Sandra Mulkens

s.mulkens@maastrichtuniversity.nl


I started my scientific career as a PhD student in 1994 at the Faculty of Health Sciences (Maastricht University), investigating fear of blushing as a form of social phobia. In this project I studied some of the maintaining factors of this disorder and treatment possibilities. For example, we investigated whether individuals with fear of blushing indeed blushed more than non-fearful individuals, the role of self-focused attention, and the effectiveness of a treatment called Task Concentration Training. Next to the experimental work for my PhD project, I enrolled in a postdoctoral education program to become a behaviour therapist. For this education, it was necessary to do clinical work as well. Therefore, I worked part of my time during the PhD project as a junior therapist at the Maastricht Mental Health Center (Riagg Maastricht). After finishing the behaviour therapy courses and supervision in 1998, I decided to continue my postdoctoral training and to become a psychotherapist. This training was finished in December 2001. After completing this education, one receives an official governmental registration (‘BIG-registratie’. BIG stands for ‘Beroepen in de Individuele Gezondheidszorg’ or ‘Professions within Individual Health Care’). In November 2000, I defended my PhD dissertation entitled: ‘Red, hot, and scared? Inquiries into fear of blushing’.

On January 1st, 2000, I started working at the Faculty of Psychology (also Maastricht University) with Prof. Dr. Anita Jansen. I also switched topics, as from now on I would start to study eating disorders, obesity and addiction. I was also interested in Body Dysmorphic Disorder, since this resembles fear of blushing and is also linked to body image disorders such as eating disorders. As a clinically educated researcher, I am relatively often involved in clinical studies, like investigating the (aspects of) effectiveness of treatments. With Anita Jansen, I formulated a treatment outcome study for bulimia nervosa which is running at the Maastricht Mental Health Center. In this study, pure cognitive therapy is compared to cognitive behavioural therapy (in which elements of the latest scientific results are incorporated). In the past years, I also studied obesity treatments in children and adolescents. In collaboration with “Huis voor de Sport Limburg”, Thuiszorg Westelijke Mijnstreek, GGD Sittard-Geleen and a fitness centre, I carried out a scientific evaluation of the project RealFit for obese adolescents in 2004. We concluded that a combination of dietary advice, exercise and psychological support in the form of cognitive therapy provided the best results. RealFit is now being implemented in several cities throughout the Netherlands. Furthermore, in 2004, a ZonMW project was granted (Drs. Esther Jansen is the phd student) in which we investigate the role of the parents in the maintenance of childhood obesity. Esther also carried out several experiments with respect to the effects of prohibition to eat certain foods.

In the past years, I also started thinking about my own line of research on Body Dysmorphic Disorder (BDD). In this line of research, attentional processes and attentional training will be central. I first conducted some experiments on mirror gazing and eye movements. From the mirror gazing study, it appeared that mirror gazing was especially detrimental for individuals who already were dissatisfied with aspects of their appearance. Individuals who were mostly happy with their appearances, became more pleased after mirror gazing. Also, I did a study with patients who had undergone cosmetic surgery but were dissatisfied about the results. It appeared that these patients more often suffered from BDD than the general population and that they had more psychopathological complaints. At the Maastricht Mental Health Center we investigate cognitie therapy and Task Concentration Training as treatment options for BDD. In the future, I want to study further the role of mirror gazing as a maintaining factor in BDD, the role of self-focused attention and the role of attention techniques within the treatment of BDD. Finally, I’m interested in who profits form cosmetic surgery in the long term.



Jansen, E., Mulkens, S., & Jansen, A. (2011). Tackling childhood overweight: treating parents exclusively is effective. International Journal of Obesity, 35 , 501-509. [Download PDF]

Jansen, E., Mulkens, S.., Sanders, E. & Jansen, A. (2011). How do children experience their parents’ feeding practices? A study using the Dutch Child Feeding Questionnaire- child version. Netherlands Journal of Psychology, 66 , 26-32.

