Zeynep Simsek

The Generalizability of the Youth Self-Report Syndrome Structure in 23 Societies.

As a basis for theories of psychopathology, clinical psychology and related disciplines need sound taxonomies that are generalizable across diverse populations. To test the generalizability of a statistically derived 8-syndrome taxonomic model for youth psychopathology, confirmatory factor analyses (CFAs) were performed on the Youth Self-Report (T. M. Achenbach & L. A. Rescorla, 2001) completed by 30,243 youths 11-18 years old from 23 societies. The 8-syndrome taxonomic model met criteria for good fit to the data from each society. This was consistent with findings for the parent-completed Child Behavior Checklist (Achenbach & Rescorla, 2001) and the teacher-completed Teachers Report Form (Achenbach & Rescorla, 2001) from many societies. Separate CFAs by gender and age group supported the 8-syndrome model for boys and girls and for younger and older youths within individual societies. The findings provide initial support for the taxonomic generalizability of the 8-syndrome model across very diverse societies, both genders, and 2 age groups.

Cross-Informant Agreement Between Parent-Reported and Adolescent Self-Reported Problems in 25 Societies

We used population sample data from 25 societies to answer the following questions: (a) How consistently across societies do adolescents report more problems than their parents report about them? (b) Do levels of parent–adolescent agreement vary among societies for different kinds of problems? (c) How well do parents and adolescents in different societies agree on problem item ratings? (d) How much do parent–adolescent dyads within each society vary in agreement on item ratings? (e) How well do parent–adolescent dyads within each society agree on the adolescents deviance status? We used five methods to test cross-informant agreement for ratings obtained from 27,861 adolescents ages 11 to 18 and their parents. Youth Self-Report (YSR) mean scores were significantly higher than Child Behavior Checklist (CBCL) mean scores for all problem scales in almost all societies, but the magnitude of the YSR–CBCL discrepancy varied across societies. Cross-informant correlations for problem scale scores varied more across societies than across types of problems. Across societies, parents and adolescents tended to rate the same items as low, medium, or high, but within-dyad parent–adolescent item agreement varied widely in every society. In all societies, both parental noncorroboration of self-reported deviance and adolescent noncorroboration of parent-reported deviance were common. Results indicated many multicultural consistencies but also some important differences in parent–adolescent cross-informant agreement. Our findings provide valuable normative baselines against which to compare multicultural findings for clinical samples.

International comparisons of behavioral and emotional problems in preschool children: Parents' reports from 24 societies

International comparisons were conducted of preschool childrens behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1½–5 by parents in 24 societies (N = 19,850). Item ratings were aggregated into scores on syndromes; Diagnostic and Statistical Manual of Mental Disorders–oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3–12%). Although societies differed greatly in language, culture, and other characteristics, Total Problems scores for 18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of 0–198). Gender and age differences, as well as gender and age interactions with society, were all very small (effect sizes < 1%). Across all pairs of societies, correlations between mean item ratings averaged .78, and correlations between internal consistency alphas for the scales averaged .92, indicating that the rank orders of mean item ratings and internal consistencies of scales were very similar across diverse societies.

The psychological impact of cutaneous leishmaniasis.

A psychiatric disorder would be associated with extensive, unsightly lesions on exposed body parts. Cutaneous leishmaniasis (CL) has long been endemic in Sanliurfa and is called ‘beauty scar’. The aim of this study was to determine psychological impact of CL. Patients with active CL, with CL that had healed with scaring, and healthy controls were included in this case–control study. The Hospital Anxiety Depression Scale (HAD), Body Image Satisfaction Scale (BIS), and Dermatology Quality of Life Scale (DQL) assessments were performed to determine the psychological effect of CL. The patients with CL had significantly higher HAD anxiety and depression subscale scores than the control groups. Patients with CL have decreased body satisfaction and lower quality of life than those in the control group. It was found that CL patients with active lesions have the lowest quality of life score than other groups. CL lesions on exposed body parts such as the face and hands, active CL for more than 1 year, permanent scar formation, and social stigmatization cause anxiety, depressive symptoms, decreased body satisfaction and quality of life in CL patients.

Effect of Giardia infection on growth and psychomotor development of children aged 0-5 years

Giardiasis, an intestinal protozoan infection caused by Giardia intestinalis, is common in southeastern Anatolia, Turkey. In this cross-sectional survey, to investigate the role of giardiasis on growth and psychomotor development, we studied 160 children aged 0-5 years. Data were collected using a structured questionnaire, anthropometry, Ankara Developmental Screening Inventory, and laboratory analysis of fecal samples. The results showed that 50 per cent of the subjects were infected with at least one pathogen of intestinal parasitic infections. Giardia intestinalis was the most frequent pathogenic parasite. Giardia-infected children had a risk for stunted (OR = 7.67, 95 per cent CI = 2.25-26.16; p = 0.001) and poor psychomotor development (OR = 2.68, 95 per cent CI = 1.09-6.58; p = 0.030). The data indicate that Giardia intestinalis infection has an adverse impact on child linear growth and psychomotor development. In the primary healthcare centers, during the programme of the monitoring growth and developmental status of children, following children in terms of Giardia, diagnosis and treatment will have a positive effect on child health.

Measurement Structure of the Turkish Translation of the Child Behavior Checklist Using Confirmatory Factor Analytic Approaches to Validation of Syndromal Constructs.

