@article{MTMT:34377784,
	title = {Psychometric properties of the Hungarian childhood trauma questionnaire short form and its validity in patients with adult attention-deficit hyperactivity disorder or borderline personality disorder},
	url = {https://m2.mtmt.hu/api/publication/34377784},
	author = {Kenézlői, Eszter and Csernela, Eszter and Nemoda, Zsófia and Lakatos, Krisztina and Czéh, Boldizsár and Unoka, Zsolt and Simon, Mária and Réthelyi, János},
	doi = {10.1186/s40479-023-00239-8},
	journal-iso = {BORDERLINE PERSONAL DISORD EMOT DYSREGUL},
	journal = {BORDERLINE PERSONALITY DISORDER AND EMOTION DYSREGULATION},
	volume = {10},
	unique-id = {34377784},
	issn = {2051-6673},
	abstract = {Compelling evidence supports the role of childhood traumatization in the etiology of 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 Childhood Trauma Questionnaire Short Form (H-CTQ-SF) and to investigate the differences between patients diagnosed with aADHD and BPD in terms of early traumatization.Altogether 765 (mean age = 32.8 years, 67.7% women) patients and control subjects were enrolled from different areas of Hungary. Principal component analysis and confirmatory factor analysis were carried out to explore the factor structure of H-CTQ-SF and test the validity of the five-factor structure. Discriminative validity was assessed by comparing clinical and non-clinical samples. Subsequently, aADHD and BPD subgroups were compared with healthy controls to test for the role of early trauma in aADHD without comorbid BPD. Convergent validity was explored by measuring correlations with subscales of the Personality Inventory for DSM-5 (PID-5).The five scales of the H-CTQ-SF demonstrated adequate internal consistency and reliability values. The five-factor model fitted the Hungarian version well after exclusion of one item from the physical neglect scale because of its cross-loading onto the emotional neglect subscale. The H-CTQ-SF effectively differentiated between the clinical and non-clinical samples. The BPD, but not the aADHD group showed significant differences in each CTQ domain compared with the healthy control group. All CTQ domains, except for physical abuse, demonstrated medium to high correlations with PID-5 emotional lability, anxiousness, separation insecurity, withdrawal, intimacy avoidance, anhedonia, depressivity, suspiciousness, and hostility subscales.Our study confirmed the psychometric properties of the H-CTQ-SF, an easy-to-administer, non-invasive, ethically sound questionnaire. In aADHD patients without comorbid BPD, low levels of traumatization in every CTQ domain were comparable to those of healthy control individuals. Thus, the increased level of traumatization found in previous studies of aADHD might be associated with the presence of comorbid BPD. Our findings also support the role of emotional neglect, emotional abuse and sexual abuse in the development of BPD.},
	keywords = {principal component analysis; Confirmatory factor analysis; childhood maltreatment; childhood adversity; Borderline Personality Disorder (BPD); Adult attention-deficit hyperactivity disorder (aADHD); Early life traumatization; Hungarian Childhood Trauma Questionnaire Short Form (H-CTQ-SF); Personality inventory for DSM-5 (PID-5)},
	year = {2023},
	eissn = {2051-6673},
	orcid-numbers = {Kenézlői, Eszter/0000-0001-5342-3056; Nemoda, Zsófia/0000-0002-9550-7730; Unoka, Zsolt/0000-0003-0103-5064; Réthelyi, János/0000-0002-3641-012X}
}

