Zsolt Unoka

Semmelweis University | SOTE · Department of Psychiatry and Psychotherapy

Although it is a widely used questionnaire, limitations regarding the scoring procedure and the structural validity of the eight-item Reflective Functioning Questionnaire (RFQ-8) were raised. The present study aimed to examine further the latent dimensionality of the RFQ-8 and to examine linear and non-linear associations between mentalization diff...

Background: Mood instability and risk-taking are hallmarks of borderline personality disorder (BPD). Schema modes are combinations of self-reflective evaluations, negative emotional states, and destructive coping strategies common in BPD. When activated, they can push patients with BPD into emotional turmoil and a dissociative state of mind. Our k...

BACKGROUND In the European Union, around 5 million people are affected by psychotic disorders, and between 30-50% of people with schizophrenia have treatment-resistant schizophrenia (TRS). Mobile interventions may be effective in preventing relapses, increasing treatment adherence and managing some of the symptoms of schizophrenia. People with schi...

Background: The Collaborative Outcome study on Health and Functioning during Infection Times (COH-FIT; www.coh-fit.com) is an anonymous and global online survey measuring health and functioning during COVID-19 pandemic. The aim of this study was to test concurrently the validity of COH-FIT items and the internal validity of the co-primary outcome,...

Background: The 11th revision of the International Classification of Diseases (ICD-11) simplified the description of post-traumatic stress disorder (PTSD) and also introduced a new trauma-related diagnosis called complex post-traumatic stress disorder (CPTSD). CPTSD is linked to earlier, prolonged interpersonal trauma, and is characterized by a bro...

Background A convincing body of research has identified childhood traumatization as an important etiological factor for psychiatric disorders, including adult attention-deficit hyperactivity disorder (aADHD) and borderline personality disorder (BPD). The aim of this study was to examine the psychometric properties of the Hungarian version of the Ch...

Background and aims In the eleventh revision of the International Classification of Diseases (ICD-11), the severity of personality dysfunction became the central dimension of personality disorder’s (PDs) definition, besides the trait domain qualifiers. Personality functioning, also known as personality organization (PO), is becoming an increasingly...

Introduction High levels of impulsive behavior represent a core symptom of different psychiatric conditions, such as Attention Deficit Hyperactivity Disorder (ADHD), Borderline Personality Disorder (BPD), impulse control and conduct disorders, bulimia nervosa, substance use disorders, and other maladaptive behaviors. Impulsivity is a multidimension...

Introduction In a significant proportion of people diagnosed with Borderline Personality Disorder (BPD) and adult Attention Deficit Hyperactivity Disorder (aADHD) comorbid mental disorders, such as mood, anxiety, personality and substance use disorders can be detected. BPD and aADHD present with a partial overlap in the clinical symptoms, including...

Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability, specifically rumination. Despite this, inconsistencies have existed in the literature regarding which rumination type is most prominent in BPD. Taking this into consideration, a meta-analysis was performed to look at how BPD symptoms co...

Objectives and methods In order to assess the internal consistency, fit indexes, test-retest reliability, and validity of the Personality Inventory for the DSM-5 (PID-5) and its associations with age, gender, and education, 471 non-clinical (69,6% female; mean age: 37,63) and 314 clinical participants (69,7% female, mean age: 37,41) were administer...

Background: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. Methods: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/re...

The numerous multistable phenomena in vision, hearing and touch attest that the inner workings of perception are prone to instability. We investigated a visual example—binocular rivalry—with an accurate no-report paradigm, and uncovered developmental and maturational lifespan trajectories that were specific for age and sex. To interpret these traje...

Objectives Our study examines how suffering in a personality disorder in general and also specifically in borderline personality disorder (BPD) affects the size and structure of ego-centered social network; in addition, our study explores associations between well-being and network characteristics in personality disorder and healthy control. Metho...

Trust is essential for establishing and maintaining cooperative behaviors between individuals and institutions in a wide variety of social, economic, and political contexts. This book explores trust through the lens of neurobiology, focusing on empirical, methodological, and theoretical aspects. Written by a distinguished group of researchers from...

Background: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. Methods: The Collaborative Outcomes study on Health and Functioning during Infection Times (C...

Social difficulties are apparent in borderline personality disorder (BPD). Behavior in BPD is characterized by mistrust and expectations of malevolence from others. We examined whether there is an asymmetry between their social behavior and their belief about other people’s social motivations. Subjects completed a task where they had to allocate mo...

Background: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID�19 pandemic are needed. Methods: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/r...

