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Publication Open Access A combined VBM and DTI study of schizophrenia: bilateral decreased insula volume and cerebral white matter disintegrity corresponding to subinsular white matter projections unlinked to clinical symptomatology(Aves, 2017) Ulaşoğlu-Yıldız, Çiğdem; Aslan, Selçuk; Talı, Erhan Turgut; N/A; N/A; Onay, Aslıhan; Eser, Hale Yapıcı; Faculty Member; School of Medicine; N/A; 134359PURPOSE: Grey matter and white matter changes within the brain are well defined in schizophrenia. However, most studies focused on either grey matter changes or white matter integrity separately; only in limited number of studies these changes were interpreted in the same frame. In addition, the relationship of these findings with clinical variables is not clearly established. Here, we aimed to investigate the grey matter and white matter changes in schizophrenia patients and exhibit the relation of these imaging findings with clinical variables. METHODS: A total of 20 schizophrenia patients and 16 matched healthy controls underwent magnetic resonance imaging to investigate the grey matter and white matter alterations that occur in schizophrenia patients using voxel-based morphometry (VBM) and whole brain voxel-wise analysis of diffusion tensor imaging (DTI) parameters with SPM8, respectively. While the preprocessing steps ofVBM were performed with the default parameters of VBM8 toolbox, the preprocessing steps of DTI were carried out using FSL. Additionally, VBM results were correlated with clinical variables. RESULTS: Bilateral insula showed decreased grey matter volume in schizophrenia patients compared with healthy controls (P < 0.01). The opposite contrast did not show a significant difference. Psychiatric scores, duration of illness, and age were not correlated with the decreased grey matter volume of insula in schizophrenia patients. DTI analysis revealed a significant increase in mean, radial, and axial diffusivity, mainly of the fibers of bilateral anterior thalamic radiation and superior longitudinal fasciculus with left predominance, which intersected with bilateral subinsular white matter (P < 0.05). CONCLUSION: Our findings suggest that insula may be the main affected brain region in schizophrenia, which is also well supported by the literature. Our results were independent of disease duration and schizophrenia symptoms. White matter alterations were observed within bilateral anterior thalamic radiation and superior longitudinal fasciculus that intersects with subinsular white matter. Studies with larger sample sizes and more detailed clinical assessments are required to understand the function of insula in the neurobiology of schizophrenia.Publication Open Access Acute dissociative reaction to spontaneous delivery in a case of total denial of pregnancy: diagnostic and forensic aspects(Routledge, 2017) Aydın, N.; van der Hart, O.; Frankel, A.S.; Şar, M.; Omay, O.; N/A; Şar, Vedat; Faculty Member; School of Medicine; 8542This article presents the history of a 21-year-old female college student with total denial of pregnancy who experienced an acute dissociative reaction during the spontaneous delivery at home without medical assistance where the newborn died immediately. Psychiatric examination, self-report questionnaires, legal documents, and witness reports have been reviewed in evaluation of the case. Evidence pointed to total denial of pregnancy, that is, until delivery. The diagnoses of an acute dissociative reaction to stress (remitted) and a subsequent PTSD were established in a follow-up examination conducted 7months after the delivery. Notwithstanding the inherently dissociative nature of total denial of pregnancy, no other evidence has been found about pre-existing psychopathology. For causing the newborn's death, the patient faced charges for aggravated murder, which were later on reduced into involuntary manslaughter. Given the physical incapacity to perform voluntary acts due to the loss of control over her actions during the delivery, and the presence of an acute dissociative reaction to unexpected delivery, the legal case represents an intricate overlap between insanity and incapacitation defenses. The rather broad severity spectrum of acute dissociative conditions requires evaluation of the limits and conditions of appropriate legal defenses by mental health experts and lawyers. Denial of pregnancy as a source of potential stress has attracted little interest in psychiatric literature although solid research exists which documented that it is not infrequent. Arguments are presented to introduce this condition as a diagnostic