INVESTIGATION IN THE CONTEXT OF POST-TRAUMATIC STRESS DISORDER

Post-Traumatic Stress Disorder (PTSD) is a psychiatric disorder in which a person exhibits long-lasting stress responses following a traumatic event. According to DSM-5, PTSD is defined based on specific criteria. These criteria include intrusive memories lasting more than a month after the trauma, distress towards internal and external stimuli related to the trauma, recurrent nightmares, avoidance of traumatic events, development of negative thoughts and emotions, and changes in behavior related to this experience. Anna appears to have experienced similar symptoms following the loss of her husband and child. It turns out that the flying images Anna sees during her panic attack are actually snowflakes flying as a result of a snow-related disaster. From here it becomes clear that Anna is experiencing flashbacks. The fact that he believes they are alive and claims that they talked on the phone shows that he is in denial about the terrible scenario he is in. From this we can conclude that the ability to evaluate reality is inhibited. Moving away from others or feeling alienated indicates avoidance behaviors. Arousal is the sudden shock caused by sounds. This assessment shows that Anna has symptoms of PTSD and is under the influence of the trauma she experienced. At this point, it is important to get professional help and be directed to treatment processes.

INVESTIGATION IN THE CONTEXT OF AGORAPHOBIA

The first pathological disease featured in the film is Anna's agoraphobia. Having lost his wife and daughter as a result of the tragedy, he became distrustful of the outside world and became unable to leave the house where he had built a safe haven for himself. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association, agoraphobia is included among the anxiety disorders. When we look at the DSM-5 A and B diagnostic criteria, we can see that there is a lot of fear and anxiety about taking public transportation, being in closed spaces, being in crowded places, and leaving the house. The main character of the film, Anna Fox, shows signs of not being able to leave her home. Although there are no visuals of Anna taking public transportation or being in a crowd in the movie scenes, it is assumed that this situation will cause serious anxiety in her. Reasons for not seeing the outside as a safe area may include his phone not working and not being able to reach anyone when he wanted to call for help to save his wife and daughter. As a result of the trauma he experienced, he thinks "No one can save me when I need help." Another striking aspect of agoraphobia in the movie is that the therapist visits Anna's house regularly and organizes the sessions accordingly. Another notable moment is when Anna wakes up to the sound of eggs being thrown into her house during the Halloween celebrations. He should approach the door and warn the children. However, this was an extremely difficult situation for her, and when Anna reached the door, her heart rate increased, she began to cry, and we see that she eventually fainted in terror.

INVESTIGATION IN THE CONTEXT OF ANTISOCIAL PERSONALITY DISORDER

Antisocial personality disorder can be interpreted by looking at the behavior of Ethan, the murderer of the movie. Individuals with antisocial personality disorder engage in illegal actions that violate social standards, such as lying, truancy, stealing, fighting, and substance use, and they do not feel bad about it. Ethan's disdain for the rights of others, violent outbursts of anger at school, his tendency to lie, and his inability to empathize can all be attributed to antisocial behavior.

Drug users often exhibit low self- esteem. Increasing social support, self-confidence and self-esteem are suggested to be "protective factors" against substance use. Substance use can also be used to relieve symptoms associated with various psychiatric problems. Among these problems, lack of self- confidence, depression, attention deficit hyperactivity disorder, anxiety disorders and experiences of physical, sexual and emotional abuse stand out. Depression is the most common disorder associated with substance use in adolescents, followed by anxiety disorders and other psychiatric conditions. It is common for substance use to coexist with high levels of anxiety and anxiety disorders, suggesting a reciprocal relationship between them. While substance use can increase anxiety levels and trigger anxiety disorders, high anxiety levels and anxiety disorders can also increase the risk of starting substance use. The emergence of substance addiction in adolescents is closely related to family structure; Conflicts, family problems, weak family ties and lack of social support are important risk factors for substance use. Our study revealed that the risk of inhalant use is higher when anxiety levels are high and social support is low. Additionally, physical and or sexual abuse are important risk factors for substance use. Studies indicate that people who have experienced abuse may turn to substance use as a result of some psychological problems caused by this experience or as a way of coping with these problems. 

According to a study, the father's or sibling's smoking and alcohol consumption habits have been identified as factors that increase the likelihood of young people turning to cigarettes and alcohol consumption. In addition, the study revealed that a close relative's involvement in substance use increases the person's risk of using substances. Adolescence, a period heavily influenced by social and environmental factors, serves as a period of significant impact where examples and modeling of identity determination and sociocultural value judgments play an important role in learning. During this stage, young individuals are sensitive to positive and negative attitudes and behaviors from their environment. There are many publications that emphasize the importance of family members and close friends in starting substance use during adolescence. It is widely accepted that the prevalence of substance use in the family contributes to the tendency of young people to imitate such behavior. Most research consistently finds that the social environment in which young people live encourages substance use, especially in households where smoking and substance use are common.

In conclusion, cigarette, alcohol and drug use is common among university students, and there are a significant number of people who start smoking at university. Findings show a relationship between substance use and exposure to violence, high trait anxiety, and low perceived social support. It is seen that the substance use of members of the family and people in the immediate environment poses a risk in terms of substance use. University students should be considered as a risky group in terms of substance use and studies should be carried out to prevent them. First of all, policies to prevent substance use should be developed in universities. Programs can be offered to reduce stress and violence and improve life skills in university students. Medico-social centers of universities can be transformed into a structure that provides not only therapeutic health services but also protective and preventive services.

