Bipolar Bozukluk Hastalarında Çocukluk Çağı Travması ile Bilişsel Duygu Düzenleme ve Başa Çıkma Tutumları Arasındaki İlişki

Year 2022, , 43 - 51, 14.01.2022

Taha Can Tuman Onur Hurşitoğlu

https://doi.org/10.33631/sabd.1055248

Cited By: 1

Abstract

Amaç: Bu çalışmada bipolar bozukluk hastalarında çocukluk çağı travması varlığı ve çocukluk çağı travmasının bilişsel duygu düzenleme ve başa çıkma tutumları ile ilişkisinin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Bu çalışmaya Temmuz 2020 ve Ocak 2021 tarihleri arasında Medipol Üniversitesi Esenler Hastanesine başvuran DSM-5 kriterlerine göre Bipolar bozukluk tanısı konmuş ve halen remisyonda olan 60 hasta dahil edilmiştir. Veriler sosyodemografik veri formu, Çocukluk çağı travma ölçeği (ÇÇTÖ), Bilişsel Duygu Düzenleme Ölçeği ve Başa Çıkma Tutumları Ölçeği (COPE) kullanılarak elde edilmiştir. Veriler Mann Whitney u testi, ki-kare testi ve Spearman korelasyon testi ile değerlendirilmiştir.
Bulgular: Hastaların ortalama yaşları 36,97 ± 10,36 idi. Hastaların çocukluk çağı travma ölçek toplam puanı ortalama 45,82 ± 12,97 idi. Hastaların %76.6 (n=46)’ sında ÇÇTÖ puanı 35 ve üstünde saptandı. Çocukluk çağı travması olan bipolar bozukluk hastalarında, kendini suçlama belirgin olarak yüksek, duygusal odaklı başa çıkma belirgin olarak düşük saptandı. Ayrıca bipolar bozukluk hastalarında çocukluk çağı travması varlığı ile kendini suçlama ve diğerlerini suçlama arasında pozitif yönde anlamlı ilişki, olumlu yeniden değerlendirme ve pozitif yeniden yorumlama ile negatif yönde anlamlı ilişki saptandı.
Sonuç: Bipolar bozukluk hastalarında yüksek oranda çocukluk çağı travması bulunduğu ve çocukluk çağı travmasının bazı bilişsel duygu düzenleme ve başa çıkma tutumlarını etkilediği belirlenmiştir.

Keywords

Bipolar, çocukluk çağı travması, başa çıkma, bilişsel duygu düzenleme

Childhood Trauma, Cognitive Emotion Regulation and Coping Attitudes in Patients with Bipolar Disorder

Abstract

Aim: In this study, it was aimed to investigate the relationship between the presence of childhood trauma and childhood trauma with cognitive emotion regulation and coping attitudes in bipolar disorder patients.
Material and Methods: In this study, 60 patients who were diagnosed with Bipolar affective disorder according to DSM-5 criteria and who were still in remission between July 2020 and January 2021 were included in the Medipol University Esenler Hospital. The data were obtained using the sociodemographic data form, the Childhood Trauma Scale (CTQ), the Cognitive Emotion Regulation Scale, and the Coping Attitudes Scale (COPE). The data were evaluated with the Mann Whitney u test, the chi-square test and the Spearman correlation test.
Results: The mean age of the patients was 36,97 ± 10,36 years. The mean childhood trauma scale score of the patients was 45,82 ± 12,97. CTQ score was found 35 and above in 76.6% (n=46) of the patients. Self-blame was significantly higher and emotionally focused coping was significantly lower in bipolar patients with childhood trauma. In addition, a positive significant relationship was found between the presence of childhood trauma and self-blame and blaming others, and a negative significant relationship with positive re-evaluation and positive reinterpretation in patients with bipolar disorder.
Conclusion: It has been determined that bipolar disorder patients have a high rate of childhood trauma and childhood trauma affects some cognitive emotion regulation and coping attitudes.

