Researcher: Şar, Vedat
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Şar, Vedat
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Publication Metadata only Trauma, creativity, and trance: special ability in a case of dissociative identity disorder(Amer Psychiatric Publishing, Inc, 2018) N/A; N/A; N/A; N/A; Şar, Vedat; Mutluer, Tuba; Necef, Işıl; Fatih, Parmis; Faculty Member; Faculty Member; Faculty Member; Researcher; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 8542; 305311; N/A; N/AN/APublication Metadata only Awareness of identity alteration and diagnostic preference between borderline personality disorder and dissociative disorders(Taylor & Francis, 2017) Alioğlu, Firdevs; Akyüz, Gamze; N/A; N/A; N/A; N/A; Şar, Vedat; Tayakısı, Emre; Öğülmüş, Fatma Ezgi; Sönmez, Doğuş; Faculty Member; Undergraduate Student; Undergraduate Student; Undergraduate Student; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 8542; N/A; N/A; N/AAim: This study inquires into identity alteration among college students and its relationship to borderline personality disorder (BPD) and/or dissociative disorders (DDs). Methods: Steinberg Identity Alteration Questionnaire (SIAQ), Childhood Trauma Questionnaire (CTQ), and self-report screening tool of the BPD section of the Structured Clinical Interview for DSM-IV (SCID-BPD) were administered to 1301 college students. Participants who fit the diagnostic criteria of BPD (n=80) according to the clinician-administered SCID-BPD and 111 non-BPD controls were evaluated using the Structured Clinical Interview for DSM-IV DDs (SCID-D) by two psychiatrists blind to the group membership and scale scores. Results: Test-retest evaluations and internal consistency analyses suggested that SIAQ was a reliable instrument. of the participants, 11.3% reported a SIAQ score 25 or above alongside some impairment. SIAQ scores differentiated participants who fit the diagnostic criteria for a DD from those who did not. While self-report identity alteration was correlated with all childhood trauma types, clinician-assessed identity alteration was correlated with childhood sexual abuse only. Those who fit criteria for both disorders had the highest identity alteration scores in self-report and clinician-assessment. Although both syndromes had significant effect on self-report identity alteration total scores, in contrast to DD, BPD did not have an effect on the clinician-administered evaluation. Conclusion: An impression of personality disorder rather than a DD may seem more likely when identity alteration remains subtle in clinical assessment, notwithstanding its presence in self-report. Lack of recognition of identity alteration may lead to overdiagnosis of BPD among individuals who have a DD.Publication Metadata only Three phases of cancer in the process of mental trauma: diagnosis, treatment, survival(Kare Publ, 2018) N/A; N/A; N/A; Güner, Perihan; Şar, Vedat; Pehlivan, Tuğba; Faculty Member; Faculty Member; PhD Student; School of Nursing; School of Medicine; Graduate School of Health Sciences; 101859; 8542; N/AObjectives: Cancer tends to trigger a psychological response that represents a form of traumatic stress. Regardless of the nature of the noxious agent, therapeutic interventions conducted for the treatment of any post-traumatic reaction must take into consideration the tri-phasic structure of adaptation (i.e. shock, mourning and integration) in defining a balanced response to a vital threat. This paper aims to gather evidence on the psychosocial dimension of cancer by applying a three-phase approach model. Methods: To fulfill the stated aim, systematic reviews and meta-analyses on non-experimental studies published in the last 15 years were screened using the following databases: CINAHL, Pubmed, Cochrane, Joanna Briggs Institute, Ulakbim, and Google Scholar. Overall, 33 reviews met the inclusion criteria. Results: The obtained data, which included findings on different types of cancer and different psychiatric reactions, disclose the presence of a psychological trauma process that occurs in response to physical illness. Conclusion: The mental trauma process was studied and is discussed in three phases, namely, diagnosis, treatment and post-treatment.Publication Metadata only Psychiatry shuffles the cards: toward new subtypes, specifiers, and qualifiers(Kare Publ, 2022) N/A; Şar, Vedat; Faculty Member; School of Medicine; 8542The anonymous tale (my version) of five medical doctors hunting is not far from telling the truth: The physicians saw a bird taking off from the bush and wanted to be sure that it was a duck and not a goose before they shot it. The general practitioner deferred the decision to the specialists. The internist did not want to comment without having a lab test. The surgeon proposed hitting the animal before it was too late. The pathologist warned that an