Adrienne Stauder

Chronic stress and social changes: socioeconomic determination of chronic stress.

Abstract:  In the last decades in the transforming societies of Central and Eastern Europe, premature mortality increased dramatically, especially among men. Increasing disparities in socioeconomic conditions have been accompanied by a widening socioeconomic gradient in mortality among men. Social cohesion and meaning in life may help to counterbalance the widening gap in material circumstances. Not the difficult social situation in itself, but the subjective experience of relative disadvantage, the prolonged negative emotional state, that is, chronic stress seems to be the most important risk factor. The health consequences of a low socioeconomic situation among men might be mostly explained by chronic stress caused by work and close‐partner–related factors, and the toxic components of this interaction are depression and hopelessness. In the case of women, the broader personal and family relations are the most important health‐related factors. Weekend workload, low social support at work and low control at work accounted for a large part of variation in male premature cardiovascular mortality rates, whereas job insecurity, high weekend workload, and low control at work contribute most markedly to variations in premature cardiovascular mortality rates among women. There are two general approaches that scientists and practitioners might take: train individuals and groups to use skills that will enable them to cope better with the stressful conditions that are damaging their health; and lobby governments to adopt policies that will result in decreased chronic stress on the societal level.

Measures of stress in epidemiological research

A comprehensive assessment of psychosocial stress often poses significant challenges due to diversity in conceptualization of stress. Consequently, a number of instruments that measure psychosocial stress, its stressors, and its impact at the individual, organizational, and societal levels have been developed. This article aims to provide a brief review of such instruments, focusing on established questionnaire and interview measures in line with the environmentalist and psychological conceptualizations of stress. This includes measures of major life events; work, marital, and social stress; the individuals coping abilities; and psychological and somatic outcomes of stress. We provide a general description of selected instruments and discuss their administration, scoring, and psychometric properties. Appropriate application of these instruments in epidemiological and clinical research, as well as in inpatient care, can aid the detection of psychosocial stress, support thorough assessment and management of the individuals illness, and ensure accurate identification of individuals who would benefit from specific behavioral (psychotherapeutic) interventions.

Severity of allergic complaints: the importance of depressed mood.

OBJECTIVE To evaluate the prevalence of depressive symptoms in patients with different kinds of allergic diseases and the connection of depressive symptoms with the severity, type and seasonality of allergic complaints. METHODS Data was obtained via a cross-sectional multicenter questionnaire survey of 528 patients aged 16-60 years attending six regional in- and outpatient allergy clinics in Hungary in June to July 1998. Consecutive patients completed a structured, self-administered questionnaire containing questions about their current and past allergic complaints. Depressive symptoms were measured by the Shortened Beck Depression Inventory (BDI). RESULTS 32.2% of patients scored above the normal level (> or =10) and 12.5% had clinically significant depressive symptomatology (> or =19) by the BDI. These rates were significantly higher than those found in the control group from a national representative population sample (22.4% and 8.3%). Patients with asthma and with perennial symptoms had significantly higher depression scores than patients with other types of allergic diseases. There was a significant association between the severity of depressive symptoms and the severity of allergic complaints independently from age, sex, type and seasonality of the allergic disease, and other current physical illnesses and symptoms tested by the General Linear Model (GLM). CONCLUSIONS Our results draw attention that patients even with mild depressive symptoms have significantly more severe allergic complaints and assess general health state as much worse than those without depressive symptoms in any types of allergic diseases. Diagnosis and treatment of depressive symptoms in allergic patients is of great concern from both a clinical and an economical point of view.

Psychometric Properties and Construct Validity of the Brief Wisconsin Inventory of Smoking Dependence Motives in an Internet-Based Sample of Treatment-Seeking Hungarian Smokers

INTRODUCTION Both full and brief versions of the Wisconsin Inventory of Smoking Dependence are promising new measurement tools for studying tobacco dependence. We assessed the psychometric properties and construct validity of the Wisconsin Inventory of Smoking Dependence Motives (WISDM)-68 and WISDM-37. METHODS Participants were adult, treatment-seeking Hungarian daily smokers (N = 720) with Internet access who were also registered on a smoking cessation Web site. Using confirmatory factor analyses (CFAs), we tested the measurement models of both WISDM-68 and WISDM-37, internal consistency of subscales of WISDM-37, and gender invariance. We tested the associations between heaviness of smoking, tobacco dependence symptoms, smoking environment, and subscales of WISDM-37. RESULTS Although the measurement model of WISDM-68 did not fit adequately, the measurement model of WISDM-37, including 11 correlating factors (affiliative attachment, automaticity, loss of control, cognitive enhancement, craving, cue exposure/associative processes, social/environmental goads, taste, tolerance, weight control, affective enhancement), satisfactorily represents the data. Latent structures are equal in both genders. Internal consistency of subscales of WISDM-37 ranges between 0.67 and 0.90. Tobacco dependence symptoms were significantly linked with all motives, heaviness of smoking was related significantly only to affiliative attachment, automaticity, loss of control, cognitive enhancement, craving, and tolerance, while tobacco dependence symptoms and gender were controlled. Gender was associated only with the weight control motive. CONCLUSIONS Concurring with previous reports using other types of sample, WISDM-37 has sufficient psychometric properties and good construct validity to make it useful in measuring the multidimensional nature of tobacco dependence even in Internet-based research. Without precedent, gender equality of WISDM-37 is also supported.

