Kovid-19 Pandemisi Sürecinde Bireylerin Travma Sonrası Stres Belirtileriyle Öz-Anlayış Düzeyleri ve Duygusal Şemaları Arasındaki İlişkinin İncelenmesi

Year 2022, Volume: 10 Issue: 2, 438 - 452, 28.10.2022

Hanife Aydın , Serpil Reisoğlu , Burak Aydın

https://doi.org/10.18795/gumusmaviatlas.1120360

Abstract

Kovit-19 salgınının sebep olduğu önemli psikolojik sorunlardan birinin travma sonrası stres bozukluğu olduğu düşünülebilir. Kovid-19 pandemisi sonucunda duygusal şemalarına ve öz-anlayış düzeylerine göre kişilerin bu süreçten nasıl etkilendiğinin incelenmesi bu çalışmanın amacını oluşturmaktadır. Çalışmanın araştırma grubunu Türkiye’de farklı şehirlerde yaşayan ve Kovid-19 pandemisi zorunlu karantina uygulamasına dahil olan 18 yaş üzeri bireylerden uygun örnekleme tekniğiyle belirlenen 197 katılımcı (Kadın=114, Erkek=83) oluşturmaktadır. Araştırma verileri çevrimiçi ortam aracılığıyla toplanmıştır. Verilerin toplanmasında kişisel bilgi formu, Leahy Duygusal Şema Ölçeği-II, Öz-Anlayış Ölçeği, Posttravmatik Stres Bozukluğu Kontrol Listesi kullanılmıştır. Verilerin normal dağıldığı durumlarda bağımsız t testi, çoklu doğrusal regresyon analizi ve Pearson korelasyon analizi, verilerin normal dağılmadığı durumlarda ise Mann Whitney-U testi ve Kruskal Wallis-H testi kullanılmıştır. Kovid-19 pandemisi sürecinde travma sonrası stres belirtileriyle duygusal şema puanları arasında, öz anlayış puanları ile duygusal şema puanları arasında ve travma sonrası stres belirtileri ile öz anlayış puanları arasında anlamlı ilişkiler olduğu belirlenmiştir. Regresyon modeline katılan değişkenlerden duygusal şema ile öz anlayışın travma sonrası stres belirtilerini %35 düzeyinde açıkladığı ve duygusal şemanın modeli anlamlı düzeyde yordadığı tespit edilmiştir. Travma sonrası stres belirtilerinin cinsiyet ve meslek değişkenlerine göre anlamlı düzeyde farklılaştığı, sosyoekonomik gelir düzeyine göre anlamlı farklılık göstermediği araştırmanın bir diğer sonucudur. Araştırma bulguları literatürle karşılaştırılarak tartışılmış ve gerekli öneriler özetlenmiştir.

Keywords

Travma sonrası stres bozukluğu, Duygusal şema, Öz-anlayış, Kovid-19

The Investigation of the Relationship Between Post-Traumatic Stress Symptoms and Self-Compassion Levels and Emotional Schemas of Individuals During the Covid-19 Pandemic Process

Abstract

It can be thought that one of the important psychological problems caused by the Covid-19 epidemic is post-traumatic stress disorder. The goal of this study is to investigate the connection between post-traumatic stress disorder symptoms and a person's level of emotional intelligence in the Covid-19 pandemic procedure. The research group of the study consists of 197 participants (Female=114, Male=83) determined by the appropriate sampling technique from individuals over the age of 18 who live in different cities in TURKIYE and are included in the Covid-19 pandemic mandatory quarantine application. Research data were collected through the online environment. Personal information form, Leahy Emotional Schema Scale-II, Self-Compassion Scale, Posttraumatic Stress Disorder Checklist were used to collect data. Independent t-test, multiple linear regression analysis, and Pearson correlation analysis were used in cases where the data were normally distributed, and Mann Whitney-U test and Kruskal Wallis-H test were used in cases where the data were not normally distributed. It has been determined that there are significant relationships between post-traumatic stress symptoms and emotional schema scores, between self-understanding scores and emotional schema scores, and between post-traumatic stress symptoms and self-understanding scores during the Covid-19 pandemic. It has been determined that emotional schema and self-understanding, among the variables included in the regression model, explain the post-traumatic stress symptoms at a level of 35%, and the emotional schema predicts the model at a significant level. Another result of the research is that the symptoms of post-traumatic stress differ significantly according to gender and occupation variables, but do not differ significantly according to socioeconomic income level. The research findings were compared with the literature and discussed, and necessary recommendations were summarized. The findings are believed to contribute to the programs for psychological assistance to be scheduled within the period following the pandemic.

