Vedat Sar

• MD
• Professor of Psychiatry and Chair of Department at Koc University Istanbul Turkey

The aim of the study was to investigate if there were any characteristics of regional cerebral blood flow (rCBF) in dissociative identity disorder. Twenty-one drug-free patients with dissociative identity disorder and nine healthy volunteers participated in the study. In addition to a clinical evaluation, dissociative psychopathology was assessed u...

It has been claimed that the progress of psychiatry has lagged behind that of other medical disciplines over the last few decades.This may suggest the need for innovative thinking and research in psychiatry, which should consider neglected areas as topics of interest in light of the potential progress which might be made in this regard. This review...

The nature of consciousness and the autonomy of the individual's mind have been a focus of interest throughout the past century and inspired many theories and models. Revival of studies on psychological trauma and dissociation, which remained outside mainstream psychiatry, psychology, and psychoanalysis for the most part of the past century, has pr...

Objective: Somatic symptom burden is frequently linked to trauma-related psychopathology; Yet, the specific contributions of PTSD, disturbances in selforganization (DSO), and dissociation remain underexplored. Our study examined the prevalence of somatic symptom burden among female mental health service users and evaluated the associations between...

Background Posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) represent divergent outcomes following trauma exposure in high-risk professions. This investigation examined the complex interplay between PTSD, PTG, and resilience in relation to occupational safety behaviors among Turkish firefighters. Methods A multi-site cross-secti...

Objective: The present investigation sought to examine the interrelationships between early-life adverse experiences, dissociative symptoms, suicidal ideation, and depressive manifestations among metropolitan firefighters screened with post-traumatic stress disorder (PTSD), and to elucidate the potential mediating effects of these psychological var...

Authorities have acknowledged the ongoing deterioration of mental health in society, despite substantial investments in the field. Over the past century, clinicians and theorists have sought to challenge and refine traditional approachs to healing. However, much like ideological movements, these efforts have resulted in a fragmented psychotherapeut...

This paper, the second of a two-part essay, delves into the implicit and immediate factors within psychotherapy, positioning estrangement from oneself and to the environment as a core psychopathological issue. Implicit Psychotherapy, as proposed and outlined in this paper is the techniqual aspect of Dialectical Dynamic Therapy (DDT), which itself i...

It is about the role of internal moderation in persistency of somatic symptoms.

Introduction Depression is a heterogeneous disorder with diverse clinical presentations and etiological underpinnings, necessitating the identification of distinct subtypes to enhance targeted interventions. Dissociative symptoms, commonly observed in major depressive disorder (MDD) and linked to early life trauma, may represent a unique clinical d...

Objective: Like other first responders, many firefighters show signs of posttraumatic stress disorder (PTSD) that often go undiagnosed. Developing accessible, brief, and efficient screening tools may improve identification and service utilization. The most recent adaptation of the Primary Care PTSD Checklist for the Diagnostic and Statistical Manua...

Internal moderation is theorized as a regulatory mental mechanism that mitigates the impact of incongruent stimuli by generating a calibrated internal response. The aim of this study was to develop a standardized self-report instrument designed to measure an individual’s current level of internal moderation. An initial version of the Internal Moder...

Recent studies showed that dissociation may be common and persistent in people with depression. Dissociation also predicts subsequent depressive symptoms. Both conditions have been linked with trauma exposure. Yet, little is known about the co-occurrence of depression and dissociation. This multi-sample study investigated the co-occurrence of depre...

Background: Somatic symptoms, such as chronic pain, fatigue, and gastrointestinal disturbances, are commonly reported in individuals with a history of childhood maltreatment (CM), which includes various forms of abuse and neglect experienced before age 18. Although CM is strongly associated with somatic symptoms, the specific relationships between...

Maladaptive Daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising, which causes clinically significant distress and functional impairment in academic, vocational, and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive, and detrimental to one’s life. It involves detachme...

Background: Perceived social support is an established predictor of post-traumatic stress disorder (PTSD) after exposure to a traumatic event. Gender is an important factor that could differentiate responses to social support, yet this has been little explored. Symptoms of complex PTSD are also common following trauma but have been under-researched...