Alberts, H., Mulkens, S., Smeets, M., & Thewissen, R. (2010). Coping with Food Cravings: Investigating the Potential of an Acceptance-based Intervention. Appetite, 55 , 160-163. [Download PDF]

Jansen, E., Mulkens, S. ., & Jansen, A. (2010). How to promote fruit consumption in children: visual appeal versus restriction. Appetite, 54 , 599-602. [Download PDF]

Mulkens, S., & Jansen, A. (2009). Mirror gazing increases attractiveness in satisfied, but not dissatisfied individuals: a model for Body Dysmorphic Disorder? Journal of Behaviour Therapy and Experimental Psychiatry, 40 , 211-218.[Download PDF]

Werrij, M.Q., Jansen, A., Mulkens, S., Elgersma, H., Ament, A., Hospers, H.J. (2009). Adding Cognitive Therapy to Dietetic Treatment Associated with Less Relapse in Obesity. Journal of Psychosomatic Research. [Download PDF]

Werrij, M.Q., Roefs, A., Janssen, I., Stapert, D., Wolters, G., Mulkens, S., Hospers, H.J., & Jansen, A. (2009). Early associations with palatable foods in overweight and obesity are not disinhibition related but restraint related. Journal of Behaviour Therapy and Experimental Psychiatry, 40, 136-146. [Download PDF]

Jansen, E., Mulkens, S. , Emond, Y. & Jansen, A. (2008). From the garden of Eden to the land of plenty. Restriction of fruit and sweets intake leads to increased fruit and sweets consumption in children. Appetite, 51, 570-575.

Werrij, M.Q., Mulkens, S., Hospers, H.J., Yvonne Smits-de Bruyn & Jansen, A. (2008). Dietary treatment for obesity reduces BMI and improves eating psychopathology, self-esteem and mood. Netherlands Journal of Psychology, 64, 8-14.

Havermans, R.C., Mulkens, S., Nederkoorn, C., & Jansen, A. (2007). The efficacy of cue exposure with response prevention in extinguishing drug and alcohol cue reactivity. Behavioral Interventions, 22, 121-135. [Download PDF]

Jansen, A., Smeets, T., Boon, B., Nederkoorn, C., Roefs, A., & Mulkens, S. (2007). Vulnerability to interpretation bias in overweight children. Psychology & Health, 22, 561-574 .

Jansen, E., Mulkens, S., Hamers, H., & Jansen, A. (2007). Assessing eating disordered behaviour in overweight children and adolescents: bridging the gap between a self-report questionnaire and a gold standard interview. Netherlands Journal of Psychology, 63, 102-106.

Jansen, E., Mulkens, S. & Jansen, A. (2007). Do not eat the red food! Prohibition of snacks leads to their relatively higher consumption in children. Appetite, 49, 572-577.

Nederkoorn, C., Jansen, E., Mulkens, S., & Jansen, A. (2007). Impulsivity predicts treatment outcome in obese children. Behaviour Research and Therapy, 45, 1071-1075. [Download PDF]

Bos, A.R., Muris, P., Mulkens, S. & Schaalma, H.P. (2006). Changing self-esteem in children and adolescents: A roadmap for future interventions. Netherlands Journal of Psychology, 62, 26-34. [Download PDF]

Mulkens, S. & Jansen, A. (2006). Changing appearances: Cosmetic surgery and Body Dysmorphic Disorder. Netherlands Journal of Psychology, 62, 34-42. [Download PDF]

Werrij, M.Q., Mulkens, S., Hospers. H.J., & Jansen, A. (2006). Overweight and obesity: the significance of a depressed mood. Patient Education and Counseling, 62, 126-131. [Download PDF]

Jansen, A. Nederkoorn, C., & Mulkens, S. (2005). Selective visual attention for ugly and beautiful body parts in eating disorders. Behaviour Research and Therapy, 43,183-196.

