A kötődési kapcsolatok stabilitása gyermekkorban = Stability of attachment relationships in childhood

Alacsony szociális rizikójú családokkal folytatott longitudinális vizsgálatunkban elsőszülött gyermekek kötődési kapcsolatainak állandóságát ill. változását, valamint ezek feltételezett korrelátumait elemeztük. A csecsemőkorban megfigyelt anya-gyermek kötődési minőség nem bizonyult stabil mintázatnak sem 1 és 4, majd 4 és 6, sem 1 és 6 éves kor között. Az anyához való kötődés változása elsősorban a fiú gyermekeket érintette, akik egyik életkori összehasonlításban sem mutattak stabil kötődési mintázatot. A lány gyermekek csoportjában ugyakkor folytonosságot találtunk mindhárom mérési időpont között a biztonságos vs. bizonytalan anyai kötődés tekintetében. Az anya-gyermek kötődési kapcsolat kevésbé optimális irányba történő változásának hátterében a gyermek nemét (fiú) és a kumulatív környezeti stresszt (súlyos betegségek, halálozások, szeparációk, stb.) azonosítottuk rizikófaktorként. Az anyához való kötődéssel ellentétben az apa-gyermek kötődési biztonság jelentős stabilitást mutatott 1,5 és 7,5 éves kor között. Kimutattuk, hogy a 6 éves korban anyjukhoz biztonságosan kötődő gyermekek jobbak az érzelmek felismerését és megnevezését vizsgáló feladatban, míg az apához való kötődés minősége ezt nem befolyásolta. Bővítve korábbi felfedezésünket a gyermekek DRD4 genotípusa és az 1 éves kori dezorganizált (D) kötődés kapcsolatáról, jelen kutatásban kimutattuk, hogy ez a genotípus a 4 és 6 éves kori D kötődés megjelenésében, valamint életkori állandóságában is szerepet játszik. | The present research investigated continuity and change in attachment relationships of firstborn children from infancy to childhood in a low-social-risk sample. For the whole sample, no longitudinal stability of mother-child attachment security was found from 1 to 4, from 4 to 6, or from 1 to 6 years. Changes in mother-child attachment mainly concerned boys, who did not show stable attachment patterns over time in any age contrasts. In the group of girls, however, security of attachment to the mother proved stable across all assessment periods. Male sex and cumulative life stress (serious illnesses, major losses, separations, etc.) were identified as risk factors for unfavourable change in mother-child attachment from infancy to childhood. In contrast to mother-child attachment, significant continuity in father-child attachment security was found from 1.5 to 7.5 years. We showed that 6-year secure attachment to the mother was associated with children?s better performance in recognition and labelling of emotions, while quality of attachment to the father was not related to the ?emotion task?. Expanding our previous findings on the association between child DRD4 genotype and 1-year disorganised (D) attachment, the present study showed that this genotype also influences the occurrence of D attachment both at 4 and 6 years of age, and its stability over early childhood

Genetikai és környezeti hatások kölcsönhatása a csecsemőkori kötődés alakulásában = Interaction of genetic and environmental influences in the development of infant attachment

