Illness Identity in Inflammatory Bowel Disease.

BACKGROUND: We examined the degree to which adults with inflammatory bowel disease (IBD) integrated their illness into their identity and linked illness identity to important patient-reported outcomes. METHODS: A total of 109 adults with IBD, aged 18 to 60 (Mage = 35.93; 77% women) completed questionnaires on the four illness identity dimensions (rejection, acceptance, engulfment, and enrichment), medication adherence, depressive symptoms, life satisfaction, health status, and health-related quality of life (HRQoL). The illness identity scores of adults with IBD were compared to existing data from adults with congenital heart disease (CHD), refractory epilepsy (RE), and multisystemic connective tissue disorders (MSDs) using multivariate analyses of covariance. In adults with IBD, associations between illness identity and patient-reported outcomes were examined through hierarchical regression analyses, controlling for sex, age, illness duration, diagnosis, self-reported flares, and co-existing illnesses. RESULTS: Adults with IBD scored higher on rejection and engulfment and lower on acceptance than adults with CHD, lower on rejection but higher on engulfment than adults with RE, and higher on engulfment and enrichment but lower on rejection than adults with MSDs. Higher engulfment scores were related to more depressive symptoms, lower life satisfaction, and a poorer health status and HRQoL. In contrast, higher enrichment scores were related to more life satisfaction and a better HRQoL. Rejection and acceptance were not uniquely related to any of the outcomes. CONCLUSIONS: Adults with IBD showed relatively high levels of engulfment. Substantial associations were observed between illness identity and patient-reported outcomes, with engulfment being the strongest, most consistent predictor.

A longitudinal perspective on perceived vulnerability to disease during the COVID-19 pandemic in Belgium.

During the coronavirus disease 2019 pandemic, individuals relied heavily on media sources to stay informed about the disease and public health measures. However, differences exist in the type and frequency of news media consumption, which can be linked to their perceived vulnerability to disease. In this longitudinal study, 1000 Flemish (Belgium) individuals were followed from March 2020 until September 2020, focussing on the evolution in perceived vulnerability to disease (i.e. perceived infectability and germ aversion). Media consumption significantly impacts perceived germ aversion; heavy consumers of commercial media reported greater germ aversion than light consumers of these media. The evolution of germ aversion among individuals from March to August depends on their gender, living environment, age and possibility to work from home. Furthermore, the evolution of perceived infectability depends on the age and living environment of the respondent. These findings may interest policy makers and media professionals to anticipate how anxieties regarding contracting an infectious disease evolve over time and how individual characteristics affect this evolution.

Informal care burden during the COVID-19 pandemic in Flanders, Belgium: The role of perceived threat, personality and resilience.

BACKGROUND: In this study, we investigate how socio-demographic characteristics (age, gender and education) and informal care relationship characteristics (e.g., time spent on care, number of informal caregivers, professional care) are linked with informal care burden during the COVID-19 pandemic. In addition, we expect this burden to differ by personality characteristics, degree of resilience, and-in this specific context-perceived the COVID-19 threat. METHOD: We used the fifth wave of a longitudinal study to identify 258 informal caregivers. These online survey data came from a five-wave longitudinal study in Flanders, Belgium that ran from April 2020 to April 2021. Data were representative of the adult population by age and gender. Analyses include t-tests, ANOVA, SEM and binomial logistic regression. RESULTS: We found that the informal care burden was strongly linked with a socio-economic gradient, time investment changes in care since the start of the pandemic, and whether there was more than one informal caregiver. Personality traits such as agreeableness and openness to experience, and the perceived threat of COVID-19 were also related to care burden. CONCLUSIONS: During the pandemic, informal caregivers were put under extra considerable pressure: restrictive government measures sometimes led to the temporary suspension of some or all professional care for persons with care needs, which may have resulted in a growing psychosocial burden. We recommend that, in the future, the focus should be on supporting the mental wellbeing and social participation of caregivers along with measures to protect caregivers and their relatives from COVID-19. Support structures for informal caregivers should be kept running during crises now and in the future, but it is also important to adopt a case-by-case basis to consider support for informal caregivers.

