Adherence to the iFightDepression® online self-help tool for depression - A pilot study.

Background and purpose:

The aim of the current observational study was to examine the level of adherence of Hungarian patients suffering from depression, using iFightDep­ression (iFD) guided online self-help tool with and without an extra weekly phone call support as well as identifying the predictors of adherence. Our hypotheses were: the additional weekly phone-calls would increase the adherence with the online self-help tool; furthermore, symptoms of depression will significantly decrease in the weekly phone support group.

During the 6 weeks of iFD® intervention, patients were divided into two groups: the first, alongside of the treatment as usual (TAU) and iFD®, received a 20-minu­tes weekly phone call support while the other group partook in only the TAU+iFD® intervention. Measures: number of completed modules and Patient Health Questionnaire-9. The study included 102 participants with diagnosis of depression (70% female, mean age: 36.9 [SD = 11.40] ys). 

Participants completed on average 4.8 (SD = 1.73) out of 6 modules. The intervention group with additional phone support completed more modules than the group of no additional phone calls (Z = –5.416, p < 0.001, rank Cohen’s d = –1.267). Participants with higher level of education completed more modules than those with lower level of education (Z = –2.198, p = 0.028, rank Cohen’s d = –0.444). Baseline depressive symptoms correlated negatively with the number of completed modules (rS = –0.22, p = 0.028). Depressive symptoms were significantly reduced between the two measurement points (main effect of time: (F(1) = 179.173, p < 0.001, partial η2 = 0.642), the improvement was significantly larger in the iFD® + phone support group (time × group interaction: F(1) = 6.492, p = 0.012, partial η2 = 0.061).

Weekly phone support increased treatment adherence. Negative correlation of symptom severity with adherence suggests that iFD can be effective in mild or moderate forms of depression. With regards to sociodemographic variables, only the level of education showed significant correlation with adherence. Our results support applicability of the iFD intervention in various kinds of sociodemographic groups.

The role of the school health care system in the prevention of childhood obesity - lessons of a pilot study / Az iskola-egészségügyi ellátórendszer szerepe a gyermekkori elhízás prevenciójában - egy pilotvizsgálat tanulságai

Childhood obesity is a growing problem with public health significance, so effective prevention is in our public inter-est. Specialists in the school health care system are of paramount importance in the prevention of childhood obesity. In the present study, the institutional framework of the Hungarian school health care system, the scope of tasks and competencies of the professionals, and the recommendations of the World Health Organization in relation to the prevention of obesity are reviewed. On the other hand, we interviewed three school doctors and a school nurse. The interviews showed that although their workload is high and their capacity is finite, in addition to their fixed tasks (such as regular physical examinations and screening of overweight students, grouping of physical education classes, public health tasks), these professionals implement sensitive care for overweight students, support for weight control, often in collaboration with school management. With their creative solutions, exemplary behavior and forward -looking proposals, they highlight the intervention points for optimizing the operation of the school health care sys-tem, with an emphasis on the role of health policy makers.

Effectiveness of iFightDepression® online guided self-help tool in depression - A pilot study.

