Estimating and managing the changing methodological parameters of self-report surveys of addictive behavior - based on the waves of the National Survey on Addiction Problems in Hungary

The standard nature of the procedures and tools of sampling and data collection cannot guarantee the stability of data reliability and validity because non-sampling errors are highly sensitive to social conditions. The present study provides a post-hoc attempt to estimate and manage the changing methodological parameters of self-report surveys of addictive behaviours (being highly subjected to changes in social conditions) to make data interpretation easier. The analysis is based on the data of two national Hungarian representative surveys assessing addiction problems in 2007 and 2015 (National Survey on Addiction Problems in Hungary [NSAPH]). Both surveys were conducted using a Hungarian nationwide representative sample aged 18-64 years applying similar procedures in data collection and-processing. Regarding data concerning substance use, both surveys included variables to estimate non-sampling errors in line with current international practices. The methodological parameters of NSAPH2015 showed an increase in non-sampling errors regarding substance use behaviour compared to NSAPH2007. The present paper elaborates an estimation procedure based on the assumption that when following a population, the proportion of people who have ever engaged in a specific type of addictive behaviour cannot be reduced in the given population over time. This also applies to cohorts followed by cross-sectional surveys among national representative samples, as far as lifetime prevalence and data on the age of first use/activity is available. To identify valid trends in different behaviours in epidemiological research assessing addictive behaviours or other sensitive data, researchers should provide the required conditions for controlling or correcting data by cohort analysis

Stigmatic attitudes towards mentally ill patients in Hungary between 2001 and 2015: results of a time-trend analysis

Background: Stigmatic attitudes towards people with the diagnosis of mental illness are widespread in the general public [1] and are the major obstacle for successful treatment, rehabilitation and reintegration of patients into the society [2]. Given the magnitude of this issue, and in the effort to develop effective anti stigma intervention programs, trend analysis studies were conducted, examining the changes in attitudes over the years [3]. The construct of social distance, which involves the desire to avoid contact with a particular group of people was commonly used to assess stigma. These studies have consistently reported that despite the improvement in mental health literacy of the public, social distance preferences concerning mentally ill patients have not changed over the last 20 years, and in some cases have even increased [3]. However, the number of studies using trend analysis is scarce and mainly limited to wealthier countries because such studies are both costly and time intensive. Consequently, most studies to date have been carried out in North Western Europe whereas data from Central and Eastern European countries, especially from former communist countries, is lacking [4,5]. Objective: In the face of underfinanced mental health system and the lack of any national anti-stigma programs or research, the aim of this study is to shed light into mental illness stigma in Hungary. More specifically, this study aimed to explore for the first time, potential changes concerning attitudes of the Hungarian population towards mentally ill patients. Method: National representative surveys (N=7605) of adults aged 18-53 years were carried out in Hungary in 2001, 2003, 2007 and 2015. An interview was conducted, asking for socio-demographic information and participants' desire for social distance from mentally ill patients, measured by Bogardus social distance scale. In order to put into context the stigmatic attitudes towards mentally ill patients, participants were also asked to report on their social distance preferences towards other minorities in the Hungarian society. Trend analysis was performed to examine the trends of social distance. Results: Time-trend analysis indicated a significant (positive) trend in public preferences for social distance towards more accepting attitudes during the years of 2001-2015. However, closer examination reveals that the effect size is very small (0.05) and the 2015 rejection level is still high (57%) compared to over 60% in both 2001 and 2003. Moreover, during a period of 15 years, mentally ill patients are among the three most rejected groups in the society (with only alcoholics and drug users being more rejected). Conclusions: As was found in other countries around the world, in Hungary as well, stigmatic attitudes towards mentally ill patients are highly prevalent, and have not changed over the last decade. While stressing a worrisome reality in Hungary, where no efforts to tackle mental illness stigma were done, this study also verifies the enormity of the stigma phenomenon. It is evident, maybe more than anything, that much effort is needed in Hungary, but also worldwide, in order to understand and defeat mental illness stigma

An empirically based typology of alcohol users in a Hungarian community sample using latent class analysis

Background. Different classification models have been proposed to explain the heterogeneity of alcohol-related problems in general populations. Such models suggest quantitatively or qualitatively different symptom endorsement characteristics between subgroups of alcohol drinkers. Objectives. The present study aimed to identify homogenous subgroups of drinkers in a general population sample in addition to examining the relationship between the subgroups and psychopathological symptoms. Method. Data of past-year alcohol users (N=1520) were analyzed from the nationally representative sample of the National Survey on Addiction Problems in Hungary 2015 (NSAPH 2015). Latent Class Analysis (LCA) was conducted to identify subgroups of drinkers based on the dichotomous indicator items of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Multinomial logistic regression and multiple comparisons were performed to explore the relationship between latent classes and socio-demographical variables and psychopathological symptoms. Results. LCA suggested a three-class model: 'Light with low risk of dependence' (19.3%) and 'Alcohol drinkers with severe dependence symptoms' (9.1%). More severe subgroups showed significantly higher level of anxiety, depression, hostility, obsessive-compulsivity, interpersonal sensitivity, and psychiatric or AUD-related treatment involvement. Male gender, younger age, lower level of educational achievement, and earlier onset of the first alcoholic drink were associated with membership of more severe subgroups. Conclusions. The present results indicated that severity-based subgroups of drinkers can be discriminated. Approximately 9% of the alcohol users showed severe symptoms of alcohol dependence. The present data also supported the association between more severe forms of alcohol consumption, and internalizing and externalizing characteristics

Understanding esports-related betting and gambling: a systematic review of the literature