Objectives. This study aimed to investigate the co-occurrence of childhood trauma, dissociation, suicidality, and depression with posttraumatic-stress disorder (PTSD) among professional firefighters working in metropolitan fire departments in Turkey. Methods. A cross-sectional study was conducted among 760 male firefighters aged 24-55 years with 2-...

Childhood maltreatment (CM) is thought to be associated with altered responses to social stimuli and interpersonal signals. However, limited evidence exists that CM is linked to larger comfortable interpersonal distance (CID) – the physical distance humans prefer towards others during social interactions. However, no previous study has investigated...

In February 2023, two catastrophic earthquakes in Turkey resulted in over 50,000 fatalities and over 300,000 injuries. This study investigated the psychological effects on firefighters who engage in rescue operations following these earthquakes, focusing on trauma-related symptoms, depression, anxiety, stress, and resilience. The research employed...

Bedensel belirtilerle kendini gösteren ruhsal bozukluklar tarih boyunca değişen açıklamalara konu olmuştur. Çağın ruhuna göre biçim alan bu açıklamalar fizikselden spiritüele, genel tıptan psikososyal kuramlara uzanan geniş bir yelpazeye yayılmıştır. Bu betimlemelerden biri olan ve geçmişi Hipokrat’a kadar dayanan “histeri” kavramı, ardında yatan v...

Objective: Studying Gender Role Stress (GRS) is important to understand how gender norms and related fears impact individual’s well-being, relationships, and societal dynamics including gender equality. To obtain a standardized instrument suitable in future research, this study investigated the validity, reliability, and utility of the Masculine Ge...

The main treatment method indicated for dissociative identity disorder (DID) is intensive psychotherapy. During the initial phase, stabilization of the patient is essential; the treatment progresses through successive crisis interventions. Short-term hospitalizations may be carried out when needed. The outcome is inversely related to age. Children,...

Dissociative depression is a complex and chronic mood disorder characterized by a combination of persistent depressive symptoms and intermittent major depressive episodes. A key feature of dissociative depression is the existence of dissociative symptoms that are linked to prolonged stress experienced during childhood and infancy. Disturbances of s...

After the changes in DSM-5, dissociative subtype was added to post-traumatic stress disorder. That caused a necessity for a scale to measure the mentioned change. A scale named Dissociative Subtype of Post-Traumatic Stress Disorder (DSPS) was developed to measure this subtype and help the diagnosis. The purpose of this study is to adapt the Dissoci...

Ruhsal bozukluklar, eski çağlardan bu yana insanlığın ele aldığı bir konu olmuştur. Modern hekimliğin ruh sağlığı ve hastalıkları ile ilgili uzmanlık dalı olarak psikiyatrinin tarihi ise oldukça yenidir. Kuşkusuz bu tarihin içerisinde psikanalistler, psikologlar, nörologlar, sosyal bilimciler, biyokimyacılar, farmakologlar ve daha birçok meslek gru...

Childhood maltreatment (CM) is thought to be associated with altered responses to socialstimuli and interpersonal signals. Correspondingly, first studies found that CM is linked tolarger comfortable interpersonal distance (CID). However, studies were limited in statisticalpower and only examined individuals from the European region. Moreover, littl...

Dialectical thinking is about dealing with thesis and antithesis (accepting coexistence of opposites) to achieve a creative-integrative synthesis. This is the highest step of the cognitive development of the individual (Basseches, 1980). Dialectical thinking is a facilitator of both true science and effective psychotherapy, as well as the core prin...

The COVID-19 pandemic brings significant challenges for college students. This study aims to investigate changes in psychiatric symptomatology among them compared to the pre-pandemic period alongside their determinants. Data are collected before and 3 months after the onset of the pandemic from 168 students who applied to a college mental health ce...

The anonymous tale (my version) of five medical doctors hunting is not far from telling the truth: The physicians saw a bird taking off from the bush and wanted to be sure that it was a duck and not a goose before they shot it. The general practitioner deferred the decision to the specialists. The internist did not want to comment without hav...

Background Reduced memory specificity (i.e., overgeneral memory) is a characteristic of autobiographical memories widely studied in clinical populations, and it is explained by rumination, functional avoidance, and executive dysfunction. Though the relationship of autobiographical memory specificity with mood and anxiety disorders has been shown, h...

This chapter explores the most pertinent research questions to understand and advance the study of dissociation. Drawing on specifi c themes, recommendations for future work are outlined at the end of each section. Our chapter in the fi rst edition of this book still contains questions empirically unanswered (e.g., genetics and neurobiology of diss...

