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Relationship between Cognitive Errors and Symptoms of Attention Deficit Hyperactivity Disorder and Substance Use Characteristics

Yıl 2019, Cilt: 20 Sayı: 2, 47 - 60, 30.06.2019

Öz

Objective: The aim of this study is to investigate the symptoms of attention-deficit/hyperactivity disorder (ADHD) cognitive errors, substance use characteristics and their relation with each other in substance use disorder (SUD).

Method: Patients with SUD and control group were administered Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS), Symptom Check List (SCL-90-R) and obtained sociodemographic data. The cognitive distortions scale (CDS) was used to evaluate cognitive errors.

Results: The working status, history of forensic prosecution and psychiatric history were significantly different for the patient group. Significant differences were found between the patient and control groups in terms of the CDS and subscales of cannabis and heroin users. 

Conclusion: Substance use was associated with bad social-economic-forensic data; the prevalence of ADHD was high in SUD; additional psychiatric symptoms were common in SUD; cognitive errors in SUD were more prominent in cannabis use compared to heroin use; there was a significant correlation between ASRS and CDA-personal achievement and CDS-interpersonal relationship and paranoid symptoms.

Kaynakça

  • 1. Francis G, Bachmann T. Registered reports for Consciousness and Cognition. Conscious Cogn 2018; 57: A1-A3.
  • 2. Kwak YT, Yang Y, Koo MS. Depression and cognition. Dement Neurocogn Disord 2016; 15(4): 103-109.
  • 3. Orum MH, Kustepe A, Kara MZ, et al. Addiction profiles of patients with substance dependency living in Adiyaman province. Med Science 2018; 7(2): 369-372.
  • 4. Orum MH, Kara MZ, Egilmez OB, Kalenderoglu A. Complete blood count alterations due to the opioid use: what about the lymphocyte-related ratios, especially in monocyte to lymphocyte ratio and platelet to lymphocyte ratio? J Immunoassay Immunochem 2018; 14: 1-12.
  • 5. Orum MH, Kara MZ, Egilmez OB. Relationship between immune cells and alcohol dependents and controls: what about the lymphocyte-related ratios? J Immunoassay Immunochem 2018; 39(3): 348-350.
  • 6. Orum MH, Kara MZ, Egilmez OB, et al. Evaluation of probation implementations of drug users in Adiyaman university training and research hospital: A one-year retrospective study. Med Science 2018; 7(4): 754-758.
  • 7. Kustepe A, Kalenderoglu A, Celik M, et al. Evaluation of impulsivity and complex attention functions of subjects with substance use: Sample from Adiyaman province. Med Science 2019; 8(1): 67-71.
  • 8. O'Connor RM, Lopez-Vergara HI, Colder CR. Implicit cognition and substance use: the role of controlled and automatic processes in children. J Stud Alcohol Drugs 2012; 73(1): 134-143.
  • 9. Lindgren KP, Neighbors C, Gasser ML, Ramirez JJ, Cvencek D. A review of implicit and explicit substance self-concept as a predictor of alcohol and tobacco use and misuse. Am J Drug Alcohol Abuse 2017; 43(3): 237-246.
  • 10. Becker MH. The health belief model and personal health behavior. New Jersey: Slack, 1974.
  • 11. Rogers RW. Cognitive and physiological processes in fear appeals and attitude change: A revised theory of protection motivation. In J. T. Cacioppo & R. E. Petty (Eds.), Social Psychophysiology (pp. 153−176). New York: Guildford Press, 1983.
