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Attila Galambos,1–3 Edina Szabó,1–3 Zita Nagy,2 Andrea Edit Édes,4,5 Natália Kocsel,1,2,4 Gabriella Juhász,4–6 Gyöngyi Kökönyei2,4,51Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; 2Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; 3MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary; 4SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary; 5Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary; 6Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, United Kingdom and Manchester Academic Health Sciences Centre, Manchester, United KingdomObjectives: Pain catastrophizing is reliably associated with pain reports during experimental pain in healthy, pain-free subjects and in people with chronic pain. It also correlates with self-reports of clinical pain intensity/severity in a variety of disorders characterized by chronic pain in adults, adolescents and children. However, processes, through which it exerts its effects are yet unclear. In this paper, our primary aim was to synthesize neuroimaging research to open a window to possible mechanisms underlying pain catastrophizing in both chronic pain patients and healthy controls. We also aimed to compare whether the neural correlates of pain catastrophizing are similar in these two groups.Methods: PubMed and the Web of Science were searched for magnetic resonance imaging (MRI) studies that explored neural correlates of pain catastrophizing.Results: Twenty articles met the inclusion criteria. The results of our review show a connection between pain catastrophizing and brain areas tightly connected to pain perception (including the somatosensory cortices, anterior insula, anterior cingulate cortex and thalamus) and/or modulation (eg, the dorsolateral prefrontal cortex). Our results also highlight that these processes - in relation to pain catastrophizing - are more pronounced in chronic pain patients, suggesting that structural and functional brain alterations (and perhaps mechanisms) related to pain catastrophizing may depend on prior and/or relatively stable/constant pain experience. However, we also found methodological issues and differences that could lead to divergent results.Discussion: Based on our results, pain catastrophizing might be related to salience detection, pain processing, and top-down attentional processes. More research is recommended to explore neural changes to specific types of catastrophizing thoughts (eg, experimentally induced and/or state). Furthermore, we provide ideas regarding pain catastrophizing studies in the future for a more standardized approach.Keywords: pain catastrophizing, DLPFC, anterior insula, chronic pain, neuroimaging

Introduction: Rumination is a transdiagnostic phenomenon that is linked to psychological and physical symptoms not only in adulthood but also in childhood. Several distal and proximal factors are believed to underlie the development of ruminative tendencies, with parental characteristics and modelling being among those with a potential association with the increased levels of children's rumination. Objectives: The primary aim of the study was to investigate the link between rumination in children and parental functioning, including rumination, worry and depressive symptoms. Additionally, we aimed to test the association between rumination and psychological and somatic health in a sample of healthy children and early adolescents. Methods: 153 children (87 girls, mean age = 10.74; SD = 0.91 years) and their parents (130 females, mean age = 42.65; SD = 4.08 years) participated in the study. For children, Kid Rumination Interview (KRI; Baiocco et al., 2017) was used, alongside the assessment of nine subjective health complaints. KRI employes 4 images to measure the frequency of rumination. Self-reported questionnaires were also completed by parents to report on worry, rumination, and depressive symptoms. Results: Contrary to our expectations, there was no significant association between children's rumination and parental rumination (r =.06, p =.506), worry (r = -.02, p =.850) and depressive symptoms (r = -.01, p =.979). Psychosomatic complaints in children exhibited a positive albeit weak association with parental depressive symptoms (r =.17, p =.046). Regression analysis revealed that the frequency of rumination occurring in the four situations associated significantly with psychosomatic symptoms (β =.266; t = 3.321; p =.001) after controlling for sex and age. Conclusions: Our findings are in line with previous studies demonstrating the relationship between rumination and psychosomatic symptoms in older adolescent samples. However, parental perseverative cognitions and depression were unrelated to ruminative tendencies in children. Nevertheless, the modest sample size and the employment of a different assessment approach compared to self-report questionnaires may have influenced our findings. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Psychological factors, such as emotional regulation strategies, play a crucial role in the management and care of chronic somatic health conditions among adolescents. In the existing literature, catastrophising has been associated negatively with health-related quality of life in the context of chronic health conditions in general. However, there is limited knowledge about its role in specific illness types. Objectives: We aimed to evaluate the impact of catastrophising on the health-related quality of life in two distinct illness groups: diabetes and oncology, within a Hungarian sample. Methods: A cross-sectional study using self-report measures was carried out, involving a total of 273 adolescents (mean age: 14.72 years, SD: 1,82 years; 50.2% females) in the two paediatric samples. The diabetes group consisted of 171 participants, while the oncology group was comprised of 102 individuals. No significant differences were found between the two chronic condition groups in terms of gender (χ2 = 116.51; p = 0.50), or mean age (F(-0.82; 0.77) = 1.66; p = 0.19). The short-version of the Cognitive Emotion Regulation Questionnaire (CERQ-short) was used to assess the cognitive emotional regulation strategies of the children, specifically focusing on the catastrophising subscale. Health-related quality of life was measured using the 4.0 version of the PedsQL, which included subscales for Physical, Emotional, Social, and School Functioning. Results: A Hayes-moderation analysis with an interaction effect was conducted, controlling for gender, age, and the duration of the illness. A significant interaction effect was observed between catastrophising and the illness groups, impacting School Functioning (F(1, 243) = 4.17; p = 0.04), Physical Functioning (F(1, 245) = 4.67; p = 0.03), Social Functioning (F(1, 245) = 4,23; p = 0.04), and Emotional Functioning (F(1, 245) = 4.20; p = 0.04). The association between catastrophising and health-related quality of life remained stronger in the oncology group. Conclusions: Catastrophising appears to be a risk factor that affects the quality of life of children facing oncology illnesses. Therefore, addressing catastrophising in interventions tailored to this paediatric illness group may be beneficial. Keywords: catastrophising, health-related quality of life, adolescents, chronic somatic This study was supported by the Hungarian National Research, Development and Innovation Office (K143764). Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Abstract Background The principals of therapeutic recreation underpin a camping program for children and adolescents living with chronic disease. This study aimed to evaluate the campers' health-related quality of life (HRQoL) before and after the program. Method We used the Hungarian version of Kidscreen-52 questionnaire to assess HRQoL. The study sample (n = 115) consisted of children and adolescents aged 10-18 (Mean Age: 13,34; SD: 2,20) collected two months before and two months after camp with the following illnesses: oncology patients (n = 32), diabetes (n = 55) and juvenile immune arthritis (JIA) (n = 28). Repeated measures of multivariate analysis of variance (MANOVA) evaluated pre and post camp changes. We used the Reliable Change Index (RCI) to calculate all the 10 subscales of clinically significant changes. Results The Self-perception subscale showed significant positive change from pre camp to post camp with small effect size. Autonomy scores showed time related decline as well as significant time and age group interaction: children under 14 years of age showed a significant moderate effect size decrease on the Autonomy subscale. 32 children (27.8%) showed clinically significant improvement (RCI > 1.96) at least on one subscale. All positive changes were independent of the type of disease, age, gender, and previous camp experience. Conclusion The therapeutic recreation camping program had a positive impact on HRQoL of children and adolescents living with cancer, diabetes mellitus and JIA. The experience enhanced their self-perception in all age groups and reduced the autonomy of children under 14 years of age. This study is an innovative use of the KIDSCREEN-52 questionnaire to measure the outcome effectiveness of a psychosocial rehabilitation program and to assess and compare HRQoL of children living with different chronic diseases.

