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    Association Between Age of Beginning Primary School and Attention Deficit Hyperactivity Disorder
    (LIPPINCOTT WILLIAMS & WILKINS, 2017) Gokce, Sebla; Yazgan, Yanki; Ayaz, Ayse Burcu; Kayan, Esengul; Yusufoglu, Canan; Bulut, Gresa Carkaxhiu; Genc, Herdem Asian; Dedeoglu, Ceyda; Demirhan, Secil; Sancak, Arzu; Saridogan, Gokce Elif
    Objective: In April 2012, the Turkish national education system was modified, and the compulsory school age of entry (first grade) was redefined as a minimum of 60 months and a maximum of 66 months (replacing the former minimum criterion of 72 months). In this study, we hypothesized that students starting school before 72 months (the previous age standard for the first grade) may experience (1) a greater number of symptoms of attention deficit hyperactivity disorder (ADHD) and (2) lower functioning in social, behavioral, and academic domains. Method: We performed a cross-sectional community-based study in the first and second grades of all primary schools (4356 students) located in the Kadkoy county of Istanbul, Turkey. Teachers completed Swanson, Nolan, and Pelham version IV and Conners' Teacher's report forms for symptoms of ADHD, the Perceived Competence Scale for functioning, and a sociodemographic questionnaire. Results: Among first graders, the group that began primary school before the age of 72 months had a higher ADHD prevalence than both of the groups that began primary school between the ages of 72 to 77 months and 78 to 83 months (p < .001 for both groups). ADHD symptoms diminished and academic, social, and behavioral functioning improved with age for the first and second grade students. Conclusion: The probability of displaying ADHD symptoms (and caseness) is greater among the "earlier" beginners, whereas the "conventional" classmates exhibited better academic, social, and behavioral functioning.
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    Dikkat-eksikliği/hiperaktivite bozukluğu tanısı konan ergenlerde cinsiyet farklılıklarının dürtüsellik üzerine etkisi
    (2017) Ayaz, Muhammed; Gokce, Sebla; Yusufoğlu, Canan; Akın, Elif
    Amaç: Dürtüsellik özellikle dikkat-eksikliği/hiperaktivite bozukluğunun (DEHB) ana belirti kümelerinden biri olarak kabul edilmektedir. Bu çalışmada DEHB tanısı konan ergenlerde cinsiyet farklılıklarının dürtüsellik üzerine etkilerinin araştırılması planlanmıştır. Yöntem: 01.01.2016-01.05.2016 tarihleri arasında Erenköy Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi Çocuk ve Ergen Psikiyatri Polikliniği'nde DEHB tanısı konan 156 ergen (91 erkek, 65 kadın) bu araştırmanın örneklem grubunu oluşturmaktadır. Çalışmaya katılan ergenler Barratt Dürtüsellik Ölçeğini (BIS-11), anne-babalar SNAP DEHB Ölçeğini doldurmuşlardır. Bulgular: Katılımcıların %41.7'sı (s=65) kadın, %58.3'ü (s=91) erkektir. Kızların yaş ortalaması 14.3±1.7 yıl, erkeklerin yaş ortalaması 14.4±1.7 yıldır. BIS11 toplam dürtüsellik ortalama puanı, motor alt test dürtüsellik ortalama puanı ve dikkate bağlı dürtüsellik alt test ortalama puanı kadınlarda erkeklere göre anlamlı oranda daha yüksek bulunmuştur. Çoklu doğrusal regresyon analizinde bağımsız değişken olarak cinsiyet, toplam dürtüsellik, motor dürtüsellik, dikkate bağlı dürtüsellik puanı ile ilişkili bulunmuştur. Sonuç: Bu çalışmada DEHB'li kız ergenlerin BIS-11 ile ölçülen toplam dürtüsellik, motor dürtüsellik ve dikkate bağlı dürtüsellik puanları DEHB'li erkek ergenlere göre daha yüksek bulunmuştur. Önceki çalışmalarda cinsiyet ve dürtüsellik ilişkisi ile ilgili tutarlı sonuçlar bulunmamıştır. Bu çalışma klinik örneklemde kadın cinsiyetinde daha fazla dürtüsellik olduğunu gösteren çalışmaların sonuçlarını desteklemektedir.
