A Rebuttal To Psychoanalytic Biography Of Mustafa Kemal Atatürk

Mustafa Kemal Atatürk (1881-1938) was the founder of the modern-day Turkish Republic. Although much has been published about his life, only one biography adopted a psychological/psychoanalytic perspective. The authors Vamık Volkan and Norman Itzkowitz argued that the main driving mechanism behind Atatürk's behavior was his narcissistic personality organization. Their framework considered Mustafa's birth, which occurred shortly after his elder brothers had passed away, and how his mother, presumably in a state of severe depression, could not provide adequate emotional care, which gave way to compensatory narcissistic tendencies in the child. For several decades, the hypothesis has remained unchallenged, and no serious review has yet been carried out. In this article, I argue that Mustafa Kemal was a highly intelligent and gifted child based on his well-developed verbal skills and his record as a high achiever at school. While considering the impact of adverse events in early childhood on cognitive development and personality, a review of historical texts revealed that his elder brothers died in 1883-not before Mustafa's birth, as the authors had believed. Thus, no serious event appears to have taken place in his early years when rapid brain development is thought to occur. Since the central premise has lost its integrity to support the biography, Volkan and Itzkowitz's hypothesis can no longer be regarded as tenable and viable.

Can sleeping habits be associated with sleep bruxism, temporomandibular disorders and dental caries among children?

BACKGROUND

Sleeping problems are common in the pediatric population. Their potential relationship with oral manifestations is in the scope of researchers' interest.

OBJECTIVES

The aim of the present study was to evaluate the possible associations between sleeping habits and sleep bruxism, temporomandibular disorders (TMD) and dental caries among children by using Children's Sleep Habits Questionnaire (CSHQ).

MATERIAL AND METHODS

A cross-sectional study was carried out at the Faculty of Dentistry of Istanbul Aydin University, Turkey, with a representative sample of 100 children aged 6-13 years. The CSHQ was completed by their parents. In addition, an intraoral examination was carried out in a clinical setting and sleep bruxism was recorded. The temporomandibular joints (TMJ) were examined and TMD were rated according to the Helkimo anamnestic and clinical dysfunction index. Data was analyzed with Fisher's exact test and the χ2 test.

RESULTS

Among sleeping habits, bedtime resistance was found to be significantly associated with sleep bruxism and TMD symptoms in children. Sleep behavior problems were also found to be related to TMD. Untreated dental caries was significantly associated with sleep fragmentation.

CONCLUSIONS

Sleep bruxism, TMD and untreated dental caries might have a negative impact on children's sleeping habits and characteristics. Pediatricians and pedodontists should collaborate to identify the causes and clinical features of sleeping habits and disorders in order to avoid adverse effects on the child's stomatognathic system.

Life in Family Buildings as a unique environment in Turkey

Family building (FB) is a building where residents of different flats are close relatives. Being quite common in metropolitan areas, these unique psychosocial environments remain underexamined. We aimed to research into the interactions within the family and psychosocial features of FBs. One hundred and one children living in FBs and FB-experiences of their parents were assessed by semi-structured interviews using K-SADS-PL. Mothers scored their satisfaction from FB-lifestyle in the scale of 0-100. The sample consisted of 35 girls and 66 boys. Mean age was 108±37.4 months. ADHD and anxiety disorders were the common diagnoses. Eighty-two families lived with paternal relatives. Number of relative-neighbors in the building changed between 2-10. Forty-one mothers scored ?50 for their satisfaction; 58% believed FBs affected their children's symptoms negatively. Examining the perceived advantages and disadvantages of FBs, ‘extreme criticism' and ‘social support' were the decisive items to predict mothers' satisfaction levels. Having both positive and negative effects, FB-lifestyle seem to complicate interpersonal relations within the family. This study has revealed some preliminary findings, but further studies are required in the field.