Vizsgáltuk a genetikai és a környezeti tényezők hatásait, valamint a gén-környezet kölcsönhatást a korai kötődés jellemzőire. Fontosabb eredményeink: 1. A családi genotípusok és az öröklésmenet vizsgálatával megerősítettük az elsőszülött csecsemők DRD4 genotípusának és anyához való kötődésének asszociációját. A kötődés és a szülői DRD4 genotípusok között nincs összefüggés (Gervai et al., 2005). 2. Kimutattuk, hogy a BCsV elsőszülött csecsemők szülőkhöz való kötődése között szignifikáns egyezés van, és az apához való kötődés biztonsága összefügg a csecsemő DRD4 genotípusával (Tóth et al., előkészületben). 3. Kimutattuk, hogy a szerotonin transzporter gén 5-HTTLPR genotípusa nem függ össze a kötődéssel, de a DRD4 genotípussal együtt hat az idegenfélelem mértékére (Lakatos et al., 2003). 4. Kidolgoztuk a magyar kisgyermekes családokban a jelentős életesemények súlyozásának módját (Danis et al., elfogadva). Becsültük a környezeti stressz mértékét a csecsemők első életévére (Danis et al., előkészületben). 5. Kimutattuk a dezorganizált kötődés és az atipikus anyai viselkedés kapcsolatát és felfedeztük a csecsemők DRD4 genotípusának módosító hatását. A DRD4 gén 7-ismétlésű változatának hiányában az anyai atipikus viselkedés összefügg a dezorganizált kötődéssel, a 7-ismétlésű változatot hordozó csecsemők azonban érzéketlenek az anyai viselkedés atipikusságára. Az eredményeket közlő cikket meghívták a Social Neuroscience különszámába (Gervai et al., közlésre benyújtva). | The research concerned genetic and environmental effects on infant attachment, and gene-environment interactions. 1. We confirmed the association of firstborn infants? DRD4 genotype and attachment to the mother by examining family genotypes and the pattern of allele transmissions. Parental DRD4 genotypes were not associated with infant attachment (Gervai et al., 2005). 2. We found a significant association between infant attachment to the parents. Further, security of attachment to the father was associated with the infant?s DRD4 genotype (Tóth et al., in prep). 3. The 5-HTTLPR repeat polymorphism of the serotonin transporter promoter region was not associated with infant attachment, but together with the DRD4 genotype it affected the degree of stranger fear (Lakatos et al., 2003). 4. We obtained Hungarian weights for significant life events in families with young children (Danis et al., accepted). Using these, we estimated life-stress for the first year of infants? life (Danis et al., in prep). 5. We found an association between disorganized attachment and atypical maternal behavior, which was moderated by infant genotype. In the absence of the DRD4 7-repeat allele, atypical maternal behavior was strongly related to infant disorganization, but infants with the 7-repeat allele were insensitive to maternal atypical behavior. The paper describing the results was invited for publication in Social Neuroscience (Gervai et al., submitted)

How to Decrease Suicide Rates in Both Genders? An Effectiveness Study of a Community-Based Intervention (EAAD)

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

The effects of dissection-room experiences and related coping strategies among Hungarian medical students

Background: Students get their first experiences of dissecting human cadavers in the practical classes of anatomy and pathology courses, core components of medical education. These experiences form an important part of the process of becoming a doctor, but bring with them a special set of problems. Methods: Quantitative, national survey (n = 733) among medical students, measured reactions to dissection experiences and used a new measuring instrument to determine the possible factors of coping. Results: Fifty per cent of students stated that the dissection experience does not affect them . Negative effects were significantly more frequently reported by women and students in clinical training (years 3,4,5,6). The predominant factor in the various coping strategies for dissection practicals is cognitive coping (rationalisation, intellectualisation). Physical and emotional coping strategies followed, with similar mean scores. Marked gender differences also showed up in the application of coping strategies: there was a clear dominance of emotional-based coping among women. Among female students, there was a characteristic decrease in the physical repulsion factor in reactions to dissection in the later stages of study. Conclusions: The experience of dissection had an emotional impact on about half of the students. In general, students considered these experiences to be an important part of becoming a doctor. Our study found that students chiefly employed cognitive coping strategies to deal with their experiences. Dissection-room sessions are important for learning emotional as well as technical skills. Successful coping is achieved not by repressing emotions but by accepting and understanding the negative emotions caused by the experience and developing effective strategies to deal with them. Medical training could make better use of the learning potential of these experiences

Gender Differences in Deliberate Self-Poisoning in Hungary

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

The four-level approach of the European Alliance Against Depression.

<p>The four-level approach of the European Alliance Against Depression.</p