BACKGROUND: Depression is one of the leading causes of human misery and disability worldwide. For those fortunate enough to have access to the rapidly expanding World Wide Web, online self-help tools can guide those suffering from depression, with or without professional intervention, to better manage their symptoms and maintain some measure of self-actualization. This study assesses the efficacy of the widely used, online self-help tool, iFightDepression®. METHODS: A six-week, observational study was conducted with 143 participants (29.4% men, mean age: 37.8; standard deviation [SD] = 12.05, range = 18-70, years) in three intervention groups, as follows: 1) Treatment As Usual (TAU), 2) TAU combined with access to the iFightDepression® tool (TAU + iFD®), 3) TAU combined with iFightDepression® and weekly phone support (TAU + iFD® + phone). Depression symptoms were measured pre- and post- by Patient Health Questionnaire-9. RESULTS: There was a significantly greater decrease of depressive symptoms in both iFD® groups compared to the TAU group (time × group interaction: F(2) = 34.657, p < 0.001, partial η2 = 0.331). The reliable change index calculation identified one participant (0.7%) as having experienced a statistically reliable deterioration in depression. A total of 102 participants (71.3%) showed no reliable change, while 40 participants (28.0%) showed a statistically reliable improvement. Multiple binary logistic regression analysis found odds of reliable improvement to be significantly higher in both iFD® groups compared to the TAU group (TAU + iFD®: OR = 18.52, p = 0.015, TAU + iFD® + Phone: OR = 126.72, p < 0.001). Participants living in Budapest were found to have significantly higher odds for a reliable improvement compared to those living in the countryside (odds ratio [OR] = 4.04, p = 0.023). Finally, higher levels of depressive symptoms at baseline (pretest) were also associated with increased odds for post-intervention improvement (OR = 1.58, p < 0.001). The variance explained by the model is 62.0%. With regards to the iFD® self-help program, the mean of completed modules was 4.8 (SD = 1.73, range = 1-6). Participants in the group supported by weekly phone calls completed significantly more modules (n = 50, M = 5.7, SD = 0.76) than participants without weekly telephone support (n = 52, M = 3.9, SD = 1.94, Z = 5.253, p < 0.001). However, there was no significant difference in the number of completed modules between respondents with a reliable improvement in depression (n = 39, M = 4.9, SD = 1.57) and those without a reliable change (n = 63, M = 4.7, SD = 1.83, Z = 0.343, p = 0.731). CONCLUSION: Our results confirm previous findings regarding the efficacy of web-based interventions with the low-intensity guidance of mental health professional. Findings suggest that a relatively short additional weekly call may result in a significant decrease in depressive symptoms and higher number of completed iFD® modules. The study confirms that the IFD® tool, both alone and with additional phone support, is a possible and effective way to help patients with mild to moderate and, in some cases, even severe depression. Providing mental and primary health care systems with the availability of online self-help tools may contribute to the efficacious treatment of depression and prevention of the increase in depressive symptoms.

[A new tool to measure orthorexia nervosa - applying the Eating Habits Questionnaire (Revised) in Hungary].

INTRODUCTION AND OBJECTIVES: Orthorexia nervosa is a new type of disordered eating, characterized by an unhealthy fixation on healthy food. Those who suffer from it are showing compulsive behaviors and increasing dietary restrictions, that can lead to anxiety and physical health problems. Measuring tools for estimating the seve rity of its symptoms are available in Hungary only to a limited extent. The aim of this study was to adapt the Eating Habits Questionnaire's revised version (EHQ-R) to Hungarian, and to perform a psychometric analysis, moreover, to explore the demographic features of orthorexic tendencies. METHODS: The cross-sectional online questionnaire included adults who perform physical exercize regularly (n = 175, 29% male; mean age 35.4 [SD = 7.59] years). MEASUREMENTS: sociodemographic data, anthropometric data (body - weight, height), EHQ-R, ORTO-11-Hu questionnaires. RESULTS: Confirmatory factor analysis supported the EHQ-R's five-factor theoretical structure (c2 (395) = 856.2; p < 0.001; CFI = 0.914; TLI = 0.906; RMSEA = 0.082 [CI 90: 0.074-0.089]). Both the internal reliability of the scales (Cronbach-a = 0.75-0.87) and its consistency over time (r / r = 0.67-0.86) were adequate. The construct validity of the questionnaire is supported by the close correlation of the scales with the ORTO-11-Hu questionnaire (r / r = | 0.63-0.68 |). Regarding gender differences, women scored higher than men on the EHQ-R's Rigidity subscale (t [173] = -1.807; p = 0.073). Age showed a significant, weak, negative relationship with the Negative Emotionality (r = -0.18; p = 0.017) and Time Impairment (r = -0.21; p = 0.005) subscales. CONCLUSION: The EHQ-R has proven to be a reliable and valid measurement tool, thus, we recommend utilizing it as it can provide a quick and valid assessment about the severity of orthorexia symptoms, enabling appropriate interventions.

Differences in well-being and fear of death among female hospice employees and volunteers in Hungary.

