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AbstractObjective:The aim of the present study is to investigate the duration of breastfeeding in relation to various parafunctional oral habits in children with anxiety disorders.Materials and Methods:The study includes 195 children and adolescents with anxiety disorders and age- and gender-matched 255 healthy control subjects. Diagnoses were made with semistructured interview (K-SADS). Information about breastfeeding and parafunctional oral habits was investigated via a questionnaire prepared for the study.Results:The mean age was 11.50 ± 2.50 years for clinical group and 11.27 ± 2.33 years for controls. Fifty-four percent of the clinical group and 56% of the control group were female subjects. Duration of exclusive (4.72 ± 2.86, 5.55 ± 2.36; p= 0.002) and total breastfeeding (12.38 ± 10.32, 15.89 ± 9.09; p< 0.001) was significantly lower and duration of bottle-feeding (22.30 ± 19.54, 16.64 ± 12.79; p= 0.005) was higher than controls in the clinical group. Duration of exclusive breastfeeding was significantly correlated with duration of bottle-feeding (r= −0.263, p< 0.001) and duration of pacifier use (r= −0.249, p= 0.001). Multiple regression analysis showed that duration of exclusive breastfeeding (β= 0.88, p= 0.006) and bottle-feeding (β= 1.02, p= 0.005), as well as various oral habits, was associated with diagnosis of an anxiety disorder.Conclusion:Nutrition methods in early years of life may result in long-term consequences regarding anxiety disorders for children. Clinicians should encourage parents for a shorter duration of bottle-feeding and a longer duration of exclusive breastfeeding.

ABSTRACTObjective:The purpose of this study was to evaluate an innovative, protocol-based, group cognitive behavioral therapy (CBT) program delivered by trained teachers to reduce emotional distress and improve psychological functioning among the war-traumatized Syrian refugee students living in Istanbul.Methods:A total of 32 participants, aged between 10 and 15 years (mean = 12.41, SD = 1.68) and mostly females (m/f = 12/20) were randomly selected from a sample of 113 refugee students based on their trauma-related psychopathology as reflected in the Child Post-Traumatic Stress – Reaction Index (CPTS-RI) total score. The treatment program was implemented by the teachers trained by the study team to deliver a weekly, eight-session, protocol-based intervention in school setting. The degree of the fidelity to the original program was tested via video-recordings and subsequent analyses of the sessions. Effectiveness of the intervention was evaluated by a pre-test/post-test comparison using the CPTS-RI, Spence Children’s Anxiety Scale (SCAS), and Strengths and Difficulties Questionnaire (SDQ).Results:All participants were accompanied minors. A significant proportion of them had either witnessed or been personally exposed to traumatic events. Statistically significant reduction in post-intervention evaluation was observed in the SCAS total score (t = 3.73, p = 0.001); CPTS-RI total score (t = 2.72, p = 0.011) and in the intrusive (t = 3.88, p = 0.001) and arousal (t = 2.60, p = 0.015) symptoms of the post-traumatic stress disorder (PTSD). In line with improvement in emotional problems as revealed in the anxiety and PTSD scales, the SDQ subcategory of the emotional problems was the only symptom area that showed a significant improvement (t = 2.85, p = 0.008). No significant change was seen in the SDQ subcategories of conduct (t = 1.01, p = 0.32), hyperactivity (t = 1.30, p = 0.20), peer problems (t = .66, p = 0.51), or in prosocial behavior (t = 2.15, p = 0.039). A significant proportion of the participants did no longer meet the diagnostic threshold for anxiety (p = 0.001) and PTSD (p = 0.021) after completion of the intervention. However, the post-intervention SDQ subcategories and the total SDQ score showed no significant difference as compared with the pre-intervention group.Conclusions:To the best of our knowledge, this is the first interventional study reporting promising results from a school-based, teacher-led and culturally sensitive psychological intervention program for refugee children in Turkey. Such protocol-based interventions need to be examined in controlled designs and larger samples so that a well-established intervention can be created and disseminated to provide the psychosocial support for this vulnerable and traumatized population.

ABSTRACTObjective: The shortage of cross-culturally validated instruments limits the study and treatment of psychopathology in countries other than English-speaking ones. The Revised Child Anxiety and Depression Scale – Child Version (RCADS-CV) is a self-report questionnaire that assesses dimensions of DSM anxiety and depressive disorders in youths. In this present study, we aimed to examine the psychometric properties of the Turkish version of the RCADS-CV in a clinical sample of children in Turkey.Method: The participants were 483 children aged 8–17 years old. Subjects were recruited from the following centers: Bezmialem University Hospital (55.7%), Kütahya Regional Hospital (17.4%), Istanbul Medical Faculty Hospital of the Istanbul University (16.7%), and Sakarya University Hospital (12.2%). A semi-structured diagnostic interview was carried out and the following measures were used: Children’s Depression Inventory, Screen for Child Anxiety-Related Emotional Disorders (SCARED), and Strengths and Difficulties Questionnaire (SDQ).Results:Inter-scale reliability was strong/excellent with a Cronbach’s αof .95 and coefficients for the RCADS-CV subscales ranging from .75 to .86, demonstrating good internal consistency. Convergent and discriminant validity tests against both a semi-structured clinical interview and self-report measures suggested favorable properties. Confirmatory factor analysis supported the original six-factor model. RCADS-CV showed greater correspondence to specific diagnoses in comparative tests with the existing measures of anxiety and depression.Conclusion: Overall, the study provides satisfactory evidence that the Turkish RCADS-CV yields valid scores for clinical purposes among Turkish children.