Does sensation-seeking behavior influence the patterns of flavored e-cigarette use? A cross-sectional study among Indonesian adolescents and young adults

BACKGROUND

The variety of available flavors in e-cigarettes may be a driver for young people to start using these products. The objectives of our study were to examine the relationship between sensation-seeking behavior and e-cigarette use, and to identify the predictors of flavor use patterns among adolescents in Indonesia.

METHODS

Students aged 15 to 24 years participated from randomly selected high schools and universities in Indonesia. Participants answered questions about their demographic data, e-cigarette use, conventional cigarette use, and sensation-seeking. Flavor preferences were identified from eight different flavor categories. Multivariate multinomial regression analysis was employed to predict conventional cigarette and e-cigarette use among students. A latent class analysis was conducted to determine the number of latent classes of flavor use.

RESULTS

One thousand six hundred high school and university students, with a mean age of 18.2 years (SD 2.19), were recruited between March and August, 2023. Conventional cigarette use in the past 30 days was higher (16.3%) compared to e-cigarette use (13.3%, p = 0.017), with approximately 8.5% of students were being dual users. Higher levels of sensation-seeking significantly increased the odds of being a current e-cigarette user (OR = 2.54, 95%CI 1.99-3.25) and a current conventional cigarette smoker (OR = 2.38, 95%CI 1.85-3.07). Three groups of flavor classes were identified: 1) primarily menthol flavor users (14%), who had a strong association with current conventional cigarette use; 2) experimenters, who mostly preferred fruit-flavored e-cigarettes (76%); and 3) the multi-flavor user group (10%), who had a higher sensation-seeking tendency.

CONCLUSIONS

Flavors, especially menthol and fruit flavors, attract youth, broaden the e-cigarette audience and are particularly appealing to high sensation-seekers. Banning these flavors could significantly deter e-cigarette initiation among youth.

Prevalence of celebrity worship: Development and application of the short version of the Celebrity Attitude Scale (CAS-7) on a large-scale representative sample

Background and aims

Celebrity worship, defined as an excessive admiration towards celebrities, has generated considerable research and public interest. A widely used assessment instrument to measure celebrity worship is the 23-item Celebrity Attitude Scale. However, concerns have been raised regarding the measurement, including the inconsistent factor structure and lack of a cut-off point to identify "celebrity worshipers". The present study aims to address these concerns by testing the psychometric appropriateness of a short, 7-item version of the CAS (i.e., CAS-7) and estimating the prevalence of individuals with high-level celebrity admiration using a representative sample of Hungarian adults (between 18 and 64 years of age) according to gender, age, geographic location, and size of residence.

Methods

The total sample comprised 2028 respondents, of which 769 valid responses were administered from participants who reported having a favorite celebrity (51.11% men, Mage = 36.38 years, SD = 13.36).

Results

Results indicated an excellent model fit for the two-factor and bifactor model of the CAS-7. Based on the suggested cut-off score of 26, the prevalence of high-level celebrity admiration is 4.53% in the Hungarian adult population (18-64 years of age) and 8.51% among young adults (18-34 years of age). Individuals with this high level of admiration towards a favorite celebrity reported more symptoms of problematic Internet use, depression, anxiety, and stress than individuals with general celebrity admiration levels.

Discussion and conclusions

The CAS-7 demonstrated sound psychometric properties, confirming its applicability in research and practice.

Emotion Regulation Predicts Depressive Symptoms in Adolescents: A Prospective Study

Emotion regulation as a proximal factor has been linked with depressive symptoms. However, studies have mainly focused on a limited number of strategies and have mostly been cross-sectional in design. This is particularly evident when examining the protective effects of adaptive strategies. This study aimed to investigate the prospective relationship between putatively adaptive and maladaptive emotion regulation strategies and depressive symptoms among adolescents. Additionally, a person-oriented approach was applied to identify latent classes of adolescents based on their depressive symptoms and compared these classes in terms of their adaptive and maladaptive strategies. Two waves of data from a prospective study, which included 1371 youth (mean age: 15.66 years; SD = 0.49 years; 55.1% girls), were analysed. The two points of data collection were spaced approximately half a year apart. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale, and putatively adaptive and maladaptive emotion regulation strategies were assessed with the Cognitive Emotion Regulation Questionnaire. Seven strategies (acceptance, positive refocusing, positive reappraisal, putting into perspective, self-blame, rumination, and catastrophizing) were categorised into adaptive and maladaptive factors using exploratory structural equation modeling. After controlling for gender, age, and depressive symptoms at Time 1, both maladaptive and adaptive emotion regulation strategies at Time 1 predicted depressive symptoms at Time 2. Three subgroups emerged based on the intensity of depressive symptoms across the waves: the stable low, stable moderate, and stable high depressive symptom groups. The use of maladaptive emotion regulation strategies (such as rumination, self-blame, and catastrophizing) at Time 1 was more pronounced in the stable moderate and high symptom groups compared to the stable low depressive symptom group. The comparable prospective associations between putatively adaptive and maladaptive strategies with symptoms suggest the need to identify factors that may mitigate the negative impact of maladaptive emotion regulation and/or promote adaptive emotion regulation to buffer the effects of everyday stressors.

Antecedents and components of burnout among Hungarian teachers in a cross-sectional study: Development of the Burnout Antecedents and Components Questionnaire

BACKGROUND

Studies have focused more on the outcome than on the antecedents of burnout. We aimed to develop a new measurement tool for burnout, including the antecedents and different components drawing from theories of the developmental aspect of burnout.

METHODS

In this cross-sectional study we tested the Burnout Antecedents and Components Questionnaire on a convenience sample of teachers (n = 618, 83.9 % women; mean age 44.52 years). We used confirmatory factor analyses to test our measurement model. We examined the concurrent validity with the Maslach Burnout Inventory. We also tested construct validity with depression, overcommitment, demographic characteristics and work-related factors.

RESULTS

The confirmatory factor analyses supported our measurement model with seven primary factors (need to prove oneself, overload of tasks, neglecting one's needs, conflict between values, interpersonal conflicts, passivity, and emotional drain) and three second-order factors (excessive effort, conflict, and total depletion). The covariates in the Maslach Burnout Inventory showed that emotional exhaustion had a strong relationship with the first- and second-order factors. Overcommitment showed a stronger relationship with factors at the beginning whereas depression showed a stronger relationship with factors at the end of the process. Demographic characteristics and work-related factors did not show strong associations.

CONCLUSIONS

The Burnout Antecedents and Components Questionnaire is a promising measurement tool with good convergent validity. Future research should further validate our questionnaire for burnout research, prevention, and screening. It adds a new dimension to the measurement of burnout. The approach involving the antecedents in measuring burnout among teachers can guide future research and tailored prevention programs.

The role of stigma and depression in the reduced adherence among young breast cancer patients in Hungary

BACKGROUND

The main aim of our study was to investigate the role of depression, stigmatization, body shame and self-compassion in the adherence of young Hungarian breast cancer patients aged between 18 and 45 years.

METHODS

In a cross-sectional online survey, data were collected from 99 young breast cancer patients (BC). Participants completed self-report questionnaires on socio-demographic and cancer-specific parameters as well as psychological factors (adherence: 12-item Medication Adherence Scale; depression: Hospital Anxiety and Depression Scale; stigmatization: Stigma Scale for Chronic Illnesses; body shame: Experience of Shame Scale; self-compassion: Self-Compassion Scale). We tested the predictors and mediators of adherence using hierarchical regression, mediation and moderation analysis among BC patients.

RESULTS

We found that adherence was significantly associated with body shame and stigmatization in our BC sample. In addition, stigmatization alone was a significant predictor of lower adherence. Finally, in mediation models, where body shame was a mediator, we found a significant direct effect between stigma and adherence, in other words body shame had a significant mediating effect between these variables. According to our moderation analysis, self-compassion as a significant moderator acts as a protective factor in the linear relationship between stigma and lower adherence.

CONCLUSIONS

Our results highlight the importance of stigma and body shame in the development of adherence in oncological care among young Hungarian BC patients aged between 18 and 45 years. Assessment of stigma, body shame, self-compassion, and the improvement of the availability of evidence-based psychological interventions may increase the adherence of young Hungarian BC patients, leading to more favourable rates of survival.