Life in Family Buildings as a unique environment in Turkey

Family building (FB) is a building where residents of different flats are close relatives. Being quite common in metropolitan areas, these unique psychosocial environments remain underexamined. We aimed to research into the interactions within the family and psychosocial features of FBs. One hundred and one children living in FBs and FB-experiences of their parents were assessed by semi-structured interviews using K-SADS-PL. Mothers scored their satisfaction from FB-lifestyle in the scale of 0-100. The sample consisted of 35 girls and 66 boys. Mean age was 108±37.4 months. ADHD and anxiety disorders were the common diagnoses. Eighty-two families lived with paternal relatives. Number of relativeneighbors in the building changed between 2-10. Forty-one mothers scored ≤50 for their satisfaction; 58% believed FBs affected their children’s symptoms negatively. Examining the perceived advantages and disadvantages of FBs, ‘extreme criticism’ and ‘social support’ were the decisive items to predict mothers’ satisfaction levels. Having both positive and negative effects, FB-lifestyle seem to complicate interpersonal relations within the family. This study has revealed some preliminary findings, but further studies are required in the field.

Towards a further understanding of prenatal thyroid theory of homosexuality: Autoimmune thyroiditis, polycystic ovary syndrome, autism and low birth weight

Research into the neurobiological origins of same-sex attraction is inconclusive. A recent theory of homosexuality posited that maternal thyroid dysfunction during pregnancy is associated with an increased rate of homosexual orientation in offspring. Relevant studies from the prenatal thyroid model perspective were reviewed, the major findings of which are as follows: i) An increased prevalence of Hashimoto’s disease in lesbian women suggests a maternal and even familial presence of the same autoimmune thyroid disease. Female-tomale transsexuals and lesbian women were also reported to have higher rates of polycystic ovary syndrome (PCOS). Over the last several years, reports suggesting a strong link between PCOS and thyroid autoimmunity have accumulated. ii) The increased risk of autism spectrum disorders (ASD) in the offspring of mothers with thyroid autoimmunity in pregnancy and the association between ASD and gender dysphoria indicate a link between maternal thyroid dysfunction and gender dysphoria/same-sex attraction in the offspring. iii) The high risk of miscarriage and retarded fetal growth in pregnancies of mothers who give birth to homosexual offspring can be explained by the impact of maternal thyroid dysfunction during pregnancy. This perspective review highlights relevant research findings and integrates them into the prenatal thyroid model of homosexuality. A better understanding of the mechanisms involved in the generation of same-sex orientation will contribute to the betterment of individual lives, as well as of society.

Towards a further understanding of prenatal thyroid theory of homosexuality: Autoimmune thyroiditis, polycystic ovary syndrome, autism and low birth weight

Research into the neurobiological origins of same-sex attraction is inconclusive. A recent theory of homosexuality posited that maternal thyroid dysfunction during pregnancy is associated with an increased rate of homosexual orientation in offspring. Relevant studies from the prenatal thyroid model perspective were reviewed, the major findings of which are as follows: i) An increased prevalence of Hashimoto's disease in lesbian women suggests a maternal and even familial presence of the same autoimmune thyroid disease. Female-to-male transsexuals and lesbian women were also reported to have higher rates of polycystic ovary syndrome (PCOS). Over the last several years, reports suggesting a strong link between PCOS and thyroid autoimmunity have accumulated. ii) The increased risk of autism spectrum disorders (ASD) in the offspring of mothers with thyroid autoimmunity in pregnancy and the association between ASD and gender dysphoria indicate a link between maternal thyroid dysfunction and gender dysphoria/same-sex attraction in the off-spring. iii) The high risk of miscarriage and retarded fetal growth in pregnancies of mothers who give birth to homosexual off-spring can be explained by the impact of maternal thyroid dysfunction during pregnancy. This perspective review highlights relevant research findings and integrates them into the prenatal thyroid model of homosexuality. A better understanding of the mechanisms involved in the generation of same-sex orientation will contribute to the betterment of individual lives, as well as of society.

Empathy and Facial Expression Recognition in Children With and Without Attention-Deficit/Hyperactivity Disorder: Effects of Stimulant Medication on Empathic Skills in Children with Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

The aim of this study was to compare children and adolescents with attention-deficit/hyperactivity disorder (ADHD) to healthy children and adolescents in terms of state and trait empathy and emotion expression recognition skills. The goal was also to determine whether there are changes in emotion recognition and empathy measures in children with ADHD after methylphenidate (MPH) treatment.

