Association of Dissociation with Suicide Attempt and Non-Suicidal Self Injury in Adolescents with a History of Sexual Abuse.

Objective: Dissociative symptoms are considered risk factors for suicide and non-suicidal self-injury (NSSI). In this study, the relationship between suicidal behaviors and NSSI with dissociative symptoms in adolescents with a history of Child Sexual Abuse (CSA) was investigated. Methods: A total of 100 adolescents with a history of CSA were evaluated with a detailed forensic psychiatric interview. Dissociative symptoms were measured with the self-report Adolescent Dissociative Experiences Scale (A-DES) and the parent-reported Child Dissociative Checklist (CDC). Results: While dissociative symptoms did not differ between adolescents with and without suicide attempts (CDC; p = .068 and A-DES; p = .060), they were significantly higher in adolescents with non-suicidal self-harming behavior (CDC; p < .001 and A-DES; p = .001). Suicide attempts and NSSI were more common in those who reported genital touching as a type of sexual abuse (respectively, p = .003; p = .048). In regression analysis; history of psychiatric treatment (OR = 9.09 [95% CI = 1.52, 54.29]) and NSSI (OR = 8.18 [95% CI = 2.01, 33.23]) were independently associated with suicide attempts. In addition, parent-reported dissociative symptoms (CDC scores) (OR = 1.27 [95% CI = 1.06, 1.53] and suicide attempt (OR = 8.09 [95%CI = 1.96,33.42] showed independent association with NSSI. Conclusions: Dissociative symptoms may be predictive factors for NSSI and should be considered in risk assessment of adolescents with a history of CSA.

Psychosocial problems and cognitive functions in children with spina bifida.

Objectives: This study aims to assess psychosocial functioning in relation to lesion level and ambulatory status in children with spina bifida (SB) and compare them to their peers. Patients and methods: Between March 2013 and May 2013, a total of 31 patients with SB (11 males, 20 females; mean age: 9.4 years; range, 6 to 14.7 years) and 36 typically developing peers (16 males, 20 females; mean age: 9.8 years; range, 6.5 to 14.8 years) were included in the study. All participants were assessed using a semi-structured psychiatric diagnostic interview via the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL), Wechsler Intelligence Scale for Children-Revised (WISC-R), Behavioral Rating Inventory of Executive Functions (BRIEF) parent form, Social Responsiveness Scale (SRS), and Aberrant Behavior Checklist (ABC). Results: In the SB group, the rate of psychiatric disorders was significantly higher (p=0.001) and the SRS scores and the planning and organizational components of the executive function were higher than their peers (p=0.02 and p=0.007, respectively). The psychiatric diagnosis rate, BRIEF, and SRS total scores did not significantly differ according to lesion level and ambulatory status. The BRIEF initiate and organization of materials subtest scores and ABC scores were significantly lower at high lesion levels (p=0.02, p=0.02, and p=0.02, respectively) and non-community walkers (p=0.002, p=0.03, and p=0.003, respectively). Conclusion: Psychiatric disorders, impairment in social responsiveness, and planning and organization components of the executive function are prevalent in children with SB with no intellectual disabilities, compared to their peers. Therefore, psychosocial counseling and multidisciplinary follow-up for SB patients seem to be beneficial.

Psychometric properties of the Cognitive Behaviour Therapy Scale for Children and Young People (CBTS-CYP) in a Turkish sample.

BACKGROUND: Cognitive behavioural therapy (CBT) training is highly demanded by clinicians; however, a standardized competence assessment for professionals working with children and young people (CYP) can be problematic. Psychometric tools used for this purpose are typically adult oriented measures. AIM: The present study provides psychometric properties of the Cognitive Behaviour Therapy Scale for Children and Young People (CBTS-CYP) derived from a comparative analysis with the Cognitive Therapy Scale (CTS). METHOD: The CBTS-CYP was used alongside CTS in a CBT supervision training course, consisting of a cohort of 51 therapists. A total of 36 audio/video recorded full CBT sessions were assessed for the purpose of determining CBT competence and adherence to the theory and model. The training involved a total of 80 hours of supervision in 10 meetings via an online videoconferencing platform between July 2020 and February 2021. RESULTS: Face validity and inter-rater reliability of CBTS-CYP were high, with the intraclass correlation values being good (0.60-0.74) or excellent (0.74 and above); the correlations of each CBTS-CYP and CTS items were significant; internal consistency of the scale showed that Cronbach alpha values for total-scale and its two subdimensions were above .93. For a cut-off score of 55 out of 90, sensitivity reached 90.73% and specificity 90.73%. A score of 2 points or above from any single item could be considered as the second minimum criterion for competence. CONCLUSIONS: CBTS-CYP offers a valid and reliable scale to evaluate the competence and adherence quality of CBT sessions with children and adolescents.

Effects of tracheostomy on mothers of children with cerebral palsy.

