Browsing by Author "Cinaroglu, Metin"

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Case Report: Physiological and Psychological Underpinnings of Muscle Dysmorphia Using EEG, GSR, and Eye-Tracking
(Frontiers Media SA, 2025) Cinaroglu, Metin; Ulker, Selami Varol; Yilmazer, Eda; Sayar, Goekben Hizli
Background Muscle dysmorphia (MD), a subtype of Body Dysmorphic Disorder (BDD), involves an obsessive preoccupation with perceived insufficient muscularity despite an objectively muscular physique. While its psychological features are well-documented, physiological and attentional underpinnings remain underexplored.Objective This exploratory, proof-of-concept case series examines the psychological, physiological, and attentional characteristics of individuals with varying experiences of MD using a multimodal approach combining electroencephalography (EEG), galvanic skin response (GSR), and eye-tracking technologies.Methods Three male participants were purposefully selected to represent distinct clinical profiles: one with active MD and steroid use, one in sustained remission from MD, and one with no MD history. Participants completed validated psychological scales (MDDI, BIDQ, STAI, RSES) and were exposed to personalized visual stimuli (past, current, and idealized body images). A triangulated recording protocol was used to capture EEG, GSR, and eye-tracking data during stimulus exposure.Results Participants with current and past MD showed elevated beta wave activity, increased skin conductance, and attentional biases toward muscular regions, corresponding with higher self-reported distress and anxiety. In contrast, the control participant exhibited stable physiological responses and emotionally neutral reactions. Triangulated data revealed coherent patterns across subjective and physiological domains, supporting the internal validity of the findings despite the small sample.Conclusion These findings illustrate the potential of multimodal assessment in identifying candidate psychophysiological markers of MD. While not generalizable, this case-series provides a valuable framework for future hypothesis-driven research and supports the need for gender-specific diagnostic and intervention strategies in muscle dysmorphia.
Cognitive Behavioral Therapy for Muscle Dysmorphia and Anabolic Steroid-Related Psychopathology: A Randomized Controlled Trial
(MDPI, 2025) Cinaroglu, Metin; Yilmazer, Eda; Ulker, Selami Varol; Sayar, Gokben Hizli
Background/Objectives: Muscle dysmorphia (MD), a subtype of body dysmorphic disorder, is prevalent among males who engage in the non-medical use of anabolic-androgenic steroids (AASs) and performance-enhancing drugs (PEDs). These individuals often experience severe psychopathology, including mood instability, compulsivity, and a distorted body image. Despite its clinical severity, no randomized controlled trials (RCTs) have evaluated structured psychological treatments in this subgroup. This study aimed to assess the efficacy of a manualized cognitive behavioral therapy (CBT) protocol in reducing MD symptoms and associated psychological distress among male steroid users. Results: Participants in the CBT group showed significant reductions in MD symptoms from the baseline to post-treatment (MDDI: p < 0.001, d = 1.12), with gains sustained at follow-up. Large effect sizes were also observed in secondary outcomes including depressive symptoms (PHQ-9: d = 0.98), psychological distress (K10: d = 0.93), disordered eating (EDE-Q: d = 0.74), and exercise addiction (EAI: d = 1.07). No significant changes were observed in the control group. Significant group x time interactions were found for all outcomes (all p < 0.01), indicating CBT's specific efficacy. Discussion: This study provides the first RCT evidence that CBT significantly reduces both core MD symptoms and steroid-related psychopathology in men engaged in AAS/PED misuse. Improvements extended to mood, body image perception, and compulsive exercise behaviors. These findings support CBT's transdiagnostic applicability in addressing both the cognitive-behavioral and affective dimensions of MD. Materials and Methods: In this parallel-group, open-label RCT, 59 male gym-goers with DSM-5-TR diagnoses of MD and a history of AAS/PED use were randomized to either a 12-week CBT intervention (n = 30) or a waitlist control group (n = 29). CBT sessions were delivered weekly online and targeted distorted muscularity beliefs, compulsive behaviors, and emotional dysregulation. Primary and secondary outcomes-Muscle Dysmorphic Disorder Inventory (MDDI), PHQ-9, K10, EDE-Q, EAI, and BIG-were assessed at the baseline, post-treatment, and 3-month follow-up. A repeated-measures ANOVA and paired t-tests were used to analyze time x group interactions. Conclusions: CBT offers an effective, scalable intervention for individuals with muscle dysmorphia complicated by anabolic steroid use. It promotes broad psychological improvement and may serve as a first-line treatment option in high-risk male fitness populations. Future studies should examine long-term outcomes and investigate implementation in diverse clinical and cultural contexts.