Jansen, A., Theunissen, N., Slechten, K., Nederkoorn, C., Boon, B, Mulkens, S. & Roefs, A. (2003). Overweight children overeat after exposure to food cues. Eating Behaviors, 4, 197-209.

Mulkens, S., Bögels, S.M., de Jong, P.J. & Louwers, J. (2001). Fear of blushing: Effects of task concentration training versus exposure in vivo on fear and physiology. Journal of Anxiety Disorders, 15, 413-432. [Download PDF]

Arrindell, W.A., Mulkens, S., Kok, J. & Vollenbroek, J. (1999). Disgust sensitivity and the sex difference in fears to common indigenous animals. Behaviour Research and Therapy, 37, 273-280. [Download PDF]

Mulkens, S., Bögels, S.M. & de Jong, P.J. (1999). Attentional focus and fear of blushing: A case study. Behavioural and Cognitive Psychotherapy, 27, 153-164. [Download PDF]

Mulkens, S., & Bögels, S.M. (1999). Learning history in fear of blushing. Behaviour Research and Therapy, 37, 1159-1167. [Download PDF]

Mulkens, S., de Jong, P.J., Dobbelaar, A. & Bögels, S.M. (1999). Fear of blushing: Fearful preoccupation irrespective of facial coloration. Behaviour Research and Therapy, 37, 1119-1128. [Download PDF]

Mulkens, S., de Jong, P.J., & Bögels, S.M. (1997). High blushing propensity: fearful preoccupation or facial coloration? Personality and Individual Differences, 22, 817-824. [Download PDF]

Bögels, S.M., Mulkens, S. en de Jong, P.J. (1997). Task concentration training and fear of blushing. Clinical Psychology and Psychotherapy, 4, 251-258. [Download PDF]

Mulkens, S., de Jong, P.J. & Merckelbach, H. (1996). Disgust and spider phobia. Journal of Abnormal Psychology, 105, 464-468. [Download PDF]



Jansen, A., Nederkoorn, C., Roefs, A., Martijn, C., Havermans, R., & Mulkens, S. (2009). Waarom obesitas in de GGZ behandeld moet worden. GZ-Psychologie, 1, , 38-44. [Download PDF]

Smits, Y & Mulkens, S., (2008). Diëtist en gedragstherapeut: tandem tegen overgewicht. Nederlands Tijdschrift voor voeding en diëtetiek, 63, 20-22. [Download PDF]

Mulkens, S. (2008). Boekbespreking G. Noordenbos: Gids voor herstel van eetstoornissen. Maandblad Geestelijke Volksgezondheid, 63, 364-366.

Mulkens, S. (2007). Boekbespreking C. Exterkate: Eating Disorders in day treatment. Maandblad Geestelijke Volksgezondheid, 62, 1091-1092.[Download PDF]

Mulkens, S., Fleuren, D. Nederkoorn, C. Meijers, J. (2007). RealFit: een mutidisciplinaire groepbehandeling voor obese jongeren. Gedragstherapie, 40, 27-48. [Download PDF]

Mulkens, S., Kerzel, C., Merckelbach, H., & Jansen, A. (2006). Mooi maar ontevreden: Over psychische stoornissen en cosmetische chirurgie. Maandblad Geestelijke Volksgezondheid, 61, 34-47. [Download PDF]

Havermans, R., Mulkens, S., Franken, I., Vanwingh, M. Sanderson, R. & Jansen, A. (2003). Cue-exposure met responspreventie bij de behandeling van verslavingsgedrag, Directieve Therapie, 23, 247-261.

Mulkens, S. & Jansen, A. (2003). Als je neus maar goed zit: over het belang van selectieve aandacht en schoonheid bij Body Dysmorphic Disorder. De psycholoog, 38, 3-7. [Download PDF]

Mulkens, S. & Werrij, M. (2002). You can’t always get what you want. Bijeenkomsten. De Psycholoog, 37, 682-683.

