Measuring dysfunctional grief due to a COVID-19 loss: A Turkish validation study of the Pandemic Grief Scale.

The global death toll to date of the COVID-19 pandemic has been enormous, and millions of people are grieving these losses. The aim of the current study is to validate a Turkish version of the Pandemic Grief Scale (PGS), which is a brief English-language mental health screener to identify probable cases of dysfunctional grief associated with a COVID-19 death. Participants were assessed using the PGS, Patient Health Questionnaire-4 (PHQ-4) and Work and Social Adjustment Scale (WSAS). We surveyed 758 Turkish native speakers who participated online. Confirmatory factor analysis showed that the factor structure of the PGS was satisfactory. The scale was internally consistent with a Cronbach's alpha of 0.77 and a composite reliability of 0.90. The PGS demonstrated construct validity with strong correlations with suicidal ideation and substance use coping. Positive correlations of the PGS with the PHQ-4 and the WSAS demonstrated adequate convergent validity. The PGS discriminates well between persons with and without dysfunctional grief using an optimized cut score of ≥ 3 (89% sensitivity and 72% specificity). The PGS also demonstrates incremental validity by explaining most of the variance (43%) in functional impairment due to a COVID-19 loss beyond measures of depression and generalized anxiety. These findings closely replicate the original validation study on the PGS in English and suggest that the current Turkish version of the PGS is a valid and reliable measure to assess the severity of dysfunctional grief associated with a COVID-19 death.

Measuring anxiety related to COVID-19: A Turkish validation study of the Coronavirus Anxiety Scale.

The aim of the current study is to validate the Turkish version of the Coronavirus Anxiety Scale (CAS). Participants were assessed across the CAS, Obsession with COVID-19 Scale (OCS) and Fear of COVID-19 Scale. We surveyed 1023 Turkish native speakers who participated online. Confirmatory factor analysis showed that the factor structure of the CAS was satisfactory. The scale was internally consistent with a Cronbach's alpha of 0.80. Positive correlations of the CAS with the OCS and the Fear of COVID-19 Scale demonstrated adequate convergent validity. These findings suggest that the CAS is a valid and reliable measure to assess the severity of dysfunctional coronavirus related anxiety.

Relationships of Internet addiction and Internet gaming disorder symptom severities with probable attention deficit/hyperactivity disorder, aggression and negative affect among university students.

The aim of the present study was to evaluate relationships of Internet addiction (IA) and Internet gaming disorder (IGD) symptom severities with probable attention deficit/hyperactivity disorder (ADHD) and aggression among university students, while controlling the effects of anxiety and depressive symptoms. The study was conducted with online survey among 1509 volunteered university students in Ankara who regularly use the Internet, among whom we conducted analyses related with IA. Among these students, 987 of them, who play video games, were included in the analyses related with IGD. Correlation analyses revealed that the severities of the scale scores were mildly correlated with each other both among students who regularly use the Internet and students who play video games. Probable ADHD was associated with the severity of IA symptoms, together with depression and aggression, particularly physical aggression and hostility, in ANCOVA analyses. Similarly probable ADHD was also associated with the severity of IGD symptoms, together with depression and aggression, particularly physical aggression, anger and hostility, in ANCOVA analyses. These findings suggest that the presence of probable ADHD is related with both severity of IA and IGD symptoms, together with aggression and depression.

The impact of depression, anxiety, neuroticism, and severity of Internet addiction symptoms on the relationship between probable ADHD and severity of insomnia among young adults.