category of female reproductive psychiatry with a more neutral label: unperceived pregnancy.Publication Open Access Adverse childhood experiences and global mental health: avenues to reduce the burden of child and adolescent mental disorders(Cambridge University Press (CUP), 2022) Ceccarelli, C.; Prina, E.; Muneghina, O.; Jordans, M.; Barker, E.; Miller, K.; Singh, R.; Sorsdhal, K.; Cuijpers, P.; Lund, C.; Barbui, C.; Purgato, M.; Department of Psychology; Department of Psychology; Acartürk, Ceren; Faculty Member; College of Social Sciences and Humanities; 39271Mental disorders are one of the largest contributors to the burden of disease globally, this holds also for children and adolescents, especially in low-and middle-income countries. The prevalence and severity of these disorders are influenced by social determinants, including exposure to adversity. When occurring early in life, these latter events are referred to as adverse childhood experiences (ACEs). In this editorial, we provide an overview of the literature on the role of ACEs as social determinants of mental health through the lenses of global mental health. While the relation between ACEs and mental health has been extensively explored, most research was centred in higher income contexts. We argue that findings from the realm of global mental health should be integrated into that of ACEs, e.g. through preventative and responsive psychosocial interventions for children, adolescents and their caregivers. The field of global mental health should also undertake active efforts to better address ACEs in its initiatives, all with the goal of reducing the burden of mental disorders among children and adolescents globally.Publication Open Access Adverse childhood experiences and global mental health: avenues to reduce the burden of child and adolescent mental disorders- Corrigendum (vol 31, E75, 2022)(Cambridge University Press (CUP), 2022) Ceccar, C.; Prina, E.; Muneghina, O.; Jordans, M.; Barker, E.; Miller, K.; Singh, R.; Sorsdhal, K.; Cuijpers, P.; Lund, C.; Barbui, C.; Purgato, M.; Department of Psychology; Department of Psychology; Acartürk, Ceren; Faculty Member; College of Social Sciences and Humanities; 39271Publication Open Access Alexithymia in nurses and its relationship with burnout, anger, and somatization(Kare Yayıncılık, 2020) Korkmaz, Ebru Konal; Kadıoğlu, Hasibe; Karaca, Semra; Telli, Sibel; Koç University HospitalObjectives: the aim of the study was to evaluate the alexithymia levels of nurses and the relationship between alexithymia and burnout, anger, and somatization. Methods: this correlational descriptive study was conducted with 339 nurses working in four training research hospitals between February 3 and 28, 2014. Data were collected using the Demographic Questionnaire, Toronto Alexithymia Scale, Maslach Burnout Inventory, State-Trait Anger Expression Inventory, and SCl-90 somatization subscale. The analysis of the data was performed using descriptive statistics, the Mann-Whitney U test, Kruskal-Wallis test, and Spearman's correlation. Results: the mean age of the nurses participating in the research was 30.8±7.3, 91.2% were female, and 28.6% (n=97) had moderate alexithymia. The alexithymic nurses had higher burnout (p<0.05), öfke puanı (p><0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.05), anger (p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01), and somatization (p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01) scores than those who did not exhibit alexithymia. A positive weak relationship was found between the alexithymia scores and burnout (r=0.18; p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01), anger (r=0.34; p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01), and somatization (r=0.32; p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01) scores. Conclusion: the findings of the study showed that the level of alexithymia in nurses was high and the level of burnout, anger, and somatization increased as the alexithymia score increased. / Amaç: bu çalışma hemşirelerin aleksitimi düzeylerini ve aleksitiminin tükenmişlik, öfke ve somatizasyon ile ilişkisini incelemek amacıyla yapılmıştır. Gereç ve yöntem: ilişkisel tanımlayıcı tipte olan çalışma 3–28 Şubat 2014 tarihleri arasında, İstanbul Anadolu Kuzey Kamu Hastaneleri Birliğine bağlı tam teşekküllü dört eğitim ve araştırma hastanesinde çalışan hemşireler ile yürütülmüştür (n=339). Araştırma verileri “Kişisel Bilgi Formu”, “Toronto Aleksitimi Ölçeği”, “Maslach Tükenmişlik Ölçeği”, “Spielberger Sürekli Öfke ve Öfke İfade Tarzı Ölçeği” ve “SCl-90 Somatizasyon Alt Ölçeği” ile toplanmıştır. Verilerin değerlendirilmesinde