[Defense Style Questionnaire (DSQ-40): factors, validity and reliability].

INTRODUCTION: Empirical research in defense mechanisms - a concept that stem from the work of Sigmund and Anna Freud and gave rise to a number of thematic approaches - dates back to the mid-20th century. From the psychometric measure instruments developed since that time, the present investigation was aimed to assess the short form of Defense Style Questionnaire that can be efficiently applied in clinical practice and that was supposed to be used as the sixth diagnostic factor of the new version of DSM. A multi-level validity analysis of DSQ-40 was carried out. METHODS: We applied trait assessing measures for anxiety, avoidant behavior, schizotypal traits and personality disorder diagnostic measures developed for DSM-5. To evaluate discriminant validity we applied instruments that assess the stability of self-esteem and the state of self and that can measure the clarity of self-representations. 670 healthy university students volunteered to participate in the investigation. RESULTS: Based on the applied questionnaires, it was revealed that its inner consistency and validity measures are adequate. Its factors that discriminate neurotic and immature defense styles can be applied to identify persons inclined to use either adaptive or maladaptive defense mechanisms. Our findings correspond to other international research results. CONCLUSION: Our results attest that DSQ-40 is a reliable instrument to assess defense style.

[The medical psychology in Hungary: way of thinking, frame of references and applications]. / Az orvosi pszichológia fejlodése hazánkban: szemléleti keretek, határterületek és alkalmazások.

The present study aims at overviewing the different stages of the education of medical psychology in Hungary. In the perspective of the achievements of cognitive and affective neuroscience as well as developmental psychology, we intend to define the roots of doctor-patient relationship, certain determining factors of diagnosis forming and therapy efficiency as well as the essential components of empathy. We attest to the fact that the current psychosomatic medicine with its evidence-based achievements is a valid component and constitutive pillar of everyday medical care. The integrated university level instruction of medical psychology and behavioral sciences aims at consolidating this perspective. We also emphasize that the ill body hinders adequate psychological functioning and mental disorders provide risk factors concerning somatic illnesses. Through spreading health psychology perspective, we support the concept that in everyday medical care, health protection and the development of health conscious behavior relies on responsible, informed and committed decision-making patients as well as on similarly educated extended medical care teams. Orv Hetil. 2018; 159(36): 1455-1464.

[Experiences with the validation of the Hungarian version of Personality Inventory for DSM-5 Brief Form: predicting personality disorders based on self-report inventory].

INTRODUCTION: The recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provided a dimensional model of personality disorders grounded on the empirical validated concept of maladaptive personality traits. Accordingly, based on this model, the Personality Inventory for DSM-5 Brief Form (PID-5-BF) enables the identification of maladaptive personality traits in 5 dimensions: Negative Affect, Detachment, Antagonism, Disinhibition and Psychoticism. Former studies showed, that this self-report measure can reliably predict the likelihood of the development of personality disorders. AIM: We aimed to develop the Hungarian version of the PID-5-BF and to verify its construct-, concurrent-, predictive-, and discriminative validity. METHOD: Based on the results of former studies regarding PID-5-BF, we asked 379 participants to fill out several selfreport measures. Besides PID-5-BF, the Bipolar Rating Scale for the Big Five Personality, the Unconventionality subscale from the Openness scale of the HEXACO model and the Interpersonal Problems-Personality Disorders-25 were also administered. RESULTS: According to the original 5 factor version, the fit of our model was acceptable (CFI = 0,868; RMSEA = 0,061 [90% CI = 0,055 - 0,068]; Cronbach-alpha = 0,61-0,79). In our view, the results vindicate the reliability and validity of the Hungarian PID-5-BF. CONCLUSIONS: According to former studies along with our recent findings, the PID-5-BF can be seen as an effective and reliable self-report scale for clinical studies and at the same time, it may be useful for the psychiatric diagnostic process, mainly in the case of personality disorders. With more clinical data and knowledge, this inventory could be useful for psychiatrists and clinical psychologists in planning of clinical treatment.

[Schizotypy Personality Questionnaire Brief Revisited (SPQ-BR) Hungarian adaptation and interpretation of factors].

