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.

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.

Relationship of PTSD With impulsivity Dimensions While Controlling the Effect of Anxiety and Depression in a Sample of Inpatients With Alcohol Use Disorder.

OBJECTIVE: The aim of the present study was to evaluate the relationship of posttraumatic stress disorder (PTSD) with impulsivity dimensions while controlling the effect of anxiety and depression in a sample of inpatients with alcohol use disorder (AUD). METHODS: Participants were 190 male patients admitted to a specialized center for substance use disorders within a six month period. Participants were evaluated with the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Traumatic Experiences Checklist, and PTSD Checklist-Civilian version. RESULTS: Age was lower in the group with PTSD (n = 63, 33.2%) than the group without PTSD (n = 127, 66.8%). Duration of education, marital, and employment status did not differ between the groups. STAI, BDI, and BIS-11-SF scores were higher in the group with PTSD. Trait anxiety, depression, and impulsivity predicted high PTSD risk in a logistic regression model. Same variables predicted the severity of PTSD symptoms in a linear regression. Among dimensions of impulsivity attentional component was the only predictor of PTSD symptoms severity, not motor or nonplanning impulsivity. CONCLUSIONS: These findings suggest that the PTSD may be related to impulsivity, particularly attentional impulsivity, even after controlling anxiety and depression among inpatients with AUD.

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.

Non-suicidal self-harm behavior within the previous year among 10th-grade adolescents in Istanbul and related variables.

BACKGROUND: Non-suicidal self-harm behavior (SHB), which is a pervasive and dangerous problem, is frequent among adolescents and it is important to evaluate the associated psychological and social factors to better understand its nature and to plan treatment programs. AIMS: Aim of the present study is to determine the prevalence of SHB and the associated variables such as substance use, psychological, behavioral and social factors among 10th-grade students in Istanbul/Turkey. METHODS: Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul/Turkey. A representative sample of 4957 10th-grade students was studied between October 2012 and December 2012. RESULTS: SHB within the previous year were reported by 14.4% of the students (n = 713). Lifetime suicidal thoughts or behavior, tobacco, alcohol and/or drug use, symptoms of depression, anxiety and impulsive, delinquent and aggressive behaviors were also associated with SHB in Turkish 10th-grade students. CONCLUSIONS: The findings of the present study may be relevant in prevention and management of SHB as well as important problems among students, such as substance use, impulsive, delinquent, aggressive and suicidal behavior.

Relationships of personality dimensions with impulsivity in alcohol-dependent inpatient men.

BACKGROUND: Impulsivity is closely related to substance use and abuse, both as a contributor to use and as a consequence of use. Particular dimensions of temperament and character were reported to be associated with trait impulsivity in different populations. AIM: The aim of the present study was to evaluate the relationship of personality dimensions with impulsivity among men with alcohol dependence. Also we wanted to control the effect of depression and anxiety symptoms on this relationship. METHODS: Participants were consecutively admitted male alcohol-dependent inpatients (n = 94) and healthy controls (n = 63). Patients were investigated with the Barratt Impulsiveness Scale, version 11 (BIS-11), the Temperament and Character Inventory (TCI) and the Symptom Checklist-Revised (SCL-90-R). RESULTS: Severity of impulsivity and dimensions of impulsivity were higher in alcohol-dependent inpatients than in healthy controls. Impulsivity was negatively correlated with reward dependence, persistence, self-directedness and cooperativeness, but positively correlated with novelty seeking, harm avoidance, depression and anxiety. Although high depression and temperament dimensions (high novelty seeking, harm avoidance and low reward dependence) predicted impulsivity, combinations of personality dimensions that predict dimensions of impulsivity differed. CONCLUSIONS: RESULTS may suggest that together with depression when impulsivity is the problem, both dimensions of impulsivity and personality must be evaluated and the treatment should be shaped accordingly for alcohol-dependent inpatients.

Psychometric properties of the Turkish versions of the Drug Use Disorders Identification Test (DUDIT) and the Drug Abuse Screening Test (DAST-10) in the prison setting.

The aim of this study was to evaluate psychometric properties of the Drug Use Disorders Identification Test (DUDIT) and the Drug Abuse Screening Test (DAST-10) in prisoners with (n = 124) or without (n = 78) drug use disorder. Participants were evaluated with the DUDIT, the DAST-10, and the Addiction Profile Index-Short (API-S). The DUDIT and the DAST-10 were found to be psychometrically sound drug abuse screening measures with high convergent validity when compared with each other (r = 0.86), and API-S (r = 0.88 and r = 0.84, respectively), and to have a Cronbach's α of 0.93 and 0.87, respectively. In addition, a single component accounted for 58.28% of total variance for DUDIT, whereas this was 47.10% for DAST-10. The DUDIT had sensitivity and specificity scores of 0.95 and 0.79, respectively, when using the optimal cut-off score of 10, whereas these scores were 0.88 and 0.74 for the DAST-10 when using the optimal cut-off score of 4. Additionally, both the DUDIT and the DAST-10 showed good discriminant validity as they differentiated prisoners with drug use disorder from those without. Findings support the Turkish versions of both the DUDIT and the DAST-10 as reliable and valid drug abuse screening instruments that measure unidimensional constructs.