insufficient specimen would not allow a definitive opinion even after a completed action. The psychiatrist was the last resort. After a short silence, she asked: Is what you see what you get?Publication Metadata only Post-traumatic stress in terror and war(İstanbul Prof. Dr. Cemil Taşçıoğlu Şehir Hastanesi, 2017) N/A; Şar, Vedat; Faculty Member; School of Medicine; 8542Psychological trauma represents a discrepancy between external threat and individual’s capacity of coping with it. War and terrorism increase the risk of traumatic experiences due to potential bodily injury and other adversities. Beside singular events, war and terrorism may also lead to chronic psychological processes due to traumatization in childhood and adverse experiences affecting a large number individuals. They constitute Type I, Type II, and Type III traumatization, respectively. The prevalence of posttraumatic stress disorder is reported as approximately 10% during the first few months among individuals who were exposed to a terrorist act of bombing. These rates are higher among women and refugees who escape from war. Psychological interventions for those populations should consider the existent natural and social coping mechanisms as a way of healing. Hence, the response to these extraordinary events should not be pathologized and the role of survivor rather than victim should be supported. The window of tolerance in regard to emotions should be considered in all interventions, anger should be managed while mourning should be facilitated. Government, media, medical system, and legal institutions should participate in management of the crisis. Maladaptive reactions should be managed on an individual basis. Mental circulus vitious created by cumulative traumatization can be solved by re-organization of perceived priorities and by widening the perspective. Anger and social disintegration leading to disturbances of daily life are predictors of crisis in mass trauma. In well chosed cases, effective psychotherapeutic techniques tailored for processing of traumatic experiences may be of help. Eye Movement Desensitization and Reprocessing (EMDR) is one of these tools. Appropriate intervention to maladaptive developments would repair the broken cognitive and emotional links and assist in prevention of further damage which may exceed individual psychopathology and may affect the future of the society in subtle ways. / Dış dünyadan kaynaklanan tehdit ile kişinin bu tehditle başetme kapasitesi arasında ortaya çıkan yaşamsal bir dengesizlik ruhsal travmaya yol açar. Olağan gündelik yaşamı aşan şiddette stres verici olayları artırması nedeniyle (Örn. bedensel yaralanma ve diğer olumsuz etkenler) savaş ve terör ruhsal travma riskini artırmaktadır. Bu gibi koşullar aniden ortaya çıkan tekil olaylara yol açabileceği gibi, kronik ya da birikimli travma anlamına gelen gelişimsel nitelikli çocukluk çağı stres verici yaşantılarını ya da kitleleri topluca olumsuz yönde etkileyen olayları artırarak uzun vadeli zihinsel süreçlere de yol açmaktadır. Bunlar sırası ile Tip I, Tip II, ve Tip III travma yaşantısı oluştururlar. Terör kaynaklı bir bombalama olayına tanık olanlarda ilk aylarda travma sonrası stres bozukluğu sıklığı yaklaşık %10 olarak bildirilmekte olup, kadınlarda bu tanıya daha sık rastlanmaktadır. Savaş ortamında bulunanlarda ve savaş ortamından kaçan sığınmacılarda bu oran %50 dolayına kadar tırmanmaktadır. Bu durumlara müdahelede öncelikle doğal ve toplumsal baş etme mekanizmalarından yararlanılması, ortaya çıkan tepkileri patolojik olarak görmekten kaçınma, kurbandan çok üstesinden gelen kişi rolünün desteklenmesi, duyguların kişinin kendisi için kabul edilebilir bir çerçevede tutulması, matem süreçlerinin yaşanabilmesine olanak tanınması yerinde olacaktır. Çok sayıda kişiyi aynı anda etkileyen travmatik yaşantılarda devlet kurumları, medya, sağlık ve hukuk sisteminin desteği önem taşırken, görece maladaptif tepki geliştiren kişilere tedavi yaklaşımlarında bireysel yaşam öyküsü ön plana çıkmakta ve değişik türde travmatik olayların oluşturduğu örgünün yol açtığı tıkanıklık yaşanmış olayların kişi için öncelik sırasının yeniden düzenlenmesi ve geleceğe bakışı daraltmasını önüne geçilmesi başlıca işlemler olarak kendini göstermektedir. Son birkaç on yıldır gelişen psikotravmatolojinin ilkelerine uyulması yanı sıra göz hareketleri eşliğinde duyarsızlaştırma ve yeniden işleme (EMDR) gibi görece kısa sürede olumlu etki yaratabilen psikolojik destek yaklaşımlarından yararlanılmasının yaşamsal kırılmaya uğrayan zihinsel süreçlerin kişinin ve toplumun geleceğini karartmasını önlemede yararlı olduğu görülmektedir.Publication Metadata only Separating fact from fiction: an empirical examination of six myths about dissociative identity disorder(LIPPINCOTT WILLIAMS & WILKINS, 2016) Brand, Bethany