Mulkens, S. (2001). Aandacht voor bloosangst. De Psycholoog, 36, 342-347. [Download PDF]

Mulkens, S. (2001). Behandeling van bloosangst met taakconcentratietraining. Gedrag en Gezondheid, 29, 333-340. [Download PDF]

Mulkens, S. (1996). Een hoofd als een boei... Over het fenomeen blozen.Psychoskoop, 7, 28-35.

Bögels, S.M., Mulkens, S. en de Jong, P.J. (1995). Overmatig zelfbewustzijn en taakconcentratie training: een nieuw model voor de behandeling van bloosangst. Gedragstherapie, 28, 153-174.

Mulkens, S. (1995). Waarom blozen mensen eigenlijk? De Psycholoog, 30, 490-495.



Jansen, A. & Mulkens, S. (2011). Cognitieve therapie bij eetstoornissen en obesitas. In: Van Oppen, P. en Bögels, S.M. (Eds.). Cognitieve therapie: Theorie en praktijk. Houten: Bohn Stafleu van Loghum.

Mulkens, S. & Bögels, S.M. (2011). Protocollaire behandeling van patiënten met een sociale-angststoornis: Taakconcentratietraining en cognitieve therapie. In: K eijsers, G.P.J., van Minnen, A. & Hoogduin, C.A.L. (Eds.). Protocollaire behandelingen in de ambulante geestelijke gezondheidszorg. Amsterdam: Uitgeverij Boom.

Mulkens, S. (2011). Diagnostiek van BDD. In Denys, D. & Vulink, N.C.C. (Eds.) Handboek Body Dysmorphic Disorder. Assen: Van Gorcum.

Van Rood, Y.R. , Mulkens, S., en Bouman, T. K. (2011). Psychometrie. In Denys, D. & Vulink, N.C.C. (Eds.) Handboek Body Dysmorphic Disorder. Assen: Van Gorcum.

Bos, A. E. R., Uleman, R., Mulkens, S., Muris, P., Mayer, B., Steenhuis, I. & Velthuis, P. (2008). Blij met je lijf? De invloed van sociale en temporele vergelijkingen op de lichaamswaardering en zelfwaardering van vrouwelijke cosmetisch chirurgiepatiënten. In J. Karremans, B. Beersma, R. Custers, F. van Harreveld & W. van Rijswijk (Red), Jaarboek Sociale Psychologie 2007. Groningen: ASPO Pers.

Jansen, A., Elgersma, H. & Mulkens, S., (2008). Boulimia Nervosa en verwante eetstoornissen. In Braet, C. & Bögels, S.M. (red.) Protocollaire behandelingen voor kinderen met psychische klachten. Amsterdam: Boom, p. 495-523.

Mulkens, S. (2000). Red, hot, and scared? Inquiries into fear of blushing. Doctoral dissertation, Maastricht University.

Bögels, S.M. & Mulkens, S. (1997). Protocollaire behandeling van patiënten met een sociale fobie: Taakconcentratietraining en cognitieve therapie. In: Keijsers, G.P.J., van Minnen, A. & Hoogduin, C.A.L. (Red.). Protocollaire behandelingen in de ambulante geestelijke gezondheidszorg (pp.127-157). Houten/Diegem: Bohn Stafleu van Loghum.



Mulkens, S., Baars, S., Roefs, A., Smeets, E. , Beckers, L. (in press). Do obese children detect high caloric food faster than normal-weight children? Appetite

Mulkens, S., Emond, Y. & Nederkoorn, C. (2008). RealFit really Works for obese adolescents: post test and 1-year follow-up of a multidisciplinary (CBT) group treatment for obese adolescents. Appetite, 50 563.

Jansen, E., Mulkens, S., & Jansen, A. (2008). Do not eat the red food! Prohibition of snacks l;eads to their relatively higher consumption in children. Appetite, 50 560.

