Social and emotional outcomes of child sexual abuse: a clinical sample in Turkey.

Childhood sexual abuse is a traumatic life event that may cause psychiatric disorders such as posttraumatic stress disorder and depression. During 2003-2004, 20 sexually abused children were referred to the Child and Adolescent Psychiatry Clinic of Ege University in Izmir, Turkey. Two years later, the psychological adjustment of these children (M age = 9.4 years, SD = 3.63 years, range = 5 to 16 years) is evaluated. Semistructured interviews, a form for the sociodemographic characteristics, are used for evaluations by a child psychiatrist who is blind to the first evaluation. It is determined that sexually abused children have more psychiatric disorders within the first year than 2 years later. However, some behavior problems occur at both short-term and long-term follow-ups.

[Sexual behavior and sources of information about sex among male adolescents: An 8-year follow-up]. / Erkek ergenlerde cinsel davranis ve cinsel bilgi kaynaklari: Sekiz yil arayla degerlendirme.

OBJECTIVE: This study aimed to determine the changes over time in sexual attitude and behavior among adolescents, and to measure the effect of sources information about sex on these changes. METHOD: This study was conducted in 2 stages, the first in 1996 and the second in 2004. In all, 392 male tenth grade students (150 in the first stage and 242 in the second stage) were evaluated. A personal information questionnaire developed by the authors was used to collect sociodemographic data, including sexual behavior, sexual attitude, and sources of information about sex. RESULTS: The findings show that there was a significant increase in intercourse and flirting behavior from 1996 to 2004, although no significant difference in masturbation was observed. Additionally, the number of male adolescents that reported family and pornographic films as their sources of information about sex increased 1.6-fold and 2.9-fold, respectively. A significant relationship between watching pornographic films and engaging in sexual intercourse was noted. CONCLUSION: The number of male adolescents age mean 16, engaging in sexual intercourse increased between 1996 and 2004. Pornographic films were observed to be the most common source of information about sex and also predicted the probability of adolescents having sex. Findings that indicate the need for better and more accurate sources of information about sex. The availability of good quality information about sex is critical to the development of the sexual identity and mental health of male adolescents.

Zuclopenthixol-induced neuroleptic malignant syndrome in an adolescent girl.

We present the case of a 14-year-old female who had many characteristics of neuroleptic malignant syndrome (NMS) without pyrexia following a single depot injection of 200 mg of zuclopenthixol. The patient presented with a change in mental status that had progressed over the preceding 48 hours. Subsequently, she became increasingly agitated and confused, and developed diffuse muscular rigidity, mutism, tremor, tachycardia, diaphoresis, sialorrhea, and incontinence. Results of laboratory tests showed elevated CPK levels, leukocytosis, and a low serum iron level. Bromocriptine and diazepam were used as initial treatment of a probable NMS and provided significant improvement. During the next seven days, she clinically improved but continued to exhibit emotional lability, logorrhea, elevated mood, and increased psychomotor activity. Therefore, bromocriptine and diazepam were discontinued and lorazepam and lithium were administered as treatment of a bipolar disorder. Four weeks later, she was discharged in stable condition. The presentation of this case report suggests that the primary psychiatric diagnosis is important in antipsychotic usage in the pediatric population, and that young patients receiving neuroleptic treatment should be monitored for the early signs of NMS. Using the diagnostic criteria of a neuroleptic toxicity spectrum may result in greater clinical awareness and earlier recognition of NMS.

The characteristics of separation-individuation in Turkish High School students.