A challenging epigenetic message: telomerase activity is associated with complex changes in lifestyle

As an outcome of The 2009 Nobel Prize in Physiology or Medicine, a connection has been highlighted between the length of telomeres and epigenetic effects, such as intensive changes in lifestyle and nutrition as well as behavioural and psychological factors. In this review, the various elements of molecular, cell biological, nutritional and lifestyle changes are introduced and discussed.

Gender Differences in Deliberate Self-Poisoning in Hungary

BACKGROUND The suicide rate in Hungary is one of the highest in the European Union, with a male-female ratio of 3.55:1. Suicide rates correlate positively with suicide attempts, for which depression is the most frequent underlying disorder. AIMS The aim of this qualitative study was to examine gender differences in suicide attempts, with a focus on the effect of precipitating factors on depression. METHOD Semistructured interviews were conducted among 150 suicide attempters. Data on circumstances, reason, and method of attempt were recorded. Patients completed the Shortened Beck Depression Inventory, the Beck Hopelessness Scale, the Sense of Coherence Scale, and the Social Support Questionnaire. RESULTS Interpersonal conflict was found to be the most frequent precipitating factor. There were significant gender differences in depressive symptoms among patients with interpersonal conflicts. We found differences in depressive symptoms according to presence or absence of interpersonal conflicts among men, but not among women. Male suicide attempters who indicated interpersonal conflicts had lower levels of depression. CONCLUSION Depressive symptoms are frequent among suicide attempters. However, a subgroup of male attempters reporting interpersonal conflicts are characterized by a lower level of depression. This subgroup of attempters would probably not be detected with depression screening programs and may have an unmet need for other forms of screening and prevention.

Relationship between meaning in life and intensity of smoking: do gender differences exist?

Little is known about the relationship between smoking and meaning in life, although the association of meaninglessness with other addictive behaviours has been widely investigated. The aim of this study is to examine whether a relationship exists between meaning in life and intensity of smoking as measured by cigarettes smoked per day. The study population was 3506 current smokers from the Hungarostudy 2002 Hungarian representative cross-sectional survey. Age, educational level, marital status, subjective financial status, household income, coffee consumption, hazardous alcohol use, general well-being, anxiety, and depressive symptomatology were included in the analyses as covariates. On the bivariate level, life meaning was associated with smoking intensity in the total sample and among women (p < 0.001), while for males, only a tendency was found (p = 0.069). In the multivariate analyses, life meaning proved to be a significant negative predictor of smoking intensity for females (p = 0.005) even after controlling for the covariates, whereas in men, meaning in life completely lost its significance (p = 0.852). In the total sample, both meaning in life (p = 0.005) and its interaction with gender (p = 0.024) related to the dependent variable. Further research is needed to confirm these explorative findings concerning the protective role of life meaning against more intense smoking among women.

2009 Nobel Prize in Medicine and an interesting message: telomerase activity is associated with lifestyle

A 2009. evi orvosi Nobel-dijat a telomerak es a telomeraz enzim felfedezeseert es az ezekkel kapcsolatos uttorő kutatasokert harom, Amerikaban dolgozo tudos kapta megosztva. Nem regota az is ismert, hogy bizonyos eletmod- es taplalkozasbeli valtozasok (Ornish-fele eletmodvaltozas), magatartasbeli, pszichologiai tenyezők, valamint a telomerarovidules kozott bizonyitott kapcsolat letezik. Az osszefoglaloban ezen osszefuggesek molekularis, sejtbiologiai, eletmodbeli es magatartasi vonatkozasait, valamint ezek lehetseges osszefuggeseit mutatjak be.The 2009 Nobel Prize in Physiology and Medicine was awarded to three scientists for their pioneer research on telomeres – and the enzyme that forms them – telomerase. Their work highlighted the considerable connection between the length of telomeres and intensive changes in lifestyle and nutrition (Ornish method) as well as behavioral and psychological factors. In this review the various elements of molecular, cell biological, nutritional and lifestyle changes are introduced and discussed.The 2009 Nobel Prize in Physiology and Medicine was awarded to three scientists for their pioneer research on telomeres - and the enzyme that forms them - telomerase. Their work highlighted the considerable connection between the length of telomeres and intensive changes in lifestyle and nutrition (Ornish method) as well as behavioral and psychological factors. In this review the various elements of molecular, cell biological, nutritional and lifestyle changes are introduced and discussed.