INTRODUCTION: The purpose of the Schizotypy Personality Questionnaire - Brief Revised (SPQ-BR) is to help the diagnosis of schizotypial personality disorders within the framework of the DSM-5 and identification of people with an increased vulnerability towards schizophrenia related symptoms. The aim of our current study is twofold; validation of the SPQ-BR's Hungarian adaptation and investigating it's latent structure. METHODS: The sample consisted of 1702 Hungarian university students and university graduated persons. Exploratory factor analytic procedures were performed, cross-validating their results by the use if confirmatory factor analysis. RESULTS: The results suggested that the Hungarian SPQ-BR is best represented by a model of the hierarchical structure, reflected by seven first order factors, and two higher order dimensions of positive and negative symptoms. On lower order factors males were shown significantly greater constricted affects, and proneness to eccentric behaviors and unusual perceptions, while females were characterized by higher magical thinking, next to stronger social anxieties. Gender differences in the Ideas of references - Suspicion and odd speech scales were found to be non-significant. Concerning it''s validity with other scales we found that magical thinking and unusual perceptions from the positive symptoms significantly positively correlated with the magical ideation (MI), anxiousness (ASI), and self-concept clarity (SCCS) scales, next to a negative correlation between unusual perceptions and the self-esteem (RSES) scale. Among the negative symptoms the No close friends-Constricted affect and the Ideas of references - Suspicion subscales showed significant negative linear associations with the ASI, SCCS scales. CONCLUSION: The Hungarian version of the SPQ-BR showed adequate psychometrical properties, it was found to be reliable.

Multisensory integration and age-dependent sensitivity to body representation modification induced by the rubber hand illusion.

The aim of the present study was to compare junior and senior healthy participants for their multimodal integration capability. The instrument used for the investigation was the rubber hand illusion (RHI) where synchronous and asynchronous multimodal stimulation were applied. The study focused on assessing the rate of integration for visuo-tactile and visuo-proprioceptive stimuli. METHODS: From a large sample of right-handed volunteers, 50 senior employees (containing younger and middle age adults) and 51 senior retired (senior adults) participants were recruited. RESULTS: The between-subject analyses revealed that individuals both the junior and the senior participants responded to induction of RHI with vivid ownership and disownership experiences and a higher mislocalization error in the synchronous condition. However, the between-group analysis showed that participants in the senior group reported less vivid ownership and less vivid total RHI experiences scores compared to members of the junior group, but no mislocalization error differences were found between the groups. CONCLUSION: The results indicated that when visuo-tactile stimuli synchronously presented, the gain in multisensory integration decreased in seniors group. In contrast, in the case of visuo-proprioceptive synchronous presentation, the efficiency of multisensory integration remained unchanged across the lifespan.

[Schizotypy: detachment or magical fusion].

Nowadays, both in the clinical population, and in general communities, we tend to encounter an increasing number of personality disorder patients, whose social adjustment, partnerships and efficient life management is made difficult by the disorder. The ideas of borderline personality disorder patients, who fluctuate between farfetched expectations and fears of their selves being demolished, schizoid patients, who close their selves in their own alienating prison, avoidant patients, who try to escape difficulties, which would enhance their self-esteem, OCD patients, who build their own mythic superstitious world, and antisocial patients who tend to ignore and aggressively override others' interests are all important in the development of cultures with insecure identities. Taking into consideration the symptoms enlisted in the diagnostic system of DSM-5, it is the task of experts of cultural anthropology, psychology, psychopathology and cognitive neuroscience to explore the referring ways of personality development, relationships and of conflict management. Notwithstanding, avoiding the psychopathological terminology, rather pointing at population characteristics, we need to identify personal functionings of the general features of perception, cognition and world views, which in the long run, may modify personal developmental possibilities, individual approaches to information technology, and emotional, family or professional motivations. Based on the respective literature and clinical experience, below we intend to explore the different aspects of schizotypy, which contribute to the formation of schizoid personality disorder. We analyze the interrelations of avoiding relationships and empathy toward relationship building.

[Magical and physical reality].

