9.6.4 Resultaten voor volwassenen ........................................................................................................................... 61
9.6 Oorzaken........................................................................................................................................................................ 61
9.6.1 Genetische invloeden .......................................................................................................................................... 61
9.6.2 Prenatale factoren en geboortecomplicaties ............................................................................................... 61
9.6.3 Neurobiologische factoren ............................................................................................................................... 62
9.6.4 Sociale-cognitieve factoren .............................................................................................................................. 62
9.6.5 Familie factoren ................................................................................................................................................... 62
9.6.6 Maatschappelijke factoren ................................................................................................................................ 63
9.6.7 Culturele factoren ............................................................................................................................................... 63
9.7 Behandeling en preventie......................................................................................................................................... 63
9.7.1 Parent Management Training (PMT)............................................................................................................. 63
9.7.2 Problem Solving Skills Training (PSST) ........................................................................................................... 63
9.7.3 Multisystemic Therapy (MST) ........................................................................................................................... 64
9.7.4 Preventieve interventies .................................................................................................................................... 64
10. Depressieve en bipolaire stoornissen ......................................................................................................................... 65
10.1 Overzicht van stemmingsstoornissen ................................................................................................................... 65
10.2 Depressieve stoornissen .......................................................................................................................................... 65
10.2.1 Geschiedenis........................................................................................................................................................ 65
Vroeger werd ontkent dat kinderen last kunnen hebben van een depressie. Ook werd er gedacht dat
............................................................................................................................................................................................ 65
de symptomen van een depressie hoorde bij de ontwikkeling. Nu zijn ze er wel zeker van dat .......... 65
kinderen depressief kunnen zijn, alleen zijn de symptomen wat meer indirect en verborgen............... 65
10.2.2 Depressie bij jonge mensen ........................................................................................................................... 65
10.2.3 Anatomie van ontwikkeling ............................................................................................................................ 65
10.3 Ernstige Depressieve Stoornis (MDD: Major Depressive Disorder) ............................................................. 66
10.3.1 Prevalentie ................................................................................................................................................................ 67
10.3.2 Comorbiditeit...................................................................................................................................................... 67
10.3.3 Begin, verloop en uitkomst ............................................................................................................................. 67
10.3.4 Geslacht................................................................................................................................................................ 67
10.3.5 Etniciteit en cultuur ........................................................................................................................................... 67
10.4 Persistente depressieve stoornis (P-DD) ............................................................................................................. 68
10.4.1 Prevalentie en comorbiditeit ........................................................................................................................... 68
10.4.2 Begin, verloop en uitkomst............................................................................................................................. 68
10.5 Disruptieve stemmingsregulatie stoornis (DMDD) ........................................................................................... 68
, Pagina |7
10.6 Bijhorende kenmerken van depressieve stoornissen ...................................................................................... 68
10.6.1 Intellectueel en academisch functioneren ................................................................................................... 68
10.6.2 Cognitieve biases en vervormingen ............................................................................................................. 69
10.6.3 Negatief gevoel van eigenwaarde................................................................................................................ 69
10.6.4 Sociale- en peerproblemen............................................................................................................................ 69
10.6.5 Familieproblemen.............................................................................................................................................. 69
10.6.6 Depressie en zelfmoord .................................................................................................................................. 69
10.7 Theorieën over depressie........................................................................................................................................ 69
10.7.1 Psychodynamisch ............................................................................................................................................... 70
10.7.2 Hechting ............................................................................................................................................................... 70
10.7.3 Gedragsmatig ..................................................................................................................................................... 70
10.7.4 Cognitief............................................................................................................................................................... 70
10.8 Oorzaken van depressie.......................................................................................................................................... 70
10.8.1 Genetische en familiare risico’s ...................................................................................................................... 70
10.8.2 Neurobiologische invloeden .......................................................................................................................... 70
10.8.3 Familiaire invloeden ........................................................................................................................................... 71