Sensation seeking, drinking motives, and going out mediate the link between eveningness and alcohol use and problems in adolescence

The present study was aimed at obtaining a more comprehensive understanding of the possible mediating factors in the morningness-eveningness → alcohol consumption relation. We explored the role of mediators such as sensation seeking, the frequency of going out in the evenings, and drinking motives. We tested the proposed mediation model via structural equation modeling based on cross-sectional research conducted among Hungarian adolescents and young adults (N = 1695, 42.5% male, Mage = 18.98, SDage = 1.89). The outcomes included the frequency of alcohol consumption and problematic drinking. Both alcohol consumption and problematic drinking were predicted in similar directions and magnitudes by sensation seeking, "going out," and coping drinking motives. However, eveningness still had a significant direct effect on alcohol consumption and problematic drinking after we controlled for sensation seeking, going out, and drinking motives. For problematic drinking, the possible role of drinking motives seems to be higher and more complex than it is for alcohol consumption. The mediators, such as sensation seeking, the amount of time spent out in the evenings, and drinking motives, can explain the eveningness → alcohol consumption relationship and should be targeted for alcohol prevention programs among evening-type adolescents.

Adaptation and validation of the Hungarian version of Thyroid-Related Patient-Reported Outcome-39 (ThyPro-39) questionnaire: testing factor structure, known-group validity with the comparison of quality of life in Hashimoto's thyroiditis and Graves' disease

BACKGROUND

Living with autoimmune thyroid disease is a longstanding challenge and can seriously affect the quality of life. We aimed to adapt and validate the Hungarian version of the Thyroid-Related Patient-Reported Outcome-39 (ThyPro-39) questionnaire, test its factor structure, and compare two frequent autoimmune thyroid diseases, Hashimoto's thyroiditis, and Graves' disease. We tested the factor structure of ThyPro-39 with a series of confirmatory factor analyses (CFAs). To examine the validity of ThyPro-39 and to compare the quality of life of the two groups - Hashimoto's thyroiditis (N = 240), Graves' disease (N = 51) - CFA with covariates were used.

RESULTS

Our results supported a bifactor model with psychosocial and somatic symptoms as general factors, and 12 symptom-specific factors. Based on the analysis of omega hierarchical indices ranging between 0.22 and 0.66, the specific scales also carry information besides the composite scores and should be used when a more detailed analysis is required. In the multivariate analysis, perceived stress was significantly associated with the general psychosocial factor (β = 0.80), symptom factors (β = 0.34), anxiety (β = 0.43), depressivity (β = 0.37), and emotional susceptibility (β = 0.38) specific factors. Graves' patients reported more eye symptoms (d = 0.45) and cosmetic complaints (d = 0.40), while Hashimoto patients had more cognitive problems (d = 0.36) and more severe hypothyroid symptoms (d = 0.35). These group differences confirm the known-group validity of the questionnaire.

CONCLUSIONS

The validity of the Hungarian version of ThyPRO-39 is supported. We recommend using two composite scores of psychosocial and somatic symptoms and the specific symptoms scores to measure the quality of life in clinical practice and research.

Seasonality and Delirium Tremens in Hospitalized Patients with Alcohol Dependence Syndrome

INTRODUCTION

Due to the high rate of mortality, recognizing the contributing factors of alcohol-related delirium tremens (DT), which is the most severe form of alcohol withdrawal state (AWS) is pivotal in clinical settings. Previous studies suggested relationship between seasonality and other types of delirium; however, to our knowledge, this is the first empirical study which examined the role of seasonality in DT in alcohol dependence syndrome (ADS).

METHODS

A retrospective study was undertaken between 2008 and 2015; medical records of 1,591 patients were included, which yielded 2,900 hospital appearances. Three groups were formed based on the ICD-10 diagnoses: ADS, AWS, and DT. The characteristics of the groups were analysed with one-way ANOVA and χ2 tests. Multinomial logistic regression was used to explore the potential predictors of DT, including seasonality.

RESULTS

The highest incidence of DT was in spring (36.8%; χ2 (3) = 27.666; p < 0.001), especially in March (13.9%; χ2 (11) = 33.168; p < 0.001). Spring, higher mean age, higher presence of comorbid somatic disorders, and lower occurrence of comorbid psychiatric disorders were significant predictive variables for DT with the control of socio-demographic and clinical variables.

CONCLUSIONS

The present study revealed that spring, especially March is a critical period in temperate climate zone regarding DT. This can be interpreted as a late winter effect since the temperature is lower in this month compared to other spring months. Furthermore, higher age and the occurrence of comorbid somatic disorders can be considered as risk factors in case of DT. These results support the need of further clinical studies to better understand the impact of seasonality on DT.

Ki adná a veséjét, és ki nem?

Bevezetés: Napjainkban az élő donorral történő szervtranszplantáció egyre gyakrabban végzett egészségügyi beavatkozás. Az élő szervdonáció az egészségügyi kérdéseken túl számos pszichoszociális kérdést felvet az adományozókkal és motivációjukkal kapcsolatban. Célkitűzés: Az élő vesedonációhoz fűződő attitűd, ismeretek, hiedelmek feltárása és az élődonációs hajlandóságot meghatározó főbb tényezők – mint érintettség, személyiségvonások, egyéni értékrend, jóllét és életcél – feltárása. Módszer: Keresztmetszeti vizsgálatban 571 felnőtt, magyar, önkéntes résztvevő töltötte ki az online kérdőívcsomagot, amely attitűdre, hiedelmekre és ismeretekre vonatkozó kérdéseket tartalmazott, a Schwartz Értékrend Kérdőívet, a Nagy Ötök személyiségtesztet, a WHO-5 Jóllét kérdőívet és az Életcél kérdőívet. Eredmények: A válaszadók többsége családtagnak és barátoknak adományozná életében egyik veséjét, a legkevesebben nem adományoznának egyáltalán, míg a válaszadók 16,8%-a akár ismeretlennek is hajlandó lenne. A résztvevők többsége tudta (71,8%), hogy a vese a leggyakrabban átültetett szerv, valamint hogy élő donorból is e szervet transzplantálják a leggyakrabban. Szignifikáns, de gyenge összefüggést találtunk az élődonációs szándék tekintetében az érintettséggel (r = 0,187), az egyéni értékrenddel (Én-átalakulás) (r = 0,208) és a transzplantációról való ismeretszinttel (r = 0,104). Szignifikáns összefüggés volt az ismeretek (r = –0,352) és a donorokkal kapcsolatos hiedelmek között (r = 0,136). Többszörös lineáris regresszióelemzés alapján az élődonációs szándékot szignifikánsan magyarázta az értékrend (Én-átalakulás) (β = 0,218) és az a negatív hiedelem a donorokkal kapcsolatban, hogy az élődonációt követően rosszabb egészségügyi állapotba kerülnek (β = –0,207). Megbeszélés: Az élő szervadományozáshoz való hozzáállás összefüggésben áll a hiedelmekkel, melyek az egyén ismereteitől függenek, az ismereteket pedig befolyásolja az érintettség. A hozzáállás továbbá összefüggésben áll az egyén mások iránti jóindulatával és felelősségérzetével. Következtetés: Az élő szervadományozásról való ismeretek és az egyéni értékrend tényezői, mint jóindulat és szociális felelősségérzet, központi szerepet játszanak az egyén hozzáállásának alakulásában. Orv Hetil. 2022; 163(45): 1798–1805.

Momentarily narcissistic? Development of a short, state version of the Pathological Narcissism Inventory applicable in momentary assessment

Background

Narcissism viewed as a personality process rather than a stable trait explains narcissistic functioning as a tool for maintaining a positive self-view. Studying narcissism therefore needs adequate momentary measures for collecting higher frequency longitudinal data in experience sampling method (ESM) studies. In this study, a shorter version of the Pathological Narcisissm Inventory is offered to measure vulnerable and grandiose narcissistic states, applicable in momentary assessment.

Methods

The measurement tool was tested in three samples. First, we assessed the factor structure and associations with other contemporary measures of narcissism in a cross-sectional design on one English speaking (n = 319) and one Hungarian sample (n = 236). Second, we conducted a five-day long experience sampling method study with a total of 15 measurement points (n = 123).

Results

Based on structural equation modelling and multilevel analyses, the results suggest that the measure has adequate psychometric properties in both the within and between subject levels as well as acceptable convergent and discriminant validity.

Conclusions

The Pathological Narcissism Inventory – State Version (PNI-S) can be a useful tool in momentary data collection enabling the examination of personality processes behind narcissistic functioning.

A comprehensive model to understand and assess the motivational background of video game use: The Gaming Motivation Inventory (GMI)

BACKGROUND AND AIMS

The popularity of video gaming has generated significant interest in research methods to examine motivations for gaming. Current measures of gaming motives are limited by lack of scope and/or their applicability to specific game genres only. We aimed to create a comprehensive motivation inventory applicable to any gaming genre and to evaluate its psychometric properties in a large sample of highly engaged video gamers.

METHODS

Stage 1 of this project involved a systematic review that generated the items for the Gaming Motivation Inventory (GMI). Stages 2-4 involved an evaluation of the psychometric properties of the GMI. A sample of 14,740 video gamers (89.3% male; mean age 24.1 years) were recruited via an online survey promoted by a popular gaming magazine.

RESULTS

In Stage 2, twenty-six gaming motives were identified, which clustered into six higher-order dimensions (Mastery, Immersion/Escapism, Competition, Stimulation, Social, Habit/Boredom). In Stage 3, construct validity of the six higher-order motives was assessed by associations with gaming-related, personality, and psychological variables. In Stage 4, the relationships between motives and depression symptoms and gaming disorder symptoms were explored. Although gaming motives had weak associations with gaming genres, they were moderately related to variables such as competitiveness, sociability, and positive and negative affect. Gaming disorder symptoms were directly predicted by depression symptoms and indirectly via Immersion/Escapism, Habit/Boredom, and Competition motives.

DISCUSSION AND CONCLUSIONS

These findings support the notion that motives are one of the primary causes of gaming behavior and play an important role in predicting its problematic nature. The GMI is a psychometrically valid tool that will be useful for gaining insights into factors underlying gaming behaviors.

Dimensionality of narcissism: a Bifactorial model of the Narcissistic Personality Inventory using single-stimulus response formats

The Narcissistic Personality Inventory is a widely used measure of narcissism; however, several different conflicting factor structures have been proposed. The present study aimed to untangle those differences by offering a bifactor model of narcissism with an underlying general narcissism factor and several specific factors. Our objective was to estimate the variance explained by the general and the specific factors. Therefore, we applied a set of confirmatory factor analyses on three independent studies (N = 791; N = 319 and N = 237), and also tested the construct validity of these factors with other contemporary measures of grandiose and vulnerable narcissism, big five personality traits, explicit self-esteem, gender and well-being. Our results suggest that the bifactor model with three specific factors yielded acceptable fit to our data in all of the different single-stimulus response formats and languages used in our studies and modelling three specific factors offered more insight into the adaptive and maladaptive characteristics of narcissism. The general narcissism factor alone explains only about half of the common variance, highlighting the importance of the specific factors as well.

Externalizing personality characteristics define clinically relevant subgroups of alcohol use disorder

AIMS

Higher levels of externalizing characteristics, i.e. impulsivity, novelty seeking and aggression, could contribute to the development, progression and severity of alcohol use disorder (AUD). The present study aims to explore whether these externalizing characteristics together have a potential group-forming role in AUD using latent profile analysis (LPA).

METHODS

Externalizing characteristics of 102 AUD patients were analyzed using LPA to explore the group-forming role of externalizing symptoms; groups were compared in terms of demographic and alcohol-related variables, indices of psychopathological, depressive and anxiety symptom severity.

RESULTS

LPA revealed and supported a two-group model based on externalizing symptoms. The group with higher levels of externalizing symptoms showed significantly elevated levels of alcohol-related and anxio-depressive symptoms.

CONCLUSIONS

Externalizing characteristics converge and have a group-forming role in chronic AUD, and are associated with a more severe form of AUD. By making the diagnostic category less heterogeneous, these different subtypes within AUD may provide aid in tailoring treatments to patients' specific needs.

Perceived harm of heated tobacco products, e-cigarettes, and nicotine replacement therapy compared with conventional cigarettes among ever and current heated tobacco users

•

Hungarian HTP users similarly perceive the harm of HTPs and NRT.

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Compared to CCs, HTP users perceive HTPs less harmful than of e-cigarettes.

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Current and exclusive HTP users more likely perceive HTPs as less harmful than CCs.

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HTP users have distorted harm perceptions of nicotine products.

Aims

There is limited knowledge on how ever and current heated tobacco product (HTP) users perceive the relative harm of various nicotine-containing products. The aim of this study was to explore relative harm perceptions of HTPs, e-cigarettes, and nicotine replacement therapy (NRT) relative to conventional cigarettes (CCs) among ever versus current HTP users, and exclusive (who use only a HTP) versus dual/poly-users (concurrent users of HTP and CCs and/or e-cigarettes).

Methods

Data came from 1423 ever or current Hungarian adult HTP users who participated in a cross-sectional web-based survey in 2020. Unadjusted and adjusted logistic regression analyses were performed to explore the associations between relative harm perceptions, HTP use patterns, past tobacco use, HTP dependence, and socio-demographic variables.

Results

81.2% of the sample was current HTP users, of them 78.4% were exclusive HTP users. Compared to CCs, 86.2% of the sample perceived HTP to be less harmful, with current and exclusive HTP users endorsing more this belief, followed by NRT (79.8%), and e-cigarettes (45.2%). In general, neither socio-demographic variables nor past tobacco use, HTP use pattern, and HTP dependence were related to perceived harmfulness across the tested products. However, there was a specific pattern for each tested product with a set of explanatory variables.

Conclusions

Ever/current HTP users presented misperceptions about the harms of HTPs, e-cigarettes, and NRT. They underestimated the potential health benefits of NRT and had distorted harm perceptions about HTPs and e-cigarettes. Public education about the relative harms of different nicotine and tobacco products is urgently needed.

FOXN3 and GDNF Polymorphisms as Common Genetic Factors of Substance Use and Addictive Behaviors

Epidemiological and phenomenological studies suggest shared underpinnings between multiple addictive behaviors. The present genetic association study was conducted as part of the Psychological and Genetic Factors of Addictions study (n = 3003) and aimed to investigate genetic overlaps between different substance use, addictive, and other compulsive behaviors. Association analyses targeted 32 single-nucleotide polymorphisms, potentially addictive substances (alcohol, tobacco, cannabis, and other drugs), and potentially addictive or compulsive behaviors (internet use, gaming, social networking site use, gambling, exercise, hair-pulling, and eating). Analyses revealed 29 nominally significant associations, from which, nine survived an FDRbl correction. Four associations were observed between FOXN3 rs759364 and potentially addictive behaviors: rs759364 showed an association with the frequency of alcohol consumption and mean scores of scales assessing internet addiction, gaming disorder, and exercise addiction. Significant associations were found between GDNF rs1549250, rs2973033, CNR1 rs806380, DRD2/ANKK1 rs1800497 variants, and the “lifetime other drugs” variable. These suggested that genetic factors may contribute similarly to specific substance use and addictive behaviors. Specifically, FOXN3 rs759364 and GDNF rs1549250 and rs2973033 may constitute genetic risk factors for multiple addictive behaviors. Due to limitations (e.g., convenience sampling, lack of structured scales for substance use), further studies are needed. Functional correlates and mechanisms underlying these relationships should also be investigated.

Development and validation of the Reward Deficiency Syndrome Questionnaire (RDSQ-29)

BACKGROUND

The reward deficiency syndrome (RDS) integrates psychological, neurological, and genetic factors of addictive, impulsive, and compulsive behaviors. However, to date, no instrument has been validated to assess the RDS construct.

AIMS

The present study developed and tested a tool to assess RDS.

METHODS

Data were collected on two college and university samples. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed on Sample 1 (N = 1726), and confirmatory analysis was conducted on an independent sample (N = 253). Impulsivity and sensation-seeking were assessed.

RESULTS

Based on EFAs, a 29-item Reward Deficiency Syndrome Questionnaire (RDSQ-29) was developed, containing four subscales (lack of sexual satisfaction, activity, social concerns, and risk-seeking behavior). CFA indicated good fit (comparative fit index (CFI) = 0.941; Tucker-Lewis index (TLI) = 0.933; root mean square error of approximation (RMSEA) = 0.068). Construct validity analysis showed strong relationship between sensation-seeking and the RDS scale.

CONCLUSION

The RDSQ-29 is an adequate scale assessing psychological and behavioral aspects of RDS. The RDSQ-29 assesses psychological and behavioral characteristics that may contribute to addictions generally.

