Hasan Can Özbay

Background: Functional somatic symptoms are common in children and adolescents and are often associated with anxiety and perceived stress. Mindfulness may be protective, but the mechanisms linking mindfulness to somatic symptom severity remain unclear. This study aimed to examine relationships between mindfulness, perceived stress, anxiety, and somatic symptom severity using a serial mediation model.Methods: This study included 55 children and adolescents, aged 10-18, diagnosed with anxiety disorders. Participants were recruited from a child psychiatry outpatient clinic. After semi-structured interview, self-report measures were administered, including Mindful Attention Awareness Scale, Perceived Stress Scale, Screen for Child Anxiety and Related Disorders, and Level 2 Somatic Symptoms Scale. Correlation, regression, and serial mediation analyses were conducted, controlling for age and sex.Results: Somatic symptom severity was negatively correlated with mindfulness and positively correlated with perceived stress and anxiety. Regression analysis indicated that higher anxiety and lower mindfulness were associated with somatic symptom severity, while perceived stress was not. Mediation analysis revealed a significant total indirect effect of mindfulness on somatic symptoms. Anxiety alone significantly mediated this relationship, whereas perceived stress did not act as an independent mediator. A significant serial mediation was identified: higher mindfulness was associated with lower perceived stress and lower anxiety, which were in turn associated with lower somatic symptom severity.Conclusion: Findings suggest that mindfulness is associated with lower somatic symptom severity both directly and indirectly, primarily through anxiety and sequentially through perceived stress and anxiety. Working with mindfulness and anxiety may be beneficial for youth presenting with somatic symptoms.

Background/Objective: Cognitive disengagement syndrome (CDS), formerly known as sluggish cognitive tempo, is characterized by excessive daydreaming, mental fogginess, slowed behaviour and low initiative. In addition to attentional difficulties, CDS has been linked to social withdrawal and internalizing symptoms. This study examined the association between maternal social anxiety symptoms and CDS severity in children and adolescents with attention deficit hyperactivity disorder (ADHD), while also considering maternal depressive symptoms and child ADHD symptom dimensions. Methods: This cross‐sectional study included 116 children and adolescents aged 6–18 years diagnosed with ADHD and their mothers. ADHD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , and confirmed using the Schedule for Affective Disorders and Schizophrenia for School‐Age Children—Present and Lifetime Version . Participants with psychiatric comorbidity were excluded. CDS symptoms were assessed using the Barkley Child Attention Scale, and participants were classified into high‐CDS ( n = 54) and low‐CDS ( n = 62) groups based on a cut‐off score of 23. Maternal depressive symptoms were measured with the Patient Health Questionnaire‐9, and maternal social anxiety symptoms were assessed with the Liebowitz Social Anxiety Scale. Group comparisons, Spearman correlation analyses and multivariable linear regression analyses were conducted. Results: The mean age of the sample was 13.59 years, and 50.0% of participants were boys. Compared with the low‐CDS group, the high‐CDS group had significantly higher inattentiveness scores (13.87 vs. 11.68, p < 0.001) and lower hyperactivity/impulsivity scores (12.59 vs. 13.76, p = 0.022). Mothers of children in the high‐CDS group had significantly higher Liebowitz Social Anxiety Scale avoidance scores (40.76 vs. 35.21) and total scores (79.61 vs. 70.59). In the high‐CDS group, CDS scores were positively correlated with inattentiveness ( rho = 0.39, p < 0.01), maternal social anxiety total score ( rho = 0.45, p < 0.01) and maternal depressive symptoms ( rho = 0.40, p < 0.01). In multivariable linear regression, inattentiveness ( B = 0.823, p = 0.002) and maternal social anxiety total score ( B = 0.095, p = 0.002) independently predicted CDS severity ( F [4,49] = 9.111, p < 0.001, R ² = 0.427). Conclusion: Among children and adolescents with ADHD, greater CDS severity was associated not only with attentional difficulties but also with higher levels of maternal social anxiety. These findings suggest that maternal social anxiety may be a clinically relevant familial correlate of CDS and should be taken into account when assessing youths with prominent CDS symptoms.

This study investigates the relationships between cybervictimization, cyberbullying, Internet Gaming Disorder (IGD), depression, and Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in adolescents with a history of cybervictimization. A clinical sample of 89 adolescents aged 12-17 years was assessed using standardized diagnostic interviews and self-report scales. Correlation and regression analyses revealed that depression severity was independently associated with cybervictimization, age, and IGD severity. Oppositional defiant disorder (ODD) symptoms were significantly associated with cyberbullying perpetration, whereas cybervictimization was only related to depression severity. Additionally, moderation analyses showed that IGD did not significantly moderate the relationship between cybervictimization and depression or between ODD symptoms and cyberbullying. These findings highlight the complex interplay between psychiatric symptoms and problematic online behaviors. Our results emphasize the importance of routine screening for cyberbullying experiences in adolescents with depression or ADHD. Further longitudinal studies are needed to clarify causal pathways and inform targeted interventions aimed at mitigating the negative mental health outcomes associated with cyberbullying and IGD.