Fragmentation and Beyond Considering the mind as an integrated system, which strives to maintain the biopsychosocial “homeostasis” of the individual, any psychotic condition, per this defi nition, implies some type of “disintegration” of this functional unity. Such disintegration may aff ect one or more mental processes, with a particular emphasis...

https://www.tandfonline.com/doi/full/10.1080/15299732.2022.2079110

The clinical heterogeneity of dissociation constitutes a challenge to the culture-sensitive clinician. Variability in experiencing dissociation, the interplay between acute and chronic conditions, and the predominance of a nosologically interface-type of clinical surface conceal core dissociative symptoms. While the latter (amnesia, depersonalizati...

Childhood maltreatment (CM) is linked to impairments in various domains of social functioning. Here, we argue that it is critical to identify factors that underlie impaired social functioning as well as processes that mediate the beneficial health effects of positive relationships in individuals exposed to CM. Key research recommendations are prese...

Objective: COVID-19 pandemic brought significant challenges for college students. This study aimed to investigate changes in psychiatric symptomatology among them compared to the pre-pandemic period alongside their determinants. Methods: Data were collected before and three months after the onset of the pandemic from 168 students who had applied to...

In individuals with a history of child maltreatment (CM), impairments in many domains of social functioning are well-documented but poorly understood. We summarize evidence for the detrimental effects of CM on social functioning and present key research recommendations focused on: 1. Identifying alterations in specific inter- and intra- personal pr...

The clinical heterogeneity of dissociation constitutes a challenge to the culture-sensitive clinician. Variability in experiencing dissociation, the interplay between acute and chronic, and predominance of a nosologically interface type of clinical surface conceal core dissociative symptoms. While the latter (amnesia, depersonalization, derealizati...

Background and Purpose The Cancer Rehabilitation Evaluation System-Short Form (CARES-SF) is one of the first self-report measurement tools that addresses problems and rehabilitation needs of patients with cancer. This study aimed to examine the validity and reliability of the CARES-SF for Turkish-speaking patients with cancer. Methods The Turkish...

Dissociative disorders constitute an exemplary disease model of the biopsychosocial paradigm in psychiatry. Being a post-traumatic condition related to developmental adversities, both biological underpinnings, as well as the neurobiological consequences of chronic stress, and the social context where the traumatic experiences occur, influence the p...

This study was concerned with associations between narcissism, childhood trauma, dissociation, attachment styles, and depression among young adults. Childhood Trauma Questionnaire, Dissociative Experiences Scale (DES), Relationship Styles Questionnaire, Beck Depression Scale, and the Five-Factor Narcissism Questionnaire were administered to 422 col...

Dissosiyatif bozuklukların tümünün tanı ölçütleri, ayırıcı tanı ve tedavi açısından gözden geçirilmesi

This study was concerned with a culture-sensitive revision of the Turkish version of the Childhood Trauma Questionnaire (CTQ-28) and expansion of the instrument through integration of a dimension assessing overprotection – overcontrol (OP-OC). Participants (n = 783) were 37 dissociative and 78 non-dissociative and non-psychotic psychiatric outpatie...

Inaccurate diagnosis of dissociative disorders (DDs) remains a frequent problem. Misdiagnoses may lead to delayed or ineffective treatment, and subsequently poorer quality of life for those struggling with DDs, who frequently utilize mental health treatment and evidence high rates of self-harm and suicidality. This study’s objective was to examine...

While many theories and models have emerged in psychiatry and psychology over time, a “meta” or “supra” theory covering all of them has yet to be generated. Ironically, a silent consensus seems to “unknowingly” occur around the central role of one phenomenon: dividedness (aka dissociation). Yet, the “rumors” about what is divided are plenty.

Psikiyatri ve psikoloji pek çok kuram ve model üretmiş olmakla birlikte kuramlarüstü bir kuramortaya çıkaramamıştır. Ancak ironik olarak, bir fenomenin merkezsel rolü üzerinde farkında olunmadan birleşildiği görülmektedir: bölünme. Neyin bölündüğü konusunda rivayet muhtelif de olsa.