In the postmodern countries the computer generated virtual reality provides new perceptual domains wherein the evaluation of real and unreal contents generates an essential challenge for both children and adults. The expectances to perceive unreal content which is contradictory with the common sense experiences become seductive for most of people. The time in front of the screen that emits the magic reality gradually rises. The sudden advance in generation of alternative realities demands that we have to recall the basic principles of psychological reality testing and the involving mechanism that produces a distinction between phantasy and reality for both healthy and pathological mind. Frame of reference usually restrains the thinking. This review contains two parts, the first is focuses on the historical aspect of magical and physical reality and the second one, that will be published in a next issue, will present an evaluation of the boundary between self and another person in point of view of the psychopathological phenomenon. This analysis will focus on how the boundary of the self behaves in physically real and magic computer generated environment.

[Critical issues of the biopsychosocial treatment of Parkinson's disease]. / A Parkinson-kór biopszichoszociális ellátásának kritikus kérdései.

This paper is a summary report on the basic questions of the biopsychosocial approach to Parkinson's disease. It deals with cognitive, affective and psychological health issues which significantly influence the outcome of the physical rehabilitation. In spite of the unchanged cognitive status, the psychological burden of the changes in the quality of life, the obstruction, the change in the affective tone, and the shrinking ability to fulfil social roles decrease the patient's quality of life. An interdisciplinary approach is best suited for mitigating these effects. Not only the patient but also his/her family and environment is seriously affected by the disease and its consequences. Treatment and rehabilitation options for increasing or maintaining the quality of life of the affected patients are diverse, and significantly depend on the features of the health care system. The authors believe that the following review emphasizing health psychological principles may contribute to the work of professionals working in clinical and rehabilitational fields and through them may increase the quality of life of patients and their family.

[Diagnosis and therapy for neurocognitive disorders in Parkinson's disease]. / Neurokognitív zavarok diagnosztizálási és kezelési lehetoségei Parkinson-kórban.

In the present review the recent developments in the definitions of neurocognitive disorders associated with Parkinson's disease are summarized including the possibilities for screening and treating. For a long time, the recognition of neurocognitive disorders associated in patients with Parkinson's disease was unsatisfactory due to the heterogeneity of definitions. The recently developed Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) introduced the definitions of mild and major neurocognitive disorders instead of mild cognitive impairment and dementia. The new DSM-5 definitions are clinically well applicable; therefore, the validation of the most frequent screening tests (Mini-Mental State Examination; Addenbrooke's Cognitive Examination; Montreal Cognitive Assessment; Mattis Dementia Rating Scale) is warranted. Based on a Hungarian sample of 295 patients with Parkinson's disease, the cut-off scores having the best discriminative values are highly dependent on education years (Addenbrooke's Cognitive Examination: 0-8 years of education: 82.5 points, 9-12 years of education: 83.5 points, and ≥13 years of education: 84.5 points; Mini-Mental State Examination: 26.5-27.5-28.5 points, Montreal Cognitive Assessment: 23.5-24.5-24.5 points, Mattis Dementia Rating Scale: 138.5-139.5-139.5 points, respectively).

[MAM-E17 schizophrenia rat model]. / A MAM-E17 szkizofrénia patkánymodell.

Schizophrenia is a serious neuropsychiatric disorder. Several brain structures, neurotransmitter systems, genetic and environmental risk factors are suspected in the background. Because of its complexity the mechanism of the disorder is not known exactly, so the treatment of patients is unsolved. In the research of schizophrenia application of the rodent models is widespread. In this study one of these models based on the effect of methylazoxymethanol- acetate (MAM) is described, which is a neurodevelopmental, validated rat model. This antimitotic agent is able to evoke a number of schizophrenic symptomes temporarily disrupting the prenatal neurogenesis. The model reproduces numerous histological and neurophysiological changes of the human disorder, moreover it also represents several behavioral and cognitive phenomena resembling those in schizophrenia. A salient advantage of the model is the demonstration of the diachronic feature of the disorder, that is, postpubertal appearance of the positive symptoms. This model provides widespread opportunities for manipulations of the symptoms, so that using it in the future investigations can lead to a better understanding of this disorder.