@article{MTMT:34168417,
	title = {Moral Injury and Shame Mediate the Relationship Between Childhood Trauma and Borderline Personality Disorder, PTSD, and Complex PTSD Symptoms in Psychiatric Inpatients},
	url = {https://m2.mtmt.hu/api/publication/34168417},
	author = {Békés, Vera and Szabó, Dominik and Lévay, Erika Evelyn and Salgó, Ella and Unoka, Zsolt},
	doi = {10.1521/pedi.2023.37.4.406},
	journal-iso = {J PERS DISORD},
	journal = {JOURNAL OF PERSONALITY DISORDERS},
	volume = {37},
	unique-id = {34168417},
	issn = {0885-579X},
	abstract = {Moral injury (MI) has received increased research attention in the past decades. However, despite its detrimental mental health consequences, MI has not been studied in psychiatric patients. We aimed to establish the relationship between childhood trauma, MI, and borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and disturbances in self-organization symptoms (DSO), a core diagnostic criterion of complex PTSD besides PTSD symptoms, and shame as a moral emotion in an inpatient psychiatric sample (N = 240). We found that the impact of childhood trauma on present BPD, PTSD, and DSO symptoms was mediated by MI and shame; the models accounted for up to 31% of variance in symptomatology. To our knowledge, this study is the first to investigate MI in a psychiatric sample, and our results highlight the importance of considering MI as a critical factor of patient experiences in relation to childhood trauma that potentially contributes to the development of psychiatric symptoms.},
	year = {2023},
	eissn = {1943-2763},
	pages = {406-423},
	orcid-numbers = {Szabó, Dominik/0000-0002-6040-1944; Lévay, Erika Evelyn/0000-0002-2672-6307; Salgó, Ella/0000-0002-7492-2767; Unoka, Zsolt/0000-0003-0103-5064}
}

@article{MTMT:34168259,
	title = {Disturbed body schema, perceptual body image, and attitudinal body image in patients with borderline personality disorder},
	url = {https://m2.mtmt.hu/api/publication/34168259},
	author = {Szily, Dorottya and Kelemen, Rebeka and S. Nagy, Zita and Szabó, Dominik and Unoka, Zsolt},
	doi = {10.3389/fpsyt.2023.1168611},
	journal-iso = {FRONT PSYCHIATRY},
	journal = {FRONTIERS IN PSYCHIATRY},
	volume = {14},
	unique-id = {34168259},
	issn = {1664-0640},
	year = {2023},
	eissn = {1664-0640},
	orcid-numbers = {Szily, Dorottya/0000-0001-5877-9123; S. Nagy, Zita/0000-0003-1402-2895; Szabó, Dominik/0000-0002-6040-1944; Unoka, Zsolt/0000-0003-0103-5064}
}

@article{MTMT:34125513,
	title = {Moral injury in psychiatric patients with personality and other clinical disorders: development, psychometric properties, and validity of the Moral Injury Events Scale–Civilian Version},
	url = {https://m2.mtmt.hu/api/publication/34125513},
	author = {Szabó, Dominik and Békés, Vera and Lévay, Erika Evelyn and Salgó, Ella and Unoka, Zsolt},
	doi = {10.1080/20008066.2023.2247227},
	journal-iso = {EU J PSYCHOTRAUMA},
	journal = {EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY},
	volume = {14},
	unique-id = {34125513},
	issn = {2000-8198},
	year = {2023},
	eissn = {2000-8066},
	orcid-numbers = {Szabó, Dominik/0000-0002-6040-1944; Lévay, Erika Evelyn/0000-0002-2672-6307; Salgó, Ella/0000-0002-7492-2767; Unoka, Zsolt/0000-0003-0103-5064}
}

@article{MTMT:34088764,
	title = {Impaired decision-making in borderline personality disorder},
	url = {https://m2.mtmt.hu/api/publication/34088764},
	author = {Bajzát, Bettina and Soltész, Péter and Soltész-Várhelyi, Klára and Lévay, Erika Evelyn and Unoka, Zsolt},
	doi = {10.3389/fpsyg.2023.1109238},
	journal-iso = {FRONT PSYCHOL},
	journal = {FRONTIERS IN PSYCHOLOGY},
	volume = {14},
	unique-id = {34088764},
	issn = {1664-1078},
	year = {2023},
	eissn = {1664-1078},
	orcid-numbers = {Bajzát, Bettina/0000-0002-6343-1372; Soltész-Várhelyi, Klára/0000-0003-4369-6936; Lévay, Erika Evelyn/0000-0002-2672-6307; Unoka, Zsolt/0000-0003-0103-5064}
}