The aim of this study was to identify types and number of traumatic experiences and to determine the predictors of severity of posttraumatic stress disorder (PTSD) in Syrian refugees who were residing in a camp in Turkey. Face-to-face psychiatric interviews were carried out with 342 participants to make a diagnosis of PTSD according to the Diagnost...

Abstract This paper proposes a model that explains the response to complex psychological trauma and dissociation. This tri-modal reaction model tries to account for the mental striving of the traumatized individual in dealing with unbearable pain when fighting for overall survival. Rather than conceptualizing this process in consecutive phases, the...

• Major Depressive Disorder (MDD) is one of the most debilitating disorders worldwide, with a lifetime prevalance of 20% . • Despite its high prevalence, current treatment options of MDD are limited and almost 30-40% of the patients are treatment resistant. • One of the reasons for treatment resistance in MDD could be the comorbidities and persiste...

Aims: This study aimed to evaluate fear of happiness among college students and its relationship to gender, childhood psychological trauma, and dissociation. Setting and Design: College students were addressed as study population and a relational screening method was implemented. Method and Material: Among 184 participants, 93 (50.5%) were women....

Childrearing practices have undergone a cultural evolution throughout history. This evolution leads to better self-realization and less sacrifice of the child’s potentials. The prevailing childrearing practice is as traumatic as one goes back in history. Childhood traumata have lifetime consequences, in particular when they are of relational and re...

The interrelationships between the symptom domains of dissociation, such as the loss of continuity in subjective experience, the inability to access personal information, and the distortions about the perception of self and the environment, need to be better understood. In the current study, 2274 adults from Italy completed the Dissociative Experie...

Supplementary figure depicting the DAG Strength Plot of the network analysis

Psychotic symptoms may occur in dissociative identity disorder (DID), in its partial presentations, and in acute dissociative conditions. This chapter summarizes clinical observations and the existing empirical data on the prevalence and significance of psychotic symptoms in dissociative disorders. Formal thought disorder is related to the disturba...

işinin karşılaştığı stres verici bir olay ile onunla psikolojik açıdan baş ede-bilme kapasitesi arasında yaşamsal bir dengesizlik ortaya çıktığında ruhsal travmadan söz edilir. 1 Öznel etkenleri de dikkate alan bu tanıma karşın, trav-matik durumların genellikle nesnel açıdan hemen herkesi derinden yaralayabilecek şiddette olaylar sonrasında ortaya...

Psikiyatrinin daha çok kalp ile mi yoksa beyinle mi ilişkili olduğu sorusuna yanıt vermek güçtür. Bu yazının konusu olan kardiyoloii açısından bakıldı-ğında bu ilişkinin iki yönlü olduğu görülür: Kardiyovasküler hastalıklarda psikiyatrik bozukluk riski ve psikiyatrik bozukluklarda kardiyovasküler hastalık riski karşılıklı olarak anlamlı derecede yü...

This study inquires into neurobiological response to stress and its clinical correlates among adolescents with post-traumatic stress disorder (PTSD). Structural magnetic resonance imaging (MRI) measures of cerebral anatomy were carried out on 23 female adolescents with PTSD related to severe childhood sexual abuse and 21 matched healthy controls. C...

Gates and Rowan's Nonepileptic Seizures - edited by W. Curt LaFrance, Jr

INTRODUCTION: Aim: Cancer usually triggers a psychological response representing traumatic stress. Regardless of the nature of the noxious agent, therapeutic interventions to any post-traumatic reaction have to consider the tri-phasic structure adaptation in defining harmony towards a vital threat: shock, mourning, and integration. This paper is ai...

Psychological trauma represents a discrepancy between external threat and individual’s capacity of coping with it. War and terrorism increase the risk of traumatic experiences due to potential bodily injury and other adversities. Beside singular events, war and terrorism may also lead to chronic psychological processes due to traumatization in chil...

Identity has been a relatively underreferenced concept in psychiaty and clinical psychopathology. It is of particular interest that the few diagnostic categories associated with some type of identity disturbance are related to chronic psychological traumatization in childhood such as abuse an/or neglect or deficiencies in secure interpersonal attac...

Individuals who differ markedly by sleep chronotype, i.e., morning-type or evening-type also differ on a number of psychological, behavioral, and biological variables. Among several other psychological functions, dissociation may also lead to disruption and alteration of consciousness, which may facilitate dream-like experiences. Our study was aime...