BACKGROUND: Voluntary work plays a significant role in hospice care, but international research has mainly been conducted on the mental health and fear of death of paid hospice staff. The aim of the present study was to compare the Hungarian hospice volunteers with paid employees with regard to attitudes and fear of death, as well as mental health in order to see their role in hospice work and their psychological well-being more clearly. METHODS: The target population of the cross-sectional questionnaire study was hospice care providers in Hungary (N = 1255). The response rate was 15.5% (N = 195); 91.8% (N = 179) of them were women. The mean age of female hospice workers was 45.8 years (SD = 10.46 years, range: 23-73 years). One-quarter (27.9%, N = 50) of the female respondents were volunteers. The instruments were: the Multidimensional Fear of Death Scale, the Perceived Stress Scale, the WHO-5 Well-Being Index, and a shortened versions of the Beck Depression Inventory and the Maastricht Vital Exhaustion Questionnaire. RESULTS: Volunteers scored significantly lower on 5 dimensions of fear of death than paid employees, and showed significantly lower levels of vital exhaustion and significantly higher levels of psychological well-being than paid employees. Fear of the dying process was associated with an increased perceived stress, depressive symptoms, and vital exhaustion in both groups. Psychological well-being showed a significant negative, moderate correlation with four aspects of fear of death among paid staff; this pattern did not appear in the volunteer group. In addition, the association between fear of premature death and perceived stress, vital exhaustion, and depressive symptoms was more pronounced is case of paid workers. CONCLUSION: Higher levels of psychological well-being and lower levels of fear of death among hospice volunteers suggest that they are less exhausted than paid employees. Increasing the recruitment of volunteers in hospices may help reduce the overload and exhaustion of paid employees.

Influential factors of well-being among Hungarian female hospice workers examined through structural equation modelling.

According to national hospice data in Hungary, approximately 1,600 healthcare employees and volunteers work in hospice care (country population of 9.9 million). The aim of the study was to identify and examine influential relationships among several variables that may affect well-being among female hospice workers. Structural equation modeling analysis was conducted utilising survey responses of 179 female hospice workers, including 79 nurses. Path analysis revealed that work over-commitment (being employed in more than one job) contributed to decreased psychological well-being through increased perceived stress, sleep difficulties and vital exhaustion. A greater sense of coherence was associated with lower levels of subjective stress, depressive symptoms and vital exhaustion and negatively correlated with over-commitment. Overall, even though the physical and mental burden of the workers is increasing because of increased use of hospice, according to these results, most still engaged in hospice work. Deeper analysis of the sense of coherence may point to development of effective interventions that can help maintain well-being of hospice workers and reduce attrition.

[The relationship between diabetes, stress and sleep problems in the light of the Hungarostudy 2013 research data]. / A diabetes, a stressz és az alvásproblémák kapcsolata a Hungarostudy 2013 kutatás adatainak fényében.

Introduction: The problem of diabetes worldwide raises increasingly serious public health issues in Hungary. In recent years, the emphasis on obesity as a primary cause of diabetes has been driven by a complex understanding of the causes of civilization: the role of sleep problems and stress in the development of the disease and the aggravation of the condition has been proven and supported. Aim: The aim of the study was to investigate the relationship between stress, sleep problems and diabetes in the representative Hungarostudy 2013 survey. Method: In the cross-sectional questionnaire study, 2000 adults participated. Mean of age was 46.9 (SD = 18.24) years. The average BMI was 26.0 (SD = 4.97) kg/m2. Measures: socio-demographic data, question about the presence of treated diabetes, symptomatic list, Perceived Stress Scale. Results: The frequency of diabetes treated one year before the date of the survey was 8.2%. The levels of stress experienced by diabetic patients were significantly higher than those experienced by participants not treated with diabetes (t(1944) = -2.586, p = 0.010). After adjusting potential background variables, perceived stress shows a marginally significant relationship with diabetes (OR = 1.03, p = 0.052). 26.0% of the respondents reported sleep problems last month, while 40.2% of them reported fatigue and energy shortages. The presence of sleep problems (χ2(2) = 61.108, p<0.001) and feeling of fatigue or lack of energy (χ2(2) = 51.061, p<0.001) are significantly more frequent among people with diabetes. Treated diabetes also predicts the presence of sleep problems (OR = 1.77, p = 0.003) as well as fatigue and lack of energy (OR = 1.88, p = 0.004) under the control of potential background variables. Conclusion: Our results show that, according to trends in other parts of the world, both sleep problems and stress play a significant role in the development of diabetes in Hungary. This draws attention to the need for effective screening and treatment of these factors in the prevention and treatment of diabetes in accordance with international protocols. Orv Hetil. 2019; 160(47): 1872-1880.

