Barna Konkolÿ Thege

How to decrease suicide rates in both genders? An effectiveness study of a community-based intervention (EAAD).

Background The suicide rate in Hungary is high in international comparison. The two-year community-based four-level intervention programme of the European Alliance Against Depression (EAAD) is designed to improve the care of depression and to prevent suicidal behaviour. Our aim was to evaluate the effectiveness of a regional community-based four-level suicide prevention programme on suicide rates. Method The EAAD programme was implemented in Szolnok (population 76,311), a town in a region of Hungary with an exceptionally high suicide rate. Effectiveness was assessed by comparing changes in suicide rates in the intervention region after the intervention started with changes in national suicide rates and those in a control region (Szeged) in the corresponding period. Results For the duration of the programme and the follow-up year, suicide rates in Szolnok were significantly lower than the average of the previous three years (p = .0076). The suicide rate thus went down from 30.1 per 100,000 in 2004 to 13.2 in 2005 (−56.1 %), 14.6 in 2006 (−51.4 %) and 12.0 in 2007 (−60.1 %). This decrease of annual suicide rates in Szolnok after the onset of the intervention was significantly stronger than that observed in the whole country (p = .017) and in the control region (p = .0015). Men had the same decrease in suicide rates as women. As secondary outcome, an increase of emergency calls to the hotline service (200%) and outpatient visits at the local psychiatry clinic (76%) was found. Conclusions These results seem to provide further support for the effectiveness of the EAAD concept. Whilst the majority of suicide prevention programs mainly affect female suicidal behaviour, this programme seems to be beneficial for both sexes. The sustainability and the role of the mediating factors (social service and health care utilization, community attitudes about suicide) should be key points in future research.

Social judgments of behavioral versus substance-related addictions: A population-based study

BACKGROUND Recently, the concept of addiction has expanded to include many types of problematic repetitive behaviors beyond those related to substance misuse. This trend may have implications for the way that lay people think about addictions and about people struggling with addictive disorders. The aim of this study was to provide a better understanding of how the public understands a variety of substance-related and behavioral addictions. METHODS A representative sample of 4000 individuals from Alberta, Canada completed an online survey. Participants were randomly assigned to answer questions about perceived addiction liability, etiology, and prevalence of problems with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (problematic gambling, eating, shopping, sexual behavior, video gaming, and work). RESULTS Bivariate analyses revealed that respondents considered substances to have greater addiction liability than behaviors and that most risk factors (moral, biological, or psychosocial) were considered as more important in the etiology of behavioral versus substance addictions. A discriminant function analysis demonstrated that perceived addiction liability and character flaws were the two most important features differentiating judgments of substance-related versus behavioral addictions. Perceived addiction liability was judged to be greater for substances. Conversely, character flaws were viewed as more associated with behavioral addictions. CONCLUSIONS The general public appreciates the complex bio-psycho-social etiology underlying addictions, but perceives substance-related and behavioral addictions differently. These attitudes, in turn, may shape a variety of important outcomes, including the extent to which people believed to manifest behavioral addictions feel stigmatized, seek treatment, or initiate behavior changes on their own.

Substance-related and behavioural addiction problems: Two surveys of Canadian adults

Abstract Objectives: To describe absolute and relative prevalence of 10 self-attributed substance-related and behavioural addiction problems among Canadian adults, to describe perceived prevalence of these problems in the general population, and to examine whether estimates varied by survey mode. Methods: Sample 1 included 4000 adults recruited from an online research panel; Sample 2 included 2000 randomly selected adults who completed a computer-assisted telephone interview. Respondents in both samples were asked (1) whether or not they had experienced a problem in the preceding year with each of four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviours (gambling, eating, shopping, sex, video gaming, and work), (2) whether they had ever personally knew someone exhibiting a problem with each behaviour, and (3) perceived prevalence of problems in the general population. Results: About half of the respondents reported experiencing any past-year addiction problems. Tobacco and alcohol were the most common substance-related problems, while the most common behavioural problems were related to eating and work. Respondents consistently overestimated perceived population prevalence relative to self-attributed problems; however, the magnitude of overestimation was significantly greater among those who personally reported a problem with these behaviours. Online survey participants consistently reported higher self-attributed problem rates compared with CATI respondents, but rank-order correlations across self-, acquaintances-, and population-attributed prevalence estimates were very high in both samples. Conclusions: Both survey modes provided accurate relative prevalence estimates, but further research should explore determinants of higher prevalence rates among online participants and respondents’ consistent tendency to overestimate perceived population prevalence.

