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Objective: Job satisfaction of physicians is closely related to patient satisfaction, the quality and efficiency of medical care, and the enhancement of physicians' well-being. While there is a consensus on the global rise in job dissatisfaction among physicians, most studies in this field have primarily concentrated on the association between job satisfaction and depression, burnout, and work productivity. The number of studies examining the relationship between psychological processes and job satisfaction is limited. This study aimed to examine the impact of self-esteem, thwarted belongingness, and values on job satisfaction among medical professionals. Methods: A total of 196 physicians, aged between 18 and 65, who were working in state or private hospitals all over Turkiye at the time of the study (between December 2022 and February 2023), were included in this cross-sectional study. Data were collected using a sociodemographic form, Valuing Questionnaire (VQ), Interpersonal Needs Questionnaire (INQ), Rosenberg self-esteem scale (RSES) and Job satisfaction scale (JSS). Results: A positive correlation was found between job satisfaction (JSS) and valued living (VQ) (r=0.621; p<0.001), while negative correlations were found between thwarted belongingness (INQ-TB) (r=-0.352; p<0.001) and self-esteem (RSES) (r=-0.400; p<0.001). Multiple linear regression analyses demonstrated that VQ and work experience are significant predictors of Job Satisfaction (JSS) (p < 0.001, R² = 0.449). Conclusions: Findings of this study highlight the crucial role of personal values and work experience on job satisfaction. Incorporating personal values into future interventions is vital for enhancing job satisfaction among physicians.

Coronavirus disease (COVID-19) became a pandemic and is causing unprecedented biopsychosocial, spiritual and economic issues across the world while mostly affecting unprivileged populations. Turkey has gradually implemented new regulations, which slowly affected the entire country and increased the need for mental health services disproportionally. We conducted a comprehensive literature review on mental health in Turkey during COVID-19. There was no well-grounded peer-reviewed manuscripts or projects utilized a framework. Therefore, we wrote this manuscript to provide a conceptual framework grounded in ecological systems theory, acceptance and commitment therapy, and community-based participatory action research to introduce contextually evidence-based online mental health services: hotline, psychiatric interview, counseling, and Read-Reflect-Share group bibliotherapy. The framework aims to (1) address biopsychosocial spiritual and economic issues, (2) enhance wellbeing, and (3) empower the mental health profession in research and practice. Our preliminary findings and clinical experience indicated that the proposed framework and interventions derived from the framework enhanced wellbeing and decreased psychopathological symptoms in experimental group compared to control groups. Based on the preliminary analysis, most of the online, phone based, or face-to-face mental health services introduced in this manuscript were highly recommended by the participants to be provided to general public during and after COVID-19. Mental health professionals and authorities can use the proposed framework and interventions to develop interventions and research in order to alleviate pandemic-based biopsychosocial spiritual and economic issues and enhance wellbeing.