Dissociative identity disorder (DID) is a chronic post-traumatic disorder where developmentally stressful events in childhood, including abuse, emotional neglect, disturbed attachment, and boundary violations are central and typical etiological factors. Familial, societal, and cultural factors may give rise to the trauma and/or they may influence t...

Dissosiyasyon normalde bütünlük içersinde olan bilinç, bellek, kimlik, duygu, algı, beden temsili, motor kontrol ve davranışta ayrışma ve/ya da süreksizlik olmasıdır. Bu ayrışma ve süreksiz-likler psikolojik işlevlerin her alanını etkileyebilir. Dissosiyatif bozuklukların en kapsamlısı olan dissosiyatif kimlik bozuklu-ğunda (DKB) bu işlevlerin heme...

Dissociative identity disorder [DID] is a chronic complex psychiatric condition related to cumulative psychological traumatization in childhood. It is characterized by a marked disturbance of identity due to the presence of distinct personality states and repetitive dissociative amnesias which interfere with the continuity of the affected person’s...

This paper seeks to highlight phenomena related to resistance in the psychotherapy of dissociative disorders and other trauma- and stress-related psychiatric disorders. The authors consider a particular psychological construct to be at the origin of resistance: the trauma-self. The resistances of the trauma-self consist of three main groups: Depres...

Aim: This study inquires into identity alteration among college students and its relationship to borderline personality disorder (BPD) and/or dissociative disorders (DDs). Methods: Steinberg Identity Alteration Questionnaire (SIAQ), Childhood Trauma Questionnaire (CTQ), and self-report screening tool of the BPD section of the Structured Clinical...

This article presents the history of a 21-year-old female college student with total denial of pregnancy who experienced an acute dissociative reaction during the spontaneous delivery at home without medical assistance where the newborn died immediately. Psychiatric examination, self report questionnaires, legal documents, and witness reports hav...

Depersonalization and derealization were examined among college students with and without borderline personality disorder (BPD) and/or dissociative disorders (DDs) by self-report and clinician assessment. The Steinberg Depersonalization and Derealization Questionnaires (SDEPQ and SDERQ), the Childhood Trauma Questionnaire, and the screening tool of...

Controversy exists regarding the merits of exposure-based treatments for posttraumatic stress disorder (PTSD) versus a phased approach when prominent dissociative symptoms are present. The first aim of this study was to examine the degree to which diagnosing dissociation in two traumatized patients’ vignettes influenced clinicians’ preference for p...

Dissociative identity disorder (DID) is a complex, posttraumatic, developmental disorder for which we now, after four decades of research, have an authoritative research base, but a number of misconceptualizations and myths about the disorder remain, compromising both patient care and research. This article examines the empirical literature pertain...

The aim of the present study was to investigate the potential influence of childhood trauma on clinical presentation, psychiatric comorbidity, and long-term treatment outcome of the bipolar disorder. One hundred thirty-five consecutive patients with bipolar disorder type I were recruited from an ongoing prospective follow-up project. The Childhood...

There is a lack of knowledge about the state of affairs of the trauma treatments in Europe. To start to fill in this gap, key persons from seven European countries-Georgia, Germany, Lithuania, the Netherlands, Poland, Switzerland, and Turkey-accepted the invitation to give their expert opinion on the state of affairs in their country at an invited...

Background: Posttraumatic stress disorder (PTSD) and depression are common among populations displaced due to large-scale political conflicts and war. Objective: The aim of this study is to investigate the prevalence and gender-based differences in symptoms of PTSD and depression among Iraqi Yazidis displaced into Turkey. Method: The study was...

Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale-originally designed to assess a...

This Excel spreadsheet that contains the pooled, raw, data from all of the collaborating investigators. This has been submitted at the request of the publishing entity, so that other researchers may also have access to the dataset used in our analyses. (CSV)

Samples included in the analysis. This table lists all of the data sets used for this research by primary investigator, providing the: number of community members in their sample; number of clinical patients used in their sample (alongside the type of clinical sample used); the language used by that research group; and a reference to where else the...

A new concept introduced by the author, the “dissociative depression” differs from primary depression in symptomatology, course and treatment response. Being related to traumatization in childhood, dissociative depression tends to be chronic and is usually classified as treatment-resistant due to its limited response to biological interventions. Tr...