Is there a complex relation between social anxiety disorder, childhood traumatic experiences and dissociation?

BACKGROUND: A possible relationship has been suggested between social anxiety and dissociation. Traumatic experiences, especially childhood abuse, play an important role in the aetiology of dissociation. AIM: This study assesses childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with social anxiety disorder (SAD). METHOD: The 94 psychotropic drug-naive patients participating in the study had to meet DSM-IV criteria for SAD. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), the Dissociation Questionnaire (DIS-Q), the Liebowitz Social Anxiety Scale (LSAS), and the Childhood Trauma Questionnaire (CTQ). Patients were divided into two groups using the DIS-Q, and the two groups were compared. RESULTS: The evaluation found evidence of at least one dissociative disorder in 31.91% of participating patients. The most prevalent disorders were dissociative disorder not otherwise specified (DDNOS), dissociative amnesia, and depersonalization disorders. Average scores on LSAS and fear and avoidance sub-scale averages were significantly higher among the high DIS-Q group (p < .05). In a logistic regression taking average LSAS scores as the dependent variable, the five independent variables DIS-Q, CTQ-53 total score, emotional abuse, sexual abuse, and emotional neglect were associated with average LSAS scores among patients with SAD (p < .05). CONCLUSIONS: It is concluded that, on detecting SAD symptoms during hospitalization, the clinician should not neglect underlying dissociative processes and traumatic experiences among these patients.

[Psychometric Properties of the Metacognition Scales about Rumination in Clinical and Non-clinical Turkish Samples]. / Ruminasyonla Ilgili Üstbilis Ölçeklerinin Klinik ve Klinik Olmayan Türk Örneklemlerindeki Psikometrik Özellikleri.

AIM: The aim of this study is to examine the reliability and validity of the Turkish adaptations of the Positive Beliefs about Rumination Scale (PBRS) and the Negative Beliefs about Rumination Scale (NBRS) in clinical and non-clinical samples. METHOD: While the non-clinical sample of the study consisted of 455 participants, the clinical sample was composed of 60 major depressive disorder (MDD), 30 panic disorder (PD) and 30 social anxiety disorder (SAD) cases. RESULTS: The results of the factor analyses confirm the construct validity and original factor structure of the scales. Findings obtained from internal consistency and test-retest analyses indicated good reliability for the scales. Supporting the convergent validity of the scales, the correlations between metacognitions about rumination and depressive symptoms, rumination, metacognitions about worry, pathological worry, and anxiety symptoms were found to be positive and significant in the non-clinical sample. Hierarchical regression analyses demonstrated that both scales have predictive validity for depressive symptoms after controlling for anxiety symptoms. As for extreme group comparisons, it supported the criterion-related validity of the scales. In discriminant clinical validity examinations, although both scales were able to differentiate MDD, PD, and SAD groups from healthy controls, they were unable to differentiate the depressive group from the other anxiety disorder groups. CONCLUSION: A comprehensive psychometric evaluation of the scales demonstrated that both PBRS and NBRS are reliable and valid assessment devices that can be used for research purposes both in clinical and non-clinical groups in Turkey.

Depression, loneliness, anger behaviours and interpersonal relationship styles in male patients admitted to internet addiction outpatient clinic in Turkey.

BACKGROUND: 'Internet addiction' is excessive computer use that interferes with daily life of a person. We designed this study in order to evaluate the predictor effect of depression, loneliness, anger and interpersonal relationship styles for internet addiction as well as develop a model. SUBJECTS AND METHODS: Forty (40) male internet addicted patients were selected from our hospital's internet Addiction Outpatient Clinic. During the study, the Internet Addiction Test (IAT), the Beck Depression Inventory (BDI), the State Trait Anger Expression Scale (STAXI), the UCLA-Loneliness Scale (UCLA-LS), and the Interpersonal Relationship Styles Scale (IRSS) were used for the evaluation of the patients. RESULTS: The results of this study showed that the 'duration of internet use' (B=2.353, p=0.01) and STAXI 'anger in' subscale (B=1.487, p=0.01) were the predictors of internet addiction. CONCLUSION: When the clinicians suspect for the internet overuse, regulation of internet usage might be helpful. Psychiatric treatments for expressing anger and therapies that focus on validation of the feelings may be useful.

Attachment and family functioning in patients with internet addiction.