OBJECTIVE: We aimed to investigate psychosocial changes such as burnout, caregiver burden, depression, and coping in mothers of children with cerebral palsy (CP) after tracheostomy placement. DESIGN: A total of 48 children with CP and chronic respiratory insufficiency and their mothers participated in the study. The children with tracheostomy were classified as T (+) (n = 26) and those who did not have tracheostomy were classified as T (-) (n = 22). The patients with tracheostomy through invasive mechanical ventilation were classified as TIV (+). The data about the clinical conditions of the patients and the sociodemographic characteristics of the mothers were recorded. Zarit caregiver burden, Maslach burnout, Beck depression, and Coping Orientation to Problems Experienced (COPE) questionnaires were applied to all mothers. FINDINGS: Beck depression score was 14 ± 8.24 in T (+) group and 16.09 ± 9.65 in T (-) group (p = .576). There was no significant difference between the T (+) and T (-) groups in the Maslach burnout inventory, Zarit caregiver burden scale, and their subgroups. The first two methods from the COPE scales were identical. In the T (+) group, the third coping method was found as "planning" and in the T (-) group as "active coping". Maslach burnout inventory, Zarit 1, and Zarit 2 scores were higher in patients with only tracheostomy compared to those with TIV (p = .002, p = .018, p = .021). CONCLUSION: In the study presented, the placement of tracheostomy in children with CP does not increase mother's depression tendencies and mood changes.

Parental psychological distress associated with COVID-19 outbreak: A large-scale multicenter survey from Turkey.

AIMS: Pandemics can cause substantial psychological distress; however, we do not know the impact of the COVID-19 related lockdown and mental health burden on the parents of school age children. We aimed to comparatively examine the COVID-19 related the stress and psychological burden of the parents with different occupational, locational, and mental health status related backgrounds. METHODS: A large-scale multicenter online survey was completed by the parents (n = 3,278) of children aged 6 to 18 years, parents with different occupational (health care workers-HCW [18.2%] vs. others), geographical (Istanbul [38.2%] vs. others), and psychiatric (child with a mental disorder [37.8%]) backgrounds. RESULTS: Multivariable logistic regression analysis showed that being a HCW parent (odds ratio 1.79, p < .001), a mother (odds ratio 1.67, p < .001), and a younger parent (odds ratio 0.98, p = .012); living with an adult with a chronic physical illness (odds ratio 1.38, p < .001), having an acquaintance diagnosed with COVID-19 (odds ratio 1.22, p = .043), positive psychiatric history (odds ratio 1.29, p < .001), and living with a child with moderate or high emotional distress (odds ratio 1.29, p < .001; vs. odds ratio 2.61, p < .001) were independently associated with significant parental distress. CONCLUSIONS: Parents report significant psychological distress associated with COVID-19 pandemic and further research is needed to investigate its wider impact including on the whole family unit.

Executive Functions and Social Responsiveness in Children and Adolescents With Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder.

Objective: To evaluate the executive functions and social reciprocity of children and adolescents diagnosed with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) and compared them with healthy controls. Material and Method: Patients aged 6-17 years diagnosed with ASD (n = 33) and ADHD (n = 37) and healthy controls in the same age range (n = 33) were included in the study. Behavioral Rating Inventory of Executive Functions (BRIEF) sub-scales and Social Responsiveness Scale (SRS) were used for evaluating executive function areas and social responsiveness. Results: Our results revealed that children and adolescents with ASD and ADHD were significantly impaired for all BRIEF sub-scales except emotional control and that the significant increase in sub-scale scores expressing deterioration continued after adjustment for SES, verbal IQ scores, and gender. ASD patients received significantly higher SRS scores compared to ADHD and control groups and ADHD patients also had significantly higher values compared to the controls. Conclusion: Further studies with parent-report scales that allow easier and faster evaluation of executive functions and social reciprocity will contribute to better understanding of the personal needs of children with neurodevelopmental disorders and the finding of new treatments.

Clinical features of the diabetes eating problem survey-revised Turkish version in children and adolescent with type 1 diabetes.

Objectives We aim to delineate clinical characteristics that place individuals with type 1 diabetes (T1DM) at risk of developing eating problems by using Turkish version of diabetes eating problem survey-revised (DEPS-R). Methods The patients aged 9-18 years with T1DM who came to the pediatric endocrine outpatient clinic for control between February and December 2019 completed Turkish version of DEPS-R. Clinical and laboratory findings were obtained from patient files. Cases with a questionnaire score ≥20 were considered to be at risk for eating disorders (ED). Parents were informed when the results of the screening were positive, and were offered to child psychiatrist. Results The median scores obtained with the Turkish version of DEPS-R for the total sample, for females and males were 15, 16, and 13 respectively. The score was significantly higher among females compared to males (p<0.001). DEPS-R score positive group had higher age (mean [SD]=14.6 [2.7], p=0.009), BMI (mean [SD]=21.4 [3.2], p<0.001), HbA1c % (mean [SD]=9.37[2.3], p<0.001) and year of diabetes duration (mean [SD]=5.5 [3.6], p<0.001) compared to the negative group. Conclusions Early recognition and adequate treatment of ED in T1DM is essential. DEPS-R is sensitive in identifying young people with ED.

