Browsing by Author "Kefeli, Mehmet Celal"

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Childhood Maltreatment Is Associated With Attachment Insecurities, Dissociation and Alexithymia in Bipolar Disorder
(Elsevier Ireland Ltd, 2018) Kefeli, Mehmet Celal; Turow, Rachel Goldsmith; Yildirim, Abdullah; Boysan, Murat
Child maltreatment is a public health issue that is a well-established risk factor for many psychological conditions, including bipolar disorder. The current study is one of the first to investigate associations among child maltreatment, dissociative symptomatology, alexithymia, anxiety, depression, and attachment insecurities. 40 patients with bipolar disorder-I and 40 healthy subjects matched for age, gender, and education participated in the study. The Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ), Childhood Trauma Questionnaire (CTQ-28), Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scale (DASS-21), and Experiences in Close Relationships-Revised (ECR-R) were completed by participants. In comparison to control participants, patients with bipolar disorder-I reported significantly more frequent abusive experiences in childhood, higher levels of attachment insecurities, more severe pathological and somatoform dissociation, as well as higher scores on measures of alexithymia, anxiety, depression and psychological stress. Reports of psychopathology among first-degree relatives (OR = 102.169, 95%IC = 4.596-2271.255; P < 0.01) and childhood emotional trauma (OR = 1.032; 95%CI = 0.782-1.363, P = 0.05) significantly contributed to bipolar disorder-I diagnosis. In contrast, absorption was negatively associated with bipolar illness (OR = 0.852; 95% CI = 0.747-0.973, P < 0.05). Our results showed significant associations between childhood trauma exposure and risk of bipolar disorder. Moreover, the results demonstrate that emotional abuse exposure predicts bipolar illness.
Development and Preliminary Psychometric Properties of an Instrument for the Measurement of Obsessional Dissociative Experiences: the Van Obsessional Dissociation Questionnaire (vod-Q)
(Springer, 2018) Boysan, Murat; Yildirim, Abdullah; Besiroglu, Lutfullah; Kefeli, Mehmet Celal; Kagan, Mucahit
A growing body of research evidence documents the substantial associations between obsessive-compulsive disorder (OCD) and dissociation. This article describes the development and preliminary psychometric properties of the Van Obsessional Dissociation Questionnaire (VOD-Q). Obsessional dissociation is defined as a tendency to dissociate in reaction to distressing, unwanted and intrusive thoughts, images and impulses. The screening tool is conceptualized to tap obsessional dissociation across three dimensions: obsessional absorption, obsessional depersonalization/ derealization and obsessional amnesia. The VOD-Q, the Padua Inventory-Revised (PI-R), the Dissociative Experiences Scale (DES), and the Obsessive Belief Questionnaire (OBQ-44) were administered in this study. The results showed that the VOD-Q had excellent test-retest reliability (ranging from 0.73 to 0.90) and internal consistency (ranging from 0.90 to 0.97). The VOD-Q total and subscale scores were significantly associated with measures of obsessive-compulsive symptoms and dissociative experiences. OCD patients scored significantly higher on the VOD-Q than community participants. Based on the present findings, the VOD-Q appears to be a reliable and valid instrument for the measurement of obsessional dissociative experiences.
Psychometric Properties of the Turkish Version of the Clinician-Administered Ptsd Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (Turkish Caps-5)
(Aves, 2017) Boysan, Murat; Ozdemir, Pinar Guzel; Yilmaz, Ekrem; Selvi, Yavuz; Ozdemir, Osman; Kefeli, Mehmet Celal
Background: In the subsequent revision of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013) symptoms of diagnostic criteria for post-traumatic stress disorder (PTSD) are defined in four clusters and the number of PTSD symptoms was expanded to 20. The Clinician-Administered PTSD Scale (CAPS) is the most widely used structured clinical interview and recognized as the golden standard in PTSD diagnosis. The final revision of the clinical interview form as the CAPS for DSM-5 (CAPS-5) was advanced in line with the recent revisions in DSM-5 with regards to the PTSD definition. The aim of this study was to examine the psychometric properties of the Turkish version of CAPS-5 in clinical samples and healthy controls. Methods: In the present study, 30 inpatients with PTSD and 30 inpatients with major depressive disorder consecutively presented to the Psychiatry Outpatient Clinic Yuzuncu Yil University Research Hospital, and 30 healthy controls were enrolled. All participants were included if only they reported an index trauma in the Life Events Checklist for DSM-5 (LEC-5) that bothered them during the past month. Subjects were administered a socio-demographic questionnaire, the Dissociative Experiences Scale (DES), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) along with the LEC-5, CAPS-5 and PTSD Checklist for DSM-5 (PCL-5). We used confirmatory factor analysis to compare a structured clinical interview (CAPS-5) and a self-report measure, the PCL-5 and to examine DSM-5 implied four-symptom clusters and several factor structures proposed in the literature to understand which model best represents the latent factor structure of PSTD symptoms. Using multivariate analysis of covariance, concurrent validity of both self-report and structured clinical interview was evaluated. Receiver operating characteristics (ROC) curve was utilized to obtain an optimal cut-off value of the PCL-5 scores in order to use in demarcating cases with non-cases. Results: Even though DSM-5 implied four-factor model adequately fit to either data collected using self-report or clinician-administered measures of PTSD, the latent structure of PTSD symptoms measured by either CAPS-5 or PCL-5 were best represented by six-factor Externalizing Behaviors model, particularly compared to seven-factor Hybrid model. In comparison to depressive and control groups, PTSD patients reported greater scores on the PCL-5, DES, BDI, and BAI and McNemar.2 values between two applications with two weeks interval were unsubstantial. Additionally, PTSD patients exhibited greater symptom endorsement on B, C, D, E, F, G symptom clusters and dissociative subtype than depressive patients and controls. Using signal detection analysis, a significant area under the curve (AUC) was calculated for the PCL-5 (AUC = 0.87 p < 0.001 asymptotic 95% Confidence Interval = 0.798-0.942). The PCL-5 had excellent diagnostic utility with 0.90 sensitivity and 0.80 specificity on a cut-off score >= 47. Conclusion: Turkish versions of the CAPS-5 and PCL-5 are demonstrated to have very good psychometric properties. Implications regarding the findings are discussed.
Psychometric Properties of the Turkish Version of the Depression Anxiety Stress Scale-21 (dass-21)
(Routledge Journals, Taylor & Francis Ltd, 2018) Yildirim, Abdullah; Boysan, Murat; Kefeli, Mehmet Celal
The study examined the psychometric properties of the Turkish version of the DASS-21. Thirty patients with major depression and 30 patients with anxiety disorders and 250 health controls participated in the study. We tested six alternative models using CFA. We found that tripartite model comprised of anhedonia and physiological hyperarousal along with a general negative affectivity outperformed alternative models. The DASS-21 distinguished clinical groups from healthy controls. The scale had excellent internal reliability, with Cronbach's alphas ranging from 0.87 to 0.90, and temporal stability, with intra-correlations ranging from 0.82 to 0.93. The Turkish version of the DASS-21 appears to have adequate psychometric properties in clinical and non-clinical samples.