Physically real and virtual reality exposed line bisection response patterns: visuospatial attention allocation in virtual reality.

Introduction: To understand the nature of hemispatial attention allocation in virtual reality (VR), a line bisection task (LBT) was administered both in a real environment and a virtual environment to assess the rate of pseudoneglect. The mental construction of real and virtual environments was assumed to increase visuospatial activity in right hemisphere-related cognitive processes; an alteration in the activity that manifests in the direction and rate of line bisection lateral error. Methods: In the present study, fifty-one right-handed healthy college students were recruited. They performed a line bisection task in real and virtual environments. Results: The obtained data showed that LBT errors in real and VR environments were correlated and individually consistent. Furthermore, a leftward LBT error was found in the physically real environment, however, in a VR the line bisection bias drifted towards the right hemispace. Participants with a lower right-handedness score showed a lower rate of left LBT bias in a real environment, but in VR, their LBT error showed a stronger rightwards error. Discussion: Participants showed an individually consistent pattern in both real and VR environments, but VR-induced visuospatial reality construction was associated with rightward LBT bias in a virtual environment.

Physical exercise induces mental flow related to catecholamine levels in noncompetitive, but not competitive conditions in men.

The study aimed to reveal physical exercise conditions and catecholamine response-dependent differences while an individual experiences a flow state (FS) following noncompetitive and competitive running drills. Urine laboratory catecholamine levels were measured using a standard clinical method during pre- and post-physical exercises. The noncompetitive task involved intermittent running drills, from an absolute beginning up through exhaustion. Initially, the drill is performed individually then later competing alongside other runners. Twenty-two males (mean age: 40.27; SD: 5.4; min-max: 31-49 years) were selected in accordance to the following criterion: healthy status without using medication, routine forms of training (running, cycling or swimming) ideally performed with regularity, at least three times per week, 45 min per session. During the noncompetitive task, a high FS experience was associated with a low level of catecholamines, (noradrenaline and adrenaline) while in parallel, the high FS was associated with a low concentration of homovallinic acid. During competitive conditions, the FS-related catecholamine level changes have not yet been found. In conclusion, the low concentration of the circulating catecholamines supports the transient hypofrontality hypothesis regarding the FS experiences. Furthermore, synchronized noradrenaline and adrenaline neurosecretion play an essential role in the manifestation and the prolongation of FS in noncompetitive exercise conditions.

Correlation between calbindin expression in granule cells of the resected hippocampal dentate gyrus and verbal memory in temporal lobe epilepsy.

Calbindin expression of granule cells of the dentate gyrus is decreased in temporal lobe epilepsy (TLE) regardless of its etiology. In this study, we examined the relation between reduction of calbindin immunoreactivity and the verbal and visuo-spatial memory function of patients with TLE of different etiologies. Significant linear correlation was shown between calbindin expression and short-term and long-term percent retention and retroactive interference in auditory verbal learning test (AVLT) of patients including those with hippocampal sclerosis. In addition, we found significant linear regression between calbindin expression and short-term and long-term percent retention of AVLT in patients whose epilepsy was caused by malformation of cortical development or tumor and when no hippocampal sclerosis and substantial neuronal loss were detected. Together with the role of calbindin in memory established in previous studies on calbindin knock-out mice, our results suggest that reduction of calbindin expression may contribute to memory impairments of patients with TLE, particularly, when neuronal loss is not significant.

Ambiguous handedness and visuospatial pseudoneglect in schizotypy in physical and computer-generated virtual environments.

