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    Behavioral Emotion Regulation Strategies and Symptoms of Psychological Distress Among Turkish University Students
    (MDPI, 2025) Keskiner, Edib Sevki; Sahin, Ertugrul; Topkaya, Nursel; Yigit, Zehra
    The purpose of this study was to examine the association between behavioral emotion regulation strategies and symptoms of depression, anxiety, and stress among Turkish university students. Participants consisted of 633 students continuing their university education in two different universities in T & uuml;rkiye. Participants completed a data collection tool comprising a Sociodemographic Information Form, the Behavioral Emotion Regulation Questionnaire, and the Depression Anxiety Stress Scales-21. Data were analyzed using descriptive statistics, Pearson's product-moment correlation coefficient analysis, and multivariate multiple regression analysis. The results of this study revealed that seeking distraction was negatively associated with symptoms of depression, anxiety, and stress, whereas withdrawal, seeking social support, and ignoring were positively associated with symptoms of depression, anxiety, and stress among university students. Additionally, actively approaching was negatively associated with depressive symptoms. Overall, the findings demonstrate that university students who use maladaptive behavioral emotion regulation strategies (e.g., withdrawal, ignoring) tend to have higher levels of psychological distress, whereas university students who use adaptive emotion regulation strategies (e.g., distraction) tend to have lower levels of psychological distress. However, contrary to expectations, seeking social support was positively associated with symptoms of psychological distress. Given the paucity of research on the relationship between behavioral emotion regulation strategies and psychological distress in the Turkish cultural context, this study may contribute to identifying both universal and culturally specific strategies associated with depressive, anxiety, and stress symptoms among Turkish university students.
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    Examining posttraumatic growth among Turkish family caregivers of cancer patients
    (Nature Portfolio, 2024) Guven, Serkan; Topkaya, Nursel; Sahin, Ertugrul; Aras, Nur Yagmur
    Cancer is a deadly disease that affects millions of people worldwide and is a source of great difficulty, stress, and trauma not only for patients but also for their caregivers. The physical and emotional suffering that patients experience by patients can lead their caregivers to cope with constant anxiety, sadness, and uncertainty. Moreover, during the cancer treatment process, caregivers must make a great effort to meet the needs of patients and support them. This situation may negatively affect the quality of life and psychological health of cancer patients' caregivers and may lead them to experience trauma. The aim of this cross-sectional study was to examine posttraumatic growth's relationship with age, the transformative power of suffering, and hope in family caregivers of cancer patients. Participants consisted of 314 Turkish family caregivers of cancer patients (73.2% women; Mage = 39.89 years) selected by using convenience sampling method. Participants answered a data collection tool consisting of a demographic information form, the Posttraumatic Growth Inventory, Trait Hope Scale, and Transformative Power of Suffering Scale. Data were analyzed using descriptive statistics, the Pearson product-moment correlation coefficient analysis, simple mediation analysis, and moderated mediation analysis. The results of this study revealed that hope mediated the association between the transformative power of suffering and posttraumatic growth in family caregivers of cancer patients, whereas age moderated this relationship. Psychosocial support programs for cancer caregivers could benefit from incorporating interventions that explore the transformative potential of suffering and cultivate hope. Tailoring these interventions to address the specific needs of different age groups may enhance their effectiveness. Future researchers should investigate the factors associated with posttraumatic growth in caregivers across diverse cultures, age ranges, and cancer diagnoses.
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    Predictors of Couple Burnout among Turkish Married Individuals
    (Mdpi, 2024) Topkaya, Nursel; Sahin, Ertugrul; Yilmaz, Cansu Terziogullari; Asantugrul, Nuray
    Couple burnout has been linked to several negative consequences for both individuals and couples. Identifying the factors that predict couple burnout is essential for developing effective interventions to prevent or lessen its detrimental impact on marital relationships. The aim of this cross-sectional study was to investigate sociodemographic factors, relationship self-efficacy, happiness, and self-compassion as predictors of couple burnout in Turkish married individuals. A convenient sample of 401 married individuals completed a questionnaire that comprised a Personal Information Form, Couple Burnout Measure-Short Version, Relationship Self-Efficacy Scale, Self-Compassion Scale, and Single-Item Happiness Scale. The data were analyzed using descriptive statistics, Pearson's product-moment correlation analysis, linear multiple regression analysis, and relative importance analyses. The results of this study suggest that being women, having a higher number of offspring, and lower levels of relationship self-efficacy, self-compassion, and happiness were significant positive predictors of couple burnout among married individuals. The type of marriage, monthly income, and duration of marriage were not significant predictors of couple burnout. Moreover, the results of the relative importance analyses consistently demonstrated that happiness was the strongest predictor of couple burnout among married individuals. The research findings demonstrate the multidimensional nature of couple burnout and provide a more nuanced understanding of its predictive factors. These results have potential implications for the development of evidence-based and targeted interventions in relationship education programs.
