Beliefs and Predictors of Negative Attitudes Toward Obesity Among Turkish Healthcare Professionals: Assessing the Bias with Sub-group Analysis.

AIM: This study aimed to examine Turkish healthcare professionals' beliefs and predictors of negative attitudes toward obesity and to investigate whether those beliefs and negative attitudes differ per their profession and sociodemographic and familial variables. METHOD: In this cross-sectional study, healthcare professionals (n = 495) working in four hospitals of Ankara completed a sociodemographic questionnaire and two self-report scales: the Attitudes Toward Obese Persons Scale and the Beliefs About Obese Persons Scale. Data were collected during May, 2018. RESULTS: Female healthcare professionals had significantly higher (p = 0.03) positive attitude scores than males, and nurses had significantly higher (p = 0.04) Beliefs About Obese Persons Scale scores than physicians, representing their belief that obesity is not under the control of the individual. The Attitudes Toward Obese Persons Scale scores of university hospital healthcare professionals were significantly higher (p = 0.00) than those of public hospital and private hospital healthcare professionals, and Attitudes Toward Obese Persons Scale scores of healthcare professionals who have a family member with a chronic disease were significantly higher (p = 0.027) than those who do not. CONCLUSION: The work experience, spending more time with a patient, and having a member of the family with a chronic illness lead to a more positive attitude toward people with obesity. This result emphasizes the importance of interventions that promote sensitive and empathic communication skills.

Relationship of depression, impulsivity, distress intolerance and coping styles with maladaptive eating patterns in bariatric candidates.

PURPOSE: The study aimed to investigate the problematic eating patterns and understand their relationship to psychological constructs, including stress intolerance, coping mechanisms and impulsivity, and psychiatric symptoms among bariatric surgery candidates. METHODS: The bariatric candidates were evaluated by psychiatric interview and standard scales assessing maladaptive eating behaviors (Eating Attitudes Test (EAT), Bulimia Investigatory Test-Edinburgh (BITE), Dutch Eating Behavior Questionnaire (DEBQ)), depression (Beck Depression Inventory (BDI)), psychiatric symptoms (Brief Symptom Inventory (BSI)), and psychological constructs (Distress Intolerance Index (DSI), Coping Styles Scale (CSS), UPPS Impulsive Behavior Scale(UPPS)). RESULTS: More than half (57.8%) had maladaptive eating behaviors, and 23.6% had binge-eating behavior. Depression and anxiety predicted EAT, BITE, and DEBQ emotional and external eating sub-scale scores; distress intolerance, helpless coping style, and impulsivity predicted maladaptive eating behaviors in bariatric candidates. CONCLUSION: Maladaptive eating patterns play an essential role in the failure to lose weight and regain weight and are predicted by depression, anxiety, and psychological constructs in this study. Evaluation of pathological trait characteristics besides discrete psychiatric syndromes should be recommended in the pre-operation process to plan relevant interventions in the long-term management of weight. LEVEL OF EVIDENCE: Level III, evidence obtained from well-designed cohort analytic studies.

Investigation of the relationship between continuing bonds and adjustment after the death of a first-degree family member by using the Multidimensional Continuing Bonds Scale.

OBJECTIVES: The study aims to develop a continuing bonds scale, investigate the relationship between continuing bonds and adjustment after loss, and test the moderating role of meaning reconstruction in this relationship. METHODS: Data were collected from two different samples of 306 (Study 1) and 271 (Study 2) bereaved adults. RESULTS: The four factors structure of the Multidimensional Continuing Bonds Scale (MCBS) was explored and confirmed. Hierarchical regression analysis revealed that continuing bonds showed a significant relationship with prolonged grief symptoms after controlling the risk factors such as gender, age of the deceased, time since loss, and cause of death. Meaning reconstruction moderated the relationship between continuing bonds and prolonged grief symptoms. CONCLUSION: The results revealed that the MCBS can be used as a valid and reliable scale to assess the continuing bonds construct. The relationship between continuing bonds and prolonged grief symptoms varies according to the levels of meaning reconstruction.