Esports gambling has steadily grown in popularity alongside esports itself. While research has been increasing in the field of esports-related gambling, no study has yet reviewed the relevant literature on esports gambling. The present study aimed to comprehensively review all empirical research conducted in the wider field of esports gambling. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was undertaken using PsycINFO, PubMed, Scopus, and Web of Science databases. Only empirical studies were included and were also assessed for potential biases using the ROBUST guidelines. A total of 30 studies from eight countries were included in the review. Esports gamblers were found more likely to be young males, likely to score high on problematic gambling scales, and likely to belong to households speaking a non-English language at home in English speaking countries. Esports gamblers are a unique type of gambling population, with rare characteristics and behaviors compared to other types of gamblers. Given the limited number of studies, there is a need for further research in this field to understand these populations, as well as the need for longitudinal research

Discriminative characteristics of marginalised novel psychoactive users: A transnational study

New psychoactive substances (NPS) continue to be considered as a major public health concern in many European countries. The study was implemented within the framework of a transnational project of six European countries (Germany, Hungary, Ireland, Netherlands, Poland, Portugal). Our aim here is to report on the distinct and differentiating characteristics of marginalised NPS users. Three subgroups of a total of 3023 adult NPS users (socially marginalised, night life, online community) were examined regarding their socio-demographic characteristics, substance use, and external motives towards NPS use. Poland and Hungary reported higher rates of NPS use in comparison to traditional controlled drugs. The external/contextual motives did not play a central role in the background of NPS use, the least important motives were alleged legality and non-detectability of these substances. Marginalised (defined as those accessing low threshold harm reduction services) users’ substance use patterns are different from the other two groups in terms of showing more intense and riskier drug use. The most important variables which contributed to be categorised as a marginalised NPS user were lower level education, being older, having an unfavourable labour market position and using drugs intravenously. Contextual motives did not play a decisive role in being categorised as a marginalised user when drug use pattern was controlled. These identified discriminative features of marginalised drug users should inform policy makers to develop and implement tailor-made interventions targeting this user group to successfully tackle the elevated public health concerns associated with NPS use

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

This study was supported by the European Union (New Psychoactive Substances: transnational project on different user groups, user characteristics, extent and patterns of use, market dynamics, and best practices in prevention [HOME/2014/JDRU/AG/DRUG/7077]), the Hungarian National Research, Development and Innovation Office (Grant number: KKP126835; NKFIH1157-8/2019-DT). The study was also supported for the realization of this international cofinanced science project in 2016-2017 by the Polish Ministry of Science and Higher Education. Máté Kapitány-Fövény acknowledges the support by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences and the support by the ÚNKP-19 New National Excellence Program of the Hungarian Ministry for Innovation and Technology. The funding institutions had no role in the study design or the collection, analysis and interpretation of the data, writing the manuscript, or the decision to submit the paper for publication

How and where to find NPS users: a cross national survey among current users of new psychoactive substances.

Use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes potentials and limitations of methods in a transnational survey of recent marginalized, nightlife and online community NPS users in Germany, Hungary, Ireland, the Netherlands, Poland and Portugal (n=3023). In terms of demographic profile, drug use history and type of NPS, different methods reached different segments of the NPS-using population. Last year use of different NPS varied across countries and groups. Respondents used NPS in a variety of settings, with public spaces most common in marginalized group. The study suggests that prevalence rates can reveal a picture of the NPS market that significantly deviates from what law enforcement seizures indicate. Outreach in nightlife settings and peer education are recommended to inform users about health risks and to improve access to drug services and care

A four-factor model of work addiction: the development of the work addiction risk test revised (WART-R)

Work has a crucial role in individuals’ productivity, social life and psychological wellbeing. Despite various definitions of work addiction in the literature, the number of psychometrically reliable instruments is limited. The aim of this study was to psychometrically test and revise the factor structure of the Work Addiction Risk Test (WART), one of the most widely used instruments assessing work addiction. The full version of the WART (Robinson, Post, & Khakee, 1992) was assessed using a nationally representative sample of Hungary (N = 2710). To increase validity, the analyses were conducted among individuals who worked at least 40 hours a week (N = 1286, 43% women, mean age = 38.9 years, SD = 10.8). Using confirmatory factor analysis, the originally proposed four- and five-factor solutions did not have adequate model fit indices. Thus, the sample was randomly divided into two subsamples. Exploratory factor analysis conducted in the first half of the sample supported a four-factor solution, which was confirmed in the other half of the sample. The Work Addiction Risk Test Revised (WART-R) comprises 17 items and four factors (i.e., Overcommitment, Impatience, Hard-working, and Salience). As a conclusion, the WART-R is suitable to be used as an indicator work addiction based on clinically relevant symptom dimensions

Health and social problems associated with recent Novel Psychoactive Substance (NPS) use amongst marginalised, nightlife and online users in six European countries.

Continued diversification and use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes health and social consequences of recent NPS use as reported in a survey of marginalised, nightlife and online NPS users in the Netherlands, Hungary, Portugal, Ireland, Germany and Poland (n = 3023). Some respondents were unable to categorise NPS they had used. Use of ‘herbal blends’ and ‘synthetic cannabinoids obtained pure’ was most reported in Germany, Poland and Hungary, and use of ‘branded stimulants’ and ‘stimulants/empathogens/nootropics obtained pure’ was most reported in the Netherlands. Increased heart rate and palpitation, dizziness, anxiety, horror trips and headaches were most commonly reported acute side effects. Marginalised users reported substantially more acute side effects, more mid- and long-term mental and physical problems, and more social problems. Development of country-specific NPS awareness raising initiatives, health and social service needs assessments, and targeted responses are warranted