Depression in Belgian first-year university students: A longitudinal study of self-definition, interpersonal relatedness, mentalizing, and integration.

Despite evidence of increasing prevalence of depression in university students, few studies investigated how depression evolves over the first months at university. We investigate severity of depression among first-year university students during their first semester at university, and whether it was associated with impairments in personality, mentalizing (or reflective functioning), and social and academic integration. Participants in this two-wave prospective study were 377 Belgian first-year students in 2018 and 2019. Results showed that maladaptive interpersonal relatedness and self-definition at the start of the first semester (T1) were prospectively associated with increases in the prevalence and severity of depression at the end of the semester (T2). Uncertainty, but not certainty, with regard to mentalizing was positively associated with severity of depression at T2 and mediated the association between personality dimensions and severity of depression. The implications of these findings for depression prevention and intervention strategies in first-year university students are discussed.

Perceived vulnerability to disease and attitudes towards public health measures: COVID-19 in Flanders, Belgium.

During the COVID-19 pandemic, governments installed measures to contain the disease. Information about these measures was disseminated through news media. Nonetheless, many individuals did not abide by these guidelines. We investigated how perceived vulnerability to disease and personality characteristics related to support for public health measures. We analyzed survey data of 1000 Flemish (Belgium) adults, collected between March 17, 2020 and March 22, 2020. Older age, low educational attainment, gender (female) and work situation (no telecommuting) were associated with greater perceived vulnerability. Greater expectations of loneliness and more solidarity with our fellow men were associated with gender (female), younger age and work situation (telecommuting). Greater perceived vulnerability to disease was related to a greater belief that public health measures protect the population, but also to a critical stance towards the Belgian government's handling of the crisis. High agreeableness and high emotional stability were associated with respectively greater belief that health measures protect the population, and greater support for the government's crisis management. Watching television news was related to a greater belief that public health measures are necessary, and specifically consuming public television news increased support for public health measures. We discuss the implications for handling the COVID-19 pandemic.

To be a freshman during the COVID-19 pandemic: A cross-lagged model of depression, mentalizing, and epistemic trust.

Research has shown that severity of depression increased in freshmen during their first months at university due to increased social and academic pressures. Since the start of the COVID-19 pandemic, several cross-sectional studies have suggested that levels of depression in university students are higher than before the pandemic, but longitudinal data are largely lacking. This study investigated severity of depression and negative affect linked to the pandemic among freshmen during their first semester at a large university in Flanders, Belgium. We also investigated whether epistemic trust predicted severity of depression and pandemic-related negative affect and whether problems with reflective functioning (or mentalizing) mediated these relations. Participants in this two-wave prospective study were 289 first-year students of the Faculty of Psychology and Educational Sciences of a large Belgian university. We conducted paired samples t-tests and cross-panel analysis to answer the research question. The number of students at risk of clinical depression increased by 41% between T1 (early October 2020) and T2 (late December 2020). Epistemic mistrust at T1 was prospectively associated with an increase in the prevalence and severity of depression at T2. Problems with mentalizing and negative COVID-19-related affect were positively associated with severity of depression at T2 and mediated the association between epistemic mistrust and severity of depression at T2. The findings highlight the key role of epistemic trust in the development of depression among freshmen, with the COVID-19 pandemic presenting an additional source of uncertainty.

Is blood thicker than water? Perceptions on the role of stepparents in medical decisions among minors.

Alternative family configurations are becoming more prevalent, yet current legislative statutory does not support stepparents in medical decisions for their stepchildren. We investigate opinions of Belgian and Dutch adults regarding inclusion of stepparents in medical decision-making in minors. We make two observations. First, participants wanted stepparents to be involved in cases when medical information had to be shared or informed consent signed. Second, when stepparents object against previously approved medical interventions by a biological parent, respondents were less likely to support stepparents. Participants with stepchildren were likely to favour inclusion of stepparents in decision-making. Overall, our findings indicate that Belgian and Dutch adults view stepparents as potential executive actors in medical decision-making for minors, but not as primary decision-makers. This study is a first step in showing to what extent stepparents could be included in medical information and decision-making regarding stepchildren. We reflect on these findings in light of implications for medical practice and legislative shortcomings.