Background The current study's goal was to examine the multivariate patterns of associations between schema modes and emotion regulation mechanisms in personality disorders. Schema modes are either integrated or dissociative states of mind, including intense emotional states, efforts to regulate emotions, or self-reflective evaluative thought proce...

Objectives Emotion regulation difficulties are a major characteristic of personality disorders. Our study investigated emotion regulation difficulties that are characteristic of borderline personality disorder (BPD), compared to a healthy control group. Methods Patients with BPD (N = 59) and healthy participants (N = 70) filled out four self-repor...

Shame has been found to be a core feature of borderline personality disorder (BPD). To date, there is no existing systematic review or meta-analysis examining shame in individuals with BPD as compared to healthy controls (HCs). A meta-analysis of 10 studies comparing reported shame in BPD patients to HCs was carried out. Demographic and clinical mo...

Choosing between alternatives is the stuff of everyday life. Many choices require trades between competing objectives, such as between capitalizing on past experience ('exploitation') and updating this experience ('exploration'). In visual perception, where speed is important, there are tensions between stability of appearance, sensitivity to visua...

Introduction: Community services are gaining ground when it comes to attention to patients with psychiatric diseases. Regarding patients with treatment-resistant schizophrenia (TRS), the use of information and communication technology (ICT) could help to shift the focus from hospital-centered attention to community services. This study compares th...

Introduction: High levels of impulsivity represent a core feature of various psychiatric conditions, such as Attention Deficit Hyperactivity Disorder (ADHD), Borderline Personality Disorder (BPD), Impulse Control and Conduct Disorders, Bulimia Nervosa, Substance Use Disorders, and other maladaptive behaviors, like non-suicidal self-harm and suicid...

In the European Union between 0.2 and 2.6% of the population suffer from psychotic disorders, and around 40% can be considered resistant to pharmacological treatment [1]. Interventions based on m-Health solutions may be effective in increasing treatment adherence, relieving some of the symptoms of schizophrenia and thus, preventing relapses. Althou...

Background Numerous studies have been using peripheral tissues (e.g., blood or saliva) for DNA methylation analyses in psychiatric epigenetics. The glucocorticoid receptor gene (NR3C1) was among the first ones to show DNA methylation changes due to adverse social environment. Importantly, the NR3C1 gene has several alternative promoters, out of whi...

The Hungarian Association for Behavioural, Cognitive and Schema Therapies (HABCT) has continuously been developing since its foundation 30 years ago. László Tringer was the first to teach Cognitive and Behavioural Therapy (CBT) in Hungary and to establish the first educational team. Their goal was to familiarise doctors and other professionals with...

Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and effective liability. Of this domain, ruminative behaviors have been considered a core feature of emotion dysregulation difficulties. Taking this into consideration, a meta-analysis was performed to assess how BPD symptoms correlate with rumination, while al...

Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability. Of this domain, ruminative behaviors have been considered a core feature of emotion dysregulation difficulties. Despite this, inconsistencies have existed in the literature regarding which rumination type is most prominent in those with...

According to Dunbar's social brain hypothesis, brain capacity puts a limit on the size of social network in humans. At the same time, emotional-cognitive systems such as attachment and different relational models (Fiske, 1991) may also act as driving forces behind network structure underlying relationship quality of the various ego-centered layers....

INTRODUCTION: Treatment-resistant schizophrenia (TRS) is a severe form of schizophrenia. In the European Union, approximately 40% of people with schizophrenia have TRS. Factors such as the persistence of positive symptoms or higher risk of comorbidities leave clinicians with a complex scenario when treating these patients. Intervention strategies b...

Introduction Treatment-resistant schizophrenia (TRS) is a severe form of schizophrenia. In the European Union, approximately 40% of people with schizophrenia have TRS. Factors such as the persistence of positive symptoms or higher risk of comorbidities leave clinicians with a complex scenario when treating these patients. Intervention strategies ba...

Borderline personality disorder (BPD) is characterized by impaired functioning of autobiographical memory (AM). We use a quantitative meta-analysis to assess AM performance in adults diagnosed with BPD as compared to healthy controls (HC). Moderator variables included type of autobiographical memory as well as clinical and demographic variables. La...

Borderline personality disorder (BPD) is characterized by impulsivity, emotion dysregulation, disturbed relationships, and identity disturbances. Despite the known variable co-occurrence of BPD symptoms, the possible causal relationships are not well understood. We addressed this by creating a hierarchical network model of BPD, which identifies the...