Aims: Trait impulsivity and trait rumination appear to uniquely contribute to problem gambling. However, only a limited number of studies have investigated their relationship with each other, and no study has tested whether their interplay could explain problem gambling. In this study, we aimed to examine these associations, especially focusing on the putative moderator role of gender., Methods: The present study utilized data from the first wave of the Budapest Longitudinal Study, representatively surveying young adults. The final, weighted sample consisted of N = 1202 (649 men; mean age = 28.04 years; SD = 4.31) participants who reported gambling in the past year. Gambling severity was assessed by the Problem Gambling Severity Index (PGSI), trait impulsivity was measured by Barratt Impulsiveness Scale short form (BIS-R-10), while rumination was assessed by the short version of Ruminative Response Scale (RRS)., Results: Multiple linear regression analysis showed significant positive association between impulsivity and problematic gambling, and we found that both trait rumination and gender moderated this association, even after controlling for depressed mood, age, level of education, and subjective relative wealth. For men, when the level of trait rumination was high, higher levels of trait impulsivity were associated with an increase in gambling problems. However, these associations were not found among women., Conclusions: Our results suggested that the interplay of trait rumination and trait impulsivity might contribute to problem gambling, potentially by the impulsive desire to alleviate negative mood states. Our results also revealed that these associations could be stronger among men than in women., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Objectives: Work addiction (WA), characterized by dimensions such as overcommitment, difficulties in detachment from work, and work-life imbalance, is presumed to be associated with increased smartphone usage, even during risky activities like driving. The study investigated the connection between WA and future problematic and hazardous smartphone use, considering personality factors: anxiety, rumination, and worry., Methods: A three-wave longitudinal study (N = 1,866) was conducted from March to July 2019, June to September 2020, and June to November 2021, involving a representative sample of 18-34-year-old residents in Hungary's capital. The study employed Hungarian versions of the Bergen Work Addiction Scale, Problematic Mobile Phone Use Questionnaire, Ruminative Response Scale, Anxiety subscale of the Brief Symptom Inventory 18, and Penn-State Worry Questionnaire. Additionally, author-developed questions on mobile phone use while driving were included., Results: At baseline, those at risk for WA showed more frequent mobile phone use while driving at both time points 2 and 3 compared to the non-risk group. Path analyses revealed rumination, anxiety at time 1, and worry at time 2 as significant mediators between baseline WA and mobile phone use while driving at time 3. However, when analyzing all three mediators together, only anxiety at time 1 and worry at time 2 remained significant., Discussion and Conclusion: This study demonstrates that WA predicts future mobile phone use while driving through mediation by anxiety and worry. Our findings add to the growing evidence highlighting the detrimental aspects of WA, emphasizing the need for improved prevention and treatment strategies.

