Key factors behind various specific phobia subtypes.

While it has been suggested that more than a quarter of the whole population is at risk of developing some form of specific phobia (SP) during their lives, we still know little about the various risk and protective factors and underlying mechanisms. Moreover, although SPs are distinct mental disorder categories, most studies do not distinguish between them, or stress their differences. Thus, our study was manifold. We examined the psychometric properties of the Specific Phobia Questionnaire (SPQ) and assessed whether it can be used for screening in the general population in a large sample (N = 685). Then, using general linear modeling on a second sample (N = 432), we tested how potential socio-demographic, cognitive emotion regulatory, and personality variables were associated with the five SP subtypes. Our results show that the SPQ is a reliable screening tool. More importantly, we identified transdiagnostic (e.g., younger age, female gender, rumination, catastrophizing, positive refocusing) as well as phobia-specific factors that may contribute to the development and maintenance of SPs. Our results support previous claims that phobias are more different than previously thought, and, consequently, should be separately studied, instead of collapsing into one category. Our findings could be pertinent for both prevention and intervention strategies.

Screen time and sleep among medical students in Germany.

Medical students are a vulnerable group for harmful health behaviours due to academic stress. Increased screen time is associated with adverse health behaviour, particularly delayed bedtime, shorter sleep duration and poorer sleep quality. This possible relationship has not yet been examined among medical students in Europe. Medical students at the Technical University of Dresden were invited to participate in an online questionnaire based cross-sectional study. To analyse correlations between screen time and sleep parameters, correlation coefficients, linear regression and mixed-model analysis were calculated. 415 students (average age 24 years, 70% female) were included in the analysis. The students reported an average of 7 h screen time per day and 7.25 h sleep duration per night. Approximately 23% (n = 97) reported sleeping less than 7 h per night and 25% (n = 105) reported fairly to very poor sleep quality. Students who reported more screen time for leisure went to bed significantly later (r = 0.213, p < 0.001). Students who spent more screen time for study/work tended to sleep shorter (r = - 0.108, p < 0.015). There was no significant association between screen time and sleep quality (p = 0.103). The results show a need for educational interventions to promote healthy sleep behaviour and to limit screen time.

Comparison of typical Thai and Hungarian personality profiles using the Zuckerman-Kuhlman-Aluja Personality Questionnaire.

The aim of our study was to compare typical Thai and Hungarian personality profiles of the Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ). 672 Thai and 647 Hungarian were included in our study. The distribution of age, gender and education level were matched. The ZKA-PQ was administered that measures Aggression, Extraversion, Activity, Sensation Seeking and Neuroticism. We tested reliability, the structural invariance and analyzed aggregated mean profiles for cultures as well as typical profiles by cluster analyses. Reliability of factors were acceptable in both cultures, but some facets (especially AC3 Restlessness) showed low reliability. The global Tucker's coefficient of congruence (TCC) for cross-cultural factorial invariance was 95. We have also run a Multigroup Confirmatory Factor Analysis, but fit indices were not adequate. Cross-cultural neural network invariance was not met either. Hungarians scored significantly higher on Extraversion, Sensation Seeking, Aggression and Activity. Cluster-analyses revealed six typical profiles: Introverted impulsive, Reserved, Resilients, Overcontrolled, Aggressive impulsive and Positive sensation seeker. Majority of first two clusters were Thai respondents, majority for last two clusters were Hungarians. In sum, there were some cross-cultural congruence in factor structure, but strict invariance was not fulfilled. Comparison of mean profiles remain tentative, but cluster analysis revealed cross-cultural differences in typical profiles.

The role of self-reported fear and disgust in the activation of behavioral harm avoidance related to medical settings.

Introduction: Although adaptive defense mechanisms are useful in helping us avoid getting injured, they are also triggered by medical interventions and procedures, when avoidance is harmful. A body of previous results showed that both fear and disgust play a pivotal role in medical avoidance. However, the underlying mechanisms are not fully understood. Thus, the aim of the current study was to examine the effects of experience, perceived control, and pain on medical avoidance with disgust and fear as mediating factors from an evolutionary perspective. Methods: We assessed participants' knowledge of and experience with medical procedures, former negative medical experiences, and health-related information; their life history strategy variation; pain-related fear and anxiety of medical procedures; perceived control over emotional reactions and extreme threats; disgust sensitivity; blood-injury-injection phobia and medical treatment avoidance. Results: We found that more knowledge, experience, and a slower life strategy were linked to a greater level of perceived control and attenuated emotional reactions. Further, better ability to control affective and stress reactions to negative experiences was linked to reduced disgust and fear of pain, and thus might mitigate the level of perceived threat, and diminish fear and disgust reactions. Discussion: More knowledge and experiences, better perceived control together with reduced disgust and fear of pain can decrease the probability of avoiding medical situations. Implications to treatment are discussed. Results support the importance of targeting these contextual factors in prevention to increase the likelihood of people attending regular screenings or seeking medical care when needed.