[Tools for increasing adherence in weight control]. / Az együttmuködés növelésének eszközei a testsúlykontrollban.

Long-term successful weight control poses a huge challenge to people who are overweight and treat them in the obesogenic environment. After reaching a clinically significant (5-10%) weight loss, the goal is to maintain the weight loss achieved. However, this requires virtually constant resistance to temptations and requires sustained effort in terms of dietary restriction and physical activity, which requires a strong motivational base. From the point of view of behavior, motivation is the probability that the patient starts, pursues, or persistently follows a strategy that triggers change, that is, in the case of obesity, is committed to health-related behaviors that support weight management and abandons health risk behaviors that hinders weight control efforts. The present study describes the transtheoretical model of behavioral change and provides examples of practical ways to increase motivation and adherence at all stages of behavioral change. All this can contribute to the work of primary care and outpatient care professionals in supporting weight loss patients with excess weight. Orv Hetil. 2019; 160(43): 1687-1697.

[Characteristics and prevention of burnout syndrome among nurses]. / A kiégés elofordulása és megelozési lehetoségei ápolók körében.

Within the health care system, nurses face multiple hazards from the aspect of burnout syndrome (emotional exhaustion, depersonalisation, and reduced personal accomplishment) development. Burnout has a negative impact on the health and economic status of individuals. Moreover, burnout diminishes compliance, reduces the quality of care, and it influences the prevalence of medical malpractice and complications. Therefore the identification, prevention and treatment of burnout are of public interest. In this study, we present the occurrence of burnout among Hungarian nurses, and we recommend options to prevent the burnout of nurses, focusing especially on the role and possibilities of psychological counselling. All these provide practical aspects and feasibility in preventing and overcoming burnout. Orv Hetil. 2019; 160(1): 12-19.

[Motivation for weight loss among weight loss treatment participants]. / A fogyás motivációi súlycsökkento kezelésben részt vevok körében.

INTRODUCTION: Unrealistic expectations about weight goal and about weight loss-related benefits can hinder the effort for a successful long-term weight control. AIM: To explore weight loss-related goals and their background among overweight/obese patients. METHOD: Study sample consisted of patients who participated in the inpatient weight loss treatment in the Lipidological Department of Szent Imre Hospital (n = 339, 19% men). Mean age: 50.2 years (SD = 13.47 years), mean BMI: 38.6 (SD = 7.58). MEASURES: self-reported anthropometric data, type and number of treated illnesses, Goals and Relative Weights Questionnaire, Motivations for Weight Loss Scale, Body Shape Questionnaire. RESULTS: Participants would feel disappointed with a possible 10% weight loss in a half-year time span. The acceptable weight loss percentage was higher among women, younger participants and among those who had more excess weight. Motivation regarding the increase in social desirability by weight loss is in association with body dissatisfaction, health related motivation is in association with the number of treated illnesses. CONCLUSIONS: Our results are contributing to the understanding of motivational factors behind weight reduction efforts, considering these can improve treatment success rates. Orv Hetil. 2017; 158(49): 1960-1967.

[Experiences with the Three-Factor Eating Questionnaire-R21 in young men]. / A 21 tételes Háromfaktoros Evési Kérdoívvel szerzett tapasztalatok fiatal férfiak körében.