  • 12. Fishbein M, Ajzen I. Belief, attitude, intention, and behavior. Reading: Addison-Wesley, 1975.
  • 13. Ajzen I. Attitudes, personality, and behavior. Chicago: Dorsey Press, 1988.
  • 14. Meier MH, Hall W, Caspi A, et al. Which adolescents develop persistent substance dependence in adulthood? Using population-representative longitudinal data to inform universal risk assessment. Psychol Med 2016; 46(4): 877-889.
  • 15. Thylstrup B, Hesse M. Why run the risk? Motivation for offences by patients with substance use and antisocial personality disorders which they rated as most risky to their own well-being. Crim Behav Ment Health 2018; 28(2): 187-201.
  • 16. Infante MA, Courtney KE, Castro N, et al. Adolescent brain surface area pre- and post-cannabis and alcohol initiation. J Stud Alcohol Drugs 2018; 79(6): 835-843.
  • 17. Wiers RW, Stacy AW. Implicit cognition and addiction. Current Directions in Psychological Science 2006; 15: 292-296.
  • 18. Rooke SE, Hine DW, Thorsteinsson EB. Implicit cognition and substance use: a meta-analysis. Addict Behav 2008; 33(10): 1314-1328.
  • 19. Bechara A, Noel X, Crone EA. Loss of willpower: Abnormal neural mechanisms of impulse control and decision making in addiction. In R.W. Wiers & A.W. Stacy (Eds.), Handbook of implicit cognition and addiction (pp. 215-233). Thousand Oaks: Sage Publications, Inc, 2006.
  • 20. Yin HH, Knowlton BJ. Addiction and learning in the brain. In R.W. Wiers & A.W. Stacy (Eds.), Handbook of implicit cognition and addiction (pp. 167-185). Thousand Oaks: Sage Publications, Inc, 2006.
  • 21. Ozen ME, Orum MH, Kalenderoglu A, Atmaca M. Attention-deficit/hyperactivity disorder in patients attending remedial treatment due to substance use disorder in Adiyaman University Training and Research Hospital. Psychiatry and Behavioral Sciences 2018; 8(2): 57-62.
  • 22. Kara MZ, Orum MH. Dikkat sorunlarında artış ile prezente olan bir Hashimoto Tiroiditi olgusu. Adıyaman Üni Sağlık Bilimleri Derg 2018; 4(0): 45-50.
  • 23. Güven A, Altinkaynak M, Dolu N, et al. Effects of Methylphenidate on Reaction Time in Children with Attention Deficit / Hyperactivity Disorder. Noro Psikiyatr Ars 2019; 56(1): 27-31.
  • 24. Ozturk Y, Akay A. Attention deficit hyperactivity disorder and substance use disorders. Turkiye Klinikleri Child Psychiatry-Special Topics 2015; 1(1): 64-67.
  • 25. Wang K, Xu M, Ji Y, et al. Altered social cognition and connectivity of default mode networks in the co-occurrence of autistic spectrum disorder and attention deficit hyperactivity disorder. Aust N Z J Psychiatry 2019: 4867419836031.
  • 26. Özdel K, Taymur I, Guriz SO, et al. Measuring cognitive errors using the cognitive distortions scale (CDS): Psychometric properties in clinical and non-clinical samples. PLoS ONE 2014; 9(8): e105956.
  • 27. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  • 28. Çilli AS, Kaya N, Bodur S ve ark. Ev kadınlarında ve çalışan evli kadınlarda psikolojik belirtilerin karşılaştırılması. Genel Tıp Derg 2004; 14(1): 1-5.
  • 29. Doğan S, Öncü B, Varol-Saraçoğlu G ve ark. Erişkin Dikkat Eksikliği Hiperaktivite Bozukluğu Kendi Bildirim Ölçeği (ASRS-v1.1): Türkçe formunun geçerlilik ve güvenilirliği. Anadolu Psikiyatri Dergisi 2009; 10: 77-87.