The aim of the present study was to evaluate the impact of depression, anxiety, neuroticism, and severity of Internet addiction symptoms (IAS) on the relationship between probable attention deficit/hyperactivity disorder (ADHD) and severity of insomnia among young adults. The study was conducted with online survey among 1010 volunteered university students in Ankara, people who are in the e-mail database of a company located in Istanbul that organizes e-sports tournaments and Turkish gamers from gaming forums. Scale scores were higher among the group with high probability of insomnia (n = 200, 19.8%). Also risk of high probability of insomnia was 2.7 times higher among those with probable ADHD. In linear regression analysis, both inattentiveness and hyperactivity/impulsivity dimensions of ADHD were related with the severity of insomnia, together with severities of anxiety, depression, neuroticism and IAS. Similarly, presence of probable ADHD was related with the severity of insomnia in ANCOVA, together with severities of anxiety, depression, neuroticism and IAS. These findings suggest that the presence of probable ADHD and the severity of ADHD symptoms are related with the severity of insomnia, even after controlling the depression, anxiety, neuroticism and IAS, which are all related with the severity of insomnia, among young adults.

The Relationship of Posttraumatic Stress Disorder with Childhood Traumas, Personality Characteristics, Depression and Anxiety Symptoms in Patients with Diagnosis of Mixed Anxiety-Depression Disorder.

BACKGROUND: The purpose of the current study is to investigate the relationship of symptoms of Posttraumatic Stress Disorder (PTSD) to childhood trauma and personality characteristics among patients with the diagnosis of mixed anxiety-depression disorder. SUBJECTS AND METHODS: A total of 130 patients who were admitted to the psychiatry outpatient and were diagnosed with mixed anxiety-depression disorder were conveniently sampled in the current study. In order for the researchers to complete the assessment, the patients with a history of at least one traumatic experience (40.8%, n=53) were asked to complete a socio-demographic form, the Beck Anxiety Inventory and Beck Depression Inventory, the Childhood Trauma Questionnaire-Short Form, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Eysenck Personality Questionnaire Revised/Abbreviated Form. RESULTS: One hundred thirty patients participated in the current study. In the study, 40.8 % of the patients (n=53) reported that they had been exposed to at least one traumatic event during their lifetime. Patients with a history of at least one traumatic experience (40.8%, n=53) were separated into two groups: those with a diagnosis of PTSD (n=21) (39.6%) and those without PTSD (n=32) (60.4%) (cut off score is 50 and above). The mean comparisons concluded that the group with PTSD and the group without PTSD were significantly different from each other in terms of depression and anxiety symptom severity, neuroticism, and history of physical abuse and neglect. Spearman's correlation analysis revealed that PTSD severity was significantly and positively correlated with neuroticism, and with depression and anxiety symptom severity, as the scores were significantly and negatively correlated with extraversion. The two-step logistic analysis first revealed the severity of the depression symptom, and secondly, physical abuse significantly predicted PTSD in the PTSD group. CONCLUSIONS: In patients with anxiety and/or depressive disorder, PTSD is one of the most frequently-observed comorbid psychiatric disorders. The current study revealed that a history of childhood trauma, neuroticism, and introversion can be considered risk factors for PTSD among patients with mixed anxiety-depression disorder in adulthood. Therefore, it should be taken into consideration that those neurotic and introverted patients with childhood trauma history could be more at risk for PTSD.

Relationship of internet addiction severity with probable ADHD and difficulties in emotion regulation among young adults.

The aim of the present study was to evaluate relationship of Internet addiction (IA) symptom severity with probable attention deficit/hyperactivity disorder (ADHD) and difficulties in emotion regulation, while controlling the effects of depression, anxiety and neuroticism. The study was conducted with online survey among 1010 volunteered participants of university students and/or amateur or professional gamers. Scale scores were higher among the group with high probability of ADHD (n = 190, 18.8%). In linear regression analysis, both Inattentiveness and hyperactivity/impulsivity dimensions of ADHD were related with the severity of IA symptoms, together with depression and non-accept dimension of the Difficulties in Emotion Regulation Scale (DERS). Similarly, presence of probable ADHD was related with the severity of IA symptoms in ANCOVA, together with depression, neuroticism and non-accept dimension of DERS. Participants were two different groups of non-clinical samples and all scales were self-rated. Also common comorbidities were not screened. Finally, since this study is cross-sectional the findings of this study cannot address the causal relationships among the primary constructs of interest. These findings suggest that the presence of probable ADHD is related with the severity of IA symptoms, together with the difficulties in emotion regulation, particularly non-accept dimension, depression and neuroticism among young adults.

