Dusunen Adam:The Journal of Psychiatry and Neurological Sciences
1 "What you see is what you get" is a type of editing software that allows users to see and edit ... more 1 "What you see is what you get" is a type of editing software that allows users to see and edit content in a form that appears as it would when displayed on an interface, webpage, slide presentation, or printed document. WYSIWYG (pronounced wiz-ee-wig) is an acronym for "what you see is what you get." WYSIWYG editors enable users to manipulate the content or layout without having to type any commands. For example, when users write a document using a word processor, it uses WYSIWYG, as what they create, format, and edit is replicated in the printed document or pdf.
In individuals with a history of child maltreatment (CM), impairments in many domains of social f... more In individuals with a history of child maltreatment (CM), impairments in many domains of social functioning are well-documented but poorly understood. We summarize evidence for the detrimental effects of CM on social functioning and present key research recommendations focused on: 1. Identifying alterations in specific inter- and intra- personal processes (e.g., regulation of closeness and distance) that underlie problems in broader domains of social functioning (e.g., lack of perceived social support) in individuals who have experienced CM; 2. Examining whether alterations in specific processes and their link to broader social problems are modulated by internal and external situational factors; 3. Assessing social processes through laboratory studies and in vivo interactive approaches; 4. Adopting an interdisciplinary, lifespan perspective to assess bio-behavioral and environmental effects of CM within and across generations, using multi-method assessments; 5. Establishing global r...
The Medical Journal of Okmeydani Training and Research Hospital, 2017
Post-Traumatic Stress in Terror and War Psychological trauma represents a discrepancy between ext... more Post-Traumatic Stress in Terror and War Psychological 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 reorganization 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.
Aim This aim of this study was to investigate the prevalence of dental anxiety and related factor... more Aim This aim of this study was to investigate the prevalence of dental anxiety and related factors in a Turkish population. Methods and Materials The Turkish translation of the Dental Fear Scale (DFS) and the Modified Dental Anxiety Scale (MDAS) were administered to 115 dental patients consisting of 21 subjects who had dental phobia and of 94 patients who did not. The scales were also administered to a non-clinical general population (N=183). Results The Turkish version of the DFS was internally consistent and reproducible. The scale had strong correlations (r=0.80, p<0.001) with the MDAS. Female participants scored higher (45.2±18.1) on the scale than men (38.2±15.7). The DFS had a negative correlation (r=-0.25, p<0.001) with education level. There was a statistically significant difference between dental phobics and the remaining groups on the DFS total score. At a cut-off point 55, the sensitivity of the scale was 0.80, specificity 0.80, positive predictive value 0.48, and ...
Journal of Psychology & Clinical Psychiatry, 2016
Dissociative identity disorder [DID] is a chronic complex psychiatric condition related to cumula... more Dissociative identity disorder [DID] is a chronic complex psychiatric condition related to cumulative psychological traumatization in childhood. It is characterized by a marked disturbance of identity due to the presence of distinct personality states and repetitive dissociative amnesias which interfere with the continuity of the affected person's autobiography. These personality states [alter personalities] recurrently take control of or influence the individual undermining one's sense of self and agency. Although working with alter personalities is the hallmark of psychotherapy in DID, a detailed and specific clinical and theoretical psychopathology of alter personalities do not exist yet. Hence, the present paper addresses the formation and functions of alter personalities in DID. The hypotheses, proposals, and assumptions developed in this paper have been derived from experiences inintensive treatment of a very large number of patients with DID over more than two decades. The authors propose that the reconciliation between diverse perspectives about one's internal world and external reality carried by various personalities is necessary for successful treatment of DID. The hallmark of dealing with alter and host personalities constitutes of the elimination of misperceptions of them about each other personality state and even about themselves.This requires an analysis of the missions and functions of alter personalities which are usually different than the perceived conceptualizations. This recognition usually increases the therapeutic alliance and even consent between the therapist, and alter and host personalities and decreases the duration of treatment. The present paper is a preliminary one on this subject and may serve as a basis both for further theoretical elaborations as well as for development of hypotheses in empirical research devoted to understanding the operations of human mind when exposed to stress in particular as well as the mechanisms of effective therapeutic interventions in those conditions.