  • 30. http://tuik.gov.tr/Start.do
  • 31. Ögel K. Madde kullanım bozuklukları epidemiyolojisi. Turkiye Klinikleri J Int Med Sci 2005; 1(47): 61-64.
  • 32. Asan Ö, Tıkır B, Okay İT, Göka E. Bir AMATEM birimine başvuran alkol ve madde kullanım bozukluğu olan hastaların sosyodemografik ve klinik özellikleri. Bağımlılık Dergisi 2015; 16(1): 1-8.
  • 33. Evren EC, Ögel K, Çakmak D. Esrar ve meperidin (Petidin) kullanım bozukluğu nedeni ile yatarak tedavi gören hastaların özeliklerinin karşılaştırılması. Anadolu Psikiyatri Dergisi 2002; 3(1): 20-27.
  • 34. Turhan E, İnandı T, Özer C ve ark. Üniversite öğrencilerinde madde kullanımı, şiddet ve bazı psikolojik özellikler. Türkiye Halk Sağlığı Dergisi 2011; 9(1): 33-44.
  • 35. Yüncü Z, Kesebir S, Özbaran B ve ark. Madde kullanım bozukluğu olan ergenlerin ebeveynlerinde psikopatoloji ve mizaç: Kontrollü bir çalışma. Türk Psikiyatri Dergisi 2009; 20(1): 5-13.
  • 36. Altuner D, Engin N, Gürer C ve ark. Madde kullanımı ve suç ilişkisi: kesitsel bir araştırma. Tıp Araştırmaları Dergisi 2009; 7(2): 87-94.
  • 37. Ögel K, Tamar D, Evren C ve ark. Madde kullanıcılarının özellikleri: Gözden geçirme. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi 1999; 7(Ek4): 5-32.
  • 38. Gattamorta KA, Mena MP, Ainsley JB, Santisteban DA. The comorbidity of psychiatric and substance use disorders among hispanic adolescents. J Dual Diagn 2017; 13(4): 254-263.
  • 39. Herken H, Bodur S, Kara F. Üniversite öğrencisi kızlarda madde kullanımı ile kişilik ve ruhsal belirti ilişkisi. Klinik Psikiyatri 2000; 3: 40-45.
  • 40. Ksir C, Hart CL. Cannabis and Psychosis: a Critical Overview of the Relationship. Curr Psychiatry Rep 2016; 18(2): 12.
  • 41. De Crescenzo F, Cortese S, Adamo N, Janiri L. Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review. Evid Based Ment Health 2017; 20(1): 4-11.
  • 42. Ciccarelli M, Griffiths MD, Nigro G, Cosenza M. Decision-making, cognitive distortions and alcohol use in adolescent problem and non-problem gamblers: An experimental study. J Gambl Stud 2016; 32(4): 1203-1213.
  • 43. Curran HV, Freeman TP, Mokrysz C, et al. Keep off the grass? Cannabis, cognition and addiction. Nat Rev Neurosci 2016; 17(5): 293-306.
  • 44. Özen ME, Örüm MH, Kalenderoğlu A. Hot shower therapy in cannabinoid hyperemesis syndrome: A case report. FNG & Bilim Tıp Dergisi 2018; 4(3): 142-144.
  • 45. Terrett G, Lyons A, Henry JD, et al. Acting with the future in mind is impaired in long-term opiate users. Psychopharmacology (Berl) 2017; 234(1): 99-108.
  • 46. Charles-Walsh K, Upton DJ, Hester R. Examining the interaction between cognitive control and reward sensitivity in substance use dependence. Drug Alcohol Depend 2016; 166: 235-242.
  • 47. Gruber SA, Silveri MM, Yurgelun-Todd DA. Neuropsychol Rev 2007; 17(3): 299-315. Neuropsychological consequences of opiate use.
  • 48. Saban A, Flisher A, Laubscher R, et al. The association between psychopathology and substance use: adolescent and young adultsubstance users in inpatient treatment in Cape Town, South Africa. Pan Afr Med J 2014; 17(1): 8.
  • 49. Kelly LM, Becker SJ, Wolff JC, et al. Interactive effect of parent and adolescent psychiatric symptoms on substance use among adolescents in community treatment. Community Ment Health 2017; 53(4): 383-393.