INTRODUCTION: Eating behaviours play a crucial role in the development of obesity. AIMS: To conduct a psychometric analysis of the Three-Factor Eating Questionnaire-R21 and to investigate the correlates of obesogenic eating behaviours among males. METHOD: Participants of the cross-sectional questionnaire-based study were male university students (n = 239, mean of age: 20.3 years, SD = 2.78 years). MEASURES: self-reported body weight and body height, Three-Factor Eating Questionnaire-R21, Trait Anxiety Scale of the State-Trait Anxiety Inventory. RESULTS: Results of confirmatory factor analysis supported the theoretical model of the Three-Factor Eating Questionnaire-R21 (χ2(186) = 366.1, p<0.001, CFI = 0.959, TLI = 0.954, RMSEA = 0.064). Internal consistency of the scales was adequate (Cronbach's α: 0.79-0.88). Body Mass Index and trait anxiety showed significant, positive associations with eating behaviours, such as uncontrolled eating, cognitive restraint, and emotional eating. CONCLUSIONS: Results support the construct validity and reliability of the Three-Factor Eating Questionnaire-R21 among males and highlight the importance of taking psychological factors into account in the prevention of obesity. Orv Hetil. 2017; 158(37): 1469-1477.

[Smoking trajectories among Hungarian adolescents]. / Dohányzói életutak magyar serdülok körében.

INTRODUCTION: Understanding adolescent smoking trajectories is necessary for tailored prevention programs. AIM: To identify adolescent cigarette use patterns and risk factors of smoking trajectories by a longitudinal study. METHOD: We conducted a three-year prospective survey in two age cohorts (6th and 9th school grades) of metropolitan adolescents (n = 1,092) with yearly data collection by self-administered questionnaires. Five smoking trajectory groups were defined by cigarette smoking data. RESULTS: 67.5% of the sample remained nonsmoker, 11.3% smoked all the time, 14.3% were initiators, 3.3% quitters and 3.7% experimenters. Members of smoking trajectory groups differed significantly from each other according to number of smoking friends, parental smoking, family structure, academic achievement and weekly allowance at baseline. CONCLUSIONS: Concerning tobacco prevention programs, adolescents are not homogenous population, because distinct set of risk factors are highlighted in their different smoking behavior groups. Orv. Hetil., 2017, 158(2), 67-76.

Eating behaviors among the participants of an inpatient weight loss treatment.

BACKGROUND AND PURPOSE: Eating behaviors play a crucial role in the development and maintenance of excess weight. The aim of the study was to explore the predictors and changes in eating behaviors among overweight and obese patients. METHODS: The sample of the 6-month prospective survey consisted of patients who participated in the inpatient weight loss treatment program in the Lipidological Department of the Szent Imre Hospital (baseline: N=339, 19% men; follow-up: N=175, 16% men). The mean age was 50.2 years (SD=13.47), the mean BMI was 38.6 (SD=7.58) at baseline. Measures: self-reported anthropometric data, Three-Factor Eating Questionnaire Revised 21-Items, CES-D Depression Scale. RESULTS: According to the results of Multiple Indicators and Multiple Causes analysis, older age predicted greater cognitive restraint (b=0.12, p=0.047). Women were more prone to emotional eating than men (b=0.21, p<0.001). Higher levels of education predicted greater uncontrolled eating (b=0.16, p=0.007) and emotional eating (b=0.12, p=0.039). Depression showed a positive relationship with emotional eating (b=0.19, p=0.001), and mediated the relationship between gender and emotional eating (b=0.04, p=0.009), and BMI and emotional eating (b=0.03, p=0.015). Those whose weight loss was at least 5% showed a greater improvement in the eating behaviors than those whose weight loss was below 5% (cognitive restraint: t(168)=-4.765, p<0.001, uncontrolled eating: t(168)=-2.442, p=0.016, and emotional eating: Z=-2.011, p=0.044). CONCLUSION: Results reveal certain determinants of eating behaviors that enhance or obstruct successful long term weight loss and highlight the role of eating behavior changes in weight loss. These mark intervention points for the optimization of results achievable by weight loss treatments.

HUNGARIAN EXPERIENCES WITH THE BELIEFS ABOUT ATTRACTIVENESS SCALE.