Objective: Acceptance and Action Questionnaire-II (AAQ-II) is a self-evaluating scale that has been developed for assessing psychological inflexibility levels. The aim of the present study is to examine reliability and validity of the Turkish version of Acceptance and Action Questionnaire-II (Turkish AAQ-II) using clinical and non-clinical sample. Methods: The study group consisted of 207 patients who have at least one diagnosis of anxiety disorders, anti-social personality disorder, unipolar depression or bipolar disorder, and 267 healthy controls. A socio-demographic form, Turkish AAQ-II, Panic Disorder Severity Scale (PDSS), Ruminative Thinking Style Questionnaire (RTSQ), Beck Depression Inventory (BDI), Padua Inventory Washington State University Revision (PI-WSUR), Short Form-36 (SF-36), STAI (State-Trait Anxiety Inventory) I-II were all administered. Internal consistency and temporal stability analyses were performed to evaluate the reliability of Turkish AAQ-II. Exploratory factor analysis and confirmatory factor analysis (CFA) were also conducted to evaluate the construct validity of this instrument. Convergent, concurrent and predictive validity analyses were also performed. Results: From 474 participants across clinical and non-clinical samples our results indicated satisfactory reliability and validity of the Turkish AAQ-II. The Turkish AAQ-II showed good internal consistency with Cronbach’s α coefficient of 0.84. 60 days test–retest reliability analysis also showed good temporal stability (Pearson’s correlation coefficient, r = 0.85). For structural validity; principal component analysis was conducted and Kaiser-Meyer-Olkin index (r=0.83) showed suitability for factor analysis (Bartlett chisquare=1151.20; p<0.0001). One-factor solution (Eigenvalue of 3.62) accounted for 51.76% of the total variance. Confirmatory factor analysis demonstrates that a revised model of scale fits well with 7 items and a one-factor structure [RMSEA (0.079), SRMR (0.0210), CFI (0.971), GFI (0.972), NFI (0.961)]. Pearson’s correlation analysis was used for evaluating convergent validity of Turkish AAQ-II and resulted in moderate correlations with RTSQ and STAI-II total scores (coefficients r = 0.566, r = 0.669, respectively). Concurrent validity analysis was performed to examine the predictive power of Turkish AAQ-II. Statistically significant correlations were found between total scores of Turkish AAQ-II and BDI (r=0.632), STAI-I (r=0.535), PI-WSUR (r=0.668) and PDSS (r=0.670). Predictive validity examined by comparing mean total Turkish AAQ-II scores of clinical and non-clinical groups and found statistically significantly higher scores in clinical (M=26.17, SD=8.81) group compared to to non-clinical [M=19.05, SD=7.76; t(443)=9.05, p<.0001] study group. Conclusions: It was found that Turkish AAQ-II has an one-factor structure with 7-item version. Higher levels of Turkish AAQ-II were found correlated with higher depressive, obsessive-compulsive, and anxiety related symptoms, and lower quality of life scores. Finally, it can be proposed that psychological inflexibility, assessed by Turkish AAQ-II, is a valid unidimensional measure in a variety of clinical sample as good as in non-clinical sample to measure the level of psychological distress.

Objective: Although there is a wide range of theoretical perspectives and clinical practices, there is no assessment tool that reveals these variations among clinicians. In this study, we presented the development process of a new measure for clinicians that assess their psychological flexibility levels, attitudes towards psychotherapy and inclination to the mechanistic approach. Method: Participants included 167 psychiatrists and psychiatry residents from all over Turkey. They completed 29 items intended to form the basis for the Bakirkoy Clinician's Attitude Questionnaire (BCSQ). Item-total correlation and Cronbach's alpha correlation analyses were performed to determine internal consistency. The Acceptance and Action Questionnaire-II (AAQ-II) and the Mental Illness: Clinicians' Attitude Scale V.4 (MICA v4) were used to assess the convergent and concurrent validity of BCSQ. Results: Principal component analyses with varimax rotation were conducted to ensure construct validity and to explore subdimensions. Finally, a three-dimensional version (Clinical inflexibility, Treatment preference, Mechanistic approach) of the scale with 20 items was created. The BCSQ demonstrated good internal consistency (Cronbach's alpha coefficient was 0.82) and transient stability. Convergent validity analyses showed that BCSQ subscales have significant relationships with higher psychological inflexibility and stigmatization levels. Conclusion: BCSQ proves to be a valuable tool for assessing changes in the level of psychological flexibility of clinicians in clinical practice, their attitudes towards psychotherapy/psychopharmacology and their view of psychopathology.

OBJECTIVES: Although there are studies investigating the relationship between anxiety disorders, depression, and hyperemesis gravidarum (HG), none have sufficiently clarified the link between underlying psychological processes and HG. The present study aimed to examine the relationship between rumination, worry, and HG and their possible triggering effects on HG. METHODS: The study was designed as a prospective, self-reported, cohort research and the study sample consists of 350 pregnant women. Socio-demographic Form, Ruminative Thinking Style Questionnaire (RTSQ), Trait Anxiety Inventory (STAI-2), and Beck Depression Inventory (BDI) were administered to the participants at the first 6 weeks of their pregnancies (time 1). Second consultation was made to detect women with HG diagnosis between the 6 and 18 weeks' gestation (time 2). Forty participants diagnosed with HG and 40 randomly chosen participants who had healthy pregnancy process at the end of the 18th gestational week were compared by using independent-samples T-test. RESULTS: While there was no significant difference between the time 1 RTSQ scores and the time 1 BDI scores of the HG and control groups, time 1 STAI-2 scores of the HG group were found to be significantly higher than the control group. CONCLUSIONS: Our results show that worry process plays an active role in the development of HG rather than rumination. As a well-known mechanism of trait anxiety, worry could be a vulnerability factor for HG.