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 mediator roles of trait anxiety, hostility, and impulsivity in the association between childhood trauma and dissociation in male substance-dependent inpatients.

The aim of this study was to investigate the mediator roles of negative affect, aggression, and impulsivity in the association between childhood trauma and dissociation in male substance-dependent inpatients. In addition, the effect of some variables that may be related with childhood trauma and dissociation among treatment-seeking substance dependents, such as substance of choice (alcohol/drug), mean of current age, and age at regular substance use was controlled. Participants were consecutively admitted 200 male substance-dependent inpatients. Patients were investigated with the Dissociative Experiences Scale, the Childhood Trauma Questionnaire, the Barratt Impulsiveness Scale, the Buss-Perry Aggression Questionnaire, the Beck Depression Inventory, and the Spielberger State-Trait Anxiety Inventory. Seventy-seven patients (38.5%) with pathologic dissociation were compared with 123 nondissociative patients (61.5%) classified by dissociative taxon membership. The dissociative group had lower age, age at regular substance use, duration of education, and higher rate of drug dependency rather than alcohol dependency. Beside higher scores on anxiety, depression, childhood trauma, aggression, and impulsivity, a larger proportion of dissociative group reported suicide attempts and self-mutilation than did the nondissociative group. Results of regression analyses suggest that severity of chronic anxiety, aggression (particularly hostility), and impulsivity were found to be mediators of association between childhood trauma and dissociation. Results suggest that, to reduce the risk of dissociation and related behavior such as suicide attempt and self-mutilation among substance dependents, chronic anxiety together with the feelings of hostility and impulsivity must be the targets of evaluation and treatment among those with history of childhood trauma.

Self-mutilative behaviors in male substance-dependent inpatients and relationship with anger and aggression: mediator effect of childhood trauma.

The aim of this study was to investigate the relationship of self-mutilation (SM) with anger and aggression in male substance-dependent inpatients. Also, we wanted to evaluate the mediator effect of childhood trauma on these relationships while controlling variables such as age, substance of dependence (alcohol/drug), and negative effect. Participants were consecutively admitted 200 male substance-dependent inpatients. Patients were investigated with the Self-mutilative Behaviour Questionnaire, the Childhood Trauma Reports, the Buss-Perry's Aggression Questionnaire, the State-Trait Anger Expression Inventory, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. Rate of being married, current age, and age onset of regular substance use were lower, whereas being unemployed and history of childhood trauma (HCT) were higher in group with SM (n = 124, or 62.0%). Higher mean scale scores were found in SM group. Predictors of SM were being younger, impaired anger control, and physical aggression in logistic regression model. Being younger and the outward expression of anger (anger-out) predicted SM in the subgroup of patients without HCT, whereas being younger, severity of anger, and the inward expression of anger (anger-in) predicted SM in the subgroup of patients with HCT. Thus, to reduce self-mutilative behavior among substance-dependent patients, clinicians must improve anger control, particularly in younger patients. Type of strategy for coping with anger, which must be worked on, may differ in different subgroup patients, that is, focusing anger toward self among those with HCT, whereas anger toward others among those without.

Relationship of alexithymia and dissociation with severity of borderline personality features in male substance-dependent inpatients.

The aim of this study was to evaluate possible interactions between severity of borderline personality features (BPFs), dissociative experiences, and alexithymia among substance-dependent men while controlling for their current age, depression, and anxiety. Participants were 200 substance-dependent men consecutively admitted to a dependency treatment unit. The Borderline Personality Inventory, the Toronto Alexithymia Scale, the Dissociative Experiences Scale, the Beck Depression Inventory, and the Spielberger State-Trait Anxiety Inventory were administered to all participants. Severity of negative affect, alexithymia, dissociative experiences, and BPF were correlated with each other. Being younger, severity of dissociative experiences, difficulty in identifying feelings, depression, and trait anxiety predicted the severity of BPF in linear regression analysis. These findings suggest that alexithymia and dissociative experiences may be a way of coping with depression and chronic anxiety, but they also seem to be related to the severity of BPF independent of the negative affect and from each other.

History of suicide attempt in male substance-dependent inpatients and relationship to borderline personality features, anger, hostility and aggression.