Psychometric validation of the Turkish nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF).

The main aims of the current study were to test the factor structure, reliability and validity of the nine-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF), a standardized measure to assess symptoms and prevalence of Internet Gaming Disorder (IGD). In the present study participants were assessed with the IGDS9-SF, nine-item Internet Gaming Disorder Scale (IGDS) and the Young's Internet Addiction Test-Short Form (YIAT-SF). Confirmatory factor analyzes demonstrated that the factor structure (i.e., the dimensional structure) of the IGDS9-SF was satisfactory. The scale was also reliable (i.e., internally consistent with a Cronbach's alpha of 0.89) and showed adequate convergent and criterion-related validity, as indicated by statistically significant positive correlations between average time daily spent playing games during last year, IGDS and YIAT-SF scores. By applying the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) threshold for diagnosing IGD (e.g., endorsing at least five criteria), it was found that the prevalence of disordered gamers ranged from 0.96% (whole sample) to 2.57% (e-sports players). These findings support the Turkish version of the IGDS9-SF as a valid and reliable tool for determining the extent of IGD-related problems among young adults and for the purposes of early IGD diagnosis in clinical settings and similar research.

The relationship of social anxiety disorder symptoms with probable attention deficit hyperactivity disorder in Turkish university students; impact of negative affect and personality traits of neuroticism and extraversion.

The aim of the present study was to evaluate relationship of social anxiety disorder symptoms with probable attention deficit hyperactivity disorder (ADHD) while controlling the personality traits of neuroticism and extraversion, anxiety and depression symptoms in a sample of Turkish university students (n=455). Participants were evaluated with the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Eysenck Personality Questionnaire Revised-Abbreviated Form (EPQR-A), the Adult ADHD Self-Report Scale (ASRS-v1.1) and the Liebowitz Social Anxiety Scale (LSAS). Severity of social anxiety, depression, anxiety and neuroticism were higher among those with probable ADHD, whereas extraversion score did not differ between the groups. The severity of ADHD score, particularly hyperactivity/impulsivity score, was related with the "fear or anxiety" together with low extraversion (introversion) and high neuroticism dimensions of personality, whereas the severity of ADHD score, both inatentiveness and hyperactivity/impulsivity scores, was related with "avoidence" together with low extraversion (introversion) dimension of personality. These findings suggest that probable ADHD and severity of ADHD symptoms are related with both "fear or anxiety" and "avoidance" of social anxiety, while personality dimensions of low extraversion (introversion) and high neuroticism may have an effect on this relationships among young adults.

The impact of sensation seeking on the relationship between attention deficit/hyperactivity symptoms and severity of Internet addiction risk.

The aim of this study was to investigate the relationship of attention deficit/hyperactivity symptoms (ADHS) with severity of Internet addiction risk (SIAR), while controlling the effects of variables such as depression, anxiety, anger, sensation seeking and lack of assertiveness among university students. Cross-sectional online self-report survey was conducted in two universities among a representative sample of 582 Turkish university students. The students were assessed through the Addiction Profile Index Internet Addiction Form Screening Version (BAPINT-SV), the Psychological Screening Test for Adolescents (PSTA) and the Adult Attention deficit/hyperactivity disorder Self-Report Scale (ASRS). The participants were classified into the two groups as those with high risk of Internet addiction (HRIA) (11%) and those with low risk of Internet addiction (IA) (89%). The mean age was lower in the group with HRIA, whereas depression, anxiety, sensation seeking, anger, lack of assertiveness and ADHS scores were higher in this group. Lastly, a hierarchical regression analysis suggested that severity of sensation seeking and ADHS, particularly attention deficiency, predicted SIAR. The severity of sensation seeking and ADHS, particularly attention deficit symptoms, are important for SIAR. Awareness of sensation seeking among those with high ADHS may be important in prevention and management of IA among university students.