Mating Performance and Singlehood Across 14 Nations.

Adult individuals frequently face difficulties in attracting and keeping mates, which is an important driver of singlehood. In the current research, we investigated the mating performance (i.e., how well people do in attracting and retaining intimate partners) and singlehood status in 14 different countries, namely Austria, Brazil, China, Greece, Hungary, Italy, Japan, Peru, Poland, Russia, Spain, Turkey, the UK, and Ukraine (N = 7,181). We found that poor mating performance was in high occurrence, with about one in four participants scoring low in this dimension, and more than 57% facing difficulties in starting and/or keeping a relationship. Men and women did not differ in their mating performance scores, but there was a small yet significant effect of age, with older participants indicating higher mating performance. Moreover, nearly 13% of the participants indicated that they were involuntarily single, which accounted for about one-third of the singles in the sample. In addition, more than 15% of the participants indicated that they were voluntarily single, and 10% were between-relationships single. We also found that poor mating performance was associated with an increased likelihood of voluntary, involuntary, and between-relationships singlehood. All types of singlehood were in higher occurrence in younger participants. Although there was some cross-cultural variation, the results were generally consistent across samples.

The role of fear, disgust, and relevant experience in the assessment of stimuli associated with blood-injury-injection phobia.

Individuals with high levels of blood-injection-injury (BII) fears are more likely to avoid health screenings, vaccination, and even minor medical interventions. This could result in more serious health issues, lower quality of life, and even shorter life expectancy. However, still little is known about how various emotions (i.e., fear and disgust) affect subjective evaluation on phobia-related stimuli, and what are the potential risk and protective factors that may change the perception of such stimuli throughout these emotions. We investigated the role of fear of medical interventions and the degree of disgust sensitivity in the evaluation of BII phobia-related content and whether previous relevant experience and age may provide protection against the development of a phobia. We collected online survey data from multiple university sources. Participants (N = 228) completed measures of medical fear, disgust sensitivity, prior relevant experience and medical knowledge. Participants were also asked to rate images related to medical settings on dimensions of valence, arousal, disgust, and threat. Our results suggest that high disgust sensitivity and fear of medical interventions may be a risk factor for avoiding medical settings. However, previous relevant medical experience may function as protective factor. The pandemic of recent years underscored the importance of medical intervention and screening tests. These results have implications for professionals helping (e.g., as counselors) people with BII phobia, and physicians and nurses in informing and treating patients.

Examining the mental health adversity among healthcare providers during the two waves of the COVID-19 pandemic: results from a cross-sectional, survey-based study.

OBJECTIVES: The current global health crisis of the COVID-19 pandemic has drastically affected the whole population, but healthcare workers are particularly exposed to high levels of physical and mental stress. This enormous burden requires both the continuous monitoring of their health conditions and research into various protective factors. DESIGN: Cross-sectional surveys. SETTING AND PARTICIPANTS: Self-administered questionnaires were constructed assessing COVID-19-related worries of health workers in Hungary. The surveys were conducted during two consecutive waves of the COVID-19 pandemic (N-first wave=376, N-second wave=406), between 17 July 2020 and 31 December 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: COVID-19-related worry, well-being and distress levels of healthcare workers. We also tested whether psychological resilience mediates the association of worry with well-being and distress. Multiple linear regression analyses were performed. RESULTS: The results indicated that healthcare workers had high levels of worry and distress in both pandemic waves. When comparing the two waves, enhanced levels of worry (Wald's χ2=4.36, p=0.04) and distress (Wald's χ2=25.18, p<0.001), as well as compromised well-being (Wald's χ2=58.64, p<0.001), were found in the second wave. However, not all types of worries worsened to the same extent across the waves drawing attention to some specific COVID-19-sensitive concerns. Finally, the protective role of psychological resilience was shown by a mediator analysis suggesting the importance of increasing resilience as a key factor in maintaining the mental health of healthcare workers in the burden of the COVID-19 pandemic. CONCLUSIONS: Our results render the need for regular psychological surveillance in healthcare workers. REGISTRATION: Hungarian Scientific and Research Ethics Committee of the Medical Research Council (IV/5079-2/2020/EKU).