Bilişsel Hatalar ve Dikkat-Eksikliği Hiperaktivite Bozukluğu Belirtilerinin Madde Kullanım Özellikleri ile İlişkisi

Yıl 2019, Cilt: 20 Sayı: 2, 47 - 60, 30.06.2019

Öz

Amaç: Bu çalışmada madde kullanım bozukluğu (MKB) tanılı erişkin bireylerde dikkat-eksikliği/hiperaktivite bozukluğu (DEHB) semptomlarını, ek psikiyatrik semptomları, bilişsel hataları, madde kullanım özelliklerini ve bunların birbirleri ile ilişkisini incelemeyi amaçlanmıştır.

Yöntem: Bu çalışmada MKB olan hastalara ve kontrol grubuna Erişkin Dikkat Eksikliği ve Hiperaktivite Bozukluğu Kendi Bildirim Ölçeği (ASRS), Belirti Tarama Listesi (SCL-90-R) uygulandı ve sosyodemografik verileri elde edildi. Bilişsel hataları değerlendirmek amacıyla Düşünce Özellikleri Ölçeği (DÖÖ) kullanıldı.

Bulgular: Çalışma durumu, adli kovuşturma öyküsü, psikiyatrik başvuru öyküsü hasta grubunda kendi aleyhine anlamlı olarak farklıydı.Hasta ve kontrol grubu arasında, esrar ve eroin kullanıcıları arasında DÖÖ ve alt ölçekleri açısından anlamlı farklılıklar saptandı. 

Sonuç: Çalışmamızda, madde kullanımı kötü sosyal-ekonomik-adli verilerle ilişkili, MKB’ye DEHB’nin eşlik etme oranı yüksek, MKB’de ek psikiyatrik semptomlar daha sık, MKB’de bilişsel hatalar esrar kullanımında daha belirgin olmak üzere fazla, ASRS ile DÖÖ-PA, DÖÖ-IP ile paranoid belirtiler arasındaki korelasyon yüksek bulundu. 


