[Sensory food aversion in the context of a modern approach to eating disorders in early childhood]. / A szenzoros ételelutasítás a kora gyermekkori evészavarok korszeru megközelítésének tükrében.

Sensory food aversion, an early childhood eating disorder, is a serious, permanent form of picky eating, in which the infant or the child consistently and persistently refuses certain foods based on specific characteristics, following one or more previous aversive experiences. Biological (sensory processing disorder, taste sensitivity) and environmental factors contribute to its development. Due to limited diet, specific dietary deficiencies may occur but weight gain is usually normal. Behavioral problems, anxiety disorder, autism spectrum disorder are often associated. Diagnosis can usually be made based on a detailed history, but further assessment may include pediatric examination, nutritionist consultation, and psychologic and occupational therapy assessment. Treatment is based on parent education and support in order to minimize mealtime battles and anxiety and to think together about strategies for expanding the child's diet and to help them to accept new foods. As part of the interdisciplinary team, the pediatrician's role is to monitor appropriate growth and development, exclude dietary deficiencies or prescribe supplementation if necessary. In our article, the screening and treatment of sensory processing disorder as part of the assessment of eating problems are introduced as an example of good clinical practice at the Early Childhood Eating and Sleep Disorder Outpatient Clinic at the Heim Pál National Institute of Pediatrics. Orv Hetil. 2023; 164(45): 1767-1777.

[Relation between adverse childhood experiences and problematic alcohol consumption in adulthood]. / Az ártalmas gyermekkori élmények és a felnottkori alkoholfüggoség közötti összefüggések.

Alcohol use disorder and its consequences are a major public health problem not only worldwide, but in Hungary as well. The problem is aggravated by the low rate of admission to treatment, and by the high dropout rate of the treatment prior to its completion date. The relapse rate is also high, up to more than half of the patients are not able to maintain their abstinence following the first few months after their treatment. Although most patients enrolling in the addiction care system are over the age of 35, the causes of alcohol use disorder often stem from early childhood experiences. Long-term traumas in early childhood are significantly associated with somatic and mental health problems later in life such as substance use, including alcohol dependence. The article begins with reviewing the prevalence of alcohol dependence and defining childhood maltreatment and adverse childhood experiences, then discusses the effects and mechanisms of adverse childhood experiences in light of the development of alcohol use disorders in adults and their low treatment rates. The article also aims to raise awareness of the importance of trauma-focused thinking and trauma-informed approaches in the healthcare system and in planning addiction interventions and services. Orv Hetil. 2023; 164(41): 1628-1636.

Factor Structure, Psychometric Properties, and Validation of the Hungarian Version of the Experiences in Close Relationships Revised (ECR-R-HU) Questionnaire in a Nationally Representative Community Sample.

The Experiences in Close Relationships - Revised (ECR-R) is a widely used self-report instrument to assess adult romantic attachment. The present study aimed at examining the factor structure, reliability, construct validity, and temporal stability of the Hungarian version of the ECR-R (ECR-R-HU) in a nationally representative community sample (N = 958). The original avoidance and anxiety dimensions of the ECR-R could only be identified, when reversed-item method factors and residual correlations were included in the confirmatory factor analysis (CFA). The Avoidance and Anxiety subscales of the ECR-R-HU showed high reliabilities and adequate temporal stability over 4 months. The subscales were not significantly associated with respondents' age, gender, and residence type, while being engaged in a romantic relationship was related to significantly lower scores on both subscales. Correlations with measures of family functioning problems, perceived stress, depressed mood, and well-being were significant and in the expected directions. These results confirm the ECR-R-HU as a reliable and valid assessment tool.

Training therapists in emotionally focused therapy: A longitudinal and cross-sectional analysis.

Using cross-sectional and longitudinal data, our study looks at the effectiveness of the Emotionally Focused Therapy (EFT) Externship and Core Skills trainings. It is the first study to evaluate EFT Core Skills trainings and the first to evaluate change longitudinally throughout the standardized EFT training program. We used the Hungarian EFT Knowledge and Competency Scale (Hungarian EFT-KACS) to examine self-perceived knowledge, competency, and alliance over three 4-day training blocks (Externship, Core Skills Modules 1&2, Core Skills Modules 3&4). Results indicate that each training block significantly increased self-perceived knowledge, competency, and alliance. During the Externship, participants' knowledge increased the most and remained at this level after each training block. Competency showed a more modest but significant increase during the Externship. However, by the end of the Core Skills training, competency showed a significant increase compared to post-Externship results, demonstrating the unique role of Core Skills training in developing competency in EFT.