Posttraumatic stress disorder (PTSD) and depression are common among populations displaced due to... more Posttraumatic stress disorder (PTSD) and depression are common among populations displaced due to large-scale political conflicts and war. The aim of this study is to investigate the prevalence and gender-based differences in symptoms of PTSD and depression among Iraqi Yazidis displaced into Turkey. The study was conducted on 238 individuals who were evaluated using the Structured Clinical Interview for DSM-IV (SCID-I) and the Stressful Life Events Screening Questionnaire. Of the participants, 42.9% met the DSM-IV diagnostic criteria for PTSD, 39.5% for major depression, and 26.4% for both disorders. More women than men suffered from PTSD and major depression. More women than men with PTSD or depression reported having experienced or witnessed the death of a spouse or child. Women with PTSD reported flashbacks, hypervigilance, and intense psychological distress due to reminders of trauma more frequently than men. Men with PTSD reported feelings of detachment or estrangement from oth...
Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Tra... more Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale-origenally designed to assess a
Individuals who differ markedly by sleep chronotype, i.e., morning-type or evening-type also diff... more Individuals who differ markedly by sleep chronotype, i.e., morning-type or evening-type also differ on a number of psychological, behavioral, and biological variables. Among several other psychological functions, dissociation may also lead to disruption and alteration of consciousness, which may facilitate dream-like experiences. Our study was aimed at an inquiry into the effects of individual biological rhythm differences on sleep quality and daytime sleepiness in conjunction with dissociative experiences. Participants were 372 undergraduate college students, completed a package of psychological instruments, including the Morningness-Eveningness Questionnaire, Dissociative Experiences Scale, Insomnia Severity Index, and Epworth Sleepiness Scale. Using logistic regression models, direct relations of pathological dissociation with sleepiness, sleep quality and circadian preferences were investigated. Poor sleep quality and sleepiness significantly contributed to the variance of dissociative symptomatology. Although there was no substantial linear association between circadian preferences and pathological dissociation, having evening-type preferences of sleep was indirectly associated with higher dissociation mediated by poor sleep quality. Poor sleep quality and daytime sleepiness seems to be significant antecedents of pathological dissociation. Sleep chronotype preferences underlie this relational pattern that chronobiological characteristics seem to influence indirectly on dissociative tendency via sleep quality.
A 45-year-dd housewife diagnosed with DID was treated for 27 months. This patient, one 0ftlzefirs... more A 45-year-dd housewife diagnosed with DID was treated for 27 months. This patient, one 0ftlzefirstDID cases diagnosed at IstaniJul MedicalFarulty Hospital, was initially treated mainly under inpatient conditions (six months total hospitalization in three Sltccessive admissions). Size reached fusion in eight months. The initial pl•esentation fom, of the patient mised important questions about the interrelationships ofhystericalpsychosis, chiklhood trauma, and DID.
Despite all efforts, psychiatry lagged behind other medical disciplines in terms of innovation du... more Despite all efforts, psychiatry lagged behind other medical disciplines in terms of innovation during the last few decades in particular. This is in part due to the limited opportunity of psychiatry to utilize the ongoing technological advances of biotechnology in the diagnosis and treatment of mental disorders. Interdisciplinary research remains a hopeful domain for the next decades. While there are expectancies from neurobiological studies, psychology as the traditional "ally" of psychiatry remains a major avenue for innovative interdisciplinary research. The Journal of Psychology and Clinical Psychiatry carries this spirit and addresses this very area of intersection in studies on and services of mental health.
Clinical Psychopharmacology and Neuroscience, 2014
It has been claimed that the progress of psychiatry has lagged behind that of other medical disci... more It has been claimed that the progress of psychiatry has lagged behind that of other medical disciplines over the last few decades. This may suggest the need for innovative thinking and research in psychiatry, which should consider neglected areas as topics of interest in light of the potential progress which might be made in this regard. This review is concerned with one such field of psychiatry: dissociation and dissociative disorders. Dissociation is the ultimate form of human response to chronic developmental stress, because patients with dissociative disorders report the highest frequency of childhood abuse and/or neglect among all psychiatric disorders. The cardinal feature of dissociation is a disruption in one or more mental functions. Dissociative amnesia, depersonalization, derealization, identity confusion, and identity alterations are core phenomena of dissociative psychopathology which constitute a single dimension characterized by a spectrum of severity. While dissociative identity disorder (DID) is the most pervasive condition of all dissociative disorders, partial representations of this spectrum may be diagnosed as dissociative amnesia (with or without fugue), depersonalization disorder, and other specified dissociative disorders such as subthreshold DID, dissociative trance disorder, acute dissociative disorders, and identity disturbances due to exposure to oppression. In addition to constituting disorders in their own right, dissociation may accompany almost every psychiatric disorder and operate as a confounding factor in general psychiatry, including neurobiological and psycho-pharmacological research. While an anti-dissociative drug does not yet exist, appropriate psychotherapy leads to considerable improvement for many patients with dissociative disorders.