BACKGROUND AND PURPOSE: Sociocultural influences regarding bodily appearance and their psychological consequences play a considerable role in the development and maintenance of body image disturbance and eating disorders. The purpose of the study was to explore the psychometric properties of the Beliefs About Attractiveness Scale-Revised and its correlates among young adults in Hungary. METHODS: In our cross-sectional online study, participants were 18-35 years old (N = 820, 40% male). MEASURES: self-reported anthropometric data, Beliefs About Attractiveness Scale-Revised, Eating Disorder Inventory, SCOFF questionnaire, Sociocultural Attitudes Towards Appearance Questionnaire-3, and Rosenberg Self-esteem Scale. RESULTS: The exploratory factor analysis showed that the fit indices of the three-factor solution are acceptable (χ²(171)) = 5124.8, p < 0.001, CFI = 0.944, TLI = 0.918, RMSEA = 0.054, SRMR = 0.030). Along the original 'Importance of being thin' and the 'Importance of being fit' factors, a third factor emerged, namely the 'Life fulfilment aspect of attractiveness' factor. Internal consistency and construct validity of the scales were confirmed. Among those who were at risk of developing an eating disorder, all of the measured beliefs were significantly greater than among those who were not at risk (thin: Z = 6.501, p < 0.001, Cohen's d = 0.63, fit: t(818) = -4.749, p < 0.001, Cohen's d = 0.41, and life fulfilment: t(239) = -5.702, p < 0.001, Cohen's d = 0.53). CONCLUSION: The Hungarian version of the Beliefs About Attractiveness Scale-Revised is a reliable, valid measure and we suggest its introduction into Hungarian research. Relationships between beliefs about attractiveness and self- esteem, body image and eating disorders suggest intervention opportunities in with regards to prevention and treatment of eating disorders.

Medical students' health behaviour and self-reported mental health status by their country of origin: a cross-sectional study.

BACKGROUND: Numerous previous studies have investigated the lifestyle and self-perceived health status of medical students. This study examined whether students' country of origin contributed to their mental health and health risk behaviour. METHODS: We conducted our cross-sectional questionnaire survey over four consecutive years (2009-2012). The target population was fourth-year English- and Hungarian-language course medical students at Semmelweis University, Hungary. We gathered data on medical students' health behaviour (tobacco smoking, alcohol consumption, dietary habits and exercise) and mental health status and used analysis of variance (ANOVA) to examine the association between country of origin and mental health. RESULTS: The response rate was 76.1 % for the Hungarian and 63.4 % for the English course students. The mean age of our sample was 24.1 years (SD = 2.42). Only 15.3 % of students reported following dietary recommendations, but 75.0 % reported engaging in vigorous and regular physical exercise. The prevalence of tobacco smoking was 18.6 % and 13.8 % overconsumed alcoholic beverages. Hungarian and Iranian students reported lower mental well-being than Mediterranean, Israeli and Scandinavian students (F(4) = 18.943, p < 0.001, η(2) = 0.103). Results of the multiway ANOVA indicated that both country of origin and exercise showed a significant relationship with mental health: vigorous exercise was associated with better mental health status (F(1) = 5.505, p = 0.019). CONCLUSIONS: Medical students' mental health and health behaviour are associated with multiple factors. One of these is country of origin but exercise may also influence mental health. Health promotion programmes organised for medical students should take their country of origin into consideration and should include physical activity.

[Options for stress management in obesity treatment]. / A stresszkezelés alkalmazási lehetoségei az elhízás kezelésében.

Overeating and physical inactivity are of great importance in the etiology of obesity. Psychological factors are often found in the background of life style. Chronic stress can contribute to physical inactivity and behaviors that hinder the keeping of a diet (e.g., irregular eating pattern, emotional eating). Results of randomized controlled trials show that relaxation can reduce emotional eating, improve cognitive restraint, and thereby reduce weight. However, stress management is more than relaxation. It consists of adaptive emotion-focused and problem-focused coping strategies and skills to improve relationships. Deflection skills may help in replacing emotional eating with other behaviors. Cognitive restructuring, saying no, and problem solving help to prevent or manage conflicts and difficulties otherwise would result in overeating due to distress. Developing stress management skills may result in greater compliance with the treatment. The techniques presented in the study can be easily applied by general practitioners or specialists, and provide tools for optimizing obesity treatment.

Adult attachment and parental bonding in irritable bowel syndrome and in panic disorder - Implications for psychotherapy.

