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In this study, our aim was to evaluate the internal and external validity of Sluggish Cognitive Tempo (SCT) and to determine if it is an independent factor from Attention Deficit Hyperactivity Disorder (ADHD) in Turkish children, like in other cultures. Two hundred sixty-one children (6–12 years of age) who applied to Ankara University Child and Adolescent Psychiatry outpatient clinics and diagnosed with ADHD recruited the study. All children were evaluated with the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime Version which is a semi-structured diagnostic interview (K-SADS-PL) for ADHD diagnosis. Child Behavior Checklist for ages 6–18, The Barkley’s Child SCT Ratings Scale, SNAP-IV Parent and Teacher Scale, and Sociodemographic Information Form were enrolled by the parents and teachers of the children. Our results demonstrated that SCT symptoms formed two distinct but interrelated factors (Sluggish and Daydreaming) separate from those for ADHD. Due to regression analyses, higher levels of SCT predicted higher levels of ADHD-IN (Inattentive) and internalizing symptoms including anxiety-depression, social problems, and social withdrawal. These findings distinguished SCT cases from ADHD-IN in Turkish children. Results also indicated that ADHD- IN symptoms are risk factors for lower academic achievement while SCT symptoms haven’t such an effect. Our study is the first which demonstrates SCT’s construct validity relative to ADHD-IN by parental and teacher ratings in Turkey. Similar findings with Turkish children to the findings with children from other cultures would increase our confidence in the transcultural generalizability of SCT’s internal-external validity.

Background Executive functioning (EF) difficulties may play a significant role in the vicious cycle of overeating and metabolic disturbances. We aimed to investigate the correlates of EF difficulties in terms of food addiction symptoms, eating attitudes, and metabolic syndrome markers among adolescents seeking obesity treatment. Methods Thirty-five adolescents seeking obesity treatment were included. Executive functioning difficulties were assessed using both performance tasks (i.e. Stroop’s task and Cancellation task) and parent reports on the Behavior Rating Inventory of Executive Function (BRIEF). Other measurements included adolescent self-reports of food addiction symptoms on the Yale Food Addiction Scale (YFAS) and eating attitudes on the Eating Attitudes Test-40 (EAT-40). Results The mean total symptom score was 4.66 (± 1.45) on the YFAS. The most commonly endorsed symptoms were ‘Repeated unsuccessful attempts to stop or decrease food consumption’ in 94.3% ( N  = 32), ‘Tolerance to the same amount of certain foods and consuming increasing amounts’ in 80.0% ( N  = 28), and ‘Continuing to eat despite knowing the negative consequences’ in 77.1% (N = 27) of the sample. 48.6% of the adolescents with obesity (N = 17) met the criteria for diagnostic evaluation threshold according to YFAS, which was related to worse performance in Stroop Task and parent-reported difficulties in Emotional Control (p < .05 for both). Food addiction symptoms had differences in correlations with EF difficulties. “Eating for longer durations and higher amounts than intended” was related to difficulties in Emotional Control and Working Memory (p < .05 for both). “Continuing to eat despite knowing the negative consequences” was associated with difficulties in Shift, Emotional Control, Initiate, Plan/Organize, and Organization of Materials (p < .05 for all). Dieting was the only disordered eating attitude significantly correlated with EF difficulties. Specifically, less endorsement of dieting was correlated with difficulties in Inhibit and Working Memory (p < .05). Moreover, executive functioning difficulties were related to increased body mass index and waist circumference, in addition to worse metabolic parameters including fasting blood glucose, insulin, HOMA-IR, triglycerides, and blood pressure measurements. Conclusion Our study points out that specific EF difficulties were related to food addiction symptoms, dieting, and metabolic syndrome markers among adolescents with obesity. Further studies are needed to with larger and more diverse samples. Plain English Summary This study explored how thinking skills, known as executive functions, are connected to eating habits, food addiction symptoms, and health markers in teenagers receiving treatment for obesity. Executive functions help people control their behavior, plan ahead, switch between tasks, and manage emotions. We worked with 35 adolescents who were seeking help for obesity.We tested their executive functions using both performance tasks and questionnaires completed by their parents. The teenagers also answered questions about food addiction and eating attitudes, and we measured their body weight, waist size, and various health indicators like blood sugar, insulin, and blood pressure. Almost half of the participants met the criteria for food addiction. Common signs included repeatedly failing to cut down on certain foods, needing more of the same food to feel satisfied, and continuing to eat despite knowing it could cause harm. Those with food addiction had more difficulties with emotional control, working memory, and other thinking skills. Lower interest in dieting was linked to poorer self-control and working memory. Importantly, teenagers with greater executive function difficulties tended to have higher body weight, larger waistlines, and less healthy metabolic measures. These findings suggest that challenges with thinking and self-control skills may play an important role in both unhealthy eating behaviors and physical health problems in adolescents with obesity. Understanding and addressing these thinking skills could help improve treatment for young people struggling with obesity and related health issues.