[The epidemiology of smoking and e-cigarette use in the Hungarian adult population in 2018]

Összefoglaló. Bevezetés: Nagyszámú kutatás igazolta, hogy a dohányzás növeli a legjelentősebb krónikus betegségek kockázatát. Habár 2009 óta csökkenő tendenciát mutat Magyarországon a hagyományos dohányzók aránya, az e-cigarettát kipróbálóké az utóbbi években folyamatosan növekszik. Célkitűzés: A 2018-ban a felnőtt lakosság körében végzett Népegészségügyi Felmérés dohányzásra és e-cigaretta-használatra vonatkozó eredményeinek bemutatása az előző vizsgálatok tükrében. Módszer: A kérdőíves felmérésben 1586 fő került személyesen lekérdezésre. Az iteratív súlyozás a többlépcsős mintavételi designhatást és a 2016-os mikrocenzus adatait vette figyelembe. Eredmények: 2018-ban a dohányzók aránya a magyar felnőtt lakosság körében 28,7% (95% MT: 26,3-31,1%), az e-cigarettát használók aránya pedig 1,7% (95% MT: 1,1-2,5%) volt. Az iskolai végzettség a 65 év alattiak esetében a dohányzást befolyásoló tényező volt (EH: 3,32; 95% MT: 2,53-4,34), de a 65 éves és annál idősebb korcsoportban már nem (EH: 1,11; 95% MT: 0,59-2,09). Az e-cigarettát kipróbálók és használók között a leginkább említett (54,3% 95% MT: 44,0-64,5%) motivációs tényezőcsoport a dohányzásról való leszokással, az ártalomcsökkentéssel és a visszaesés megelőzésével volt kapcsolatos. A 65 éves és idősebb korcsoportban a dohányzók aránya 2015-höz képest emelkedett. 2018-ban az alapfokú iskolai végzettségűek körében volt a legmagasabb a dohányzók aránya, míg 2014-ben az érettségivel nem rendelkező középfokú végzettségűek körében. Következtetés: Bár összességében csökkent, az alacsony iskolai végzettségűek és az idősek körében emelkedett a dohányzók aránya Magyarországon. Az e-cigarettát kipróbálók és használók száma növekvő tendenciát mutat hazánkban. Eredményeink az alacsony iskolai végzettségűekre kiemelten fókuszáló, megelőző és leszokást támogató népegészségügyi alprogramokat is tartalmazó komplex beavatkozást sürgetnek. Orv Hetil. 2022; 163(1): 31-38.

INTRODUCTION

The body of evidence suggests that smoking increases the risk of the most prevalent chronic diseases. Although the proportion of traditional smokers in Hungary has been on a declining trend since 2009, the proportion of those who tried e-cigarette has been steadily increasing in recent years.

OBJECTIVE

To present - in the light of previous studies - the results of the Public Health Survey among adults in 2018 on smoking and e-cigarette use.

METHOD

1586 persons were personally interviewed in a survey. The iterative weighting algorithm considered both the design effect of multistaged sampling and the 2016 Hungarian microcensus.

RESULTS

In 2018, the proportion of smokers in the Hungarian adult population was 28.7% (95% CI 26.3-31.1%), and the proportion of e-cigarette users was 1.7% (95% CI 1.1-2.5%). Educational level was a predictor of smoking among respondents younger than 65 years old (OR 3.32; 95% CI 2.53-4.34), but not for those aged 65 years or older (OR 1.11; 95% CI 0.59-2.09). Among e-cigarette ever or current users, the most commonly mentioned (54.3% 95% CI 44.0-64.5%) motivational factor-group to try or use e-cigarettes included motivations to quit smoking, to reduce harm, and to avoid relapsing. In the population aged 65 years old or older, the proportion of smokers increased compared to 2015. The proportion of smokers was the highest among those with primary education in 2018, while in 2014, it was the highest among those with secondary education without a graduation certificate.

CONCLUSION

In Hungary, although overall smoking rates are declining, the smoking rate in the low educational group and among the elderly increased. The number of people trying or using e-cigarettes is showing an increasing trend in our country. Our results call for a complex public health intervention program including prevention and smoking cessation supporting subprograms with high focus on those with primary education. Orv Hetil. 2022; 163(1): 31-38.

A dohányzás és az e-cigaretta-használat epidemiológiája a felnőtt magyar népesség körében 2018-ban

Összefoglaló. Bevezetés: Nagyszámú kutatás igazolta, hogy a dohányzás növeli a legjelentősebb krónikus betegségek kockázatát. Habár 2009 óta csökkenő tendenciát mutat Magyarországon a hagyományos dohányzók aránya, az e-cigarettát kipróbálóké az utóbbi években folyamatosan növekszik. Célkitűzés: A 2018-ban a felnőtt lakosság körében végzett Népegészségügyi Felmérés dohányzásra és e-cigaretta-használatra vonatkozó eredményeinek bemutatása az előző vizsgálatok tükrében. Módszer: A kérdőíves felmérésben 1586 fő került személyesen lekérdezésre. Az iteratív súlyozás a többlépcsős mintavételi designhatást és a 2016-os mikrocenzus adatait vette figyelembe. Eredmények: 2018-ban a dohányzók aránya a magyar felnőtt lakosság körében 28,7% (95% MT: 26,3–31,1%), az e-cigarettát használók aránya pedig 1,7% (95% MT: 1,1–2,5%) volt. Az iskolai végzettség a 65 év alattiak esetében a dohányzást befolyásoló tényező volt (EH: 3,32; 95% MT: 2,53–4,34), de a 65 éves és annál idősebb korcsoportban már nem (EH: 1,11; 95% MT: 0,59–2,09). Az e-cigarettát kipróbálók és használók között a leginkább említett (54,3% 95% MT: 44,0–64,5%) motivációs tényezőcsoport a dohányzásról való leszokással, az ártalomcsökkentéssel és a visszaesés megelőzésével volt kapcsolatos. A 65 éves és idősebb korcsoportban a dohányzók aránya 2015-höz képest emelkedett. 2018-ban az alapfokú iskolai végzettségűek körében volt a legmagasabb a dohányzók aránya, míg 2014-ben az érettségivel nem rendelkező középfokú végzettségűek körében. Következtetés: Bár összességében csökkent, az alacsony iskolai végzettségűek és az idősek körében emelkedett a dohányzók aránya Magyarországon. Az e-cigarettát kipróbálók és használók száma növekvő tendenciát mutat hazánkban. Eredményeink az alacsony iskolai végzettségűekre kiemelten fókuszáló, megelőző és leszokást támogató népegészségügyi alprogramokat is tartalmazó komplex beavatkozást sürgetnek. Orv Hetil. 2022; 163(1): 31–38.

Summary. Introduction: The body of evidence suggests that smoking increases the risk of the most prevalent chronic diseases. Although the proportion of traditional smokers in Hungary has been on a declining trend since 2009, the proportion of those who tried e-cigarette has been steadily increasing in recent years. Objective: To present – in the light of previous studies – the results of the Public Health Survey among adults in 2018 on smoking and e-cigarette use. Method: 1586 persons were personally interviewed in a survey. The iterative weighting algorithm considered both the design effect of multistaged sampling and the 2016 Hungarian microcensus. Results: In 2018, the proportion of smokers in the Hungarian adult population was 28.7% (95% CI 26.3–31.1%), and the proportion of e-cigarette users was 1.7% (95% CI 1.1–2.5%). Educational level was a predictor of smoking among respondents younger than 65 years old (OR 3.32; 95% CI 2.53–4.34), but not for those aged 65 years or older (OR 1.11; 95% CI 0.59–2.09). Among e-cigarette ever or current users, the most commonly mentioned (54.3% 95% CI 44.0–64.5%) motivational factor-group to try or use e-cigarettes included motivations to quit smoking, to reduce harm, and to avoid relapsing. In the population aged 65 years old or older, the proportion of smokers increased compared to 2015. The proportion of smokers was the highest among those with primary education in 2018, while in 2014, it was the highest among those with secondary education without a graduation certificate. Conclusion: In Hungary, although overall smoking rates are declining, the smoking rate in the low educational group and among the elderly increased. The number of people trying or using e-cigarettes is showing an increasing trend in our country. Our results call for a complex public health intervention program including prevention and smoking cessation supporting subprograms with high focus on those with primary education. Orv Hetil. 2022; 163(1): 31–38.

Polysubstance Use Is Positively Associated with Gaming Disorder Symptom Severity: A Latent Class Analytical Study

INTRODUCTION

The link between gaming disorder (GD) and substance use amongst adolescents is not clear. Some studies reported positive associations, whereas others suggested that alcohol and illicit drug use are not related to GD severity.

OBJECTIVES

The present study aimed to identify empirically based latent classes of alcohol and illicit drug use amongst adolescents and explore their associations with GD symptom severity and whether endorsement of specific criteria of GD is linked to the membership of latent classes of alcohol and illicit drug use.