Previous research indicated that pain catastrophizing-a negative emotional and cognitive response toward actual or anticipated pain-could contribute to pain intensity and could be associated with depressive symptoms not just in chronic pain patients but in healthy population as well. Accumulated evidence suggests that resting heart rate variability (HRV) as a putative proxy of emotion regulation could moderate the association of self-reported pain catastrophizing and depressed mood. In the present cross-sectional study, we investigated these associations in a healthy young adult sample controlling for the effect of trait rumination. Seventy-two participants (58 females, mean age = 22.2 ± 1.79 years ranging from 19 to 28 years old) completed the Pain Catastrophizing Scale, the Zung Self-Rating Depression Scale and the Ruminative Response Scale. Resting HRV was measured by time domain metric of HRV, the root mean square of successive differences (RMSSD). The results showed that the relationship between pain catastrophizing and depressive symptoms is significantly moderated by resting HRV (indexed by lnRMSSD). Specifically, in participants with higher resting HRV there was no significant relationship between the two investigated variables, while in participants with relatively low or medium HRV pain catastrophizing and depressed mood showed significant positive association. The relationship remained significant after controlling for sex, age and trait rumination. These results might indicate that measuring pain catastrophizing and depressive symptoms is warranted in non-clinical samples as well and higher resting HRV could have a buffer or protective role against depressive symptoms., (© 2023. The Author(s).)

Objective: We aimed to assess the parent-child agreement on various domains of health-related quality of life (HRQoL) in a Hungarian pediatric sample. We examined the associations of demographic, illness-specific factors and the perceived consequences of the illness with the parent-child disagreement., Design: A cross-sectional study was carried out with child-parent pairs in a heterogeneous pediatric sample (n = 259)., Outcome Measures: Child and parent versions of Kidscreen-52 and the consequences scale of the Revised Illness Perception Questionnaire (IPQ-R) were applied. We used intraclass correlation coefficients to measure agreement. We computed directional discrepancies as dyadic indexes and applied them in multinomial regression analysis to identify factors influencing agreement., Results: Agreement between children and parents on the KIDSCREEN-52 instrument was moderate to good (ICC = 0.41 to 0.66). Significant (p < 0.005) parent-child disagreement was observed on 6 out of 10 dimensions of HRQoL: Parents rated their children's well-being lower on Physical Well-being, Psychological Well-being, Parent Relations and Home Life, Social Support and Peers, and Financial Resources scales and rated higher on Moods and Emotions compared to child-reported HRQoL. Both parent's and child's higher perceived illness consequences made disagreement significantly more likely on various domains., Conclusions: Direction of disagreement may draw attention to potentially vulnerable domains of the child's well-being, like moods and emotions and self-perception.

Emotion regulation as a proximal factor has been linked with depressive symptoms. However, studies have mainly focused on a limited number of strategies and have mostly been cross-sectional in design. This is particularly evident when examining the protective effects of adaptive strategies. This study aimed to investigate the prospective relationship between putatively adaptive and maladaptive emotion regulation strategies and depressive symptoms among adolescents. Additionally, a person-oriented approach was applied to identify latent classes of adolescents based on their depressive symptoms and compared these classes in terms of their adaptive and maladaptive strategies. Two waves of data from a prospective study, which included 1371 youth (mean age: 15.66 years; SD = 0.49 years; 55.1% girls), were analysed. The two points of data collection were spaced approximately half a year apart. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale, and putatively adaptive and maladaptive emotion regulation strategies were assessed with the Cognitive Emotion Regulation Questionnaire. Seven strategies (acceptance, positive refocusing, positive reappraisal, putting into perspective, self-blame, rumination, and catastrophizing) were categorised into adaptive and maladaptive factors using exploratory structural equation modeling. After controlling for gender, age, and depressive symptoms at Time 1, both maladaptive and adaptive emotion regulation strategies at Time 1 predicted depressive symptoms at Time 2. Three subgroups emerged based on the intensity of depressive symptoms across the waves: the stable low, stable moderate, and stable high depressive symptom groups. The use of maladaptive emotion regulation strategies (such as rumination, self-blame, and catastrophizing) at Time 1 was more pronounced in the stable moderate and high symptom groups compared to the stable low depressive symptom group. The comparable prospective associations between putatively adaptive and maladaptive strategies with symptoms suggest the need to identify factors that may mitigate the negative impact of maladaptive emotion regulation and/or promote adaptive emotion regulation to buffer the effects of everyday stressors., (© 2023. The Author(s).)

Background: Bullying leads to adverse mental health outcomes and it has also been linked to nonsuicidal self-injury (NSSI) in community adolescents. It is not clear whether different roles of bullying (bully, victim, bully-victim) are associated with NSSI, furthermore the same associations in cyberbullying are even less investigated., Methods: The aim of the current study was to test whether students involved in school or online bullying differed from their not involved peers and from each other in psychological symptoms (externalizing and internalizing problems) and in NSSI severity (number of episodes, number of methods). Furthermore, mediation models were tested to explore the possible role of externalizing and internalizing problems in the association of school and online bullying roles with NSSI. In our study, 1011 high school students (66.07% girls; n = 668), aged between 14 and 20 years (M age = 16.81; SD = 1.41) participated., Results: Lifetime prevalence of at least one episode of NSSI was 41.05% (n = 415). Students involved in bullying used more methods of NSSI than not involved adolescents. In general, victim status was associated mostly with internalizing symptoms, while bully role was more strongly associated with externalizing problems. Bully-victims status was associated with both types of psychological problems, but this group did not show a significantly elevated NSSI severity compared to other bullying roles. Externalizing and internalizing problems mediated the relationship between bullying roles and NSSI with different paths at different roles, especially in case of current NSSI that happened in the previous month., Conclusions: Results highlight that students involved in bullying are more vulnerable to NSSI and to psychological symptoms compared to their peers who are not involved in bullying. It is suggested that bullying roles, especially bully-victim status, need to be identified in school and online settings and thus special attention should be addressed to them to reduce psychological symptoms and NSSI, for example by enhancing adaptive coping skills., (© 2023. The Author(s).)