Validation of the prolonged grief scale (PG-13) and investigation of the prevalence and risk factors of prolonged grief disorder in Turkish bereaved samples.

The aim of this study was to validate the Turkish version of the Prolonged Grief Scale (PG-13) and to determine the prevalence and predictors of prolonged grief disorder (PGD). Data were gathered from two independent samples of 306 (Study 1) and 271 (Study 2) bereaved adults to determine if findings in one sample could be replicated in the other. The results supported the one-factor structure of PG-13. PGD prevalence rates were 11.4% in Study 1 and 10% in Study 2. Lower level meaning reconstruction and unnatural cause of death were found as risk factors for the PGD diagnosis in both studies.

Adaptation of the Measures of Criminal Attitudes and Associates to the Turkish Language: Validity and Reliability Study. / Suça Yönelik Tutumlar ve Iliskiler Ölçegi Türkçe Formu’nun Geçerlik ve Güvenirlik Çalismasi.

OBJECTIVE: There are many biopsychosocial determinants among factors that trigger criminal behavior. Social variables such as the number of friends involved in criminal activity and the amount of time spent with them, as well as psychological processes such as sentiments of entitlement, antisocial attitudes of the individual can influence the possibility of getting involved in acts of crime. The purpose of this study was to adapt the Measures of Criminal Attitudes and Associates (MCAA) to Turkish language and to test its reliability and validity of the Measurement of Criminal Attitudes and Associates (MCAA), adapted to the Turkish language (MCAA-TR). METHOD: The Turkish version of the scale was tested on 202 adult convicts and 208 undergraduate university students. In order to assess the concurrent validity of the MCAA-TR, the UPPS Impulsive Behavior Scale and Criminal Thinking Scale (MCAA) were given to participants. RESULTS: Principal component analysis showed that the factor structure of the MCAA-TR was highly consistent with the original version of the scale. The Cronbach's Alpha internal consistency was 0.86 for the total scale and ranged from 0.68 to 0.82 for subscales. Results of discriminant function analysis showed a classification efficiency of 77.6%. Also, the total sub-dimension scores of the MCAA-TR showed significant correlation with the scores on the relevant sub-dimensions of the scales used to evaluate concurrent validity. CONCLUSION: The MCAA-TR was found to be a valid and reliable tool for assessing crime related cognitions and attitudes.

Investigation of the Effects of Violence Experience During Political Demonstrations.

In this study, predictors of post-traumatic stress symptom levels (PTSSL) and post-traumatic growth levels (PTGL) resulting from the experience of violence were investigated. The sample of the study consisted of 514 Gezi Park demonstrators. Participants completed measures assessing stress symptoms, post-traumatic growth, social support and beliefs about the world as well as the open-ended event specific questions. Results showed that being politically active, psychologically prepared and experiencing mild levels of violence were related with decreased PTSSL individually but not in combination as the literature suggested. The two hierarchical regression analyses showed that: (1) PTSSL were predicted by violence exposure levels, perceived social support from significant others and "randomness" and "self-worth" beliefs about the world; (2) PTGL were predicted by violence exposure levels, total amount of time spent at the demonstrations and "benevolence" and "justice" beliefs about the world. These findings suggest that psychological preparedness might be an important variable in violence experience regarding human masses. Also, violence exposure levels and duration of participation seems to be important event- specific variables. Lastly, political activism needs to be more precisely operationalized and measured in future studies.

Adaptation of the Cognitive Triad Inventory into Turkish: a Validity and Reliability Study.