Comparing Cognitive Behavioral Therapy and Ericksonian Hypnotherapy for Subclinical Depression and Anxiety: A Randomized Controlled Trial
(Routledge Journals, Taylor & Francis Ltd, 2025) Cinaroglu, Metin; Yilmazer, Eda; Odabasi, Cemre; Ulker, Selami Varol; Sayar, Gokben Hizli
This randomized controlled trial examined the effectiveness of Cognitive Behavioral Therapy (CBT) and Ericksonian Hypnotherapy (EH) in reducing symptoms of depression and anxiety among individuals with subclinical levels of distress. A total of 150 participants were screened, and 45 eligible participants were randomized into three groups: CBT (n = 15), EH (n = 15), and a waitlist control group (n = 15). Interventions consisted of 12 weekly sessions, with assessments conducted at baseline, mid-intervention, and post-intervention using the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI). Both CBT and EH significantly reduced symptoms of depression and anxiety compared to the control group, with no significant differences in efficacy between the two interventions. CBT's structured approach demonstrated consistent improvements across both depression and anxiety, while EH showed a slightly faster reduction in anxiety symptoms at mid-intervention, highlighting its potential for addressing somatic and cognitive dimensions of anxiety. This study extends previous findings by focusing on a non-clinical population, emphasizing the potential of these interventions as early strategies for preventing symptom escalation. Unlike prior work primarily targeting diagnosed populations, this research underscores the applicability of CBT and EH in addressing subthreshold distress. Limitations include a small sample size, lack of follow-up assessments, and reliance on self-reported measures. Future research should explore long-term outcomes, larger samples, and the integration of CBT and EH. These findings contribute to the growing body of evidence supporting diverse psychotherapeutic modalities for early mental health intervention.
Effects of Ericksonian Hypnotherapy Versus Cognitive Behavioral Therapy on Prolonged Grief Among University Students: A Randomized Clinical Trial
(Routledge Journals, Taylor & Francis Ltd, 2025) Cinaroglu, Metin; Yilmazer, Eda; Ulker, Selami Varol; Cinar, Fadime
This study evaluates the comparative effectiveness of Ericksonian Hypnotherapy (EH) and Cognitive Behavioral Therapy (CBT) in addressing prolonged grief among university students in Istanbul. Transitioning through critical developmental phases, 39 students who had experienced significant loss and demonstrated symptoms of prolonged grief participated in this randomized controlled trial. They were divided equally into three groups: those receiving EH, those undergoing CBT, and a control group placed on a waiting list. Assessments utilized the Prolonged Grief Scale and the Beck Depression Inventory to measure the interventions' impact on grief. Findings revealed significant improvements in both EH and CBT groups compared to the control, with EH showing marginally higher effectiveness in reducing grief symptoms. This research underlines EH's potential as a culturally adaptable and effective treatment for prolonged grief in a diverse academic setting, advocating for its broader application and further exploration across various populations.
Efficacy of Cognitive-Behavioral Therapy in Reducing Muscle Dysmorphia Symptoms Among Turkish Gym Goers: A Pilot Study
(Elsevier, 2024) Cinaroglu, Metin; Yilmazer, Eda; Ulker, Selami Varol; Ahlatcioglu, Esra Noyan; Sayar, Gokben Hizli
Muscle dysmorphia (MD) is a disorder marked by an obsessive focus on muscularity, often leading to excessive exercise, rigid dieting, and use of performance-enhancing drugs (PEDs). While Cognitive-Behavioral Therapy (CBT) is known to be effective for various body image disorders, its specific effects on individuals with MD have been less studied. This qualitative case series involved seven male participants, aged 35-55, all diagnosed with MD and with a history of anabolic steroid use, undergoing a 12-week manualized CBT intervention. The study aimed to explore how CBT impacts their body image perceptions, exercise behaviors, steroid use, and emotional responses. Data were collected through participant feedback during therapy sessions, with thematic analysis revealing significant shifts in body image perception and reductions in compulsive behaviors and steroid use. Despite these improvements, participants experienced feelings of loss and anxiety as they modified their routines, and some reported relapses under stress, indicating the chronic nature of MD. The findings suggest that CBT effectively reshapes cognitive and behavioral patterns in MD sufferers but also highlight the need for ongoing support to manage the disorder's emotional complexities and prevent relapses. Future research should focus on long-term and individualized therapeutic approaches to better support those with muscle dysmorphia.
Exploring the Psychological and Social Dynamics of Steroid and Performance-Enhancing Drug (PED) Use Among Late Adolescents and Emerging Adults (16-22): A Thematic Analysis
(MDPI, 2025) Cinaroglu, Metin; Yilmazer, Eda; Noyan Ahlatcioglu, Esra
Background: Performance-enhancing drug (PED) use has become increasingly prevalent among adolescents and emerging adults, not solely for athletic advantage but as a psychological and sociocultural coping mechanism. In T & uuml;rkiye, where Westernized body ideals intersect with traditional values, the emotional and symbolic meanings of PED use among youth remain underexplored. Methods: This qualitative study employed semi-structured interviews and reflexive thematic analysis to examine the subjective experiences of 26 Turkish adolescents and emerging adults (19 males, 7 females; ages 16-22) in Istanbul who reported non-medical use of steroids or other PEDs. Participants were recruited through snowball sampling in gym-adjacent communities across six urban districts. Interviews were conducted online, recorded, transcribed, and analyzed to identify emergent psychological themes. Results: Six interconnected themes were identified: (1) body-based insecurity and the fantasy of reinvention; (2) emotional regulation through bodily control; (3) secrecy as autonomy; (4) compulsive enhancement and dissatisfaction; (5) psychological dependency and regret; and (6) PED use as agency and protest. While male and female participants differed in aesthetic goals and social narratives, both groups framed PED use as a means of identity construction, emotional survival, and social validation. Participants did not perceive themselves as deviant but as strategic actors navigating a performance-driven culture. Conclusions: PED use among youth in urban T & uuml;rkiye emerges as a psychologically embedded coping mechanism rooted in emotional regulation, self-concept, and perceived control. Rather than a deviant behavior, it reflects an adaptive but precarious strategy for managing insecurity and achieving recognition during a critical developmental stage.
Interhemispheric EEG Coherence as a Candidate Biomarker in Gambling Disorder: Evidence of Frontal Hyperconnectivity and Posterior Disconnectivity
(Frontiers Media SA, 2025) Yilmazer, Eda; Cinaroglu, Metin; Ulker, Selami Varol; Tarlaci, Sultan
Background Gambling Disorder (GD) is a behavioral addiction marked by impaired decision-making and poor impulse control. We investigated whether resting-state interhemispheric quantitative EEG (qEEG) coherence-a measure of functional connectivity between homologous cortical regions-could serve as a biomarker of GD.Methods Twenty-nine male patients with GD and 45 healthy male controls underwent resting-state qEEG recording. Coherence was computed for homologous electrode pairs across delta, theta, alpha, and beta bands. Group differences were analyzed using independent-samples t-tests; associations with disorder duration were assessed via age-controlled partial correlations.Results Consistent with our hypothesis, GD participants exhibited frontal pole hypercoherence (Fp1-Fp2) across delta, theta, and beta bands, which is likely influenced by prefrontal/orbitofrontal generators. In contrast, GD showed hypocoherence in temporal (T3-T4, T5-T6), central (C3-C4), and parietal (P3-P4) regions across these frequencies. Greater disorder duration was associated with lower beta coherence at F3-F4 and Fp1-Fp2, and higher delta coherence at O1-O2.Conclusions These findings reveal a dual pattern of interhemispheric connectivity disruption in GD-hypercoherence at frontal pole sites and hypocoherence in sensorimotor and attentional posterior networks-supporting theoretical models of addiction neurocircuitry. Resting-state qEEG coherence holds promise as a clinically relevant biomarker for GD and may inform the development of neuromodulatory interventions aimed at network rebalancing.
Multimodal Neurophysiological Responses to Body Image Stimuli in Men with Muscle Dysmorphia and Steroid Use
(Elsevier, 2025) Cinaroglu, Metin; Yilmazer, Eda; Ulker, Selami Varol; Sayar, Gokben Hizli
Muscle dysmorphia (MD), a subtype of body dysmorphic disorder (BDD), involves a pathological preoccupation with muscularity and is commonly linked to anabolic steroid and performance-enhancing drugs (PEDs) use. Despite its rising prevalence, the neurophysiological and affective mechanisms underlying MD, particularly in steroid users, remain underexplored. This study examined 71 male strength-training participants (35 with BDD/ steroid use; 36 controls) during a passive viewing task of muscular, average, and slender male physiques while recording electroencephalography (EEG), electrodermal activity (EDA), and eye-tracking data. Psychometric assessments captured muscularity concerns (Muscle Dysmorphic Disorder Inventory, MDDI), anxiety (State-Trait Anxiety Inventory, STAI), obsessive-compulsive symptoms (Obsessive-Compulsive Inventory-Revised, OCI-R), appearance-related anxiety (Social Appearance Anxiety Scale, SAAS; Social Physique Anxiety Scale, SPAS), and selfesteem (Self-Liking/Self-Competence Scale-Revised, SLCS-R). The BDD/MD group showed significantly heightened responses to muscular stimuli across all modalities. EEG results revealed increased P300 and late positive potential (LPP) amplitudes, along with greater left-lateralized frontal alpha asymmetry. Eye-tracking indicated longer fixation durations and more frequent fixations on muscular images. EDA results showed elevated levels of autonomic arousal. Between-group differences in psychometric measures were substantial, with large effect sizes. Correlational analyses demonstrated significant associations between MD severity and neurophysiological markers, including LPP amplitude, frontal asymmetry, and EDA reactivity. These findings suggest that men with MD and steroid/PEDs use exhibit amplified attentional, emotional, and physiological reactivity to muscular body images. The integration of EEG, EDA, and eye-tracking provides novel insights into the neurocognitive-affective profile of BDD/MD, emphasizing the salience of idealized physiques in this population. Results support the potential utility of multimodal measures as objective indicators for assessing body image disturbance and underscore the need for targeted interventions addressing perceptual and emotional dysregulation in BDD/MD.
Problematic Social Media Use, Self-Objectification, and Body Image Disturbance: The Moderating Roles of Physical Activity and Diet Intensity
(Dove Medical Press Ltd, 2025) Cinaroglu, Metin; Yilmazer, Eda
Purpose: This study examines the relationship between problematic social media use, self-objectification, and body image disturbance in women, with physical activity and diet intensity as moderators. It also explores the psychological outcomes of depression and anxiety.
Methods: A cross-sectional study was conducted with 594 women aged 18- 65 in Istanbul, T & uuml;rkiye. Participants completed validated measures assessing social media use, self-objectification, body image disturbance, physical activity, diet intensity, depression, and anxiety. A moderated mediation analysis was performed.
Results: Self-objectification significantly mediated the relationship between problematic social media use and body image disturbance (b = 0.14, SE = 0.03, 95% CI [0.10, 0.21], p < 0.01, R-2 = 0.18). Physical activity buffered this effect (b = - 0.12, SE = 0.05, p = 0.02, d = 0.36), while diet intensity exacerbated it (b = 0.15, SE = 0.04, p < 0.01, d = 0.42). Body image disturbance also mediated the association between social media use and depression (b = 0.18, SE = 0.05, p < 0.01, R-2 = 0.22) and anxiety (b = 0.16, SE = 0.04, p < 0.01, R-2 = 0.19).
Conclusion: The findings highlight the dual roles of physical activity and diet intensity in shaping body image outcomes. The study underscores the need for targeted interventions to mitigate the negative impact of social media-driven self-objectification on body image and mental health.
Psychological Correlates of Performance-Enhancing Drug Use: Emotional, Cognitive, and Social Functioning in Long-Term and Short-Term Users
(Frontiers Media SA, 2025) Cinaroglu, Metin; Yilmazer, Eda
Introduction Performance-enhancing drug (PED) use-particularly anabolic-androgenic steroids (AAS)-has expanded from competitive sport into mainstream fitness settings. Although PED use is associated with emotional, cognitive, and social difficulties, less is known about how duration of use or psychosocial factors shape these outcomes. Understanding these dynamics is essential for identifying individuals at greater risk for psychological impairment.Methods A total of 285 adult gym-goers (87 long-term users, 95 short-term users, 103 non-users) completed validated measures of depression (BDI-II), anxiety (BAI), muscle dysmorphia (MDDI), self-efficacy (GSE), social support (MSPSS), and social functioning (SASS), along with the Stroop test assessing executive function. Group comparisons, multiple regressions, and PROCESS-based mediation and moderation analyses were conducted, controlling for demographic covariates.Results Long-term PED users reported significantly higher depression, anxiety, and muscle dysmorphia than short-term users and non-users, and showed poorer Stroop interference performance. Mediation analysis revealed that depression and anxiety partially explained the link between PED use and poorer social functioning. Moderation results indicated that stronger self-efficacy and higher perceived social support buffered depressive and anxious symptoms among users.Discussion Chronic PED use is associated with heightened emotional distress and reduced executive functioning, which in turn contribute to impaired social functioning. However, psychosocial resources such as self-efficacy and social support may mitigate these adverse effects. These findings underscore the need for routine psychological assessment and the development of supportive, prevention-oriented interventions for individuals engaged in PED use.
Psychological Impact of the 2023 Kahramanmaras Earthquakes on Non-Victims: A Cross-Sectional Study
(BMC, 2025) Cinaroglu, Metin; Yilmazer, Eda; Sayar, Gokben Hizli
The 2023 Kahramanmara & scedil; earthquakes, with magnitudes of 7.7 and 7.6, caused extensive destruction and psychological distress across southeastern Turkey. This study explores the psychological impact on non-victims, particularly Istanbul residents, focusing on mental health outcomes and coping mechanisms. A cross-sectional survey was conducted from March to May 2024 with 721 participants from various Turkish cities, including a significant portion from Istanbul. Validated psychological scales such as the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and PTSD Checklist for DSM-5 (PCL-5) measured depression, anxiety, well-being, and PTSD symptoms. Sociodemographic factors like age, gender, occupation, income, education level, and previous earthquake experience were also analyzed. Results showed significant psychological distress among non-victims: 51.9% reported high levels of distress, with 24% meeting PTSD criteria, 30% exhibiting moderate to severe depression, and 28% experiencing significant anxiety. Higher income and education levels correlated with better mental health outcomes. Higher education levels were linked to lower PTSD risk (beta = -0.20, p < 0.01) and fewer depression symptoms (beta = -0.15, p < 0.05). Higher income was associated with lower depression scores (beta = -0.20, p < 0.01) and fewer PTSD symptoms (beta = -0.15, p < 0.05). Age positively correlated with well-being (r = 0.68, p < 0.001) and negatively with PTSD symptoms (r = -0.15, p < 0.05). Comparisons with victim studies of major earthquakes, such as the 1995 Great Hanshin-Awaji earthquake, the 1999 Marmara earthquake, the 2008 Wenchuan earthquake, and the 2000 Iceland earthquakes, revealed similar profound psychological impacts. This highlights the need for comprehensive mental health interventions for both direct and indirect exposures. This study underscores the necessity for inclusive mental health strategies to enhance resilience and well-being, ensuring robust recovery after catastrophic events.
Psychological Impact of the 2023 Kahramanmaraş Earthquakes: A Systematic Review and Meta-Analysis of PTSD, Depression, and Anxiety Among Turkish Adults
(Frontiers Media SA, 2025) Cinaroglu, Metin; Yilmazer, Eda; Ahlatcioglu, Esra Noyan; Ulker, Selami Varol; Sayar, Gokben Hizli
Background The twin earthquakes that struck Kahramanmara & scedil;, T & uuml;rkiye, on February 6, 2023, caused widespread devastation and loss of life. Beyond the physical destruction, such large-scale disasters often result in significant psychological trauma. This study systematically reviewed and meta-analyzed the prevalence and severity of probable post-traumatic stress disorder (PTSD), depression, and anxiety among adult Turkish survivors during the first 18 months post-disaster. Methods Following PRISMA 2020 guidelines, a systematic search of Web of Science, PubMed, and Scopus was conducted for peer-reviewed studies published between February 6, 2023, and May 30, 2025. Eligible studies included quantitative assessments of PTSD, depression, or anxiety using validated Turkish-language scales, with general adult population samples (N >= 370). Eight studies (N = 5,965) met inclusion criteria. A random-effects meta-analysis was conducted for studies reporting prevalence of probable PTSD, while depression and anxiety outcomes were synthesized descriptively due to limited and heterogeneous data. Risk factors for psychological morbidity were also extracted and analyzed. This review was registered with PROSPERO (CRD42025644127). Results The pooled prevalence of probable PTSD was 41% (95% CI: 32-52%). Reported PTSD rates ranged from 29 to 54%, and symptom severity remained high throughout the first year. Depression and anxiety were also widespread, with up to 40% screening positive for depression and 40-50% reporting moderate-to-severe anxiety symptoms. Comorbidity between PTSD, depression, and anxiety was common. Significant risk factors included female gender, bereavement, home destruction, displacement, job loss, and low social support. Resilience was protective in some studies, though findings were inconsistent. Conclusion Eighteen months after the 2023 Kahramanmara & scedil; earthquakes, Turkish adult survivors continued to experience high levels of probable PTSD, depression, and anxiety. These findings highlight a prolonged mental health crisis and underscore the urgent need for sustained, targeted psychosocial interventions. Integrating mental health support into disaster preparedness and long-term recovery efforts is essential for mitigating psychiatric morbidity in future disasters.Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42025644127.
Resting-State EEG Power and Machine-Learning Classification in Adult Males with Gambling Disorder
(Frontiers Media SA, 2026) Cinaroglu, Metin; Yilmazer, Eda; Ulker, Selami Varol; Tarlaci, Sultan
Background: Gambling disorder (GD) is a behavioral addiction sharing neurobiological features with substance use disorders, yet objective biomarkers remain limited. This study examined resting-state EEG power and applied machine learning to identify potential electrophysiological markers of GD. Methods: Resting eyes-closed Electroencephalography (EEG) was recorded from 47 individuals with GD and 32 healthy controls. Absolute and relative power across delta (1-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), and beta (13-30 Hz) bands were quantified over eight cortical regions. Group differences and correlations with the South Oaks Gambling Screen (SOGS) were analyzed. Multiple comparisons were controlled using the Benjamini-Hochberg False Discovery Rate (FDR) correction. A Linear Discriminant Analysis (LDA) classifier was trained to differentiate GD from controls based on EEG features. Results: Group differences in EEG power were subtle, with GD showing significantly higher delta power in the left temporal region (p = 0.032, d = 0.43). Within the GD group, greater gambling severity was associated with higher absolute beta power across frontal, parietal, temporal, and occipital regions (r approximate to 0.40-0.50, p < 0.01), and these associations remained significant after FDR correction (pFDR < 0.05). The LDA model using absolute power achieved 73.7% classification accuracy (AUC = 0.74), whereas relative power yielded near-chance accuracy (57.9%). Conclusions: GD is characterized by subtle but meaningful EEG alterations, particularly increased beta activity linked to gambling severity. Multivariate EEG patterns can distinguish GD from controls, supporting the potential of resting-state EEG as a biomarker for clinical assessment and severity monitoring in behavioral addiction.