Keywords

Bipolar, childhood trauma, coping attitudes, cognitive emotion regulation

References

• Diagnostic and Statistical Manual of Mental Disorders: DSM-5TM. 5th ed. American Psychiatric Publishing, Inc.;2013.
• Vieta E, Berk M, Schulze TG, Carvalho AF, Suppes T, Calabrese JR, et al. Bipolar disorders. Nat Rev Dis Primers. 2018; 4: 18008.
• Misiak B, Stramecki F, Gaweda L, Prochwicz K, Sasiadek MM, Moustafa AA, et al. Interactions between variation in candidate genes and environmental factors in the etiology of schizophrenia and bipolar disorder: a systematic review. Mol Neurobiol. 2018; 55(6): 5075-100.
• Jangam K, Muralidharan K, Tansa KA, Aravind Raj E, Bhowmick P. Incidence of childhood abuse among women with psychiatric disorders compared with healthy women: Data from a tertiary care centre in India. Child Abuse Negl. 2015; 50: 67-75.
• Turla A. Çocuk istismarı ve ihmali olgularında tıbbi yaklaşım. Ondokuz Mayıs Üniversitesi Tıp Dergisi. 2002; 19(4): 291-300.
• Yurdakök K, İnce O. Duygusal istismar ve ihmal. Katkı Pediatri Dergisi. 2010; 32(4): 423-33.
• Heim C, Nemeroff CB. The impact of early adverse experiences on brain systems involved in the pathophysiology of anxiety and affective disorders. Biol Psychiatry. 1999; 46(11): 1509-22.
• Holtzman CW, Trotman HD, Goulding SM, Ryan AT, Macdonald AD, Shapiro DI, et al. Stress and neurodevelopmental processes in the emergence of psychosis. Neuroscience. 2013; 249: 172-91.
• Belsky J. Attachment, mating, and parenting. Hum Nat. 1997; 8(4): 361-81.
• Folkman S, Moskowitz JT. Coping: pitfalls and promise. Annu Rev Psychol 2004; 55: 745-74.
• Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: A theoretically based approach. J Pers Soc Psychol. 1989; 56(2): 267-83.
• Lazarus RS, Cohen JB, Folkman S, Kanver ASC. Psychological stress and adaptation. Some unresolved issues. In: H. Selye, edıtor. Selye's guide to stress research. New York, NY: Von Nostrand Reinhold; 1980. p. 90-117.
• Garnefski N, Kraaij V, Spinhoven P. Negative life events, cognitive emotion egulation and depression. Pers Individ Di. 2001; 30(8): 1311-27.
• Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003; 27(2): 169-90.
• Sar V, Öztürk E, Ikikardes E. Cocukluk Cagi Ruhsal Travma Ölceginin Türkce uyarlamasinin gecerlilik ve güvenilirligi. Turkiye Klinikleri J Med Sci. 2012; 32(4): 1054-63.
• Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology. 1989; 56(2): 267-83.
• Ağargün MY, Beşiroğlu L, Kıran ÜK, Özer ÖA, Kara H. COPE (Başa çıkma tutumlarını değerlendirme ölçeği): Psikometrik özelliklere ilişkin bir ön çalışma. Anatolian Journal of Psychiatry. 2005; 6(4): 221-6.
• Garnefski N, Kraaij V, Spinhoven P. CERQ: Manual for the use of the cognitive emotion regulation Questionnaire. Leiderdorp, the Netherlands: DATEC V.O.F; 2002.
• Ataman Temizel E, Dağ İ. Relationships among stressful life events, cognitive emotion regulation strategies, depressive symptoms and anxiety levels. Klinik Psikiyatri. 2014; 17(1): 7-17.
• Heim C, Nemeroff CB. The role of childhood trauma in the neorobiology of mood and anxiety disorders: ptrcilinical and clinical studies. Biol Psychiatry. 2001; 49(12): 1023-39.
• Leverich GS, McElroy SL, Suppes T, Keck PE, Denicoff KD, Nolen WA, et.al. Early physical and sexual abuse associated with an adverse course of bipolar illness. Biol Psychiatry. 2002; 51(4): 288-97.
• Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Impact of childhood abuse on clinical course of bipolar disorder. Br J Psychiatry. 2005; 186(2); 121-5.
• Erten E, Uney Kalkay AF, Saatçioğlu Ö, Özdemir A, Fıstıkçı N, Çakmak D. Effects of childhood trauma and clinical features on determining quality of life in patients with bipolar disorder. J Affect Disord. 2014; 162: 107-13.
• Hyun M, Friedman SD, Dunner DL. Relationship of childhood physical and sexual abuse to adult bipolar disorder. Bipolar Disord. 2000; 2(2): 131-5.
• Dodd A, Lockwood E, Mansell W, Palmier-Claus J. Emotion regulation strategies in bipolar disorder: a systematic and critical review. J Affect Disord. 2019; 246: 262-84.
• Green MJ, Lino BJ, Hwang E-J, Sparks A, James C, Mitchell PB. Cognitive regulation of emotion in bipolar I disorder and unaffected biological relatives. Acta Psychiatr Scand. 2011: 124(4): 307-16.
• Rowland JE, Hamilton MK, Lino BJ, Ly P, Denny K, Hwang EJ, et al. Cognitive regulation of negative affect in schizophrenia and bipolar disorder. Psychiatry Res. 2013; 208(1): 21-8.
• Eisenberg N, Fabes RA. Emotion and its regulation in early development: New directions for child development. San Francisco: Jossey- Bass; 1992.
• Hall K, Dunner DL, Zeller G, Fieve RR. Bipolar illness: a prospective study of life events. Comp Psychiatry. 1977; 18(5): 497-502.
• Ak M, Lapsekili N, Hacıömeroğlu B, Sütçügil L, Türkçapar H. Early maladaptive schemas in bipolar disorder. Psychol Psychother. 2012; 85(3): 260-7.
• Folkman S, Moskowitz JT. Coping: pitfalls and promise. Annual Review of Psychology. 2004; 55: 745–74.
• Parikh SV, Velyvis V, Yatham L, Beaulieu S, Cervantes P, Macqueen G, et al. Coping styles in prodromes of bipolar mania. Bipolar Disorders. 2007; 9(6): 589–95.
• Coulston CM, Bargh DM, Tanious M, Cashman EL, Tufrey K, Curran G. Is coping a well matter of personality? A study of euthymic unipolar and bipolar patients. J Affect Disord. 2013; 145(1): 54-61.
• Usta H, Güleç H, Hariri AG, Yazıcı Güleç M. The effect of cluster B personality disorder comorbidity on the coping styles in patient with bipolar disorder. Anadolu Psikiyatri Dergisi. 2015; 16(4): 247-54.