The impact of childhood traumas, depressive and anxiety symptoms on the relationship between borderline personality features and symptoms of adult attention deficit hyperactivity disorder in Turkish university students.

BACKGROUND: Previous studies reported that there is a significant association between attention deficit hyperactivity disorder (ADHD) in childhood and borderline personality disorder (BPD) in adulthood. AIM: The aim of this study is to investigate the relationship of borderline personality features (BPF) and ADHD symptoms while controlling the effect of childhood traumas, symptoms of depression and anxiety in adulthood on this relationship in Turkish university students. METHODS: A total of 271 Turkish university students participated in this study. The students were assessed through the Turkish version of the Borderline Personality Inventory (BPI), the Adult ADHD Self-Report Scale (ASRS), the Childhood Trauma Questionnaire (CTQ-28), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). RESULTS: Correlation analyses have revealed that severity of BPF is related with adult ADHD symptoms, emotional, physical abuse and depression scores. Hierarchical regression analysis has indicated that depressive symptoms, emotional and physical abuse and the severity of ADHD symptoms are the predictors for severity of BPF. CONCLUSIONS: Findings of the present study suggests that clinicians must carefully evaluate these variables and the relationship between them to understand BPF and ADHD symptoms in university students better. Together with depressive symptoms, emotional and physical abuse may play a mediator role on this relationship. Further studies are needed to evaluate causal relationship between these variables in both clinical and non-clinical populations.

High risk of Internet addiction and its relationship with lifetime substance use, psychological and behavioral problems among 10(th) grade adolescents.

BACKGROUND: The aim of this study was to investigate the relationship of higher risk of Internet addiction (HRIA) with lifetime substance use, psychological and behavioral factors among Turkish 10(th) grade students. SUBJECTS AND METHODS: Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul, Turkey. A representative sample of 4957 10(th) grade students was studied between October 2012 and December 2012. Other than sociodemographic variables the survey included the Addiction Profile Index Internet Addiction Form-Screening Version (BAPINT-SV) and the Psychological Screening Test for Adolescents (PSTA). RESULTS: The participants were classified into two groups as those with HRIA (15.96%) and those with lower risk of Internet addiction. The rate of HRIA was higher in the males. The findings indicated that HRIA is related with negative consequences in school, lifetime use of tobacco, alcohol and/or drug, suicidal thoughts, self-harming and delinquent behaviors. CONCLUSIONS: Male gender, lifetime use of tobacco, alcohol and/or drug, depression, attention deficit and hyperactivity symptoms and lack of assertiveness predicted the HRIA in Turkish 10(th) grade students. Being aware of those with HRIA is important in prevention and management of Internet addiction as well as other important problems among students, such as substance use.

The severity of attention deficit hyperactivity symptoms and its relationship with lifetime substance use and psychological variables among 10th grade students in Istanbul.

AIM: The aim of this study was to determine the severity of attention deficit hyperactivity symptoms (ADHS) and related psychological and behavioral variables among 10th grade students in Istanbul/Turkey. METHODS: Cross-sectional online self-report survey conducted in 45 schools in 15 districts Istanbul. The questionnaire included sections about demographic data and use of substances including tobacco, alcohol and drugs. Also ADHS, depression, anxiety, anger and sensation seeking subscales of Psychological Screening Test for Adolescents (PSTA) were used. The analyses were conducted based on the 4938 subjects. RESULTS: Mean ADHS score was higher in females and among those with a lifetime use of tobacco, alcohol and drug, and having self-harming behavior and suicidal thoughts. ADHS score was correlated with depression, anxiety, anger and sensation seeking scores. In univariate covariance analysis (ANCOVA); depression, anxiety, anger, sensation seeking, lifetime alcohol use and suicidal thoughts predicted the severity of ADHS. CONCLUSIONS: The findings suggest that, since ADHS is associated with depression, anxiety, anger, sensation seeking, lifetime alcohol use and suicidal thoughts among 10th grade students, clinicians should screen suicidality and comorbid psychiatric symptoms routinely in adolescents with ADHS.