Health-related confidentiality and consent among minors: Data on adult perspectives from Belgium and The Netherlands.

The data presented in this article provide one of the first large-scale insights on adult preferences for confidentiality and consent with regards to medical decision-making for minors. We collected data on these preferences through 12 hypothetical scenario's that were presented, for which each participant had to indicate if they would (not) follow the minor's preferences. Data regarding family communication, relationship quality, and sociodemographic characteristics were also collected. The data were collected through an online survey in September and October 2020, which yielded responses from 1000 Belgian and 1000 Dutch participants between 35 and 55 years of age. We selected this age range because it increased the chances that they had a child near the age of the fictional minor in the hypothetical cases. These data can be of interest for family researchers and/or health workers who want to explore adults' perceptions regarding confidentiality and consent among minors.

Parental Opinions on Medical Decision-Making in Adolescence: A Case-Based Survey.

OBJECTIVE: Patient trust and consent are complex topics for health care workers in pediatrics, specifically when relating to adolescent's legal status. In the context of medical decisions, not much work has been performed to understand the opinion of parents on health care decision-making, especially on confidentiality concerning their adolescent children. The purpose of this research was to assess the parental opinions on these decisions and the influence of different perspectives. METHODS: We used a case-based methodology to assess parental opinions on fictional medical decisions. A survey was provided to parents in 2 pediatric outpatient departments in Belgium and the Netherlands. The survey contained cases regarding medical care related to confidentiality and consent about which participants gave their opinion. RESULTS: In total, 222 surveys were completed. Overall, most parents would allow an adolescent to make his/her own decision (58.6%-70.4%), except in the case of confidentiality on alcohol-related trauma (28.9%). The results show a significant difference in how parents responded when answering from the parental perspective or adolescents' perspective. They granted significantly more authority to the adolescent in the latter view. CONCLUSION: Our study shows that parents who were confronted with cases from an adolescent perspective were significantly more likely to give the patient authority. In addition, the medical issue and context influence how the parents responded. These data provide insight into the parental opinions and could lead to more evidence-based frameworks for shared medical decision-making of adolescents and their parents.

Updating 'Perceptions and opinions on the COVID-19 pandemic in Flanders, Belgium' with data of two additional waves of a longitudinal study.

Adding to longitudinal data of three waves that were presented in an original dataset on perceptions and behaviours regarding government measures, fear of getting ill, and media use during the COVID-19 pandemic in Flanders (Belgium), this article presents information on two additional waves that were collected at two key moments in the pandemic in the same region: in late August 2020 (W4; as infection rates increased again; N = 505) and in the middle of March 2021, exactly one year after the first data collection (W5; N = 408). In W4 and W5, new respondents were added to the longitudinal sample to strengthen cross-sectional analyses. Additional information on informal care and physical activity was also collected. These data may be of interest to researchers who wish to explore dynamics of fear and attitudes towards public health measures during this particularly challenging time.

Marrying in the city in times of rapid urbanization.

Economic, social, political, and demographic processes changed Western European cities strongly during the nineteenth century. Especially during this time, the northern part of Belgium (Flanders) became highly urbanized. Investigating the long-term development of the marriage pattern in the cities of Antwerp, Aalst, and Ghent gives a detailed picture of the evolution of the urban marriage pattern. In this article, specific emphasis is on gender, social, and migration distinctions. The results confirm that there is a male-female difference and variation among various social and migrant groups in the age at first marriage during the period 1800-1906. Moreover, regional differences are also visible. In the port city of Antwerp, massive immigration caused a unique evolution in the age at first marriage during the last decades of the nineteenth century, which did not appear in the textile cities of Aalst and Ghent during this time.

Late adolescents' own and assumed parental preferences towards health-care related confidentiality and consent in Belgium.

