COVID-19 vaccine hesitancy and Its relationship with illness risk perceptions, affect, worry, and public trust: An online serial cross-sectional survey from Turkey

Objective: A better understanding of public attitudes towards vaccination and recognition of associated factors with vaccine hesitancy or refusal is important regarding the control of the pandemic. Our aim was to analyze the public's attitudes toward COVID-19 vaccines and to identify factors affecting them. Materials and Methods: Data were drawn from the Turkish COVID-19 Snapshot Monitoring, between July-December 2020, a serial online cross-sectional survey. The sample comprised 3888 adult respondents. Attitudes to vaccines and trust were investigated in 3 periods corresponding to the timeline of pandemic-related events in Turkey. Results: In the third period of our study, in parallel with the increase in the spread of COVID-19, vaccine hesitancy/refusal increased significantly from 43.9% to 58.9% (P < .001). The significant predictors of vaccine refusal were female gender, being elder, and conspiracy thinking. Having a chronic illness, worrying more about loved ones and the health system being overloaded were significant predictors of vaccine willingness. Less compliance with preventive measures, less knowledge of prevention, reduced risk perception, and higher perception of media hype were COVID-19 variables that correlated with vaccine refusal. Trust in the Ministry of Health and medical professional organizations (e.g., Turkish Medical Association) was the lowest in the third period and vaccine refusal was significantly related to the decreased trust (P < .001, P = .002). Conclusion: Most respondents (approximately 60%) refused or hesitated to get a COVID-19 vaccine, though acceptability should be monitored when a vaccine becomes available. Health authorities should consider public trust, risk perception, and behavioral factors to improve COVID-19 vaccine acceptability

Behaviors and pandemic-related knowledge, perceptions, worry content, and public trust in a Turkish sample

Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18–30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals’ knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required

Behavioral and Neurodevolopmental Effects of Early Stressful and Ambivalence Life Events

Küçükkarapınar, M., Erken Dönem Ambivalan ve Stresli Yaşam Olaylarının Davranışsal ve Nörogelişimsel Etkileri, Gazi Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Uzmanlık Tezi, Ankara, 2015 Yaşamın erken döneminde stresli yaşam olaylarına maruziyet erişkin dönemde artmış stres duyarlılığı, bilişsel ve davranışsal bozukluklarla ilişkilidir. Bu dönemde birden fazla stres etkenine maruz kalınabileceğinden erişkin dönemde ortaya çıkan bozukluğu tek bir etkene bağlamak mümkün değildir. Erken dönem stresli tek bir yaşam olayının erişkin dönemde davranışsal ve nörokimyasal etkilerinin anlaşılması hayvan deneyleri ile daha mümkündür. Bu çalışmanın amacı erken dönem stresli yaşam olaylarının erişkin dönemde sosyal etkileşim, bellek anksiteyete düzeyleri ve beynin belirli bölgelerindeki nörogenez üzerine etkilerini incelemektir. Çalışmada sıçanlar kontrol grubu (12), hafif stres grubu (12), ağır stres grubu (14) ve ambivalan anne grubu (13) olmak üzere dört grubu ayrılmıştır. Kontrol grubuna herhangi bir müdahalede bulunulmamış, hafif stres grubu erken elleme yöntemine, ağır stres grubu anneden ayırma yöntemine ve ambivalan anne grubu ambivalan anne modeline maruz bırakılmıştır. Erişkin dönemde sıçanların davranış analizi yapılmış, sosyal etkileşim testi, yükseltilmiş artı labirent ve yeni nesne tanıma testi performansları değerlendirilmiştir. Nörogelişimlerini değerlendirmek amacıyla prefrontal korteks ve hipokampus NMDA R2B düzeyleri ELISA yöntemi aracılığıyla bakılmıştır. Plazma kortizol düzeylerine bakılmıştır. Davranış analizi ve davranış deneyleri sonucuna göre ambivalan anne grubu ve ağır stres grubu daha anksiyeteliydi. Ambivalan anne grubu sıçanlarının sosyal etkileşim testinde diğer gruplara kıyasla daha az sosyal davranış davranış sergiledikler, erkek sıçanlarının daha agresif olduğu, uzun süreli bellek işlevlerinin daha düşük olduğu sonucuna varılmıştır. Çoğunlukla gruplar arası farklılıklar erkek cinsiyetten kaynaklanmaktaydı. Plazma kortizol düzeyi bakımından gruplar arası bir farklılık saptanmadı. NMDAR2B düzeyi hipokampuste erken dönem stresli yaşam olaylarına maruz kalan sıçanlarda artmıştır. Bu çalışma ambivalan anne grubunun sıçanlarının en az ağır stres grubu kadar erişkin dönemde anksiyeteye duyarlı hale geldiği hipotezini desteklemektedir.Exposure to stressful life events in early life is associated with in adulthood increased stress sensitivity, cognitive and behavioral disorders. During this period multiple stresful factors may be exposed. Therfore disorders which occur in adulthood are not able to correlate to one reason. Understanding of behavioral and neurochemical effects of early stresful life events in adulthood is possible with the animal experiments. The aim of the study was to investigate whether early stressful life events might effect social interaction, memory, anxiety levels, neurogenesis in specific brain regions. In this study rats divided into four groups: control group (n:12 ), mild stress group (n:12), severe stress group (n:14) and ambivalent mother(n:13). Control group was raised with standart care, mild stress group was exposed to early handling model, severe stress group was exposed to maternal separation, ambivalent mother group was exposed to fake mother during an hour. In adulthood analysis of behavior was made and social interaction test, elevated plus maze and new object recognition test performances have been evaluated. To assess the neurodevelopment of rats NMDA R2B levels in prefrontal cortex and hippocampus were evaluated by using ELISA. According to the results of behavior analysis and behavioral experiments, ambivalent mother group and severe stress group were anxious than other groups. The rats of the ambivalent mother group exhibited less social behavior and more aggressive behavior than the other groups in tihe social interaction test. Their long-term memory functions were lower than other groups. Mostly the differences between the groups were due to male gender. There were not statistically differences between the groups with regard to plasma cortisol levels. The level of NMDAR2B in the hippocampus increased in rats exposed to early stressful life events. These results support that being raised by ambivalent mother increase anxiety level in adulthood