BACKGROUND AND PURPOSE: Attachment theory provides an integrative perspective about the interplay between cognitive, affective, behavioral and interpersonal processes and is relevant for understanding irritable bowel syndrome (IBS) and panic disorder (PD). The aim of the present study was to examine the adult attachment style and parental bonding of IBS and PD patients. METHODS: In a cross-sectional questionnaire-based study, 65 PD and 65 IBS patients with clinical diagnosis participated. Measures were Attachment Style Questionnaire, Experiences in Close Relationships Scale - Revised, and Parental Bonding Instrument. RESULTS: The frequencies of insecure attachment (80.0% vs. 63.1%) and paternal neglect (35.4% vs. 16.9%) were higher in IBS than in PD (χ2 (1)=4.571, p=0.033, and χ2 (3)=7.831, p=0.050, respectively). The frequency of secure attachment was significantly higher for optimal paternal bonding than with suboptimal paternal bonding (75.0% vs. 21.9%, χ2 (1)=19.408, p<0.001). According to the results of multiple binary logistic analysis, optimal paternal bonding predicted secure attachment after adjusting for the background variables (OR=9.26, p=0.001). CONCLUSION: A high frequency of insecure attachment was present in both groups, especially in IBS. With regard to maternal bonding, IBS and PD groups showed similar patterns, while an apparent difference was observed for paternal bonding. These highlighted the developmental similarities of these two, symptomatically different disorders. While optimal maternal bonding did not predict adult attachment security, paternal bonding did thus replete with therapeutic implications. Attachment functions, like responsiveness, attunement and affection modulation were apparent in the psychotherapist-patient relationship as well.

The European Initiative ProYouth for the promotion of mental health and the prevention of eating disorders screening results in Hungary.

OBJECTIVE: The ProYouth programme focuses on the promotion of mental health and the prevention of eating disorders (EDs) among young people. The aim of our study was to explore whether the programme can address individuals who are at risk for developing 2EDs. METHOD: This study is designed as an online cross-sectional survey (n = 664, 12.2% men, 87.8% women, mean age: 24.9 years, SD = 5.4 years, range: 18-40 years). Measures included demographic data, self-reported weight and height, the Patient Health Questionnaire for Depression and Anxiety, Short Evaluation of Eating Disorders, Weight Concerns Scale and previous/current treatment for EDs. RESULTS: In terms of severity of EDs, 22.9% (n = 152) of the screened participants were symptom free, 48.8% (n = 324) had considerable concerns about their weight, 11.1% (n = 74) were slightly impaired, 15.1% (n = 100) had severe impairment and 2.1% (n = 14) of participants are currently under treatment for EDs. In total, 56.3% of users (n = 374) registered in the programme. According to our results, those who had considerable concerns about their weight and individuals who were severely impaired registered with a greater odds to the programme than those who were symptom free [odds ratio (OR) = 1.64, p = .021 and OR = 1.90, p = .023, respectively]. Furthermore, those who previously received treatment for their ED registered to the programme with greater odds than those who did not (OR = 2.40, p = .017). CONCLUSION: ProYouth successfully addressed those who have elevated concerns about their weight and who also registered with greater odds to the programme than those who were symptom free regarding EDs. The screening results show that there is a greater need for specialized care targeting EDs in Hungary than what is currently available.

Differentiating the levels of risk for muscle dysmorphia among Hungarian male weightlifters: a factor mixture modeling approach.

Muscle dysmorphia (MD) is a body image disturbance characterized by a pathological preoccupation with muscularity. The study aimed to differentiate the levels of risk for MD among weightlifters and to define a tentative cut-off score for the Muscle Appearance Satisfaction Scale (MASS) for the identification of high risk MD cases. Hungarian male weightlifters (n=304) completed the MASS, the Exercise Addiction Inventory, and specific exercise and body image related questions. For the differentiation of MD, factor mixture modeling was performed, resulting in three independent groups: low-, moderate-, and high risk MD groups. The estimated prevalence of high risk MD in this sample of weightlifters was 15.1%. To determine a cut-off score for the MASS, sensitivity and specificity analyses were performed and a cut-off point of 63 was suggested. The proposed cut-off score for the MASS can be useful for the early detection of high risk MD.