Background: Diffusion-tensor imaging can be applied to describe the microstructural integrity of the whole brain. As findings about microstructural alterations in migraine are inconsistent, we aimed to replicate the most frequent results and assess a relationship between migraine parameters and changes in microstructure., Methods: Diffusion-weighted MRI data of 37 migraine patients and 40 controls were collected. Two indices of diffusion of water molecules, fractional anisotropy and mean diffusivity were used in a voxel-wise analysis. Group comparisons were carried out in SPM12 using age and sex as covariates. Statistically significant results survived family-wise error correction (p FWE  < 0.05). Migraine intensity, frequency, and duration were self-reported and correlated with mean fractional anisotropy and mean diffusivity values across clusters., Results: Migraine patients showed significantly lower fractional anisotropy in occipital regions, and significantly higher fractional anisotropy in thirteen clusters across the brain. Mean diffusivity of migraine patients was significantly decreased in the cerebellum and pons, but it was not increased in any area. Correlation between migraine duration and fractional anisotropy was significantly positive in the frontal cortex and significantly negative in the superior parietal lobule., Conclusion: We suggest that microstructural integrity of the migraine brain is impaired in visual areas and shows duration-related alterations in regions of the default mode network., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Rumination has mostly been studied in relation to depression, however, it may also occur in response to positive emotions (i.e., positive rumination) and therefore may be a protective factor related to the maintenance of positive mood., Objective: We hypothesized that daily positive and negative affect would be associated with daily positive and negative rumination even after controlling for trait-level rumination., Method: We carried out a diary study with university students (n = 178), where participants had to answer short surveys online about their daily affect and daily rumination every evening for 10 days. We analyzed our data with multilevel regression in R., Results: Daily positive and negative affect were significantly associated with daily negative and positive rumination, while trait-level rumination scores were not. Daily and trait-level rumination were moderately correlated (r = 0.333-0.440)., Conclusions: Our findings highlight that daily rumination plays a more significant role in daily emotional experiences than trait rumination across positive and negative valence domains. Daily negative affect appears to be more closely related to higher daily negative rumination than the lack of daily positive rumination, which could be relevant for intervention strategies., (© 2023 The Authors. Journal of Personality published by Wiley Periodicals LLC.)

The present meta-analytic study examined the association between alexithymia and psychoactive substance use. Studies published from 1988 to August 20, 2022 were identified by a systematic search and 168 eligible studies were included in five meta-analyses. Results showed that (1) the correlation between substance use and alexithymia is small but significant (r = 0.177); (2) substance users have substantially higher alexithymia than nonusers (g = 0.545); (3) alexithymic participants have significantly but slightly higher levels of substance use than non-alexithymics (g = 0.242); (4) substance users are significantly but only slightly more likely to be alexithymic than nonusers (OR = 2.392); and (5) alexithymic individuals are not more likely to be substance users than non-alexithymics. Larger effects were observed among samples diagnosed with substance use disorder (SUD), and the use of depressants, alcohol, opiates, and illicit stimulants had stronger relation to alexithymia. We found a tendency for a larger association with problematic use as compared to other indicators (e.g., frequency and duration) of substance use. Among the components of alexithymia, difficulties in identifying feelings has the strongest association with substance use. Our findings support clinical practice by suggesting the improvement of emotion regulation in SUD., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Emotional flexibility reflects the ability to adjust the emotional response to the changing environmental context. To understand how context can trigger a change in emotional response, i.e., how it can upregulate the initial emotional response or trigger a shift in the valence of emotional response, we used a task consisting of picture pairs during functional magnetic resonance imaging sessions. In each pair, the first picture was a smaller detail (a decontextualized photograph depicting emotions using primarily facial and postural expressions) from the second (contextualized) picture, and the neural response to a decontextualized picture was compared with the same picture in a context. Thirty-one healthy participants (18 females; mean age: 24.44 ± 3.4) were involved in the study. In general, context (vs. pictures without context) increased activation in areas involved in facial emotional processing (e.g., middle temporal gyrus, fusiform gyrus, and temporal pole) and affective mentalizing (e.g., precuneus, temporoparietal junction). After excluding the general effect of context by using an exclusive mask with activation to context vs. no-context, the automatic shift from positive to negative valence induced by the context was associated with increased activation in the thalamus, caudate, medial frontal gyrus and lateral orbitofrontal cortex. When the meaning changed from negative to positive, it resulted in a less widespread activation pattern, mainly in the precuneus, middle temporal gyrus, and occipital lobe. Providing context cues to facial information recruited brain areas that induced changes in the emotional responses and interpretation of the emotional situations automatically to support emotional flexibility., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Biró et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background and Aims: COVID-19 posits psychological challenges worldwide and has given rise to nonadaptive behavior, especially in the presence of maladaptive coping. In the current study, we assessed whether the relationship between COVID-related distress and compulsive buying is mediated by task-focused and emotion-focused coping. We also examined whether these associations were invariant over time as the pandemic unfolded., Methods: Self-report surveys were administered online in the United States in the first six months of the pandemic (March-October 2020) in sampling batches of 25 participants every three days, resulting in a total sample of N = 1,418 (40% female, mean age = 36.6). We carried out structural equation modeling to assess whether the relationship between distress related to COVID-19 and compulsive buying is mediated by task-focused and emotion-focused coping. Time was used as a grouping variable based on events related to the pandemic in the U.S. to calculate model invariance across three time periods., Results: The results indicated significant mediation between distress, emotion-focused coping, and compulsive buying, but not between task-focused coping and compulsive buying. The mediation model showed excellent fit to the data (χ² = 1119.377, df = 420, RMSEA = 0.059 [0.055-0.064], SRMR = 0.049, CFI = 0.951, TLI = 0.947). Models were not invariant across the three examined time periods., Conclusions: Our results indicate that compulsive buying is more likely to occur in relation to emotion-focused coping as a response to COVID-related distress than in relation to task-focused coping, especially during periods of increasing distress. However, model paths varied during the course of the pandemic., Competing Interests: The authors have declared that no competing interests exist.