METHODS

The research sample consisted of outpatient drug-naive children and adolescents between the age of 8 and 14 years (n = 65) with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria, and healthy children and adolescents of the same age (n = 61). Scores of the oppositional problems (OPs) and conduct problems (CPs) were obtained to evaluate their impact on children's empathy skills with the Child Behavior Checklist. Self-reported (Bryant Index of Empathy, BEI) and parent-reported (Griffith Empathy Measurement-Parent Rating, GEM-PR) scales were used to evaluate trait empathy. The Empathy Response Task (ERT) was used to evaluate state empathy, and the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA-2) was used to evaluate facial expression recognition skills. The scales and tests were repeated after 12 weeks of MPH treatment in the ADHD group.

RESULTS

There were no significant statistical differences in trait empathy skills evaluated by parent-reported and self-reported measures, ERT, and DANVA-2 scores. In self-reported measures, the girls had higher scores than boys. From the results of the regression analysis, it was concluded that OPs were not associated with the measures. However, CPs were associated with the scores of the BEI, GEM-PR, and the match scores of the ERT. The average dosage of MPH in the group with ADHD was 0.83 ± 0.21 mg/(kg·d). While there was no change in the BEI and GEM-PR scores after 12 weeks of treatment, there was a significant increase in the ERT interpretation subscore and a significant decrease in the recognition error of anger and sadness expressions in the DANVA-2.

CONCLUSIONS

The findings of our study suggest that children with ADHD have similar levels of trait and state empathy skills and facial expressions as healthy controls and CPs negatively affect their empathy skills. MPH treatment does not change trait empathy skills, yet there are some improvements in state empathy skills.

The attention-deficit/hyperactivity disorder model for traumatic dental injuries: a critical review and update of the last 10 years

It has been more than 10 years since the proposal of attention-deficit/hyperactivity disorder (ADHD) model as an explanatory construct for traumatic dental injuries (TDIs) in children. The aim of this review was to address developments in the study of the issue after 2005-2016. A systematic literature search covering the period from 2005 to 2016 was conducted on PubMed, the Cochrane library and Google Scholar using relevant keywords. Fourteen studies exploring the relationship between ADHD and TDIs from 2005 and onward (including the proposal paper) were identified. Of the 12 controlled studies, nine reported confirming findings for a link with ADHD in the occurrence of TDIs. More than one-third of all children with ADHD may suffer from TDIs. In ADHD children, the most common types of injury were uncomplicated/complicated crown fractures and subluxation of maxillary central incisors resulting from falls and collisions. There is also evidence that ADHD represents an independent risk factor other than the well-established risk factor of incisor overjet. Over the last 10 years, convincing evidence has accumulated that ADHD is an important and common risk factor for TDIs. Increased awareness and side-by-side work of medical, dental and mental professionals at both clinical and research settings are necessary.

The Presentation Of Childhood Obsessive–Compulsive Disorder Across Home and School Settings

This study aimed to determine the exact pattern of obsessive–compulsive disorder (OCD) symptoms in children displayed across school and home settings. Twenty-six school children (aged 7 through 17) with OCD were tested using the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the Clinical Global Impression (CGI) – severity subscale and a questionnaire which consists of items serving to compare the symptoms between home and school settings. The mean obsession and compulsion subscores on the CY-BOCS were found to be 10.73 ± 3.14 and 10.88 ± 3.17, respectively, both summing up a Total score of 21.61 ± 5.52. The mean CGI-severity scores, rated for home and school settings were 4.42 ± 0.90 and 2.42 ± 1.13 respectively, indicating a strong difference in the presentation of OCD between those settings ( t= 7.02, df = 50, p< 0.0001). No gender, diagnosis (pure versus comorbid) and age effect (7 to = 12 years versus > 12 to 17 years) was found on the CY-BOCS and CGI-severity subscale (Mann–Whitney U test, all p> 0.05). The presentation difference we have noted in this study is a significant finding. Further studies are needed to delineate the characteristics of this phenomenon with possible implications for diagnosis, management and treatment.