Keywords

Post traumatic stress disorder, Emotional schema, Self-compassion, Covid-19

References

• Aker, A. T., Özeren, M., Başoğlu, M., Kaptanoğlu, C., Erol, A., & Buran, B. (1999). Klinisyen tarafindan uygulanan travma sonrasi stres bozukluğu ölçeği (TSSB-Ö)-Geçerlik ve güvenilirlik çalişmasi [Clinician-Administered Post-Traumatic Stress Disorder Scale (CAPS): A validity and reliability study]. Türk Psikiyatri Dergisi, 10(4), 286–293.
• APA, A. P. B. (2013). Mental bozuklukların tanısal ve sayımsal el kitabı (DSM5) (K. E, Çev. 5. Baskı). Ankara: Hekimler Yayın Birliği
• Athanasakou, D., Karakasidou, E., Pezirkianidis, C., Lakioti,A., & Stalikas, A. (2020). Self-compassion inclinical samples: A systematic literatüre review. Psychology, 11, 217-244.doi.org/10.4236/psych.2020.112015
• Batmaz, S., Kaymak, S. U., Kocbiyik, S., & Turkcapar, M. H. (2014). Meta cognitions and emotional schemas: a new cognitive perspective fort hedistinction between unipolar and bipolar depression. Comprehensive psychiatry, 55(7), 1546-1555.
• Batmaz, S. & Özdel, K. (2015). Psychometric properties of the Turkish version of the Leahy Emotional Schema Scale-II. Anatolian Journal of Psychiatry, 16(Supl.1), 23-30.
• Bekaroğlu, E., & Yılmaz, T. (2020). COVID-19 ve psikolojik etkileri: Klinik psikoloji perspektifinden bir derleme. Nesne, 8(18), 573-584.
• Bistricky, S. L., Gallagher, M. W., Roberts, C. M., Ferris, L., Gonzalez, A. J., & Wetterneck, C. T. (2017). Frequency of interpersonal trauma types, avoidant attachment, self-compassion, and interpersonal competence: A model of persisting posttraumatic symptoms. Journal of Aggression, Maltreatment&Trauma, 26(6), 608-625.
• Bonanno, G. A., & Mancini, A. D. (2006). Bereavement-Related Depression and PTSD: Evaluating Interventions. In L. Barbanel & R. J. Sternberg (Eds.), Psychological interventions in times of crisis (pp. 37–55). Springer Publishing Company.
• Boudoukha, A. H., Przygodzki-Lionet, N., & Hautekeete, M. (2011). Traumatic events and Early Maladaptive Schemas (EMS): Prison guard psychological vulnerability. European Review of Applied Psychology, 61(4). doi: 10.1016/j.erap.2011.05.004
• Boyraz, G., Legros, D. N., & Tigershtrom, A. (2020). COVID-19 and traumatic stress: The role of perceived vulnerability, COVID-19-related worries, and social isolation. Journal of Anxiety Disorders, 76, 102307.
• Boysan, M., Güzel-Özdemir, P., Özdemir, O., Selvi, Y., Yilmaz, E. & Kaya, N. (2017). Psychometric properties of the Turkish version of the PTSD checklist for diagnostic and statistical manual of mental disorders, fifth edition (PCL-5). Psychiatry and Clinical Psychopharmacology, 27(3), 306-316.
• Braehler, C., & Neff, K. (2020). Self-compassion in PTSD. In M. T. Tull & N. A. Kimbrel (Eds.), Emotion in posttraumaticstressdisorder: Etiology, assessment, neurobiology, andtreatment (pp. 567–596). Elsevier Academic Press. doi: 10.1016/B978-0-12-816022-0.00020-
• Cameron, R. P., &Gusman, D. (2003). Theprimarycare PTSD screen (PC-PTSD): developmentandoperatingcharacteristics. Primarycarepsychiatry, 9(1), 9-14.
• Christiansen, D. M. & Berke, E. T. (2020). Gender- and sex-based contributors to sex differences in PTSD. Current Psychiatry Reports, 22(19), 1-9. doi.org/10.1007/s11920-020-1140-y
• Chua SE, Cheung V, McAlonan GM, Cheung C, Wong JW, Cheung EP, & et al. (2004). Stress and psychological impact on SARS patients during the outbreak. Can J Psychiatry , 49:385-90.
• Copeland, W. E., Shanahan, L., Hinesley, J., Chan, R. F., Aberg, K. A., Fairbank, J. A., ... & Costello, E. J. (2018). Association of childhood trauma exposure with adult psychiatric disorders and functional outcomes. JAMA network open, 1(7), e184493-e184493.