@{MTMT:34079698,
	title = {A rumináció és a nem-szuicidális önsértés kapcsolatának vizsgálata klinikai populációban},
	url = {https://m2.mtmt.hu/api/publication/34079698},
	author = {Kovács, Lilla Nóra and Reinhardt, Melinda and Klein, Mária and Drubina, Boglárka and Hammer , Angéla Márta and Szőke, Júlia and Unoka, Zsolt and Kökönyei, Gyöngyi},
	booktitle = {Találkozás a változásban - Változások a találkozásban},
	unique-id = {34079698},
	year = {2023},
	pages = {130-131},
	orcid-numbers = {Kovács, Lilla Nóra/0000-0002-0416-3283; Reinhardt, Melinda/0000-0001-7010-5623; Unoka, Zsolt/0000-0003-0103-5064; Kökönyei, Gyöngyi/0000-0001-6750-2644}
}

@article{MTMT:34045752,
	title = {m-RESIST, a Mobile Therapeutic Intervention for Treatment-Resistant Schizophrenia: Feasibility, Acceptability, and Usability Study},
	url = {https://m2.mtmt.hu/api/publication/34045752},
	author = {Grasa, Eva and Seppälä, Jussi and Alonso-Solis, Anna and Haapea, Marianne and Isohanni, Matti and Miettunen, Jouko and Caro Mendivelso, Johanna and Almazan, Cari and Rubinstein, Katya and Caspi, Asaf and Unoka, Zsolt and Farkas, Kinga and Usall, Judith and Ochoa, Susana and van der Graaf, Shenja and Jewell, Charlotte and Triantafillou, Anna and Stevens, Matthias and Reixach, Elisenda and Berdun, Jesus and Corripio, Iluminada},
	doi = {10.2196/46179},
	journal-iso = {JMIR FORM RES},
	journal = {JMIR FORMATIVE RESEARCH},
	volume = {7},
	unique-id = {34045752},
	year = {2023},
	eissn = {2561-326X},
	orcid-numbers = {Grasa, Eva/0000-0003-1100-7489; Seppälä, Jussi/0000-0002-8752-2041; Alonso-Solis, Anna/0000-0002-5393-9391; Haapea, Marianne/0000-0002-3989-9354; Isohanni, Matti/0000-0002-3692-8228; Miettunen, Jouko/0000-0003-0575-2669; Caro Mendivelso, Johanna/0000-0001-6405-6239; Almazan, Cari/0000-0001-8556-0792; Rubinstein, Katya/0000-0003-2875-4456; Caspi, Asaf/0000-0003-1205-6557; Unoka, Zsolt/0000-0003-0103-5064; Farkas, Kinga/0000-0002-1125-3957; Usall, Judith/0000-0002-1746-7737; Ochoa, Susana/0000-0001-6792-1080; van der Graaf, Shenja/0000-0002-3338-3453; Jewell, Charlotte/0000-0002-5093-6689; Triantafillou, Anna/0000-0003-1609-7356; Stevens, Matthias/0000-0001-6636-0672; Reixach, Elisenda/0000-0001-8557-0771; Berdun, Jesus/0000-0002-5955-9920; Corripio, Iluminada/0000-0003-2562-711X}
}

@article{MTMT:33753450,
	title = {Measuring post-traumatic stress disorder and complex post-traumatic stress disorder using the International Trauma Questionnaire: results from a Hungarian clinical and non-clinical sample},
	url = {https://m2.mtmt.hu/api/publication/33753450},
	author = {Rácz, Anna and Horváth, Zsolt and Vizin, Gabriella and Berán, Eszter and Unoka, Zsolt},
	doi = {10.1080/20008066.2022.2152929},
	journal-iso = {EU J PSYCHOTRAUMA},
	journal = {EUROPEAN JOURNAL OF PSYCHOTRAUMATOLOGY},
	volume = {14},
	unique-id = {33753450},
	issn = {2000-8198},
	year = {2023},
	eissn = {2000-8066},
	orcid-numbers = {Rácz, Anna/0000-0001-8203-6813; Horváth, Zsolt/0000-0001-9088-8186; Vizin, Gabriella/0000-0003-4892-5195; Berán, Eszter/0000-0001-7009-3386; Unoka, Zsolt/0000-0003-0103-5064}
}