OBJECTIVES: Health care professionals regularly struggle with issues relating to confidentiality and consent for physical and/or mental health issues among adolescents. We investigate late adolescents' own and assumed parental preferences towards health-care related confidentiality and consent. METHODS: We analyzed online survey data of four vignettes from 463 first-year university students at KU Leuven (Flanders, Belgium). We used paired samples t-tests to assess the (in)consistency between attitudes of late adolescents and their assumed parental attitudes, independent samples t-tests to estimate gender differences, and binomial logistic regressions to analyze the association of assumed parental preferences with late adolescents' own preferences. RESULTS: Attitudinal inconsistencies were present in all vignettes. Late adolescents were significantly more in favor of confidentiality and adolescent consent than what they believed their parents were. Gender differences were limited. Binomial logistic regressions indicated that assumed parental preferences were strongly associated with late adolescents' own preferences. CONCLUSIONS: Findings suggest a clear difference between late adolescents' preferences and assumed parental preferences: they believe that their parents are less inclined to favor confidentiality and adolescent consent. We also find that this difference depends on the case, indicating that there is no such thing as general 'confidentiality preferences'. Rather, a decision- and/or context-specific perspective should be adopted.

Beliefs in Conspiracy Theories and Misinformation About COVID-19: Comparative Perspectives on the Role of Anxiety, Depression and Exposure to and Trust in Information Sources.

While COVID-19 spreads aggressively and rapidly across the globe, many societies have also witnessed the spread of other viral phenomena like misinformation, conspiracy theories, and general mass suspicions about what is really going on. This study investigates how exposure to and trust in information sources, and anxiety and depression, are associated with conspiracy and misinformation beliefs in eight countries/regions (Belgium, Canada, England, Philippines, Hong Kong, New Zealand, United States, Switzerland) during the COVID-19 pandemic. Data were collected in an online survey fielded from May 29, 2020 to June 12, 2020, resulting in a multinational representative sample of 8,806 adult respondents. Results indicate that greater exposure to traditional media (television, radio, newspapers) is associated with lower conspiracy and misinformation beliefs, while exposure to politicians and digital media and personal contacts are associated with greater conspiracy and misinformation beliefs. Exposure to health experts is associated with lower conspiracy beliefs only. Higher feelings of depression are also associated with greater conspiracy and misinformation beliefs. We also found relevant group- and country differences. We discuss the implications of these results.

Perceptions and opinions on the COVID-19 pandemic in flanders, belgium: Data from a three-wave longitudinal study.

During the COVID-19 pandemic, people have become increasingly fearful of the disease as death tolls rise, while governments attempt to combat it by installing restrictive measures. News media play a vital role as they are the main sources from which people gather information regarding the disease and the public health measures. The present longitudinal data reflect a bird's eye view of people's fears towards getting ill, their news media consumption, and their attitudes regarding the (Belgian) government's handling of the COVID-19 crisis. Data were collected at three key moments in the pandemic among adults in Flanders, Belgium: in the middle of March (when the first restrictive measures went into effect; N = 1,000), early April (as hospital admissions and death toll peaked; N = 870), and at the end of May and beginning of June (as several measures were lifted or relaxed; N = 768). With only 23.2% drop-out across the three waves, these data may be of interest to researchers who wish to explore dynamics of fear and attitudes towards public health measures during this particularly challenging time.

Determinants of divorce in nineteenth-century Flanders.

In 1830, the year Belgium became independent, there were four divorces in Belgium. From about 1870 to 1910, there were about one hundred divorces per year, and since 1910, there have been about 1,000. The aim of this research is to investigate the factors that played a role in the increase in the number of divorces in Belgium in the course of the nineteenth century. The research relates to information from four Flemish municipalities for the period 1800-1913. Results indicate that an explanation of the rising divorce rate can be sought in the psychological and social consequences of the more pronounced shift in marriage, gender and family expectations. Increasing numbers of women threw themselves more and more into their gender-specific expressive gender role, whereas the objective opportunities and attainability of this role did not increase commensurately. The result was role strain: high marriage and family expectations soon come up against intrinsic limitations. As a result of this, both individual and general frustration increased, and this was an ideal social substratum for facilitating divorce.

Salmon Bias or Red Herring? : Comparing Adult Mortality Risks (Ages 30-90) between Natives and Internal Migrants: Stayers, Returnees and Movers in Rotterdam, the Netherlands, 1850-1940.