The aim of this study was to investigate the relationship between severity of borderline personality features and history of suicide attempt (HSA) in male substance-dependent inpatients and the effect of anger, hostility and aggression on this relationship. Further, the effect of some variables that may be related to suicide and/or borderline personality, such as age at inception of regular substance use, substance of dependence (alcohol/drug), depression, and both state and trait anxiety, were controlled. Participants were 200 consecutively admitted male substance-dependent inpatients. Patients were investigated with the Borderline Personality Inventory (BPI), the Buss-Perry Aggression Questionnaire (AQ), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). Among substance-dependent inpatients, 33.0% (n=66) were identified as the group with HSA. Mean scores employment status, marital status and duration of education did not differ between groups, whereas current age and age at onset of regular substance use were lower in group with HSA. Mean scores of BPI, AQ and its subscales (anger, hostility and physical/verbal aggression), BDI and STAI were higher in the HSA group. In addition, the rates of drug dependency and borderline personality disorder were higher in this group. The severity of borderline personality symptoms was highly correlated with subscales of the AQ, depression and anxiety, whereas it was negatively correlated with age at onset of regular substance use. The severity of anger and borderline personality features predicted HSA in the logistic regression model. Results suggest that, to reduce the risk of suicide attempt among substance-dependent patients, the feeling of anger must be the target of evaluation and treatment among those with borderline personality features.

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.

Childhood trauma and psychopathology among alcohol-dependent men: no interaction with temperament and character.

OBJECTIVE: The aim of this study was to evaluate possible interactions between childhood trauma, temperament, character, and psychopathology among alcohol-dependent men. METHODS: Participants were 156 alcohol-dependent men consecutively admitted to a dependency treatment unit. The Childhood Abuse and Neglect Questionnaire, the Temperament and Character Inventory, and the Symptom Checklist-Revised were administered to all participants. RESULTS: Childhood abuse and neglect did not have any effect on temperament and character scores in multivariate analysis. Whereas childhood abuse had a significant main effect on all types of clinical psychopathology except depression and psychoticism scores, childhood neglect only had a significant main effect on depression scores. There was no interaction between childhood abuse and neglect on these analyses. CONCLUSIONS: Among alcohol-dependent men, childhood abuse and neglect contribute to general psychopathology through distinct clinical consequences, independently of temperamental and characterological features.

The Mediating Effects of Self-Esteem and Harm Avoidance on the Association between Social Anxiety Symptoms and Adult Attention Deficit Hyperactivity Disorder Symptom Severity in Turkish Inpatients with Alcohol Use Disorder.

Objective: The first objective of this research was to examine the association of the symptom severity of social anxiety with the adult attention deficit hyperactivity disorder (ADHD) symptom severity in Turkish patients with alcohol use disorder (AUD). The second objective was to examine if harm avoidance and self-esteem mediated this relationship. Method : This cross-sectional analysis was performed among 151 inpatients with AUD at the Bakirkoy/AMATEM, a treatment center for substance use disorder, in Istanbul. Patients were examined with the Liebowitz Social Anxiety Scale (LSAS), the Adult ADHD Self-Report Scale (ASRS), the Rosenberg Self-Esteem Scale (SES), and the temperament dimension of Harm Avoidance (HA). Using SPSS-20 software, the data was analyzed using Pearson correlations, multivariate analysis of covariance (MANCOVA), and multiple linear regressions. Results: The scales scores were mildly correlated with each other. The low self-esteem and high HA were related with the inattentive (IN) dimension of ADHD, whereas low self-esteem solely predicted hyperactivity/impulsivity (HI) dimension of ADHD in MANCOVA. In the linear regression analysis, the severity of social anxiety, particularly avoidance dimension, was associated with the symptom severity of ADHD. In the second step of the analysis, together with the avoidance dimension of social anxiety, self-esteem was associated with the symptom severity of ADHD. However, in the third step, after including HA as an independent variable in the analysis, the avoidance dimension of social anxiety was no longer associated with the severity of adult ADHD symptoms, whereas self-esteem together with HA (particularly "anticipatory worry and pessimism" [HA-1], and "asthenia and fatigability" [HA-4]) predicted. Conclusion: Findings of the present study shows that although the symptom severity of social anxiety is associated with the severity of ADHD symptoms among inpatients with AUD, among dimensions of social anxiety, the avoidance dimension plays a main role in this relationship. Also, while the self-esteem partially mediates this relationship, HA seems to have a full mediator effect on this relationship.

Effect of malpractice claims on orthopedic and traumatology physicians in Turkey: A survey study.

