Barna Konkolÿ Thege

Aggressive/antisocial behaviors in children and youth may result in impairments in family, social, or academic functioning and lead to long-term negative consequences for both the individual and society as a whole. The potential of healthy diet and nutritional supplements to reduce aggression and antisocial behavior is an active area of study in nutritional mental health sciences. The goal of this systematic review is to (1) investigate the effectiveness/efficacy of nutritional interventions (dietary manipulation, fortification or supplementation) in reducing excessive aggression, antisocial behaviors, and criminal offending in children/youth (systematic review and meta-analysis); and (2) provide an overview of implementation barriers and facilitators regarding nutritional interventions in children/youth (qualitative/narrative synthesis). After consulting the Campbell Collaboration's methodological guidelines, a comprehensive search for published and unpublished papers on controlled intervention studies was performed (up to February 26, 2024) using both electronic databases (MEDLINE, Embase, Cochrane Library, APA PsycInfo, Scopus, and the Allied and Complementary Medicine Database) and other resources (e.g., Google Scholar, reference list of included studies and other reviews, websites of public health agencies). This study focuses on children and youth (up to the age of 24) presenting with an above-average level of aggression/antisocial behavior. In terms of the intervention, we considered both dietary manipulation and nutritional supplementation with a duration long enough (minimum of 1 week) that a significant change in the individual's nutritional status could be expected. We included studies with a controlled design if, for outcomes, they reported on (1) behavioral-level violence/aggression toward others in real-life (non-simulated) settings, (2) antisocial behaviors, or (3) criminal offending. Initial screening, checking for eligibility criteria, data extraction from, and risk of bias assessment for each eligible study were conducted independently by two reviewers. To perform the meta-analysis, data from each original report were standardized (transformed into Hedges' g ) so that results across studies could be meaningfully combined and interpreted. Data conversions, computation of pooled effect sizes, and estimation of publication bias were conducted using the Comprehensive Meta-analysis software (Version 4). Altogether, 51 reports (describing 50 individual studies) met our inclusion criteria, and 72 effect sizes were extracted from these reports. Nutritional interventions with a broad target (e.g., broad-spectrum micronutrient supplementation or general improvement in diet quality) had the most consistent and largest intervention benefit across all outcomes (aggression: k = 7, N = 797, g = −0.31, 95% CI = −0.50 to −0.12, p = 0.001; antisocial behavior: k = 13, N = 2109, g = −0.49, 95% CI = −0.73 to −0.24, p < 0.001; criminal offending: k = 2, N = 117, g = −1.25, 95% CI = −2.39 to −0.11, p = 0.031). These intervention benefits range from small (aggression) through medium (antisocial behavior) to large (offending), and for each outcome, dietary change was considerably more effective than supplementation. Eliminating studies with high risk of bias reduced the treatment benefit to close to zero regarding aggression and small in relation to antisocial behaviors. The most commonly studied narrow-focused nutritional intervention was omega-3 fatty acid supplementation with a small, beneficial effect and with less consistency in statistical reliability across outcomes (aggression: k = 9, N = 706, g = −0.33, 95% CI = −0.87 to 0.22, p = 0.240; antisocial behavior: k = 21, N = 2,081, g = −0.15, 95% CI = −0.26 to −0.03, p = 0.013). Eliminating studies with a high risk of bias did not change the small effect size related to aggression, but further reduced the negligibly small effect size regarding antisocial behavior. Pooled effect size for vitamin D supplementation showed small-to-moderate treatment benefit in terms of antisocial behaviors ( k = 4, N = 226, g = −0.48, 95% CI = −0.74 to −0.22, p < 0.001). Elimination of studies with a high risk of bias reduced the effect size from moderate to small. The overall number of and sample size in some of the studies limit our confidence in the validity of the above meta-analytic results. Further, prediction intervals always included the possibility of no effect, suggesting considerable heterogeneity in the data. While there were several studies on other narrow-focused nutritional interventions, these were not studied frequently enough to allow the generation of even preliminary meta-analytic conclusions. A large set of barriers and facilitators to the implementation of nutritional interventions was also identified and narratively summarized. While the evidence on nutritional interventions to reduce aggression/antisocial behaviors is not conclusive, these interventions are safe (especially compared to psychotropic medications), easy-to-implement (especially nutritional supplements), and cheap (especially on the societal level). These characteristics make such interventions feasible and desirable, especially as their benefits are not aggression-specific: good nutritional status is the basis for both physical and mental health in general; and therefore, investment in – especially broad-spectrum – nutritional interventions seems warranted.

