[The clinical significance of mindfulness: Hungarian adaptation of the Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF-15)].

INTRODUCTION: Mindfulness based interventions belongs to the third wave of cognitive behavioural therapies, where the focus is shifted from restructuring negative automatic thoughts and dysfunctional attitudes to the awareness and acceptance of mental events. The effectiveness of mindfulness based interventions also encouraged researchers to explore more precisely the mechanism of mindfulness. One of the most common measuring instruments is the Five Facet Mindfulness Questionnaire (FFMQ). In recent years, several versions of the questionnaire have been developed, but so far no Hungarian sample has yet been used to assess which version is the most suitable for clinical and research use. OBJECTIVE: Hungarian adaptation and internal / external validity testing of the short version of FFMQ. METHOD: In our cross-sectional, non-randomized study, we included 1413 patients from the psychotherapy outpatient clinic of our institution between 2018 and 2022. RESULTS: Compared to the original 39 items, the 15-item version of the FFMQ has better validity indicators. Based on the confirmatory factor analysis, the five-factor model shows an excellent fit. The internal and external reliability of the five-factor structure proved to be better, than the one-factor model. The correlation coefficients also are indicating, that the direction and strength of the relationship are equivalent for the examined variables. CONCLUSIONS: The FFMQ-SF-15 version is a reliable and valid instrument for measuring mindfulness in a clinical sample.

Investigating suicidal behavior among prisoners in the light of the behavioral addiction approach: results of a multicenter cross-sectional study.

Introduction: The behavioral addiction model posits that repetitive suicidal behaviors can serve as maladaptive strategies for managing stress and negative emotional states, akin to substance addiction. Both behaviors involve negative emotions, offer temporary psychological relief, and persist, indicating shared neurobiological mechanisms. This study explored psychometric differences among major repeaters, occasional attempters, and non-suicidal prisoners. Methods: A multi-centre cross-sectional survey of 363 inmates across four prisons assessed depression, cognitive-emotional regulation, impulsivity, perceived stress, lifetime non-suicidal self-injury and suicide attempts. Results: Mild depression, moderate suicidal ideation, and moderate impulsivity were common, with nearly half of the participants having attempted suicide at least once. Hierarchical multiple regression analyses revealed that repeated suicidal behavior in the past increases susceptibility to future suicidal thoughts, with suicide attempts serving as a maladaptive emotion regulation strategy among repeated attempters. Discussion: The results reveal differences in emotional dysregulation, impulsivity, and stress coping strategies among the studied groups, reinforcing the idea of suicidality as a form of behavioral addiction. The addiction approach helps explain the sensitivity to later suicidal thoughts in former attempters and self-harmers, offering valuable insights for tailored interventions within correctional settings.

[Borderline personality disorder and non-suicidal self-injury: the role of mindfulness training in risk reduction].

INTRODUCTION: Due to patients diagnosed with borderline personality disorder (BPD) can engage risky behaviors, it is necessary to develop evidence based interventions in healthcare that can help to reduce the most pressing problems. BPD-specific cognitive therapy-based mindfulness training (MBCT) can be a solution to this challange. LITERATURE REVIEW: Non-suicidal self-injury (NSSI) is a significant predictor of subsequent suicide attempts and occurs in 80% of BPD patients. It is related to impulse- and emotion-dysregulation (cognitive-emotional model), as well as the deficit of mindfulness skills, which are also key difficulties in BPD (emotional cascade model, mindfulness deficit theory). The cognitive-emotional reactivity model of NSSI based on the reactivity model in recurrent depression, the four-function model and theories above. The model differs situational, cognitive, emotional, physiological, and behavioral factors that can trigger or maintain NSSI, and it also helps to determine intervention points. STUDY PROTOCOL: Our hypothesis is that the 8-week MBCT training is more effective in developing mindfulness skills, emotion- and impulse control, and in reducing self-harm also than waiting list or supportive therapy. Participants are BPD patients with NSSI, in a quasi-experimental repeated measure design, planned sample size is N=60 per group. Before the training there is a two-stage interview procedure, patients fill out a questionnaire survey and they have to sign a suicide prevention contract. The planned waiting time between the first interview and the start of the training is 8-12 weeks. The group sessions are based on the MBCT training protocol designed to reduce the risk of suicide, supplemented with BPD-specific elements (specific psychoeducation, loving-kindness meditation). DISCUSSION: Based on the effectiveness of small-sample research, our aim is to test the effectiveness of MBCT training among BPD patients based on the above protocol.

Psychotherapy in obstetrics: implementing low intensity psychological interventions / Pszichoterápia a szülészeten: lehetoségek alacsony intenzitású kognitív viselkedésterápiás intervenciókra.

