Kendine zarar verme davranışı olan ergenlerde duyu profili, duygu düzenleme güçlükleri ve yürütücü işlevlerin incelenmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda, kendine zarar verme davranışı (KZVD) olan ergenler sosyodemografik veriler, klinik özellikler, duyu profili, duygu düzenleme güçlükleri ve yürütücü işlevler açısından değerlendirilmiş, sağlıklı kontrollerle karşılaştırılmıştır. Çalışmamızın örneklemini, 12-18 yaş ergenler ve bir bakımvereni oluşturmaktadır. Araştırma grubu olarak, Trakya Üniversitesi Tıp Fakültesi Hastanesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Polikliniği'ne 18.10.2022-18.04.2023 tarihleri arasında başvuran veya halen polikliniğimizde takip edilmekte olan, son 1 yılda en az 5 defa olmak üzere kendine zarar verici davranışı olan 60 ergen alınmıştır. Sağlıklı kontrol grubu olarak, Trakya Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Genel Pediatri Polikliniği'nde değerlendirilen çalışmamızın dahil edilme kriterlerini karşılayan 55 ergen alınmıştır. Araştırmaya dahil edilen tüm olgular ve bakım verenleri ile ayrı ayrı görüşme yapılmış ve araştırmacı tarafından sosyodemografik veri formu doldurulmuştur. KZVD grubuna dahil edilen olgulara, Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Versiyonu-DSM 5-Türkçe Uyarlaması ve Kendine Zarar Verme Davranışı Değerlendirme Envanteri uygulanmıştır. Tüm olgulara; Çocuklarda Anksiyete ve Depresyon Ölçeği Yenilenmiş Çocuk Formu (ÇADÖ-Y), Duygu Düzenlemede Güçlükler Ölçeği Kısa Formu (DDGÖ-16) ve Adölesan/Yetişkin Duyu Profili (AYDP); bakım verenlerine ise Yürütücü İşlevleri Davranışsal Değerlendirme Envanteri Ebeveyn Formu (BRİEF) uygulanmıştır. KZVD grubundaki ergenler, Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Versiyonu- DSM 5- Türkçe Uyarlaması'nda saptanan birincil tanılarına göre alt gruplara ayrılmıştır. Çalışmamızda, KZVD grubundaki ergenlerin tespit edilen birincil tanılarına göre, %48,3'ü depresyon bozuklukları, %30'u anksiyete bozuklukları ve %21,6'sı yıkıcı davranış bozuklukları grubuna alınmıştır. KZVD olan ergenlerde; en sık kendine zarar verme yönteminin sert bir yere veya kendine vurma ve kesme davranışı olduğu, en sık kullanılan KZVD işlevinin afekt regülasyonu olduğu saptanmıştır. KZVD alt grupları arasında KZVD'nin kendini cezalandırma işlevi açısından anlamlı farklılık saptanmıştır (p<0,05). AYDP'nin düşük kayıt ve duyusal hassasiyet kadranında, KZVD grubu, sağlıklı kontrollerden anlamlı olarak daha yüksek puanlar almıştır (p<0,001). KZVD grubunun ÇADÖ-Y, DDGÖ-16 ve BRİEF alt ölçeklerinde aldığı puanlar, sağlıklı kontrollerden anlamlı olarak daha yüksek bulunmuştur. DDGÖ-16'nın açıklık ve dürtü puanlarının, KZVD'yi yordayıcı özellik gösterdiği tespit edilmiştir. KZVDDE'nin otonom işlevlere bağımsız olarak etki eden değişkenlerin, DDGÖ 16'nın dürtü ve kabul etmeme puanları olduğu; KZVDDE'nin sosyal işlevlerine bağımsız olarak etki eden değişkenin, BRIEF'in izleme puanları olduğu bulunmuştur. Çalışmamızda kullanılan ölçeklerin birbiri ile korelasyonuna bakıldığında; KZVD sergileyen ergenlerin total anksiyete ve depresyon puanları ve duygu düzenleme güçlükleri arttıkça duyu profilinde düşük kayıt, duyusal hassasiyet ve duyusal kaçınma sergilemelerinin arttığı tespit edilmiştir. Çalışmamızın sonuçları, duyusal uyaranları düzenleyip, günlük aktivitelere uyumlu çıktılar elde etmekte sorun yaşayan ergenlerin, özellikle değişken durumlar karşısında duygusal yanıtlarını düzenlemekte zorlandıkları ve bu nedenle, KZVD gibi uyumsuz baş etme stratejilerine yöneldiklerini göstermektedir.
