Alkol Kullanım Bozukluğu Olan Hastalarda Öfke ve Agresyonun Ortaya Çıkışında Üstbilişin Rolü

Year 2023, Volume: 15 Issue: 1, 24 - 33, 15.03.2023

Neslihan Kara , Enes Sarıgedik , Ahmet Ataoğlu

https://doi.org/10.18521/ktd.1181749

Abstract

Amaç: Bu çalışmada alkol bağımlılığı olan hastalarda üstbiliş işlevleri ve üstbilişin öfke ve
agresyon ile ilişkisi araştırılmıştır. Alkol bağımlılığı olan hastalarda öfke ve agresyonun
ortaya çıkmasında hangi üstbilişsel inançların rol oynadığı hakkında bilgi sahibi olmak
amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya DSM-5'e gore Alkol Kullanım Bozukluğu (AKB) tanısı alan
hasta grubu (n=72) ile herhangi bir psikiyatrik tanısı olmayan kontrol grubu (n=71) dahil
edildi. Sosyodemografik veri formu, Alkol Kullanım Bozuklukları Tanıma Testi (AKBTT),
Üstbiliş Ölçeği (ÜBÖ-30), Sürekli Öfke ve Öfke İfade Tarzı Ölçeği (SÖ-ÖİTÖ) ve BussPerry Agresyon Ölçeği (AÖ) kullanılmıştır.
Bulgular: AKB grubunda ÜBÖ-30 toplam, SÖ-ÖİTÖ sürekli öfke, öfke dışa ve öfke içe ve
AÖ toplam puanları kontrol grubuna göre anlamlı olarak yüksek bulundu (sırasıyla
p<0,001, p<0,001, p=0,001, p=0,001 ve p<0,001). Gruplar arasında ÜBÖ-30 ve diğer
ölçeklerin korelasyon katsayıları karşılaştırıldığında, AKB grubunda sürekli öfke ve fiziksel
agresyon arasında farklılık saptanmıştır (sırasıyla z=2,035; p=0,042 ve z=2,120; p=0,034).
Çalışmamızda yapılan regresyon analizi sonucunda, AKB olan kişilerde agresyonu
yordayan en önemli üstbilişsel inancın düşünceleri kontrol etme ihtiyacı olduğu
bulunmuştur (β=0.567,t(66)= 4.034, p<0.001,pr2 =0.20).
Sonuç: Üstbilişsel inançlar AKB olan kişilerde yüksek oranda etkilenir ve daha fazla öfke
ve agresyona neden olur. Öfkenin ortaya çıkmasında düşünceleri kontrol etme ihtiyacının
önemli bir rol oynadığı gösterilmiştir

Keywords

Alkol bağımlılığı, Üstbiliş, Öfke, Agresyon

The Role of Metacognition in The Emergence of Anger and Aggression in Patients with Alcohol Use Disorder

Abstract

Objective: In this study, weaimed to investigate metacognitive functions, anger and aggression and the relationship in patients with alcohol dependence. It is to have information about which metacognitive beliefs plays a role in the emergence of anger and aggression in people with alcohol dependence.
Method: The patient group diagnosed with Alcohol Use Disorder (AUD) according to DSM-5 (n = 72) and the control group without any psychiatric diagnosis (n = 71) were included in the study. Sociodemographic data form, Alcohol Use Disorders Identification Test (AUDIT), Metacognition Questionnaire (MCQ-30), Trait Anger and Anger Expression Scale (STAXI) and Buss-Perry’s Aggression Questionnaire (AQ) were used.
Results: In the AUD group, the MCQ-30, STAXI trait anger, anger out and anger in, and AQ scores were found to be significantly higher than the control group (p<0,001, p<0,001, p=0,018, p<0,001, p=0,001 and p=0,001, p<0,001, respectively). When comparing the correlation coefficients of MCQ-30 and other scales between the groups, a difference was found between the AUD group, trait anger and physical aggression (z=2,035; p=0,042 ve z=2,120; p=0,034, respectively). As a result of the regression analysis performed in our study, it was found that the need to control thoughts is the most metacognitive beliefs that predicts aggression in people with AUD(β=0.567,t(66)= 4,034, p<0.001,pr2=0.20).
Conclusion: Metacognitive beliefs are highly affected in people with AUD and they cause more anger and aggression. It has been shown that the need to control thoughts plays an important role in the emergence of anger.