tanımlayıcı istatistikler (ortalama, sayı, yüzde dağılımları) ve Kruskall Wallis testi, Mann-Whitney-U testi ve Spearman’s Korelasyon analizi kullanılmıştır. Bulgular: çalışmaya katılan hemşirelerin, yaş ortalamasının 30.8±7.3, %91.2’sinin kadın ve %28.6’sının orta düzeyde aleksitimik olduğu bulunmuştur. Aleksitimik hemşirelerin tükenmişlik puanı (p<0.05), öfke puanı (p><0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.05), öfke puanı (p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01) ve somatizasyon puan ortalamaları (p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01), öfke (r=0.34; p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01) ve somatizasyon (r=0.32; p<0.01) ve somatizasyon puan ortalamaları (p><0.01) aleksitimik olmayan hemşirelerden daha yüksektir. Aleksitimi ile tükenmişlik (r=0.18; p><0.01), öfke (r=0.34; p><0.01) ve somatizasyon (r=0.32 p><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: Çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir><0.01) arasında pozitif bir ilişki olduğu saptanmıştır. Sonuç: çalışma bulguları hemşirelerde aleksitimi düzeyinin yüksek olduğunu, aleksitimi puanı arttıkça tükenmişlik, öfke ve somatizasyon düzeylerinin de arttığını göstermiştir.Publication Open Access An inquiry into the TUI design space for parent-child math engagement at home(Association for Computing Machinery (ACM), 2022) Department of Psychology; Department of Media and Visual Arts; Department of Psychology; Department of Media and Visual Arts; Beşevli, Ceylan; Göksun, Tilbe; Özcan, Oğuzhan; Faculty Member; Faculty Member; KU Arçelik Research Center for Creative Industries (KUAR) / KU Arçelik Yaratıcı Endüstriler Uygulama ve Araştırma Merkezi (KUAR); College of Social Sciences and Humanities; N/A; 47278; 12532Preschoolers' early-math development is vital for their later math and academic achievement. Tangible user interfaces (TUI) may support early math as they feature physical objects imperative to math development and multimedia to support engagement. As a potentially meaningful context for TUIs, developmental studies highlight the need to support the home math environment (HME) that covers math-related interactions among parents and children. Therefore, we focus on HME as a design space that has not been investigated in TUI literature. We conducted an observational study involving physical-object based math activities and semi-structured interviews with 13 parent-child dyads. Our findings revealed the multifaceted nature of the HME, where children's agency is valued and providing lasting materials is challenging. Also, we realized that parents juggled their child's demands and the object-based physical activity at once. By reflecting on these findings, we propose design directions for supporting the home-math environment with TUIs.Publication Open Access Association of borderline intellectual functioning and adverse childhood experience with adult psychiatric morbidity. findings from a British birth cohort(BioMed Central, 2019) Hassiotis, Angela; Brown, Emma; Harris, James; Helm, David; Münir, Kerim; Salvador-Carulla, Luis; Bertelli, Marco; Baghdadli, Amaria; Wieland, Jannelien; Novell-Alsina, Ramon; Cid, Jordi; Verges, Laura; Martinez-Leal, Rafael; İsmayilov, Fuad; Emerson, Eric; Mutluer, Tuba; Faculty Member; Koç University Hospital; 305311Background: to examine whether Borderline Intellectual Functioning (BIF) and Adverse Childhood Experiences independently predict adult psychiatric morbidity. Methods: we performed a secondary analysis of longitudinal data derived from the 1970 British Birth Cohort Study to examine whether BIF and Adverse Childhood Experiences independently predict adult mental distress as measured by the Malaise Inventory. Factor analysis was used to derive a proxy measure of IQ from cognitive testing at age 10 or 5. Variables that could be indicators of exposure to Adverse Childhood Experiences were identified and grouped into health related and socio-economic related adversity. Results: children with BIF were significantly more likely than their peers to have been exposed to Adverse Childhood Experiences (BIF mean 5.90, non-BIF mean 3.19; Mann-Whitney z = 31.74, p < 0.001). As adults, participants with BIF were significantly more likely to score above the cut-off on the Malaise Inventory. We found statistically significant relationships between the number of socio-economic Adverse Childhood Experiences and poorer adult psychiatric morbidity (r range 0.104-0.141, all p < 001). At all ages the indirect mediating effects of Adverse Childhood Experiences were significantly related to adult psychiatric morbidity. Conclusions: the