@article{MTMT:33668655,
	title = {The Reflective Functioning Questionnaire–Revised– 7 (RFQ-R-7): A new measurement model assessing hypomentalization},
	url = {https://m2.mtmt.hu/api/publication/33668655},
	author = {Horváth, Zsolt and Demetrovics, Orsolya and Paksi, Borbála and Unoka, Zsolt and Demetrovics, Zsolt},
	doi = {10.1371/journal.pone.0282000},
	journal-iso = {PLOS ONE},
	journal = {PLOS ONE},
	volume = {18},
	unique-id = {33668655},
	issn = {1932-6203},
	abstract = {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 difficulties and maladaptive psychological characteristics. Data from two separate representative samples of young adults ( N = 3890; females: 51.68%; mean age: 27.06 years [ SD = 4.76]) and adults ( N = 1385; females: 53.20%; mean age: 41.77 years [ SD = 13.08]) were used. In addition to the RFQ-8, standardized questionnaires measured the levels of impulsivity, sensation seeking, rumination, worry and well-being. Confirmatory factor analysis (CFA) was used to test the model fit of competing measurement models. CFA revealed that a revised, seven-item version of the RFQ (RFQ-R-7) with a unidimensional structure showed the most optimal levels of model fit in both samples. Impulsivity, sensation seeking, rumination and worry consistently presented significant, positive, linear associations with general mentalization difficulties in both samples. Significant quadratic associations were also identified, but these relationships closely followed the linear associations between the variables and increased only marginally the explained variance. The supported unidimensional measurement model and the associations between the general mentalization difficulties factor and maladaptive psychological characteristics indicated that the RFQ-R-7 captures a dimension of hypomentalization ranging between low and high levels of uncertainty. Increasing levels of hypomentalization can indicate a risk for less adaptive psychological functioning. Further revisions of the RFQ-8 might be warranted in the future to ensure adequate measurement for hypermentalization.},
	year = {2023},
	eissn = {1932-6203},
	orcid-numbers = {Horváth, Zsolt/0000-0001-9088-8186; Paksi, Borbála/0000-0002-3616-2867; Unoka, Zsolt/0000-0003-0103-5064; Demetrovics, Zsolt/0000-0001-5604-7551}
}

@article{MTMT:33641806,
	title = {Stronger coupling of emotional instability with reward processing in borderline personality disorder is predicted by schema modes},
	url = {https://m2.mtmt.hu/api/publication/33641806},
	author = {Csukly, Gábor and Farkas, Kinga and Fodor, Tímea and Unoka, Zsolt and Polner, Bertalan Kristóf},
	doi = {10.1017/S0033291723000193},
	journal-iso = {PSYCHOL MED},
	journal = {PSYCHOLOGICAL MEDICINE},
	volume = {53},
	unique-id = {33641806},
	issn = {0033-2917},
	abstract = {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 knowledge of the underlying neurocognitive mechanisms driving these changes is incomplete. We hypothesized that in patients with BPD, affective instability is more influenced by reward expectation, outcomes, and reward prediction errors (RPEs) during risky decision-making than in healthy controls. Additionally, we expected that these alterations would be related to schema modes. Methods. Thirty-two patients with BPD and thirty-one healthy controls were recruited. We used an established behavioral paradigm to measure mood fluctuations during risky decision-making. The impact of expectations and RPEs on momentary mood was quantified by a computational model, and its parameters were estimated with hierarchical Bayesian analysis. Model parameters were compared using High-Density Intervals. Results. We found that model parameters capturing the influence of RPE and Certain Rewards on mood were significantly higher in patients with BPD than in controls. These model parameters correlated significantly with schema modes, but not with depression severity. Conclusions. BPD is coupled with altered associations between mood fluctuation and reward processing under uncertainty. Our findings seem to be BPD-specific, as they stand in contrast with the correlates of depressive symptoms. Future studies should establish the clinical utility of these alterations, such as predicting or assessing therapeutic response in BPD.},
	keywords = {IMPULSIVITY; DECISION-MAKING; psychiatry; Suicidal ideation; Personality Disorders; Psychology, Clinical; reward processing; Computational psychiatry; Reward prediction error; risky decision; Mood instability; hierarchical Bayesian analysis; AXIS-II COMORBIDITY},
	year = {2023},
	eissn = {1469-8978},
	pages = {6714-6723},
	orcid-numbers = {Csukly, Gábor/0000-0002-5006-9407; Farkas, Kinga/0000-0002-1125-3957; Unoka, Zsolt/0000-0003-0103-5064}
}