The severity of Internet addiction risk and its relationship with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students.

The aim of this study was to investigate the relationship of Internet addiction (IA) risk with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students. A total of 271 Turkish university students participated in this study. The students were assessed through the Internet Addiction Scale (IAS), the Borderline Personality Inventory (BPI), the Dissociative Experiences Scale (DES), the Childhood Trauma Questionnaire (CTQ-28), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The rates of students were 19.9% (n=54) in the high IA risk group, 38.7% (n=105) in the mild IA risk group and 41.3% (n=112) in the group without IA risk. Correlation analyses revealed that the severity of IA risk was related with BPI, DES, emotional abuse, CTQ-28, depression and anxiety scores. Univariate covariance analysis (ANCOVA) indicated that the severity of borderline personality features, emotional abuse, depression and anxiety symptoms were the predictors of IAS score, while gender had no effect on IAS score. Among childhood trauma types, emotional abuse seems to be the main predictor of IA risk severity. Borderline personality features predicted the severity of IA risk together with emotional abuse, depression and anxiety symptoms among Turkish university students.

The relationship of Internet addiction severity with Attention Deficit Hyperactivity Disorder symptoms in Turkish University students; impact of personality traits, depression and anxiety.

AIM: The aim of this study was to investigate the relationship of Internet addiction (IA) with Attention Deficit Hyperactivity Disorder (ADHD) symptoms while controlling the effect of personality traits, depression and anxiety symptoms in Turkish university students. METHODS: A total of 271 university students participated in the present study. The students were assessed through the Internet Addiction Scale (IAS), the Wender Utah Rating Short Scale (WURS-25), the Turkish version of the Adult ADHD Self-Report Scale (ASRS), the Eysenck Personality Questionnaire Revised Abbreviated Form (EPQR-A), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). RESULTS: According to IAS, participants were separated into three groups, namely, moderate/high, mild and without IA groups. The rates of groups were 19.9% (n=54), 38.7% (n=105) and 41.3% (n=112), respectively. Correlation analyses revealed that the severity of IAS is positively correlated with WURS-25, ASRS (total, inattention and hyperactivity/impulsivity subscales), neuroticism personality trait, depression and anxiety scores, whereas it is negatively correlated with extraversion personality trait. Hierarchical regression analysis indicated that depression and anxiety symptoms, introversion and neuroticism personality traits and the severity of ADHD symptoms (particularly hyperactivity/impulsivity symptoms) are the predictors for IAS score, respectively. CONCLUSIONS: The severity of ADHD symptoms has predicted the severity of IA even after controlling the effect of personality traits, depression and anxiety symptoms among Turkish university students. University students with severe ADHD symptoms, particularly hyperactivity/impulsivity symptoms may be considered as a risk group for IA.

Relationship of Internet addiction with impulsivity and severity of psychopathology among Turkish university students.

The previous studies have found a relationship between IA and both impulsivity and psychopathology when they were considered separately. The aim of this study was to investigate the relationship of Internet addiction (IA) with impulsivity and severity of psychopathology among Turkish university students. We also wanted to control the effect of impulsivity dimensions on the relationship between IA and psychopathology. A total of 319 university students from two universities in Ankara participated to the study. Students were assessed through the Internet Addiction Scale (IAS), the Symptom Checklist-Revised (SCL-90-R) and the Barratt Impulsiveness Scale-11 (BIS-11). Correlational analyses revealed that severity of IA was related to both SCL-90-R and BIS-11 scores. Among SCL-90-R subscales, severity of obsessive-compulsive symptoms (OCS) was the only predictor for IAS score. Hierarchical regression analysis indicated that interpersonal sensitivity, additional to attentional and motor impulsiveness, was the predictor of IAS score. Although severity of IA is associated with wide range of psychopathology, particularly OCS, interpersonal sensitivity seems to be the main dimension that predict severity of IAS additional to impulsiveness (attentional and motor). Impulsivity seems to be an important construct when considering IA and its treatment among Turkish university students.