Objective: The purpose of this study is to evaluate the reliability and validity of the Turkish Version of the Bipolar Spectrum Diagnostic Scale (BSDS). Method: The study was carried out with 130 patients diagnosed with bipolar I disorder, 15 patients diagnosed with bipolar II disorder, and 38 patients diagnosed with major depressive disorder attending the outpatient psychiatry departments of the Bakırköy Prof. Dr. Mazhar Osman Training and Research Hospital for Mental Health and Neurological Diseases. The Mood Disorder Questionnaire (MDQ) was used for convergent validity. The internal consistency coefficient, itemtotal score correlation coefficients, test-retest correlation coefficient, confirmatory factor analysis, correlation with concurrent scale, and ROC curve were statistically calculated. Results: Confirmatory factor analysis indicated that the 20-item version did not show adequate goodness-of-fit. The item 4 with a relatively low regression weight was removed from the model. For the 19-item revised and corrected model, the observed goodness-of-fit indexes were RMSEA = 0.040, CFI = 0.900, GFI = 0.890, IFI = 0.900 and χ2/df = 1.230. The internal consistency Cronbach’s alpha coefficient was 0.831. The correlation coefficient between the Turkish version of the BSDS and the MDQ was 0.54. The cutoff point of the scale calculated by the ROC analysis was 12 with a sensitivity of 78.6% and a specificity of 86.8%. Conclusion: The Turkish Version of the BSDS, has been shown to be reliable and valid tool for screening bipolar disorder after removal of the item 4 of the original version of the scale.

Objective: This study aimed to investigate stress appraisals, rumination, worry, and experiential avoidance (EA) in patients with bipolar disorder-I (BD-I) in the euthymic phase of the illness. The effects of these processes on functionality in individuals with BD-I are also investigated. Method: Using the Stress Appraisal Measure Dispositional Form (SAM-D), Ruminative Thinking Style Questionnaire (RTSQ), Penn State Worry Questionnaire (PSWQ), and Acceptance and Action Questionnaire-II (AAQ-II), we compared 67 BD-I patients with 70 healthy controls. Additionally, multiple linear regression analysis was used to determine the predictors of functionality levels measured by the Bipolar Disorder Functioning Questionnaire (BDFQ). Results: BD-I group showed significantly higher SAM-D \"threat,\" \"uncontrollable by anyone,\" and \"control by others\" scores. The BD-I group also reported higher EA (AAQ-II) than the control group. Rumination (RTSQ) and worry (PSWQ) did not show any significant differences between groups. BDFQ was negatively predicted \"uncontrollable by anyone\" and positively predicted by \"control by others\" subdimensions of SAM-D. Conclusion: Our findings suggested that patients with BD-I have differences in stress appraisals, even in the euthymic phase. Higher AAQ-II scores seemed to be a distinctive feature for patients with BD-I that may be related to perceiving stressful situations as threatening and uncontrollable. Our results present new perspectives for psychotherapeutic interventions both for the treatment and for the improvement of the functioning of these patients.