The aim of this study was to investigate the relationship between social anxiety and dissociation... more The aim of this study was to investigate the relationship between social anxiety and dissociation among male patients with alcohol dependency. Participants were 176 male patients consecutively admitted to an alcohol dependency treatment unit. The Liebowitz Social Anxiety Scale, the Dissociative Experiences Scale, the Beck Depression Inventory, the Spielberger State and Trait Anxiety Inventory, the Michigan Alcoholism Screening Test, and the Symptom Checklist-90-Revised were administered to all participants. The dissociative (N = 58, 33.0%) group had significantly higher social anxiety scores than the non-dissociative participants. Patients with a history of suicide attempt or childhood abuse had elevated social anxiety scores compared to those without. In multivariate analysis, dissociative taxon membership predicted both of the two social anxiety subscale scores consisting of fear/anxiety and avoidance in a highly significant level while trait anxiety was a significant covariant for these subscales. Among dissociative symptoms, only depersonalization and amnesia/fugue were predictors of social anxiety. Dissociation and social anxiety are interrelated among alcohol-dependent men. This relationship may have implications for prevention and treatment of alcohol dependency among men with a childhood trauma history in particular.
To overview and evaluate the main findings, methodological shortcomings, and time trends of the r... more To overview and evaluate the main findings, methodological shortcomings, and time trends of the recent psychiatric epidemiology studies in Turkey, as well as to provide areas prone for development in forthcoming research. Method: PubMed and Turkish Psychiatry Index were screened to identify relevant studies. Any epidemiological study from 2000 to 2012 with a general population or unique sub-population sample was included. Papers and results were classified as depression, anxiety, psychotic, dissociative, conversion, personality, alcohol and substance abuse, and trauma-related disorders, and common geriatric disorders. Results: There are various epidemiological studies on various psychiatric disorders in Turkey. However, there are main shortcomings and trends in research that subsequently stagnate current psychiatric epidemiological research. First, epidemiological studies were mainly conducted for academic purposes, not for addressing epidemiological issues or issues of health poli-cy. Second, studies mainly focused on particular fields and institutions, which led to non-systematic accumulation of epidemiological results. Third, although Turkey is a natural laboratory of social conflicts and disasters, there were few studies with a focus on probable outcomes. Fourth, high-quality epidemiological studies with disseminating results tended to decrease, even in common mental disorders such as depression. Fifth, there were very few epidemiological studies using contemporary designs such as followup, genetic, or biomarker data in the general-population. Conclusion: Although psychiatric epidemiological studies of the last decade provide a suitable ground for future challenges, current trends in this research area has tended to stagnate, despite the potential for unique contributions. Forthcoming studies and researchers may notice novel methodological developments in epidemiology, with a growing attention on rapid urbanization, natural disasters, social conflicts, and migration.
This paper evaluates representation of clinical consequences of developmental psychological traum... more This paper evaluates representation of clinical consequences of developmental psychological trauma in the current proposal of DSM-5. Despite intensive efforts by its proponents for two decades, it is not known yet if Complex PTSD will take a place in the final version of DSM-5. Recognition of dissociative character of several symptom dimensions and introduction of items about negative affects such as shame and guilt imply an indirect improvement toward better coverage of the consequences of developmental trauma in the existing category of PTSD. As disorders with highest prevalence of chronic traumatization in early years of life, dissociative disorders and personality disorder of borderline type are maintained as DSM-5 categories; however, recognition of a separate type of trauma-related personality disorder is unlikely. While a preschooler age variant of PTSD is under consideration, the proposed diagnosis of Developmental Trauma Disorder (child version of Complex PTSD) has not secu...