Relationship of internet addiction severity with depression, anxiety, and alexithymia, temperament and character in university students.

The aim of the study was to investigate the relationship of Internet addiction (IA) severity with alexithymia, temperament, and character dimensions of personality in university students while controlling for the effect of depression and anxiety. A total of 319 university students from two conservative universities in Ankara volunteered for the study. Students were investigated using the Toronto Alexithymia Scale-20, the Temperament and Character Inventory, the Internet Addiction Scale, the Beck Anxiety Inventory, and the Beck Depression Inventory. Of the university students enrolled in the study, 12.2 percent (n=39) were categorized into the moderate/high IA group (IA 7.2 percent, high risk 5.0 percent), 25.7 percent (n=82) were categorized into the mild IA group, and 62.1 percent (n=198) were categorized into the group without IA. Results revealed that the rate of moderate/high IA group membership was higher in men (20.0 percent) than women (9.4 percent). Alexithymia, depression, anxiety, and novelty seeking (NS) scores were higher; whereas self-directedness (SD) and cooperativeness (C) scores were lower in the moderate/high IA group. The severity of IA was positively correlated with alexithymia, whereas it was negatively correlated with SD. The "difficulty in identifying feelings" and "difficulty in describing feelings" factors of alexithymia, the low C and high NS dimensions of personality were associated with the severity of IA. The direction of this relationship between alexithymia and IA, and the factors that may mediate this relationship are unclear. Nevertheless, university students exhibiting high alexithymia and NS scores, along with low character scores (SD and C) should be closely monitored for IA.

Alexithymia and personality in relation to social anxiety among university students.

The aims of the present study were to investigate the relationship of social anxiety symptoms with alexithymia and personality dimensions in university students and to control the effects of depression and anxiety on this relationship. A total of 319 university students (85 males and 234 females) from two different universities in Ankara were investigated with the Liebowitz Social Anxiety Scale (LSAS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Toronto Alexithymia Scale (TAS-20) and the Temperament and Character Inventory (TCI). We found that subscales of the LSAS (fear or anxiety and avoidance) were positively correlated with depression and alexithymia and "difficulty in identifying feelings" (DIF) and "difficulty in describing feelings" (DDF) subscales of the TAS-20. Harm avoidance (HA) showed positive correlations with subscales of the LSAS, whereas self-directedness (SD) showed negative correlations with these subscales. High TAS-20 DDFand HA and low SD predicted fear or anxiety LSAS subscale scores, whereas high TAS-20 DDF, HA and depression scores were predictors for LSAS avoidance subscale scores. Although our sample is not representative of the whole Turkish university student population, we conclude that both fear or anxiety and avoidance were mainly interrelated with DDF and HA, although the causal relationship is not clear.

Relationship of relapse with impulsivity, novelty seeking and craving in male alcohol-dependent inpatients.

INTRODUCTION AND AIMS: Aim of this study was to evaluate the relationship of relapse with impulsivity, novelty seeking (NS) and craving during 12 month follow up after inpatient treatment in male alcohol dependents. DESIGN AND METHODS: Among 156 consecutively admitted male alcohol dependents, 102 were examined by face to face interview 12 months after discharge from hospital. Patients were investigated with the Barratt Impulsiveness Scale, version 11 (BIS-11), the NS dimension of the Temperament and Character Inventory, the Penn Alcohol Craving Scale (PACS) and Michigan Alcoholism Screening Test at the end of 12 months. RESULTS: Among 102 alcohol-dependent inpatients 61.8% (n = 63) were considered as relapsed to alcohol use during 12 month follow up. Sociodemographic variables did not differ between relapsed and non-relapsed groups. Mean scores of BIS-11 and NS and subscales of these scales were higher in relapsed group than non-relapsed group. BIS-11 and NS and their subscales were positively correlated with each other. PACS was also positively correlated with these scales and their subscales. Only exception was 'exploratory excitability' (NS1) subscale of NS, which did not differ between groups and did not correlate with PACS or BIS-11. Extravagance (NS3) and BIS-11 non-planning impulsiveness (NPI) scores were associated with craving in Stepwise Linear Regression model. Only NS3 showed an association with relapse in the first Forward Wald logistic regression model. When severity of craving was included in the second model, as an independent variable, it was also associated with relapse additional to NS3. DISCUSSION AND CONCLUSIONS: Both impulsivity and NS seem to be related with craving and relapse. Particularly, NS3 may be related with relapse both directly and indirectly via craving, whereas NPI may be related with relapse only indirectly via craving. Thus severity of craving may be a final pathway to relapse in these relationships of NS3 and NPI with relapse. These findings suggest that impulsivity, NS and craving are important variables to predict outcome and also for the treatment plan.