L.; Stavropoulos, Pam; Krüger, Christa; Korzekwa, Marilyn; Martinez-Taboas, Alfonso; Middleton, Warwick; N/A; Şar, Vedat; Faculty Member; School of Medicine; N/A; 8542Dissociative identity disorder (DID) is a complex, posttraumatic, developmental disorder for which we now, after four decades of research, have an authoritative research base, but a number of misconceptualizations and myths about the disorder remain, compromising both patient care and research. This article examines the empirical literature pertaining to recurrently expressed beliefs regarding DID: (1) belief that DID is a fad, (2) belief that DID is primarily diagnosed in North America by DID experts who overdiagnose the disorder, (3) belief that DID is rare, (4) belief that DID is an iatrogenic, rather than trauma-based, disorder, (5) belief that DID is the same entity as borderline personality disorder, and (6) belief that DID treatment is harmful to patients. The absence of research to substantiate these beliefs, as well as the existence of a body of research that refutes them, confirms their mythical status. Clinicians who accept these myths as facts are unlikely to carefully assess for dissociation. Accurate diagnoses are critical for appropriate treatment planning. If DID is not targeted in treatment, it does not appear to resolve. The myths we have highlighted may also impede research about DID. The cost of ignorance about DID is high not only for individual patients but for the whole support system in which they reside. Empirically derived knowledge about DID has replaced outdated myths. Vigorous dissemination of the knowledge base about this complex disorder is warranted.Publication Metadata only Psychotic presentations of dissociative disorders(Taylor and Francis, 2022) Şar, Vedat; Faculty Member; School of Medicine; 8542Dissociative identity disorder (DID) is both a disorder of one’s sense of self and an effective developmental adaptation to childhood trauma. Controversies surrounding DID, historically, have impeded its study. However, a burgeoning body of research links DID to a particular causal environment and biological correlates. Here we provide an innovative theory of DID that translates the phenomenology using modern models of cognition and neuroscience to ground DID in environmental experience, the brain and body. Research suggests DID self-states are dynamic, distributed networks of brain activity that prepare the body to interact with the world. Furthermore, a constellation of early childhood trauma and dysfunctional family dynamics interact with a genetic predisposition for the capacity to dissociate to cause DID. DID has distinct patterns in brain structure, function, and peripheral psychophysiology, and cutting-edge neuroscience suggests there may be a measurable fingerprint of DID distinguishable in the brain on an individual basis. Altogether, this novel synthesis has demonstrated what many clinicians and people with lived experience have long known – DID is a valid disorder and a developmental posttraumatic adaptation. Yet many fruitful directions for future work in development, distinguishing pre-existing neural vulnerabilities versus corollaries of DID, integration, treatment, and the biology of recovery remain.Publication Metadata only A research agenda for the dissociative disorders field(Taylor and Francis, 2022) Şar, Vedat; Faculty Member; Other; School of Medicine; School of Medicine; 8542; N/AN/APublication 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 Identity revised: a clinician's perspective on what an identity-based model of mind looks like(Springer, 2017) N/A; Şar, Vedat; Faculty Member; School of Medicine; 8542Identity has been a relatively underreferenced concept in psychiaty and clinical psychopathology. It is of particular interest that the few diagnostic categories associated with some type of identity disturbance are related to chronic psychological traumatization in childhood such as abuse an/or neglect or deficiencies in secure interpersonal attachment. As developmental traumatization is usually associated with dissociation regardless the prevailing diagnostic pattern, models of mind considering the relationships between childhood adversities, dissociation, and identity are compelling not only for social scientists but also for clinicians who are exposed to Dissociative Identity Disorder (aka Multiple Personality Disorder), Borderline Personality Disorder, and Complex PTSD as conditions responding to psychotherapy rather than speficic drug regimens. This chapter is concerned with the Theory of “Functional Dissociation of Self” (Şar and Öztürk, 2007) which proposes such a model of mind. As newly introduced concepts, “Sociological Self” and “Trauma-Self” (Symptomatic Self) are presented as elements of this model which have direct implications about disturbances of identity and psychotherapeutic interventions taylored to address them.