A complex, Nature-, and Adventure Therapy - integrated Schema Therapeutic program (N-ABST) and a related efficacy study was launched in 2022 April at the Psychotherapy Department, at Semmelweis University. The participants had the opportunity of having outdoor, experience based group processes – seven full days in a month - in addition to the classic Schema Therapy (ST) sessions. According to the study design, 4-week long traditional thematic ST programs and 4-week long N-ABST programs were taken place alternately.

Our aim was to compare the efficacy in a randomized, controlled design, short and medium terms. The participants of the programs and thus the target group of the research were adults, diagnosed mainly with Borderline Personality Disorder, inpatients in psychiatry.

This methodological innovation also meant the integration of two therapeutic teams in practice. When establishing the collaboration, we put emphasis on finding common points and understanding how N-AT contributes to schema therapy goals. During our joint work, it became clear that the elemental need for contact with nature enriched the schema therapy approach with a new basic need that was not included in it before. Measurements were taken before the start of the entire program and at the end of the 4-week cycle. Preliminary results are presented based on the Personality Inventory for DSM-5 - Hungarian Short Form (PID-5-HSF), and the Derogatis Symptom Checklist (SCL90).

In the N-ABST group (n=23) the PID5 “Dysinhibition” scale (p < .01, Cohen’s d = .636), and the “Negative Affectivity” scale (p < .05, Cohen’s d = .388) showed significantly lower scores after therapy. In the case of the “Detachment” we have found a tendency to decrease after the therapy. Regarding the comparison of the effectiveness of N-ABST and classical Schema Therapy - with the current state of analysis - there was a significant difference in the PID5 values for “Suspiciousness” and “Manipulativeness”. The former characteristic was reduced to a greater extent by the schema therapy, and the latter by the N-ABST therapy. Based on the SCL90, the N-ABST program resulted in a significant symptom reduction measured by the following subscales: somatization, obsessive compulsive, interpersonal sensitivity, depression, phobia. Global symptom severity also decreased significantly (p < .05, Cohen’s d = .588).

According to our results, Nature- Adventure Therapy enhanced Schema Therapy seems to be an innovative and efficient method in the psychotherapy of personality disorders. Besides the effectiveness, there is a great challenge to design programs that are sustainable and therefore serves therapy long term as well.

This study was supported by the National Research, Development and Innovation Office grant K 129195.

None Declared

Most previous research focused on the association between mentalizing and specific mental disorders, while less is known about the relationship between mentalizing and quality of life among adolescents.

This study aimed to validate The Reflective Function Questionnaire for Youth in the Hungarian language and evaluate the moderating influence of mentalizing on the relationship between psychopathology and quality of life.

A community sample of 384 youths of 12–18 years (72.7% females) completed the following questionnaires: The Reflective Function Questionnaire for Youth (RFQY), The Measure of Quality of Life for Children and Adolescents and The Strengths and Difficulties Questionnaire. First, we tested the different factor structures of the RFQY: the two-factor, the eight-item, and the five-item versions. We conducted a series of moderation analyses with quality of life as the dependent variable, higher-order symptom categories (internalizing or externalizing symptoms separately) as the independent variable, and mentalization as the moderator.

The confirmatory factor analysis supported the five-item version of the RFQY (Cronbach’s alpha .61) and resulted in a new, 10-item version of The Reflective Function Questionnaire for Youth on the Hungarian sample (Cronbach’s alpha .76). Mentalization had a moderator effect on the relationship between internalizing and externalizing symptoms and quality of life.

Our study provides the first psychometric support for the Hungarian version of the RFQY and underlines the importance of assessing the complex relationships between mentalization, quality of life and symptomatology. Targeting mentalization to improve the quality of life among adolescents might be a key factor.

None Declared

Previous studies indicated, that mentalization mediates the link between adult attachment and stress, however, this relationship was not tested before among non-clinical parents of children aged between 12 and 18 years.

The aim of this study was to explore the relationship between parental reflective functioning, attachment style, perceived parental sense of competence, and stress among parents.

After providing written consent, 186 non-clinical mothers completed a questionnaire packet that included a demographic form, The Parental Reflective Functioning Questionnaire - Adolescent version, the Attachment Style Questionnaire, the Parental Sense of Competence Scale, and the Perceived Stress Scale. A moderated mediation analysis with parental sense of competence as a dependent variable, mother’s attachment style as an independent variable, certainty about mental states hypermentalization subscale as a mediator, and stress as a moderator was conducted.

In the moderated mediation analysis, the direct effect of the attachment style on the parental sense of competence in the case of preoccupied attachment style was significant (p < .001). The interaction term of the hypermentalization subscale by perceived stress was also significant in the case of low level (w = -1.57, p < .001) and high level of perceived stress (w= 1.21, p = .049) among mothers with a preoccupied attachment style.

These findings suggest that the preoccupied attachment style is related to the parental sense of competence through certainty about mental states hypermentalization in case of low level and high level of perceived stress, so mentalization-based interventions are warranted.

No significant relationships.