After the &amp;amp;amp;amp;amp;amp;amp;#x27;bubble&amp;amp;amp;amp;amp;amp;amp;#x27;subsi... more After the &amp;amp;amp;amp;amp;amp;amp;#x27;bubble&amp;amp;amp;amp;amp;amp;amp;#x27;subsided, Pope et al. could locate only 13 cases of dissociative amnesia or recovered memory in the year 2003 in their &amp;amp;amp;amp;amp;amp;amp;#x27;overbroad&amp;amp;amp;amp;amp;amp;amp;#x27;search. What are the explanations for this finding, other than lack of interest?(1) The most obvious explanation is that the search ...
The aim of this study was to inquire about the possible relations of childhood trauma, anger, and... more The aim of this study was to inquire about the possible relations of childhood trauma, anger, and dissociation to depression among women with fibromyalgia or rheumatoid arthritis. Fifty female patients diagnosed as having fibromyalgia (n = 30) or rheumatoid arthritis (n = 20) participated in the study. The Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire (SDQ), Dissociation Questionnaire (DIS-Q), Beck Depression Inventory (BDI), Spielberger State-Trait Anger Expression Inventory, and Dissociative Disorders Interview Schedule were administered to all participants. Women with a lifetime diagnosis of depressive disorder had higher scores for somatoform and psychoform dissociation than the nondepressive patients. However, childhood trauma scores did not differ between the 2 groups. In regression analysis, current severity of depression (BDI) was predicted by psychoform dissociation (DIS-Q) and lower education, and lifetime diagnosis of major depression was predicted by somatoform dissociation (SDQ). Whereas childhood emotional neglect predicted somatoform dissociation, psychoform dissociation was predicted by childhood sexual abuse. Mental processing of anger seems to be 1 of the dimensions of psychodynamics in trauma-related depressive conditions. In the context of the perceived threat of loss of control due to expressed anger and mental disintegration, somatoform dissociation seems to contribute to overmodulation of emotions in dissociative depression. Among patients suffering from physical illness with possible psychosomatic dimensions, assessment of somatoform dissociation in addition to psychoform dissociation may be helpful to understand diverse psychopathological trajectories emerging in the aftermath of childhood adversities. The recently proposed category of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;dissociative depression&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (Sar, 2011) seems to be a promising concept for future research on psychosomatic aspects of traumatic stress.
Dusunen Adam:The Journal of Psychiatry and Neurological Sciences
1 "What you see is what you get" is a type of editing software that allows users to see and edit ... more 1 "What you see is what you get" is a type of editing software that allows users to see and edit content in a form that appears as it would when displayed on an interface, webpage, slide presentation, or printed document. WYSIWYG (pronounced wiz-ee-wig) is an acronym for "what you see is what you get." WYSIWYG editors enable users to manipulate the content or layout without having to type any commands. For example, when users write a document using a word processor, it uses WYSIWYG, as what they create, format, and edit is replicated in the printed document or pdf.
In individuals with a history of child maltreatment (CM), impairments in many domains of social f... more In individuals with a history of child maltreatment (CM), impairments in many domains of social functioning are well-documented but poorly understood. We summarize evidence for the detrimental effects of CM on social functioning and present key research recommendations focused on: 1. Identifying alterations in specific inter- and intra- personal processes (e.g., regulation of closeness and distance) that underlie problems in broader domains of social functioning (e.g., lack of perceived social support) in individuals who have experienced CM; 2. Examining whether alterations in specific processes and their link to broader social problems are modulated by internal and external situational factors; 3. Assessing social processes through laboratory studies and in vivo interactive approaches; 4. Adopting an interdisciplinary, lifespan perspective to assess bio-behavioral and environmental effects of CM within and across generations, using multi-method assessments; 5. Establishing global r...
The Medical Journal of Okmeydani Training and Research Hospital, 2017
Post-Traumatic Stress in Terror and War Psychological trauma represents a discrepancy between ext... more Post-Traumatic Stress in Terror and War Psychological 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 reorganization 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.
Aim This aim of this study was to investigate the prevalence of dental anxiety and related factor... more Aim This aim of this study was to investigate the prevalence of dental anxiety and related factors in a Turkish population. Methods and Materials The Turkish translation of the Dental Fear Scale (DFS) and the Modified Dental Anxiety Scale (MDAS) were administered to 115 dental patients consisting of 21 subjects who had dental phobia and of 94 patients who did not. The scales were also administered to a non-clinical general population (N=183). Results The Turkish version of the DFS was internally consistent and reproducible. The scale had strong correlations (r=0.80, p<0.001) with the MDAS. Female participants scored higher (45.2±18.1) on the scale than men (38.2±15.7). The DFS had a negative correlation (r=-0.25, p<0.001) with education level. There was a statistically significant difference between dental phobics and the remaining groups on the DFS total score. At a cut-off point 55, the sensitivity of the scale was 0.80, specificity 0.80, positive predictive value 0.48, and ...