In our study, adolescents with nonsuicidal self injury (NSSI) were evaluated in terms of sociodemographic and cninical characteristics, sensory profile, emotion regulation difficulties and executive functions, and compared with healthy controls. The sample of our study consists of 12-18 year old adolescents and a caregiver. As the research group, 60 adolescents were recruited, those who applied to Trakya University Faculty of Medicine Child and Adolescent Psychiatry Outpatient Clinic between 18.10.2022- 18.04.2023 or are still being followed up in our outpatient clinic, who have self-harming behavior at least 5 times in the last 1 year. As the healthy control group, 55 adolescents who met the inclusion criteria of our study, which were evaluated in Trakya University Faculty of Medicine Pediatrics General Pediatrics Outpatient Clinic, were recruited. Separate interviews were conducted with all the cases and their caregivers included in the study, and a sociodemographic data form was filled in by the researcher. Affective Disorders and Schizophrenia Interview Schedule-Now and Lifetime Version-DSM 5-Turkish Version for School-Age Children and Inventory of Statements About Self Injury were applied to the subjects included in the NSSI group. All adolescents participating in the study completed the Revised Child Anxiety and Depression Scale (RCADS-CV), Emotion Regulation Scale-Brief Form (DERS-16), Adolescent/Adult Sensory Profile (AASP). One caregiver of each adolescent participating in the study completed the Behavior Rating Inventory of Executive Functions Parent Form (BRIEF). Adolescents in the NSSI group were divided into subgroups according to their primary diagnosis determined in the Affective Disorders and Schizophrenia Interview Schedule-Now and Lifetime Version-DSM 5-Turkish Version for School-Age Children. In our study, 48.3% of the adolescents in the NSSI group were included in the depression disorders subgroup, 30% anxiety disorders subgroup and 21.6% disruptive behavior disorders subgroup according to their primary diagnoses determined according to the Affective Disorders and Schizophrenia Interview Schedule-Now and Lifetime Version-DSM 5-Turkish Version for School-Age Children. It was determined that the most common method of NSSI in adolescents with NSSI was cutting and hitting a hard place or self, and the most frequently used NSSI function was affect regulation. There was a significant difference between NSSI subgroups in terms of self punishment function of NSSI (p<0,05). In the low registration and sensory sensitivity quadrant of the AASP, the NSSI group scored significantly higher than the healthy controls (p<0.001). The scores of the NSSI group on the RCADS-CV, DERS-16 and BRIEF subscales were found to be significantly higher than the healthy controls. It was determined that the clarity and impulse scores of the DERS-16 were predictive of NSSI. It was found that the variables that affect intrapersonal functions independently are the nonaccept and impulse scores of DERS-16, and the variable that affects interpersonal functions independently is the monitor scores of BRIEF. Considering the correlation of the scales used in NSSI group with each other; it has been determined that as the total anxiety and depression scores and emotion regulation difficulties of adolescents exhibiting NSSI increase, they exhibit low registration, sensory sensitivity and sensory avoidance in the sensory profile. The results of our study show that adolescents who have problems in modulating sensory stimuli appropriately and obtaining outputs compatible with daily activities have difficulty in regulating their emotional responses, especially in the face of variable situations, and therefore they tend to maladaptive coping strategies such as NSSI.
In our study, adolescents with nonsuicidal self injury (NSSI) were evaluated in terms of sociodemographic and cninical characteristics, sensory profile, emotion regulation difficulties and executive functions, and compared with healthy controls. The sample of our study consists of 12-18 year old adolescents and a caregiver. As the research group, 60 adolescents were recruited, those who applied to Trakya University Faculty of Medicine Child and Adolescent Psychiatry Outpatient Clinic between 18.10.2022- 18.04.2023 or are still being followed up in our outpatient clinic, who have self-harming behavior at least 5 times in the last 1 year. As the healthy control group, 55 adolescents who met the inclusion criteria of our study, which were evaluated in Trakya University Faculty of Medicine Pediatrics General Pediatrics Outpatient Clinic, were recruited. Separate interviews were conducted with all the cases and their caregivers included in the study, and a sociodemographic data form was filled in by the researcher. Affective Disorders and Schizophrenia Interview Schedule-Now and Lifetime Version-DSM 5-Turkish Version for School-Age Children and Inventory of Statements About Self Injury were applied to the subjects included in the NSSI group. All adolescents participating in the study completed the Revised Child Anxiety and Depression Scale (RCADS-CV), Emotion Regulation Scale-Brief Form (DERS-16), Adolescent/Adult Sensory Profile (AASP). One caregiver of each adolescent participating in the study completed the Behavior Rating Inventory of Executive Functions Parent Form (BRIEF). Adolescents in the NSSI group were divided into subgroups according to their primary diagnosis determined in the Affective Disorders and Schizophrenia Interview Schedule-Now and Lifetime Version-DSM 5-Turkish Version for School-Age Children. In our study, 48.3% of the adolescents in the NSSI group were included in the depression disorders subgroup, 30% anxiety disorders subgroup and 21.6% disruptive behavior disorders subgroup according to their primary diagnoses determined according to the Affective Disorders and Schizophrenia Interview Schedule-Now and Lifetime Version-DSM 5-Turkish Version for School-Age Children. It was determined that the most common method of NSSI in adolescents with NSSI was cutting and hitting a hard place or self, and the most frequently used NSSI function was affect regulation. There was a significant difference between NSSI subgroups in terms of self punishment function of NSSI (p<0,05). In the low registration and sensory sensitivity quadrant of the AASP, the NSSI group scored significantly higher than the healthy controls (p<0.001). The scores of the NSSI group on the RCADS-CV, DERS-16 and BRIEF subscales were found to be significantly higher than the healthy controls. It was determined that the clarity and impulse scores of the DERS-16 were predictive of NSSI. It was found that the variables that affect intrapersonal functions independently are the nonaccept and impulse scores of DERS-16, and the variable that affects interpersonal functions independently is the monitor scores of BRIEF. Considering the correlation of the scales used in NSSI group with each other; it has been determined that as the total anxiety and depression scores and emotion regulation difficulties of adolescents exhibiting NSSI increase, they exhibit low registration, sensory sensitivity and sensory avoidance in the sensory profile. The results of our study show that adolescents who have problems in modulating sensory stimuli appropriately and obtaining outputs compatible with daily activities have difficulty in regulating their emotional responses, especially in the face of variable situations, and therefore they tend to maladaptive coping strategies such as NSSI.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Psikiyatri, Psychiatry