OBJECTIVE: This study aimed to investigate the malpractice claims experienced by orthopedic and traumatology physicians and to determine their effects on burnout, job satisfaction, and clinical practice. METHODS: A questionnaire survey was conducted on orthopedic and traumatology specialists between May 2019 and February 2020. Data collection was carried out via e-survey at "turk-ortopedi" mail group, which is an electronic communication network of orthopedic and traumatology physicians. For data collection, sociodemographic data forms were used including the general characteristics, working conditions, and the malpractice claim events along with the Maslach Burnout Inventory scale to evaluate burnout and the Minnesota Satisfaction Questionnaire to investigate job satisfaction. RESULTS: In total, 353 orthopedic and traumatology physicians (348 men, 5 women), including 37 professors, 41 associate professors, and 275 surgeons, completed the questionnaire. In total, 65.4% of the participants (231 physicians and 471 relevant dossiers) stated that they were currently facing a malpractice claim. Emotional burnout and hesitant behavior in medical practices were significantly higher among the physicians who had undergone an investigation/trial with the claim of malpractice (p<0.05), whereas intrinsic job satisfaction was significantly lower (p<0.05). It was determined that orthopedic and traumatology physicians dealing with arthroplasty, vertebral surgery, hand surgery, and foot/ankle surgeries had undergone significantly more trials (p<0.05). In the evaluation of the burnout levels and job satisfaction scores of the physicians according to the age, academic title, seniority, and institution, it was determined that burnout level decreased with age, those between the ages of 25 and 34 years were exhausted the most, and job satisfaction increased with age. It was also found that burnout level decreased and job satisfaction increased as the academic title became higher, and attending physicians were the most exhausted. Moreover, burnout level decreased as seniority increased, the most senior ones were the ones most exhausted, and job satisfaction increased with seniority. CONCLUSION: Evidence from this study has revealed that malpractice claims cause emotional burnout, low intrinsic job satisfaction, and a hesitant behavior in medical practice for the orthopedic and traumatology physicians. The concept of malpractice alone may result in unnecessary analyses/examinations for patients. LEVEL OF EVIDENCE: Level IV, Diagnostic Study.

Relationship of alexithymia and temperament and character dimensions with lifetime post-traumatic stress disorder in male alcohol-dependent inpatients.

AIMS: The purpose of the present study was to evaluate the prevalence of lifetime post-traumatic stress disorder (PTSD) in male alcohol-dependent inpatients and to investigate the relationship of PTSD with alexithymia and temperament and character dimensions. METHODS: Participants were 156 consecutively admitted male alcohol-dependent subjects. Patients were investigated using the Clinician-Administered PTSD Scale (CAPS), the Toronto Alexithymia Scale (TAS-20) and the Temperament and Character Inventory (TCI). RESULTS: Among alcohol-dependent inpatients 32.1% were considered as having lifetime PTSD. Mean scores of alexithymia, novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) were higher in the PTSD group, whereas age and self-directedness (S) were lower. Among age and other factors of TAS-20, 'difficulty in identifying feelings (DIF)' predicted PTSD in a logistic regression model. When age and personality dimensions of TCI were taken as independent variables, S predicted PTSD in the logistic regression model. Finally, among subscales of TCI, 'impulsiveness versus reflection' (NS2) and 'congruent second nature versus bad habits' (S5) predicted PTSD. CONCLUSIONS: Alexithymia and personality traits, particularly high DIF and S scores are related with lifetime PTSD diagnosis, even when controlling for age among alcohol-dependent inpatients. Causal relationships between alexithymia, personality dimensions and PTSD, and their implications on treatment are not clear and should be evaluated in longitudinal studies.

Childhood abuse and neglect as a risk factor for alexithymia in adult male substance dependent inpatients.

The prevalence of childhood abuse and neglect (CAN) histories and their associations with alexithymia among male substance-dependent inpatients were studied. Participants were 159 consecutively admitted male substance dependents (115 alcohol and 44 other drugs). Substance dependence was diagnosed by means of the Structured Clinical Interview for DSM-IV (SCID-I), Turkish version. Patients were investigated with the Toronto Alexithymia Scale (TAS-20) and Childhood Abuse and Neglect Questionnaire. Among substance-dependent patients, 57.0% had at least one type of CAN and 45.3% were considered as alexithymic since they had a score greater than 60 on the TAS-20. Rate of unemployment, low educational status, emotional abuse and history of suicide attempts were higher in alexithymic substance dependent patients. Those who had histories of two or more types of childhood abuse or neglect had also higher mean score on TAS-20, particularly on the item "difficulty in identifying feelings-DIF." Also, the number of childhood trauma types was positively correlated with TAS-20 and DIF and the "difficulty in describing feelings-DDF" items of TAS-20. History of childhood emotional abuse was the only determinant for alexithymia. Childhood emotional abuse might be a risk factor for alexithymia among inpatient substance dependents.

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.