A questionnaire consisting of items about abuse, neglect, self-mutilation and suicide attempt and the Turkish Version of the Dissociative Experiences Scale were given to 862 high school students. The rates of suicide attempt and self-mutilative behaviors were 10.1% and 21.4%, respectively. Abused or neglected groups (34.3%) had 7.6-fold higher suicide attempts and 2.7-fold higher selfmutilation behaviours. The logistic regression model showed that each type of trauma and dissociation contributed to suicide attempts and self-mutilation, but dissociation was the most powerful. Suicidal and self-destructive adolescents should precisely be evaluated for abuse, neglect and dissociation in clinical practice.
Grief and dissociation after traumatic exposures are among the most important predictors of posttraumatic stress disorder (PTSD). This article introduces the Traumatic Dissociation and Grief Scale (TDGS), a 23-item measure easily administered. The TDGS, the Child PTSD-Reaction Index (CPTSD-RI), and a questionnaire concerning risk factors related to the event (losses, injury, and witnessing death and injuries) were administered to school-aged children who had been directly exposed to the 1999 earthquakes in Turkey and to a nonexposed control group. Factor analysis of the TDGS yielded four factors: perceptual distortions, body-self distortions, irritability, and guilt and anhedonia. A moderate positive correlation was noted between the TDGS and the CPTSD-RI. Different sets of risk factors were associated with the different scale factors. The results suggest that the assessment of psychopathology in children following a disaster requires the complementary evaluation of symptoms of posttrauma, dissociation, and grief.
The aim of our study is to report the relation between pathological care and impairment in social interaction, communication, language development, and stereotypical behaviors. Fifteen cases (9 boys, 6 girls) who have the symptoms listed above and who were misdiagnosed with pervasive developmental disorder (PDD), were referred to our clinic for evaluation and treatment. After the cases were evaluated by a semi-structured interview, symptoms related to pathological care were fortified; maternal depressive symptoms associated with child neglect and overexposure to television viewing. The cases and the mothers/primary caretakers were treated in a standardized psycho-educational program of 3 months. After this period improvements were observed in all of the symptom clusters. Twelve cases (80%) had improvements in eye contact. Eleven cases (73.3%) began to engage in reciprocal play and ten cases (66.6%) showed social imitative behaviors. Six cases (40%) began to form sentences. Stereotypic behaviors diminished in six cases (40%) and disappeared in nine cases (60%). According to our findings, although the symptoms of PDD and reactive attachment disorder (RAD) resemble each other, presence of pathological care and good response to treatment in RAD can be important for the differential diagnosis with PDD.
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