REFERENCES
Asan, Ö., Tıkır, B., Okay, İ. T., & Göka, E. (2015). Bir AMATEM birimine başvuran alkol ve madde kullanım
bozukluğu olan hastaların sosyodemografik ve klinik özellikleri. Bağımlılık Dergisi, 16(1), 1-8.
Balseven, A., Özdemir, Ç., Tuğ, A., Hancı, H., & Doğan, Y. B. (2002). Madde kullanımı, bağımlılıktan
korunma ve medya. Sürekli Tıp Eğitim Dergisi, 11(3), 91-93.
Kaya, E. (2014). Madde kullanım bozuklukları. Okmeydanı Tıp Dergisi, 30(2), 79-83.
Turhan, E., Inandi, T., Cahit, Ö. Z. E. R., & Akoğlu, S. (2011). Üniversite öğrencilerinde madde kullanımı,
şiddet ve bazı psikolojik özellikler. Turkish Journal of Public Health, 9(1), 33-44.

The core symptoms of DID relate to identity and memory. Different personality states, which are self-continuous and interchangeable, co-exist in the same person, and recurrent amnesias accompany the picture. Kluft defines it as follows: Differentiated self-states, that is, (alter) personalities are mental foci of (relatively stable and ongoing) patterns of selective activation of mental content and functions. The mental content and functions in question can be clearly expressed in behavior through role-taking and role-playing dimensions. They are sensitive to intra-psychic, interpersonal, and environmental stimuli; They have their own sense of identity and mindset, and they have the capacity to initiate thought processes and actions. Each should be understood not as a part of the mind, but as a different form of organization of the mind. When alter personalities are considered as different patterns rather than a part of the whole, it is better understood why their number can be so high. A patient may have many minor parts as well as developed alter personalities. Some pieces carry only an emotion or a memory, and their emergence occurs in a flashback style. DID patients show many symptoms of borderline personality disorder. However, in these people, symptoms such as self-harm and anger outbursts occur due to the activities of the alter personalities and disappear suddenly when the relevant alter personalities merge with the host personality. For this reason, it is controversial whether a person diagnosed with DID should also be diagnosed with borderline personality or another personality disorder. Many somatic complaints are expressed. Among these, headache, migraine, and conversion symptoms are the most common and usually occur at the time of personality change or when one alter personality forces the other to take control. Trance states are observed as periods spent doing nothing and staring blankly. Supernatural experiences such as déjà vu, telepathy, seeing the future, moving objects with thoughts, being possessed by demons or other beings, and reincarnation experiences can be described.

Additionally, the most obvious symptom of those with this disease is having more than one identity subsystem. Each identity has a unique name, age, gender, language, and personality characteristics. Transitions may occur between these identities. Secondly, memory loss may occur. The individual may experience memory loss during transitions between different identities. These losses can leave a person unaware of what is happening as they transition from one identity to another. Third, individuals with DID are often unconscious when transitioning between identities. Therefore, one identity may be unaware of the consciousness of the other. Fourthly, individuals with DID may experience periods in which they forget their primary identity or true identity. This can lead to a feeling of self-alienation. Dissociative identity disorder is often associated with severe traumatic experiences, and therefore symptoms of post-traumatic stress may also often occur. DID can sometimes be associated with suicidal thoughts, especially when individuals with DID have difficulty understanding and coping with themselves.

Dissociative Identity Disorder is a complex disorder that requires treatment. Treatment may include different components, such as individualized psychotherapy, learning emotional regulation skills, and medication when necessary. Additionally, understanding and supporting this disease is an issue that needs to be raised awareness in society. Although the causes of Dissociative Identity Disorder are not fully known, some events may increase the risk. These may be due to serious childhood trauma (sexual abuse, physical abuse, emotional abuse), genetic predisposition, family history of similar disorders, or problems related to the person's mother experiencing stress during pregnancy. The only effective treatment for DID is psychotherapy which recognizes and accepts personality states and works on the trauma experienced, aiming to reverse the psychological processes that lead to their dissociation. Many methods are used together during the psychotherapy of DID. DID psychotherapy consists of three phases: stabilization, handling of traumatic experiences, and integration. It is important to establish trust and secure attachment in the initial period of treatment. Understanding the functions of altered personalities forms part of treatment. The patient must also learn to use existing support systems and social networks. The DID patient is primarily in the victim position in the trauma triangle consisting of victim, abuser, and rescuer (or bystander). He/she continues to be attached to the abuser and cannot maintain self-control. Additionally, no drug that specifically affects dissociative psychopathology is yet known. Anxiolytics, antidepressants, and sedatives can be
used symptomatically. Antidepressants may work well when depression is present. However, there are also observations that medications can worsen the condition. The effect of antiepileptics and mood stabilizers has not been demonstrated. Various medications can have varying effects on different personalities. Dissociative Identity Disorder can significantly impact quality of life, but with appropriate treatment, individuals can achieve a better quality of life. Starting treatment early and getting expert support is important in managing this disorder. 

In conclusion, Dissociative Identity Disorder is a complex psychological disorder and reflects a situation in which the integrity of a person's identity is fragmented. Although it is a treatable disorder, it requires expert help. Individuals and society must raise awareness to understand and support this disorder.

REFERENCES
BOZUKLUĞU, D. K. DİSSOSİYATİF BOZUKLUKLAR.
Öztürk, E. (2018). Travma merkezli alyans model terapi: dissosiyatif kimlik bozukluğunun
psikoterapisi. Turkiye Klinikleri Psychology‐Special Topics, 3, 31-38.