Virtual reality (VR) technology has increased clinical attention in the health care of schizophrenia spectrum disorders in both diagnoses of the symptoms and assessment of schizotypal traits. However, the exact nature of VR-induced positive treatment effect in schizotypy is still unknown. In this study, VR technology was used as a non-invasive neurocognitive trigger to test the asymmetric visuospatial representational instability found in individuals with high schizotypy. The study aimed to reveal the brain functional hemispheric laterality in physical and virtual realities in individuals with schizotypal traits. Fifty-one healthy, right-handed participants (24 males and 27 females) were enrolled through public advertisements. Hemispheric functional asymmetry was measured by the Line Bisection Task (LBT). The results revealed that (a) LBT bias in the physical reality showed a handedness-related leftward pseudoneglect, however, similar handedness-related pseudoneglect in VR has not been found. (b) Comparing LBT bias in physically real and VR environments showed rightward drift in VR environments independently to the degree of handedness. (c) The schizotypy has no association with handedness, however, the cognitive schizotypy is related to the LBT bias. Higher cognitive schizotypy in VR associated with left hemispatial pseudoneglect. In conclusion, schizotypy is associated with ambiguous behavioral and cognitive functional laterality. In individuals with high cognitive schizotypy, the VR environment enhanced the representational articulation of the left hemispace. This effect may be originated from the enhancement of the right hemisphere overactivation and is followed by a lower mental control of the overt behavior.

Measuring Immersion, Involvement, and Attention Focusing Tendencies in the Mediated Environment: The Applicability of the Immersive Tendencies Questionnaire.

This study explores the personal predispositions and dependencies while individuals use digital media and communication devices and analyses the statistical features of the Immersive Tendencies Questionnaire (ITQ) that is popular in assessing the personality trait-dependent reaction to mediated environments. The study evaluated 781 healthy graduates and postgraduates, of which 192 were men (average age: 28.6 years) and 589 were women (average age: 28.4 years). We applied several questionnaires to measure immersive tendencies in a mediated environment, adaptive and maladaptive personality predispositions, and problematic Internet use and Facebook addiction scales. We analyze the statistical features of the long and short forms of the Immersive Tendencies Questionnaire. The data obtained support the reliable usage of the short form of the instrument. The factor structure of the questionnaire presents dual facets. First, it indicates an absorptive and immersive tendency in any case of maladaptive tendencies. Second, it reflects an intensive capability to focus on the mediated environment with adequate cognitive control to avoid any contingency of being addicted. The short form of the ITQ is reliable and adequate to assess the relationship between the self-referred and environment-dependent psychological functions.

Factors influencing schizotypal personality trait-dependent immersion and digital media usage: Adaptation and maladaptation.

Immersion in the digital environment has been widely researched; however, the effects of adaptive and maladaptive schizotypal personality traits on immersion have received relatively little attention up till now. This study investigates the factors of personal immersion while using entertainment and digital communication applications and other variables such as problematic internet usage, and Facebook addiction. The Immersive Tendency Questionnaire was applied to measure participants' tendency to experience artistic and life-like scenarios in traditional settings (reading a book and watching a movie) and digital environments (playing computer games and using the internet). The study was conducted with 717 college students and graduate persons including, 186 males (mean age: 28.49) and 531 females (mean age: 28.4). The results show that lowered focusing abilities are directly linked with deficiencies in self-coherence, and maladaptive behavior that manifests in problematic internet and Facebook usage. Furthermore, the attention/focusing ability during immersion is accompanied by coherent self-structure and psychological well-being. Therefore, for people who have adequate focusing skills and coherent self-structure, the usage of social media and computer gaming can be considered adequate digital tools for developing their cognitive and social skills.

Reward Dependence-Moderated Noradrenergic and Hormonal Responses During Noncompetitive and Competitive Physical Activities.

The aim of this study was to reveal whether increased reward dependence (RD) plays a role in the catecholamine neurotransmitter release and testosterone hormone regulation during physical activities among healthy trained participants. Twenty-two male participants (mean age: 40.27 ± 5.4 years) participated in this study. Two conditions were constructed, namely, a noncompetitive and a competitive running task (RT), which were separated by a 2-week interval. Urine and blood samples were collected prior to and following the running tasks. Noradrenaline (NA), adrenaline (A), dopamine (D), and their metabolites, vanillylmandelic acid (VMA) and homovanillic acid (HVA), were measured from urine, while testosterone levels were analyzed from blood samples. RD was assessed using the Cloninger's Personality Inventory (PI). Mental health was evaluated using the WHO Well-Being, Beck Depression, and Perceived Life Stress Questionnaires. According to our findings, levels of NA, A, D, VMA, and testosterone released underwent an increase following physical exertion, independently from the competitive condition of the RT, while HVA levels experienced a decrease. However, we found that testosterone levels showed a significantly lower tendency to elevate in the competitive RT, compared with the noncompetitive condition (p = 0.02). In contrast, HVA values were higher in the competitive compared with the noncompetitive condition (p = 0.031), both before and after the exercise. Considering the factor RD, in noncompetitive RT, its higher values were associated with elevated NA levels (p = 0.007); however, this correlation could not be detected during the competitive condition (p = 0.233). Among male runners, the NA and testosterone levels could be predicted to the degree of RD by analyzing competitive and noncompetitive physical exercises.

