Joanne E.L. VanDerNagel

University of Twente | UT · Department of Human Media Interaction (HMI)

Although the use of psychoactive substances seems to be a growing problem among clients of intellectual disability services (IDS) in the Netherlands, rates of such substance use are unknown, and it is unclear how the services deal with substance‐related problems. This study explored the perspectives of staff with respect to the occurrence of substa...

Abuse of substances by persons with a mild or borderline intellectual disability (IQ 50-85) (ID) is frequently missed, as our cases illustrate. The first dient, a 19-year-old man, denied illicit drug use on admittance to a facility for persons with ID. His mood swings, irritability, and fatigue could eventually be attributed to cannabis and cocaine...

Little is known about rates and risk factors of substance use (SU) in individuals with mild to borderline intellectual disabilities (MBID, IQ 50–85). This hinders targeted prevention and treatment. In this study we assessed SU rates and risk factors in individuals with MBID in 419 adults (63% male, average IQ = 66) in 16 Dutch disability services....

Recovery capital (RC) encompasses the wide range of resources individuals can employ to recover from Substance Use Disorder (SUD). It consists of five subdomains: human, social, cultural, financial, and community RC. Negative recovery capital (NRC) represents the obstacles to recovery. Research on (N)RC in complex multimorbid populations is scarce....

Background: People with mild to borderline intellectual disability (MBID; IQ=50-85) are at risk for developing an alcohol use disorder (AUD). One factor contributing to this risk is sensitivity to peer pressure. Hence, tailored trainings are needed to practice alcohol refusal in impacted patients. Immersive virtual reality (IVR) appears promising t...

Instead of treating Long Covid as a functional disorder without any evidence to back up that claim, first and foremost we should step up our efforts to find out what the exact underlying pathophysiological mechanisms are to be able to find effective treatments for millions of patients.

Das Fundament der Suchthilfe für Menschen mit Intelligenzminderung oder Lernbehinderung ist ein Versorgungsnetzwerk von Behinderten- und Suchthilfe mit konstruktiver Zusammenarbeit in den Bereichen Prävention, Screening, Frühintervention, kognitive Verhaltenstherapie und Rehabilitation/Begleitung. Die in den Niederlanden entwickelten Methoden wurde...

Background: Immersive virtual reality (IVR) has been investigated as a tool for treating psychiatric conditions. In particular, the practical nature of IVR, by offering a doing instead of talking approach, could support people who do not benefit from existing treatments. Hence, people with mild to borderline intellectual disability (MBID; IQ=50-85)...

BACKGROUND: Immersive Virtual Reality (IVR) has been investigated as tool for treating psychiatric conditions. Especially the practical nature of IVR, by offering a doing instead of talking approach, could support people who do not benefit from existing treatments. Hence, people with mild to borderline intellectual disability (MBID, IQ = 50-85) mi...

Objective In the Netherlands, seclusion of patients with a psychiatric disorder is a last-resort measure to be used only in the event of (imminent) severe danger or harm. Although aggressive behavior is often involved, seclusions not preceded by aggression also seem to occur. We sought insight into the non-aggressive reasons underlying seclusion an...

The European Union (EU) Commission’s whitepaper on Artificial Intelligence (AI) proposes shaping the emerging AI market so that it better reflects common European values. It is a master plan that builds upon the EU AI High-Level Expert Group guidelines. This article reviews the masterplan, from a culture cycle perspective, to reflect on its potenti...

(1) Background: Virtual reality (VR) has been investigated in a variety of psychiatric disorders, including addictive disorders (ADs); (2) Objective: This systematic review evaluates the current evidence of immersive VR (using head-mounted displays) in the clinical assessment and treatment of ADs; (3) Method: PubMed and PsycINFO were queried for pu...

Abstract—Tobacco smoking is substantially more prevalent in vulnerable groups, such as people with intellectual disability, psychiatric disorders, or low socioeconomic status. Though smoking cessation programs for the general population are available, accessible and inclusive approaches are lacking. An encouraging new approach toward more practice-...