Why Hungarians Have Sex: Development and Validation of a Brief 15-Item Instrument (YSEX?-15H).

The present study developed a brief version of the Hungarian Why Sex? questionnaire (Meskó et al., 2022). The study was in part based on previously reported data obtained from several samples (N = 6193; 1976 men, 4217 women). Using Mokken Scaling Procedure, Item Response Model and redundancy analysis indicated that retaining three summary scales comprising five items each was the optimal solution for the brief version. The validity of the brief scale was tested with the Sexual System Functioning Scale (SSFS), the Experiences in Close Relationships Scale-Short Form (ECR-S) and, the Hungarian version of the Attachment Style Questionnaire (ASQ-H; n = 297, 127 men, 170 women). In addition, correlations between the long and brief versions of YSEX? with sociosexual orientation (SOI-R) and the five-factor personality construct (BFI-S) were compared (n = 1024, 578 women, 446 men). The results suggest that the three summary scales of the Hungarian 15-item Form of the Why Sex Questionnaire (YSEX?-15H) provide reliable and valid measures of the previously affirmed three broad sexual motives (Personal Goal Attainment, Relational Reasons, Sex as Coping). The Relational Reasons summary scale was associated with secure emotional and sexual attachment. The Personal Goal Attainment and Sex as Coping summary scales showed coherent patterns of associations with the emotional and sexual aspects of secondary attachment strategies (over- and under-functioning). The YSEX?-15H offers both researchers and practitioners a concise and useful instrument for the assessment of sexual motivation.

Pain catastrophizing, pain sensitivity and fear of pain are associated with early life environmental unpredictability: a path model approach.

BACKGROUND: Socioeconomic disadvantages in the childhood environment might strongly influence beliefs and behavior characterizing the adult years. When children experience unpredictable and adverse situations, they develop an unpredictability schema with the core belief that situations are unpredictable. METHODS: In two studies, we examined the association of childhood socioeconomic disadvantages with self-reported pain sensitivity, pain catastrophizing, and pain-related fear. Multidimensional survey measures were used to assess environmental conditions experienced in childhood. In addition, participants completed the Pain Catastrophizing Scale, Pain Sensitivity Questionnaire, Body Awareness Questionnaire, Unpredictability Schema Questionnaire, and Fear of Pain Questionnaire. In Study 1 (N = 252), in separate models, we examined pain sensitivity and pain catastrophizing of a community sample of pain-free young individuals in association with their childhood experiences. In Study 2 (N = 293), in a new sample, but with a wider age range, we examined the association of early life socioeconomic disadvantages with pain-related fear. In both studies, the predictions were tested with Structural Equation Modeling. Our models constituted a path from childhood socioeconomic status and household unpredictability to pain variables via the factors of family resources, unpredictability schemas, and body awareness. RESULTS AND CONCLUSIONS: The findings converged on the conclusion that individuals experiencing disadvantageous early life conditions tended to have an elevated level of pain catastrophizing, higher perceived sensitivity to pain, and higher level of pain-related fear. These associations were mediated by an unpredictability schema and body awareness.

Negative time perspective predicts the self-perceived affective and physical components of pain independently from depression, anxiety, and early life circumstances.

People's attitudes toward time, the time perspectives (TPs) rooted in past experiences, might be crucial for the emotional evaluation of life events, such as painful situations. In a survey-based study (N = 353), we investigated the relationship of TPs with the self-perceived affective and physical aspects of pain. Specifically, we hypothesised that past-negative TP would be associated with a negative emotional appraisal of pain characterised by higher pain-related catastrophizing, fear, and physical sensitivity to pain. We tested this hypothesis with hierarchical regression models, adding depression, anxiety, and variables of early life circumstances to the model stepwise. Early life circumstances (i.e., socioeconomic status, household unpredictability, and family resources) were measured retrospectively using questionnaires. In addition, based on the results of the regression analyses, we built a structural equation model (SEM) and tested whether past-negative mediates the effect of household unpredictability toward emotional and physical appraisal of pain. We found that individuals scoring high on past-negative TP had greater pain catastrophizing, pain-related fear, and sensitivity to pain. Further, there was evidence that these associations are independent from depression, anxiety, and early life circumstances. Finally, SEM analysis suggested that unpredictable early life circumstances were directed toward intense, negatively emotionalised pain perception via the mediation of the past-negative TP. The findings generally support the view that pain behaviour is formed by emotional states and attitudes that are linked to past experiences that are not necessarily specific to the context of pain.