• Creaser, J. L., Storr, J. & Karl, A. (2022). Brain responses to a self-compassion ınduction in trauma survivors with and without post-traumatic stress disorder. Frontiers in Psychology, 22, 1-19. doi: 10.3389/fpsyg.2022.765602
• Creswell, J. W. (2019). Eğitim araştırmaları. İstanbul: Edam.
• Deniz, M. E., Kesici, Ş., & Sümer, A. S. (2008). The validity and reliability study of the Turkish version of self-compassion scale. Social Behavior and Personality, 36(9), 1151-1160.
• Duman, N. (2019). Travma sonrası büyüme ve gelişim. Uluslararası Afro-Avrasya Araştırmaları Dergisi, 4(7), 178-184.
• Finlay‐Jones, A. L. (2017). The relevance of self‐compassion as an intervention target in mood and anxiety disorders: A narrative review based on an emotion regulation framework. Clinical Psychologist, 21(2), 90-103.
• Germer, C. K. (2020). Öz şefkatli farkındalık: Tahrip edici duygularla başa çıkabilmek (Çev. H. Ü. Haktanır). Diyojen Yayıncılık.
• Germer, C. K., & Neff, K. D. (2013). Self-compassion in clinical practice. Journal of Clinical Psychology, 69(8), 856–867.
• Germer, C. K., & Neff, K. D. (2015). Cultivating self-compassion in trauma survivors. Mindfulness-oriented interventions for trauma: Integrating contemplative practices, 43-58.
• Graf, N. M. (2015). War and post traumatic growth. C. R. Martin, V. R. Preedy, V. B. Patel (E.Editör). Comprehensive Guide to Post-Traumatic Stress Disorder içinde. DOI 10.1007/978-3-319-08613-2_59-1
• Greenberg, L. S. ve Safran, J. D. (1987). Emotion in psychotherapy: Affect, cognition, and the process of change. The Guilford Clinical Psychology and Psychotherapy Series.
• Güloğlu, B., & Karairmak, Ö. (2013). Güneydoğu gazilerinde travma sonrası stres bozukluğu gelişimi. Anatolian Journal of Psychiatry/Anadolu Psikiyatri Dergisi, 14(3).
• Gümüş, F., & Yiğitalp, G. (2020). Orjinal Makale Uzun süreli terör eylemlerinin olduğu bölgede yaşayan veya tanık olan bireylerde travmatik stres, anksiyete ve depresif belirti sıklığı.
• Güzey, A. (2020). Erken dönem uyum bozucu şema alanları ile mülteci yardım çalışanlarındaki ikincil travmatik stresi arasındaki ilişki üzerinde öz-şefkatin aracı rolü (Tez No. 639485) [Yüksek Lisans Tezi, Başkent Üniversitesi]. YÖK Tez Merkezi.
• Heffernan, M., Quinn Griffin, M. T., McNulty, S. R., & Fitzpatrick, J. J. (2010). Self‐compassion and emotional intelligence in nurses. International journal of nursing practice, 16(4), 366-373.
• Herman JL. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress. 5, 377-91.
• Hollis-Walker, L., & Colosimo, K. (2011). Mindfulness, self-compassion, and happiness in non-meditators: A theoretical and empirical examination. Personality and Individual differences, 50(2), 222-227.
• Horesh, D., & Brown, A. D. (2020). Traumatic stress in the age of COVID-19: A call to close critical gaps and adapt to new realities. Psychological Trauma: Theory, Research, Practice, and Policy, 12(4), 331.
• Houbre, B., Dodeler, V., Peter, L., Auxéméry, Y., Lanfranchi, J.-B., & Tarquinio, C. (2012). Stress post-traumatique et altération des schémas cognitifs: Cas de la victimation à l’école. L’Évolution Psychiatrique, 77(1), 1–14. doi:10.1016/j.evopsy.2011.09.009
• İnci, F. ve Boztepe, H. (2013). Travma sonrası büyüme: öldürmeyen acı güçlendirir mi? Psikiyatri Hemşireliği Dergisi, 4(2):80-4.
• Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social cognition, 7(2), 113-136.
• Janoff-Bulman, R., & McPherson Frantz, C. (1997). The impact of trauma on meaning: From meaningless world to meaningful life. In M. J. Power & C. R. Brewin (Eds.), The transformation of meaning in psychological therapies: Integrating theory and practice (pp. 91–106). John Wiley & Sons Inc.
• Jativa, R., & Cerezo, M. A. (2014). The mediating role of self-compassion in the relationship between victimisation and psychological maladjustment in a sample of adolescents. Child Abuse & Neglect, 38, 1180-1190. doi.org/10.1016/j.chiabu.2014.04.005
