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The clinical themes (developmental and behavioural disorders, tic disorders, and anxiety and mood disorders) are studied from several perspectives. Each perspective focuses on specific research issues.

1) Behavioural description

A detailed and extensive behavioural description is a precondition for clinical work. But scientific research (information processing, genetics, neurochemistry, research of the effects of treatment) also relies on a good description of the behavioural characteristics of clinical groups. Good, standardised tools, such as questionnaires and interviews that specifically focus on mapping out the relevant problems (autism, PDDNOS, ADHD, tic disorders, anxiety and mood disorders), are essential to behavioural description. Therefore, the development of tools is important in this line of research.
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2) Epidemiological research

Accare participates in several long-term epidemiological studies that are carried out in collaboration with other centres. In these studies, large groups of children (population cohorts and clinical cohorts) are observed over a long period of time as they develop toward adulthood. Key questions in this type of research include: Why does one person to develop a psychiatric disorder while the next doesn't? Why does one person deteriorate while the next improves? It is likely that both environmental factors and genetic tendency play a role here. It is important to know how the environment and personal qualities can mutually influence each other, both positively and negatively. Under which circumstances will a genetic tendency actually manifest itself in a disorder and which personal qualities contribute to that? Which circumstances and/or qualities create a buffer, so that no problems develop?

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3) Information processing

This study aims to chart the genes/gene areas that detect aspects of developmental disorders with children. This line of research concentrates on several aspects of information processing in children. Computer tasks are often used to measure how children process information. In order to gain an insight into the brain areas and systems involved in processing information, the child's performance for computer tasks is compared against psychophysiological measures. These include status changes (changes in pulse, blood pressure and breathing) and changes in brain activity (measured in the EEG) which occur when the computer tasks are carried out. In the future, fMRI techniques will also be used.
In addition, 'information-processing profiles' (strengths and weaknesses) are connected with specific behavioural problems, and research is done on how different groups of children learn from feedback and rewards.
The results of this type of research allow us to distinguish groups of children with different kinds of psychopathology (for example, which differences occur in information processing between children with PDDNOS and ADHD?).
The information-processing tasks are also used in medication studies in order to shed light on the selective effects of medication on specific information-processing processes.

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4) Neurochemical research

The raised serotonin count in platelets in approximately 30% of all people with autism has intrigued many a scientist for a very long time. This line of research studies the relationship between effects of serotonergic drugs (serotonin reuptake inhibitors), the serotonin count in the platelets and genes that detect the transporter protein which transports serotonin across the membrane, in order to learn more about the functioning of the serotonergic system in children with autism and children with PDDNOS.

5) Immunological research

Immunological research carried out at Accare focuses on mapping the role of the immune system in the development and deterioration of tics (for instance in Tourette syndrome). Research results show that the typical variations in seriousness of the tics over time could possibly be related to previously contracted infections. Autoimmunity can play a role here - autoantibodies acting against certain areas of the brain.

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6) Genetic research

This research aims to map out genes/gene areas which detect for aspects of developmental disorders in children. The research is based on the IBD approach (Identity By Descent). This method uses the relative mutual kinship of people living in the North Netherlands. This population possesses a large degree of mutual kinship of a relatively recent date. Therefore, the inhabitants of such a region share relatively large gene areas. This makes it easier to track genes or gene areas which play a role in certain genetically determined disorders. So far this project has concentrated on the creation of DNA databases of children with specific disorders, such as autism, GTS, OCD and ADHD. The ultimate issue behind these studies is the translation of genes in terms of the creation of proteins which determine the tendency and the functioning of the nervous system.

7) Effects of medication

There is a dire need for scientific research into the effects of drugs in children with psychiatric disorders. The central issues in this line of research concern the effectiveness of various drugs used for several behavioural problems (which medication works for which problems?), the side-effects of drugs and their use in actual practice (how do children use the medication? Why do they stop or continue?).

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8) Effects psych. forms of treatment

Behavioural therapy (individual meditation therapy, parent training, social skills training, cognitive behavioural therapy) are an important aspect of the treatment of developmental disorders (PDDNOS, ADHD) and anxiety disorders. The central issues in this line of research concern the effectiveness of these forms of treatment. Which children benefit from which treatment? Why does a treatment work better for some children than for others? And which factors predict the success of the treatment?
In order to assess the effect of treatments, it is important that a certain treatment is given at the exact same way each time. This is why there is a protocol to report what exactly is being done (for example, which information is given and which exercises are done?). The effectiveness of the reported forms of treatment is then compared with the effectiveness of medicine or so-called 'care-as-usual'.

Read more about current research projects