Background The prevalence of Substance Use Disorder (SUD) in people with Mild Intellectual Disability and Borderline Intellectual Functioning (MID-BIF) is high and evidence-based treatment programs are scarce. The present study describes the development of a personalised SUD treatment for people with MID-BIF. Method The personalised SUD treatment...

PurposeTo evaluate the long-term effectiveness of a web-based therapist-delivered cognitive behavioral therapy (CBT) for patients with eating disorders (ED).Methods We used follow-up data from a randomized controlled trial that evaluated a web-based CBT on ED psychopathology and related health, compared to a waiting list control (WL) condition. As...

Background: This paper describes the theory and development of Take it personal! an indicated prevention programme aimed at reducing substance use in individuals with mild intellectual disabilities and borderline intellectual functioning. Method: The process of the development of Take it personal! followed the steps of the Intervention Mapping p...

Aims To assess the effectiveness of Take it personal!, a prevention programme for individuals with mild intellectual disabilities and borderline intellectual functioning (MID‐BIF) and substance use (SU). The prevention programme aims to reduce SU (alcohol, cannabis, and illicit drugs) among experimental to problematic substance users. Design A qua...

Introduction Personality traits may predict the use of substances in individuals with mild intellectual disabilities (MID) or borderline intellectual functioning (BIF). The Dutch version of the Substance Use Risk Profile Scale (SURPS), adapted for this population, was tested on its psychometric properties. Method Individuals with MID or BIF (IQ 50...

Background Recent technological developments in virtual reality (VR) provide a potential to reduce the burden of tobacco addiction. Despite efforts to reduce smoking initiation and to increase smoking cessation, still approximately 19.2% of female and 25.7% of male adults in the Netherlands smoke. Recent research indicates even higher prevalence ra...

Interventions for substance use-related problems are limited for individuals with intellectual disability (ID). This is problematic, as the lack of interventions can lead to substance use initiation, progression of substance use into substance use disorder, poorer outcomes of treatment, and stigmatization of individuals with dual diagnosis. Additio...

In diesem Beitrag beschreiben wir, wie in den Niederlanden mehrere Projekte (z. B. wissenschaftliche Studien, Entwicklung der zielgruppenspezifi- schen Behandlungsprotokolle und Fragebiigen, Ausbildung fiir Mitarbeitende) zu einem koiffi-enten Hilfsangebot gefhrt haben.

Soms passen de problemen van patiënten niet in één vakje: een probleem komt immers zelden alleen. Gelukkig is er steeds meer aandacht voor zogenaamde dubbeldiagnose problematiek, zoals het samengaan van verslaving en andere psychische stoornissen of verslaving bij mensen met een licht verstandelijke beperking (LVB). Maar wat als de problemen nog co...

Take it personal! is een programma om risicovol gebruik van alcohol, cannabis of harddrugs te beperken bij jongeren met een licht verstandelijke beperking (LVB) en gedragsproblemen. Het programma is bedoeld voor jongeren met gebruik van experimenteel gebruik tot een milde stoornis in gebruik. Take it personal! houdt rekening met verschillende perso...

[BACKGROUND Individuals with a mild intellectual disability or borderline intellectual functioning (mbid)are at risk for psychiatric disorders, including addictive disorders. Treatment of these disorders is often complicated by co-morbidity, as well as caregiver’s and practitioner’s struggle to effectively help. AIM To provide guidelines for psychi...

[Triple diagnosis is the combination of a mental disorder and addiction in individuals with a mild intellectual disability. It is especially common among clients receiving intensive and long-term care and among clients within the judicial domain. Triple diagnosis is by definition complex. It is difficult to address for health care professionals. Ex...

Although the attention for substance use (SU) and SU disorders (SUD) among individuals with mild to borderline intellectual disability (MBID) has been growing exponentially, this form of dual diagnosis has largely been ignored by addiction medicine. In this article, we systematically review the research between January 2000 and June 2018 on the pre...