High Rates of Same-Sex Attraction/Gender Nonconformity in the Offspring of Mothers with Thyroid Dysfunction During Pregnancy: Proposal of Prenatal Thyroid Model

Both youngsters and adults with same-sex attraction are at greater risk for negative health outcomes. Despite mounting efforts to determine the biological background, a satisfactory conclusion has not been reached and there is a need to explore alternate factors like functioning of thyroid system during pregnancy. A retrospective chart review was undertaken of 790 eligible children and adolescents who had been admitted to child psychiatry between 2005 and 2013. This population consisted of 520 (65%) males and 270 (35%) females, aged 8 to 17 years. Fifteen mothers (1.8%) were found to have a history of thyroid dysfunction during pregnancy. Sixteen youngsters (2%) had a history of same-sex attraction. Twelve overlapping cases with both same-sex attraction and maternal thyroid dysfunction during pregnancy were identified, which was extremely significant (P<0.0001, by Fisher’s exact test). The association was also significant for each sex (P<0.0001, by Fisher’s exact test). There is evidence that thyroid gland plays a crucial and decisive role in determining sexual orientation in people. Maternal thyroid dysfunctions during pregnancy may result in homosexual orientation in the offspring.

High rates of same-sex attraction/gender nonconformity in the offspring of mothers with thyroid dysfunction during pregnancy: proposal of prenatal thyroid model

Both youngsters and adults with same-sex attraction are at greater risk for negative health outcomes. Despite mounting efforts to determine the biological background, a satisfactory conclusion has not been reached and there is a need to explore alternate factors like functioning of thyroid system during pregnancy. A retrospective chart review was undertaken of 790 eligible children and adolescents who had been admitted to child psychiatry between 2005 and 2013. This population consisted of 520 (65%) males and 270 (35%) females, aged 8 to 17 years. Fifteen mothers (1.8%) were found to have a history of thyroid dysfunction during pregnancy. Sixteen youngsters (2%) had a history of same-sex attraction. Twelve overlapping cases with both same-sex attraction and maternal thyroid dysfunction during pregnancy were identified, which was extremely significant (P<0.0001, by Fisher's exact test). The association was also significant for each sex (P<0.0001, by Fisher's exact test). There is evidence that thyroid gland plays a crucial and decisive role in determining sexual orientation in people. Maternal thyroid dysfunctions during pregnancy may result in homosexual orientation in the off-spring.

Pregnancy health problems and low birth weight associated with maternal insecure attachment style

We aimed to determine the association between attachment style and health problems during pregnancy, as well as perinatal health variables. In 122 mothers who were 2–18 months postpartum, hot flushes, vaginal discharge, back pain, breast tenderness, hair changes, and psychological problems were shown to be associated with insecure attachment as measured by the Adult Attachment Style Questionnaires. Babies born to mothers with insecure attachment were more likely to have a low birth weight. It is vital to increase awareness of insecure attachment style as a risk factor among perinatal health care providers to optimize services.

Breastfeeding and parafunctional oral habits in children with and without attention-deficit/hyperactivity disorder

INTRODUCTION

Although children with attention-deficit/hyperactivity disorder (ADHD) were reported to have insufficient breastfeeding, consequences and oropharyngeal implications of this finding have not been studied. In this case-control study, we aimed to investigate early feeding practices and parafunctional oral habits in children with ADHD.

SUBJECTS AND METHODS

The study group consisted of 200 children and adolescents, 7-17 years old, diagnosed as having ADHD at Marmara University Child Psychiatry Clinics in Istanbul, Turkey. The Conners Parent and Teacher Rating Scales were used to assess behavioral disturbances. A questionnaire was developed consisting of items pertaining to breastfeeding period, early feeding history, and parafunctional oral habits. The study data were compared with those for 175 healthy schoolchildren after exclusion of possible ADHD cases.

RESULTS

The children with ADHD were found to have insufficient exclusive breastfeeding (less than 6 months) (p=0.0001). The children with insufficient exclusive breastfeeding were more likely to have a history of bottle feeding, longer duration of bottle feeding, and early introduction of bottle feeding (p=0.01). Overall, significant differences were detected on the domains of duration of bottle feeding, introduction of bottle feeding, introduction of pacifier use, variables of nail and toenail biting, as well as pencil biting, bruxism, and snoring between the ADHD group and the control group.

CONCLUSIONS

The present results indicate that early in life, children with ADHD are subject to insufficient exclusive breastfeeding, different feeding practices, and elevated parafunctional oral habits more often than typically developing children. For all professionals who provide healthcare to children, increased awareness and attention to these factors are suggested.