METHODS

Data of the national sample of Hungarian adolescents from the Health Behaviour in School-aged Children survey (N = 2,768; females: 52.08%; mean age: 16.73 years) were analysed. Measures for frequency of alcohol and illicit drug use, gaming, GD symptom severity, and life satisfaction were included in the analyses.

RESULTS

Latent class analysis discriminated 4 subgroups of alcohol and illicit drug use: polysubstance users, high-risk alcohol users, moderate alcohol users, and infrequent substance users. Polysubstance users presented significantly higher levels of GD symptom severity and higher odds for endorsement of criteria of "giving up other activities" and "negative consequences."

CONCLUSIONS

Positive associations were shown between higher GD severity and the polysubstance using class. The roles of criteria of "giving up other activities" and "negative consequences" were highlighted in more severe substance use patterns. However, GD severity and criteria did not differ as a function of the level of alcohol use. These findings may imply common roots of GD and illicit drug use in adolescents.

Dissociative Tendencies Aggregate the Impact of Negative Life Events on Non-Suicidal Self-Injury among Male Juvenile Delinquents

Non-suicidal self-injury is a significant global public health problem during adolescence, nevertheless there is a lack of investigations among juvenile offenders. Our cross-sectional study aimed to investigate the relationship between negative life events and self-harm, including the effects of dissociation and experiential avoidance that accounted for this link in a sample of underaged male offenders (N = 226; Mage = 16.97, SD = 1.31; 23.5% performed self-harm in the past month). Structural equation modeling showed that dissociation can explain the effect of friendship- and romantic relationship-related negative life events on self-harm. Our findings pointed out that dissociative tendencies could reduce intense emotions stemming from negative life events associated with peer relationships, but consequences of such tendencies might be self-harm in a correctional context.

Self-Medication of ADHD Symptoms: Does Caffeine Have a Role?

OBJECTIVE

Stimulants are the most effective treatment for Attention Deficit/ Hyperactivity disorder (ADHD). In addition, studies have shown that nicotine dependence in patients with ADHD is probably best explained by self-medication. The question is whether this is also true for caffeine use and caffeine dependence. The aim of our study was, therefore, to examine the relationship of ADHD symptoms, caffeine consumption, caffeine use disorder (CUD) and well-being. We hypothesized that those who have more ADHD symptoms and regularly consume caffeine have higher psychological well-being than those who have more ADHD symptoms, but do not consume caffeine.

METHODS

A general population sample (N = 2,259, 70.5% male, mean age 34.0) filled out the 10-item Caffeine Use Disorder Questionnaire (CUDQ), the Adult ADHD Self-report Scale (ASRS) and the WHO-5 Well-Being Index (WHO-5) and were asked about their caffeine consumption habits in an online survey.

RESULTS

There were no associations between ADHD and coffee, tea, energy drink or cola consumption or daily caffeine consumption. However, the results of the path analysis showed that the level of ADHD symptoms was positively associated with the level of CUD (β = 0.350) and negatively with the WHO-5 (β = -0.259).

CONCLUSIONS

Caffeine consumption was not associated with ADHD symptom severity and thus not likely to represent self-medication. On the contrary, caffeine use disorder severity is associated with more ADHD symptoms and both caffeine use disorder and ADHD are associated with lower well-being.

Functions of nonsuicidal self-injury in a Hungarian community adolescent sample: a psychometric investigation

BACKGROUND

The Inventory of Statements About Self-Injury (ISAS) is a psychometrically valid tool to evaluate the motives of nonsuicidal self-injury (NSSI), but there are a few studies that test gender differences in the factor structure of the measurement. However, several differences across gender were identified in NSSI (e.g., in prevalence, methods, functions). Therefore, our study focused on further analyses of the dimensionality of the ISAS functions.

METHODS

Among Hungarian adolescents with a history of NSSI (N = 418; 70.6% girls; mean age was 16.86, SD = 1.45), confirmatory factor analysis and exploratory structural equation modeling frameworks were used to test the factor structure of the ISAS part II.

RESULTS

Results support the two-factor structure of the questionnaire. Intrapersonal and interpersonal motivation factors emerged in the whole sample, but this factor structure varied across gender. Among girls, intrapersonal motivation of NSSI was associated with higher loneliness, more inflexible emotion regulation, and a more pronounced level of internalizing and externalizing mental illness symptoms.

CONCLUSIONS

Our findings provide sufficiently solid arguments for the need to examine NSSI functionality separately for adolescent girls and boys because there were clear gender differences in the motives underlying NSSI. In addition, precise scanning of patterns of NSSI functions may further help us to identify the most at-risk adolescents regarding self-injury.

Intuitive eating in light of other eating styles and motives: Experiences with construct validity and the Hungarian adaptation of the Intuitive Eating Scale-2

Intuitive eating (IE), an adaptive eating approach, has been identified as a plausible positive determinant of physical and mental well-being. This cross-sectional survey study aimed to examine the construct validity of IE measured by the Intuitive Eating Scale-2 (IES-2). The conceptual network of different adaptive and maladaptive eating behaviors was also explored. Confirmatory factor analysis (CFA), measurement invariance testing, and correlation analyses were applied on the data from a sample of 732 Hungarian university students. Validating variables included several eating behavior styles (i.e., obesogenic eating behaviors, mindful eating [ME], and dieting practices) and motivational factors (i.e., autonomous, controlled, and amotivational sources of healthy eating, and internalization of the thin and muscular body ideals). The results of the CFA supported the original four-factor structure of the IES-2 without a global second-order factor. The scale exhibited measurement invariance on the scalar level across sexes and BMI categories. The IES-2 subscales showed adequate reliability. IE and ME were found to be positively related but conceptually distinct constructs. Autonomous motivation for healthy eating, restrained eating, and current dieting exhibited different yet meaningful associations to IE on the subscale level. Undertaking subscale-level analyses is recommended when using the IES-2.

A bifactor structural model of the Hungarian Pain Catastrophizing Scale and latent classes of a clinical sample

Pain catastrophizing is an exaggerated cognitive-affective response to actual or anticipated pain, usually measured by the Pain Catastrophizing Scale (PCS). Our study aimed to test the bifactor measurement model of the Hungarian PCS and to identify a catastrophizing risk group with a clinically meaningful cut-off score.

The data of 404 chronic spine-related (neck, back and low-back) pain patients (mean age: 58.61 (SD = 14.34)) were used in our cross-sectional study. Besides pain-related and demographic data, pain catastrophizing and depressive symptoms were measured with questionnaires. Confirmatory factor analyses confirmed that the bifactor model outperformed the other tested measurement models, and the general catastrophizing factor was responsible for 81.5% of the explained variance. Using latent class analysis, we found that even moderately elevated pain catastrophizing score was related to more depressive symptoms and higher perceived pain intensity, and 22 score could be used as a cut-off score. Our results support the concept of global pain catastrophizing and the validity of the Hungarian PCS. Further studies are needed to evaluate the bifactor structure of this scale and the predictive value of the proposed cut-off score.

Vaping-Related Adverse Events and Perceived Health Improvements: A Cross-Sectional Survey among Daily E-Cigarette Users

Web-based samples of e-cigarette users commonly report significant vaping-related health improvements (HIs) and mild adverse events (AEs). This cross-sectional study with in-person interviewing data collection examined self-reported AEs and perceived HIs among Hungarian adult current daily exclusive e-cigarette (n = 65) and dual users (n = 127), and former daily e-cigarette users (n = 91) in 2018. Logistic regression was used to evaluate associations between reporting any AEs/HIs, vaping status, and covariates. More former users (52.7%) reported AEs than current users (39.6%; p = 0.038). Exclusive and dual daily users reported similar rates of AEs (44.6% and 37.0%, respectively; p = 0.308). More current users (46.9%) experienced HIs than former users (35.2%; p = 0.064). Exclusive daily users were more likely to report HIs than dual users (63.1% versus 38.6%; p = 0.001). Former user status and smoking cessation/reduction reasons increased the odds of reporting AEs, whereas nicotine-containing e-liquid use and older age decreased the odds of reporting AEs. Exclusive vaper status, using advanced generation devices, and smoking cessation/reduction reasons increased the odds of experiencing HIs. This study, which used a traditional data collection methodology, found a higher rate of AEs and a lower rate of HIs compared to web-based surveys. Our results highlight that experiencing AEs and HIs is affected by users’ characteristics, in addition to the device and e-liquid type.