Background Challenging Behaviour (CB) is a common problem among people with intellectual disability (ID), leading to a lower quality of life and a negative impact on the emotional well-being of family, staff and fellow clients. Additionally, reduced access to community services and (avoidable) high consumption of specialist care has been reported....

Purpose of review: To provide an overview of studies on substance use and substance use disorder (SUD) in individuals with mild intellectual disability or borderline intellectual functioning (MID-BIF). Recent findings: Many individuals with MID-BIF use tobacco, alcohol, and drugs. On average, rates of substance use and SUD are similar to or even...

Mild to borderline intellectual disabilities (MBID) are often accompanied by alcohol misuse and alcohol use disorder (AUD). Although the risk of co-occurring alcohol misuse or AUD has previously been underestimated in individuals with MBID, they have now been identified as a risk group for more severe negative consequences of alcohol use and an inc...

In this paper we argue that in the multidisciplinary field related to behavior change support systems using a body-centric approach where participants act rather than discuss and contemplate is a worthwhile technique and should also be investigated more often. Especially now that technology better allows to respond to bodily actions in an appropria...

Individuals with intellectual disability (ID) & substance use disorders (SUD) require adapted treatment with training in a safe environment. VIrtual Reality offers exciting opportunities in treatment of patients with ID and SUD. It could save organizational resources, and add to treatment satisfaction & adherence. This poster describes a pilot stud...

Introduction and Aims Cognitive impairments in substance use disorder predict treatment outcome and are assumed to differ between substances. They often go undetected, thus the current study focuses on the prevalence of and differences in cognitive functioning across substances by means of a cognitive screen at the early stage of addiction treatmen...

Background: Individuals with a mild intellectual disability or borderline intellectual functioning (mbid) are at risk for psychiatric disorders, including addictive disorders. Treatment of these disorders is often complicated by co-morbidity, as well as caregiver's and practitioner's struggle to effectively help. AIM: To provide guidelines for psy...

In 2012 verscheen in Nederland het eerste boek over Lichte Verstandelijke Beperking (LVB) en Verslaving "Iedereen gebruikt toch?!". Vijf jaar later verscheen een volledig herziene versie getiteld "Handboek LVB en Verslaving", samen met een casusboek waaraan ruim 25 auteurs uit binnen-en buitenland een bijdrage hebben geleverd. Het handboek en het c...

Mensen met een Lichte Verstandelijke Beperking (LVB) vormen een risicogroep voor (problematisch) middelengebruik. Dat betoogt Joanneke van der Nagel, psychiater bij Tactus verslavingszorg en Aveleijn verstandelijk ge-handicaptenzorg in haar proefschrift dat zij op 8 november 2016 verdedigde (VanDerNagel, 2016). Zij bepleit meer structurele aandacht...

Introduction: Substance use disorders (SUD) are common among individuals with intellectual and developmental dis- orders (IDD). The quality of care individuals with these con- ditions receive can be affected by perceptions and attributions of SUD among clinicians, professional care- givers, and family members. The aim of this study was to explore s...

Toegang tot verslavingszorg is ingewikkeld voor mensen met een lichte verstandelijke beperking (LVB) en problematisch middelengebruik. Dit heeft verschillende oorzaken, waarbij de verwijzing naar de verslavingszorg, de intake en de samenwerking tussen verslavingszorg en gehandicaptenzorg instellingen een rol spelen. Om de verslavingszorg toegank...

Knowledge regarding substance-related problems and offending behavior in individuals with mild intellectual disability or borderline intellectual functioning (MBID; IQ 50-85) has increased over the last years, but is still limited. The present study examined differences in prevalence and clinical characteristics of individuals with and without MBID...

Background: Although several authors have suggested that a single externalizing spectrum encompassing both antisocial behavioral syndromes and substance use disorder is to be preferred, this assumption has not been evaluated systematically throughout studies. Purpose: The objective was to establish the generalizability of transdiagnostic models...

