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    Coping skills and smartphone addiction in adolescents with ADHD: A predictive model and relationship
    (Routledge Journals, Taylor & Francis Ltd, 2025) Kara, Tayfun; Kocaman, Orhan; Avsar, Pinar Aydogan; Kuru, Tacettin
    Background: We sought to examine the relationship between smartphone addiction and coping skills in adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD), together with potential predictive factors. Method: Two hundred seventy-five participants (144 diagnosed with ADHD and 131 healthy controls) were included in the study. All participants were evaluated via DSM-5-based psychiatric examinations. Smartphone addiction levels were assessed using the Smartphone Addiction Scale-Short Version (SAS-SV), and coping skills were evaluated using the Coping Scale for Children and Youth (CSCY). The scores were then subjected to statistical comparisons. Results: Higher SAS-SV scores were observed in the adolescents with ADHD compared to the control group (p = 0.047). Significant positive correlations were found between cognitive avoidance (CAV) (p < 0.001, r = 0.377) and behavioural avoidance (BAV) (p < 0.001, r = 0.297) in the ADHD group. In contrast, significant negative correlations were found with Problem-solving (PROB) (p = 0.001, r =-0.281) and assistance-seeking (ASK) (p = 0.013, r = -0.206). Following model analysis, CAV emerged as a significant positive predictor of SAS-SV scores, and PROB as a significant negative predictor (p =0.005 and p = 0.016, respectively). Conclusions: The decrease in coping skills in adolescents diagnosed with ADHD was associated with an increase in smartphone addiction. Additionally, increased cognitive avoidance and low problem-solving skills also predicted addiction.
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    Evaluation of primary markers of inflammation and the systemic inflammation index in specific learning disabilities
    (Taylor & Francis Ltd, 2024) Avsar, Pinar Aydogan; Kara, Tayfun; Kocaman, Orhan; Akkus, Merve
    Aim: Specific learning disorder (SLD) is a term that refers to reading, writing and arithmetic difficulties. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic inflammation index (SII) are affordable and accessible inflammatory biomarkers. This research aims to evaluate the relationship between NLR, PLR, SII and SLD to determine whether inflammation contributes to pathogenesis. Methods: This study included 90 SLD-diagnosed patients and 90 age-, sex- and ethnicity-matched healthy controls. Blood cell counts and NLR, PLR and SII values were obtained from medical records and compared between the two groups. Results: The NLR, PLR and SII were significantly higher (p = 0.029, p = 0.033 and p = 0.018 respectively) and lymphocyte counts were significantly lower (p = 0.041) in the SLD group. WISC-R total scores decreased with age in the SLD group (-1.988 coefficient, Beta = -0.247 beta, p = 0.041). Multivariate logistic regression analysis revealed that the SII was the only parameter independently associated with the diagnosis of SLD (Beta = 0.003, p = 0.023). Conclusion: Inflammation might play a role in SLD etiopathogenesis. NLR, PLR and SII may be potential biomarkers for SLD in children. Further research may lead to early diagnosis and additional anti-inflammatory pharmacological therapies for SLDs.
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    Is Problematic Media Use a Marker for Aggression in Children with Attention Deficit/Hyperactivity Disorder?
    (Yerkure Tanitim & Yayincilik Hizmetleri A S, 2023) Kara, Tayfun; Kocaman, Orhan; Avsar, Pinar Aydogan; Kuru, Tacettin
    Objective: Attention Deficit/Hyperactivity Disorder (ADHD) is associated with a series of problems, including aggressive behavior and problematic media use (PMU). However, the literature concerning the relationship between PMU and aggressive behavior patterns in children diagnosed with ADHD is limited. This study examines the relationships between PMU and aggression in children with ADHD.Methods: One hundred sixty-two children aged 6-12 years diagnosed with ADHD were included in the study. All participants were assessed with DSM-5-based psychiatric evaluations. Aggressive behaviors in children were evaluated using the Children's Aggression Scale Parent Version (CAS-P). The children's screen use was scored using the Problematic Media Use Measure Short Form (PMUM-SF). The data obtained were compared using statistical methods.Results: A significant correlation at the p<.05 level was determined between PMU and the severity of ADHD (mild-moderate and severe). PMU was positively and statistically significantly correlated with verbal aggression (r = 0.422, p < 0.001), aggression against objects and animals (r = 0.367, p < 0.001), provoked physical aggression (r = 0.365, p < 0.001) and unprovoked physical aggression (r = 0.283, p < 0.001). In addition, PMU significantly (p <0.001) predicted verbal aggression, aggression against objects and animals, and provoked and unprovoked physical aggression.Conclusion: A positive correlation was observed between PMU in children and the risk of aggression in this group, and PMU predicted aggression. These findings may contribute to the formation of guidelines for intervention when problematic behaviors emerge in children diagnosed with ADHD.