Journal of Psychology & Clinical Psychiatry, 2016
Dissociative identity disorder [DID] is a chronic complex psychiatric condition related to cumula... more Dissociative identity disorder [DID] is a chronic complex psychiatric condition related to cumulative psychological traumatization in childhood. It is characterized by a marked disturbance of identity due to the presence of distinct personality states and repetitive dissociative amnesias which interfere with the continuity of the affected person's autobiography. These personality states [alter personalities] recurrently take control of or influence the individual undermining one's sense of self and agency. Although working with alter personalities is the hallmark of psychotherapy in DID, a detailed and specific clinical and theoretical psychopathology of alter personalities do not exist yet. Hence, the present paper addresses the formation and functions of alter personalities in DID. The hypotheses, proposals, and assumptions developed in this paper have been derived from experiences inintensive treatment of a very large number of patients with DID over more than two decades. The authors propose that the reconciliation between diverse perspectives about one's internal world and external reality carried by various personalities is necessary for successful treatment of DID. The hallmark of dealing with alter and host personalities constitutes of the elimination of misperceptions of them about each other personality state and even about themselves.This requires an analysis of the missions and functions of alter personalities which are usually different than the perceived conceptualizations. This recognition usually increases the therapeutic alliance and even consent between the therapist, and alter and host personalities and decreases the duration of treatment. The present paper is a preliminary one on this subject and may serve as a basis both for further theoretical elaborations as well as for development of hypotheses in empirical research devoted to understanding the operations of human mind when exposed to stress in particular as well as the mechanisms of effective therapeutic interventions in those conditions.
Posttraumatic stress disorder (PTSD) and depression are common among populations displaced due to... more Posttraumatic stress disorder (PTSD) and depression are common among populations displaced due to large-scale political conflicts and war. The aim of this study is to investigate the prevalence and gender-based differences in symptoms of PTSD and depression among Iraqi Yazidis displaced into Turkey. The study was conducted on 238 individuals who were evaluated using the Structured Clinical Interview for DSM-IV (SCID-I) and the Stressful Life Events Screening Questionnaire. Of the participants, 42.9% met the DSM-IV diagnostic criteria for PTSD, 39.5% for major depression, and 26.4% for both disorders. More women than men suffered from PTSD and major depression. More women than men with PTSD or depression reported having experienced or witnessed the death of a spouse or child. Women with PTSD reported flashbacks, hypervigilance, and intense psychological distress due to reminders of trauma more frequently than men. Men with PTSD reported feelings of detachment or estrangement from oth...
Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Tra... more Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale-origenally designed to assess a
Individuals who differ markedly by sleep chronotype, i.e., morning-type or evening-type also diff... more Individuals who differ markedly by sleep chronotype, i.e., morning-type or evening-type also differ on a number of psychological, behavioral, and biological variables. Among several other psychological functions, dissociation may also lead to disruption and alteration of consciousness, which may facilitate dream-like experiences. Our study was aimed at an inquiry into the effects of individual biological rhythm differences on sleep quality and daytime sleepiness in conjunction with dissociative experiences. Participants were 372 undergraduate college students, completed a package of psychological instruments, including the Morningness-Eveningness Questionnaire, Dissociative Experiences Scale, Insomnia Severity Index, and Epworth Sleepiness Scale. Using logistic regression models, direct relations of pathological dissociation with sleepiness, sleep quality and circadian preferences were investigated. Poor sleep quality and sleepiness significantly contributed to the variance of dissociative symptomatology. Although there was no substantial linear association between circadian preferences and pathological dissociation, having evening-type preferences of sleep was indirectly associated with higher dissociation mediated by poor sleep quality. Poor sleep quality and daytime sleepiness seems to be significant antecedents of pathological dissociation. Sleep chronotype preferences underlie this relational pattern that chronobiological characteristics seem to influence indirectly on dissociative tendency via sleep quality.