Handbook for clinicians and caregivers working with individuals with intellectual disabilities and substance use disorder. Contains information about the conditions, co-morbidity, prevalence & risk factors, screening & assessment, interventions (from prevention to inpatient treatment), policies, as well as practical advice on how to communicate wit...

Casebook with contributions of 25 authors, describing how they work with individuals with intellectual disabilities and substance use disorder.

Mensen met een licht verstandelijke beperking (LVB) vormen een risicogroep voor middelengebruik. Dit artikel beschrijft een Nederlands onderzoeksproject naar vóórkomen en risicofactoren van (problematisch) middelengebruik bij deze groep, en de manier waarop dit gebruik gemeten kan worden. Uit de literatuur, een enquête in de gehandicaptenzorg en da...

Menschen mit einer geistigen Behinderung bilden eine Risikogruppe für Suchtprobleme. Leider stellen Strukturmerkmale der traditionellen Suchtkrankenhilfe oft Barrieren für diese Menschen dar. In den Niederlanden erhält diese Gruppe immer mehr Aufmerksamkeit. Verschiedene Leitlinien zur Behandlung von Suchtproblemen bei Menschen mit einer geistigen...

Toegang tot verslavingszorg is ingewikkeld voor mensen met een lichte verstandelijke be- perking (LVB) en problematisch middelenge- bruik. Dit heeft verschillende oorzaken, waarbij de verwijzing naar de verslavingszorg, de in- take en de samenwerking tussen instellingen voor verslavingszorg en gehandicaptenzorg een rol spelen. Om de verslavingszorg...

In deze handreiking staan concrete tips en adviezen om de toegankelijkheid van de verslavingszorg voor cliënten met een lichte verstandelijke beperking (LVB) te verbeteren. De handreiking bestaat uit drie onderdelen. Wat kun je doen om een LVB-cliënt binnen de verslavingszorg te krijgen en te houden? Wat kun je doen als je gaandeweg de intake ontde...

Background The goal of this study was to examine the relationship between drinking motives and interpretation bias (interpreting ambiguous stimuli in an alcohol-related way) in problematic drinkers with and without mild to borderline intellectual disability (MBID). Method Participants (N = 178) were divided into 4 groups based on severity of alcoho...

Background and aims: Adolescents with Intellectual Disability (ID) are at risk for tobacco and alcohol use, yet little or no prevention programs are available for this group. 'Prepared on time' is an e-learning program based on the attitude - social influence - efficacy model originally developed for fifth and sixth grades of mainstream primary sc...

[Substance use (SU) and substance use disorders (SUD) among individuals with mild to borderline intellectual disability (MBID) has received growing attention over the past years. However, individuals with MBID and SU(D) often do not receive the required specialised care and clinicians report the lack of knowledge and skills to adequately care for t...

Until recently, individuals with mild intellectual disability were not seen as a risk group for alcohol, tobacco, or drug use. Wrongly, according to this PhD study by Joanne van der Nagel. She examined - with a grant from ZonMW - substance use and its risk factors among adults with MID. The percentages of users of tobacco and cannabis in this group...

We examined cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability (MBID). Problematic drinkers were expected to show a significantly lower estimated performance IQ (PIQ), but not a lower estimated verbal IQ (VIQ), compared to light drinkers. Participants (N = 474) were divided into four groups based...

This manual (in Dutch) describes an 18-sessions CBT program for the treatment of substance use disorder in individuals with mild intellectual disabilities. It combines individual sessions with a social system based approach, and aims to increase self-control techniques, as well as to provide caregivers with skills and knowledge to support the patie...

Workbook for patients with Substance Use Disorder and Intelleactual Disabilities. To be used with CBT protocol described in Manual CBT+

There is a growing body of research on substance use and substance use disorders among individuals with intellectual and developmental disabilities who have been identified as a group at risk. Use of alcohol, tobacco and/or illicit drugs is prevalent, especially among those with mild to borderline intellectual and developmental disabilities. Epidem...