Kaynakça

  • 1. Francis G, Bachmann T. Registered reports for Consciousness and Cognition. Conscious Cogn 2018; 57: A1-A3.
  • 2. Kwak YT, Yang Y, Koo MS. Depression and cognition. Dement Neurocogn Disord 2016; 15(4): 103-109.
  • 3. Orum MH, Kustepe A, Kara MZ, et al. Addiction profiles of patients with substance dependency living in Adiyaman province. Med Science 2018; 7(2): 369-372.
  • 4. Orum MH, Kara MZ, Egilmez OB, Kalenderoglu A. Complete blood count alterations due to the opioid use: what about the lymphocyte-related ratios, especially in monocyte to lymphocyte ratio and platelet to lymphocyte ratio? J Immunoassay Immunochem 2018; 14: 1-12.
  • 5. Orum MH, Kara MZ, Egilmez OB. Relationship between immune cells and alcohol dependents and controls: what about the lymphocyte-related ratios? J Immunoassay Immunochem 2018; 39(3): 348-350.
  • 6. Orum MH, Kara MZ, Egilmez OB, et al. Evaluation of probation implementations of drug users in Adiyaman university training and research hospital: A one-year retrospective study. Med Science 2018; 7(4): 754-758.
  • 7. Kustepe A, Kalenderoglu A, Celik M, et al. Evaluation of impulsivity and complex attention functions of subjects with substance use: Sample from Adiyaman province. Med Science 2019; 8(1): 67-71.
  • 8. O'Connor RM, Lopez-Vergara HI, Colder CR. Implicit cognition and substance use: the role of controlled and automatic processes in children. J Stud Alcohol Drugs 2012; 73(1): 134-143.
  • 9. Lindgren KP, Neighbors C, Gasser ML, Ramirez JJ, Cvencek D. A review of implicit and explicit substance self-concept as a predictor of alcohol and tobacco use and misuse. Am J Drug Alcohol Abuse 2017; 43(3): 237-246.
  • 10. Becker MH. The health belief model and personal health behavior. New Jersey: Slack, 1974.
  • 11. Rogers RW. Cognitive and physiological processes in fear appeals and attitude change: A revised theory of protection motivation. In J. T. Cacioppo & R. E. Petty (Eds.), Social Psychophysiology (pp. 153−176). New York: Guildford Press, 1983.
  • 12. Fishbein M, Ajzen I. Belief, attitude, intention, and behavior. Reading: Addison-Wesley, 1975.
  • 13. Ajzen I. Attitudes, personality, and behavior. Chicago: Dorsey Press, 1988.
  • 14. Meier MH, Hall W, Caspi A, et al. Which adolescents develop persistent substance dependence in adulthood? Using population-representative longitudinal data to inform universal risk assessment. Psychol Med 2016; 46(4): 877-889.
  • 15. Thylstrup B, Hesse M. Why run the risk? Motivation for offences by patients with substance use and antisocial personality disorders which they rated as most risky to their own well-being. Crim Behav Ment Health 2018; 28(2): 187-201.
  • 16. Infante MA, Courtney KE, Castro N, et al. Adolescent brain surface area pre- and post-cannabis and alcohol initiation. J Stud Alcohol Drugs 2018; 79(6): 835-843.
  • 17. Wiers RW, Stacy AW. Implicit cognition and addiction. Current Directions in Psychological Science 2006; 15: 292-296.
  • 18. Rooke SE, Hine DW, Thorsteinsson EB. Implicit cognition and substance use: a meta-analysis. Addict Behav 2008; 33(10): 1314-1328.
  • 19. Bechara A, Noel X, Crone EA. Loss of willpower: Abnormal neural mechanisms of impulse control and decision making in addiction. In R.W. Wiers & A.W. Stacy (Eds.), Handbook of implicit cognition and addiction (pp. 215-233). Thousand Oaks: Sage Publications, Inc, 2006.
  • 20. Yin HH, Knowlton BJ. Addiction and learning in the brain. In R.W. Wiers & A.W. Stacy (Eds.), Handbook of implicit cognition and addiction (pp. 167-185). Thousand Oaks: Sage Publications, Inc, 2006.
  • 21. Ozen ME, Orum MH, Kalenderoglu A, Atmaca M. Attention-deficit/hyperactivity disorder in patients attending remedial treatment due to substance use disorder in Adiyaman University Training and Research Hospital. Psychiatry and Behavioral Sciences 2018; 8(2): 57-62.
  • 22. Kara MZ, Orum MH. Dikkat sorunlarında artış ile prezente olan bir Hashimoto Tiroiditi olgusu. Adıyaman Üni Sağlık Bilimleri Derg 2018; 4(0): 45-50.
  • 23. Güven A, Altinkaynak M, Dolu N, et al. Effects of Methylphenidate on Reaction Time in Children with Attention Deficit / Hyperactivity Disorder. Noro Psikiyatr Ars 2019; 56(1): 27-31.
  • 24. Ozturk Y, Akay A. Attention deficit hyperactivity disorder and substance use disorders. Turkiye Klinikleri Child Psychiatry-Special Topics 2015; 1(1): 64-67.
  • 25. Wang K, Xu M, Ji Y, et al. Altered social cognition and connectivity of default mode networks in the co-occurrence of autistic spectrum disorder and attention deficit hyperactivity disorder. Aust N Z J Psychiatry 2019: 4867419836031.
