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  • Yayın
    Attentional bias and training in social anxiety disorder
    (Turkish Neuropsychiatric Society, 2015-03) Fıstıkçı, Nurhan; Saatçioğlu, İbrahim Ömer; Keyvan, Ali; Topçuoǧlu, Volkan
    Cognitive behavioral therapy (CBT) is one of the most effective treatment modalities for social anxiety disorder (SAD), showing a high level of clinical evidence supporting its effectiveness. On the other hand, lack of the desired benefit from this treatment in some patients causes continuation of the search for new techniques. Recent research studies have focused on attentional bias and attention training in SAD. Attention processes in SAD have been a major target of interest and investigation since the introduction of the first cognitive models explaining SAD. In the first model, it was highlighted that attention was self-focused. The relationship between threatening stimuli and attention was considered in the subsequent models. Attentional bias towards threat may take place in several ways, such as facilitated processing of threat, difficulty in disengaging attention from the threat and avoidance of attention from the threat. After these descriptions regarding the phenomenology of the disorder, treatments to modify attention, processes were developed. In spite of conflicting results, investigations on attentional training are promising. Attention processes, attentional bias and attentional training in SAD are discussed in this review.
  • Yayın
    Uncontrolled avoidance of threat: Vigilance-avoidance, executive control, inhibition and shifting
    (Routledge Journals, 2014) Booth, Robert William
    It has been argued that anxious individuals orient their attention initially towards and then away from threat; this pattern is known as vigilance-avoidance. While the mechanisms underlying the initial vigilance have been subject to intense speculation and study, mechanisms underlying any subsequent avoidance have been neglected, although it has often been assumed that avoidance is a controlled coping strategy. Using a correlational design, the present study assessed avoidance in a dot-probe task, along with anxiety and two aspects of goal-driven executive control: Shifting and inhibition. Avoidance of threat correlated with state of anxiety; separate from this, avoidance also correlated negatively with shifting performance and was unrelated to inhibition performance. In other words, avoidance appeared to represent a shifting failure in this study. These results suggest that avoidance may occur ballistically in any individual as a consequence of threat exposure and does not necessarily represent a controlled coping response.
  • Yayın
    Treatment of preschool children with obsessive compulsive disorder
    (SAGE Publications Ltd, 2023-04) İnci İzmir, Sevim Berrin; Ercan, Eyüp Sabri
    The aim was to examine the clinical features of Obsessive-Compulsive Disorder (OCD) in preschool and the effectiveness of aripiprazole with a standardized Cognitive-Behavioral Family Therapy (CBFT) in the treatment of preschoolers with OCD. Twelve preschool children, 36–72 months of age were diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition criteria by a fellowship-trained child and adolescent psychiatrist. They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version and Childhood Yale-Brown Obsessive Compulsive Scale (CY-BOCS) at baseline, at the end of the 12th and 24th weeks of treatment. The baseline mean of total CY-BOCS score decreased from 33.67 to 13.83 at the 12th week and 5.58 at the end of the 24th week of treatment. Also, 66.7% of them had at least one psychiatric comorbidity. Overall, this study revealed the effect of aripiprazole with CBFT in preschool-aged children with OCD. Also, the presence of comorbidity that is seen frequently in preschoolers with OCD may complicate the treatment. Therefore, there is a need to increase awareness of OCD and its comorbidities in preschoolers to supply treatment at an early age.
