TY - JOUR T1 - Deprem Sonucu Gelişen Travma Sonrası Stres Bozukluğu ile Kişilik Bozuklukları Arasında İlişki TT - The Relationship between Personality Disorders and Post-Traumatic Stress Disorder Developed After Earthquake AU - Özçetin, Adnan AU - Maraş, Abdullah AU - Ataoğlu, Ahmet AU - İçmeli, Celalettin PY - 2008 DA - July JF - Duzce Medical Journal JO - Duzce Med J PB - Duzce University WT - DergiPark SN - 1307-671X SP - 8 EP - 18 VL - 10 IS - 2 LA - tr AB - Giriş ve Amaç: Travma sonrası stres bozukluğu (TSSB) maruz kalınan travma ile ilişkilidir, ancak tek belirleyici travma değildir. Kişilik bozuklukları ile TSSB arasındaki ilişki tartışılmaktadır. Biz kişilik bozukluğu olanlarda TSSB’nin daha kolay geliştiğini ileri sürerek bu çalışmayı planladık. Gereç ve Yöntem: Çalışmamızı 17 Ağustos ve 12 Kasım 1999’da iki şiddetli deprem yaşayan Düzce’de yaptık. Travma birimine yönlendirilen 18 yaş üstü 109 hastadan klinisyen tarafından travma sonrası stres bozukluğu ölçeği (CAPS) ile TSSB tanısı konan 62 hasta çalışmaya alındı. Bunlara SCID-II, yaşam olaylarının etkisi ölçeği (IES) ve sosyodemografik bilgi formu uygulandı. Bulgular: Hastaların 35’inde (%56,5) kişiliği bozukluğu bulundu., kalan 27 hastada (%43,5) kişilik bozukluğu yoktu. 62 hastanın 54‘ü kadındı. Diğer sosyodemoğrafik değişkenler açısından iki grup arasında istatistiksel fark yoktu, sadece sosyal güvence oranı kişilik bozukluğu olmayanlarda daha yüksekti(MWU:312500, z:-2.303, p:0.021 ). Kişilik bozukluğu olan 35 hastada toplam 52 adet kişilik bozukluğu tanısı kondu. Bunların %84,7’sini kaçıngan, obsesif-kompulsif, bağımlı ve paranoid kişilik bozuklukları oluşturuyordu. Kişilik bozukluğu olan ve olmayan iki grup arasında CAPS alt ölçekleri ve IES alt ölçekleri puanları açısından istatistiksel anlamlı fark yoktu. Sonuç: Bulgularımız bize kişilik bozukluğunun TSSB şiddeti üzerinde belirleyici olmadığını, ancak TSSB’nin ortaya çıkışını belirleyen önemli bir faktör olduğunu düşündürmektedir KW - Travma sonrası stres bozukluğu KW - kişilik bozukluğu KW - deprem N2 - Introduction and Aim: Posttraumatic stress disorder (PTSD) is related to the trauma exposed, yet not the single predictive one. The relationship between personality disorders and PTSD has not been fully determined. We planned the present study claiming that personality disorders can facilitate the development of PTSD. Material and Method: We conducted the current study in Duzce where two severe earthquakes occurred on 17th August and 12th November 1999. One- hundred and nine patients above 18 years of age were referred to psychiatry trauma unit from the general psychiatry out-patient clinic. CAPS scale was administered to these patients and 62 patients diagnosed with PTSD were included in this study. We administered SCID-II, IES, and sociodemographic data form to these patients. Results: We found personality disorder in 35 patients (56.5%). No personality disorder was found in the remaining 27 patients (43.5%). There was no statistical difference between two groups with regar do other sociodemographic characteristics. Only social security rate was higher in patients who had not personality disorder (MWU: 312500, z:-2.303, p: 0.021). Fifty-two elements of personality disorders were diagnosed in 35 patients with personality disorders. 84.7% of these included avoidant, obsessive compulsive, dependant, and paranoid personality disorders. No statistically significant difference was found between the groups with or without personality disorder with regard to CAPS subscales and IES subscales scores. Conclusion: Our findings suggest that personality disorder has not a predictive role on PTSD but it is an important factor in the development of this disorder CR - Helzer JE, Robins LN, McEvoy L. Post- traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey. N Engl J Med. Dec 24;317:1630-1634, 1987 CR - Kaplan HI, Sadock BJ (Eds). Anxiety disorders. In:Kaplan and Sadock’s Synopsis of psychiatry. Mass Publishing Co. Egypt. pp.581-628, 1998 CR - Hammond KW, Scurfield RM, Risse SC. Post-Traumatic Stress Disorder. In Current Psychiatric Therapy. Philadelphia, Edited by Dunner D.L, W.B. Sounders Company, 288-295, 1993 CR - Labbate L.A, Snow M.P. Posttraumatic Stress Sympyoms Among Soldires Exposed to Combat in Persion Gult. Hospital and Community Psychiatry, 43:831-833, 1992 CR - Breslau N, Kessler RC, Chilcoat HD, Schultz LR, Davis GC, Andreski P. Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Arch Gen Psychiatry. 