A bifactor model of the Posttraumatic Growth Inventory

Purpose: The Posttraumatic Growth Inventory (PTGI) is a self-administered measurement instrument designed to provide information concerning positive psychological changes after a traumatic life event. The aim of the present study was to examine the psychometric properties of the PTGI in a Hungarian sample. By examining a bifactor model of the instrument, we also wanted to contribute to the establishment of an evidence-based practice concerning the use of different score types (total score versus subscale scores). Methods: Altogether, 691 Hungarian respondents (82.2% female; Mage = 33.0 ± 13.4 years), who experienced some kind of trauma or loss, participated in this study. Results: A series of confirmatory factor analyses revealed that among the tested first- and second-order models, a bifactor model provided the best-fit to our data (χ2/df = 4.32, Comparative Fit Index = .91, root mean square error of approximation = .07, standardized root mean square residual = .04). Further, the Hungarian version of the PTGI showed high internal consistency (Cronbachs alpha = .93, omega total = .95, omega hierarchical = .87) and test–retest reliability (r = .90; p < .01) coefficients. However, omega hierarchical coefficients (.14–.40) and explained variance values (.05–.10) for the subscales were low. Conclusions: The present study provided empirical support for the psychometric adequacy of the Hungarian adaptation of the PTGI and suggests that only the total and not the subscale scores of the inventory should be used.

Four-year prospective evaluation of the relationship between meaning in life and smoking status

BackgroundTo date, all investigations on the relationship between smoking and perceived level of meaning in life have used cross-sectional designs. Therefore, the purpose of the present prospective study, conducted with a four-year time lag, was to test the predictive power of the life meaning construct concerning changes in smoking status.MethodsThe data of 4,294 respondents (40.3% male, Mage = 54.7 ± 16.5 yrs) from the Hungarian Epidemiological Panel Survey were analyzed using the Kruskal-Wallis and Mann–Whitney U-test and structural equation modeling (SEM) with a nominal outcome variable. Gender, age, and educational level were included in the study as covariates.ResultsOn the bivariate level, results showed that both baseline and follow-up meaning in life scores were higher in stable non-smokers when compared to stable smokers. However, quitters and starters differed from stable non-smokers in their baseline but not in follow-up life meaning scores. The other relationships (stable smokers vs. quitters; stable smokers vs. starters, starters vs. quitters) were non-significant in both time points. According to the SEM-analysis, a higher sense of meaning in life measured at baseline and follow-up is associated with a lower likelihood (OR = 0.54, z = 2.80, p = 0.005; OR = 0.64, z = 2.88, p = 0.004, respectively) of being a stable smoker compared to being a stable non-smoker, confirming the expected relationship between smoking and decreased level of meaning in life. However, neither baseline nor follow-up life meaning scores predicted significantly quitting and uptake of smoking.ConclusionsIf future research from other cultures verifies the protective role of a higher level of meaning in life against smoking, then smoking prevention and cessation programs will also have to include such components that help individuals experience more meaning in their lives.

Co-occurring substance-related and behavioral addiction problems: A person-centered, lay epidemiology approach

Background and aims The aims of this study were (a) to describe the prevalence of single versus multiple addiction problems in a large representative sample and (b) to identify distinct subgroups of people experiencing substance-related and behavioral addiction problems. Methods A random sample of 6,000 respondents from Alberta, Canada, completed survey items assessing self-attributed problems experienced in the past year with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (gambling, eating, shopping, sex, video gaming, and work). Hierarchical cluster analyses were used to classify patterns of co-occurring addiction problems on an analytic subsample of 2,728 respondents (1,696 women and 1032 men; Mage = 45.1 years, SDage = 13.5 years) who reported problems with one or more of the addictive behaviors in the previous year. Results In the total sample, 49.2% of the respondents reported zero, 29.8% reported one, 13.1% reported two, and 7.9% reported three or more addiction problems in the previous year. Cluster-analytic results suggested a 7-group solution. Members of most clusters were characterized by multiple addiction problems; the average number of past year addictive behaviors in cluster members ranged between 1 (Cluster II: excessive eating only) and 2.5 (Cluster VII: excessive video game playing with the frequent co-occurrence of smoking, excessive eating and work). Discussion and conclusions Our findings replicate previous results indicating that about half of the adult population struggles with at least one excessive behavior in a given year; however, our analyses revealed a higher number of co-occurring addiction clusters than typically found in previous studies.

The ‘light drugs’ of gambling? Non-problematic gambling activities of pathological gamblers

Our aim was to investigate whether harmless gambling activities exist for pathological gamblers. A total of 169 pathological gamblers who recently quit were recruited by media announcements. Respondents were asked at baseline to report any gambling activities not causing them problems, as well as those causing problems. The gambling activities were categorized as follows: lottery, scratch tickets, bingo, betting or card games with friends/family, horse racing, raffle, casino games and video lottery terminals. Only a small proportion (16%) of respondents reported not having any non-problematic gambling activities, 45% reported one, 28% two, 10% three, and 1% four non-problematic activities. Further, involvement in most of these activities was unrelated to both baseline and follow-up gambling problem severity (NODS, SOGS), depression level (CES-D), frequency of gambling and extent of gambling losses. However, some exceptions were observed in case of involvement in casino (higher NODS and SOGS scores and gambling-related losses) and bingo games (higher gambling-related losses). These findings provide some support for the idea that pathological gamblers who wish to give up harmful gambling can continue involvement in some types of gambling and that this is a ‘good enough’ goal for pathological gamblers; complete abstinence may not be necessary.