  • 26. Özdel K, Taymur I, Guriz SO, et al. Measuring cognitive errors using the cognitive distortions scale (CDS): Psychometric properties in clinical and non-clinical samples. PLoS ONE 2014; 9(8): e105956.
  • 27. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  • 28. Çilli AS, Kaya N, Bodur S ve ark. Ev kadınlarında ve çalışan evli kadınlarda psikolojik belirtilerin karşılaştırılması. Genel Tıp Derg 2004; 14(1): 1-5.
  • 29. Doğan S, Öncü B, Varol-Saraçoğlu G ve ark. Erişkin Dikkat Eksikliği Hiperaktivite Bozukluğu Kendi Bildirim Ölçeği (ASRS-v1.1): Türkçe formunun geçerlilik ve güvenilirliği. Anadolu Psikiyatri Dergisi 2009; 10: 77-87.
  • 30. http://tuik.gov.tr/Start.do
  • 31. Ögel K. Madde kullanım bozuklukları epidemiyolojisi. Turkiye Klinikleri J Int Med Sci 2005; 1(47): 61-64.
  • 32. Asan Ö, Tıkır B, Okay İT, Göka E. Bir AMATEM birimine başvuran alkol ve madde kullanım bozukluğu olan hastaların sosyodemografik ve klinik özellikleri. Bağımlılık Dergisi 2015; 16(1): 1-8.
  • 33. Evren EC, Ögel K, Çakmak D. Esrar ve meperidin (Petidin) kullanım bozukluğu nedeni ile yatarak tedavi gören hastaların özeliklerinin karşılaştırılması. Anadolu Psikiyatri Dergisi 2002; 3(1): 20-27.
  • 34. Turhan E, İnandı T, Özer C ve ark. Üniversite öğrencilerinde madde kullanımı, şiddet ve bazı psikolojik özellikler. Türkiye Halk Sağlığı Dergisi 2011; 9(1): 33-44.
  • 35. Yüncü Z, Kesebir S, Özbaran B ve ark. Madde kullanım bozukluğu olan ergenlerin ebeveynlerinde psikopatoloji ve mizaç: Kontrollü bir çalışma. Türk Psikiyatri Dergisi 2009; 20(1): 5-13.
  • 36. Altuner D, Engin N, Gürer C ve ark. Madde kullanımı ve suç ilişkisi: kesitsel bir araştırma. Tıp Araştırmaları Dergisi 2009; 7(2): 87-94.
  • 37. Ögel K, Tamar D, Evren C ve ark. Madde kullanıcılarının özellikleri: Gözden geçirme. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi 1999; 7(Ek4): 5-32.
  • 38. Gattamorta KA, Mena MP, Ainsley JB, Santisteban DA. The comorbidity of psychiatric and substance use disorders among hispanic adolescents. J Dual Diagn 2017; 13(4): 254-263.
  • 39. Herken H, Bodur S, Kara F. Üniversite öğrencisi kızlarda madde kullanımı ile kişilik ve ruhsal belirti ilişkisi. Klinik Psikiyatri 2000; 3: 40-45.
  • 40. Ksir C, Hart CL. Cannabis and Psychosis: a Critical Overview of the Relationship. Curr Psychiatry Rep 2016; 18(2): 12.
  • 41. De Crescenzo F, Cortese S, Adamo N, Janiri L. Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review. Evid Based Ment Health 2017; 20(1): 4-11.
  • 42. Ciccarelli M, Griffiths MD, Nigro G, Cosenza M. Decision-making, cognitive distortions and alcohol use in adolescent problem and non-problem gamblers: An experimental study. J Gambl Stud 2016; 32(4): 1203-1213.
  • 43. Curran HV, Freeman TP, Mokrysz C, et al. Keep off the grass? Cannabis, cognition and addiction. Nat Rev Neurosci 2016; 17(5): 293-306.
  • 44. Özen ME, Örüm MH, Kalenderoğlu A. Hot shower therapy in cannabinoid hyperemesis syndrome: A case report. FNG & Bilim Tıp Dergisi 2018; 4(3): 142-144.
  • 45. Terrett G, Lyons A, Henry JD, et al. Acting with the future in mind is impaired in long-term opiate users. Psychopharmacology (Berl) 2017; 234(1): 99-108.
  • 46. Charles-Walsh K, Upton DJ, Hester R. Examining the interaction between cognitive control and reward sensitivity in substance use dependence. Drug Alcohol Depend 2016; 166: 235-242.
  • 47. Gruber SA, Silveri MM, Yurgelun-Todd DA. Neuropsychol Rev 2007; 17(3): 299-315. Neuropsychological consequences of opiate use.
  • 48. Saban A, Flisher A, Laubscher R, et al. The association between psychopathology and substance use: adolescent and young adultsubstance users in inpatient treatment in Cape Town, South Africa. Pan Afr Med J 2014; 17(1): 8.
  • 49. Kelly LM, Becker SJ, Wolff JC, et al. Interactive effect of parent and adolescent psychiatric symptoms on substance use among adolescents in community treatment. Community Ment Health 2017; 53(4): 383-393.
Toplam 49 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri, Psikiyatri, Madde Bağımlılığı
Bölüm Araştırma
Yazarlar

Mehmet Hamdi Örüm 0000-0002-4154-0738

Mahmut Zabit Kara 0000-0002-7727-3838

Ali Kuştepe Bu kişi benim 0000-0001-9734-5360

Aysun Kalenderoğlu 0000-0002-8216-8610

Yayımlanma Tarihi 30 Haziran 2019
Kabul Tarihi 30 Mart 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 20 Sayı: 2

Kaynak Göster

AMA Örüm MH, Kara MZ, Kuştepe A, Kalenderoğlu A. Bilişsel Hatalar ve Dikkat-Eksikliği Hiperaktivite Bozukluğu Belirtilerinin Madde Kullanım Özellikleri ile İlişkisi. Bağımlılık Dergisi. Haziran 2019;20(2):47-60.

Bağımlılık Dergisi - Journal of Dependence