Recognizing Early Regulation Disorders in Pediatric Care: The For Healthy Offspring Project.

BACKGROUND Regulation disorders are already apparent in infancy. The For Healthy Offspring Project was the first Hungarian study aimed at building an effective model for screening and examining the prevalence and complex (medical and psychosocial) background of classic behavior regulation disorders (excessive crying, feeding, and sleep problems) in infancy. MATERIAL AND METHODS Data were collected from families of 0- to 3-year-old children in a pediatric hospital and its neighboring areas through questionnaires, medical examinations, and individual and small-group consultations. RESULTS In the questionnaire study about their children's behavior (n=1133), 15% of mothers reported excessive crying, 16% reported feeding problems, and 10% reported sleep problems. In a subsample (n=619) in which medical examinations were also conducted, the prevalence of medical diagnoses was 15.0% for excessive crying, 15.2% for sleep disorders, 10.3% for breastfeeding difficulties, and 14.8% for feeding disorders. Children who were referred to the screening program (n=183) had significantly more behavior regulation disorders than the other children in our study. Regulation disorders were found to be comorbid with other health conditions in some cases. CONCLUSIONS We developed a complex model to screen for regulatory problems in early childhood. This study adds more information about the relationship between regulation problems and other health conditions. The general incidence (5-15%) of early childhood regulation disorders in other countries is likely similar to that found in Hungary. In order to effectively recognize early regulation disorders, diagnostic instruments widely used in the international field should be adapted in general Hungarian pediatric care.

Measuring the Effectiveness of the Emotionally Focused Therapy Externship Training in Hungary done through Translation.

Our study adds to the rising field of dissemination and implementation research on Emotionally Focused Therapy. We evaluated the psychometric characteristics of the Hungarian EFT-KACS, examined the impact of the EFT Externship training done through translation on Hungarian therapists, and we investigated how therapist background characteristics related to outcomes. A total of 340 Hungarian professionals completed the questionnaires (N = 152 in 2016; and N = 188 in 2018) at three data collecting points-prior to (N = 329), after the training (N = 254), and 6 months later (N = 101). Results suggest the Hungarian EFT-KACS has similar psychometric properties as the original English version and shows high internal consistency. The 4-day EFT Externship trainings done through translation provided significant, lasting increases in perceived EFT-specific knowledge and competency, and in alliance, similar to findings in English- and Spanish-speaking countries. Externship outcomes were also found to be related to specific therapist experience and background characteristics.

[Additional psychometric data for the DS1K mood questionnaire. Experience from a large sample study involving parents of young children]. / Kiegészítö pszichometriai adatok a DS1K hangulati kérdöívhez. Egy kisgyermekes szülöket bevonó nagymintás kutatás tapasztalatai.

AIMS: A new instrument for assessing depressive mood, the first version of Depression Scale Questionnaire (DS1K) was published in 2008 by Halmai et al. This scale was used in our large sample study, in the framework of the For Healthy Offspring project, involving parents of young children. The original questionnaire was developed in small samples, so our aim was to assist further development of the instrument by the psychometric analysis of the data in our large sample (n=1164). METHOD: The DS1K scale was chosen to measure the parents' mood and mental state in the For Healthy Offspring project. The questionnaire was completed by 1063 mothers and 328 fathers, yielding a heterogenous sample with respect to age and socio-demographic status. Analyses included main descriptive statistics, establishing the scales' inner consistency and some comparisons. Results were checked in our original and multiple imputed datasets as well. RESULTS: According to our results the reliability of our scale was much worse than in the original study (Cronbach alpha: 0.61 versus 0.88). During the detailed item-analysis it became clear that two items contributed to the observed decreased coherence. We assumed a problem related to misreading in case of one of these items. This assumption was checked by cross-analysis by the assumed reading level. According to our results the reliability of the scale was increased in both the lower and higher education level groups if we did not include one or both of these problematic items. However, as the number of items decreased, the relative sensitivity of the scale was also reduced, with fewer persons categorized in the risk group compared to the original scale. CONCLUSION: We suggest for the authors as an alternative solution to redefine the problematic items and retest the reliability of the measurement in a sample with diverse socio-demographic characteristics.