Trauma, stress, and attachment problems are negatively related to the development of mentalization. Children raised in institutional care are more exposed to these difficulties, therefore the development of population-specific interventions that aim to improve mentalization skills would be highly desirable.

Our goal is to develop mentalization-based intervention programs for specific age groups (9-13 years, 14-18 years, and adult staff members of institutional care centers) - that support children’s and adolescents’ social functioning and conflict resolution skills.

The mentalization-based intervention targeting institutional care staff was launched first. Due to the pandemic, this intervention was executed online with two intervention (N = 17) and two passive control (N = 15) groups. Before and after the intervention, participants completed a demographic questionnaire, the Parenting Sense of Competence Scale, the Reflective Functioning Questionnaire, the Mini Oldenburg Burnout Inventory, The Strengths, and Difficulties Questionnaire, and the Ways of Coping Questionnaire.

The intervention protocol and our results will be shown at the conference. There was no significant difference between the two intervention and two passive control groups in the demographic features. Mentalization uncertainty and burnout was positively related(rs(23) = .42, p = .034), while mentalization uncertainty and parental competence was negatively associated (rs(23) = - .41, p = .041).

The intervention program will be fine-tuned and optimized based on the results of the pilot study. In the next interventions, we plan to focus on the issues that the staff perceived as most difficult and to conduct interventions among the children.

No significant relationships.

Parental reflective function is the ability of a parent to attribute mental states to their child and to themselves. The Parental Reflective Functioning Questionnaire is widely used for the measurement of this construct, the adolescent version of which can be used by parents of children aged 12-18.

The aim of our research was to adapt the adolescent version of The Parental Reflective Functioning Questionnaire to the Hungarian language.

In our study 240 mothers completed the adolescent version of The Parental Reflective Functioning Questionnaire (PRFQ-A), and the Reflective Function Questionnaire (RFQ).

Confirmatory factor analysis did not confirm the original three-factor structure. The principal component analysis resulted in a two-factor structure. Factors corresponded to the original questionnaire’s certainty in mental states (Alpha = .81) and interest and curiosity subscales (Alpha = .70). When analyzing the relationship between parental reflective function and reflective function, the subscales of the parental reflective function questionnaire were examined with two types of median coding in addition to polar coding. During the first median coding, the frequency of scores in the middle of the scales reflected optimal mentalization, while the frequency of extreme values on the scales corresponded to less favorable reflective functioning. With the second median coding, hypermentalization and hypomentalization subscales were also created. The second median transcoding proved to be the most suitable for capturing the relationship between RFQ and PRFQ-A.

The questionnaire proved to be a reliable measure on the Hungarian sample and we recommend using the additional subscales.

No significant relationships.

Osia is a new, transcutaneous, active bone-conduction implant. This study aimed to compare the BAHA Attract and the first-generation Osia system after BAHA Attract to Osia conversion surgery.

Five patients who had previously used the BAHA Attract system were converted to the first generation of the Osia system. Surgical aspects of the two different systems, audiological performance and subjective opinions of the patients were investigated. Pure tone audiometry and speech audiometry in quiet was performed with each patient's BAHA 5 sound processor on Attract, and the test battery was repeated six weeks after the Attract to Osia conversion and at different time points after the first fitting. Details of the surgery and patients' feedback were analysed.

Audiology tests showed significant improvement when using either system; however, the Osia system performance was better. Based on patient feedback, all the five implantees preferred the Osia system.

The study results suggest that the Osia system is a safe and powerful hearing implant that provides good clinical outcomes.

Reduced heart rate variability (HRV) is a prognostic factor for cardiac mortality. Both depression and anxiety have been associated with increased risk for mortality in cardiac patients. Low HRV may act as an intermediary in this association. The present study examined to what extent depression and anxiety differently predict 24-h HRV indices recorded post-myocardial infarction (MI).

Ninety-three patients were recruited during hospitalization for MI and assessed on self-reported symptoms of depression and anxiety. Two months post-MI, patients were assessed on clinical diagnoses of lifetime depressive and anxiety disorder. Adequate 24-h ambulatory electrocardiography data were obtained from 82 patients on average 78 days post-MI.

In unadjusted analyses, lifetime diagnoses of major depressive disorder was predictive of lower SDNN [standard deviation of all normal-to-normal (NN) intervals; β=−0.26, p=0.022] and SDANN (standard deviation of all 5-min mean NN intervals; β=0.25, p=0.023), and lifetime anxiety disorder of lower RMSSD (root mean square of successive differences; β=−0.23, p=0.039). Depression and anxiety symptoms did not significantly predict HRV. After adjustment for age, sex, cardiac history and multi-vessel disease, lifetime depressive disorder was no longer predictive of HRV. Lifetime anxiety disorder predicted reduced high-frequency spectral power (β=−0.22, p=0.039) and RMSSD (β=−0.25, p=0.019), even after additional adjustment of anxiety symptoms.

Clinical anxiety, but not depression, negatively influenced parasympathetic modulation of heart rate in post-MI patients. These findings elucidate the physiological mechanisms underlying anxiety as a risk factor for adverse outcomes, but also raise questions about the potential role of HRV as an intermediary between depression and post-MI prognosis.