• Johnson, B. & Christensen, L. (2014). Eğitim araştırmaları nicel, nitel ve karma yaklaşımlar, (S.B. Demir, Çev. Ed.). Eğiten Kitap.
• Kaurin, A., Schönfelder, S., &Wessa, M. (2018). Self-compassionbuffersthe link between self-criticismanddepression in trauma-exposedfirefighters. Journal of CounselingPsychology, 65(4), 453–462. doi: 10.1037/cou0000275
• Kearns, M. C., Ressler, K. J., Zatzick, D., & Rothbaum, B. O. (2012). Early interventions for PTSD: a review. Depression and anxiety, 29(10), 833-842.
• Kessler, R. C. (2000). Post-traumatic stress disorder: the burden to the individual and to society. Journal of Clinical Psychiatry, 61, 4-12.
• Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Benjet, C., Bromet, E. J., Cardoso, G., ... & Koenen, K. C. (2017). Trauma and PTSD in the WHO world mental health surveys. European journal of psychotraumatology, 8(sup5), 1353383.
• Kessler, R. C., Rose, S., Koenen, K. C., Karam, E. G., Stang, P. E., Stein, D. J., ... & Viana, M. C. (2014). How well can post-traumatic stress disorder be predicted from pre-trauma risk factors? An exploratory study in the WHO World Mental Health Surveys. World Psychiatry, 13(3), 265- 274. https://doi.org/10.1002/wps.20150
• Khursheed, M. &Shahnawaz, M. G. (2020). Traumaand post‑traumaticgrowth: Spiritualityand self‑compassion as mediatorsamongparentswholosttheiryoungchildren in a protractedconflict. Journal of ReligionandHealth, 59, 2623-2637. doi: 10.1007/s10943-020-00980-2
• Koçak, L. & Çelik, E. (2021). Lise öğrencilerinde öz-şefkat ile duygusal özerklik arasındaki ilişkide erken dönem uyumsuz şemaların aracı rolü. OPUS– Uluslararası Toplum Araştırmaları Dergisi, 18(Eğitim Bilimleri Özel Sayısı), 4360-4399. DOI: 10.26466/ opus.906143.
• Leahy RL. (2001). Overcoming Resistance in Cognitive Therapy. First ed., New York: Guilford Press.
• Leahy, R. L. (2002). A model of emotional schemas. Cognitive and behavioral practice, 9(3), 177-190.
• Leahy R.L. (2007). Emotional schemas and resistance to change in anxiety disorders. Cognitive and Behavioral Practice ,14:36-45
• Leary, M. R., Tate, E. B., Adams, C. E., Batts Allen, A., & Hancock, J. (2007). Self-compassion and reactions to unpleasant self-relevant events: the implications of treating oneself kindly. Journal of personality and social psychology, 92(5), 887.
• Lee AM, Wong JG, McAlonan GM, Cheung V, Cheung C, Sham PC, et al. (2007). Stress and psychological distress among SARS survivors 1 year after the outbreak. Can J Psychiatry, 52:233-40.
• Lecigne, M. & Tapia, G. (2018). The mediating role of early maladaptive schemas on relations between post-traumatic stress disorder symptom severity and illicit substance use disorder, Journal of Substance Use, 23(6), 634-639. doi: 10.1080/14659891.2018.1489005
• Liang, L., Gao, T., Ren, H., Cao, R., Qin, Z., Hu, Y., … Mei, S. (2020). Post-traumatic stress disorder and psychological distress in Chinese youths following the covid-19 emergency. Journal of Health Psychology, 25(9), 1164-1175. doi:10.1177/13591053209370
• MacBeth, A., & Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical psychology review, 32(6), 545-552.
• Manser, R., Cooper, M., & Trefusis, J. (2012). Beliefs about emotions as a metacognitive construct: Initial development of a self-report questionnaire measure and preliminary investigation in relation to emotion regulation. Clinical Psychology and Psychotherapy, 19(3), 235–246.
• Mayer, S. E., Surachman, A., Prather, A. A., Puterman, E., Delucchi, K. L., Irwin, M. R., ... & Epel, E. S. (2021). The long shadow of childhood trauma for depression in midlife: examining daily psychological stress processes as a persistent risk pathway. Psychological medicine, 1-10.