The information capacity of adolescent alcohol consumption indicators along a continuum of severity: A cross-national comparison of sixteen Central and Eastern European countries

BACKGROUND

There is high variability between European countries in prevalence levels of various alcohol consumption forms. The informational value of adolescent's alcohol consumption indicators remains an issue. The present study aimed to examine information capacity and measurement invariance of different alcohol consumption indicators in adolescents coming from countries of the former Soviet (Eastern) Bloc in Central and Eastern Europe (CEE).

METHODS

Data of 15-year-old adolescents who reported to have had consumed alcohol at least once in their lifetime were analysed. Data were collected in sixteen CEE countries, as part of the 2013/2014 Health Behavior in School-aged Children (HBSC) study wave. Four binary items were selected for the analyses and measured the presence (vs. absence) of alcohol consumption in the last 30 days, lifetime drunkenness, weekly drinking frequency and binge drinking on a typical occasion. Multiple group confirmatory factor analysis and item response theory analysis were used.

RESULTS

In most of the included countries, alcohol consumption in the last 30 days and lifetime drunkenness were indicative for lower severity levels, while binge drinking and weekly drinking frequency were informative at higher severity levels of alcohol use. A low proportion of the estimated intercepts and factor loadings were non-invariant which indicated approximate cross-national invariance of these indicators.

CONCLUSIONS

Adolescent alcohol consumption indicators are informative for different severity levels and provide a cross-nationally invariant measurement. However, diverging drinking cultures in the CEE regions was suggested by different indicators with the highest discrimination capacity at the lower and the higher ends of the continuum severity.

Non-adherence to preventive behaviours during the COVID-19 epidemic: findings from a community study

Backgrounds

Preventive behaviours are an essential way to slow down and eliminate the transmission of SARS-CoV-2. The aim of this study was to estimate adherence to preventive behaviors and to identify whether any subgroups were not adopting these behaviours and for whom greater engagement in these approaches was indicated.

Methods

In this cross-sectional study, we obtained data from a random sample of a panel representing men and women of adult age residing in Hungary (N = 5254). The survey included questions about the frequencies of preventive behaviours, perceived susceptibility and severity of COVID-19.

Results

We found four factors of preventive behaviours: using physical barriers (mask and gloves), avoidance of close contacts, personal hygiene, and preparation. We identified two broadly adherent groups (36.8 and 45.3%) and two non-adherent groups (13.1 and 4.8%). Being male and being aged between 18 and 29 years were the strongest predictors of non-adherence. Concern about the severity of COVID-19 was a predictor of adherence.

Conclusions

To ensure maximal adherence to preventive behaviours for COVID-19, additional strategies should focus on their adoption by men and young adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11506-0.

Who complies with coronavirus disease 2019 precautions and who does not?

PURPOSE OF REVIEW

Severe acute respiratory syndrome (SARS)-coronavirus disease 2019 (COVID-19) virus imposes a higher risk of complications and mortality among people with mental disorders. Until widely available vaccines, adherence to preventive behaviours remains the most crucial tool to prevent SARS/COVID-19 virus transmission. Our review focuses on the determinants of adherence behaviours.

RECENT FINDINGS

Adherence behaviours include the use of a face mask and protective gloves, personal hygienic behaviours (handwashing or using hand sanitiser), and keeping physical distance and avoiding social gatherings. In almost all studies, males and younger people show less adherence. Risk perception and health beliefs (especially perceived severity of COVID-19 related conditions) can explain the sex and age differences in adherence. Studies covering the impact of mental disorders on adherence are surprisingly missing, with the exception of smoking.

SUMMARY

Engaging men and young people in adopting preventive behaviours is crucial in protecting the whole community and specific vulnerable populations. There is a lack of studies investigating preventive behaviours among people living with mental disorders and addiction problems. Furthermore, descriptive and intervention studies are needed to understand and improve the adherence of this population to preventive behaviours.

Health-related quality of life of COPD patients aged over 40 years

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is the fourth most frequent disease globally, and its worldwide prevalence is projected to increase in the following decades. Health-related quality of life (HRQOL) of COPD patients depends on multiple factors.

OBJECTIVE

The aim of this study was to identify the most important risk factors affecting HRQOL of COPD patients and to measure how specific clinical parameters can predict HRQOL.

METHODS

A questionnaire-based cross-sectional study combined with clinical data was conducted among patients diagnosed with COPD (n = 321, 52.6% females, mean age 66.4 ± 9.5) at the National Koranyi Institute for Pulmonology, Budapest in 2019-2020. The inclusion criteria were age ≥40 years and existing COPD. Multivariate linear regression analyses were conducted on three components of the COPD-specific Saint George's Respiratory Questionnaire (SGRQ-C) and on the physical (PCS) and mental component scales (MCS) of the 36-Item Short Form Health Survey (SF-36). Multiple linear regression analysis was performed to evaluate the effects of patient and disease characteristics on COPD Assessment Test (CAT) scores.

RESULTS

We found that frequent exacerbations, multiple comorbidities and tobacco smoking were associated with worse HRQOL. Engaging in more frequent physical activity and better 6-minute walking distance results were associated with better HRQOL.

CONCLUSIONS

Our results indicate that the complex therapy of COPD should focus not only on improving lung functions and preventing exacerbation, but also on treating comorbidities, encouraging increased physical activity, and supporting smoking cessation to assure better HRQOL for patients.

The paradoxical role of insight in mental illness: The experience of stigma and shame in schizophrenia, mood disorders, and anxiety disorders

This study examined the factor structure of the Hungarian version of the Birchwood Insight Scale (BIS) and analyzed its association with socio-demographics, diagnosis, internalized stigma, and shame using confirmatory factor analysis (CFA) with covariates. Mentally ill patients (N = 200) completed self-report questionnaires. CFA supported a two-factor structure. While previous hospitalizations and diagnosis were associated with insight, insight predicted higher internalized stigma and shame. Efforts to increase insight should be matter of importance in the wider spectrum of mental diagnoses. However, such efforts should be conducted with special care as further research is needed to understand the impact of insight on wellbeing.

Patterns and temporal change of psychopathological symptoms among inpatients with alcohol use disorder undergoing a twelve-step based treatment

•

Psychopathological symptom profiles and trajectories were examined among AUD inpatients.

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Three quantitatively different subgroups were identified in terms of psychopathological symptoms.

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Classes were discriminated by different psychopathological symptom change trajectories.

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Subgroups with more severe psychopathological symptoms used alcohol in a more harmful way.

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Drinking of the more severely affected classes were more motivated by coping and conformity motives.

Background

Patients diagnosed with Alcohol Use Disorder (AUD) present an increased risk for experiencing severe internalizing and externalizing symptoms. Involvement in twelve-step based treatment programs, such as the Minnesota Model (MM), can contribute to improvement of an individual’s psychopathological symptom profile. The present study’s main objective was to examine profiles and change trajectories of psychopathological symptoms of AUD subgroups during an eight-week long period of MM treatment attendance.

Method

Inpatients with AUD (N = 303) who attended MM treatment programs participated in the present study. Latent Class Growth Analysis (LCGA) was used to evaluate the psychopathological symptom change trajectories assessed by using the Brief Symptom Inventory (BSI). Multiple comparisons and multinomial logistic regression were performed to validate the subgroups.

Results

Three subgroups were identified: low severity (48.5%), moderate severity (35.2%), and high severity (16.2%) symptomatic subgroups. The moderate severity class demonstrated the largest effect in terms of symptoms decrease. Higher severity classes showed significantly higher rates of harmful alcohol drinking and drinking motives.

Conclusions

The present study identified three severity-based subgroups which indicate that psychopathology sits on a spectrum of severity among AUD patients. The findings highlight the associations between AUD and internalizing symptoms, negative reinforcement drinking motives, and the symptomatic improvement that can occur among those participating in MM treatment programs.

Long-term effect of participation in one-month alcohol abstinence campaign on individual consumption

Objective

There is limited amount of evidence concerning the effect of population-based interventions. Dry November campaign asks people to go booze-free for a month. The goal of our study was to assess whether success rate of participation in the 2017 Dry November campaign leads to long-term change in alcohol consumption of participants.

Methods

A longitudinal study was conducted in 2017-2018 in the form of an online survey. Alcohol consumption characteristics of respondents (N = 125) were measured by the short-form AUDIT test. Participants filled out the first survey at the end of October 2017 with a one-year follow-up questionnaire. We used the reliable change index to identify participants whose c-AUDIT scores changed significantly over time. We collated participants who exhibited no change or significant decrease in c-AUDIT scores into one group, which was used as reference in our logistic regression analyses. We first conducted a series of univariate regression analyses to identify significant confounders, which were then included in the subsequent multivariate regression analysis.