Recurrent acute pancreatitis prevention by the elimination of alcohol and cigarette smoking (REAPPEAR): protocol of a randomised controlled trial and a cohort study.

BACKGROUND/OBJECTIVES: Acute recurrent pancreatitis (ARP) due to alcohol and/or tobacco abuse is a preventable disease which lowers quality of life and can lead to chronic pancreatitis. The REAPPEAR study aims to investigate whether a combined patient education and cessation programme for smoking and alcohol prevents ARP. METHODS AND ANALYSIS: The REAPPEAR study consists of an international multicentre randomised controlled trial (REAPPEAR-T) testing the efficacy of a cessation programme on alcohol and smoking and a prospective cohort study (REAPPEAR-C) assessing the effects of change in alcohol consumption and smoking (irrespective of intervention). Daily smoker patients hospitalised with alcohol-induced acute pancreatitis (AP) will be enrolled. All patients will receive a standard intervention priorly to encourage alcohol and smoking cessation. Participants will be subjected to laboratory testing, measurement of blood pressure and body mass index and will provide blood, hair and urine samples for later biomarker analysis. Addiction, motivation to change, socioeconomic status and quality of life will be evaluated with questionnaires. In the trial, patients will be randomised either to the cessation programme with 3-monthly visits or to the control group with annual visits. Participants of the cessation programme will receive a brief intervention at every visit with direct feedback on their alcohol consumption based on laboratory results. The primary endpoint will be the composite of 2-year all-cause recurrence rate of AP and/or 2-year all-cause mortality. The cost-effectiveness of the cessation programme will be evaluated. An estimated 182 participants will be enrolled per group to the REAPPEAR-T with further enrolment to the cohort. ETHICS AND DISSEMINATION: The study was approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (40394-10/2020/EÜIG), all local ethical approvals are in place. Results will be disseminated at conferences and in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04647097.

Confirming the factor structure and improving the screening function of the Medical Fear Survey - short in a Hungarian community sample.

Medical Fear Survey (MFS) was designed to assess the fear of medical treatments and related factors through five dimensions including fears of injections and blood draws, sharp objects, blood, mutilation, medical examination and physical symptoms. We analysed the factor structure and validity of a short version of MFS in Hungarian, on a large sample (2631 participants; 558 men, 2067 women) focusing on possible age and gender differences (aged Mean = 30.4, SD = 13.4), which were not reported for the original version. Furthermore, using discriminant analysis, potential screening function of the MFS-short was examined. Results supported construct and convergent validity and scale-reliability for the five-factor structure of the MFS-short. Further analyses demonstrated excellent discriminatory power for four subscales, while one subscale had acceptable power. Our findings provide implications for the utility of MFS-short as a screening measure in assessing the severity of medical fears controlling for gender differences and age-biases.

Help Is in Your Blood-Incentive to "Double Altruism" Resolves the Plasma Donation Paradox.

Blood donation is considered as one of the purest forms of altruism. Plasma donation, in contrast, despite being a similar process, is mostly a paid activity in which donors are compensated for their contribution to the production of therapeutic preparations. This creates a so-called "plasma paradox:" If remuneration is promised for a socially useful effort, volunteers with altruistic motives might be deterred. At the same time, regular plasma donors who pursue the monetary benefits of donation might drop out if remuneration stops. The same controversy can be caught in the messages of most plasma donation companies as well: They promise a monetary reward (MR), and at the same time, highlight the altruistic component of donation. In this study, we tested the assumption that emphasizing the social significance enhances the willingness to donate blood plasma more effectively than either MR or the combination of these two incentives. This had to be rejected since there was no significant difference between the three scenarios. Furthermore, we also hypothesized that individuals might be more motivated to donate plasma if there is a possibility of offering an MR toward other socially beneficial aims. We found an increased willingness to donate in scenarios enabling "double altruism", that is, when donating plasma for therapeutic use and transferring their remuneration to nongovernmental organizations, is an option. We propose relying on double altruism to resolve the plasma paradox, and suggest that it could serve as a starting point for the development of more optimized means for donor recruitment.

The role and tools of trust and empathic communication in healthcare during the COVID-19 epidemic / A bizalom és az empatikus kommunikáció szerepe és eszközei az egészségügyben a COVID-19-járvány idején.

Összefoglaló. A járvánnyal szembeni védekezés során mindennapossá vált a maszkhasználat, amely jelentos kihívást jelent a hétköznapi kommunikációs helyzetekben. Az egészségügy bizonyos területein korábban is jelen volt ez a probléma, azonban a most általános érvényu, folyamatos maszkviselés és védoruha-használat szimbolikus és gyakorlati értelemben is akadályként jelenik meg az orvos és a páciens között, ami több szinten nehezíti a hatékony kapcsolatteremtést és kommunikációt. Ezért szükségessé vált olyan egységes kommunikációs protokollok kidolgozása, amelyek segítik a bizalmi kapcsolat kiépítését az egészségügyben úgy, hogy az ellátók érzelmi elérhetosége és a biztonságos fizikai távolságtartás egyszerre valósuljon meg. Tanulmányunk célja, hogy a kurrens szakirodalom áttekintése révén összefoglaljuk a maszkviselés és a védoruha-használat hatásait az orvos-beteg kommunikációra és a kapcsolatban megjeleno bizalomra és empátiás folyamatokra, valamint fel kívánjuk hívni a figyelmet az egészségügyi személyzetet éro hatásokra is. Célunk továbbá, hogy a hazai és nemzetközi tapasztalatokat figyelembe véve olyan ajánlásokat fogalmazzunk meg, melyek segítségével javítható az egészségügyi dolgozók kommunikációja, azon keresztül pedig az ellátás legfontosabb szereploinek, a betegeknek és az ellátóknak az elégedettsége a kapcsolattal. Orv Hetil. 2021; 162(23): 897-904. Summary. In the fight against the epidemic, the use of masks has become commonplace, which is a significant challenge in everyday communication situations. This problem has been present in some areas of healthcare in the past, but today's universal use of masks and personal protective equipment (PPE) is both a symbolic and practical barrier between doctor and patient, making it difficult to establish an effective communication and connectivity on several levels. Therefore, it has become necessary to develop unified communication protocols that help building a relationship of trust in healthcare so that emotional availability of providers and safe physical distance are achieved simultaneously. The aim of our study is to summarize the effects of mask wearing and PPE usage on the physician-patient communication and also the trust and empathy processes that emerge within the relationship through the review of the current literature. We would also like to draw attention to the effects on healthcare staff. Our goal is also to formulate recommendations, taking into account domestic and international experience, that can be used to improve the communication of healthcare professionals, and through that, the satisfaction of the most important actors in care, patients and caregivers. Orv Hetil. 2021; 162(23): 897-904.

Accepting cultural differences in the integration of foreign medical students / Kulturális különbözoségek elfogadása a külföldi orvostanhallgatók beilleszkedésében.