Objective: Our research aimed to determine the frequency of methamphetamine use among people referred to health institutions for treatment with the probation decision and to reveal the sociodemographic and clinical profile of people who use methamphetamine. Method: Four hundred and forty-two consecutive cases between 18 and 65 years of age who were referred for treatment to the Probation Outpatient Clinic in Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery were included in the study. Sociodemographic and clinical information of the cases, substance use and treatment histories, and criminal histories were recorded and evaluated with a semi-structured form. Urine toxicology results, which were taken as one of the obligations of the probation treatment program, were examined. Results: Substance metabolites were detected in the urine toxicological analysis of 81% of the cases. Methamphetamine use was detected in 24.4% of the sample. It was the second most common illicit substance after cannabis and the fourth common seized. Inhalation was the most common method of methamphetamine use. Of the cases still using methamphetamine, 90.7% (n=98) were found to use at least one substance other than methamphetamine. Emergency admissions for substance-related problems, inpatient addiction treatment, outpatient psychiatric treatment, and forensic histories were significantly higher in the group with methamphetamine use than in the group without methamphetamine use. Conclusion: Our study is the first to evaluate the rate of methamphetamine use in the probation population and the sociodemographic and clinical profile of people with methamphetamine use. According to the data obtained, one-fourth of the probation population was using methamphetamine. This group represented a more criminally engaged subgroup of substance users with more inpatient addiction treatment and outpatient psychiatric treatment needs with a high rate of polysubstance use. Recognizing the profile of methamphetamine users is essential to develop strategies to meet their treatment needs. In addition, a probation program might provide an opportunity to raise awareness of substance-related medical and social problems and to motivate individuals who are relatively less engaged with treatment to initiate a therapeutic process.

Objective: In this study, we examined the presence of some dysfunctional cognitive contents, processes and attitudes which are supposed to accompany the primary headache and described to take part in psychopathologies like anxiety and depression. Method: Thirty three patients diagnosed with migraine, 34 patients diagnosed with chronic tension type headache according to IHS (International Headache Society) criteria who referred to a Turkish training and research hospital neurology outpatient clinic were included. Thirty three healthy volunteers without headache were included as the control group. Automatic Thought Questionnaire (ATQ), White Bear Suppression Inventory (WBSI), Pain Catastrophizing Scale (PCS) and Demographic Information Questionnaire (DIQ) were administered to the participants for the determination of cognitive contents and attitudes. Results: The results showed that in the tension type headache group, ATQ total scores and ‘’Negative Self-Concepts’’, ‘’Personal Maladjustment and Desire for Change’’ and ‘’Giving up/Helplessness’’ subscale scores were significantly higher than the control group. There was no significant difference between the three groups in WBSI. It was shown that in PCS total scores and all scores of ‘’rumination’’, ‘’magnification’’ and ‘’helplessness’’ subscales, tension type headache group and migraine group had significantly higher scores according to the controls. Conclusion: Higher levels of negative cognitive contents in both of the migraine and tension type headache groups according to the healthy controls can explain high depression frequencies in these clinical manifestations. Another result obtained in our study was that as a way of coping with pain, rumination is used more than thought suppression in these individuals.

Objective: Self-related problems and psychological inflexibility, which can also lead to a vulnerability to depression, often accompany substance use disorders. This study examined whether psychological inflexibility and self-criticism mediated the relationship between depression and addiction severity. Method: We examined 111 patients with Substance use disorders (SUDs) using the Addiction Profile Index (API), Beck Depression Inventory (BDI), Forms of Self-criticizing/Attacking and Self-reassuring Scale (FSCRS), and Acceptance and Action Questionnaire-Substance Abuse (AAQ-SA). Mediation analysis was conducted to examine the mediating role of psychological inflexibility on the relationship between depression and addiction severity. Results: API total score was negatively correlated with AAQ-SA and positively correlated with BDI and FSCRS. Because FSCRS did not have a significant predictive effect on addiction severity (p=0.966), only AAQ-SA was included in the mediation analysis. According to the results of the mediation analysis, depression was found to directly affect addiction severity (direct effect, p=0.007), and it constitutes 54.5% of the total effect. Also, depression predicted addiction severity (indirect effect, p<0.001) through psychological flexibility, and it constitutes 45.5% of the total effect. Conclusion: According to our findings, psychological inflexibility is an important variable between depression and addiction severity. Although patients with SUDs may have negative evaluations about self, they may not use self-criticism as a coping strategy. Psychological inflexibility may be a substantial target for interventions in patients who use substances to avoid depressive symptoms.