relationship between BIF and adult psychiatric morbidity appears to be partially mediated by exposure to Adverse Childhood Experiences. Where possible, targeting Adverse Childhood Experiences through early detection, prevention and interventions may improve psychiatric morbidity in this population group.Publication Open Access Astrocytic outer retinal layer thinning is not a feature in AQP4-IgG seropositive neuromyelitis optica spectrum disorders(BMJ Publishing Group, 2021) Lu, A.; Zimmermann, HG.; Specovius, S.; Motamedi, S.; Chien, C.; Bereuter, C.; Lana-Peixoto, MA.; Fontenelle, MA.; Ashtari, F.; Kafieh, R.; Dehghani, A.; Pourazizi, M.; Pandit, L.; D Cunha, A.; Kim, HJ.; Hyun, JW.; Jung, SK.; Leocani, L.; Pisa, M.; Radaelli, M.; Siritho, S.; May, E.F.; Tongco, C.; De Sèze, J.; Senger, T.; Palace, J.; Roca-Fernández, A.; Leite, MI.; Sharma, SM.; Stiebel-Kalish, H.; Asgari, N.; Soelberg, K.K.; Martinez-Lapiscina, EH.; Havla, J.; Mao-Draayer, Y.; Rimler, Z.; Reid, A.; Marignier, R.; Cobo-Calvo, A.; Tanriverdi, U.; Yildirim, R.; Aktas, O.; Ringelstein, M.; Albrecht, P.; Tavares, IM.; Bichuetti, DB.; Jacob, A.; Huda, S.; Soto de Castillo, I.; Petzold, A.; Green, AJ.; Yeaman, MR.; Smith, TJ.; Cook, L.; Paul, F.; Brandt, AU.; Oertel, FC.; GJCF International Clinical Consortium for NMOSD.; Altıntaş, Ayşe; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; 11611Background: patients with anti-aquaporin-4 antibody seropositive (AQP4-IgG+) neuromyelitis optica spectrum disorders (NMOSDs) frequently suffer from optic neuritis (ON) leading to severe retinal neuroaxonal damage. Further, the relationship of this retinal damage to a primary astrocytopathy in NMOSD is uncertain. Primary astrocytopathy has been suggested to cause ON-independent retinal damage and contribute to changes particularly in the outer plexiform layer (OPL) and outer nuclear layer (ONL), as reported in some earlier studies. However, these were limited in their sample size and contradictory as to the localisation. This study assesses outer retinal layer changes using optical coherence tomography (OCT) in a multicentre cross-sectional cohort. Method: 197 patients who were AQP4-IgG+ and 32 myelin-oligodendrocyte-glycoprotein antibody seropositive (MOG-IgG+) patients were enrolled in this study along with 75 healthy controls. Participants underwent neurological examination and OCT with central postprocessing conducted at a single site. Results: no significant thinning of OPL (25.02 +/- 2.03 mu m) or ONL (61.63 +/- 7.04 mu m) were observed in patients who were AQP4-IgG+ compared with patients who were MOG-IgG+ with comparable neuroaxonal damage (OPL: 25.10 +/- 2.00 mu m; ONL: 64.71 +/- 7.87 mu m) or healthy controls (OPL: 24.58 +/- 1.64 mu m; ONL: 63.59 +/- 5.78 mu m). Eyes of patients who were AQP4-IgG+ (19.84 +/- 5.09 mu m, p=0.027) and MOG-IgG+ (19.82 +/- 4.78 mu m, p=0.004) with a history of ON showed parafoveal OPL thinning compared with healthy controls (20.99 +/- 5.14 mu m); this was not observed elsewhere. Conclusion: the results suggest that outer retinal layer loss is not a consistent component of retinal astrocytic damage in AQP4-IgG+ NMOSD. Longitudinal studies are necessary to determine if OPL and ONL are damaged in late disease due to retrograde trans-synaptic axonal degeneration and whether outer retinal dysfunction occurs despite any measurable structural correlates.Publication Open Access Behavioral immune system and trypophobia(ANP Sağlık Hizmetleri Yayınevi, 2022) Öztürk, Süleyman; Demir, Ayşe Banu; Kazdağlı, Hasan; Erdeniz, Burak; Ceylan, Deniz; Faculty Member; School of Medicine; 137755Pathogens, which are the source of infectious diseases, have imposed a strong selection pressure on human evo-lution as one of the most important causes of human death during the natural selection process. As a result of this, it is assumed that a variety of adaptations have evolved against infection threats and one of these adap-tations is the physiological immune system. However, activation of the physiological immune system can be quite costly for organisms in some cases, and therefore it has been recently proposed in evolutionary psychology that an adaptive system called behavioral immune sys-tem may have evolved in association with the proactive functional processes against pathogen threats. Furthermore, it was hypothesized that a number of psy-chopathologies might develop as a result of maladaptive processes affecting the functionality of this system, and one of these psychopathologies might be trypophobia. Trypophobia refers to a psychological disorder in which individuals experience aversion and disgust at excessive levels toward