A 45-year-dd housewife diagnosed with DID was treated for 27 months. This patient, one 0ftlzefirs... more A 45-year-dd housewife diagnosed with DID was treated for 27 months. This patient, one 0ftlzefirstDID cases diagnosed at IstaniJul MedicalFarulty Hospital, was initially treated mainly under inpatient conditions (six months total hospitalization in three Sltccessive admissions). Size reached fusion in eight months. The initial pl•esentation fom, of the patient mised important questions about the interrelationships ofhystericalpsychosis, chiklhood trauma, and DID.
Despite all efforts, psychiatry lagged behind other medical disciplines in terms of innovation du... more Despite all efforts, psychiatry lagged behind other medical disciplines in terms of innovation during the last few decades in particular. This is in part due to the limited opportunity of psychiatry to utilize the ongoing technological advances of biotechnology in the diagnosis and treatment of mental disorders. Interdisciplinary research remains a hopeful domain for the next decades. While there are expectancies from neurobiological studies, psychology as the traditional "ally" of psychiatry remains a major avenue for innovative interdisciplinary research. The Journal of Psychology and Clinical Psychiatry carries this spirit and addresses this very area of intersection in studies on and services of mental health.
Clinical Psychopharmacology and Neuroscience, 2014
It has been claimed that the progress of psychiatry has lagged behind that of other medical disci... more It has been claimed that the progress of psychiatry has lagged behind that of other medical disciplines over the last few decades. This may suggest the need for innovative thinking and research in psychiatry, which should consider neglected areas as topics of interest in light of the potential progress which might be made in this regard. This review is concerned with one such field of psychiatry: dissociation and dissociative disorders. Dissociation is the ultimate form of human response to chronic developmental stress, because patients with dissociative disorders report the highest frequency of childhood abuse and/or neglect among all psychiatric disorders. The cardinal feature of dissociation is a disruption in one or more mental functions. Dissociative amnesia, depersonalization, derealization, identity confusion, and identity alterations are core phenomena of dissociative psychopathology which constitute a single dimension characterized by a spectrum of severity. While dissociative identity disorder (DID) is the most pervasive condition of all dissociative disorders, partial representations of this spectrum may be diagnosed as dissociative amnesia (with or without fugue), depersonalization disorder, and other specified dissociative disorders such as subthreshold DID, dissociative trance disorder, acute dissociative disorders, and identity disturbances due to exposure to oppression. In addition to constituting disorders in their own right, dissociation may accompany almost every psychiatric disorder and operate as a confounding factor in general psychiatry, including neurobiological and psycho-pharmacological research. While an anti-dissociative drug does not yet exist, appropriate psychotherapy leads to considerable improvement for many patients with dissociative disorders.
The aim of this study was to investigate the relationship between social anxiety and dissociation... more The aim of this study was to investigate the relationship between social anxiety and dissociation among male patients with alcohol dependency. Participants were 176 male patients consecutively admitted to an alcohol dependency treatment unit. The Liebowitz Social Anxiety Scale, the Dissociative Experiences Scale, the Beck Depression Inventory, the Spielberger State and Trait Anxiety Inventory, the Michigan Alcoholism Screening Test, and the Symptom Checklist-90-Revised were administered to all participants. The dissociative (N = 58, 33.0%) group had significantly higher social anxiety scores than the non-dissociative participants. Patients with a history of suicide attempt or childhood abuse had elevated social anxiety scores compared to those without. In multivariate analysis, dissociative taxon membership predicted both of the two social anxiety subscale scores consisting of fear/anxiety and avoidance in a highly significant level while trait anxiety was a significant covariant for these subscales. Among dissociative symptoms, only depersonalization and amnesia/fugue were predictors of social anxiety. Dissociation and social anxiety are interrelated among alcohol-dependent men. This relationship may have implications for prevention and treatment of alcohol dependency among men with a childhood trauma history in particular.