The association of tattooing/body piercing and psychopathology in adolescents: a community based study from Istanbul

We aimed to investigate the association of psychopathology with tattooing and body piercing among adolescents in Istanbul by means of self-report questionnaires. Tenth, eleventh and twelfth grade students from 2 high schools in Istanbul with a total number of 607 participated in the study. The Youth Self Report, Children's Depression Inventory and a detailed semi-structured inquiry assessing tattooing, body piercing and some psychiatric and psychosocial variables were administered to the students. The prevalence of tattooing and body piercing were 4.8 and 7 %, respectively. The adolescents with tattooing and body piercing were found to have a higher frequency of alcohol and drug use, smoking, going to bars/night clubs and lower school grades when compared to those without tattooing and body piercing. Externalizing problems, mainly delinquent and aggressive behaviours were more prominent in the adolescents with tattooing and body piercing. Tattooing and body piercing in adolescents may be indicative of mental health risks.

Traumatic dental injuries and attention-deficit/hyperactivity disorder: is there a link?

Traumatic dental injuries (TDIs) constitute a major cause of morbidity among children worldwide. Both TDIs and attention-deficit/hyperactivity disorder (ADHD) are prevalent conditions with similar male-to-female predominance and similar age of presentation. While the commonest causes of TDIs have been identified as playground or sports accidents, a well-known feature of ADHD is accident proneness. Violence, another significant risk factor for TDIs, is more likely to be observed in conduct disorder, a common comorbidity of ADHD. Also, both TDIs and ADHD have been found to be associated with left-handedness. The presence of multiple dental trauma episodes (MDTE), as well as increased risk for non-dental injuries in children with TDIs indicates an underlying persistent condition, which resembles ADHD. Higher point prevalence of mental distress at age 30, found to be associated with increased lifetime prevalence of TDIs, may also be taken as an evidence of a background developmental disorder persisting into adulthood with various comorbidities. In conclusion, this review combines the results of several studies and explains the significance of ADHD as an underlying and predisposing factor for TDIs. Increased awareness and close collaboration between different disciplines involved are essential.

Risperidone-to-methylphenidate switch reaction in children: three cases

As atypical antipsychotics are increasingly used in the treatment of childhood behavioural disorders either as monotherapy or in combination with other medications, there is a need to know more about their safety, in particular during switching to and from methylphenidate treatment, as antipsychotics and methylphenidate have opposing effects on dopaminergic neurotransmission. This report is about three cases of children who developed severe adverse reactions during switching from risperidone to methylphenidate. The first patient was a 6-year-old boy, diagnosed with attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). He developed severe hyperactivity and agitation on taking methylphenidate after the discontinuation of risperidone treatment. The second patient was a girl of 6, already on risperidone for ADHD and borderline intellectual functioning when referred. She displayed severe hyperactivity, agitation and irritability upon switching to methylphenidate medication. The third patient was a 15-year-old female adolescent with a similar clinical course as the previous patients. In all the cases described here, it is only with the discontinuation of methylphenidate that the adverse reactions resolved and readministration of methylphenidate in two patients did not produce any adverse effect after a drug-free interval. Functional regulation of certain neuroreceptors during risperidone treatment may lead to altered behavioural responses upon switching to methylphenidate. Thus, a drug-free interval is recommended in order to prevent adverse reactions.

Relationship between traumatic dental injuries and attention-deficit/hyperactivity disorder in children and adolescents: proposal of an explanatory model

The objective of the present study was to determine the association between attention-deficit/hyperactivity disorder (ADHD) and traumatic dental injuries in a child psychiatric clinical population in Istanbul. A total of 475 consecutive children aged 8-17 years were enrolled in the study. Children and their parents were interviewed about the presence of traumatic dental injury and if a positive response was obtained further questions were inquired regarding the time and cause of the injury, and whether treatment had been sought. Child psychiatric diagnosis was based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria. Of the 475 children, 32 reported a traumatic dental injury (6.7%) with statistically significant association with ADHD (chi(2) = 26.90, d.f. = 1, P = 0.0001; odds ratio = 17.41, 95% CI: 4.11-73.55). On the Conners Teacher Report Questionnaire, children with dental trauma group differed significantly from the non-ADHD group but not from the ADHD group (F = 17.02, d.f. = 2, P = 0.0001). Among children with ADHD and dental fracture, the most common subtype was combined ADHD (90%). This is the first study describing a significant association between dental fractures and ADHD which contributes to an explanatory model on dental traumas among children. According to us, awareness of this association is essential at child psychiatry and pediatric dentistry settings and we recommend preventive efforts to be directed at the treatment of ADHD.