Coping and psychopathology in children with malignancy and bronchiectasis.

AIM: We aimed to evaluate the coping styles and social support perceived by the children with two different chronic diseases (cancer and bronchiectasis), their mothers' coping styles and compare them with a control group without any chronic physical or psychiatric disorder. METHODS: Our sample consisted of 114 children and adolescents, with an age range from 9 to 15 years. The data were collected by using schedule for affective disorders and schizophrenia for school-age children-present and lifetime version, kid-coping orientation to problems experienced (Kid-COPE), social support appraisals scale (SSAS), and COPE. RESULTS: All three groups were similar with respect to age and sex distribution. Around 50% to 60% of the children in both patient groups had a psychiatric diagnosis. Remarkably, 30% of the children had an internalizing disorder. The most commonly used coping style by the mothers was religious coping in all groups. Kid-COPE scores did not significantly differ between groups. The scores on Family and Friend subscales of SSAS in the bronchiectasis group were significantly lower when compared with those of participants in hematology-oncology and control groups. CONCLUSION: Chronic medical illnesses may have a similar psychological impact on children regardless of disease-specific clinical presentations and outcomes. Future studies need to focus on identifying protective and risk factors that potentially mediate psychosocial well-being.

Duration of Breastfeeding, Bottle-Feeding, and Parafunctional Oral Habits in Relation to Anxiety Disorders Among Children.

OBJECTIVE: The aim of the present study is to investigate the duration of breastfeeding in relation to various parafunctional oral habits in children with anxiety disorders. MATERIALS AND METHODS: The study includes 195 children and adolescents with anxiety disorders and age- and gender-matched 255 healthy control subjects. Diagnoses were made with semistructured interview (K-SADS). Information about breastfeeding and parafunctional oral habits was investigated via a questionnaire prepared for the study. RESULTS: The mean age was 11.50 ± 2.50 years for clinical group and 11.27 ± 2.33 years for controls. Fifty-four percent of the clinical group and 56% of the control group were female subjects. Duration of exclusive (4.72 ± 2.86, 5.55 ± 2.36; p = 0.002) and total breastfeeding (12.38 ± 10.32, 15.89 ± 9.09; p < 0.001) was significantly lower and duration of bottle-feeding (22.30 ± 19.54, 16.64 ± 12.79; p = 0.005) was higher than controls in the clinical group. Duration of exclusive breastfeeding was significantly correlated with duration of bottle-feeding (r = -0.263, p < 0.001) and duration of pacifier use (r = -0.249, p = 0.001). Multiple regression analysis showed that duration of exclusive breastfeeding (ß = 0.88, p = 0.006) and bottle-feeding (ß = 1.02, p = 0.005), as well as various oral habits, was associated with diagnosis of an anxiety disorder. CONCLUSION: Nutrition methods in early years of life may result in long-term consequences regarding anxiety disorders for children. Clinicians should encourage parents for a shorter duration of bottle-feeding and a longer duration of exclusive breastfeeding.

Breastfeeding and parafunctional oral habits in children with and without attention-deficit/hyperactivity disorder.

INTRODUCTION: Although children with attention-deficit/hyperactivity disorder (ADHD) were reported to have insufficient breastfeeding, consequences and oropharyngeal implications of this finding have not been studied. In this case-control study, we aimed to investigate early feeding practices and parafunctional oral habits in children with ADHD. SUBJECTS AND METHODS: The study group consisted of 200 children and adolescents, 7-17 years old, diagnosed as having ADHD at Marmara University Child Psychiatry Clinics in Istanbul, Turkey. The Conners Parent and Teacher Rating Scales were used to assess behavioral disturbances. A questionnaire was developed consisting of items pertaining to breastfeeding period, early feeding history, and parafunctional oral habits. The study data were compared with those for 175 healthy schoolchildren after exclusion of possible ADHD cases. RESULTS: The children with ADHD were found to have insufficient exclusive breastfeeding (less than 6 months) (p=0.0001). The children with insufficient exclusive breastfeeding were more likely to have a history of bottle feeding, longer duration of bottle feeding, and early introduction of bottle feeding (p=0.01). Overall, significant differences were detected on the domains of duration of bottle feeding, introduction of bottle feeding, introduction of pacifier use, variables of nail and toenail biting, as well as pencil biting, bruxism, and snoring between the ADHD group and the control group. CONCLUSIONS: The present results indicate that early in life, children with ADHD are subject to insufficient exclusive breastfeeding, different feeding practices, and elevated parafunctional oral habits more often than typically developing children. For all professionals who provide healthcare to children, increased awareness and attention to these factors are suggested.