• Maynard, B. R., Farina, A., Dell, N. A., & Kelly, M. S. (2019). Effects of trauma‐informed approaches in schools: A systematic review. Campbell Systematic Reviews, 15(1-2), e1018.
• Mazloom, M., Yaghubi, H., & Mohammadkhani, S. (2016). Post-traumatic stress symptom, metacognition, emotional schema and emotion regulation: A structural equation model. Personality and Individual Differences, 88, 94–98.
• Mitmansgruber, H., Beck, T. N., Höfer, S., & Schüßler, G. (2009). When you don’t like what you feel: Experiential avoidance, mindfulness and meta-emotion in emotion regulation. Personality and Individual Differences, 46(4), 448–453.
• Naderi Rajeh, Y., Zarghami, M., & Bagheri, M. (2017). The Efficiency of Emotional Schema Therapy on level of anxiety and depression, symptom and signs of patients suffering from Post-Traumatic Stress Disorder (PTSD). International Journal of Behavioral Sciences, 11(3), 114-120.
• Neff, K. D. (2003a). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and identity, 2(2), 85-101.
• Neff, K. D. (2003b) Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85-102. doi: 10.1080/15298860309032
• Neff, K. D., Rude, S. S., & Kirkpatrick, K. L. (2007). An examination of self-compassion in relation to positive psychological functioning and personality traits. Journal of research in personality, 41(4), 908-916. Norman, E., & Furnes, B. (2016). The concept of “metaemotion”: What is there to learn from research on metacognition? Emotion Review, 8(2), 187–193.
• Olff, M. (2017). Sex and gender differences in post-traumatic stress disorder: an update, European Journal of Psychotraumatology, 8(4), 1351204. doi: 10.1080/20008198.2017.1351204
• Özcan, N. A. (2019). Yetişkinlerde travma sonrası stres ve öz duyarlılığın travma sonrası büyüme üzerindeki yordayıcı rolü. OPUS Uluslararası Toplum Araştırmaları Dergisi, 14(20), 621-642.
• Park, S., Lee, Y., & Jun, J. Y. (2018). Trauma and depression among North Korean refugees: the mediating effect of negative cognition. International journal of environmental research and public health, 15(4), 591.
• Pauley, G., & McPherson, S. (2010). The experience and meaning of compassion and self‐compassion for individuals with depression or anxiety. Psychology and Psychotherapy: Theory, Research and Practice, 83(2), 129-143.
• Qiu, J., Shen, B., Zhao, Mk., Wang, Z., Xie, B., & Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatr, 33:100213
• Ramos, C. ve Leal, I. (2013). Posttraumatic growth in the aftermath of trauma: a literature review about related factors and application contexts. Psychology, Community & Health, 2(1):43–54, doi:10.5964/pch.v2i1.39
• Scheff, T. J. (1981). The distancing of emotion in psychotherapy. Psychotherapy: Theory, Research and Practice, 18(1), 46-53.
• Scoglio, A. A., Rudat, D. A., Garvert, D., Jarmolowski, M., Jackson, C., & Herman, J. L. (2018). Self-compassion and responses to trauma: The role of emotion regulation. Journal of interpersonal violence, 33(13), 2016-2036.
• Seligowski, A. V., Miron, L. R., & Orcutt, H. K. (2015). Relations amongself-compassion, PTSD symptoms, and psychological health in atrauma-exposed sample. Mindfulness, 6(5), 1033–1041
• Shapiro, F., & Maxfield, L. (2002). Eye movement desensitization and reprocessing (EMDR): Information processing in the treatment of trauma. Journal of Clinical Psychology, 58:933-46.
• Shebuski, K., Bowie, J. A., & Ashby, J. S. (2020). Self‐compassion, trait resilience, and trauma exposure in undergraduate students. Journal of College Counseling, 23(1), 2-14.
• Sippel, L. M., & Marshall, A. D. (2013). Posttraumatic stress disorder and fear of emotions: The role of attentional control. Journal of Traumatic Stress, 26, 397–400. https://doi. org/10.1002/jts.21806
• Stein, M.B. (2020). Coronavirus disease 2019 (COVID-19): Psychiatric symptoms and disorders. UpToDate. May 19,