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    Disrupted latent decision processes in medication-free pediatric OCD patients
    (ELSEVIER SCIENCE BV, 2017) Erhan, Ceyla; Bulut, Gresa Carkaxhiu; Gokce, Sebla; Ozbas, Duru; Turkakin, Esin; Dursun, Onur Burak; Yazgan, Yanki; Balci, Fuat
    Background: Decision-making in Obsessive Compulsive Disorder has typically been investigated in the adult population. Computational approaches have recently started to get integrated into these studies. However, decision-making research in pediatric OCD populations is scarce. Methods: We investigated latent decision processes in 21 medication-free pediatric OCD patients and 23 healthy control participants. We hypothesized that OCD patients would be more cautious and less efficient in evidence accumulation than controls in a two alternative forced choice (2AFC) task. Results: Pediatric OCD patients were less efficient than controls in accumulating perceptual evidence and showed a tendency to be more cautious. In comparison to post-correct decisions, OCD patients increased decision thresholds after erroneous decisions, whereas healthy controls decreased decision thresholds. These changes were coupled with weaker evidence accumulation after errors in both groups. Limitations: The small sample size limited the power of the study. Conclusions: Our results demonstrate poorer decision-making performance in pediatric OCD patients at the level of latent processes, specifically in terms of evidence accumulation. (C) 2016 Elsevier B.V. All rights reserved.
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    Erken dönem uyumsuz şemaların ergenlik dönemi depresif bozuklukla ilişkisi
    (2017) Gokce, Sebla; Yusufoğlu, Canan; Önal Sönmez, Arzu; Adak, İbrahim; Yulaf, Yasemin
    Amaç: Bu çalışmanın amacı, kliniğe başvuran ergenlerin erken dönem uyumsuz şemalarının depresif bozuklukla ilişkisini araştırmak ve depresif bozukluk tanısı konan ergenlerin erken dönem uyumsuz şemalarını, depresif bozukluk dışında psikiyatrik tanı konan ergenlerin erken dönem uyumsuz şemaları ile karşılaştırmaktır. Yöntem: Ocak-Mayıs 2016 tarihleri arası Erenköy Ruh ve Sinir Hastalıkları Hastanesi Çocuk ve Ergen Psikiyatri Polikli-niği'ne başvuran, Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı Do?rdu?ncu? Baskı (DSM-IV) tanı o?lc?u?tlerine göre depresif bozukluk tanısı konan 80 ergen ve depresif bozukluk dışı psikiyatrik bozukluk tanıları konan 138 ergen çalışmaya alınmıştır. Sosyodemografik form uzmanlar tarafından, çocuk ve ergenler için Erken Dönem Uyumsuz Şema Ölçekler Takımı (ÇEŞÖT) ergenler tarafından doldurulmuştur. Sonuçlar: Çalışmaya alınan 11-18 yaşları arasındaki 218 ergenin (145 kız, 73 erkek) yaş ortalaması 14.8'dir. Depresif bozukluk tanısı konmayan klinik gruba dikkat eksikliği hiperaktivite bozukluğu, anksiyete bozukluğu, obsesif kompulsif bozukluk, davranım bozukluğu, karşıt olma karşı gelme bozukluğu, travma sonrası stres bozukluğu tanıları konmuştur. Kusurluluk/utanma, kuşkuculuk ve kötüye kullanılma, duygusal yoksunluk, terk edilme ve tutarsızlık, başarısızlık, kendini onaylamama, karamsarlık şema puanları depresif bozukluk tanılı ergenlerde kontrol grubuna göre istatistiksel olarak anlamlı düzeyde daha yüksek bulunmuştur. Regresyon analizi ile kusurluluk/utanma, kuşkuculuk/kötüye kullanılma, terk edilme ve tutarsızlık, kendini onaylamama şemaları depresif bozukluk ile ilişkili bulunmuştur. Tartışma: Ergenlik döneminde sıklıkla atlanmakta olan ve tedavi edilmediğinde intihar, madde kullanımı, obezite gibi sağlık sorunlarına yol açan depresif bozukluk, dünya genelinde önemli bir halk sağlığı sorunu olarak görülmektedir. Daha önce yapılan çalışmalarda ve bu çalışmada depresif bozukluk ile ilişkilendirilen şemalar daha çok kopukluk ve reddedilmişlik alanı içinde bulunan, birincil bakım verenleri ile güvenli bağlanma gereksinmesinin giderilmemesi sonucu gelişen şemalardır. Ergenlik dönemi depresif bozukluk tedavisinde depresyon ile ilişkilendirilen uyumsuz şemaların belirlenmesi ve tedavide bu şemalar üzerine odaklanılması önemlidir.