Összefoglaló. Bevezetés: A 21. századra a multikulturális társadalmi közegben az interkulturális tudás, mint készség, fokozott mértékben válik kulcskompetenciává. E társadalmi kompetencia elsajátításának egyik lehetséges területe a nemzetközi hallgatói mobilitás, mely világszerte, így hazánkban is, egyre nagyobb jelentoségu. Célkituzés: Magyar és külföldi hallgatók körében folytatott vizsgálatunk fókuszában a beilleszkedési folyamatoknak, valamint az interkulturális kompetencia és érzékenység kialakulásának és fejlodésének vizsgálata állt, a Pécsre érkezo mintegy 60 különbözo kultúra, valamint a magyar befogadó közeg vonatkozásában egyaránt. Kutatásunk során többek között arra kerestünk választ, hogy az eredeti és a befogadó kultúra közötti különbségek mely területeken nyilvánulnak meg a leginkább, illetve egy másik kultúrához történo alkalmazkodás során milyen beilleszkedést lassító vagy támogató tényezok tárhatók fel. Módszer: Kutatásunkban kvantitatív és kvalitatív módszereket alkalmaztunk, önkitöltéses kérdoíves felmérés, valamint fókuszcsoportos interjúk formájában. A PTE ÁOK német, angol és magyar nyelvu általánosorvos-képzésében részt vevo hallgatókat a 2010 és 2018 közötti idoszak tavaszi szemesztereiben saját fejlesztésu, anonim, önkéntesen kitöltheto kérdoívvel kerestük meg (a kitöltött kérdoívek száma: n = 13 084 kérdoív). A kérdoíveket három tanévben hét, félig strukturált fókuszcsoportos interjúval egészítettük ki (n = 92 fo). Eredmények: A hazánkba érkezo külföldi orvostanhallgatók számára a befogadó közeghez való alkalmazkodást tekintve a kapcsolódás elsosorban a szocializációs, nyelvi, kommunikációs különbségek miatt bizonyult kihívásnak. Megállapítható azonban, hogy a képzési ido elorehaladtával a különbözoségekbol fakadó nehézségek csökkentek, így a hallgatók egyre inkább képessé váltak az etnorelatív irányba történo elmozdulásra, valamint a multikulturális közeg pozitív aspektusainak értékelésére. Következtetések: A multikulturális környezetben folytatott tanulmányok alatt a kultúraközi kapcsolódási pontok és együttmuködések kialakulása és fejlodése lehetové teszi és támogatja az interkulturális kompetencia elsajátítását, annak minden résztvevoje számára, akár az egyetemi képzésen túlmutatóan, a késobbi orvosi pályát tekintve is. Orv Hetil. 2021; 162(25): 978-987. INTRODUCTION: In the increasingly multicultural social environment of the 21st century, intercultural knowledge as a social skill is gradually becoming a key competence. One of the possible areas of acquiring this competence is international student mobility, which is of increasing importance worldwide, including Hungary. OBJECTIVE: The focus of our study was to examine integration processes and the development and improvement of intercultural competence and sensitivity among Hungarian and international students, both in relation to the approximately 60 different cultures arriving in Pécs and in relation to the Hungarian host environment. In the course of our research, we sought - among other factors - areas, in which the differences between the original and the host culture are the most prominent, and we aimed at identifying those factors that are slowing down or supporting the integration during the adaptation period to another culture. METHOD: In our research, we used both quantitative and qualitative methods, in the form of a self-administered questionnaire and focus group interviews. General medical students of the University of Pécs studying in the German-, English- and Hungarian-language programmes participated in the survey during the spring semesters of the academic years between 2010 and 2018. We used our self-developed questionnaires (number of completed questionnaires: n = 13 084), which were filled in on a voluntary basis and anonymity was ensured. The questionnaires were supplemented with seven semi-structured focus group interviews over three academic years (n = 92 students). RESULTS: Regarding the adaptation to the host environment of foreign medical students studying in Hungary, relationship building arising from socialization, language and communication differences, proved to be a challenge. However, it can be stated that as the training time progressed, the difficulties arising from the differences decreased, so that the students gradually became more able to move towards an ethno-relative direction and evaluated the positive aspects of the multicultural environment. CONCLUSION: During studies in a multicultural university environment, the emergence and development of intercultural connections and collaborations enable and support the acquisition of intercultural competence for all of the students, which will be of great benefit for them, even beyond the university, in their future medical career. Orv Hetil. 2021; 162(25): 978-987.

It Takes Two to Tango: Development, Validation, and Personality Correlates of the Acceptance of Sugar Relationships in Older Men and Women Scale (ASR-OMWS).

Sugar relationships can be considered contemporary forms of transactional sex, that is, offering sexual services for material resources or other benefits. Considering the common age differences in these relationships, sugar relationships might be of relevance for older adults as well on the mating market. As a sequel to Birkás et al. (2020), in the present study, an attitude scale was developed to assess older women's and men's acceptance of sugar relationships. We also explored whether the acceptance of sugar relationships was associated with love styles, sociosexual orientation, sexual motivation, and certain socially aversive personality traits. In two online studies with a total number of 836 participants (N = 277 women and 559 men), the results showed that the Acceptance of Sugar Relationships in Older Men and Women Scale (ASR-OMWS) proved to be a reliable and conceptually valid measure of older individuals' attitude toward sugar relationships. A more accepting attitude toward sugar relationships was found to be associated with more unrestricted sociosexuality, preference to engage in playful love relationships and more self-focused sexual motivation (study 1; N = 481, 167 women and 314 men), and with more pronounced Dark Triad and borderline traits (study 2; N = 355, 110 women and 245 men). Our findings are discussed in an evolutionary framework.