Results

Based on our results, success rates did not differ significantly between those who exhibited a significant increase in c-AUDIT scores and those whose c-AUDIT scores did not change or decreased significantly over a one-year time period. In our multivariate regression analysis, the occurrence of alcohol consumption in the same household (OR = 3.29, 95% CI: 1.17-10.01) was the only variable significantly associated to an increase in c-AUDIT scores.

Conclusions

Even though success rate of participation in the 2017 Dry November campaign did not influence c-AUDIT scores significantly at follow-up, we were able to identify the occurrence of alcohol consumption in household as a significant risk factor for those who exhibited a significant increase in c-AUDIT score.

Key messages

A one-month alcohol-free challenge might be an effective tool for reducing alcohol consumption but further analysis is needed. The inclusion of individuals in the same household in interventions aiming to decrease alcohol intake may lead to higher success rate.

Alcohol consumption and risk for feeding and eating disorders in adolescence: The mediating role of drinking motives

BACKGROUND

A complex and bidirectional association has been assumed between feeding and eating disorders (FEDs) and alcohol consumption. Previous research has demonstrated that alcohol use among individuals with different forms of FEDs is more frequently motivated by two subtypes of internal drinking motives: coping and enhancement motives. Namely, these individuals might use alcohol primarily to regulate internal states, such as to mitigate negative emotions or enhance positive emotions.

OBJECTIVES

The present study investigated the mediating role of internal drinking motives on the association between risk for FEDs and alcohol consumption over the effects of relevant covariates, such as depressive symptoms or body mass index (BMI).

METHODS

Hungarian data of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 2015 were used. The final sample included responses from 5457 adolescents (50% males; mean age: 16.62 years). Validated self-report psychometric instruments assessed the level of alcohol use, depressive symptoms and risk for FEDs, and drinking motives.

RESULTS

Risk for FEDs presented a significant positive relationship with internal drinking motives and alcohol use. In the mediation analysis, a significant indirect effect was identified between risk for FEDs and alcohol use via internal drinking motives among females.

CONCLUSIONS

Results demonstrated that risk for FEDs was positively associated with internal drinking motives and alcohol use. An indirect effect of risk for FEDs on alcohol consumption via internal drinking motives was discriminated over the impact of depressive symptoms. However, the latter relationship was only found among females which may highlight the gender differences in the relationship between risk for FEDs and alcohol use.

Targeting the problem of treatment non-adherence among mentally ill patients: The impact of loss, grief and stigma

The present study examined the factor structure of the Hungarian version of the Medication Adherence Rating Scale (MARS) and analyzed its association with socio-demographics, insight, internalized stigma, and the experience of loss and grief as a result of the mental illness diagnosis, using confirmatory factor analysis (CFA) with a series of one covariates at a time. Mentally ill patients (N=200) completed self-report questionnaires. CFA supported the original three-factor structure although one item was moved from its original factor to another. Lower insight, higher internalized stigma, loss, and grief were significant predictors of lower treatment adherence. Lower adherence was found to be significantly associated with lower quality of life. No difference in adherence was found between different diagnostic groups, which stresses the need to examine non-adherence in the wider spectrum of mental diagnosis. The study also stresses the importance of patients' subjective experience in promoting better adherence, and raises the need to address the experience of stigma but also of less studied experiences, such as patients' feelings of loss and grief. Integrating these experiences in intervention programs might have meaningful implications for the improvement of treatment adherence and patients' quality of life.

Why do people use new psychoactive substances? Development of a new measurement tool in six European countries

INTRODUCTION

New psychoactive substances (NPS) pose a public health threat. Many studies have tried to identify the reasons of NPS use; however, none of them have so far used any standardised measures. The aim of this study was (i) to develop and cross-culturally validate the New Psychoactive Substance Use Motives Measure (NPSMM) and (ii) to compare motives of NPS use across countries and user types.

METHODS

Three subgroups (socially marginalised users, nightlife attendees and members of online communities) of NPS users (N = 3023) were recruited from six EU member countries. Demographics, motives and types of NPS used were assessed. NPS use motives were measured by adapting the extended six-factor version of the Marijuana Motives Measure.

RESULTS

Exploratory and confirmatory factor analysis resulted in a similar five-factor solution across most of the countries: coping, enhancement, social, conformity and expansion motives. Marginalised users scored higher on coping and conformity motives, nightlife groups showed higher endorsement of social motive, whereas online community users showed higher scores on expansion motives. Various types of NPS were also associated with different motives.

CONCLUSION

NPS use motives might be associated with both the groups of users and the specific types of NPS being consumed. Expansion (psychedelics) and enhancement (stimulants) motives seemed to be linked to the chosen NPS product type, while coping, social and conformity motives were rather associated with user groups. NPSMM was found to be a valid instrument to measure NPS motives.

Co-occurrences of substance use and other potentially addictive behaviors: Epidemiological results from the Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study

BACKGROUND AND AIMS

Changes in the nomenclature of addictions suggest a significant shift in the conceptualization of addictions, where non-substance related behaviors can also be classified as addictions. A large amount of data provides empirical evidence that there are overlaps of different types of addictive behaviors in etiology, phenomenology, and in the underlying psychological and biological mechanisms. Our aim was to investigate the co-occurrences of a wide range of substance use and behavioral addictions.

METHODS

The present epidemiological analysis was carried out as part of the Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study, where data were collected from 3,003 adolescents and young adults (42.6% males; mean age 21 years). Addictions to psychoactive substances and behaviors were rigorously assessed.

RESULTS

Data is provided on lifetime occurrences of the assessed substance uses, their co-occurrences, the prevalence estimates of specific behavioral addictions, and co-occurrences of different substance use and potentially addictive behaviors. Associations were found between (i) smoking and problematic Internet use, exercising, eating disorders, and gambling (ii) alcohol consumption and problematic Internet use, problematic online gaming, gambling, and eating disorders, and (iii) cannabis use and problematic online gaming and gambling.

CONCLUSIONS

The results suggest a large overlap between the occurrence of these addictions and behaviors and underlies the importance of investigating the possible common psychological, genetic and neural pathways. These data further support concepts such as the Reward Deficiency Syndrome and the component model of addictions that propose a common phenomenological and etiological background of different addictive and related behaviors.

The 21-item Barratt Impulsiveness Scale Revised (BIS-R-21): An alternative three-factor model

BACKGROUND AND AIMS

Due to its important role in both healthy groups and those with physical, mental and behavioral disorders, impulsivity is a widely researched construct. Among various self-report questionnaires of impulsivity, the Barratt Impulsiveness Scale is arguably the most frequently used measure. Despite its international use, inconsistencies in the suggested factor structure of its latest version, the BIS-11, have been observed repeatedly in different samples. The goal of the present study was therefore to test the factor structure of the BIS-11 in several samples.

METHODS

Exploratory and confirmatory factor analyses were conducted on two representative samples of Hungarian adults (N = 2,457; N = 2,040) and a college sample (N = 765).

RESULTS

Analyses did not confirm the original model of the measure in any of the samples. Based on explorative factor analyses, an alternative three-factor model (cognitive impulsivity; behavioral impulsivity; and impatience/restlessness) of the Barratt Impulsiveness Scale is suggested. The pattern of the associations between the three factors and aggression, exercise, smoking, alcohol use, and psychological distress supports the construct validity of this new model.

DISCUSSION

The new measurement model of impulsivity was confirmed in two independent samples. However, it requires further cross-cultural validation to clarify the content of self-reported impulsivity in both clinical and nonclinical samples.

Empirically Based Classification of Peer Violence in a Nationally Representative Sample of Adolescents: a Latent Class Analysis

The aim of the study was to investigate the pattern of traditional- and cyberbullying, and fighting involvement and identify its most important correlates in a nationally representative sample. We analyzed the data of Hungarian 11–18-year-old adolescents in the framework of the Health Behaviour in School-aged Children Study. A latent class analysis was performed first and afterwards a multinomial logistic regression analysis to examine factors explaining class membership. Four latent classes were identified: “high probability involvement in all forms of violence”; “low involvement in any forms of violence”; “predominantly involved in traditional bullying and fighting”; “high engagement in online victimization”. As no clear victim or perpetrator group was identified, a high overlap between these violence involvement statuses is reinforced.