INTRODUCTION: The aim of this study was to assess psychometric properties of the Turkish version of The Cognitive Triad Inventory developed to use cognitive triad based on Beck's depression model. METHODS: The study sample included 337 (female 72.2%, male 27.8%) students from Hacettepe University. Reliability was evaluated by test-retest analysis and internal consistency coefficients. For validity, explanatory and confirmatory factor analyses were performed. In addition, the scales which are assumed to measure similar cognitive structures were used to examine convergent validity. The Cognitive Triad Inventory, Beck Depression Inventory and The Hopelessness Scale were administered to the participants. RESULTS: The Cronbach Alpha coefficient reliability of The Cognitive Triad Inventory (r=0.91) showed that internal consistency reliability of inventory is high. It was found that test-retest reliability coefficients range from 0.74 to 0.94 and are high for an interval of 4 weeks (p<0.005). Confirmatory factor analysis has supported three factor structure of the inventory: "view of self", "view of world" and "view of future". The analysis showed that the model has high goodness of fit. Comparison with three self-report measures released that Cognitive Triad Inventory and its subscales have good convergent validity. CONCLUSION: The Turkish version of the Cognitive Triad Inventory has been found to be a valid and reliable measure that can be used for the university students of Turkey.

Anxiety, depression, and anger in functional gastrointestinal disorders: A Cross-sectional observational study.

Previous studies have identified a link between anger and somatization. However, little is known about the associations between anger and the development and progression of Functional Gastrointestinal Disorders (FGID). The study aim was to determine the associations between FGID and anger, anxiety, and depression. Participants in this cross-sectional observational study were 109 consecutive patients aged 18-64 years with FGID at Gastroenterology Clinic of Baskent University Hospital. A control group comprised of 96 individuals with no chronic gastrointestinal disorders recruited via snowball sampling. Sociodemographic and clinical information were obtained and participants completed the Hospital Anxiety and Depression Scale and the State-Trait Anger Expression Inventory-2. FGID participants scored higher than controls on depression, anxiety, state anger, and anger expression-in. When the FGID group was divided into upper and lower gastrointestinal symptom groups, the lower symptom group showed higher anger expression-out scores than the upper symptom group. Anger may contribute to the etiology and development of FGID. This is the first study to demonstrate a significant psychological difference between individuals with lower and upper FGID. Interdisciplinary collaboration with gastroenterologists and psychiatrists could strengthen FGID evaluation and may improve treatment compliance.

[Childhood Traumas and Attachment Style-Associated Depression Symptoms: The Mediator Role of Alexithymia]. / Çocukluk Çagi Travmalarinin ve Baglanma Biçiminin Depresyon Belirtileri ile Iliskisi: Aleksitiminin Araci Rolü.

OBJECTIVE: The aim of this study was to investigate the mediator role of alexithymia and its relationship with childhood traumas (sexual abuse, physical abuse, emotional abuse, emotional neglect, physical neglect) and attachment style (anxiety and avoidance dimensions of attachment) associated depression symptoms in adulthood. METHOD: The sample of this study included 417 undergraduate university students from different departments that studied at Hacettepe University during the 2012-2013 school years with a final analysis done over 369 participants. The Demographic Information Form, Experiences in Close Relationship Inventory-II (ECR-R), Childhood Trauma Questionnaire (CTQ), Toronto Alexithymia Scale (TAS-20), and Beck Depression Inventory (BDI) were administered to the undergraduate students who participated in this study. Mediator analyses were applied to the data. RESULTS: The results revealed that the total score of the Toronto Alexithymia Scale had a partial mediating role in the relationship of childhood traumas (the total score of Childhood Trauma Questionnaire), childhood emotional abuse and emotional neglect with depressive symptom levels in university students. Besides, the total score of the Toronto Alexithymia Scale had a full mediating role in the relationship between childhood physical neglect and depressive symptom levels in adulthood. Additionally, it was found that the total score of the Toronto Alexithymia Scale had a partial mediating role between the anxiety dimension of the attachment and the depressive symptom levels. CONCLUSION: This study revealed that alexithymia should be considered as a significant variable in the relationship of childhood traumas and attachment patterns with depression symptoms in adulthood.

[A Comparison of T-scores from MMPI and MMPI-2 in Turkish adults Turkish population]. / MMPI lineer T puanlari ve mmpi-2'nin tek tip T puanlarinin Türk yetiskin örnekleminde karsilastirilmasi.