Background and Aims Individuals with mild or borderline intellectual disability (MBID) are at risk of substance use (SU). At present, it is unclear which strategy is the best for assessing SU in individuals with MBID. This study compares three strategies, namely self-report, collateral-report, and biomarker analysis. Methods and Procedures In a sa...

Background: Over the past decades, there has been increased scientific and clinical interest in substance use among individuals with intellectual disabilities (ID). Despite raised interest and awareness in the topic, lack of supportive data on prevalence and risk factors highlights the need for ongoing research. The aims of this cross-sectional mu...

Individuals with intellectual and developmental disabilities (IDD) have an increased risk for developing problems related to use and misuse of substances such as alcohol and drugs. The consequences for mental and somatic health are often detrimental. Substance use disorder is a chronic and multifaceted problem and it is the result of an interplay b...

Minder Drank Of Drugs [Less Booze or Drugs] is an intervention for mild to moderate substance use disorder in individuals with mild to borderline intellectual disability. It is a manualized CBT protocol with 12 group sessions and 12 individual sessions, to be used within addiction treatment facilities in close collaboration with intellectual disabi...

Individuals with mild or borderline intellectual disability (MBID) (IQ 50-85) are at risk for substance use (SU). To identify SU in this group we need adequate measurements. This poster describes the SumID-Q, a questionnaire to assess SU in MBID

Background: Students without intellectual disability (ID) start experimenting with tobacco and alcohol between 12 and 15 years of age. However, data for 12- to 15-year old students with ID are unavailable. Prevention programs, like 'PREPARED ON TIME' (based on the attitude-social influence-efficacy model), are successful, but their efficacy has no...

Background Many patients with eating disorders do not receive help for their symptoms, even though these disorders have severe morbidity. The Internet may offer alternative low-threshold treatment interventions. Objective This study evaluated the effects of a Web-based cognitive behavioral therapy (CBT) intervention using intensive asynchronous the...

Principal Organizer Joanne E.L. VanDerNagel, MD, Tactus Addiction Medicine, The Netherlands Co- organizers Fleur Vruwink, MD Tactus Addiction Medicine, The Netherlands Description and justification of workshop: Background Substance use (SU) and substance use disorder (SUD) among individuals with intellectual disability (ID) have received increas...

Knowledge regarding substance use (SU) and substance use disorder (SUD) in individuals with mild to borderline intellectual disabilities (ID) has increased over the last decade, but is still limited. Data on prevalence and risk factors are fragmented, and instruments for screening and assessment and effective treatment interventions are scarce. Als...

In European countries, there is an increasing awareness that substance abuse also occurs among people with a mild intellectual disability (MID). Individuals with MID often do not fit within the traditional (addiction) treatment systems and subsequently treatment outcomes can be poor. To improve outcome and treatment retention, programmes should be...

An important aim of forensic treatment is assessment of risk factors for offending, analysis of the relationship between these factors, and reducing risk factors for offending. One of these risk factors is abuse of substances such as alcohol and drugs. In this study, we compared substance use of 51 forensic clients with intellectual disability (ID,...

No conflict of interest Today Current status and future perspectives Epidemiology of SU(D) in ID The addicted brain Welcome and introduction Introduction

Research with participants with intellectual disability is complicated by practical methodological and also ethical issues. (Inter)national legislation has additional requirements for research in this gropu that need to be met before an Ethical Review Board (ERB) can give ethical clearance. This poses challenges for both researchers and ERB members...

Literature review + expert consensus document on substance use disorder among adolescents with mild/borderline ID in the Dutch criminal justice system (In Dutch)

To facilitate the monitoring of drug abuse by patients, a method was developed and validated for fast and highly selective screening for amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine, methylenedioxyamphetamine, methylenedioxyethylamphetamine, methylphenidate, cocaine, benzoylecgonine, morphine, codeine, heroin, 6-monoacteylmorphin...