Fatma Varol Tas

Establishment of interdisciplinary child protection teams in Turkey 2002–2006: Identifying the strongest link can make a difference!

OBJECTIVES The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome. METHODS A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software. RESULTS Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R(2)=91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period. CONCLUSIONS A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear. PRACTICE IMPLICATIONS Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect.

Nitric Oxide Levels in Disruptive Behavioral Disorder

There are various evidences of the role of nitric oxide (NO) in several neuropsychiatric disorders. However, there is no clinical study which investigated the role of NO in disruptive behavioral disorders (DBD). The aim of this study is to investigate the relation between NO levels and DBD. NO levels were measured in serum from 45 patients diagnosed as having DBD (30 patients with a diagnosis of attention deficit and hyperactivity disorder [ADHD] and 15 with ADHD + oppositional defiant disorder [ODD]) and 51 healthy control subjects. It is statistically significant that the pure ADHD group’s blood NO levels are lower than those of both the ADHD + ODD and control groups. There was no significant difference between the ADHD + ODD group and the controls. The difference of the NO levels in DBD may indicate the effect of NO in the etiology of this disorder spectrum.

Maternal psychosocial aspects in hypernatremic dehydration with high sodium concentrations in breast milk: a case-control study.

Objective:  To investigate whether mothers, with no known biological reason to account for elevated breast milk sodium (BMS) and associated hypernatremic dehydration (HND) in their exclusively breastfed infants, have more adverse psychosocial characteristics compared with controls.

Amisulpride treatment of adolescent patients with schizophrenia or schizo-affective disorders

In this article, our aim was to share our clinical experience regarding the effectiveness and the side effects of amisulpride treatment in adolescent cases. We reviewed all the cases who had amisulpride treatment during their stay in a newly opened in-patient unit, and three female cases who had undergone amisulpride treatment. We observed that the drug was effective and caused side effects like galactorrhea due to increased prolactin levels, which were not severe enough to terminate the treatment. Our clinical experience provides preliminary evidence that amisulpride might be an effective antipsychotic drug for adolescent cases. However, it caused considerable side effects.

Do serum BDNF levels vary in self-harm behavior among adolescents and are they correlated with traumatic experiences?

The aim of this study was to compare serum brain-derived neurotrophic factor (BDNF) levels between adolescents that harm themselves, those that receive psychiatric treatment but do not harm themselves, healthy adolescents, and childhood traumas and to investigate the relationship between traumatic experiences and serum BDNF levels. The cases were divided into two groups of 40 adolescents exhibiting self-harm behavior (self-harm/diagnosed group) and 30 adolescents receiving psychiatric treatment but not exhibiting self-harm behaviors (non self-harm/diagnosed group). The control group (healthy control group) consisted of 35 healthy adolescents with no psychiatric disorders or self-harm behaviors. The adolescents were asked to fill in the Inventory of Statements About Self Injury (ISAS) and Childhood Trauma Questionnaire (CTQ). For BDNF measurement, blood samples were taken from the cases and controls. The serum BDNF level of self-harming adolescents who used the self-cutting method was significantly lower than that of other groups, and serum BDNF levels decreased with the increase in the emotional neglect and abuse severity of self-harming adolescents during childhood. In our study, serum BDNF levels decreased with the increase in emotional abuse in self-harming adolescents. This finding may indicate that neuroplasticity can be affected by a negative emotional environment during the early period.

A Possible Cause of Trauma for Children in Justice System of Turkey: Attitudes of Prosecutors and Judges

A possible cause of secondary traumas for children in justice system of Turkey: attitudes of prosecutors and judges Objective: Inappropriate procedures or settings may cause secondary traumas in children and adolescents who are involved in justice systems. For improving the quality of assessments and preventing court-induced traumas, it is necessary to determine the existing problems. The aim of this study was to examine the problems with forensic assessments of children and adolescents, their causes, and possible solutions from the prosecutors’ and judges’ points of view. We also aimed to determine the collaboration problems from the legal authorities’ perspective. Method: The present study was conducted in the City of Erzurum, which is one of the metropolitan cities of Turkey. Thirty-five prosecutors and 14 judges filled out a questionnaire assessing their problems in child assessments. Results: The results indicate that 87.8% of the prosecutors and judges had difficulties at child assessments but none of the participants had an education on child evaluation in law school while only 18.4% participated a post-graduate education program. 61.2% of the respondents indicated that there were problems in the application of the current law. Conclusion: Court induced trauma is a challenging issue for child and adolescent psychiatry. The skills of legal authorities on child evaluations and their cooperation with mental health professionals may directly influence the quality of legal processes. Vocational training programs, creation of direct channels to reach the mental health specialists, and reorganizing the faculty of law education programs may be useful in terms of prevention.