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    Problematic social media use, digital gaming addiction and excessive screen time among Turkish adolescents during remote schooling: implications on mental and academic well-being
    (Marmara Univ, Fac Medicine, 2023) Carkaxhiu Bulut, Gresa; Gokce, Sebla
    Objective: The present study aimed to describe screen use patterns among Turkish adolescents during the coronavirus disease 19 (COVID-19) pandemic with a special emphasis on social media and digital gaming addiction, and explore how these are linked to adolescents' mental and academic well-being.Materials and Method: The study sample consisted of 9th to 12th grade students from three public high-schools in Istanbul, Turkey (n=201). Participants were required to complete a comprehensive questionnaire which gathered information about various domains including problematic screen use, attitudes towards online education, and mental/academic well-being during the lockdown period.Results: The overall screen time exhibited a significant increase during the lockdown, with the most common discretionary screen activities being social media use, communication, and watching movies/series (p<0.001). The students spent significantly less time on physical activities (p=0.003) and face-to-face meetings with their friends (p<0.001). Male students presented with higher scores on gaming addiction (p<0.001), whereas a significantly higher proportion of the female students (28.57% vs. 14.81%) were classified as atrisk for social media addiction (p=0.046). Both gaming addiction and social media addiction were associated with higher depression scores (p=0.003 and p<0.001 respectively).Conclusion: Screen use patterns may have diverse consequences for youth's well-being during the pandemic. The addiction risk and other detrimental outcomes are likely to be associated with the qualitative features of screen activities, rather than just the amount of time spent on digital media by the adolescents.
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    Relation between early maladaptive schemas of adolescents and depressive disorder
    (CUMHURIYET UNIV TIP FAK PSIKIYATRI ANABILIM DALI, 2017) Gokce, Sebla; Onal Sonmez, Arzu; Yusufoglu, Canan; Yulaf, Yasemin; Adak, Ibrahim
    Objective: The aim of this study is to investigate relation between depressive disorder and early maladaptive schemas of adolescents and to compare early maladaptive schemas of adolescents diagnosed with depressive disorder with schemas of adolescents diagnosed with other psychiatric disorders. Methods: Eighty adolescents with depressive disorder and 138 adolescents with other psychiatric disorders who had been diagnosed through Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) between January and May 2016 in Erenkoy research and training hospital for psychiatry and neurology child and adolescent outpatient clinic were enrolled in this study. The sociodemographic form of the patients was filled out by the clinicians. The Early Maladaptive Schema Questionnaires Set for Children and Adolescents was filled out by adolescents. Results: There were 145 females and 73 males in the study. The mean age of the adolescents was 14.8 (range: 11-18) years. The control group was consisted of attention deficit hyperactivity disorder, anxiety disorders, obsessive compulsive disorder, conduct disorder, oppositional defiant disorder and post-traumatic stress disorder. Defectiveness/shame, mistrust/abuse, emotional deprivation, abandonment/instability, failure, non-self-approval, negativity/pessimism schema scores were significantly greater in adolescents diagnosed with depressive disorder than the control group. There was a statistically significant relation between the schemas of defectiveness/shame, mistrust/abuse, abandonment/instability, non-self-approval and depressive disorder in regression analysis. Discussion: Adolescent depressive disorder, frequently a missed diagnosis that when not treated can lead to health problems such as suicide, drug abuse and obesity, is accepted as an important public health issue. Consistent with literature, schemas under the title of disconnection and rejection and other directedness are related with the depressive disorder in adolescence and associated with the relationship of the primary caregivers and the children. Revealing maladaptive schemas and focusing on these schemas is important in adolescence depressive disorder treatment.
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    Towards a definitive symptom structure of obsessive-compulsive disorder: a factor and network analysis of 87 distinct symptoms in 1366 individuals
    (Cambridge Univ Press, 2022) Cervin, Matti; Miguel, Euripedes C.; Güler, Ayşegül Selcen; Ferrao, Ygor A.; Erdogdu, Ayşe Burcu; Lazaro, Luisa; Gokce, Sebla
    Background The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques. Methods A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM). Results Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables. Conclusions Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD.