Vedat Sar

Vedat Sar
Koc University · Department of Psychiatry School of Medicine

MD
Psychotraumatology and Dissociative Disorders: Epidemiology, Neurobiology, Psychotherapy, and Transdiagnostic Aspects

About

252
Publications
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Introduction
Epidemiology, clinical exploration, and psychotherapy of lifelong psychiatric consequences of childhood psychological trauma, complex PTSD, and dissociative disorders.
Additional affiliations
October 2019 - present
Koç University School of Medicine
Position
  • Chair
June 2015 - present
Koç University Hospital
Position
  • Faculty Member
Description
  • General hospital
December 2014 - October 2019
Koc University
Position
  • Visiting Faculty

Publications

Publications (252)
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
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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...
Chapter
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...
Chapter
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...
Article
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https://www.tandfonline.com/doi/full/10.1080/15299732.2022.2079110
Article
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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...
Preprint
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...
Preprint
Full-text available
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...
Article
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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...
Article
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...
Chapter
Full-text available
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...
Article
Full-text available
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...
Chapter
Full-text available
Dissosiyatif bozuklukların tümünün tanı ölçütleri, ayırıcı tanı ve tedavi açısından gözden geçirilmesi
Article
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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...
Article
Full-text available
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...
Article
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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.
Article
Full-text available
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.
Article
Full-text available
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...
Poster
Full-text available
• 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...
Article
Full-text available
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....
Article
Full-text available
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...
Article
Full-text available
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...
Data
Supplementary figure depicting the DAG Strength Plot of the network analysis
Chapter
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...
Article
Full-text available
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...
Article
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Article
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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...
Article
Full-text available
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...
Chapter
Full-text available
Gates and Rowan's Nonepileptic Seizures - edited by W. Curt LaFrance, Jr
Article
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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...
Article
Full-text available
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...
Chapter
Full-text available
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...
Article
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...
Chapter
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Article
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Dissociative identity disorder (DID) is a chronic post-traumatic disorder where developmental stress 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 the expression...
Chapter
Full-text available
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...
Article
Full-text available
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...
Article
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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...
Article
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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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
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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...
Article
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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...
Article
Full-text available
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...
Data
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)
Data
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...
Article
Full-text available
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...
Article
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Although dissociation and dissociative disorders have usually been an ordinary part of the daily clinical work in psychiatric settings and emergency wards of hospitals in Turkey, the onset of modern dissociation studies is closely linked to the clinical work and research conducted on dissociative identity disorder (DID)
Article
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Objective: To overview and evaluate the main findings, methodological shortcomings, and time trends of the recent psychiatric epidemiology studies in Turkey, as well as to provide areas prone for development in forthcoming research. Method: PubMed and Turkish Psychiatry Index were screened to identify relevant studies. Any epidemiological study...
Conference Paper
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Pierre Janet, founder of modern psychotraumatology provided a definition of mental health based on integration; i.e. he considered a well developed integrative capacity connecting several psychological phenomena as a prerequisit of mental health (Van der Hart &Horst,1989) . The basic features of dissociative disorders challenge this because they ca...
Article
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While the research on psychosis also suffered from this unrealistic delineation, in fact, it was the concept of "psychological trauma" which lost its ground [5]. Namely, the concept of "hysteria" and "hysterical neurosis" continued to live in this era, however, no more as a dissociative or trauma-related disorder but as a reaction style based alleg...
Article
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Despite all efforts, psychiatry lagged behind other medical disciplines in terms of innovation during the last few decades in particular. This is in part due to the limited opportunity of psychiatry to utilize the ongoing technological advances of biotechnology in the diagnosis and treatment of mental disorders. Interdisciplinary research remains a...
Article
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Objective: Despite its long and auspicious place in the history of psychiatry, dissociative identity disorder (DID) has been associated with controversy. This paper aims to examine the empirical data related to DID and outline the contextual challenges to its scientific investigation. Methods: The overview is limited to DID-specific research in...
Article
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ABSTRACT Dissociative amnesia (DA) among subjects with a dissociative disorder and/or borderline personality disorder (BPD) recruited from a non-clinical population was examined. The Steinberg Dissociative Amnesia Questionnaire (SDAQ), the Childhood Trauma Questionnaire (CTQ), and the self-report screening tool of the BPD section of the Structured...
Book
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3RD Fisherman: "Master, I marvel how the fishes live in the sea." 1ST Fisherman: "Why, as men do a-land -- the great ones eat up the little ones." [William Shakespeare (1564-1616), Pericles (1606-08), Act 2, Scene 1].
Article
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A total of 34 consecutive patients with dissociative identity disorder or dissociative disorder not otherwise specified were evaluated using the Turkish version of the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). They were compared with a matched control group composed of 34 patients who had a nondissociative psychiatri...
Article
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ABSTRACT The aim of this study was to determine the prevalence of dissociative identity disorder (DID) and other dissociative disorders among adolescent psychiatric outpatients. Hundred-sixteen consecutive outpatients between 11 and 17 years of age who were admitted to the child and adolescent psychiatry clinic of a university hospital for the firs...
Article
Full-text available
Abstract The aim of this study was to inquiry the possible relations of childhood trauma, anger, and dissociation to depression among women with fibromyalgia or rheumatoid arthritis. Fifty female patients diagnosed as having fibromyalgia (N=30) or rheumatoid arthritis (N=20) participated in the study. Childhood Trauma Questionnaire (CTQ-28), Somato...
Article
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ABSTRACT This study sought to determine the prevalence of experiences of possession and paranormal phenomena (PNP) in the general population, and their possible relations to each other and to traumatic stress and dissociation. The study was conducted on a representative female sample recruited from a town in central-eastern Turkey. Dissociative Dis...