Objective: Panic disorder (PD) is now recognized as a common and important problem in children, and particularly adolescents, and one that can negatively affect daily well-being and educational performance. The aim of this study was to investigate the relationship between heart rate variability (HRV) and the severity of symptoms before and after treatment with psychotherapy and fluoxetine. Methods: The PD study group consisted of 23 children diagnosed with PD and the healthy control (HC) group comprised 27 healthy children. Panic-anxiety symptoms were measured using 2 assessments performed before and after treatment. HRV was evaluated with a 24-hour Holter examination. Results: According to the analysis of the 24-hour, all-day Holter device recordings, the high frequency (HF) and parasympathetic (%) scores in the PD group were lower than those of the HC group (p<0.05). The low frequency (LF)/HF ratio and sympathetic (%) scores in the PD group were higher than those of the HC group (p<0.05). The analysis of daytime readings indicated that the HF values of the PD group were lower than those of the HC group (p<0.05), while the very LF/HF ratio and LF/HF ratio were higher than those of the HC group (p<0.05). Analysis of nighttime Holter results revealed that the rMSSD, pNN50, and HF readings of the PD group were lower than those of the HC group (p<0.05), while the LF/HF ratio in PD patients was higher than that seen in the HC group (p<0.05). Conclusion: In children and adolescents with PD, increased sympathetic activity can cause changes in some HRV parameters. Some of these changes may return to normal with treatment.

BACKGROUND: Cyberbullying, has concerned professionals due to increased use of media over time and as predicted, this type of bullying is fairly common among adolescents. We aimed to define the prevalence of cyberbullying and cyber victimization, examine relationships between problematic smartphone (SP) use (PSU), psychiatric symptoms and emotion regulation difficulties in a clinical adolescent sample. Also, we aimed to predict risk factors of being an E-Victim and E-Bully. METHODS: One hundred and fifty adolescents have recruited the study. Demographic Information Form, Problematic Mobile Phone Usage Scale, Brief Symptom Inventory, Difficulties in Emotion Regulation Scale, E-Victimization-E-Bullying Scale were filled out by adolescents. RESULTS: Our results indicated that the prevalence of cybervictimization and cyberbullying were 62.6% and 53.3%, respectively. BEVEB (Both E-Victim and E-Bully) group adolescents were older than NVB (Non-Victim/Bully) groups. Access internet via own SP, PSU, problems in strategies and impulse control and were significantly higher and \"lack of awareness\" scores were significantly lower in BEVEB group than others. In addition, when compared with OEV (only E-Victims) group, BEVEB group had also higher hostility scores. Logistic regression analysis revealed that high scores of \"lack of awareness\" and higher E-bullying scores increase the risk of being an E-Victim; and higher scores of hostility and E-victimization and lower scores of \"lack of awareness\" (in other words being more aware of feelings) increase the risk of being an E-bully. CONCLUSIONS: According to analyses, contrary to our expectations, PSU was important but not an independent predictor of being an E-Victim/E-Bully. Our results also demonstrated an interesting finding: lack of awareness is a risk factor for being an E-victim. We interpreted this result as could not be aware of feelings increase the victimization risk. On the other hand, E-Bullies have higher hostility and victimization while having lower \"lack of awareness\" scores. It could be speculated that, re-victimization and being aware of hostility feelings could increase the cyberbullying among adolescents. In addition being an E-Bully could be a consequence of being an E-victim and increasing hostility and awareness over time. These results should be re-examined in larger clinical samples.

Attention deficit hyperactivity disorder is a heterogeneous neurodevelopmental disorder characterized by inattention, hyperactivity and impulsivity in which genetic, socia land physical factors are influentia land despite the resarches in this field, currently etiology is not fully understood. The aim of this review is to evaluate research on role of environmental factors in the etiology of attention deficit hyperactivity disorder, which is attracting more and more attention all over the world.

ABSTRACT Introduction: Facial emotion recognition (FER) is crucial for effective social competency, and problems in this skill are linked depression during adolescence. In this study, we aimed to find the rates of FER accuracy for negative (fearful, sad, angry, disgusted), positive (happy, surprised), and neutral emotions, and the possible predictors of FER skill for most confusing emotions. Subjects and Methods: A total of 67 drug-naive adolescents with depression (11 boys, 56 girls; 11-17 years) were recruited for the study. The facial emotion recognition test, childhood trauma questionnaire and basic empathy, difficulty of emotion regulation, and Toronto alexithymia scales were used. Results: The analysis demonstrated that adolescents have more difficulties in recognizing negative emotions when compared the positive ones. The most confusing emotion is fear (39.8% of fear was recognized as surprise). Boys have lower fear recognition skill than girls and higher childhood emotional abuse, physical abuse, emotional neglect, and difficulty in describing feelings to predict lower fear recognition skill. For sadness recognition skill, emotional neglect, difficulty in describing feelings, and depression severity were the negative predictors. Emotional empathy has a positive effect on disgust recognition skill. Conclusion: Our findings demonstrated that impairment of FER skill for negative emotions is associated with childhood traumas, emotion regulation difficulties, alexithymia, and empathy symptoms in adolescent depression.

