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Publication Metadata only “Doing What Matters in Times of Stress” to decrease psychological distress during Covid-19: a rammed controlled pilot trial(Wolters Kluwer Medknow Publications, 2022) Uygun, Ersin; Karaoğlan Kahiloğulları, Akfer; Department of Psychology; Department of Psychology; N/A; Acartürk, Ceren; Kurt, Gülşah; İlkkurşun, Zeynep; Faculty Member; Teaching Faculty; Master Student; Department of Psychology; College of Social Sciences and Humanities; College of Social Sciences and Humanities; Graduate School of Social Sciences and Humanities; 39271; 368619; N/ADespite the increasing psychological distress during Covid-19, utilisation of face-to-face psychological interventions decreased profoundly. The aim of this study involving two parallel, two-armed pilot randomised controlled trials was to examine the effectiveness of a guided self-help intervention "Doing What Matters in Times of Stress" (DWM) in decreasing psychological distress in Turkish and Syrian participants. Seventy-four Turkish nationals and 50 Syrian refugee adults with psychological distress were randomly allocated to a DWM group or wait-list control group. The primary outcome measure was the Patient Health Questionnaire 9 postintervention. Secondary outcome measures were the Generalised Anxiety Disorder Scale, posttraumatic stress disorder (PTSD) Checklist for DSM-5, Generalized Self-Efficacy Scale and Acceptance and Action Questionnaire-II postintervention. Although this study was not powered to detect a significant effect for DWM postassessment between DWM and the control group, results showed a significant improvement in depression symptoms among Turkish participants in the DWM group (d = 0.46) and in PTSD symptoms among Syrian participants in the DWM group (d = 0.67) from pre- to postintervention assessment. These results indicate the potential of DWM to decrease mental health problems during the pandemic and importance of a fully powered, definitive controlled trial to examine its effectiveness both for the host community and refugees to reduce psychological distress during Covid-19.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 Metadata only A correlation network analysis of dissociative experiences(Routledge Journals, Taylor & Francis Ltd, 2019) Schimmenti, Adriano; N/A; Şar, Vedat; Faculty Member; School of Medicine; 8542The interrelationships between the symptom domains of dissociation, such as the loss of continuity in subjective experience, the inability to access personal information, and the distortions about the perception of self and the environment, need to be better understood. In the current study, 2274 adults from Italy completed the Dissociative Experiences Scale-II (DES-II), and their responses were examined within a correlation network analysis framework. Fifteen dissociative experiences showed the strongest associations with the other dissociative experiences included in the measure, and they were selected for further analysis. A partial correlation network was calculated to reveal the associations between such experiences, and a community detection analysis was used to explore whether they formed distinct clusters in the network. Subsequently, a Bayesian network was estimated to examine the direction of the associations among the dissociative experiences, and a directed acyclic graph (DAG) was generated to estimate a potentially causal model of their relationships. The community detection analysis revealed three clusters of experiences that were conceptualized in terms of trance, experiential disconnectedness, and segregated behaviors. Dissociative amnesia was a common denominator of all the three clusters. The analysis of the DAG further suggested that dissociation can be conceptualized as a network in which dissociative experiences are layered into groups of symptoms that interact among them. Cognizance of the configuration and interactions among the dissociative domains and their related symptoms may be critical for better understanding the internal logic behind the dissociative processes and for addressing them effectively in clinical practice.Publication Metadata only A revised and expanded version of the Turkish childhood trauma questionnaire (CTQ-33): overprotection-overcontrol as additional factor(Routledge Journals, Taylor & Francis Ltd, 2021) Türk-Kurtça, Tuğba; N/A; N/A; N/A; N/A; Şar, Vedat; Necef, Işıl; Mutluer, Tuba; Fatih, Parmis; Faculty Member; Doctor; Faculty Member; Researcher; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 8542; N/A; 305311; N/AThis study was concerned with a culture-sensitive revision of the Turkish version of the Childhood Trauma Questionnaire (CTQ-28) and expansion of the instrument through integration