[Maternal Attitudes, Irritability, Problem Solving Skills and Decision Making in Adolescents with Substance Use: Case-control Study]. / Madde Kullanan Ergenlerin Problem Çözme, Karar Verme Becerileri, Duygusal Tepkisellik Düzeyleri ve Anne Tutumlarinin Degerlendirilmesi: Olgu-Kontrol Çalismasi.

OBJECTIVE: Multiple risk factors affect the emergence of substance use disorders among adolescents and their families. To the best of our knowledge, the effects of irritability, problem solving, decision making skills and maternal attitudes on the severity of the substance use have not been evaluated on the same population. We aimed to evaluate the presence and the effects all of these variables on the severity of substance dependence. METHOD: The study included 40 adolescents, between 14 and 17 years of age, consulting the Child and Adolescent Mental Health and Diseases outpatient clinics with complaints of substance use and 40 age and gender matched healthy controls. The diagnoses were based on the DSM-5 diagnostic criteria. Both groups completed a sociodemographic questionnaire, the Parent Attitude Research Instrument (PARI), the Adolescent Decision Making Questionnaire (ADMQ), the ProblemSolving Inventory (PSI) and the DSM-5 Level 2 Irritability Scale. The patient group were also tested on the Addiction Profile Index for Adolescents (API-AF). RESULTS: Problem solving skills scores of the patients were lower and the scores on the irritability scale completed by the patients and their parents were higher as compared to the control group. Complacency (indifference) in decision-making predicted the severity of the addiction. As the complacency in decision-making increased, the severity of addiction also increased. CONCLUSION: Our results indicated that problem solving and decisionmaking skills and irritability levels of the adolescents together with the family attitudes, affect substance use disorder in adolescence. These variables should be considered in preventive and therapeutic approaches.

Reliability and Validity Study of the Turkish Version of the Clinical Opiate Withdrawal Scale.

INTRODUCTION: The aim of the present study was to perform reliability and validity analyses of the Turkish version of the Clinical Opiate Withdrawal Scale which is used to determine the severity of opiate withdrawal. METHODS: Initially, the Clinical Opiate Withdrawal Scale (COWS) was translated into Turkish and subsequently back-translated into English. The originality of the back-translated version was approved by the author who developed the scale. After the translation was completed, the scale was used to assess the withdrawal symptoms of 100 patients with opiate withdrawal and 41 patients with alcohol withdrawal. Cronbach's alpha was used in the reliability assessment; explanatory and confirmatory factor analyses were used in structural validity assessment; and in scale validity, ROC analysis was used among diagnosis groups. RESULTS: The Cronbach's alpha internal consistency coefficient was calculated as 0.74 in reliability analyses. The correlation coefficient was found to be 0.975 (p<0.001) for inter-rater reliability. Factor analysis was conducted for the structural validity of the scale and findings that support the unidimensional structure of the scale were observed. In the confirmatory factor analysis, CFI, GFI and RMSEA values were found to be 0.905, 0.905 and 0.079, respectively. It was detected that COWS was successful in distinguishing between opiate and alcohol withdrawal symptoms and the area under the ROC curve was 0.878. CONCLUSION: This study showed that the Turkish version of COWS can be used reliably and validly for assessing opiate withdrawal.