Psychometric Properties of the Multidimensional Health Locus of Control Scale Form C in a Non-Western Culture

Form C of the Multidimensional Health Locus of Control Scales (MHLC-C) was designed to investigate health-related control beliefs of persons with an existing medical condition. The aim of the present study was to examine the psychometric properties of this instrument in a culture characterized by external control beliefs and learned helplessness—contrary to the societal context of original test development. Altogether, 374 Hungarian patients with cancer, irritable bowel syndrome, diabetes, and cardiovascular and musculoskeletal disorders were enrolled in the study. Besides the MHLC-C, instruments measuring general control beliefs, anxiety, depression, self-efficacy, and health behaviors were also administered to evaluate the validity of the scale. Both exploratory and confirmatory factor analytic techniques were used to investigate the factor structure of the scale. Our results showed that the Hungarian adaptation of the instrument had a slightly different structure than the one originally hypothesized: in the present sample, a three-factor structure emerged where the items of the Doctors and the Others subscales loaded onto a single common component. Internal reliability of all three subscales was adequate (alphas between .71 and .79). Data concerning the instruments validity were comparable with previous results from Western countries. These findings may suggest that health locus of control can be construed very similarly to Western countries even in a post-communist society—regardless of the potential differences in general control beliefs.

Munkahelyi pszichoszociális kockázati tényezők kapcsolata a depressziós tünetegyüttessel a magyar munkavállalók körében: Az Országos Munkahelyi Stresszfelmérés előzetes eredményei

Bevezetés: Nemzetközi és hazai kutatások egyaránt igazolják, hogy a pszichoszociális stressz mentális megbetegedések kockázati tényezője. Célkitűzés: Jelen tanulmány célja az Országos Munkahelyi Stresszfelmérés előzetes eredményeinek feldolgozása a depressziós tünetegyüttes és a stresszterhelés kapcsolatának vonatkozásában. Módszer: Keresztmetszeti kérdőíves vizsgálat magyar munkavállalók körében (n = 1058, 27,5% férfi , 72,5% nő, átlagéletkor 37,2 év, SD = 11). A pszichoszociális tényezőket a COPSOQ II (Koppenhágai Kérdőív a Munkahelyi Pszichoszociális Tényezőkről II), míg a depressziós tünetegyüttest a rövidített Beck Depresszió Kérdőívvel mértük fel. A pszichoszociális tényezők és a depresszió kapcsolatát korrelációval, illetve bináris logisztikus regresszió analízissel vizsgáltuk. Eredmények: A minta negyede közepesen súlyos vagy súlyos depressziós tünetekről számolt be. Az eredmények igazolják a depressziós tünetegyüttes (BDI≥19) összefüggését a munka–család konfl iktussal (OR = 2,21, CI: 1,82–2,68), a fejlődési lehetőségekkel (OR = 0,76, CI: 0,59–0,97), a munka értelmességével (OR = 0,69, CI: 0,59–0,89) és a munkahely iránti elkötelezettséggel (OR = 0,60, CI: 0,47–0,78). Következtetések: A munkavállalók mentális egészségének védelme szempontjából az eredmények felvetik olyan szervezeti szintű intézkedések szükségességét, amelyek lehetővé teszik a pszichoszociális stressz csökkentését. Orv. Hetil., 2015, 156(11), 439–448.INTRODUCTION Research has shown that psychosocial stress acts as a risk factor for mental disorders. AIM The present study aims at processing the preliminary results of the Hungarian Survey of Work Stress, concerning the relationship between depressive symptoms and work stress. METHODS Cross-sectional survey among Hungarian workers was carried out (n = 1058, 27.5% man, 72.5% woman, age 37.2 years, SD = 11 years). Psychosocial factors were measured using the COPSOQ II questionnaire, while BDI-9 was used for the assessment of depressive symptoms. Statistical analysis was carried out applying Spearmans correlation and logistic regression. RESULTS A quarter of the workers reported moderate or severe symptoms of depression (BDI≥19). The study confirmed the association between depressive symptoms and work-family conflict (OR = 2.21, CI: 1.82-2.68), possibilities for development (OR = 0.76, CI: 0.59-0.97) meaning of work (OR = 0.69, CI: 0.59-0.89) and commitment (OR = 0.60, CI: 0.47-0.78). CONCLUSION The results point toward the need of such organizational measures that allow for the reduction of psychosocial stress.