This is a protocol for a Campbell systematic review of intervention effectiveness. The goal of this systematic review is to answer the following questions based on the available empirical evidence: Are there nutritional interventions (dietary manipulation, fortification or supplementation) that can reduce excessive aggression towards others in children/youth? If yes, how strong is their effect and is there a difference among the three intervention types? Are there nutritional interventions that can reduce antisocial behaviors in children/youth? If yes, how strong is their effect and is there a difference among the intervention types? Are there nutritional interventions that can reduce violent offending in children/youth? If yes, how strong is their effect and is there a difference among the intervention types? Are there nutritional interventions that can reduce non-violent offending in children/youth? If yes, how strong is their effect and is there a difference among the intervention types? What implementation barriers and solutions to these exist in relation to the above nutritional interventions in children/youth?

Goal pursuit shapes people’ everyday experiences and is deeply embedded within close relationships. Several studies have shown that goal support from romantic partners facilitates goal progress, and individual goal progress contributes to wellbeing. However, few pieces of research have examined the whole process, how efficient goal coordination in a romantic relationship contributes to life satisfaction through goal progress. In these studies, short time frames were used and only one aspect of goal coordination was examined. To generate more complex, long-term understanding we collected data from 148 married or cohabitating Hungarian heterosexual couples (mean age 39.71 ± 10.40 and 38.57 ± 10.00 years for men and women, respectively) in a two-wave longitudinal study with a year-long time window. Both partners individually completed an adapted version of the Personal Project Assessment and evaluated four chosen projects associated with project coordination (emotional support, communication, and cooperation) at baseline, and project attainment (progress, success, satisfaction) in the follow up. Life satisfaction was assessed during both waves. Results from the actor–partner interdependence mediation modeling revealed complete mediation, where project coordination increased project attainment one year later, and consequently associated with higher life satisfaction for both partners. The direct effect between project coordination and life satisfaction remained nonsignificant. This association indicates that for long-term life satisfaction, it is crucial to experience better goal outcomes as the result of the couple’s collaborative effort.

Numerous forms of psychotherapy have demonstrated effectiveness for individuals with specific mental disorders. It is, therefore, the task of the clinician to choose the most appropriate therapeutic approach for any given client to maximize effectiveness. This can prove to be a difficult task due to at least three considerations: (1) there is no treatment approach, method or model that works well on all patients, even within a particular diagnostic class; (2) several treatments are equally efficacious (i.e., more likely to be effective than no treatment at all) when considered only in terms of the patient's diagnosis; and (3) effectiveness in the real-world therapeutic setting is determined by a host of non-diagnostic factors. Typically, consideration of these latter, trans-diagnostic factors is unmethodical or altogether excluded from treatment planning – often resulting in suboptimal patient care, inappropriate clinic resource utilization, patient dissatisfaction with care, patient demoralization/hopelessness, and treatment failure. In this perspective article, we argue that a more systematic research on and clinical consideration of trans-diagnostic factors determining psychotherapeutic treatment outcome (i.e., treatment moderators) would be beneficial and – with the seismic shift toward online service delivery – is more feasible than it used to be. Such a transition toward more client-centered care – systematically considering variables such as sociodemographic characteristics, patient motivation for change, self-efficacy, illness acuity, character pathology, trauma history when making treatment choices – would result in not only decreased symptom burden and improved quality of life but also better resource utilization in mental health care and improved staff morale reducing staff burnout and turnover.

