Novel Psychoactive Substance Use and Psychological Trauma: A Multimethodological Analysis.

BACKGROUND: Authors discuss the connections between novel psychoactive substance (NPS) use and psychological trauma. The transition from classical substances to NPS, a paradigm change, poses a challenge for the treatment systems. Objective: Research evidence suggests difficulties in emotion regulation and trauma-related NPS-use. Authors explore some demographic and psychopathological characteristics related to such findings and examine the connections between emotion regulation deficiency and the choice of substance. METHOD: This study uses a methodological triangulation of a biologically identified sample to confirm NPS use, a survey method to describe users' socioeconomic characteristics, and Minnesota Multiphasic Personality Inventory (MMPI-2) subscales to study dysfunctions in emotion regulation. RESULTS: Participants (77 patients) were mainly polydrug users. The transgenerational transfer of substance use was a salient feature, but material deprivation was not characteristic of the entire sample. NPS use was not connected to certain psychopathological characteristics the way classical substance use was. More than half of the respondents had elevated scores on MMPI-2 Demoralization (RCd) and Dysfunctional Negative Emotions (RC7) scales. Nearly half of them also scored high on Neuroticism/Negative Emotionality (NEGE). CONCLUSIONS: Results suggest that NPS use in the context of polydrug use is connected to psychological trauma and emotion regulation deficiency, but the MMPI-2 scales to assess emotional dysfunctions are not connected to a particular type of NPS.

[Novel psychoactive substance users' highly valenced life story episodes: A content analysis].

INTRODUCTION: Novel psychoactive substance use (NPS) has proven a challenge for the domestic addiction treatment system. In the first few years, studies focused on types of substances and prevalence. Recently social and cultu ral background, personality/identity issues and experiences of NPS users have been thematised in scientific studies. Our study is connected to the latter tradition. METHODS: Our study comprised a questionnaire on sociodemographic factors, and a mixed method content analysis of highly valenced episodes of life interviews, combining qualitative and quantitative approaches. We analysed the data obtained from 42 NPS users entering treatment. NPS use was confirmed by preceding drug tests. We used descriptive statistical methods to analyse questionnaire data, and employed paired-sample T-test to analyse the data from quanti tative content analysis. The text corpus (personal texts) of the Hungarian National Text Resources was selected as baseline to compare percentages. In our qualitative analysis, we outlined a conceptual network on high point and low point episodes of the life story. RESULTS: Extreme poverty and deprivation was not characteristic of the current sample as a whole. Our content ana - lysis supported previous results on the highly self-destructive nature of novel psychoactive substance use. Major results of the content analysis of highly valenced low point texts were experiences of entrapment, failure, victimisation and never-ending troubles. The use of function words, especially in low point texts, bore marked resemblance with "negative code" frequencies, also indicating a self-destructive attitude. Parallel, elements related to inevitability have increased significantly, while words referring to defence (generalizations and distancing) decreased. CONCLUSION: We interpret the results in terms of the arrested flight/cry of pain model. The results support and add to the conclusions of previous studies on the highly self-destructive nature of NPS-use and may introduce new aspects into treatment. The study is persuasive on the relevance of content analysis in clinical areas.

[The centenary of Ivan Boszormenyi-Nagy's birth (1920-2007). The roots of contextual therapy].

Ivan Boszormenyi-Nagy, the founder of the contextual therapy was born on 19th May 1920. None of the psychotherapeutic models deal with the transgenerational relationships, nor do they address the issue of trustworthi - ness, relational obligations and consequences other than the contextual therapy. Its goal is the restoration and the prevention through strengthening the resources of care, concern and connection. This goal is accomplished by multi - directed partiality, which is one of the most important therapeutic attitude and dialogic methods. The paper addresses the significance of contextual approach and its historical antecedents.

[The first step towards a unified approach: validation of the Hungarian version of the Clinical Institute Withdrawal Assessment of Alcohol, Revised in Hungarian general hospital settings]. / Elso lépés egy egységes szemlélet felé: az Alkohol Megvonási Skála bevezetése a hazai betegellátási gyakorlatba.

Introduction and aim: The available literature and protocols have unequivocally suggested that the Clinical Institute Withdrawal Assessment of Alcohol, Revised is a psychometric scale for identifying and following the signs of alcohol withdrawal. However, there has not been any validated tool for the identification of withdrawal symptoms in Hungarian general hospital settings. The aim of the present study was to evaluate the validity and the reliability of the Hungarian version of this scale among patients hospitalized with alcohol withdrawal syndrome. Method: The translation of the scale into Hungarian was done by 'back translation' method, followed by testing the face validity. The empirical phase was performed in the Department of Psychiatry, University of Szeged. Patients admitted with alcohol withdrawal syndrome (n = 30) were recruited from the inpatient units of the clinic. Clinical Institute Withdrawal Assessment of Alcohol, Revised and Clinical Global Impression - Severity Scale were recorded every two days. Statistical comparisons of data were performed with repeated-measures ANOVA. Cronbach's alpha, item-total correlation, convergent and discriminant validity were determined. Results: Significant decrease of the total scores of Clinical Institute Withdrawal Assessment of Alcohol, Revised and Clinical Global Impression - Severity Scale was observed between the six measurements (F = 202.46, p<0.001; F = 503.04, p<0.001). Cronbach alpha values were above 0.7 during the first 3 measurement days. The withdrawal and severity scores recorded the same day showed positively significant correlations (>0.45). Conclusion: Our findings demonstrate that the Clinical Institute Withdrawal Assessment of Alcohol, Revised is a reliable and valid psychometric tool for the detailed analysis of withdrawal symptoms in Hungarian general hospital settings. Orv Hetil. 2019; 160(30): 1184-1192.