Borderline personality disorder (BPD) is characterized by impulsivity, emotion dysregulation, disturbed relationships, and identity disturbances. Despite the known variable co-occurrence of BPD symptoms, the possible causal relationships are not well understood. We addressed this by creating a hierarchical network model of BPD, which identifies the...

Háttér és célkitűzések: A terápiás ülésen a kliens élettörténeti epizódjai a terapeutával közös konstrukciós folyamat során átalakuláson mennek keresztül, újabb elemekkel egészülnek ki, újra íródnak. Ennek az átalakulási folyamatnak fontos eleme a beszélők narratív perspektívájának folyamatos változása, ami a narratív szelf változásához köthető fol...

Our study examined in-session affect regulation as a self-regulatory process as well as a process of interpersonal regulation during the psychoanalytical therapeutic session. We used a novel approach for studying affective involvement by analyzing narrative perspective (NP) taken by client and analyst. In a longitudinal study of 18 months we observ...

Symptoms of borderline personality disorder (BPD) can be conceptualized as the expression of and defenses against or response to the painful emotion of chronic shame, which may relate to early maladaptive schemas (EMS). The goal of this research is to examine levels of early maladaptive schemas, self-reported shame, and anxious or angry reactions t...

Living in large groups and maintaining extensive social relationships, as humans do, requires special social capabilities. Past research has shown that social cognitive abilities predict people’s social network size. To extend these findings we explored the role of a social emotional ability, and investigated how empathic abilities shape people’s s...

Wide-spread neuropsychological deficits have been identified in borderline personality disorder (BPD). Previous research found impairments in decision making, declarative memory, working memory and executive functions; however, no studies have focused on implicit learning in BPD yet. The aim of our study was to investigate implicit statistical lear...

Háttér Dunbar társas agy hipotézise szerint az emberi intelligencia és beszédképesség az evolúció során elsősorban azért fejlődött ki olyan magas szinten, hogy az egyén átlássa és kezelni tudja a mintegy 150 főt magában foglaló csoportokban kialakuló bonyolult kapcsolati rendszereket. Kutatásunkban azt vizsgáltuk, hogy a nagy csoporton belüli, szor...

Background and aims: Literature has shown that the mental disorders with most impairments in inhibition are those with impulsivity issues. Disorders included in this category include attention deficit hyperactivity disorder (ADHD), binge-purging disorder, bipolar disorder, borderline personality disorder (BPD), non-suicidal self injury (NSSI), obse...

Background: Despite the theoretical potential of mHealth solutions in the treatment of patients with schizophrenia, there remains a lack of technological tools in clinical practice. Objective: The aim of this study was to measure the receptivity of patients, informal carers, and clinicians to a European integral intervention model focused on pat...

Research has suggested inconsistencies in the literature with onset of eating disorders (e.g., restrictive anorexia (RAN), binge purging anorexia (BPA), and bulimia nervosa (BN) and perceived parenting. Literature has also shown that eating disorders are highly co-morbid with major depression (MD) and also inconsistences in major depression of perc...

Four decades have elapsed since the introduction for clinical and research purposes of the Symptom Checklist-90(-R). Yet, its underlying dimensional structure has not been clearly delineated. A shift has been observed in the methods utilized-from predominantly exploratory factor analytic in nature in the first two decades or so to different confirm...

Background Patients with major depression and borderline personality disorder are characterised by a distorted perception of other people's intentions. Deficits in mental state decoding are thought to be the underlying cause of this clinical feature.AimsTo examine, using meta-analysis, whether mental state decoding abilities in patients with major...

Our review is an overview of research literature aimed at evaluating the differential association of shame with various mental disorders. In the first part of this review, we present questionnaire and experimental methods applied in clinical trials for measuring shame. In the second part of our review, we review research that investigated the assoc...

Objective: Our first aim was to investigate the factor structure of the Hungarian version of Experience of Shame Scale (ESS) by using confirmatory factor analysis (CFA). Our second aim was to analyse the associations between the three dimensions of chronic shame and different types of predictors, such as clinical status, age, gender, school years,...

In the treatment of sexual abuse victims reconstructing the abuse narrative from fragmented memories and gaining back a healthy sense of agency are major objectives of therapeutic interventions. Our analysis of the psychotherapy process in case of a sexual abuse victim analyzes in-session interaction in terms of joint construction of narrative by c...

Studies have shown that patients with borderline personality disorder (BPD) have co-occurring disorders; literature has also suggested that BPD patients have impairments in neuropsychological functioning, as seen in a previous meta-analysis (Ruocco, 2005). This meta-analysis showed that neuropsychological functioning are marked areas of concern in...