Validation of the Turkish Yale-Brown Obsessive-Compulsive Scale and Self-Report Version: Psychometric Evidence from Clinical and Non-Clinical Populations
(Taylor & Francis Ltd, 2026) Cinaroglu, Metin; Yilmazer, Eda; Ulker, Selami Varol; Unubol, Huseyin; Sayar, Gokben Hizli
Background Obsessive - compulsive disorder (OCD) is a chronic condition that disrupts functioning and quality of life. The Yale - Brown Obsessive - Compulsive Scale (Y-BOCS; clinician-administered) and its Self-Report version (Y-BOCS-SR) are recognised gold standards for assessing OCD severity. Previous Turkish adaptations have been partial, limited by small samples or by validating only one format. This study provides the first comprehensive Turkish validation of both instruments.MethodsThe sample comprised 950 adults: 158 with DSM-5-TR - diagnosed OCD and 792 non-clinical adults. Translation followed a multi-phase process involving clinicians and a linguistics expert. Participants completed the Turkish Y-BOCS, Y-BOCS-SR, and additional OCD measures (OCI-R, VOCI, PI-R).ResultsThe clinician-administered Turkish Y-BOCS demonstrated excellent reliability (alpha = 0.91; ICC = 0.88) and strong psychometric validity, including a stable two-factor structure distinguishing obsessions and compulsions. The self-report version showed comparably high internal consistency (alpha = 0.90) and strong convergence with the clinician-administered scale. Convergent and criterion validity were robust, with high sensitivity and specificity. Cross-cultural comparisons further supported consistency and generalisability.ConclusionsThis study establishes both the clinician-administered and self-report Turkish Y-BOCS as reliable, valid, and culturally sensitive tools for assessing OCD severity in clinical and research contexts.
Volumetric and Cortical Thickness Alterations in Alcohol Dependence: Evidence of Accelerated Brain Aging and Clinical Correlations
(Frontiers Media SA, 2025) Cinaroglu, Metin; Yilmazer, Eda; Ulker, Selami Varol; Tacyildiz, Kerime; Tarlaci, Sultan
Background: Chronic alcohol dependence is associated with structural brain changes that resemble premature aging, particularly in frontal, parietal, and subcortical regions. This study examined brain volume, cortical thickness, and brain-predicted age in individuals with alcohol dependence and assessed associations with clinical symptoms. Methods: Thirty-one alcohol-dependent patients (mean age = 37.8 +/- 7.3 years) and 26 age-matched healthy controls (mean age = 35.0 +/- 8.5 years) underwent high-resolution T1-weighted MRI scanning. Brain structural analyses, including regional volumetry and cortical thickness estimation, were conducted using the validated volBrain platform. The system also provided individualized brain-predicted age estimates via its machine learning-based Brain Structure Ages (BSA) pipeline. Clinical assessments included the Michigan Alcoholism Screening Test (MATT), Penn Alcohol Craving Scale (PENN), Beck Depression and Anxiety Inventories (BDI-II, BAI), and detailed alcohol use history. Results: Alcohol-dependent participants showed significant reductions in total white matter, right frontal lobe, inferior frontal gyrus, bilateral postcentral gyri, and left superior occipital gyrus volumes (p < 0.05), along with widespread cortical thinning. Brain-predicted age was on average 11.5 years greater in patients than in controls (p < 0.001), especially in white matter and basal ganglia structures. Higher MATT scores correlated with reduced right precentral gyrus and left caudate volumes. PENN scores were positively associated with occipital volumes; however, this association weakened after controlling for age. Depression was linked to reduced frontal pole and increased amygdala volume, while anxiety was associated with smaller orbitofrontal and angular gyrus volumes. Conclusions: Alcohol dependence is marked by diffuse brain atrophy and accelerated brain aging. Structural alterations correspond to addiction severity, craving, and mood symptoms, highlighting brain-predicted age as a potential biomarker of cumulative alcohol-related neurodegeneration.