The aim of this study (ClinicalTrials.gov identifier: NCT03233958) was to provide further evidence on the effectiveness and safety of family/systemic constellation therapy, a widely used but rarely investigated form of brief group psychotherapy. Altogether, 102 individuals from the general population were followed up 1- and 6 months after their participation in the 2-day intervention. Indicators of general and problem-area-specific psychopathology, interpersonal quality of life, meaning in life, and general wellbeing were assessed. Both statistical and clinical significance were considered, and active surveillance of potential iatrogenic effects was also conducted. The data showed significant improvement post-intervention in the case of the vast majority of the 17 outcome variables. At 1-month follow-up, the magnitude of improvements was typically in the moderate range. The patterns were very similar at the 6-month follow-up, suggesting that most intervention benefits were sustained in the middle term. Sensitivity analyses showed no therapist effects across the three intervention providers. Analyses into clinical significance showed that the most reliable improvements occurred in relation to interpersonal quality of life and non-diagnosis-specific psychopathology, with approximately half of the participants showing reliable improvement. Iatrogenic effects were comparable - both in terms of frequency and severity - to those reported for other forms of psychotherapy. Findings of the present study point toward the safety and effectiveness of family constellation therapy in reducing a variety of psychopathological symptoms (e.g., depression and anxiety) and increasing general well-being. This effectiveness is especially remarkable when considering the brevity and cost-effectiveness of the intervention.

Introduction: Hunger et al. (2014, 2015, 2017) developed the Experience in Personal Social Systems Questionnaire (EXIS.pers) to assess individuals’ perceived functioning in their personal ecosystems. Aims: The present study aims to 1) provide further data regarding this instrument’s psychometric characteristics that have not yet been investigated, as well as 2) describe the scale’s Hungarian adaptation. Methods: The present data set consisted of 400 questionnaires of 182 individuals recruited from the general population (83.8% female, Mage = 39.8 years, SDage = 9.3 years) participating in repeated assessments. The Brief Symptom Inventory, the SCOFF screening test, the Patient Health Questionnaire-15, the Meaning in Life Questionnaire, and the WHO Wel-being Index were used to investigate construct validity. Results: A bifactor structure of the EXIS.pers fitted the data best according to the confirmatory factor analytic models. The results confirmed the scalar invariance of the best fitting bifactor model across both sex and time.Internal consistency of both the subscale and total scores was good according to both traditional (Cronbach’s alpha) and more advanced (omega) indicators. Test-retest reliability with one- and five-month time lag was appropriate, as well. EXIS.pers scores showed significant inverse association with all 13 indicators of psychopathology and positive associations with both indicators of positive mental health suggestive of appropriate validity. Conclusions: The results indicate that the EXIS.pers can be used with confidence when comparing men and women or in studies involving repeated measures designs, and that the Hungarian version serves as a reliable and valid adaptation of the original instrument.

Introduction: Parental burnout might take place when excessive demands overwhelm the parents’ resources. Aims: To develop and validate the Hungarian version of the Parental Burnout Assessment (PBA-HUN), an instrument designed to measure parental burnout; and to determine the prevalence of parental burnout in Hungary. Methods: Data were collected via an online survey from parents with at least one child living in the household (N = 1215; 82.6% mothers; Mage = 38.68 years; SDage = 6.27 years). Confirmatory factor analysis was used to investigate the factor structure of the PBA-HUN. Results: The four-factor structure of the original PBA was replicated, confirming the following factors: exhaustion in one’s parental role, contrast with one’s parental role, feelings of being fed up, and emotional distancing from one’s children. A second-order model with a higher-order factor representing overall parental burnout also fit the data well. The internal consistency of both the subscale and total scores was excellent (α ≥ 0.84). Parental burnout had a moderately strong negative correlation with life satisfaction, and weak or moderate positive correlations with perceived stress, depression, vital exhaustion, and COVID-specific perceived stress supporting the construct validity of the PBA-HUN. The prevalence of parental burnout stood at 5.8% in this sample. The weak relationship between PBA-HUN scores and sociodemographic factors was also similar to those found in prior studies. Parental burnout correlated negatively with the number of hours spent sleeping and engaging in spare time activity, respectively. Conclusions: The PBA-HUN is a reliable and valid tool to assess parental burnout in Hungary.