Growing incidence of nonsuicidal self-injury (NSSI) and a lack of intensive examination of NSSI variability among adolescents justify identification of latent classes based on the endorsement of different NSSI behaviors. Latent class analysis was used to detect the heterogeneity of past month NSSI among 322 high school students (73.2% female). Two interpretable latent classes emerged. The Severe/Multimethod NSSI class (39%) engaged in almost all forms of NSSI with high intensity and motivated mainly for intrapersonal reasons. The results imply that compared to Mild/Moderate NSSI group (61%), the Severe class is at greater risk for poor mental health, which can exacerbate further NSSI acts. In school settings, identifying adolescents who are vulnerable for more severe NSSI can help to interrupt NSSI trajectories to emerging adulthood., (© 2022. The Author(s).)

Background and Purpose: Previous studies using generic and disease specific instruments showed that both migraine and medication overuse headache are associated with lower health-related quality of life (HRQoL). The aim of our study was to assess HRQoL differences in migraineurs and in patients with MOH and to examine how headache characteristics such as years with headache, aura symptoms, triptan use, headache pain severity and headache frequency are related to HRQoL., Methods: In this cross-sectional study 334 participants were examined (248 were recruited from a tertiary headache centre and 86 via advertisements). The Comp-rehensive Headache-related Quality of life Questionnaire (CHQQ) was used to measure the participants' HRQoL. Data showed normal distribution, therefore beside Chi-squared test parametric tests (e.g. independent samples t-test) were used with a two-tailed p<0.05 threshold. Linear regression models were used to determine the independent effects of sex, age, recruitment method, headache type (migraine vs. MOH) and headache characteristics (presence of aura symptoms, years with headache, headache pain severity, headache frequency and triptan use) separately for each domain and for the total score of CHQQ. Significance threshold was adopted to p0.0125 (0.05/4) to correct for multiple testing and avoid Type I error., Results: Independent samples t-tests showed that patients with MOH had significantly lower scores on all CHQQ domains than migraineurs, except on the social subscale. Results of a series of regression analyses showed that triptan use was inversely related to all the domains of HRQoL after correction for multiple testing (p<0.0125). In addition, headache pain severity was associated with lower physical (p=0.001) and total scores (p=0.002) on CHQQ subscales., Conclusion: Based on the results, different headache characteristics (but not the headache type, namely migraine or MOH) were associated with lower levels of HRQoL in patients with headache. Determining which factors play significant role in the deterioration of HRQoL is important to adequately manage different patient populations and to guide public health policies regarding health service utilization and health-care costs.

Background: Anger rumination is consistently associated with maladaptive psychopathological outcomes. However, there is a lack of research on the association between problematic cannabis use, cannabis use motives and anger rumination. Coping motives showed positive relationships with negative affectivity and emotion dysregulation, thus it might be possible that coping motives can mediate the effects of hostility and anger rumination on problematic cannabis use., Aims: The goal of the present study was to examine the mediating role of anger rumination and cannabis use motives on the relationship between hostility and problematic cannabis use., Methods: The cross-sectional study used a convenience sample of 764 past year cannabis users with a risk for problematic cannabis use (Males: 70.42% [N = 538], Age: M = 29.24 [SD = 7.55]). Standardized and online questionnaires measured problematic use and motives of cannabis use, anger rumination and hostility., Results: Structural equation modelling was used to test the proposed mediation model. Four significant indirect effects were identified in the mediation model. The positive effect of hostility on cannabis use problems was mediated (i) via coping motives, (ii) via anger rumination, (iii) via anger rumination and coping motives, and (iv) via anger rumination and conformity motives., Conclusions: The present study was the first that examined the construct of anger rumination in the context of cannabis use. Possible risk mechanisms via anger rumination and cannabis use motives with negative reinforcement were suggested in the context of problematic cannabis use. Self-medication tendencies and emotion dysregulation processes might explain these pathways., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Background: Previous findings suggest a female preponderance in nonproductive thoughts -rumination and worry-, but studies on gender differences in the strength of the relationship between nonproductive thoughts, somatic symptoms and subjective well-being are scarce. Our aim was to test whether gender and age would moderate these associations., Methods: 1572 adolescents were involved in this representative cross-sectional study (770 boys; mean age = 15.39; SD = 2.26 years). Nonproductive thoughts were measured by Nonproductive Thoughts Questionnaire for Children (NPTQ-C), somatic symptoms were assessed by Somatic Complaint List (SCL), while Mental Health Continuum-Short Form (MHC-SF) was used to measure subjective well-being. To assess the moderation effects of age and gender on the relationship between nonproductive thoughts, somatic symptoms and well-being, four multiple indicator multiple causes (MIMIC) models were defined., Results: Our results suggested that higher rates of nonproductive thoughts predicted a higher level of somatic symptoms and a lower level of subjective well-being. The analyses revealed that although nonproductive thoughts were strongly and equally associated with somatic symptoms among boys and girls, age was a significant moderator. Gender also moderated the relationship between nonproductive thoughts and subjective well-being., Conclusions: Our results support the importance of nonproductive thoughts in somatic symptoms and highlight that the strength of the relationship is similar across both genders but could be dependent upon age. The findings also shed light on the decreased well-being of girls, especially with elevated level of nonproductive thoughts., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

