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Öğe Ebeveyn Gelişim Görüşmesi Üzerinden Yapılan Yansıtıcı İşleyiş Kodlama Sisteminin Psikometrik Özellikleri(2021) Halfon, Sibel; Besiroglu, BurcuEbeveynin yansıtıcı işleyişi kendisi, çocuğu ve ikisi arasındaki ilişkiye dair zihin durumları hakkında düşünebilme, bunları birbirine bağlayabilme ve etkilerini tahmin etme becerisidir. Bu çalışmada, Ebeveyn Gelişim Görüşmesi üzerinden yapılan yansıtıcı işleyiş kodlama sisteminin psikometrik özellikleri incelenmiştir. Çalışmaya bir üniversite kliniğinde psikoterapi hizmetine başvurmuş 115 anne (Ortyaş = 36.01 yaş, SS = 4.96) ve çocukları (Ortyaş = 6.99 yaş, SS = 2.09, %41.7 kız) katılmıştır. Ebeveynlerle Ebeveyn Gelişim Görüşmesi yapılmış, görüşme yansıtıcı işleyiş kapasitesi kodlama sistemi üzerinden değerlendirilmiştir. Ayrıca, ebeveynlerin sosyo-demografik bilgileri ve bağlanma stili ile çocukların duygu düzenlemesi, ifade edici dil becerisi, çocukluk çağı deneyimleri ve davranış sorunları ile ilgili bilgiler toplanmıştır. Açımlayıcı ve Doğrulayıcı Faktör analizi sonuçları üç faktörlü bir yapı ortaya çıkarmış ve her faktörün iç tutarlılık değerlerinin yeterli olduğu görülmüştür. Bunlar kavramsal olarak, çocuk- (ebeveynin çocuğunun duygularını yansıtıcı işleyiş kapasitesi), ilişki- (ebeveynin anne-çocuk arasındaki ilişkiyle ilgili yansıtıcı işleyiş kapasitesi) ve kendi-odaklı (ebeveynin kendi duygularını yansıtıcı işleyiş kapasitesi) faktörler şeklinde isimlendirilmiştir. Çocuk-odaklı yansıtıcı işleyiş kapasitesi sosyoekonomik durum ile pozitif yönde ilişkilidir. İlişkiodaklı yansıtıcı işleyiş kapasitesi ebeveynin kaçınmacı bağlanma stili, eğitim seviyesi, sosyoekonomik durumu, annenin sahip olduğu çocuk sayısı ve çocuğun olumlu ve olumsuz deneyimleri ile ilişkilidir. Kendi-odaklı yansıtıcı işleyiş kapasitesi ise annenin sahip olduğu çocuk sayısı, çocuğun ifade edici dil becerisi, duygu düzenlemesi ve dışsallaştırma sorunlarıyla ilişkilidir. Sonuçlar Ebeveyn Gelişim Görüşmesi üzerinden yapılan yansıtıcı işleyiş kodlama sisteminin Türkiye’deki klinik örneklemde kendi- ve ilişki-odaklı yansıtıcı işleyiş kapasitesini ölçmek için yeterli olabileceğini, çocuk-odaklı yansıtıcı işleyiş kapasitesini ölçmek için geliştirilmesi gerektiğini göstermektedir.Öğe Parental Reflective Function and Children's Attachment-Based Mental State Talk as Predictors of Outcome in Psychodynamic Child Psychotherapy(Amer Psychological Assoc, Div Psychotherapy, 2021) Halfon, Sibel; Besiroglu, BurcuMentalization, operationalized as reflective function, is defined as the capacity to understand behavior in terms of mental states. Mentalization can be self-focused (i.e., mentalizing that focuses on one's own thoughts and feelings) or other-focused (i.e., mentalizing that focuses on others' thoughts and feelings). Some studies in adult psychotherapy show the importance of patients' mentalization capacity for treatment outcome; however, this has not yet been investigated in psychodynamic child psychotherapy. This study aimed to investigate whether baseline parental reflective function (PRF) and children's mental state talk (MST) predicted changes in emotional and behavioral problems in psychodynamic child psychotherapy. The sample included 60 Turkish school-age children (M-age = 7.90, SD = 1.35, 43.3% girls) with internalizing (18.3%), externalizing (5%), and comorbid (56.7%) problems, and 20% of the children were in the nonclinical range. The mothers were interviewed using the Parent Development Interview, which was coded for PRF (self- and child-focused). Children were administered an attachment-based story stem task, coded for MST (self- and other-focused). The Brief Problem Monitor was administered every month over the course of treatment for a total of 366 sessions. Multilevel modeling analyses indicated that mothers' child-focused PRF and children's self-focused MST predicted changes in problem behaviors. Parents' mentalization about their children and children's mentalization about their own internal states could be predictors of treatment response in psychodynamic child psychotherapy.Öğe The Efficacy of Mentalization-Based Treatment for Children With Internalizing and Externalizing Problems: A Randomized Controlled Trial(Elsevier Science Inc, 2025) Halfon, Sibel; Besiroglu, Burcu; Bulut, Pelinsu; Epozdemir, Sevin; Aydin, Gizem I.; Koc, H. Burak; Midgley, NickObjective: High comorbidity in childhood emotional and behavioral disorders calls for transdiagnostic interventions that can address both internalizing and externalizing problems. Mentalization-Based Treatment for Children (MBT-C) is a transdiagnostic, time-limited individual child psychotherapy with parallel parent sessions that aims to promote mentalization and emotion regulation. This pragmatic randomized controlled superiority trial investigated the efficacy of MBT-C compared with a group-based parenting and child social skills intervention (PSSG) at 12 weeks (primary end point) and 36-week follow-up (secondary end point). Method: The trial included 222 children (mean age-7.89; 34% girls) at clinical levels of internalizing, externalizing, or co-occurring internalizing and externalizing problems and their families equally randomized to MBT-C or PSSG. Assessments took place at baseline, 8 and 12 weeks, and 24-and 36-week follow-up. Primary outcomes were children's internalizing, externalizing, and total problems. Secondary outcomes were parent and child emotion regulation, child global function, parent mentalizing, and parenting stress. Results: There were no statistically significant differences between MBT-C and PSSG in reducing children's total, internalizing, or externalizing problems at 12 weeks; however, MBT-C