55: 626-632, 1998 CR - McFarlane AC: The phenomenology of posttraumatic stress disorders following a natural disaster. J Nerv Ment Dis. 176: 22- 29, 1988 CR - Cohn J, Danielsen L, Holzer KI, Koch L, Severin B, Thogersen S, Aalund O. A study of Chilean refugee children in Denmark. Lancet. 24; 2:437-438, 1985 CR - Davitson JRT, Fairbank J: Position Paper on epidemiology of PTSD. Paper Prepared for the DSM-IV Workgroup on Posttraumatic Stress Disorder, 1989. CR - Breslau N, Davis GC. Posttraumatic stress disorder in an urban population of young adults: risk factors for chronicity. Am J Psychiatry. 149: 671-675, 1992 CR - Engdahl BE, Speed N, Eberly RE. Schwartz J. Comorbidity of psychiatric disorders and personality profiles of American World War II prisoners of war.J Nerv Ment Dis. 179: 181-187, 1991 CR - Resnick HS, Foy DW, Donahoe CP, Miller EN. Antisocial behavior and post- traumatic stress disorder in Vietnam veterans. J Clin Psychol. 45: 860-866, 1989 CR - American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition (DSM- IV), Washington DC. American Psychiat- ric Association 1994 CR - Personality disorders. Kaplan HI, Sadock BJ (Eds). In:Kaplan and Sadock’s Synopsis of psychiatry. Mass Publishing Co. Egypt. pp.775-796, 1998 CR - Gökalp PG. Kişilik bozukluklarının epidemiyolojisi. Doğan O, Çelikkol A (Eds.). In:Psikiyatrik epidemiyoloji. Ege Psikiyatri Yayınları. İzmir 2002 CR - Southwick SM, Yehuda R, Giller EL Jr. Personality disorders in treatment-seeking combat veterans with posttraumatic stress disorder. Am J Psychiatry. 150:1020-1023, 1993 CR - Sherwood RJ, Funari DJ, Piekarski AM. Adapted character styles of Vietnam veterans with Posttraumatic Stress Disorder. Psychol Rep. 66: 623-631, 1990 CR - Weyermann AG, Norris FH, Hyer LA. Examining co morbidity and posttraumatic stress disorder in a Vietnam veteran population using the MMPI-2. J Trauma Stress. 9:353-360, 1996 CR - Hyer L, Davis H, Woods G, Albrecht JW, Boudewyns P. Relationship between the Millon Clinical Multiaxial Inventory and the Millon-II: value of scales for Aggressive and Self-defeating personalities in Posttraumatic Stress Disorder. Psychol Rep. 71: 867-879, 1992 CR - Holeva V, Tarrier N. Personality and peritraumatic dissociation in the prediction of PTSD in victims of road traffic accidents. J Psychosom Res. 51: 687-692, 2001 CR - Bramsen I, van der Ploeg HM. Fifty years later: the long-term psychological adjustment of ageing World War II survivors.Acta Psychiatr Scand. 100: 350- 358, 1999 CR - Bollinger AR, Riggs DS, Blake DD, Ruzek JI. Prevalence of personality disorders among combat veterans with posttraumatic stress disorder. J Trauma Stress. 13:255- 270, 2000 CR - Blake DD, Weathers FW, Nagy LM, et.al. The development of a Clinician- Administered PTSD Scale. J Trauma Stress. 8: 75-90, 1995 CR - Aker AT, Özeren M, Başoğlu M, Kaptanoğlu C, Erol A, Buran B. Klinisyen Tarafından Uygulanan Travma Sonrası Stres Bozukluğu Ölçeği (TSSB-Ö)- Geçerlik ve Güvenilirlik Çalışma- sı. 10: 286-293, 1999 CR - Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 41:209-218, 1979 CR - Dreessen L, Arntz A. Short-interval test- retest interrater reliability of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) in outpatients. J Personal Disord. 12:138-148, 1998 CR - Coşkunol H, Bağdiken İ, Sorias S ve ark. SCID-II (Türkçe versiyonu) görüşmesinin kişilik bozukluklarındaki güvenilirliği. Türk Psikoloji Dergisi, 9: 26-29, 1994 CR - Faustman WO, White PA. Diagnostic and psychopharmacological treatment charac- teristics of 536 inpatients with posttrau- matic stress disorder. J Nerv Ment Dis. 177: 154-159, 1989 CR - Fleming R, Baum A, Singer JE. Toward an integrative approach to the study of stress. J Pers Soc Psychol. 46:939-949, 1984 CR - Folkman S, Lazarus RS, Dunkel-Schetter C, DeLongis A, Gruen RJ. Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes. J Pers Soc Psychol. 50: 992-1003, 1986 CR - Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol. 56: 267-283, 1989 CR - Richman H, Frueh BC. Personality disorder symptomatology among Vietnam veterans with combat-related PTSD. Anxiety, 2:286-295, 1996 CR - Yen S, Shea MT. Recent developments in research of trauma and personality disorders. Curr Psychiatry Rep. 3: 52-58, 2001 CR - Liao SC, Lee MB, Lee YJ, Weng T, Shih FY, Ma MH. Association of psychological distress with psychological factors in rescue workers within two months after a major earthquake. J Formos Med Assoc. 101: 169-176,2002 UR - https://dergipark.org.tr/en/pub/dtfd/issue//610974 L1 - https://dergipark.org.tr/en/download/article-file/793215 ER -