OBJECTIVES: The aim of this study was to compare the MMPI Lineer T scores and MMPI-2 Uni form T scores in Turkish Sample. METHOD: 50 adult (30 female and 20 male) who volunteered to participate in the study completed MMPI and MMPI-2. Participants'' age ranged from 18 to 55 (X=24.96, SD=8.66). There were at least 3 weeks between two tests' application. MMPI lineer Tscore, MMPI-2 uni form Tscore and MMPI-2 lineer T score compared by 3X2 Repeated-measures ANOVA. RESULT: According to the results there were not significant difference between the mean scores' of MMPI and MMPI-2's sub scales. Change in number of item and content did not lead to significant difference. However the minimal differences were thought to based on the method of computing T scores. Also, in Hypochondriasis, Depression and Hysteria sub scales of MMPI-2 there were group differences among men and women. DISCUSSION: These findings supported the idea about the psychometric equivalence of the Original MMPI and MMPI-2. Also there were no profile differences between two tests. Therefore the results support the idea knowledge of old profiles can be used in new ones. However during the transition from MMPI to MMPI-2, it may be helpful to alert about differences in some subscales for women.

Personality, posttraumatic stress and trauma type: factors contributing to posttraumatic growth and its domains in a Turkish community sample.

BACKGROUND: Posttraumatic growth (PTG) is conceptualized as a positive transformation resulting from coping with and processing traumatic life events. This study examined the contributory roles of personality traits, posttraumatic stress (PTS) severity and their interactions on PTG and its domains, as assessed with the Posttraumatic Growth Inventory Turkish form (PTGI-T). The study also examined the differences in PTG domains between survivors of accidents, natural disasters and unexpected loss of a loved one. METHOD: The Basic Personality Traits Inventory, Posttraumatic Diagnostic Scale, and PTGI-T were administered to a large stratified cluster community sample of 969 Turkish adults in their home settings. RESULTS: The results showed that conscientiousness, agreeableness, and openness to experience significantly related to the total PTG and most of the domains. The effects of extraversion, neuroticism and openness to experience were moderated by the PTS severity for some domains. PTG in relating to others and appreciation of life domains was lower for the bereaved group. CONCLUSION: Further research should examine the mediating role of coping between personality and PTG using a longitudinal design.

Preliminary validation of the Child Abuse Potential Inventory in Turkey.

This study aims to provide preliminary findings on the validity of Child Abuse Potential Inventory (CAP Inventory) on Turkish sample of 23 abuser and 47 nonabuser parents. To investigate validity in two groups, Minnesota Multiphasic Personality Inventory (MMPI) Psychopathic Deviate (MMPI-PD) scale is also used along with CAP. The results show that, with the 200.5 cutoff point, which is the average score of the whole Turkish sample, Abuse Scale correctly classified 83% of the participants in the abuse group and 78.8% of the participants in the control group, which gives 21.2% false-positive result. MMPI-PD to all group and Pearson correlation coefficient analysis is found to be significant for both groups. These results show us high reliability and validity of the abuse scale for Turkey.

[Assessment of the therapeutic alliance: reliability and validity of the Working Alliance Inventory]. / Terapötik ittifakin degerlendirilmesi: Terapötik ittifak ölçegi'nin güvenilirlik ve geçerlik çalismasi.

OBJECTIVE: Recent trends in psychotherapy research indicate a growing interest on the conceptualization and assessment of the therapeutic alliance. Accordingly, this study aimed to examine the reliability and validity of the Turkish Working Alliance Inventory (WAI) (Horvath and Greenberg, 1989) Therapist and Client Forms. METHOD: In the first phase of the study, the scale was presented to 5 judges, representing psychoanalytic, gestalt, and cognitive behavioral approaches, who then placed the subscale's items within the intended theoretical construct with a high degree of consensus. In the second phase, Therapists (N=21), from different theoretical traditions, filled out the WAI (Therapist Form) based on their sessions with their three patients (N=63). Patients also completed the WAI (Client Form). These evaluations by therapists and patients have been carried out for the third or following sessions. RESULTS: The internal validity of the scale was alpha = .96 for the Therapist Form and alpha = .90 for the Client Form. Factors analysis, conducted only for the Client Form, revealed that 3 factors were loaded in congruence with the original WAI. Considering the limited number of therapists participated in the study, factor analysis could not be conducted for the Therapist Form. CONCLUSION: As preliminary evidence, our findings suggest that the validity and reliability of the Turkish WAI were at acceptable levels for clinical and research settings.