Motives for viewing animated sitcoms and their associations with humor styles, positivity, and self-criticism in a sample of Hungarian viewers

In recent years, animated situation comedies (generally known as animated sitcoms) have gained widespread popularity among young adults. Animated sitcoms often dissect sensitive social and political concerns using negative humor, exaggeration, and stereotyping. The present study aimed to explore the motives for viewing animated sitcoms using qualitative and quantitative research methods and investigate their associations with humor styles, positivity, and self-criticism in a sample of Hungarian viewers. A total of 816 Hungarian adults (54.5% female; Mage = 23.9 years, SD = 5.6) completed an online questionnaire focusing on animated sitcom viewing habits and other relevant psychological constructs. As a result, three major motive dimensions were identified: (1) social criticism, (2) fun and entertainment, and (3) relaxation. These motives were assessed by the Motives for Animated Sitcom Viewing Questionnaire (MASVQ), which demonstrated strong psychometric properties. Using a MIMIC model, multiple associations were described across motives and other psychological constructs, indicating that individuals with different levels of humor, positivity, and self-criticism are motivated to view animated sitcoms for different reasons in this sample of Hungarian viewers.

Measuring Coping Among Family Members with Substance-Misusing Relatives: Testing Competing Factor Structures of the Coping Questionnaire (CQ) in England and Italy

Background: The Coping Questionnaire measures affected family members' responses to their relatives' substance misuse related problems. The Coping Questionnaire examines three main coping strategies: engaged, tolerant-inactive, and withdrawal coping. Objectives: The aim of the current study was to compare competing conceptual measurement models across two countries, including one-factor, three-factor, and higher order factor models. Methods: Secondary analysis of data from five previous studies was conducted. Samples of affected family members from England (N = 323) and Italy (N = 165) were aggregated into two country specific groups. Series of confirmatory factor analyses were performed to test the degree of model fit and the effects of socio-demographic variables on the coping factors. Results: A bifactor model fitted the data most closely relative to the one- and three-factor models. High rates of common variance (60-65%) were attributable to the general coping factor, while a high proportion of the variance related to the withdrawal coping subscale score was independent (66-89%) of the general coping factor. Family members' country, age, gender, the type of relationship and the main problematic substance had significant effects on the coping factors. Conclusions: A bifactor model related to coping behaviors is consistent with the theoretical assumptions of the general coping literature. The concept of a general coping factor also fits the theoretical assumptions of the stress-strain-coping-support model, with family members showing a general tendency to cope with the harmful circumstances which arise due to substance misuse.

Perceived loss among people living with mental disorders: Validation of the personal loss from mental illness scale

OBJECTIVE

The development of mental illness often leads to pervasive losses in different areas of people's lives. However, previous research has tended to focus on the loss experienced by families while the examination of the loss experienced by individuals who are themselves coping with mental illness has been neglected. The present study tested the factor structure of the Hungarian version of the Personal Loss from Mental Illness (PLMI) scale, and analyzed its associations with age, gender, previous hospitalizations, marital status, loneliness, grief, and quality of life.

METHODS

Mentally ill patients (N = 200) with different diagnoses were recruited from a mental health center in Hungary, and completed self-report questionnaires. Confirmatory factor analysis (CFA) with covariates was conducted.

RESULTS

CFA analyses rejected the previous four-factor structure and suggested a single factor structure to be superior. Higher loss perception was predicted by higher loneliness, grief, and lower quality of life. Patients with mood disorders reported higher loss as compared to patients with other psychiatric diagnoses.

CONCLUSIONS

The present study stresses the magnitude of loss and raises the need to examine further the role of loss in coping and recovery. Asking patients about their feelings in clinical practice is of high importance.

Parental bonding and problematic internet or social media use among adolescents

BACKGROUND AND AIMS

Parental bonding is regarded as one of the risk factors of problematic internet use among adolescents and young adults; however, only few studies have examined the association between problematic social media use and parental bonding among adolescents. The aim of this study is to investigate the difference between problematic internet use and problematic social media use in terms of their associations with parental bonding among secondary school students.

METHOD

With a cross-sectional design and convenience sampling, 2035 self-reported questionnaires were collected in a paper-pencil survey (54.2% females, mean age=16.97, SD=1.61). Problematic internet use, problematic social media use and parental bonding with both mother and father were measured. The predictors of problematic internet use and social media use were tested simultaneously with structural equation modeling.

RESULTS

Problematic internet use and social media use correlate significantly (r=0.57). Girls reported more symptoms in problematic use of internet and social media. Maternal and paternal overprotection were significantly associated with problematic social media use. Paternal care decreased and maternal overprotection significantly increased the problematic internet use. However, the model only explains a small part of the variance of both types of problematic use (10% and 7%, respectively).

CONCLUSION

Parental overprotection may be a small but significant risk factor for developing problematic internet uses. Problematic internet use and problematic social media use are not the same; they are slightly different in their associations with parental bonding dimensions.

Perceived health effects of vaping among Hungarian adult e-cigarette-only and dual users: a cross-sectional internet survey

BACKGROUND

Knowledge about the health effects of e-cigarette use (or vaping) among past and current combustible cigarette users is limited. Several studies have assessed vaping-related adverse events (AEs) and beneficial health effects, however, most studies focused on AEs in general and examined only a few physiological changes that vapers experience. This study aims to explore self-reported AEs and perceived health changes due to e-cigarette use among Hungarian adult e-cigarette-only users (former smokers who switched completely to e-cigarette use) and dual users (smokers who use e-cigarettes and combustible tobacco cigarettes concomitantly).

METHODS

A cross-sectional, web-based survey of 1042 adult Hungarian e-cigarette users was conducted in 2015. Participants reported AEs and changes in physiological functions since they switched from smoking to e-cigarette use or while dually using e-cigarettes and combustible cigarettes. Confirmatory factor analysis with covariates was applied to explain perceived health changes due to e-cigarette-only use and dual use.

RESULTS

Dual users (17.6%) were significantly more likely to report AEs of vaping than e-cigarette-only users (26.2% vs. 11.8%, p < 0.001). Experiencing health improvements were significantly more likely among e-cigarette-only users than for dual users for all surveyed physiological functions. E-cigarette-only users reported larger effects of vaping on sensory, physical functioning, and mental health factors compared to dual users. Self-reported changes in sensory and physical functioning were significantly higher among individuals using e-cigarettes more than a year and people who were past heavy smokers (smoked ≥20 cigarettes per day). Gender was related to sensory improvement only; males reported greater improvement than females.

CONCLUSIONS

The majority of e-cigarette-only users reported more perceived beneficial changes in physiological functions and fewer AEs than dual users. Perceived short-term benefits of e-cigarette use may reinforce users despite the uncertainty of long-term health consequences. Health professionals should provide balanced information regarding the possible short- and long-term positive and negative health effects of e-cigarette use during consultations with patients.

Patterns of alternative tobacco product experimentation among ever smoker adolescents

OBJECTIVES

Alternative tobacco product (ATP) use is popular among adolescents in Western countries, however, little is known about factors influencing ATP experimentation in Europe. The aim of this study was to explore factors associated with ATP experimentation, and to identify patterns of ATP experimentation among Hungarian adolescents who had ever tried manufactured cigarette smoking.

METHODS

Logistic regression analyses were applied to estimate the relationship between individual cigarette smoking experiences, social smoking influences, demographics, and ATP experimentation (roll-your-own (RYO) cigarettes, cigars/cigarillos, waterpipe, traditional pipe and flavoured cigarettes) in a cross-sectional sample of 8th and 11th grade students (N = 1,067, 56.0% of girls) who had ever tried manufactured cigarette smoking in six metropolitan cities of Hungary. Latent class analysis (LCA) was performed to identify patterns of different ATP use.

RESULTS

Almost 90% of the sample had ever tried ATPs and significantly more commonly older (91.8%) versus younger (79.8%) students. Waterpipe was the most popular product to try followed by flavoured cigarettes, cigars/cigarillos, RYO cigarettes, and pipe. Boys were more likely to report ATP experimentation compared to girls. Younger age of cigarette smoking experimentation, greater frequency of past month cigarette smoking and history of ever daily smoking for 30 days showed strong association with ATP experimentation. Students with one or more smoking friends were more vulnerable to experiment with ATPs. Weekly allowance, school academic achievement and household smoking exposure showed no effect on the experimentation. LCA identified four subgroups of ATP experimenters comprising intense polytobacco experimenters (38.4%), mainly waterpipe experimenters (34.2%), moderate polytobacco experimenters (14.9%), and less interested experimenters (12.5%).

CONCLUSION

Tobacco prevention programmes targeting adolescents should emphasize the risks of using ATPs in addition to manufactured cigarettes. Accessibility of ATPs should be better regulated and restrictions should be strongly enforced in order to prevent potential harmful consequences of adolescent polytobacco use.