assessment has been shown to improve agreement between probation professionals about the assessment of offenders’ risks and needs. The subsequent decisions about intervention plans, however, are to a large extent still unstructured. This article addresses the question of whether probation officers agree abo...

The increased use of instruments for assessing risks and needs in probation should lead to intervention plans that meet the criteria for effective practice. An analysis of 300 intervention plans from the Dutch probation service showed that the match between the assessed criminogenic needs and the goals and interventions in the intervention plan is...

ORBA is a method that aims to improve decision making about suspected child maltreatment in Advice and Reporting Centres of Child Abuse and Neglect (ARCCAN). It structures the process of judging and deciding and makes it explicit by distinguishing separate steps, and by identifying the necessary information to consider and the judgments and decisio...

In building Bayesian belief networks, the elicitation of all probabilities required can be a major obstacle. We learned the extent of this often-cited observation in the construction of the probabilistic part of a complex influence diagram in the field of cancer treatment. Based upon our negative experiences with existing methods, we designed a new...

The present study investigated whether individual differences between psychologists in thinking styles are associated with accuracy in diagnostic classification. We asked novice and experienced clinicians to classify two clinical cases of clients with two co-occurring psychological disorders. No significant difference in diagnostic accuracy was fou...

Clinical intuition in mental health care has been written off as a mysterious kind of ability to ‘see through’ clients, something that clinicians who favour evidence-based practice should have nothing to do with. We propose another understanding of clinical intuition. Similar to other types of professional intuition, we take it to refer to automati...

Experienced mental health clinicians often do not outperform novices in diagnostic decision making. In this paper we look for an explanation of this phenomenon by testing differences in memory processes. In two studies we aimed to look at differences in accuracy of diagnoses in relation to free recall of client information between mental health cli...

In two studies, we investigated the role of mood states in dominated behavioral choices. Past research has shown that mood effects on judgment and decision-making can be pervasive. Yet, the role of mood in dominated choices has so far been neglected. The present research represents a first empirical examination of mood effects on dominated choices....

This paper discusses and integrates concepts of causality in psychopathology, clinical assessment, clinical case formulation and the functional analysis. We propose that identifying causal variables, relations and mechanisms in psy-chopathology and clinical assessment can lead to more powerful and efficient in-terventions. Four criteria must be met...

Counseling studies have shown that increasing experience is not always associated with better judgments. However, in such studies performance is assessed against external criteria, which may lack validity. The authors applied the Cochran–Weiss–Shanteau (CWS) index, which assesses the ability to consistently discriminate. Results showed that novice...

Een belangrijke reden om een specifieke interventie te kiezen is de verwachting dat daarmee problemen op effectieve wijze verminderd zullen worden. Wij hebben onderzocht of de mate van effectiviteit die orthopedagogen en psychologen van verschillende interventies verwachten, samenhangt met de verklaringen die zij geven voor de problemen van een kin...

It has been suggested that illness perceptions in mental health are related to treatment outcomes. We aimed to develop a short generic questionnaire to assess clients' problem perceptions in mental health, congruent with the Illness Perception Questionnaire (IPQ) for somatic health. We adapted the IPQ-R (Moss-Morris, R., Weinman, J., Petrie, K.J.,...

Models of the psychodiagnostic process prescribe that clinicians should analyze explanations for their clients’ problems and subsequently use this information to decide upon the most appropriate treatment plan. However, studies of clinical practice suggest that the role of explanations is minimal, and that considering only symptoms gives clinicians...

In mental health care, psychologists assess clients' complaints, analyze underlying problems, and identify causes for these problems, to make treatment decisions. We present a study on psychologists' diagnostic processes, in which a mixed-method approach was employed. We aimed to identify a common structure in the diagnostic processes of different...

THOUGHT PROCESS EFFECTS IN DIAGNOSTIC DECISIONS Background: This study tests the influence of different response modes (direct, after conscious and after unconscious thinking) in clinical decision making. Recently, we published a first demonstration of unconscious thought effects in this domain, specifically in the complex and error-prone task of...

An important reason to choose an intervention to treat psychological problems of clients is the expectation that the intervention will be effective in alleviating the problems. The authors investigated whether clinicians base their ratings of the effectiveness of interventions on models that they construct representing the factors causing and maint...

The present study was designed to systematically explore individual learning abilities by an in depth analysis of the performances of two single participants on the five disk Tower of Hanoi. Verbal protocols were obtained to provide us with a detailed picture of strategy development and learning. Correct and incorrect responses were plotted on a St...

The unconscious thought effect refers to improved judgments and decisions after a period of distraction. The authors studied the unconscious thought effect in a complex and error-prone part of clinical decision making: diagnosis. Their aim was to test whether conscious versus unconscious processing influenced diagnosis of psychiatric cases. They us...

Intuitive-automatic processes are crucial for making judgements and decisions. The fascinating complexity of these processes has attracted many decision researchers, prompting them to start investigating intuition empirically and to develop numerous models. Dual-process models assume a clear distinction between intuitive and deliberate processes bu...

Empirisch ondersteunde psychologische behandelingen (EST’s) en traditionele, individuspecifieke psychologische behandelingen vullen elkaar aan. Indien geïndiceerd, verdienen EST’s de voorkeur boven traditionele, psychologische behandelingen. Ondanks de aanvankelijke vraagtekens bij het onderzoek naar EST’s wordt steeds duidelijker dat EST’s met suc...

The study of intuition and its relation to thoughtful reasoning is a burgeoning research topic in psychology and beyond. While the area has the potential to radically transform our conception of the mind and decision making, the procedures used for establishing empirical conclusions have often been vaguely formulated and obscure. This book fills a...

Het is een illusie te denken dat richtlijnen in de gezondheidszorg (GZ) door iedere hulpverlener op dezelfde manier worden toegepast en, belangrijker nog, dat iedere hulpverlener dezelfde richtlijn zal toepassen: voor eenzelfde cliënt(e) komen verschillende hulpverleners al tot verschillende classificerende diagnoses. Wij betogen dan ook dat er beh...

To prospectively evaluate the effect of experience with coronary computed tomographic (CT) angiography on the capability to detect coronary stenoses of 50% or more. The institutional review board approved the study protocol. All patients gave consent to undergo CT angiography before conventional coronary angiography after being informed of the addi...

In this study, we investigated the reliability and validity of the Perceived Modes of Processing Inventory (PMPI) by Burns and D'Zurilla, which measures two types of information processing, experiential and rational. We administered the dispositional and situa-tion-specific format of the PMPI to a sample of 64 eating-disorder (ED) patients. In the...