Divalproex sodium/valproic acid (VPA) is an antiepileptic drug which is frequently prescribed in neurology and psychiatric clinics. Common side effects of VPA are side effects of the digestive system, weight gain, tremor, sedation, hematologic side effects and hair loss. Valproate-induced hyperammonemia is almost seen in 50% of patients treated with VPA, some of which may develop encephalopathy. Valproate-induced hyperammonemic encephalopathy (NE) is a well-known subject and there are numerous publications in the current literature. Although there is substantial evidence for this side effect in patients with neurological disorders, the data in the psychiatric area are limited. When we look at publications, it seems that VHE is seen more often because it starts earlier in psychiatric patients, but we think that it is often missed. Here, we presented five cases in which we followed up and treated with VHE diagnosis in our clinic within one year and other reports published previously in a table.

The aim of this study was to evaluate the impact of childhood traumas, determine their effects on coping skills, and assess gender specific differences in patients with major depression. Fifty female and fifty male patients with unipolar depression were enrolled. All patients were administered sociodemographic a data form, the Beck Depression Inventory, and subjected to a COPE Scale. Experiences of childhood abuse and neglect were assessed by the Childhood Trauma Questionnaire (CTQ-28). First, female patients with childhood traumas were found to use emotion focused coping styles whereas, male patients used problem focused and less useful coping styles more frequently. Second, there were positive relationships between childhood trauma scores and depression severity, childhood sexual abuse, and emotion focused coping styles in both male and female groups according to correlation analyses. In addition, childhood traumas led to further modifications on coping styles in the male group. Finally, a multiple linear regression model was used to identify independent predictors of coping styles. For both men and women, it was shown that childhood sexual abuse was significantly and positively related to emotion focused coping styles. Depression severity was the other predictor for emotion focused coping styles and was less useful in only the male group. Increased information on childhood trauma history and gender specific coping strategies could help to identify individual's at risk for depression and/or predict response to treatment. Future studies should focus on the prospective investigation of potential predictors and mediators in this area.

Background: Fear of missing out (FoMO) is a kind of anxiety that arises from FoMO on rewarding online social experiences that others might be having. Recent studies demonstrated that there is a strong relationship between FoMO and problematic smartphone use (PSU). In this study, we aimed to address the relationship between age, gender, psychiatric symptoms, PSU, and FoMO among a clinical-based adolescent sample. Methods: In total, 197 adolescents (136 boys, 12-18 years) who applied to psychiatry clinics were recruited in the study. Path analysis with observed variables was used to investigate the relationships of PSU and FoMO with each other and with psychiatric symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism), age, and gender. Results: Path analysis showed that age (B1 = 2.35, P < 0.001), somatization (B1 = 1.19, P < 0.001), hostility (B1 = 0.92, P = 0.001), and paranoid ideation (B1 = 0.93, P = 0.005) have significant positive effect on PSU, when interpersonal sensitivity has a significant negative effect (B1 = -1.47, P < 0.001). For FoMO, male gender (B0 = 0.35, P < 0.001), anxiety (B1 = 1.37, P < 0.001), and PSU have positive effects, whereas age (B1 = -1.60, P < 0.001), depression (B1 = -0.58, P = 0.004), and hostility (B1 = -0.49, P = 0.001) have a negative effect. Conclusions: Our study demonstrated that although PSU and FoMO are closely related to each other in previous studies, they have different associations with age, gender, and psychiatric symptoms among a clinical-based adolescent sample. The positive effects of PSU, anxiety on FoMO are predictable; however, the negative effect of age, hostility, and depression on FoMO was interesting. These relationships could be related to social exclusion-hostility and impulsivity-male gender/younger age associations in adolescence. In addition, we did not find a significant effect of FoMO on PSU, this could be related to the social and non-social use of smartphones, and should be reevaluated in clinical samples in the future.

OBJECTIVE: In the last decade, using social network sites (SNSs) has grown and become an integral part of daily routine for adolescents. As known, ADHD is a major public health problem for all addiction types, including the Internet and SNSs addiction. Our aim was to examine the effect of ADHD, impulsivity types, using motivations, internalizing and externalizing symptoms on Facebook (FB) overuse and FB addiction among adolescents. METHODS: Participants were recruited from ADHD and non-ADHD adolescents who were applied to the child and adolescent psychiatry and have an active FB account. We used FB Use and Motivations Form, the Barratt Impulsiveness Scale (BIS), Bergen FB Addiction Scale (BFAS) and Conners-Wells' Adolescent Self-Report Scale-Long form (CASS:L). RESULTS: Our results indicated that ADHD adolescents have more fake FB accounts, have their own accounts for longer time, are using FB for more motivation types and FB overuse is more frequent than in non-ADHD counterparts. According to the degree of FB use, we have shown that adolescents with FB overuse behaviour have more externalizing symptoms and have higher CASS:L and Barrat impulsivity scores than others. Risk factors for FB overuse are: having a fake FB account and having higher ADHD index scores; risk factors for FB addiction are: higher attentional impulsivity, higher conduct problems scores and higher ADHD index scores. CONCLUSIONS: The results of this study have improved our understanding about the risk factors of a new behavioural addiction type among adolescents.