The purpose of this research is to empirically test the salmon bias hypothesis, which states that the "healthy migrant" effect-referring to a situation in which migrants enjoy lower mortality risks than natives-is caused by selective return-migration of the weak, sick, and elderly. Using a unique longitudinal micro-level database-the Historical Sample of the Netherlands-we tracked the life courses of internal migrants after they had left the city of Rotterdam, which allowed us to compare mortality risks of stayers, returnees, and movers using survival analysis for the study group as a whole, and also for men and women separately. Although migrants who stayed in the receiving society had significantly higher mortality risks than natives, no significant difference was found for migrants who returned to their municipality of birth (returnees). By contrast, migrants who left for another destination (movers) had much lower mortality risks than natives. Natives who left Rotterdam also had significantly lower mortality risks than natives who stayed in Rotterdam. Female migrants, in particular, who stayed in the receiving urban society paid a long-term health price. In the case of Rotterdam, the salmon bias hypothesis can be rejected because the lower mortality effect among migrants was not caused by selective return-migration. The healthy migrant effect is real and due to a positive selection effect: Healthier people are more likely to migrate.

Changing patterns of familial sociability: family members as witnesses to (re)marriage in nineteenth-century Flanders.

Based on research in three Flemish communities, the author concluded that during the course of the second part of the nineteenth century, there was an increasing trend toward choosing family members as witnesses to the marriage ceremony (of first marriages). This was interpreted as an aspect of the "familiarization" of marriage. It might also, however refer to changing family contexts and social networks, to switching roles of parents and youth, to shifting intergenerational power, and to new family situations of solidarity and conflict. In this follow-up study, the author demonstrates that the former conclusions also hold true for other Flemish regions, for all social groups, and for remarriages. It also appears that marrying people increasingly selected brothers and brothers-in-law as witnesses, rather than descending or ascending kin. These observations support the thesis of the increasing familiarization of family relations during the course of the nineteenth century.

Cuckolded Fathers Rare in Human Populations.

Contemporary data of extra-pair paternity (EPP) in human populations may be biased by the use of modern contraceptives. Studies have now estimated historical EPP rates in several human populations. The observed low EPP rates challenge the idea that women routinely 'shop around' for good genes by engaging in extra-pair copulations.

Joint physical custody and adolescents' subjective well-being: a personality × environment interaction.

Shared residence after divorce is rising in most Western countries and legally recommended by law in Belgium since 2006. Living with both parents after divorce is assumed to increase children's well-being, through a better parent-child relationship, but may also be stressful, as children live in 2 different family settings. In this study, we investigate whether the association between the residential arrangement of adolescents and 3 measures of subjective well-being (depressive feelings, life satisfaction, and self-esteem) is moderated by the Big Five personality factors. The sample is selected from the national representative Divorce in Flanders study and contains information about 506 children from divorced parents between 14- and 21-years-old. Our findings indicated a consistent pattern of interactions between conscientiousness and joint physical custody for 2 of the 3 subjective well-being indicators. The specific demands of this residential arrangement (making frequent transitions, living at 2 places, adjustment to 2 different lifestyles, etc.) may interfere with the nature of conscientious adolescents: being organized, ordered, and planful. Our results showed support for a Person × Environment interaction, and demonstrate the need for considering the individual characteristics of the child when settling postdivorce residential arrangements.

A social component in the negative effect of sons on maternal longevity in pre-industrial humans.

Due to their effect on maternal testosterone levels, sons are said to have reduced maternal longevity in pre-industrial humans. This analysis, using information from a Flemish agricultural village in the 18th-20th centuries, confirms the presence of a negative effect of sons on maternal longevity. However, the effect is mainly observed for mothers belonging to the least privileged social group and for sons surviving their fifth birthday. Both findings make the above-mentioned biological explanation relative. However, a plausible alternative, social interpretation is male-dominated intra-household resource competition. It is reasonable to assume that only sons above a certain age are able to claim a serious amount of resources and that competition is strongest within the least privileged social group.