Several factors can contribute to the development and chronification of migraines, including stress, which is undoubtedly a major trigger. Beyond pharmacotherapy, other treatment methods also exist, including behavioral techniques aiming at reducing patients' stress response. However, the exact brain mechanisms underlying the efficacy of such methods are poorly understood. Our pilot study examined whether the regular practice of autogenic training (AT) induces functional brain changes and if so, how it could be associated with the improvement of migraine parameters. By exploring neural changes through which AT exerts its effect, we can get closer to the pathomechanism of migraine. In particular, we investigated the effect of a headache-specific AT on brain activation using an implicit face emotion processing functional MRI (fMRI) task in female subjects with and without episodic migraine. Our focus was on migraine- and psychological stress-related brain regions. After a 16-week training course, migraineurs showed decreased activation in the migraine-associated dorsal pons to fearful compared with neutral visual stimuli. We also detected decreasing differences in supplementary motor area (SMA) activation to fearful stimuli, and in posterior insula activation to happy stimuli between healthy subjects and migraineurs. Furthermore, migraineurs reported significantly less migraine attacks. These brain activation changes suggest that AT may influence the activity of brain regions responsible for emotion perception, emotional and motor response integration, as well as cognitive control, while also being able to diminish the activation of regions that have an active role in migraine attacks. Improvements induced by the training and the underlying neurophysiological mechanisms are additional arguments in favor of evidence-based personalized behavioral therapies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dobos, Szabó, Baksa, Gecse, Kocsel, Pap, Zsombók, Kozák, Kökönyei and Juhász.)

Altered periaqueductal gray matter (PAG) functional connectivity contributes to brain hyperexcitability in migraine. Although tryptophan modulates neurotransmission in PAG projections through its metabolic pathways, the effect of plasma tryptophan on PAG functional connectivity (PAG-FC) in migraine has not been investigated yet. In this study, using a matched case-control design PAG-FC was measured during a resting-state functional magnetic resonance imaging session in migraine without aura patients (n = 27) and healthy controls (n = 27), and its relationship with plasma tryptophan concentration (TRP) was assessed. In addition, correlations of PAG-FC with age at migraine onset, migraine frequency, trait-anxiety and depressive symptoms were tested and the effect of TRP on these correlations was explored. Our results demonstrated that migraineurs had higher TRP compared to controls. In addition, altered PAG-FC in regions responsible for fear-cascade and pain modulation correlated with TRP only in migraineurs. There was no significant correlation in controls. It suggests increased sensitivity to TRP in migraine patients compared to controls. Trait-anxiety and depressive symptoms correlated with PAG-FC in migraine patients, and these correlations were modulated by TRP in regions responsible for emotional aspects of pain processing, but TRP did not interfere with processes that contribute to migraine attack generation or attack frequency., (© 2022. The Author(s).)

Background: Recent studies suggest that higher Body Mass Index (BMI) is associated with reduced inhibitory control in contexts of palatable food. However, due to limitations of previous studies, it remained the question whether this reduction is specific to food contexts, and whether it generalizes to other contexts of reward, such as money. This main question was addressed in the current study. In addition, we explored the effect of maladaptive eating and stress regarding inhibitory control across the contexts that differed in terms of reward., Methods: In total, 46 participants between 19 and 50 years old (39% males and 61% females) with an average BMI of 23.5 (SD = 3.9) participated. Participants filled out questionnaires and performed a go/no-go task (indexing inhibitory control) with three conditions (neutral, food, and money condition)., Results: Relatively high (above median) BMI was associated with challenged inhibitory control in the food relative to the neutral context, but not in the money relative to neutral context. Explorative analyses suggested that maladaptive eating and stress were associated with reduced inhibitory control in the food context. Only rumination was associated with reduced inhibitory control in the money context., Conclusions: The effects of BMI, maladaptive eating behavior, and stress on inhibitory control were specific to the food context, and did not generalize to a non-intrinsic reward condition, operationalized with money pictures. Our results imply that (research on) interventions directed at improving inhibitory control in relation to overweight and obesity, should consider food-reward context., (© 2021. The Author(s).)