Defining healthstyles to plan behavior change interventions in representative samples of children and adults.

Based on Michie's COM-B model, we developed a survey methodology and segmentation procedure to identify groups of Hungarian school children and adults with distinctive characteristics, named healthstyles. We aimed to find interventions fitting to each healthstyle to generate behavioural change. For the segmentation of data, the latent class analysis method was applied. The analysis resulted in 8 healthstyles for the school children and 13 for the adults. Each healthstyle possess distinctive 'traits' and, therefore, special behavioural change methods and prevention strategies can be fitted for them. For demonstrating the advantages of using healthstyles, we discuss possible approaches for selecting behavioural change interventions, one for school children and one for adults.

Personalised health education against health damage of COVID-19 epidemic in the elderly Hungarian population (PROACTIVE-19): protocol of an adaptive randomised controlled clinical trial.

BACKGROUND: Early reports indicate that COVID-19 may require intensive care unit (ICU) admission in 5-26% and overall mortality can rise to 11% of the recognised cases, particularly affecting the elderly. There is a lack of evidence-based targeted pharmacological therapy for its prevention and treatment. We aim to compare the effects of a World Health Organization recommendation-based education and a personalised complex preventive lifestyle intervention package (based on the same WHO recommendation) on the outcomes of the COVID-19. METHODS: PROACTIVE-19 is a pragmatic, randomised controlled clinical trial with adaptive "sample size re-estimation" design. Hungarian population over the age of 60 years without confirmed COVID-19 will be approached to participate in a telephone health assessment and lifestyle counselling voluntarily. Volunteers will be randomised into two groups: (A) general health education and (B) personalised health education. Participants will go through questioning and recommendation in 5 fields: (1) mental health, (2) smoking habits, (3) physical activity, (4) dietary habits, and (5) alcohol consumption. Both groups A and B will receive the same line of questioning to assess habits concerning these topics. Assessment will be done weekly during the first month, every second week in the second month, then monthly. The composite primary endpoint will include the rate of ICU admission, hospital admission (longer than 48 h), and mortality in COVID-19-positive cases. The estimated sample size is 3788 subjects per study arm. The planned duration of the follow-up is a minimum of 1 year. DISCUSSION: These interventions may boost the body's cardiovascular and pulmonary reserve capacities, leading to improved resistance against the damage caused by COVID-19. Consequently, lifestyle changes can reduce the incidence of life-threatening conditions and attenuate the detrimental effects of the pandemic seriously affecting the older population. TRIAL REGISTRATION: The study has been approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (IV/2428- 2 /2020/EKU) and has been registered at clinicaltrials.gov ( NCT04321928 ) on 25 March 2020.

Providing Sexual Companionship for Resources: Development, Validation, and Personality Correlates of the Acceptance of Sugar Relationships in Young Women and Men Scale (ASR-YWMS).

A sugar relationship is a transactional sexual relationship in which a younger partner (sugar baby/boy) offers companionship and sexual services to a much older partner (sugar daddy/mommy) in return for material compensation. One aim of the present study was to develop an attitude scale assessing young women's and men's acceptance of sugar relationships. Another aim was to explore the possible associations of the acceptance of sugar relationships with psychological functioning in an intimate partner relationship and in a sexual relationship and with certain socially undesirable personality traits. Two online studies were conducted with a total number of 2052 participants (1879 women; age = 18-28 years). The results show that the Acceptance of Sugar Relationships in Young Women and Men Scale (ASR-YWMS) is a reliable and valid measure of young people's attitude toward sugar relationships. The studies revealed that young women's and men's accepting attitude toward sugar relationships was positively associated with unrestricted sociosexuality, a game-playing love style (Ludus), self-focused sexual motivation (Study 1; N = 319; 272 women and 47 men), and with socially undesirable traits such as Machiavellianism, subclinical psychopathy, and a borderline personality organization (Study 2; N = 1733; 1607 women and 126 men). These findings suggest that a relatively high level of acceptance of sugar relationships is part of a mating strategy focused on opportunities of maximizing resources. This utilitarian, risk-taking and exploitative attitude is characteristic to a fast life history strategy, and it is a fundamental organizing principle of psychological and sexual functioning in intimate partner relationships.