Mulkens, S., Fleuren, D., Nederkoorn, C. & Meijers, J. (2006). RealFit: the effectiveness of a multidisciplinary (CBT) treatment for overweight adolescents. Appetite, 47, 271

Nederkoorn, C., Jansen, E., Mulkens, S., & Jansen, A. (2006). Individual differences in impulsivity predict overweight and treatment outcome in obese children. Appetite, 47, 271.

Mulkens, S. Jansen, A. & Jansen, E. (2004). Prevention of obesity in adulthood: cognitive-behaviour therapy for seriously overweight children. Appetite, 43, 116.

• “Publicatieprijs voor aankomende auteurs 1995”, Journal ‘De Psycholoog’, for the article: Mulkens, S. (1995). Waarom blozen mensen eigenlijk? De Psycholoog, 30, blz.490-495.
• “EPP-publicatieprijs onderwijsjaar 1997-1998” for the article: Mulkens, S., de Jong, P.J., Dobbelaar, A. & Bögels, S.M. (1999). Fear of blushing: Fearful preoccupation irrespective of facial coloration. Behaviour Research and Therapy, 37, 1119-1128.
• “Prof. Dr. P.E. Boekeprijs 1999-2000. Stichting Postacademiale opleidingen Psychotherapie” for the article: Mulkens, S., Bögels, S.M., de Jong, P.J. & Louwers, J. (2001). Fear of blushing: Effects of task concentration training versus exposure in vivo on fear and physiology. Journal of Anxiety Disorders, 15, 413-43.

• 2004: ZonMW grant (€ 225.000) for the project “Prevention of obesity in children and adolescents: training the parents”. (Phd student Esther Jansen)

• Internship coordinator mastertrack Health and Social Psychology.
• Coordinator of the course “Psychopathology”, a 2nd year course in the curriculum of the Psychology bachelor.
• Coordinator of the practical “Assessment of mental status” (Klachtenanamnese), a 2nd year practical in the curriculum of the Psychology bachelor.
• Coordinator of the practical “self-control” (master Health and Social Psychology).
• Supervision of bachelor theses on the topics of eating disorders, obesity, body dysmorphic disorder, and cognitive-behaviour treatment. A bachelor thesis can either be a literature review or be based on a small experiment.
• Supervison of research for master theses. Students can participate in my ongoing lines of research, or they can come up with their own idea in the field of eating research and BDD research.

• Teacher in the postdoctoral education for ‘GZ-psycholoog’, ‘Klinisch Psycholoog’ and ‘Psychotherapeut’ (Rino-Zuid, Eindhoven and Cure and Care Development, Arnhem)
• In training to become a ‘Klinisch Psycholoog NIP’ (diploma and registration expected in 2010)
• Senior member of the research school Experimental Psychopathology (EPP)
• Member editoral board “The Cognitive Behaviour Therapist”
• Member editorial board “Gedragstherapie”
• Board member VGCT section “eating disorders and obesity”
• Research coordinator team anxiety, eating, somatoform and sexual disorders, academische Riagg Maastricht
• Reviewer for: Behaviour Research and Therapy, Behavior Therapy and Experimental Psychiatry, Netherlands Journal of Psychology, Appetite, Behavioral and Cognitive Psychotherapy, Body Image, ZonMW.
• Active participation (as a NIP delegate) in the “Multidisciplinary Guidelines workgroup on Obesity” (multidisciplinaire richtlijnwerkgroep Obesitas” (CBO, Utrecht), under the chairmanship of Prof. Dr. Ir. J. Seidell: running.
• Full membership (“gewoon lid”) of the Vereniging voor Gedrags- en Cognitieve Therapie (VGCT) since July 1999/ Supervisor VGCT: October 2005.
• BIG-registration Psychotherapist: February 2001
• BIG-registration GZ-Psycholoog: August 2001
• Membership NIP (Netherlands Institute for Psychologists)