Keywords

alcohol dependence, metacognition, anger, aggression

References

• 1. Witkiewitz K, Litten RZ, Leggio L. Advances in the science and treatment of alcohol use disorder. Sci Adv. 2019;5(9):eaax4043.
• 2. American Psychiatric Association, . Diagnostic and Statistical Manual of Mental Disorders. 2013
• 3. World Health Organization. Global status report on alcohol and health - 2014 [Internet]. 2014 ed. Geneva: World Health Organization; 2014 [cited 2022 Feb 2]. Available from: https://apps.who.int/iris/handle/10665/112736
• 4. Hingson RW, Heeren T, Winter MR. Age at Drinking Onset and Alcohol Dependence: Age at Onset, Duration, and Severity. Archives of Pediatrics & Adolescent Medicine. 2006;160(7):739–46.
• 5. Kranzler HR, Soyka M. Diagnosis and Pharmacotherapy of Alcohol Use Disorder: A Review. JAMA. 2018;320(8):815–24.
• 6. Castillo-Carniglia A, Keyes KM, Hasin DS, Cerdá M. Psychiatric comorbidities in alcohol use disorder. Lancet Psychiatry. 2019;6(12):1068–80.
• 7. Norström T, Pape H. Alcohol, suppressed anger and violence. Addiction. 2010;105(9):1580–6.
• 8. Spielberger CD, Reheiser EC. Assessment of Emotions: Anxiety, Anger, Depression, and Curiosity. Applied Psychology: Health and Well-Being. 2009;1(3):271–302.
• 9. Liu J. Concept Analysis: Aggression. Issues in Mental Health Nursing. 2004;25(7):693–714.
• 10. Buss AH, Perry M. The Aggression Questionnaire. Journal of Personality and Social Psychology. 1992;63(3):452–9.
• 11. Massa AA, Subramani OS, Eckhardt CI, Parrott DJ. Problematic Alcohol Use and Acute Intoxication Predict Anger-Related Attentional Biases: A Test of the Alcohol Myopia Theory. Psychol Addict Behav. 2019;33(2):139–43.
• 12. Bertsch K, Böhnke R, Kruk MR, Naumann E. Influence of aggression on information processing in the emotional Stroop task—An event-related potential study. Frontiers in Behavioral Neuroscience. 2009;3.
• 13. Caselli G, Offredi A, Martino F, Varalli D, Ruggiero GM, Sassaroli S, et al. Metacognitive beliefs and rumination as predictors of anger: A prospective study. Aggress Behav. 2017;43(5):421–9.
• 14. Papageorgiou C, Wells A. Metacognitive beliefs about rumination in recurrent major depression. Cognitive and Behavioral Practice. 2001;8(2):160–4.
• 15. Schraw G, Dennison RS. Assessing Metacognitive Awareness. Contemporary Educational Psychology. 1994;19(4):460–75.
• 16. Wells A, Cartwright-Hatton S. A short form of the metacognitions questionnaire: Properties of the MCQ-30. Behaviour Research and Therapy. 2004;42(4):385–96.
• 17. Spada MM, Wells A. Metacognitions, emotion and alcohol use. Clinical Psychology & Psychotherapy. 2005;12(2):150–5.
• 18. Caselli G, Spada MM. Metacognitions in desire thinking: a preliminary investigation. Behav Cogn Psychother. 2010;38(5):629–37.
• 19. Spada MM, Moneta GB, Wells A. The relative contribution of metacognitive beliefs and expectancies to drinking behaviour. Alcohol and Alcoholism. 2007;42(6):567–74.
• 20. Dragan M. Difficulties in emotion regulation and problem drinking in young women: the mediating effect of metacognitions about alcohol use. Addict Behav. 2015;48:30–5.
• 21. Delonca D, Trouillet R, Alarcon R, Nalpas B, Perney P. Relationships between Attentional Bias and craving in Alcohol Use Disorder: Role of metacognitions. Addict Behav. 2021;117:106846.
• 22. Ogel K, Sarp N, Gurol D, Ermagan-Caglar E. Investigation of mindfulness and affecting factors of mindfulness among substance users and non users. Anatolian Journal of Psychiatry. 2014;15:282.
• 23. Yılmaz S, İzci F, mermi O, Atmaca M. Metacognitive functions in patients who has obsessive compulsive disorder and major depressive disorder: A controlled study. Anadolu Psikiyatri Dergisi. 2016;17.
• 24. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. Original: English Distribution: General. 2001;41.
• 25. Cartwright-Hatton S, Wells A. Beliefs about worry and intrusions: the Meta-Cognitions Questionnaire and its correlates. J Anxiety Disord. 1997;11(3):279–96.
• 26. Spielberger CD, Sydeman SJ. State-Trait Anxiety Inventory and State-Trait Anger Expression Inventory. In: The use of psychological testing for treatment planning and outcome assessment. Hillsdale, NJ, US: Lawrence Erlbaum Associates, Inc; 1994; 292–321.
• 27. Hingson RW, Heeren T, Edwards EM. Age at drinking onset, alcohol dependence, and their relation to drug use and dependence, driving under the influence of drugs, and motor-vehicle crash involvement because of drugs. J Stud Alcohol Drugs. 2008;69(2):192–201.