A félelem és elkerülési hiedelmek krónikus fájdalomban. A FABQ kérdőív magyar változatának fordítása és validálása

INTRODUCTION Chronic low back pain is one of the top reasons for seeking medical advice. In the background of the dysfunction besides the somatic pain dysfunctional thinking, negative emotional states, or interpersonal problems can be identified as well. One of the most important factors making the rehabilitation difficult is the fear and avoidance of physical activity. AIM The aim of the study was to adapt and validate the Fear Avoidance Beliefs Questionnaire (FABQ-H) in Hungarian. METHODS The FABQ (16 items) was translated into Hungarian and filled in by 90 patients suffering from low back pain for at least three months. For cross validation the FABQ-H results of 43 patients were compared with pain intensity the Oswestry Low Back Pain Questionnaire (ODI), the Roland-Morris Disability Questionnaire (RDQ), the Zung Depression Scale (Zung) and the Pain Catastrophising Scale (PCS). RESULTS The internal consistency of the FABQ-H was good: the Cronbachs alpha was 0.8. Correlation analysis revealed that the FABQ showed significant correlation only with the Pain Catastrophising Scale (r = 0.373, p = 0.014). CONCLUSION Our results confirm that the FABQ-H is a valid questionnaire that can be well implemented. Orv Hetil. 2017; 158(24): 949-955.Absztrakt: Bevezetes: A kronikus derektaji fajdalom az egyik leggyakoribb panasz, amivel a betegek orvoshoz fordulnak. A funkcioromlas hattereben, a testi tunetek mellett, a beteg diszfunkcionalis gondolatai, erzelmi lehangoltsaga es szocialis, kapcsolati problemai azonosithatok. Az egyik jelentős tenyező a mozgastol valo felelem, amely elkerulő viselkedesben nyilvanul meg. Celkitűzes: A kutatas celja a „Fear Avoidance Beliefs Questionnaire” magyar nyelvű valtozatanak (jelolese: FABQ-H) kidolgozasa es validalasa. Modszer: A 16 kerdesből allo FABQ kerdőivet leforditas utan 90, legalabb harom honapja tarto derektaji fajdalommal kezelt beteg toltotte ki. A keresztvalidalashoz a teljes kerdőivcsomagot kitoltő 43 beteg FABQ-H-eredmenyeit osszevetettuk a fajdalom intenzitasaval, az Oswestry Derekfajas Funkciomerő Indexszel, a Roland–Morris Derekfajas es Funkciokarosodas Kerdőivvel, a Zung Depresszio Skalaval es a Fajdalom Katasztrofizalas Skalaval. Eredmenyek: A FABQ kerdőiv belső konzisztenciaja jo volt: Cronb...

A Koppenhágai Kérdőív a Munkahelyi Pszichoszociális Tényezőkről II (COPSOQ II) magyar verziójának pszichometriai jellemzői

Absztrakt Elmeleti hatter: A munkahelyi stressz negativ egeszsegi hatasait szamos nemzetkozi es hazai tanulmany igazolja. Hazankban a Munkavedelmi Torveny 2008-tol előirja, hogy a munkaltato kotelessege a pszichoszocialis kockazat felmerese, eddig azonban nem volt celzottan alkalmas, validalt magyar nyelvű kerdőiv a torvenyi előiras betartasara. A COPSOQ II kerdőiv 28 skala es 7 dimenzio menten vizsgalja a munkahelyi pszichoszocialis kockazati tenyezőket, valamint az egeszsegi allapot egyes mutatoit (pl. kieges, stressz, alvaszavar). Celkitűzes: A nemzetkozi kutatasi es kockazatertekelesi gyakorlatban szeles korben elismert COPSOQ II (Copenhagen Psychosocial Questionnaire II) kerdőiv magyar adaptacioja es validalasa. Modszerek: A mintat 527 fő kepezte (25,9% ferfi; 74,1% nő; atlageletkor 35,6 ± 9,9 ev), akik a forditast es lingvisztikai tesztelest kovetően kitoltottek az online kerdőivet. A belső konzisztencia vizsgalathoz Cronbach-alfa-mutatokat elemeztunk, majd feltaro faktorelemzest vegeztunk. A kerdői...