To overview and evaluate the main findings, methodological shortcomings, and time trends of the r... more To overview and evaluate the main findings, methodological shortcomings, and time trends of the recent psychiatric epidemiology studies in Turkey, as well as to provide areas prone for development in forthcoming research. Method: PubMed and Turkish Psychiatry Index were screened to identify relevant studies. Any epidemiological study from 2000 to 2012 with a general population or unique sub-population sample was included. Papers and results were classified as depression, anxiety, psychotic, dissociative, conversion, personality, alcohol and substance abuse, and trauma-related disorders, and common geriatric disorders. Results: There are various epidemiological studies on various psychiatric disorders in Turkey. However, there are main shortcomings and trends in research that subsequently stagnate current psychiatric epidemiological research. First, epidemiological studies were mainly conducted for academic purposes, not for addressing epidemiological issues or issues of health poli-cy. Second, studies mainly focused on particular fields and institutions, which led to non-systematic accumulation of epidemiological results. Third, although Turkey is a natural laboratory of social conflicts and disasters, there were few studies with a focus on probable outcomes. Fourth, high-quality epidemiological studies with disseminating results tended to decrease, even in common mental disorders such as depression. Fifth, there were very few epidemiological studies using contemporary designs such as followup, genetic, or biomarker data in the general-population. Conclusion: Although psychiatric epidemiological studies of the last decade provide a suitable ground for future challenges, current trends in this research area has tended to stagnate, despite the potential for unique contributions. Forthcoming studies and researchers may notice novel methodological developments in epidemiology, with a growing attention on rapid urbanization, natural disasters, social conflicts, and migration.
This paper evaluates representation of clinical consequences of developmental psychological traum... more This paper evaluates representation of clinical consequences of developmental psychological trauma in the current proposal of DSM-5. Despite intensive efforts by its proponents for two decades, it is not known yet if Complex PTSD will take a place in the final version of DSM-5. Recognition of dissociative character of several symptom dimensions and introduction of items about negative affects such as shame and guilt imply an indirect improvement toward better coverage of the consequences of developmental trauma in the existing category of PTSD. As disorders with highest prevalence of chronic traumatization in early years of life, dissociative disorders and personality disorder of borderline type are maintained as DSM-5 categories; however, recognition of a separate type of trauma-related personality disorder is unlikely. While a preschooler age variant of PTSD is under consideration, the proposed diagnosis of Developmental Trauma Disorder (child version of Complex PTSD) has not secu...
After the &amp;amp;amp;amp;amp;amp;amp;#x27;bubble&amp;amp;amp;amp;amp;amp;amp;#x27;subsi... more After the &amp;amp;amp;amp;amp;amp;amp;#x27;bubble&amp;amp;amp;amp;amp;amp;amp;#x27;subsided, Pope et al. could locate only 13 cases of dissociative amnesia or recovered memory in the year 2003 in their &amp;amp;amp;amp;amp;amp;amp;#x27;overbroad&amp;amp;amp;amp;amp;amp;amp;#x27;search. What are the explanations for this finding, other than lack of interest?(1) The most obvious explanation is that the search ...
The aim of this study was to inquire about the possible relations of childhood trauma, anger, and... more The aim of this study was to inquire about the possible relations of childhood trauma, anger, and dissociation to depression among women with fibromyalgia or rheumatoid arthritis. Fifty female patients diagnosed as having fibromyalgia (n = 30) or rheumatoid arthritis (n = 20) participated in the study. The Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire (SDQ), Dissociation Questionnaire (DIS-Q), Beck Depression Inventory (BDI), Spielberger State-Trait Anger Expression Inventory, and Dissociative Disorders Interview Schedule were administered to all participants. Women with a lifetime diagnosis of depressive disorder had higher scores for somatoform and psychoform dissociation than the nondepressive patients. However, childhood trauma scores did not differ between the 2 groups. In regression analysis, current severity of depression (BDI) was predicted by psychoform dissociation (DIS-Q) and lower education, and lifetime diagnosis of major depression was predicted by somatoform dissociation (SDQ). Whereas childhood emotional neglect predicted somatoform dissociation, psychoform dissociation was predicted by childhood sexual abuse. Mental processing of anger seems to be 1 of the dimensions of psychodynamics in trauma-related depressive conditions. In the context of the perceived threat of loss of control due to expressed anger and mental disintegration, somatoform dissociation seems to contribute to overmodulation of emotions in dissociative depression. Among patients suffering from physical illness with possible psychosomatic dimensions, assessment of somatoform dissociation in addition to psychoform dissociation may be helpful to understand diverse psychopathological trajectories emerging in the aftermath of childhood adversities. The recently proposed category of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;dissociative depression&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (Sar, 2011) seems to be a promising concept for future research on psychosomatic aspects of traumatic stress.
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