  • Yayın
    EMDR Flash technique in adolescents with depression: a twelve-week follow-up study
    (Sage Publications Inc, 2024-07) İnci İzmir, Sevim Berrin; Çitil Akyol, Canan
    This study aims to investigate the specific effects of the EMDR Flash Technique on adolescents with depression. This follow-up study consists of 32 adolescents, 12-17 years of age (M = 14.34, SD = 1.56), including 7 males and 25 females. They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present, the Beck Depression Inventory (BDI), and Children Revised Impact of Event Scale-8 (Cries-8). These were administered at baseline, at the end of the 4th and 12th weeks of treatment. The EMDR Flash Technique which can be utilized in the preparation phase of Eye Movement Desensitization and Reprocessing (EMDR) to reduce the intensity of highly distressing memories rapidly and relatively painlessly was applied for 12 weeks, one session per week as a free-standing intervention. Also, the EMDR Flash Technique can be effective in decreasing the rate of noncompliance and drop-outs of adolescents. The baseline means of total BDI scores decreased from 48.19 to 2.16 at the end of the 12th week of treatment. Also, the CRIES scores decreased from 31.78 to 0.44 at the end of the 12th week of treatment. In addition, the baseline means of SUD scores decreased from 9.53 to zero at the end of the 12th week of treatment. Overall, our results underscore the effectiveness of the EMDR-Flash Technique in adolescents with depression. Depression is a significant mental health concern for adolescents due to its early onset and chronic nature. Depression can be observed in conjunction with PTSD, and sometimes, depressive symptoms may transform into traumatic experiences. EMDR is an 8-stage protocol that includes history taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation, used to alleviate the effects of traumatic experiences. It is hypothesized that unpleasant and traumatic events are stored in a dysfunctional way, and it promotes an adaptive processing and resolution of the traumatic experience. The goal of EMDR is to achieve an adequate processing of negative experiences and to create new adaptive information. The EMDR Flash Technique (FT) is utilized in the preparation phase of EMDR to reduce the intensity of highly distressing memories rapidly and relatively painlessly. Although a few studies have shown that the FT is effective in adults, there is only one study to investigate the effectiveness of the FT in children and adolescents. This research, in determining the efficacy of the EMDR FT on adolescents with depression, particularly focused on depression symptoms and assessed the observed changes in these symptoms. It aims to evaluate the specific effects of EMDR-FT on adolescents with depression, providing a unique perspective compared to previous research that has mainly focused on broader mental health disorder indicators. It is hypothesized that EMDR-FT is an effective therapy for treating adolescents with Depression. In the present study, adolescents with depression showed significant improvements in symptom severity and their traumatic events impact levels decreased. As a result of our study, a 12-week EMDR-FT treatment was observed to be effective for adolescents with depression and in reducing and improving traumatic stress levels and depression. Our results underscore the effectiveness of the EMDR-FT in adolescents with depression.
  • Yayın
    Treatment and long-term outcome of mental disorders: The grim picture from a quasi-epidemiological investigation in 54,826 subjects from 40 countries
    (Elsevier Ireland Ltd, 2025-06) Fountoulakis, Konstantinos N.; Karakatsoulis, Gregory; Abraham, Seri; Adorjan, Kristina; Uddin Ahmed, Helal; Alarcòn, Renato Daniel; Arai, Kiyomi; Auwal, Sani Salihu; Berk, Michael; Levaj, Sarah; Yılmaz Kafalı, Helin
    Introduction: This study registered rates of specific treatment options for mental disorders as well as their long-term outcome. Material and methods: The history of mental disorders was used as a proxy for diagnosis. The data came from the COMET-G study (40 countries; 54,826 subjects, 64.73 % females, 35.45±13.51 years old). The analysis included descriptive statistics, Risk Ratios, t-tests, and ANCOVA's. Results: 24.14 % reported a history of any mental disorder (depression >12 %, non-affective psychosis and Bipolar disorder 1 % each, >20 % self-injury, >10 % had attempted suicide, 7.17 % illegal substance abuse). Most patients were not under any kind of treatment (59.44 %) and most were not receiving treatment as recommended (e.g. 90 % of Bipolar and 2/3 of psychotic patients). No treatment at all and psychotherapy as monotherapy were consistently related to poorer outcomes. In anxiety or depression, only antidepressant monotherapy and benzodiazepines, in Bipolar disorder only antipsychotic monotherapy in males and antidepressant monotherapy in females and in non-affective psychosis antipsychotics and psychotherapy in females only, were related to good outcomes. No treatment modality was related to a good outcome in those with a history of self-harm, suicidal attempts, or illegal substance use. Only depression and treatment with antidepressants were related to metabolic syndrome. Discussion: In the community, the overwhelming majority of mental patients do not receive appropriate treatment or, even worse, no treatment at all. The outcome is unfavourable for the majority and only a few selective treatment options seem to make a difference.