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    Psychometric Properties of the Depression Anxiety Stress Scales (DASS-42 and DASS-21) in Patients with Hematologic Malignancies
    (MDPI, 2025) Guven, Serkan; Sahin, Ertugrul; Topkaya, Nursel; Aydin, Oznur; Aktimur, Sude Hatun; Turgut, Mehmet
    Background/Objectives: Patients with hematologic malignancies undergo prolonged, intensive treatments involving frequent hospitalizations and experience debilitating side effects. Consequently, they are at increased risk of developing symptoms of depression, anxiety, and stress, which can undermine their quality of life. However, there is a scarcity of instruments validated for the simultaneous assessment of depression, anxiety, and stress within hematologic cancer populations. The aim of this study is to examine the construct validity, convergent and discriminant validity, and reliability of the Depression Anxiety Stress Scales (DASS-42 and DASS-21) among hematologic cancer patients. Methods: We collected data from 452 hematologic cancer patients across three studies. Results: Confirmatory factor analyses indicated that the theoretical correlated three-factor model and bifactor model for DASS-42 and DASS-21 responses were sufficient to explain the underlying factor structure of the scales in hematologic cancer patients. However, the bifactor model for DASS-42 and DASS-21 fit better with the data compared to the theoretical correlated three-factor model. In addition, we found the correlated three-factor model and the bifactor structure to exhibit scalar measurement invariance across gender for DASS-42 and DASS-21. DASS-42 and DASS-21 subscales demonstrated weak to strong negative correlations with measures of psychological well-being (happiness, well-being, life satisfaction) and strong positive correlations with measures of similar constructs (depression, anxiety, and stress), thereby supporting their convergent and discriminant validity with theoretically and empirically expected correlations with external criteria. The reliability analyses demonstrated that both DASS-42 and DASS-21 subscales exhibited strong internal consistency and test-retest reliability when assessing symptoms of depression, anxiety, and stress among patients with hematologic malignancies. Moreover, the item-scale convergent and discriminant validity analyses demonstrated that items exhibited higher corrected item-total correlations with their intended subscales than with other subscales across the DASS-42 and DASS-21, providing evidence for the distinct measurement properties of each subscale. Conclusions: The findings suggest that the DASS-42 and DASS-21 are psychometrically robust instruments for use in Turkish hematologic cancer patients.
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    Psychometric properties of the Depression, Anxiety, and Stress Scale-21 (DASS-21) across nine countries/regions
    (Routledge Journals, Taylor & Francis Ltd, 2025) Zanon, Cristian; Zhao, Nan; Topkaya, Nursel; Sahin, Ertugrul; Vogel, David L.; Ertl, Melissa M.; Sanatkar, Samineh
    Examinations of the internal structure of the Depression, Anxiety, and Stress Scale-21 (DASS-21) have yielded inconsistent conclusions within and across cultural contexts. This study examined the dimensionality and reliability of the DASS-21 across three theoretically plausible factor structures (i.e., unidimensional, oblique three-factor, and bifactor) as well as measurement equivalence/invariance of the DASS-21 using two different approaches (i.e., multigroup confirmatory factor analysis and the alignment approach) with a large, diverse sample of 2,920 young adult college student participants from nine countries/regions (i.e., Australia, Brazil, Germany, Hong Kong, Lithuania, Taiwan, T & uuml;rkiye, United Arab Emirates, and the United States). Results showed an excellent fit of the bifactor model in all countries/regions except the UAE and the US in which the model did not converge. Regarding parameter equivalence, we found configural, threshold, and loading invariance for the oblique three-factor model (across the nine studied countries/regions) and for the bifactor model (across seven countries/regions). Results indicate that DASS-21 scores measure a general psychological distress factor with more validity and reliability than depression, anxiety, or stress constructs independently. Findings supported the bifactor structure of DASS-21 and demonstrated that cross-cultural comparisons using this scale should be conducted using proper procedures, such as the alignment approach.