clusters of small objects such as holes and bumps. Following this, the current review was estab-lished within the framework of three distinct goals. Firstly, this review aimed to discuss the evolutionary basis and mechanisms of the behavioral immune system. Secondly, the review aimed to discuss the characteristic features and the etiological explanations of trypophobia. Finally, the review aimed to discuss how potential changes in the behavioral immune system might lead to the development of trypophobia. / Bulaşıcı hastalıkların kaynağı olan patojenler doğal seçilim süreci boyunca insan ölümlerinin en önemli nedenlerinden biri olarak insan evrimi üzerinde güçlü bir seçilim baskısı oluşturmuşlardır. Buna bağlı olarak, patojen tehdidine karşı modern insanda birçok adaptasyonun evrimleştiği ve bu adaptasyonlardan bir tanesinin fizyolojik bağışıklık sistemi olduğu düşünülmektedir. Öte yandan, fizyolojik bağışıklık sisteminin aktif hale gelmesi bazı durumlarda organizma için oldukça maliyetli olabilmektedir. Bu nedenle, doğal seçilim süreci boyunca patojen tehdidine karşı proaktif işlevsel süreçlerle ilişkilendirilen uyumsal bir davranışsal bağışıklık sisteminin evrimleşmiş olabileceği düşünülmektedir. Bununla birlikte, çeşitli faktörlerin etkisiyle bu sistemin işlevselliğinde meydana gelebilecek bozulmalara bağlı olarak farklı psikopatolojilerin ortaya çıkıyor olabileceği ve bunlardan bir tanesinin tripofobi olabileceği düşünülmektedir. Tripofobi, kişilerin delik ve yumru gibi küçük obje kümelerinin bulunduğu uyaranlara karşı aşırı düzeyde kaçınma ve tiksinme deneyimledikleri psikopatolojik bir durumu ifade etmektedir. Buradan hareketle, bu derleme üç amaç çerçevesinde oluşturulmuştur. Bu amaçlardan ilki, davranışsal bağışıklık sisteminin evrimsel temeline ve çalışma mekanizmalarına ilişkin detaylı bir tartışma yürütülmesidir. İkinci olarak, derlemede tripofobinin karakteristik özelliklerini tespit etmek üzere yürütülen çalışmaların bulgularının ve daha önce etiyolojisine dair getirilen açıklamaların tartışılması amaçlanmıştır. Son olarak ise, davranışsal bağışıklık sisteminin mekanizmalarında meydana gelebilecek hangi değişikliklerin tripofobinin ortaya çıkması ile ilişkili olabileceğinin tartışılması amaçlanmıştır.Publication Open Access Behavioral implications of the Covid-19 process for autism spectrum disorder, and individuals' comprehension of and reactions to the pandemic conditions(Frontiers, 2020) Mutluer, Tuba; Doenyas, Ceymi; Genç, Herdem Aslan; Faculty Member; PhD Student; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Koç University Hospital; 305311; N/A; N/ADuring disasters and pandemics, vulnerable populations such as patients with mental conditions are known to be overly influenced. Yet, not much is known about how the individuals with autism spectrum disorder (ASD), one of the most common neurodevelopmental conditions globally with a prevalence of 1%, are affected from health-related disasters, especially the current Covid-19 pandemic. Therefore, we conducted an investigation of how individuals with ASD responded to Covid-19 in terms of comprehension and adherence to implemented measures; changes in their behavioral problems; and how their caregivers' anxiety levels relate with these behavioral changes. Our sample consisted of 87 individuals with ASD (15 girls; ages ranged from 3-29, with an average of 13.96 +/- 6.1). The majority of our sample had problems understanding what Covid-19 is and the measures it requires. They also had challenges in implementing social distance and hygiene-related regulations of the pandemic. The majority stopped receiving special education during this period. We observed a Covid-19-related clinical presentation that resembled PTSD in individuals with ASD in terms of increased stereotypies, aggression, hypersensitivity, behavioral problems, and sleep and appetite alterations. All subscales of Aberrant Behavior Checklist (ABC) differed significantly between before and after the pandemic conditions. The number of hours the children slept significantly decreased from before to during Covid-19. The anxiety levels of caregivers were high and correlated with the current behavioral problem levels of their children, but not with the level of their behavioral problems before the pandemic. The difference in ABC total score and specifically the lethargy/social withdrawal subscale score predicted parents' anxiety score. Our results suggest that the Covid-19 period inflicts specific challenges to individuals with ASD and their caregivers, underlining the need for targeted, distance special education interventions and other support services for this population.