Objectives: The primary objective of this study was to investigate the relationship between different types of sleep problems and specific behavioural difficulties in children and adolescents with autism spectrum disorder (ASD), compared with typically developing children (TDC). Method: We compared 40 children and adolescents with ASD and normal intellectual functioning with 50 TDC using the Sleep Disturbance Scale for Children (SDSC), the Conners' Parent Rating Scale‐Revised Short (CPRS‐RS) and the Repetitive Behaviour Scale‐Revised (RBS‐R). Results: Participants with ASD had significantly higher scores on CPRS‐RS inattention, hyperactivity and stereotyped, self‐injurious, compulsive, routine, sameness and restricted behaviours, in addition to higher RBS‐R scores. The ASD group also scored higher on the SDSC initiating and maintaining sleep subscale. Correlation analyses demonstrated significant associations between repetitive behaviours and multiple domains of sleep disturbances in the ASD group, whereas no significant correlations remained after Bonferroni correction in the TDC group. Regression analyses revealed that sleep breathing problems were associated with RBS‐R Total ( β = 0.590, p = 0.001); arousal/waking with compulsive behaviours ( β = 0.394, p = 0.014); and sameness behaviours with both timing ( β = 0.542, p = 0.012) and overall sleep problems ( β = 0.516, p = 0.002) in the ASD group. Conclusions: In this study, sameness behaviours, compulsive behaviours and total RBS‐R scores were significantly associated with several sleep problems in children and adolescents with ASD. These findings add to the literature demonstrating robust associations between specific types of sleep problems and particular behavioural difficulties in this population.

We aimed to investigate the clinical characteristics of patients presenting to child and adolescent psychiatry outpatient clinics across different age groups, and to assess the prevalence of polypharmacy along with its associated factors within a clinical sample. A total of 569 patients with complete file data were included in the study. Psychiatric diagnoses were made by a clinician based on the diagnostic criteria stipulated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A detailed medical history was obtained for each patient, and their age, gender, education level, parents' age and education level, psychiatric diagnoses, and administered treatments were recorded for further analyses. Based on a review of the relationship between complaints at presentation and polypharmacy, irritability was more prevalent among polypharmacy users, while domestic problems were more prevalent in those who did not use polypharmacy. Based on our regression analysis; conduct disorder (CD) diagnosis (B=2.405, Exp [B]=11.079, p<0.001), age (B=0.127, Exp [B]=1.136, p=0.008), and any psychiatric comorbidity (B=4.761, Exp [B]=116.874, p<0.001) were the variables most frequently and significantly associated with polypharmacy independent of other variables. This study's results indicate that the presence of CD, age, and comorbid psychiatric diagnosis significantly increase the risk of polypharmacy. A better understanding of the factors that pave the way toward polypharmacy is critical to reduce unnecessary medication use in children and adolescents.

Objective Based on the view that cognitive disengagement syndrome (CDS) and attention-deficit/hyperactivity disorder (ADHD) are distinct clinical conditions, we aimed to investigate differences between CDS and ADHD symptoms in terms of insecure attachment, temperament, and character traits in children.Methods We assessed 80 children with ADHD (24 girls and 56 boys, aged 9–12 years) through Turgay’s DSM-IV Based ADHD and Disruptive Behavior Disorders Screening Scale, Barkley Child Attention Scale, Kerns Security Scale, and the Junior Temperament and Character Inventory. Exclusion criteria included the presence of other psychiatric disorders or neurological diseases.Results CDS was significantly correlated with age (r=0.280, p=0.012), ADHD-inattention (r=0.435, p<0.001), harm avoidance (HA) (r=0.302, p=0.006), and insecure attachment (r=-0.280, p=0.012). Hierarchical multiple regression analysis indicated that age (beta=1.459, p=0.031), ADHD-inattention (beta=0.528, p=0.001), and HA (beta=0.306, p=0.044) were significant predictors of CDS severity. ADHD-inattention was significantly associated with delayed speech onset (r=-0.252, p=0.024), CDS (r=0.435, p<0.001), and novelty seeking (r=0.250, p=0.025), whereas ADHD-hyperactivity/impulsivity had an inversely significant correlation with self-directedness (r=-0.233, p=0.038). Only CDS significantly predicted the severity of ADHD-inattention (beta=0.252, p<0.001).Conclusion Our findings may suggest that examining CDS and ADHD in terms of attachment styles, temperament and character traits may improve our understanding of the distinctions between these two constructs.