10.8.4 Stressvolle gebeurtenissen in het leven ....................................................................................................... 71
10.8.5 Emotieregulatie ................................................................................................................................................... 71
10.9 Behandeling van depressie...................................................................................................................................... 71
10.9.1 Psychosociale interventies ............................................................................................................................... 72
10.9.2 Medicatie ............................................................................................................................................................. 72
10.9.3 Preventie .............................................................................................................................................................. 72
10.10 Bipolaire stoornissen ............................................................................................................................................... 72
10.10.1 Prevalentie .......................................................................................................................................................... 73
10.10.2 Comorbiditeit .................................................................................................................................................... 73
10.10.3 Begin, verloop en uitkomst ........................................................................................................................... 73
10.10.4 Oorzaken ........................................................................................................................................................... 73
10.10.5 Behandeling ...................................................................................................................................................... 73
11. Angst- en obsessieve compulsieve stoornissen ....................................................................................................... 74
11.1 Beschrijving van angststoornissen.......................................................................................................................... 74
11.1.1 Het ervaren van angst ........................................................................................................................................ 74
11.1.2 Langdurige angst vs. kortdurende angst en paniek ................................................................................. 75
11.1.3 Normale kortdurende angsten, langdurige angsten, bezorgdheden en rituelen ............................ 75
, Pagina |8
11.2 Verlatingsangststoornis ............................................................................................................................................ 76
11.2.1 Prevalentie en comorbiditeit............................................................................................................................ 76
11.2.2 Begin, verloop en uitkomst ............................................................................................................................. 76
11.2.3 Terughoudendheid en weigering van school ............................................................................................ 76
11.3 Specifieke fobieën ...................................................................................................................................................... 77
11.3.1 Prevalentie en comorbiditeit............................................................................................................................ 77
11.3.2 Begin, verloop en verloop ............................................................................................................................... 77
11.4 Sociale angststoornis (sociale fobieën) ................................................................................................................ 78
11.4.1 Prevalentie, comorbiditeit en verloop ........................................................................................................... 78
11.5 Selectief mutisme ....................................................................................................................................................... 79
11.5 Prevalentie, comorbiditeit en verloop ............................................................................................................. 79
11.6 Paniekstoornis en agorafobie ................................................................................................................................. 79
11.6.1 Prevalentie en comorbiditeit............................................................................................................................ 80
11.6.2 Begin, verloop en uitkomst ............................................................................................................................. 80
11.7 Gegeneraliseerde angststoornis ............................................................................................................................. 81
11.7.1 Prevalentie en comorbiditeit............................................................................................................................. 81
11.7.2 Begin, verloop en uitkomst............................................................................................................................... 81
11.8 Obsessieve compulsieve en gerelateerde stoornissen .................................................................................... 82
11.8.3 Prevalentie en comorbiditeit ........................................................................................................................... 82
11.8.4 Begin, verloop en uitkomst ............................................................................................................................. 82
11.9 Bijbehorende kenmerken......................................................................................................................................... 83
11.9.1 Cognitieve verstoringen .................................................................................................................................... 83
11.9.2 Fysieke symptomen ........................................................................................................................................... 83
11.9.3 Sociale en emotionele tekortkomingen ....................................................................................................... 83
11.9.4 Angst en depressie ............................................................................................................................................ 83
11.10 Geslacht, etniciteit en cultuur ................................................................................................................................ 83
11.11 Theorieën en oorzaken ........................................................................................................................................... 84
11.11.1 Vroege theorieën ............................................................................................................................................... 84
11.11.2 Temperament ..................................................................................................................................................... 84
11.11.3 Familiaire en genetische risicofactoren ....................................................................................................... 84
11.11.4 Neurobiologische factoren............................................................................................................................ 84