of a dimension assessing overprotection - overcontrol (OP-OC). Participants (n = 783) were 37 dissociative and 78 non-dissociative and non-psychotic psychiatric outpatients, and 668 non-clinical people. They completed the revised and expanded version of the CTQ, Dissociative Experiences Scale, Beck Depression Scale, and Relationship Scales Questionnaire. A test-retest assessment was conducted on 25 non-clinical individuals. Among twenty-one alternative and the twenty-five original statements, the items of subsections were selected by correlations between item and item deleted total scores for each subset of original and alternative statements. The 33-item final version (CTQ-33) included five statements for each subsection including OP-OC and three denial items. The principal component analysis on items of the CTQ-33 with a varimax rotation yielded six factors including OP-OC. The inner consistency and the test-retest reliability were good. OP-OC correlated particularly with emotional abuse and neglect, and other types of trauma. There were significant correlations between CTQ-33 and depression, dissociation, and fearful attachment scores. The CTQ-33 differentiated psychiatric from non-clinical groups. The Turkish CTQ-33 is a reliable and valid instrument. OP-OC by caregivers may be as traumatic as other types of childhood adversities. Cross-cultural research would illuminate the significance of OP-OC beyond Turkish culture. The possibility of intergenerational transmission of trauma through OP-OC by fearful parents in and after times of cultural upheaval and political oppression should be considered for future research.Publication Metadata only A study on the adaptation of the HIV/AIDS-related stigma scale into Turkish(Wiley, 2022) Bahar, Zuhal; Cal, Ayse; Cavusoglu, Figen; Deveci, Aydin; Badur, Selim; Bahar, Ismail Hakki; Beşer, Ayşe; Faculty Member; School of Nursing; 143490Purpose This study aims to test the validity and reliability of the Turkish version of the HIV/AIDS-related Stigma Scale. Design and Methods The study has a methodological design. The sample included a total of 428 participants. of the participants, 198 were HIV/AIDS patients, 230 were HIV-negative individuals. The data were analyzed using the Exploratory and Confirmatory Factor Analysis. Findings The Turkish version of the HIV/AIDS-related Stigma Scale was found to be valid and reliable for the Turkish society. Cronbach's alpha was 0.93 for the community perspectives subscale and 0.89 for the patient perspectives subscale, and all the model fit indices were acceptable. Practice Implications The level of stigmatization revealed by the scale helps gain an insight into the community and patient perspectives on HIV/AIDS.Publication Metadata only Abnormal high-energy phosphate molecule metabolism during regional brain activation in patients with bipolar disorder(Nature Publishing Group (NPG), 2015) Yuksel, C.; Du, F.; Ravichandran, C.; Goldbach, J. R.; Thida, T.; Lin, P.; Gelda, J.; O'Connor, L.; Sehovic, S.; Gruber, S.; Ongur, D.; Cohen, B. M.; Department of Psychology; Dora, Begüm; PhD Student; Department of Psychology; College of Social Sciences and Humanities; N/AConverging evidence suggests bioenergetic abnormalities in bipolar disorder (BD). In the brain, phosphocreatine (PCr) acts a reservoir of high-energy phosphate (HEP) bonds, and creatine kinases (CK) catalyze the transfer of HEP from adenosine triphosphate (ATP) to PCr and from PCr back to ATP, at times of increased need. This study examined the activity of this mechanism in BD by measuring the levels of HEP molecules during a stimulus paradigm that increased local energy demand. Twenty-three patients diagnosed with BD-I and 22 healthy controls (HC) were included. Levels of phosphorus metabolites were measured at baseline and during visual stimulation in the occipital lobe using P-31 magnetic resonance spectroscopy at 4T. Changes in metabolite levels showed different patterns between the groups. During stimulation, HC had significant reductions in PCr but not in ATP, as expected. In contrast, BD patients had significant reductions in ATP but not in PCr. In addition, PCr/ATP ratio was lower at baseline in patients, and there was a higher change in this measure during stimulation. This pattern suggests a disease-related failure to replenish ATP from PCr through CK enzyme catalysis during tissue activation. Further studies measuring the CK flux in BD are required to confirm and extend this finding.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; Acartürk, Ceren; Faculty Member; Department of Psychology; 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; Acartürk, Ceren; Faculty Member; Department of Psychology; 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.