The new correlated 8-factor measurement structure of the Child Behavior Checklist for ages 6–18 (CBCL/6-18; T. M. Achenbach & L. A. Rescorla, 2001) derived from an American sample was used as a benchmark to evaluate its generalizability to Turkish general population (N = 5,195) and clinical (N = 963) samples. Item-level confirmatory factor analysis (CFA) was used to evaluate the adequacy of the correlated 8-factor model across 3 sample conditions (general population, clinical, and combined sample whose Total Problems scores were above the Turkish national median). The results supported the generalizability of the overall measurement structure of the CBCL to the Turkish population.

Parent–Teacher Agreement on Children's Problems in 21 Societies

Parent–teacher cross-informant agreement, although usually modest, may provide important clinical information. Using data for 27,962 children from 21 societies, we asked the following: (a) Do parents report more problems than teachers, and does this vary by society, age, gender, or type of problem? (b) Does parent–teacher agreement vary across different problem scales or across societies? (c) How well do parents and teachers in different societies agree on problem item ratings? (d) How much do parent–teacher dyads in different societies vary in within-dyad agreement on problem items? (e) How well do parents and teachers in 21 societies agree on whether the childs problem level exceeds a deviance threshold? We used five methods to test agreement for Child Behavior Checklist (CBCL) and Teachers Report Form (TRF) ratings. CBCL scores were higher than TRF scores on most scales, but the informant differences varied in magnitude across the societies studied. Cross-informant correlations for problem scale scores varied moderately across societies studied and were significantly higher for Externalizing than Internalizing problems. Parents and teachers tended to rate the same items as low, medium, or high, but within-dyad item agreement varied widely in every society studied. In all societies studied, both parental noncorroboration of teacher-reported deviance and teacher noncorroboration of parent-reported deviance were common. Our findings underscore the importance of obtaining information from parents and teachers when evaluating and treating children, highlight the need to use multiple methods of quantifying cross-informant agreement, and provide comprehensive baselines for patterns of parent–teacher agreement across 21 societies.

Parasite density and serum cytokine levels in Plasmodium vivax malaria in Turkey

We aimed to investigate the relationship between quantitative Plasmodium vivax parasitaemia and serum cytokine levels in a highly endemic region of Turkey, where such a relation has not been investigated before. Active screening was done in a total of 1316 people residing in 33 villages of Sanliurfa province, Turkey. The study population consisted of 79 consecutive patients with P. vivax malaria, and a control group included 89 healthy subjects. Thick blood smears were examined for malaria parasite and parasite count. Serum samples were analysed for IL‐1β, IL‐2, IL‐4, IL‐6, IL‐8, IL‐10 and IL‐12 by the ELISA method. Compared to controls, levels of pro‐inflammatory cytokines, i.e. IL‐1β, IL‐6 and IL‐12, were significantly higher in patients with parasitaemia. There was a significant positive correlation between serum IL‐10 and IL‐12 levels and the parasite burden (r = 0·264, P = 0·024 and r = 0·264, P = 0·024, respectively). Serum IL‐8 levels showed a significant negative correlation with parasite burden (r =–0·356, P = 0·002). There was a positive correlation between IL‐8 levels and age, while the opposite was observed for IL‐12. High fever was correlated with IL‐6 and IL‐10 levels. Compared to controls, patients with a parasite count greater than 5000/µL had a significantly higher IL‐1β and IL‐10 levels (P < 0·05), while the difference was not significant for patients with a parasite count less than 1000/µL. Thus, we can conclude that pro‐inflammatory response against P. vivax gains more importance during periods of increased parasite burden.

Quality of life instrument for Turkish people with skin diseases.

Background and objective  To develop a new, short, self‐administrated subjective quality of life (QOL) instrument for Turkish people with skin diseases.

Prevalence of Staphylococcus aureus and intestinal parasites among food handlers in Sanliurfa, Southeastern Anatolia.

OBJECTIVES Food-borne diseases represent a persistent global health burden, and food handlers play a major role in their transmission. Staphylococcus aureus carriage and intestinal parasitism are important risk factors for the contamination of food and water. This study was undertaken to determine the prevalence of Staphylococcus aureus and intestinal parasites among food handlers working in Sanliurfa, Southeastern Anatolia. METHODS In this cross-sectional study, 299 food handlers selected randomly were enrolled. Nasal swabs, throat cultures, and stool samples were examined. RESULTS The mean age of participants was 26.7 (+/-9.6) years. Only 33.6 percent of food handlers had education beyond the elementary school level. Within this group, 50.8 percent had never previously received a carrier examination and only 31.4 percent received regular examinations. We found that 52.2 percent of food handlers carried intestinal parasites including Giardia intestinalis (26.8%), Ascaris lumbricoides (10.7%), Tenya saginata (10.0%), and Staphylococcus aureus (23.1%). None of the food handlers was positive for Salmonella sp and Shigella sp. CONCLUSIONS These findings necessitate improvements in regional carrier detection, infection control, and food hygiene. Subsequent to this study, researchers from the Department of Public Health, Harran University, instituted a series of interventions aimed at improving infection control. These included establishment of an evidence-based carrier control system, training of municipal food controllers and health professionals, creation of electronic outbreak records and follow-up procedures, and development of a source eradication system for Sanliurfas primary healthcare center staff.