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    Regressive autism with autoimmune encephalitis: case report and literature review of subtype of autism spectrum disorder
    (Taylor & Francis Ltd, 2024) Avsar, Pinar Aydogan; Kara, Tayfun; Kocaman, Orhan
    About one-third of individuals with autism spectrum disorder (ASD) show a sudden loss of acquired skills between the 2nd or 3rd years of life. The primary areas of loss were grouped into language skills, social interest, adaptive functioning, and motor skills. A 4-year and 2-month-old boy presented to the child and adolescent mental health and disease outpatient clinic with his parents with complaints of decreased eye contact, and regression in speech. His developmental milestones were within the typical range of three years and two months. During the investigation into the organic etiology of regression, serum anti-CASPR2 positivity was detected, and intravenous immunoglobulin administration was initiated. After 6 months of treatment and special education, there was a slight decrease in the CARS score along with improvements in adaptation to change, visual response, and non-verbal communication. This rare case of regressive autism accompanied by autoimmune encephalitis provides further evidence in the field that autoimmune encephalitis may influence the development of the regressive subtype of ASD. Differential diagnosis is crucial because additional immunotherapy may be beneficial in these cases. Further investigation is needed to identify the relationship.
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    The Effects of Anxiety on Social Competence and Behavioural Adjustment in Preschoolers With Developmental Language Disorder
    (Wiley, 2025) Kocaman, Orhan; Kuru, Tacettin; ozsan, Orgul Yildiz; Kara, Tayfun; Kilic, Umut mert; Avsar, Pinar Aydogan
    This study compared the social competence and emotional-behavioural adjustment of children aged 36-72 months with developmental language disorder (DLD) with those of typically developing peers (TD) and examined the relationship between anxiety disorders and these domains in the DLD group. The sample consisted of 229 children (92 DLD, 137 TD). Data were collected using the Social Competence and Behaviour Evaluation Scale-30 and the Preschool Anxiety Scale. Children with DLD exhibited lower social competence and higher anxiety-withdrawal and anger-aggression scores than their TD peers. In the DLD group, generalized anxiety and specific fears were negatively associated with social competence and positively associated with anxiety-withdrawal and anger-aggression. Social anxiety was negatively associated with social competence and positively associated with anxiety-withdrawal. Separation anxiety was positively associated with anxiety-withdrawal and anger-aggression. Regression analyses showed that social anxiety predicted anxiety-withdrawal, and generalized anxiety predicted anger-aggression. Moderation analysis determined that language development levels moderated the relationship between generalized anxiety and anger-aggression in children with DLD, such that generalized anxiety positively predicted anger-aggression, but this effect became weaker as language development levels increased. Children with DLD exhibit social-emotional and behavioural adjustment difficulties, with which anxiety symptoms are significantly associated. Intervention programs should consider anxiety symptoms when supporting the development of social and behavioural skills in children with DLD.