Non-suicidal self-injury is a significant global public health problem during adolescence, nevertheless there is a lack of investigations among juvenile offenders. Our cross-sectional study aimed to investigate the relationship between negative life events and self-harm, including the effects of dissociation and experiential avoidance that accounted for this link in a sample of underaged male offenders ( N  = 226; Mage = 16.97, SD = 1.31; 23.5% performed self-harm in the past month). Structural equation modeling showed that dissociation can explain the effect of friendship- and romantic relationship-related negative life events on self-harm. Our findings pointed out that dissociative tendencies could reduce intense emotions stemming from negative life events associated with peer relationships, but consequences of such tendencies might be self-harm in a correctional context.

Previous studies targeting inter-individual differences in pain processing in migraine mainly focused on the perception of pain. Our main aim was to disentangle pain anticipation and perception using a classical fear conditioning task, and investigate how migraine frequency and pre-scan cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio as an index of neurobiological stress response would relate to neural activation in these two phases. Functional Magnetic Resonance Imaging (fMRI) data of 23 participants (18 females; mean age: 27.61± 5.36) with episodic migraine without aura were analysed. We found that migraine frequency was significantly associated with pain anticipation in brain regions comprising the midcingulate and caudate, whereas pre-scan cortisol-to DHEA-S ratio was related to pain perception in the pre-supplementary motor area (pre-SMA). Both results suggest exaggerated preparatory responses to pain or more general to stressors, which may contribute to the allostatic load caused by stressors and migraine attacks on the brain., Competing Interests: The authors have declared that no competing interests exist.

Background: The Inventory of Statements About Self-Injury (ISAS) is a psychometrically valid tool to evaluate the motives of nonsuicidal self-injury (NSSI), but there are a few studies that test gender differences in the factor structure of the measurement. However, several differences across gender were identified in NSSI (e.g., in prevalence, methods, functions). Therefore, our study focused on further analyses of the dimensionality of the ISAS functions., Methods: Among Hungarian adolescents with a history of NSSI (N = 418; 70.6% girls; mean age was 16.86, SD = 1.45), confirmatory factor analysis and exploratory structural equation modeling frameworks were used to test the factor structure of the ISAS part II., Results: Results support the two-factor structure of the questionnaire. Intrapersonal and interpersonal motivation factors emerged in the whole sample, but this factor structure varied across gender. Among girls, intrapersonal motivation of NSSI was associated with higher loneliness, more inflexible emotion regulation, and a more pronounced level of internalizing and externalizing mental illness symptoms., Conclusions: Our findings provide sufficiently solid arguments for the need to examine NSSI functionality separately for adolescent girls and boys because there were clear gender differences in the motives underlying NSSI. In addition, precise scanning of patterns of NSSI functions may further help us to identify the most at-risk adolescents regarding self-injury., (© 2021. The Author(s).)

The existence of "sex phenotype" in migraine is a long-standing scientific question. Fluctuations of female sex hormones contribute to migraine attacks, and women also have enhanced brain activity during emotional processing and their functional brain networks seem to be more vulnerable to migraine-induced disruption compared to men. Periaqueductal grey matter (PAG) is a core region of pain processing and modulation networks with possible sex-related implications in migraine. In our study, sex differences of PAG functional resting-state connectivity were investigated in the interictal state in 32 episodic migraines without aura patients (16 women and 16 men). A significant main effect of sex was detected in PAG connectivity with postcentral, precentral, and inferior parietal gyri, and further differences were found between right PAG and visual areas (superior occipital gyrus, calcarine, and cuneus), supplementary motor area, and mid-cingulum connectivity. In all cases, PAG functional connectivity was stronger in female migraineurs compared to males. However, higher average pain intensity of migraine attacks correlated with stronger connectivity of PAG and middle temporal, superior occipital, and parietal gyri in male migraineurs compared to females. Migraine-related disability is also associated with PAG connectivity but without sex differences. Our results indicate that sex differences in PAG connectivity with brain regions involved in sensory and emotional aspects of pain might contribute to the "sex-phenotype" in migraine. The stronger functional connectivity between PAG and pain processing areas may be a sign of increased excitability of pain pathways even in resting-state in females compared to male migraineurs, which could contribute to female vulnerability for migraine. However, pain intensity experienced by male migraineurs correlated with increased connectivity between PAG and regions involved in the subjective experience of pain and pain-related unpleasantness. The demonstrated sex differences of PAG functional connectivity may support the notion that the female and male brain is differently affected by migraine., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Gecse, Baksa, Dobos, Aranyi, Galambos, Kocsel, Szabó, Kökönyei, Emri, Bagdy and Juhasz.)