OBJECTIVE: Although the Internet is used effectively in many areas of life, some users experience problems because of over-use due to a lack of control. The diagnostic criteria for Internet addiction include disruptions in family relationships, but adequate data on the attachment styles and family functioning associated with this condition are limited. This study aimed to investigate the attachment styles and family functioning of patients with Internet addiction. METHOD: The sample included 30 male patients consecutively admitted to the Bakirköy Mental Health and Research Hospital Internet Addiction Outpatient Clinic, who were diagnosed in clinical interviews as having Internet addiction according to Young's (1998) criteria. Thirty healthy males who were matched with the experimental group in terms of sociodemographic characteristics were included as control subjects. Both groups provided sociodemographic data and completed the Beck Depression Inventory (BDI), the Experiences in Close Relationships Questionnaire-r (ECR-r) and the Family Assessment Device (FAD). RESULTS: Patients with Internet addiction had higher BDI scores (P<.001) and higher attachment anxiety subscores on ECR-r (P<.001) compared with those in the control group. Patients with Internet addiction evaluated their family functioning as more negative and reported problems in every aspect addressed by the FAD. Scores on the FAD behaviour control, affective responsiveness, and problem-solving subscales (P<.05) and on the FAD communication, roles, and general functioning subscales (P<.001) were significantly higher in the patient compared with the control group. CONCLUSION: Patients with Internet addiction have more anxious attachment styles as well as prominent disruptions in family functioning. Thus, it may be important to evaluate the attachment styles and family functioning of patients with Internet addiction. Indeed, comprehensive treatment approaches including other family members may make important contributions to treatment success.

Coping Strategies in Patients Who Had Suicide Attempts.

INTRODUCTION: The aim of this study was to investigate coping strategies suggested to be a determinant of suicide attempt and to compare them with coping strategies of healthy volunteers. METHODS: This study was conducted on 50 patients who had suicide attempts within the past two months and 52 healthy volunteers who did not have any suicide attempt. They were evaluated with the Turkish version of COPE inventory. The results were analyzed using SPSS version 15.0 for Windows. RESULTS: In the suicide attempt group, 'active coping', 'planning', 'positive reinterpretation and growth' scores were found to be lower than that in the control group. On the other hand, 'restraint coping', 'acceptance', 'focus on and venting of emotions', 'behavioral disengagement', 'substance use' and nonfunctional coping total points were significantly higher in the suicide attempt group. The patients with depression in the suicide group were found less of the 'positive reinterpretation and growth' but more of the 'substance use' compared to the healthy group. Subjects who attempted suicide more than once tended to 'substance use' rather than 'active coping'. 'Focus on and venting of emotions' scores in suicide attempters were higher in women than in males. CONCLUSION: We observed that individuals who attempted suicide have fewer functional coping strategies and more nonfunctional coping strategies than who do not attempt suicide. It was determined that under stressful situations, individuals with depression tended to alcohol and substance abuse instead of positive reinterpretation and growth. In subjects who had recurrent suicidal attempts, alcohol and substance abuse was more common than active coping. Women were using focusing on and venting of emotions techniques much more than men. We assume that to monitor, and in case of necessity, to change the coping strategies in suicide attempters are vitally important for preventing suicide attempts.

Two Cases of Excessive Internet Use with Comorbid Family Relationship Problems.

Although the internet is used effectively and beneficially in every aspect of life, several users have been experiencing some problems due to excessive and uncontrolled use. While the term "internet addiction" still remains controversial, disturbed family relationships are considered to be a diagnostic criterion. The use of the internet, even in non-excessive levels, is associated with disturbance in family and social life. As considering from systemic point of view; while family relationships may be disturbed with internet addiction, people who have problems with their family relationships also may use internet excessively. This case report is composed of both the cases with excessive internet usage and those who had problems in complying with the changes in their family systems following the decrease in duration of internet usage during the treatment process.

The relationship between disability, quality of life and fear-avoidance beliefs in patients with chronic low back pain.

AIM: The aim of this study is to investigate the relationship between fear and avoidance beliefs with the disability of patients with chronic low back pain and the prediction of quality of life. MATERIAL AND METHODS: 105 outpatients with chronic low back pain were included in the study. Patients were evaluated with a sociodemographic questionnaire Visual Analog Scale Roland Morris Disability Questionnaire Beck anxiety inventory Beck depression inventory, Somatosensory Amplification Scale Fear and avoidance beliefs questionaire and Short form-36 health survey questionnaire. RESULTS: As pain intensity increased, FABQ increased. Higher levels of anxiety, depression, FABQ (work) leads to higher level of disability. The disability predictors were found to be pain intensity and level of anxiety. When levels of pain intensity, level of anxiety and depression, FABQ increased, physical function decreased. Pain intensity and FABQ (physical) were found to be the predictors of quality of life. CONCLUSION: Findings of our study were compatible with the previous studies that evaluated the relationship between pain intensity and FAB with the disability of patients with chronic low back pain. We think that it'd have a role for the perception of disability and connected to this to prevent the impairment of life quality by implications for FAB in these patients.