Összefoglaló. A szülés utáni idoszakban megjeleno aggodalmak természetesnek tekinthetok, az anyák jelentos részénél azonban klinikai szintu szorongásos megbetegedés alakulhat ki. A postpartum idoszakban a szorongásos tünetek gyakori elofordulása ronthatja az anya életminoségét, pszichés állapotát, s ezáltal kedvezotlen hatást gyakorol az anya-gyermek kapcsolatra, a gyermek mentális fejlodésére, a párkapcsolatra, valamint a családi rendszer egyensúlyára. Kutatási eredmények igazolják, hogy a szorongásos zavar a késobbiekben megjeleno anyai depresszió elorejelzoje lehet. A nemzetközi irányelvek (NICE) a peri- és postnatalis idoszakban jelentkezo szorongásos zavarok kezdeti kezelésében az alacsony intenzitású pszichoterápiás módszereket javasolják. Tanulmányunk elsodleges célja, hogy egy esetismertetésen keresztül, kérdoívekkel követve az állapot változását, bemutassuk a szülészet-nogyógyászat területén alkalmazható, kis intenzitású pszichológiai intervenciók eszköztárát. Az utóbbi a kognitív viselkedésterápia alapmódszereit használja kórházi osztályos, illetve ambuláns keretek között. A pszichoedukációt, normalizálást és átkeretezést, problémafókuszú keresztmetszeti konceptualizálást, szisztematikus deszenzitizálást és problémamegoldó technikákat tartalmazó intervenciók hatására az anya jelentos szenvedést okozó szorongásos panaszai már négy pszichoterápiás találkozást követoen csökkentek, az anya képessé vált arra, hogy gyermekét ellássa. A terápia hatékonyságát, a szorongás és a depresszió csökkenését a páciens szubjektív megélésén túlmenoen az állapotköveto kérdoívek eredményei is teljesen mértékben alátámasztották. Eredményeink megerosítik, hogy az alacsony intenzitású pszichológiai intervenciók hatékonyan alkalmazhatók a kórházi osztályokon a szorongásos, depressziós panaszok csökkentésében és ezáltal költségkímélo módon a pszichés zavarok megelozésében. Orv Hetil. 2021; 162(44): 1776-1782. Summary. The occurrence of postpartum worries is considered a normative phenomenon, although the threshold of anxiety reaches clinical level and can lead to the development of postpartum anxiety disorder for a significant number of new mothers. Frequent occurrence of anxiety-related symptoms can negatively influence the mother's quality of life, psychological status, the mother-child relationship, the newborn's mental development, the relationship of the couple as well as the balance of the family system as a whole. Studies show that postpartum anxiety disorder can lead to depression later on. International guidelines (NICE) suggest peri- and postnatal anxiety disorders to be treated using low intensity psychological interventions (LIPIs). The aim of this study is to present the different methods of LIPIs used in obstetrics and gynecology through a clinical case study, while monitoring the outcomes in the mothers' psychological status by the use of questionnaires. LIPIs contain the basics of cognitive behavioural therapy used in hospitals in both in- and outpatient care. After only four psychotherapy sessions using psychoeducation, normalizing and reframing, problem-centered cross-sectional conceptualisation, systematic desensitization and problem solving techniques, the mother's severe symptoms of anxiety decreased significantly, enabling her to take proper care of the newborn. The efficacy of the therapy was confirmed thoroughly not only by the subjective experience of the patient, but the results of the questionnaires used to follow the psychological status of the patient. Our results show that LIPIs can be effectively used as a cost-effective method to reduce symptoms of anxiety or depression, and to prevent the development of mental health problems among hospital patients. Orv Hetil. 2021; 162(44): 1776-1782.

[Suicide prevention contract: a possibility for reducing the risk of suicidality in outpatient psychoterapy care].

The prevention of suicide and self-harm are of particular importance in psychiatric practice handling ade - quate diagnostic procedures. Despite its decreasing tendency, suicide risk is still a serious problem facing our health care system. From the second half of the 20th century, verbal or written agreements that were intended to forestall sui - ci dal behavior became part of suicide prevention protocol. Today, we refer to them as "suicide prevention contracts" or "no-suicide contracts". Despite the fact that these agreements are becoming more and more common in medical care, there is still no general agreement among health care providers on the indication, form or other aspects of these con - tracts. However, contracting in these situations requires delicate discretion. At the outpatient psychotherapy service of the Clinical Psychology Department, Semmelweis University we have been using this tool in the last 20 years in the management of patients in suicidal crisis. In this article the establishment of contracts in clinical use and its indica - tions are described as well as some special issues like suicidality in adolescence. We also discuss the presumed positive effects of contracting, and demonstrate the use of no-suicide contracts in clinical practice by presenting selected cases.