Rechallenge of clozapine in a patient with a history of clozapine-induced myocarditis

Clozapine is the only antipsychotic with proven efficacy in treatment-resistant schizophrenia, but some life-threatening side effects limit its use. Here we report a patient with clozapine-induced myocarditis and successful rechallenge. The patient still uses clozapine and has not developed myocarditis over 36 months of observation. It may be possible to use clozapine even after myocarditis and thus improve symptoms and functionality of schizophrenia patients

Assessing the validity and reliability of the Turkish versions of craving beliefs and beliefs about substance use questionnaire in patients with heroin use disorder: demonstrating valid tools to assess cognition-emotion interplay

Background: Cognitions associated with craving and substance use are important contributors for the psychological theories of Substance use disorders (SUD), as they may affect the course and treatment. In this study, we aimed to validate Turkish version of two major scales 'Beliefs About Substance Use'(BSU) and 'Craving Beliefs Questionnaire'(CBQ) in patients with heroin use disorder and define the interaction of these beliefs with patient profile, depression and anxiety symptoms, with an aim to use these thoughts as targets for treatment. Methods: One hundred seventy-six inpatients diagnosed with heroin use disorder and 120 participants in the healthy comparison group were evaluated with CBQ, BSU, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and sociodemographic data questionnaire. Patient group was also evaluated with Addiction Profile Index. Reliability and validity analysis for scales were conducted. Linear regression analysis was conducted to evaluate the determinants of BSU and CBQ scores. Results: Cronbach alpha level was 0.93 for BSU and 0.94 for CBQ. Patient group showed significantly higher CBQ, BSU, BAI and BDI scores (p < 0.001). BSU score significantly correlated with API-substance use profile score, API-diagnosis, BAI, BDI and CBQ (p < 0.005), whereas CBQ scores significantly correlated with API-diagnosis, API-impact on life, API-craving, API-total score, BSU, BAI, BDI and amount of cigarette smoking (p < 0.002). Number of previous treatments and age of onset for substance use were not correlated with either BSU or CBQ. BAI and BDI scores significantly predicted BSU score, however only BDI score predicted CBQ score (p < 0.003). Conclusions: Craving beliefs were highly correlated with addiction profile. Anxiety and depression are significant modulators for patients' beliefs about substance use and depression is a modulator for craving and maladaptive beliefs, validating emotion-cognition interplay in addiction