The aim of the present study was examine the characteristics of separation-individuation in Turkish high school students and to investigate the contribution of sociodemographic variables on this second individuation process of adolescence. The sample consisted of 618 adolescents between the ages of 14 and 18 in three urban and two rural high schools (338 females and 280 males). Measures used included a demographic questionnaire and the Separation-Individuation Test of Adolescence (SITA), developed by Levin, Green, and Millon (1986). Results indicated that the 16-year-old group had significantly higher mean scores on the Engulfment Anxiety, Dependency Denial, and Rejection Expectancy subscales than the 15-year-old group. Males had significantly higher scores on the Practicing-Mirroring subscale than girls. Tenth graders had significantly higher mean scores on the Practicing-Mirroring, Nurturance Seeking, Peer Enmeshment, Teacher Enmeshment, and Healthy Separation subscales but the mean scores on the Dependency Denial and Engulfment Anxiety subscales decreased. The means scores on the Practicing-Mirroring, Dependency, Denial, Separation Anxiety, Teacher Enmeshment, and Rejection Expectancy subscales were significantly different among the socioeconomic status groups. Also, rural adolescents can be distinguished from urban counterparts by their increased tendency to perceive themselves as self-centered, to experience separation anxiety, to seek close interpersonal ties with caretakers, teachers, and peers, and by an integration of needs for dependence and independence. The general pattern of results investigating the separation-individuation development of Turkish adolescents suggested that compared with individualistic Western cultures, Turkish culture stressed the importance of connection as well as separation and psychic restructuring and interpersonal relatedness changes leading to an autonomous self within relational contexts.

[Tobacco, alcohol and substance use prevalence among elementary and secondary school students in nine cities of Turkey]. / Dokuz Ilde Ilk ve Ortaögretim Ogrencilerinde Tütün, Alkol ve Madde Kullanim Yayginligi.

OBJECTIVE: Previous studies in Turkey regarding substance use have failed to take into consideration the elementary school students. The purpose of the present study is to determine prevalence of tobacco, alcohol, and substance use among elementary and secondary school students in Turkey. METHOD: The study was conducted in 9 big cities that were selected from different geographic regions of Turkey. According to the student population size of the cities, a sample of 1250 or 2500 students were selected from each city. The questionnaire was administered to 11.989 elementary school students, and 12.270 secondary school students. In elementary school students' questionnaire, for the substances other than tobacco, alcohol, inhalants and cannabis a general term "drug" was used. RESULTS: Overall, Izmir had the highest rate of substance use. The prevalence of tobacco use at least once in life time was found to be 16.1% in the elementary school. The lifetime prevalence was found to be 15.4% for alcohol use and 1.7% for inhalants and for general term "drug". The prevalence of tobacco use at least once in life time was 55.9%, for alcohol use it was 45.0%, for cannabis use 4.0%, for inhalant use 5.1%, and for heroin and ecstasy use 2.5% among secondary school students. A significant difference was found between males and females in terms of tobacco, alcohol and other drug use both in the elementary and the secondary school. The risk for substance use was found to be greater in private schools than public schools. CONCLUSION: Although the prevalence of substance use among elementary and secondary school students is low when compared to the findings from other countries. It was observed that especially the prevalence of tobacco use was quite high.

Is obesity a risk factor for psychopathology among adolescents?

BACKGROUND: Although several studies have documented the existence of psychopathology in obese adolescents, disagreement remains regarding the extent and nature of this psychopathology. The aim of the present study was to explore the type and frequency of psychopathology in a clinical as well as a non-clinical sample of obese adolescents, and in a normal weight control group. METHODS: The study sample consisted of a clinical study group of 30 obese adolescents, a non-clinical obese group of 30 obese adolescents, and a control group of 30 normal weight adolescents. Psychological assessment was performed using a non-structured psychiatric interview, the Child Behavior Checklist (CBCL), Children Depression Inventory (CDI), Rosenberg Self-esteem scale (SES) and the Eating Attitude Test (EAT). RESULTS: More than half of the clinical obese adolescents (16/30) had a DSM-IV diagnosis, often involving major depressive disorder (n = 10). The mean scores of anxiety-depression, social problems, social withdrawal and total problem in the CBCL scale of the clinical obese group were significantly higher than the non-clinical obese group and the normal weight control group. The mean total scores of the SES and the CDI of the clinical obese group were higher than the normal weight control group. The mean total score of EAT of the clinical obese group was significantly higher than the normal weight control group, and the mean score of EAT of the non-clinical obese group was significantly higher than the normal weight control group. CONCLUSIONS: The results support previously published reports which show a higher ratio of psychopathology (depression, behavioral problems, low-esteem) among clinical obese adolescents than among non-clinical obese adolescents. Findings provided evidence for a psychosocial at-risk population in a subgroup of obese adolescents.