Self-mutilative behaviours in male alcohol-dependent inpatients and relationship with posttraumatic stress disorder.

The aim of this study was to investigate the relationship between self-mutilation (SM) and posttraumatic stress disorder (PTSD) in male alcohol-dependent inpatients, and to examine whether there is something unique about self-mutilaters with the PTSD/alcohol-dependence co-morbidity, compared with self-mutilaters without PTSD in this population. Participants were 156 consecutively admitted male alcohol-dependent inpatients. Patients were investigated with the Self-mutilative Behaviour Questionnaire (SMBQ), the Traumatic Experiences Checklist (TEC), the Clinician Administered PTSD Scale (CAPS), the Symptom Checklist-Revised (SCL-90-R) and the Michigan Alcoholism Screening Test (MAST). Among alcohol-dependent inpatients, 34.0% (n=53) were considered as group with SM. Rate of being unemployed, history of any trauma, history of suicide attempt and lifetime PTSD diagnosis were higher, whereas being married, current age, age at onset of regular alcohol use and duration of education were lower in the group with SM. Mean scores of SCL-90 subscales, TEC and MAST were higher in the SM group. Although SM might be related with PTSD among male alcohol-dependent inpatients, predictors of SM were age at onset of regular alcohol use, history of suicide attempt, anxiety, depression and hostility. Age at onset of regular alcohol use, history of suicide attempt, anxiety, depression and somatisation predicted SM in the subgroup of patients without PTSD, whereas hostility predicted SM alone in the subgroup of patients with PTSD. Results support the anti-suicide and the affect-regulation models of SM in the non-PTSD group, whereas they support the hostility model of SM in the subgroup with PTSD in alcohol-dependent inpatients. Thus, to reduce self-mutilative behaviour (SMB)among alcohol-dependent patients, clinicians must address different subjects in different subgroup patients; that is, focussing hostility in those with PTSD co-morbidity.

Lifetime PTSD and quality of life among alcohol-dependent men: impact of childhood emotional abuse and dissociation.

The aim of this study was to investigate the impact of lifetime posttraumatic stress disorder (PTSD), dissociation and a history of childhood trauma on quality of life (QoL) among men with alcohol dependency. A consecutive series of alcohol-dependent men (N=156) admitted to an inpatient treatment unit were screened using the Michigan Alcoholism Screening Test, the Clinician Administered PTSD Scale, the Dissociative Experiences Scale, and the Childhood Trauma Questionnaire. QoL was assessed using the Medical Outcomes Study Short-Form 36-item health survey. Fifty (32.1%) patients had lifetime diagnosis of PTSD. Besides problems related to severity of alcohol use, the lifetime PTSD group was impaired on several physical and mental components of QoL. While the lifetime PTSD group and remaining patients did not differ on reports of childhood trauma and dissociation, in lifetime PTSD group, dissociative patients had higher scores of childhood emotional abuse than those of the non-dissociative patients. In multivariate covariance analysis, both dissociation and lifetime PTSD predicted impairment in physical functioning, general health, vitality, and mental health components of QoL. Among alcohol-dependent men with lifetime PTSD, a history of childhood emotional abuse contributes to impairment of QoL through its relationship with dissociation.