[Is there a correlation between severity of trauma and serum trace element levels?]. / Travma siddeti ile serum eser element düzeyi iliskili mi?

OBJECTIVES: Trace elements zinc and copper are effective in wound and fracture healing. In this prospective study, correlations between mangled extremity severity score (MESS) and mangled extremity syndrome index (MESI) and serum zinc and copper levels were investigated in trauma patients. METHODS: Seventeen trauma patients (11 females, 6 males; mean age 41.6 years; range 11 to 73 years) were evaluated with respect to MESS and MESI scores. On the seventh day of trauma, serum samples were obtained to determine zinc and copper levels by atomic absorption spectrophotometry. RESULTS: Serum levels of zinc and copper showed significant negative correlations with both MESS (r=-0.65 and r=-0.76, respectively) and MESI (r=-0.83 and r=-0.77, respectively) scores (p<0.05). CONCLUSION: The severity of trauma is associated with significant decreases in serum levels of trace elements. Thus, trace element supplementation may be an important aspect of treatment in trauma patients.

In vivo human brain biochemistry after aerobic exercise: preliminary report on functional magnetic resonance spectroscopy.

BACKGROUND: Our aim was to disclose whether the positive psychological changes observed after a single bout of aerobic exercise have a biochemical correlate that can be visualized by proton magnetic resonance spectroscopy (MRS) of the human brain. METHODS: Right-handed male volunteers underwent psychological testing and MRS of the frontal lobe of the left hemisphere, both before and after 20 minutes of jogging at about 70% of their maximal aerobic capacity. RESULTS: Although there was a significant decrease on the postexercise anxiety test scores (z = -2.201, P < .05), there was no significant difference between the preexercise and postexercise scores of positive and negative affect. Considering both "amplitude" and "area under the curve" values calculated for the peaks of metabolites N-acetylaspartate (NAA), creatine, and choline, none were found to be significantly changed (P > .05) after the exercise. CONCLUSION: This is, to our knowledge, the first study to report on a functional application of MRS to mood states. Because it offers the ability to directly measure metabolic changes in the brain during neuronal activation, "functional MRS" may be a potential new tool that may be used as an adjunct to functional magnetic resonance imaging.

Quantitative forearm muscle strength influences radial bone mineral density in osteoporotic and healthy males.

Fractures are not rare in male osteoporosis and bone mineral density (BMD) measurement is used in the diagnosis and monitoring, preventing and/or treating the disease. Muscle strength and BMD are highly related to each other. The distal radius is one of the most common sites of osteoporotic fractures. The relationship of quantitative muscle strength and BMD of the forearm has not yet been established. The objective of this study was to assess forearm muscle strength and grip strength in relation to BMD in 46 osteoporotic and randomly selected 45 healthy male participants. Forearm muscle strength and BMD were quantitatively measured using an isokinetic dynamometer and dual-energy-X-ray-absorptiometry (DEXA), respectively. Significant correlation was found among the muscle strength and dominant forearm BMD in 60 and 120 deg/s velocities. In the non-dominant arm, the 120 deg/s velocity was only significantly positively correlated to forearm BMD. Pearson's Product coefficient presented a moderate correlation between muscle strength and BMD at the dominant arms of both groups, whereas, the difference in the non-dominant forearm came from the difference of usage frequency. In conclusion, quantitative forearm muscle strength and BMD is moderately correlated and exercise can be advised to prevent distal radius fractures in male osteoporosis.