In the treatment of sexual abuse victims reconstructing the abuse narrative from fragmented memories and gaining back a healthy sense of agency are major objectives of therapeutic interventions. Our analysis of the psychotherapy process in case of a sexual abuse victim analyzes in-session interaction in terms of joint construction of narrative by c...

THE MIND IN THE WORLD OF WEB: RELATIONSHIPS AND LEARNING IN THE CONTEXT OF NEW ICT – PLÉH, CSABA – RÁCZ, ANNA – SOLTÉSZ, PÉTER – KARDOS, PÉTER – BERÁN, ESZTER – UNOKA, ZSOLT The paper starts from considering relations between machines and human thought. How do the machine deterministic, the metaphoric and instrumental visions emerge in intellectual...

The paper starts from considering relations between machines and human thought. How do the machine deterministic, the metaphoric and instrumental visions emerge in intellectual history. This issue is part of the general topic of how do man made technical tools influence the general frameworks of human relations and cognition, i.e. the general archi...

The authors examined social decision-making strategies in borderline personality disorder (BPD) using the Ultimatum Game (UG). They sought to extend previous findings by investigating altruistic punishment, a behavior that increases group cooperation in the long term. They tested the effect of the proposer's facial expression on responses. BPD pati...

Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addit...

Shame is a particularly intense, often incapacitating negative emotion involving feeling of inferiority, powerlessness and self-conciousness, along with the desire to hide or disappear. The experience of shame is an adaptive and natural reaction until it becomes a chronic and painful emotion as a result of environment and temperamental factors. Acc...

Gender identity disorder (GID) refers to transsexual individuals who feel that their assigned biological gender is incongruent with their gender identity and this cannot be explained by any physical intersex condition. There is growing scientific interest in the last decades in studying the neuroanatomy and brain functions of transsexual individual...

Background: Despite the improving medical care and increasing survival rate, the consequences of pediatric cancer may persist for many years after the end of treatment, which can influence everyday adaptation and social relationships. Perception of the stressful life events and the long term psychosocial adaptation are influenced by social support...

Bevezetés Magyarországon évente 25.000 öngyilkossági kísérlet van és 2011-ben 2300-an követtek el befejezett öngyilkosságot. Az öngyilkossági kísérlet és a nem végzetes szándékos önsértés vagy „paraszuicidium” fogalmi és klinikai elkülönítése egyaránt nehéz. E két fogalom differenciálásában az öngyilkossági kísérlet súlyosságának és a kísérlet okán...

Hatter: A terapias diskurzusban megvalosulo narrativ konstrukcios folyamat soran a paciens es a terapeuta kolcsonosen befolyasoljak egymas nezőpontjanak valtozasait. Ez a nezőpont, vagy narrativ perspektiva (NP) valtas szorosan kapcsolodik a figyelem iranyitasanak nyelvi eszkozokkel megvalosulo szabalyozasahoz, amit korabban Chafe fogalmazott meg a...

Emotional reactions are rather flexible, due to the schema-like organization of complex socio-emotional situations. Some data on emotion development, and on certain pathological conditions such as alexithymia, give further support for the psychological constructivist view put forward by Lindquist et al. Narrative organization is a key component of...

The authors argue that the currently popular view endorsed by a number of attachment theorists and infant researchers that assumes a possibly evolutionarily based and human-specific direct causal and functional link between the ontogeny of early security of infant attachment on the one hand, and the acquisition of explicit mentalizing skills on the...

Absztrakt Korabbi kutatasokban kimutattak, hogy bizonyos tipusu narrativ perspektivak (NP) hasznalata a szelf intenzivebb affektiv bevonodasaval jar. Kutatasunkban a terapeuta es paciens verbalis erzelemkifejezeset vizsgaltuk a terapias ulesen, konkretan a narrativ perspektivahasznalatban megmutatkozo affektiv szelf-bevonodast. Hipotezisunk szerint...

Elméleti összefoglalómban a kognitív terápiás irányzaton belül kialakult terápiás irányzat, a sématerá-pia bemutatására vállalkozom. A sématerápia súlyos kapcsolati problémákkal küzdő, személyiségzavar-ban vagy krónikus első tengely zavarban szenvedő páciensek számára kidolgozott hosszú (heti két alka-lom, két éven át) egyéni vagy csoportos terápia...

Depressed patients are both characterized by social reality distorting maladaptive schemas and facial expression recognition impairments. The aim of the present study was to identify specific associations among symptom severity of depression, early maladaptive schemas and recognition patterns of facially expressed emotions. The subjects were inpati...