• 28. Foster KT, Hicks BM, Iacono WG, McGue M. Gender differences in the structure of risk for alcohol use disorder in adolescence and young adulthood. Psychol Med. 2015;45(14):3047–58.
• 29. Peltier MR, Verplaetse TL, Mineur YS, Petrakis IL, Cosgrove KP, Picciotto MR, et al. Sex differences in stress-related alcohol use. Neurobiol Stress. 2019;10:100149.
• 30. Blakey SM, Campbell SB, Simpson TL. Associations Between Lifetime Panic Attacks, Posttraumatic Stress Disorder, and Substance Use Disorders in a Nationally Representative Sample. J Dual Diagn. 2021;1–12.
• 31. Gregoire TK, Burke AC. The relationship of legal coercion to readiness to change among adults with alcohol and other drug problems. Journal of Substance Abuse Treatment. 2004;26(1):35–41.
• 32. Khan MR, Ban K, Caniglia EC, Edelman JE, Gaither J, Crystal S, et al. Brief original report: Does smoking status provide information relevant to screening for other substance use among US adults? Preventive Medicine Reports. 2021;23:101483.
• 33. Liu X, Zhao W, Hu F, Hao Q, Hou L, Sun X, et al. Comorbid anxiety and depression, depression, and anxiety in comparison in multi-ethnic community of west China: prevalence, metabolic profile, and related factors. J Affect Disord. 2022;298(Pt A):381–7.
• 34. Miller M, Anderson-Luxford D, Mojica-Perez Y, Sjödin L, Room R, Jiang H. A time-series analysis of the association between alcohol and suicide in Australia. Drug Alcohol Depend. 2022;231:109203.
• 35. Spada MM, Wells A. A metacognitive model of problem drinking. Clinical Psychology & Psychotherapy. 2009;16(5):383–93.
• 36. Torselli E, Ottonello M, Franceschina E, Palagi E, Bertolotti G, Fiabane E. Cognitive and metacognitive factors among alcohol-dependent patients during a residential rehabilitation program: a pilot study. Neuropsychiatr Dis Treat. 2018;14:1907–17.
• 37. Canham SL, Mauro PM, Kaufmann CN, Sixsmith A. Association of Alcohol Use and Loneliness Frequency Among Middle-Aged and Older Adult Drinkers. J Aging Health. 2016;28(2):267–84.
• 38. Czermainski FR, Lopes FM, Ornell F, Pinto Guimarães LS, Von Diemen L, Kessler F, et al. Concurrent Use of Alcohol and Crack Cocaine is Associated with High Levels of Anger and Liability to Aggression. Substance Use & Misuse. 2020;55(10):1660–6.
• 39. Bácskai E, Czobor P, Gerevich J. Gender differences in trait aggression in young adults with drug and alcohol dependence compared to the general population. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35(5):1333–40.
• 40. Skara S, Pokhrel P, Weiner MD, Sun P, Dent CW, Sussman S. Physical and relational aggression as predictors of drug use: Gender differences among high school students. Addictive Behaviors. 2008;33(12):1507–15.
• 41. Candini V, Ghisi M, Bianconi G, Bulgari V, Carcione A, Cavalera C, et al. Aggressive behavior and metacognitive functions: A longitudinal study on patients with mental disorders. Annals of General Psychiatry. 2020;19(1):36.
• 42. José M. S, García-Sancho E, Ramos-Cejudo J, Kannis-Dymand L. Individual differences in anger and displaced aggression: The role of metacognitive beliefs and anger rumination. Aggressive Behavior. 2020;46.
• 43. Hamonniere T, Varescon I. Metacognitive beliefs in addictive behaviours: A systematic review. Addict Behav. 2018;85:51–63.
• 44. Badawy AA. Alcohol, aggression and serotonin: metabolic aspects. Alcohol Alcohol. 1998 Feb;33(1):66–72.
• 45. Naranjo CA, Knoke DM. The role of selective serotonin reuptake inhibitors in reducing alcohol consumption. J Clin Psychiatry. 2001;62 Suppl 20:18–25.
• 46. Besiroglu L, Çetinkaya N, Selvi Y, Atli A. Effects of selective serotonin reuptake inhibitors on thought-action fusion, metacognitions, and thought suppression in obsessive-compulsive disorder. Compr Psychiatry. 2011;52(5):556–61.
• 47. Jager A, Amiri H, Bielczyk N, van Heukelum S, Heerschap A, Aschrafi A, et al. Cortical control of aggression: GABA signalling in the anterior cingulate cortex. Eur Neuropsychopharmacol. 2020;30:5–16.
• 48. Maccioni P, Colombo G. Role of the GABAB receptor in alcohol-seeking and drinking behavior. Alcohol. 2009;43(7):555–8.
• 49. Schmitz TW, Correia MM, Ferreira CS, Prescot AP, Anderson MC. Hippocampal GABA enables inhibitory control over unwanted thoughts. Nat Commun. 2017;8(1):1311.