[Dissonance in addictology - The missed encounter between Laszlo Levendel and Thomas Szasz].

The starting point for this paper is a consideration of Jozsef Gerevich's seminal study of binarisms and dissonance in the field of drug treatment policies. Gerevich suggests the possibility of a synthesis of conflicting and divergent approaches. The present study focuses on some historical aspects of this polarisation or dichotomy, as it was exemplified in the contrasting life-works of two scholars of addictionology: Laszlo Levendel and Thomas Szasz. Levendel was one of the most important founding fathers of Hungarian drug treatment system, whilst the Hungarian descended Szasz is perhaps the most famous critic and opponent of addictionology. Born at the same time and growing up in the same city, they shared a generational experience of exclusion. Both initially focused on other medical specialties before developing their careers in the field of addiction. Their approach and methods were contradictory and became polarised. On the one hand Levendel practised an eclectic and inclusive "bricolage" approach to alcohol treatment policy, whilst on the other Szasz was committed to a critical and polemical perspective of "destructive creation". After the democratic transformation of Hungary, the two were about to meet, but Levendel's sudden death prevented this from happening. The lesson we should perhaps take from this fact is that "opportunity is fleeting" and should be taken whenever it occurs.

[E. M. Jellinek's silenced and silencing transgenerational story]. / E.M. Jellinek elnémitott és elnémuló transzgeneracios története.

Jellinek is a kind of archetypal character for future generations in the field of addiction studies. His implosion in the arena of alcoholism around the age of 50 was an unexpected challenge to medical science. We know very little about his own role models giving an intellectual and moral compass to his pragmatic creativity. More than 30 years has passed since Jellinek's death when an American sociologist Ron Roizen started unearthing his silent story. Roizen discerned that there are a lot of unsaid and muted issues in his personal Hungarian past. Our paper, based on the authors' research in Hungarian archives and other sources reveals that not just Jellinek's personal but his transgenerational narrative has been not-yet-said. This silenced and silencing history appears an unfinished business of acculturation of the family, which started prior to four generations. Authors have been concluding that the issue of religious conversion is a critical point in the process of acculturation. They examine the counter move of loyalty to family values and driving force of assimilation making their story unspeakable.

[E. M. Jellinek - a "free floating" alcohologist]. / E.M. Jellinek, a ,,szabadon lebego" alkohologus.

This paper is divulging unpublished materials based on recent research on E. M. Jellinek who was the father of the scientific-medical agenda of alcohology. Results of our research in Hungarian archives not only open still unexplored realm for alcohol studies but also evoke fresh readings of its history. A good half of Jellinek's life has been uncharted and still contains terrain unbeknown to us. Following some infamous activity he fled from Hungary on the very same day (June 4, 1920) when the country lost two-thirds of its territory. After a ten-year roaming Jellinek's private Odyssey came to an end. He has started living his personal "American dream" in the country of his mother through the impersonal dream of alcohology, which was going to aspire to transform itself from a moral movement to an emerging interdisciplinary field of medicine. Jellinek had chosen to be uprooted and he managed to conceal his past in Budapest including his trans-generational past quite effectively. Authors have made an attempt to interpret the ambivalent tale and controversial personality of Jellinek embedded in the progress of alcohol studies.

The main factors of repetition: review of some results of the Pecs Center in the WHO/EURO Multicentre Study on Suicidal Behaviour.

The authors obtained more information about the characteristics of suicide attempters in order to examine the most important differences between those who attempted suicide for the first time (first-evers) and those who had a previous attempt (repeaters). Within the framework of the WHO/EURO Multicentre Study on Suicidal Behaviour in Pecs Center, 1158 cases of parasuicide were collected over 4 years (July 1, 1997-June 30, 2001). In the monitoring sample, 728 (62.9%) parasuicide acts were committed by women and 430 (37.1%) by men, and more than half of the attempters had made a previous attempt In the logistic regression model a higher risk of repetition was found to be related to being divorced (OR 1.84), unemployed or economically inactive (OR 1.45), and without higher education (OR 2.54). In the sample, mental disorders were the most significant risk factor for repeated attempts. The odds ratio was highest (OR 5) for personality disorders. The results may reflect (besides some factors of social destabilization) a higher importance of major mental health problems among repeaters. For this reason, more effective recognition and treatment of the underlying psychiatric and social conditions of suicide attempters has special importance to prevent future suicidal behaviour.