was superior at 36 weeks on total problems with a small effect (d-0.479, 95% CI [0.105, 0.854]). MBT-C was also superior in improving emotion regulation of parents (d-0.248, 95% CI [0.002, 0.493]) and children (d-0.221, 95% CI [ 0.435, 0.006]) and child-reported problems (d-0.331, 95% CI [0.029, 0.633]) at 12 weeks with small effects. These differential treatment effects were maintained during follow-up. Conclusion: MBT-C demonstrated a small superior effect to PSSG in treating overall problems over the longer term, but not immediately after the intervention, in school-age children with internalizing and externalizing problems. However, as a single-site study, generalizability is limited, and further research supporting treatment efficacy is warranted. Plain language summary: This randomized controlled trial compared the efficacy of Mentalization-Based Treatment for Children (MBT-C) to a parenting and child social skills group (PSSG) in 222 school-age children with internalizing and externalizing problems. There were significant improvements in children's emotional and behavioral problems in both interventions at the end of the treatments. However, children who received MBT-C showed significantly more reductions in their levels of problems compared to children who received PSSG at 6-month follow-up. Compared to PSSG, both children and parents in MBT-C showed significantly greater improvements in their emotion regulation capacities at the end of treatment, which were sustained during follow-up. Overall, the effect sizes for these relative improvements at follow-up were small. Clinical trial registration information: The Effectiveness and Change Mechanisms of Mentalization Based Therapy for Children (MBT-C); NCT05290714; https://clinicaltrials.gov/study/NCT05290714.Öğe The Psychometric Properties of the Children's Social Understanding Scale among Atypically Developing Children and Adolescents(Springer, 2022) Besiroglu, Burcu; Alayli, Ayca; Tahiroglu, Deniz; SelcuknAff, BilgeTheory of mind (ToM) has been frequently assessed via behavioral assessments. Recently, Tahiroglu and colleagues developed the parent-report Children's Social Understanding Scale (CSUS) to assess individual differences in ToM. They found it reliable and valid in assessing ToM of typically developing preschoolers. In the present study, we examined the psychometric properties of the CSUS in ToM assessment of children and adolescents with atypical development, who are known to have difficulties in understanding others' mental states. In two studies, we collected data from 106 children and adolescents with autism spectrum disorder (ASD; M-age = 12.06 years, SD = 2.91) and 70 children and adolescents with hearing impairment (HI; M-age = 7.3 years, SD = 2.3). The children's social understanding was assessed via the CSUS (short form in the ASD and full form in the HI samples) and behavioral ToM tasks (tasks with low-verbal demands and standard ToM tasks). Receptive language in both samples and nonverbal intelligence in ASD sample were also assessed. Analyses revealed high internal consistency for the CSUS in both samples. As expected, the CSUS correlated with performance on behavioral ToM tasks, receptive language, and nonverbal intelligence. The CSUS continued to be significantly associated with performance on behavioral ToM tasks after controlling for receptive language and nonverbal intelligence in ASD sample, and controlling for age and receptive language in HI sample. These results demonstrate that the CSUS is a reliable and valid tool in measuring ToM among children and adolescents with ASD and those with HI in Turkey.Öğe The Psychometric Properties of the Parental Reflective Functioning Questionnaire for Turkish Mothers(Springer, 2025) Besiroglu, Burcu; Halfon, SibelParental reflective functioning refers to parents' ability to think about, infer, and interpret the mental states of themselves as a parent and their children. In this study, we examined the psychometric properties of the Parental Reflective Functioning Questionnaire in a sample of Turkish mothers. We investigated the factor structure, reliability, measurement invariance, and validity of the questionnaire for psychometric evaluation. We collected data from 900 Turkish mothers (M-age = 37.06 years, SD = 11.22) whose children were between the ages of 3 and 11 years (M-age = 6.04 years, SD = 2.09). Parents filled out a battery of self-report questionnaires about their childhood trauma history, attachment style, emotion regulation difficulties, parental stress, parental self-efficacy, and psychological distress via Qualtrics. Exploratory and confirmatory factor analyses revealed a three-factor structure: prementalizing mode, certainty about mental states, and interest and curiosity in mental states. Measurement invariance demonstrated scalar invariance across low and high SES groups. Correlation analyses revealed differential associations among the PRFQ subscales and all maternal variables. These findings demonstrated that the Parental Reflective Functioning Questionnaire is a good measure to assess the key aspects of parental reflective functioning in Turkiye. Highlights Parental reflective functioning has a central role in child development, mental health, and childrearing behaviors. The Parental Reflective Functioning Questionnaire has good psychometric properties across different cultures. Though widely used, the psychometric properties of the questionnaire have not been investigated thoroughly in Turkiye. The questionnaire has good psychometric properties among mothers of children in early and middle childhood in Turkiye. The scale captures individual differences in parental mentalization capacity.