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    The relationship between digit ratio (2D:4D) and intelligence levels in specific learning disorders
    (Elsevier Ireland Ltd, 2024) Avsar, Pinar Aydogan; Kara, Tayfun; Kocaman, Orhan; Akkus, Merve
    Background: Higher prenatal testosterone exposure regulates brain development and affects learning and intelligence directly. The digit ratio (2D:4D) is regarded as an indicator of prenatal testosterone exposure. This study aims to investigate the 2D:4D ratios and intelligence levels in individuals with specific learning disorders (SLD) and compare the ratios with healthy subjects. Methods: The study included a total of 117 patients diagnosed with SLD and 67 healthy controls. We measured the 2D:4D ratios and administered the Wechsler-Intelligence Scale for Children-Revised to assess intelligence quotient (IQ) scores in the SLD group. Sociodemographic data was obtained for both patients and healthy subjects and compared in both groups, as well as 2D:4D ratios. Results: Compared to healthy controls, both-hand 2D:4D ratios were found to be lower in the SLD group. In addition, male and female participants with SLD showed lower 2D:4D ratios in both hands than controls. The total scores on the WISC-R were found to decrease as the right-hand 2D:4D ratios and the age increased in the SLD group. Conclusion: Our findings add to the literature examining the influence of prenatal testosterone exposure on learning and intelligence in the SLD sample. Further research in this domain may yield valuable insights into the underlying mechanisms and potential clinical implications for the management of SLDs examining additional variables that could potentially impact alongside the impact of sex hormones on brain development.
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    The relationship between maternal alexithymia and cognitive flexibility, children's emotional eating, and childhood obesity
    (Academic Press Ltd- Elsevier Science Ltd, 2026) Avsar, Pinar Aydogan; Caliskan, Duygu; Sengul, Merve Turkegun
    Objectives: Childhood obesity is one of the major health challenges of the 21st century, a chronic and complicated condition that requires medical intervention. The goal of this study was to investigate the emotional eating levels of children with obesity as well as their mothers' alexithymia and cognitive flexibility, which we hypothesized to contribute to childhood obesity. Methods: This is a cross-sectional, case-control study of age-, sex-, and ethnicity-matched 100 dyads. All mothers completed the Toronto Alexithymia Scale (TAS-20) and the Cognitive Flexibility Inventory (CFI), and the children completed the Emotional Eating Scale-Children (EES-C). In addition, researchers administered a clinical and sociodemographic questionnaire. Results: The childhood obesity group exhibited significantly higher levels of emotional eating and maternal alexithymia, but also significantly lower levels of maternal cognitive flexibility compared to those in the healthy control group. Further analyses revealed a significant association between childhood obesity, maternal alexithymia, and irregular sleep patterns in children. Conclusion: Our results indicate that elevated levels of alexithymia in mothers of children diagnosed with obesity may influence childhood obesity. The aims of early interventions in managing pediatric obesity may include evaluations of families and mothers.
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    Theory of Mind Abilities May Predict Treatment Outcomes in Adolescents With Obsessive-Compulsive Disorder: A Follow-Up Study
    (Wiley, 2025) Kara, Tayfun; Avsar, Pinar Aydogan; Kuru, Tacettin; Kocaman, Orhan
    Aims: Researchers report varying levels of cognitive flexibility and theory of mind (ToM) deficiencies in adolescents with obsessive-compulsive disorder (OCD). This research set out to investigate the impact of these variables on the disorder's outcomes. Method: The study involved 39 adolescents with OCD and 40 healthy controls. We assessed the case group at the initial visit to the outpatient clinic and again at the end of the first year of treatment. The Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) was applied to assess OCD symptom distribution and severity. The Reading the Mind in the Eyes of Children Test (RME-CT) was applied to evaluate ToM skills, and the Cognitive Flexibility Scale (CFS) was employed to evaluate cognitive flexibility levels. Results: Baseline RME-CT and CFS scores were significantly lower in adolescents with OCD compared to the control group (p = 0.002 p = 0.001, respectively). At the end of the 1-year follow-up, RME-CT and CFS scores increased significantly in the adolescents with OCD (p < 0.001, p = 0.003, respectively). A significant negative correlation was observed between the initial RME-CT scores and the Y-BOCS scores at the end of the 1-year follow-up (p < 0.001). The initial RME-CT score had a significant negative predictive effect on the subsequent severity of OCD (beta = -0.711, p < 0.001). Conclusions: The research revealed poorer long-term prognoses for OCD in adolescents who exhibit low ToM skills. In conclusion, the results indicate that ToM skills may serve as a predictive factor for long-term treatment outcomes among adolescents diagnosed with OCD.