• Teoh, J. Y. (2021). Population-level public mental health intervention via interdisciplinary COVID-19 health crisis communication: how can occupational therapists contribute?. World Federation of Occupational Therapists Bulletin, 77(1), 10-15.
• Thimm, J. C. (2017). Relationships between early maladaptive schemas, mindfulness, self-compassion, and psychological distress. International Journal of Psychology and Psychological Therapy, 17(1), 3-17.
• Thompson, B. L. & Waltz, J. (2008). Self-compassion and PTSD symptom severity. Journal of Traumatic Stress, 21(6), 556-558. DOI: 10.1002/jts.20374
• Tolin, D. F. & Foa, E. B. (2008). Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. American Psychological Association, 1, 37-85. doi: 10.1037/1942-9681.S.1.37
• Tull, M. T., Jakupcak, M., McFadden, M. E., & Roemer, L. (2007). The role of negative affect intensity and the fear of emotions in posttraumatic stress symptom severity among victims of childhood interpersonal violence. The Journal of Nervous and Mental Disease, 195(7), 580–587. https://doi. org/10.1097/nmd.0b013e318093ed5f
• Van Dam, N. T., Sheppard, S. C., Forsyth, J. P., & Earleywine, M. (2011). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of anxiety disorders, 25(1), 123-130.
• Wade, D., Hardy, R., Howell, D., & Mythen, M. (2013). Identifying clinical and acute psychological risk factors for PTSD after critical care: A systematic review. Minerva Anestesiologica, 79, 944 –963
• Warren, R., Smeets, E. & Neff, K. D. (2016). Self-criticism and self-compassion: Risk and resilience for psychopathology. Current Psychiatry, 15(12), 18-32
• Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in behavioral neuroscience, 12, 258.
• Wells, A. (2000). Emotional Disorders and Metacognition: Innovative Cognitive Therapy. First ed., West Sussex: John Wiley & Sons. WHO. Mental Health in Emergencies. 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/mental-health-inemergencies.
• Winders, S. J., Murphy, O., Looney, K., & O'Reilly, G. (2020). Self‐compassion, trauma, and posttraumatic stress disorder: A systematic review. Clinical psychology & psychotherapy, 27(3), 300-329.
• Xue, C., Ge, Y., Tang, B., Liu, Y., Kang, P., Wang, M., & Zhang, L. (2015). A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans. PLoS ONE, 10, e0120270. http://dx.doi .org/10.1371/journal.pone.0120270
• Yıldırım, F. B., & Demir, A. (2017). Kendini engellemenin yordayıcıları olarak öz saygı, öz anlayış ve akademik özyeterlilik. Ege Eğitim Dergisi, 18(2), 676-701.
• Yılmaz Karaman, İ. G., & Yastıbaş, C. (2021). COVID-19 Pandemisinde Görev Yapan Sağlık Çalışanlarında Depresyon, Anksiyete ve Travma Sonrası Stres Belirtilerinin Sosyodemografik ve Mesleki Değişkenler ile İlişkisi. Van Tıp Dergisi, 28(2), 249-257.
• Young, J. (1990) Cognitive therapy for personality disorders: A schema –focused approach. Sarasota, FL. Professional Resource Pres, s.9.
• Young, J.E., Klosko, J.S., Weishaar, M.E., & et.al. (2003) Schema therapy: A practitioner’s guide. New York. The Guilford Press, s.7.
• Yakin, D., Gencoz, T., Steenbergen, L. & Arntz, A. (2019). An integrative perspective on the inter play between early maladaptive schemas and mental health: The role of self-compassion and emotion regulation. Journal of Clinical Psychology, 75, 1098-1113. doi: 10.1002/jclp.22755.
• Yavuz, F. (2009). Duygusal şemalar ve leahy duygusal şema ölçeği’nin Türkçe uyarlaması, geçerlik ve güvenirliği (Uzmanlık Tezi). Dışkapı Yıldırım Beyazıt Eğitim Ve Araştırma Hastanesi, Ankara.
• Zare, M. M., Bagooli, H., Kazemi, S. A., & Javidi, H. A. (2020). Comparison of Emotional Schemes in War Veterans suffering Post Traumatic Stress Disorder with Depression Symptoms, Anxiety Symptoms and without Signs of Depression and Anxiety. Iranian Journal of War and Public Health, 12(1), 53-61.