Individual differences in the experience of body ownership are related to cortical thickness.

The widely used rubber hand illusion (RHI) paradigm provides insight into how the brain manages conflicting multisensory information regarding bodily self-consciousness. Previous functional neuroimaging studies have revealed that the feeling of body ownership is linked to activity in the premotor cortex, the intraparietal areas, the occipitotemporal cortex, and the insula. The current study investigated whether the individual differences in the sensation of body ownership over a rubber hand, as measured by subjective report and the proprioceptive drift, are associated with structural brain differences in terms of cortical thickness in 67 healthy young adults. We found that individual differences measured by the subjective report of body ownership are associated with the cortical thickness in the somatosensory regions, the temporo-parietal junction, the intraparietal areas, and the occipitotemporal cortex, while the proprioceptive drift is linked to the premotor area and the anterior cingulate cortex. These results are in line with functional neuroimaging studies indicating that these areas are indeed involved in processes such as cognitive-affective perspective taking, visual processing of the body, and the experience of body ownership and bodily awareness. Consequently, these individual differences in the sensation of body ownership are pronounced in both functional and structural differences.

[Important aspects of end-of-life care. Survey of patients visiting the primary care office]. / Az életvégi ellátás fontos kérdései. Attitudvizsgálat háziorvoshoz forduló betegek körében.

INTRODUCTION: Death and dying are still taboo topics in Hungary. The care of the dying, the adequate relief of their symptoms and the psychosocial support of both patients and their caregivers are not yet well addressed. AIMS: Authors obtained information about the feelings and thoughts of patients on death and dying, and about their expectations for end-of-life care. METHODS: Mailed questionnaire was send to a convenience sample of 29 adult primary care offices where a total of 845 unselected patients completed the questionnaire. RESULTS: More than two thirds (69%) of respondents would like to receive end of life care in their home. Only 19% of respondents would prefer to die in a hospital. Respondents' greatest fear was to lose their autonomy (55%). The second most noted concern was fear from pain (38%). According to 93% of the participants, truth telling is very important in the event of terminal illness. CONCLUSIONS: Hungarian patients prefer to receive end of life care in their home. Our data support the need for improvement in three primary areas, physician communication skills, pain and symptom management, and expansion of home hospice care.

Adaptive and maladaptive features of schizotypy clusters in a community sample.

Schizotypal personality traits correlate with psychopathology and impaired functional outcome. Yet advantageous aspects of positive schizotypy may exist which could promote resilience and creativity, and several studies have identified a high positive but low negative schizotypy group with some signs of adaptation. The aim of our study was to clarify whether such individuals demonstrate only traits associated with well-being, or they also have traits that predict impairment. Participants (N = 643 students, 71.5% female) completed measures of schizotypy, resilience, self-esteem, self-concept clarity, and absorption. We identified four clusters: an overall low schizotypy, an overall high schizotypy, a disorganised-interpersonal schizotypy and a positive schizotypy cluster. The overall high schizotypy cluster seemed to be the most vulnerable as it was the least resilient and showed widespread maladaptation, whereas the high positive schizotypy cluster had intact self-esteem and high resilience and its elevated absorption may hold the promise for adaptive outcomes such as creativity and positive spirituality. However, the high positive schizotypy cluster lacked self-concept clarity. The results suggest that individuals showing high positive and low negative schizotypy demonstrate features promoting mental well-being to an extent that is higher than in all the other clusters, while their self-concept impairment is similar to that observed in the high and the disorganised-interpersonal schizotypy clusters. Better understanding of these factors could be informative for prevention and treatment of psychosis-spectrum disorders.