Duygusal Kırılganlık Faktörlerinin Obsesif-Kompulsif Bozukluk ve Majör Depresyon Bozukluğundaki Tanılar Üstü Rolü

Abstract

Çeşitli psikopatolojilerin altında yattığı düşünülen tanılar üstü risk faktörleriyle ilgili araştırmalar, mevcut psikiyatrik sınıflandırma sistemleri ve tedavi seçenekleri açısından önemli değişiklikleri beraberinde getirme potansiyeline sahiptir. Bu çalışmanın amacı duygusal kırılganlık faktörleri olan kaygı duyarlılığı, sıkıntı toleransı ve anhedoninin obsesif-kompulsif (OK) belirtiler ve depresyon belirtileri ile ilişkilerini tespit etmek ve bu faktörlerin yaş aralığı 18-64 olan obsesif-kompulsif bozukluk (OKB) tanılı (n=37), majör depresyon bozukluğu (MDB) tanılı (n=47) ve sağlıklı bireylerden oluşan (n=70) üç grupta farklılaşıp farklılaşmadığını incelemektir. Çalışma deseni kesitsel ve ilişkiseldir. Veriler Demografik Bilgi Formu, Yale-Brown Obsesyon Kompulsiyon Ölçeği-Öz Bildirim Formu, Beck Depresyon Envanteri, Sıkıntıya Dayanma Ölçeği, Anksiyete Duyarlılığı İndeksi-3 ve Snaith-Hamilton Keyif Alma Ölçeği kullanılarak toplanmıştır. Tüm örneklemde yapılan Pearson korelasyon analizleri OK ve depresif belirtilerin tanılar üstü faktörlerle beklenen yönde ve istatistiksel açıdan anlamlı ilişkilerine işaret ederken; yalnızca klinik örneklemde yürütülen korelasyon analizleri farklı sonuçlara işaret etmiştir. Tanılar üstü faktörlerin OKB tanılı, MDB tanılı ve sağlıklı kişilerden oluşan üç grupta farklılaşıp farklılaşmadığı tek yönlü varyans analizleriyle incelenmiştir. Post-hoc testleri sağlıklı bireylerin kaygı duyarlılığı (x=16.16, SS=12.65), sıkıntı toleransı (x=54.75, SS=12.69) ve anhedoni (x=.36, SS=1.06) puan ortalamalarının klinik grupların puanlarından istatistiksel açıdan anlamlı düzeyde farklılaştığını gösterirken; OKB (x KD=38.78, SSKD=18.58, x ST=36.97, SSST=12.23, x AH=4.81, SSAH=4.65) ile MDB (x KD=35.79, SSKD=15.34, x ST=36.32, SSST=10.88, x AH=4.63, SSAH=3.72) grupları arasında tanılar üstü faktörler açısından istatistiksel olarak anlamlı fark yoktur. Bulgular ilgili alan yazını ışığında tartışılmış ve klinik uygulama önerilerinde bulunulmuştur.

Keywords

• anhedoni
• kaygı duyarlılığı
• majör depresyon bozukluğu
• obsesif-kompulsif bozukluk
• sıkıntı toleransı

The Transdiagnostic Tole of Emotional Vulnerability Factors in Obsessive-Compulsive Disorder and Major Depressive Disorder

Abstract

Research on transdiagnostic risk factors, which underlie various psychopathologies, has the potential to bring about significant changes in current psychiatric classification systems and treatment options. The aim of this study was to determine the association of obsessive-compulsive (OC) and depressive symptoms to emotional vulnerability factors of anxiety sensitivity, distress tolerance, and anhedonia and to investigate whether these factors significantly differ across three groups of people diagnosed with obsessive-compulsive disorder (OCD) (n=37), major depressive disorder (MDD) (n=47), and healthy controls (n=70) whose ages ranged from 18 to 64. Study design was cross-sectional and correlational. Data were collected using the Demographic Information Form, Yale-Brown Obsessive Compulsive Scale-Self Report, Beck Depression Inventory, Distress Tolerance Scale, Anxiety Sensitivity Index-3, and Snaith-Hamilton Pleasure Scale. Pearson correlation analyses calculated for the entire sample indicated that OC and depressive symptoms were statistically significantly associated with the transdiagnostic factors in expected directions, while correlations calculated solely for the clinical groups yielded different results. One-way analyses of variance were run to investigate whether the transdiagnostic factors differed significantly across the three groups of OCD, MDD, and healthy controls. Post-hoc tests revealed that while healthy controls had significantly different anxiety sensitivity (M=16.16, SD=12.65), distress tolerance (M=54.75, SD=12.69), and anhedonia (M=.36, SD=1.06) mean scores compared to the clinical groups, OCD (MAS=38.78, SDAS=18.58, MDT=36.97, SDDT=12.23, MAH=4.81, SDAH=4.65) and MDD (MAS=35.79, SDAS=15.34, MDT=36.32, SDDT=10.88, MAH=4.63, SDAH=3.72) groups did not have significantly different scores on the transdiagnostic variables. Findings were discussed in light of the relevant literature and recommendations for clinical practice were provided.

Keywords

• anhedonia
• anxiety sensitivity
• major depressive disorder
• obsessive-compulsive disorder
• distress tolerance

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