11.11.5 Familiaire factoren............................................................................................................................................. 85
11.12 Behandeling en preventie ...................................................................................................................................... 85
, Pagina |9
11.12.1 Overzicht ............................................................................................................................................................. 85
11.12.3 Gedragstherapie ............................................................................................................................................... 85
11.12.4 Familiaire interventies ...................................................................................................................................... 85
11.12.5 Cognitieve Gedragstherapie (CGT) ............................................................................................................. 85
11.12.6 Medicatie ............................................................................................................................................................ 86
11.12.7 Preventie ............................................................................................................................................................. 86
12. Trauma- en stressorgerelateerde stoornissen ......................................................................................................... 87
12.1 Geschiedenis en familiecontext .............................................................................................................................. 87
12.1.1 Gezonde familie .................................................................................................................................................. 87
12.1.2 Continuüm van zorg ......................................................................................................................................... 88
12.2 Trauma, stress en mishandeling: bepalende kenmerken ............................................................................... 88
12.2.1 Trauma en stress ................................................................................................................................................ 88
12.2.2 Mishandeling ...................................................................................................................................................... 89
Kindermishandeling wordt ruim gedefinieerd als 'elke recente handeling of nalatigheid van een ouder
of verzorger, die resulteert in de dood, ernstig lichamelijk of emotioneel letsel, seksueel misbruik,
uitbuiting of een handeling of nalatigheid die een onmiddellijk risico inhoudt van ernstige schade'. . 89
12.2.3 Kenmerken van kinderen welke mishandeld zijn ..................................................................................... 90
12.3 Trauma- en stressorgerelateerde stoornissen ................................................................................................... 91
12.3.1 Reactieve hechtingsstoornis ............................................................................................................................. 91
12.3.2 Ongeremde sociale betrokkenheid stoornis.............................................................................................. 92
12.3.3 Post Traumatische Stress Stoornis (PTSS) ................................................................................................... 93
12.4 Behandeling en preventie ....................................................................................................................................... 95
12.4.1 Exposure based therapy................................................................................................................................... 95
12.4.3 Speciale behoeften van mishandelde kinderen ........................................................................................ 96
13. Gezondheid-gerelateerde en middelengebruik stoornissen ............................................................................... 97
13.1 Stoornis in het gebruik van middelen bij adolescenten .................................................................................. 97
13.1.1 Prevalentie en verloop....................................................................................................................................... 98
13.1.2 Oorzaken .............................................................................................................................................................. 98
13.1.3 Behandeling en preventie ................................................................................................................................ 98
14. Voedings- en eetstoornissen ........................................................................................................................................ 99
14.1 Hoe eetpatronen zich ontwikkelen ....................................................................................................................... 99
14.1.1 Normale ontwikkeling ........................................................................................................................................ 99
14.1.2 Risicofactoren in de ontwikkeling .................................................................................................................. 99
14.1.3 Biologische regulatie ......................................................................................................................................... 99
, P a g i n a | 10
14.2 Obesitas ......................................................................................................................................................................100
14.2.1 Prevalentie en ontwikkeling............................................................................................................................100
14.2.2 Oorzaken ............................................................................................................................................................100
14.2.3 Behandeling .......................................................................................................................................................100
14.3 Voedings- en eetstoornissen die voor het eerst optreden in de zuigelingentijd en vroege
kinderjaren ..........................................................................................................................................................................100
14.3.1 Vermijdende/ beperkende voedselinname stoornis (AFRID) ...............................................................100
14.3.2 Pica ....................................................................................................................................................................... 101
14.4 Eetstoornissen bij volwassenen ............................................................................................................................ 101
14.4.1 Anorexia Nervosa.............................................................................................................................................. 101
14.4.2 Boulimia Nervosa .............................................................................................................................................103
14.4.3 Binge eating syndroom ................................................................................................................................. 104
14.4.4 Prevalentie en ontwikkeling .......................................................................................................................... 104
14.4.6 Behandeling .......................................................................................................................................................105
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