Objective: The aim of this prospective study was to investigate the association of self-critical rumination, autonomic function (indexed by a time domain metric of resting heart rate variability-RMSSD), subjective well-being and somatic symptom distress., Method: 84 healthy participants (73 females; mean age = 23.56, SD = 3.35 years) completed the Somatic Symptom Severity Scale of the Patient Health Questionnaire and Mental Health Continuum Short Form at two timepoints (at baseline and six months later). Resting heart rate variability (HRV) was assessed at baseline, along with content specific rumination using the Self-Critical Rumination Scale. Four moderation analyses were performed to test these associations., Results: The interaction between resting HRV and self-critical rumination significantly explained somatic symptom distress at baseline. For those participants who had high resting HRV, somatic symptom distress was basically independent from the level of self-critical rumination. At the same time, lower resting HRV was associated with higher somatic symptom distress, especially in the presence of more ruminative thoughts. Prospectively, however, the interaction between rumination and resting HRV was not a significant predictor of somatic symptom distress. The association between resting HRV and self-critical rumination did not explain the variance on subjective well-being, but subjective well-being was negatively related to self-critical rumination., Conclusion: Our findings potentially indicate that self-critical rumination could have a long-term negative impact on psychological functioning, even in a non-clinical sample, and highlight that a lower level of parasympathetic activation, assessed with RMSSD, might be an important factor in the relationship of self-critical rumination and somatic symptom distress., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Smoking is associated with significant negative health consequences. It has been suggested that deficient inhibitory control may be implicated in (nicotine) addiction, but its exact role has not yet been elucidated. In the current study, our aim was to investigate the role of inhibitory control in relation to nicotine addiction in contexts that differ in terms of reward., Methods: Participants filled out questionnaires and performed a go/no-go task with three conditions. In one condition, the stimuli were neutral color squares, and in the reward conditions, these were smoking-related pictures and money-related pictures, respectively. In total, 43 non-abstinent individuals that smoke and 35 individuals that do not smoke were included in the sample., Results: The main results showed that individuals that smoke, relative to individuals that do not smoke, had reduced inhibitory control in both reward contexts, relative to a neutral context. The reductions in inhibitory control were mirrored by speeded responses., Conclusions: Individuals that smoke seem to present with reduced inhibitory control, which is most pronounced in contexts of reward. Consistent with incentive sensitization theory, the reduced inhibitory control may be (at least partly) due to the heightened approach bias to reward-related stimuli as indicated by the speeded responses.

Pain catastrophizing is an exaggerated cognitive-affective response to actual or anticipated pain, usually measured by the Pain Catastrophizing Scale (PCS). Our study aimed to test the bifactor measurement model of the Hungarian PCS and to identify a catastrophizing risk group with a clinically meaningful cut-off score. The data of 404 chronic spine-related (neck, back and low-back) pain patients (mean age: 58.61 (SD = 14.34)) were used in our cross-sectional study. Besides pain-related and demographic data, pain catastrophizing and depressive symptoms were measured with questionnaires. Confirmatory factor analyses confirmed that the bifactor model outperformed the other tested measurement models, and the general catastrophizing factor was responsible for 81.5% of the explained variance. Using latent class analysis, we found that even moderately elevated pain catastrophizing score was related to more depressive symptoms and higher perceived pain intensity, and 22 score could be used as a cut-off score. Our results support the concept of global pain catastrophizing and the validity of the Hungarian PCS. Further studies are needed to evaluate the bifactor structure of this scale and the predictive value of the proposed cut-off score., Competing Interests: The authors declare no conflict of interest., (© 2021 The Author(s).)

Background: In the current study we investigated impulsivity and negative life events in relation to non-suicidal self-injury (NSSI) in correctional settings., Methods: A total of 141 male justice-involved juveniles participated in our cross-sectional study, aged between 14 and 21 years old (M = 17.75; SD = 1.38). Data collection took place in correctional institutions in Hungary. A binary logistic regression was conducted to investigate possible associations between NSSI, impulsivity and negative life events., Results: Lifetime prevalence of NSSI was 53.9% (N = 76). In a binary logistic regression model, only negative romantic relationship events were significantly associated with the risk of current NSSI (OR = 1.29; 95% CI = [1.06-1.56]). Other types of negative life events (family-related, friendship-related), impulsivity, age and conviction status did not have a significant role in the model., Conclusions: The results suggest that juvenile offenders should receive additional support to manage stress that is associated with negative life events, especially problems in romantic relationships. It is essential to help young inmates to find an adaptive way of reducing stress caused by negative relationship life events., (© 2021. The Author(s).)

The Ruminative Thought Style Questionnaire (RTSQ) is a self-report measure that aims to capture rumination globally, unbiased by depressive symptoms. We explored its psychometric properties among university students (N = 1123), as the existing models about the factor structure of the RTSQ have been inconclusive. In a second study (N = 320) we tested its convergent validity compared to the Ruminative Response Scale (RRS) and its construct validity compared to the Zung Self-rating Depression Scale (ZSDS). The results of Study 1 suggest that the factor structure of the RTSQ is best described with a 19-item bifactor Exploratory Structural Equation Modelling (ESEM), where most of the variance is explained by the general factor. The model was found to be invariant across genders. The correlations in Study 2 demonstrated that the RTSQ is congruent with the RRS, and that rumination captured by the RTSQ is rather maladaptive, as it was more strongly associated with the brooding subscale of the RRS than with reflective pondering. Significant positive associations were found with depressive symptoms, reaffirming the validity of the RTSQ due to the well-known association between rumination and depressive symptoms. Our results support that RTSQ assesses rumination globally, and it is a valid measure of ruminative thinking style that is rather negatively valenced but does not solely focus on depressive mood and symptoms., Competing Interests: The authors have declared that no competing interests exist.