[Psychometric parameters of the Hungarian version of Mothers' Object Relations Scales - Short Form (H-MORS-SF) in a large sample]. / A röviditett Szulö-Csecsemö Kapcsolat Skála magyar valtozátnak (H-MORS-SF) pszichometriai mutatói nagy mintán.

INTRODUCTION: The Mothers' Object Relations Scale (MORS) was developed by John M. Oates (Open University, Milton Keynes, UK) in the late 1990s. The MORS is an appropriate instrument for gathering parental perceptions about the child and the parent-infant relationship. The questionnaire and its short form were improved further and validated in British and Hungarian samples in the beginning of the 2000s and the questionnaire was used in several applied studies in the UK where its predictive validity was further confirmed. METHODS: The development and validation phases were based on small samples. The diverse social-demographic characteristics of the For Healthy Offspring project, allowed for further testing the reliability and validity of the Hungarian short-form in a large (n=1164) sample. RESULTS: High internal consistency was found in the original and the imputed data obtained from parents of 0-3-year old children for both of H-MORS-SF dimensions: Invasion and Warmth. The scales had interpretable and systematic cross-correlations with measures of infant temperament (IBQ-R, ECBQ) and mental state (DS1K) of both parents. These results confirm and exceed the previous results based on small samples. CONCLUSION: Given the convincing psychometric indicators and its fast and simple usage, the H-MORS-SF can be considered as an effective preventive screening test for monitoring the developing parent-infant relationship, therefore we suggest its use for professionals working in developmental psychology, child health and social fields.

Infant genotype may moderate sensitivity to maternal affective communications: attachment disorganization, quality of care, and the DRD4 polymorphism.

Disorganized attachment is an early predictor of the development of psychopathology in childhood and adolescence. Lyons-Ruth et al. (1999) developed the AMBIANCE coding scheme to assess disrupted communication between mother and infant, and reported the link between maternal behavior and disorganized attachment. The Hungarian group found an association between a polymorphism of the DRD4 gene and disorganized attachment (Lakatos et al., 2000; 2002; Gervai et al., 2005). The present collaborative work investigated the interplay between genetic and caregiving contributions to disorganized attachment. 138 mother-infant dyads, 96 from a Hungarian low-social-risk sample and 42 from a US high-social-risk sample, were assessed for infant disorganized attachment behavior, for DRD4 gene polymorphisms, and for disrupted forms of maternal affective communication with the infant. In accord with literature reports, we found a robust main effect of maternal AMBIANCE scores on infant disorganization. However, this relation held only for the majority of infants who carried the short form of the DRD4 allele. Among carriers of the 7-repeat DRD4 allele, there was no relation between quality of maternal communication and infant disorganization. This interaction effect was independent of degree of social risk and maternal DRD4 genotype.

[Evaluation of major life events among Hungarian mothers rearing small children]. / Jelentös életesemények megítélése kisgyermekeket nevelö magyar anyák körében.

In this study we present LCU (life change unit) and quality rank orders of 92 significant life events as perceived by 184 Hungarian mothers caring for young children. For data collection, a modified Hungarian version of the Social Readjustment Rating Questionnaire (Miller and Rahe, 1997) was used. As with the American results, we could find no significant demographic effects in our sample on the LCU and quality ranking of the events. Although the Hungarian and the American LCU rank orders of 1997 showed high correlation, the LCU mean of the 63 common items was significantly lower for Hungarian mothers than for American ones. In addition, the stressfulness of some specific life events was perceived differently in the two cultures. The rank order of several life events obtained in an earlier Hungarian study (Tringer and Veér, 1977) allowed us to make a chronological comparison. The correlation of the rank orders of the 32 common items used in the two Hungarian data sets almost 30 years apart was somewhat lower than the association of the present Hungarian rank orders and American ones of 1997. In addition, some life events were ranked quite differently in the two Hungarian studies. Thus, perception of significant life events might differ by culture and by time and this observation should be taken into account in the design of research projects and mainly in their evaluation.