Separation individuation process in adolescents with eating disorders and its impact on resilience

Year 2025, Volume: 50 Issue: 1, 168 - 180, 31.03.2025

Ezgi Çetin Gök , İrem Damla Çimen

https://doi.org/10.17826/cumj.1550449

Abstract

Purpose: The present study aimed to examine the relationship between eating disorders, resilience and the separation-individuation (SI) process in adolescents.
Materials and Methods: The study included 49 adolescents with eating disorders and 126 adolescents as a control group. Control group did not have any psychiatric diagnosis or were diagnosed with conditions categorized under "neurodevelopmental disorders". K-SADS-PL-DSM-5 diagnostic interview was conducted with the case group. All adolescents in the study filled in self‐reported questionnaires.
Results: When the adolescents in the case group were compared with the control group; having divorced parents, caregiving by relatives, having a history of anxiety and mood disorders comorbidity, parental eating attitude problems, history of traumatic experiences were found to be higher and school achievement was found to be lower. In the case group, separation-individuation subscales, including "need denial", "separation anxiety", "engulfment anxiety", "teacher enmeshment", and "rejection expectancy" were found to be higher compared to the control group. Resilience scores in the case group (37.00) were found to be significantly lower than those in the control group (48.00). In addition, there was a positive correlation between resilience scores and 'nurturance seeking' (r=0.364, p=0.01), and a negative correlation between resilience scores and ‘rejection expectancy' (r=-0.447, p<0.01) and 'engulfment anxiety' (r=-0.283, p=0.48).
Conclusion: Our study found associations between eating disorders and adolescents' exposure to adverse life events, unhealthy navigation of separation-individuation processes, and lower levels of psychological resilience. Approaches to increase resilience can reduce the risk of psychopathology. It is also believed that providing informative psychological counseling services to families, and offering seminars on healthy separation-individuation processes may also prove beneficial. In future research, conducting longitudinal studies would be beneficial for establishing causal relationships among variables.

Keywords

Separation-individuation, adolescents, psychological resilience, eating disorders, negative life events

Ethical Statement

The study protocol was approved by Kocaeli University Medical Faculty Non-Interventional Clinical Research Ethics Committee. Informed consent was obtained from all participants and their families.

Supporting Institution

The authors declared that this study has received no financial support.

Yeme bozukluğu olan ergenlerde ayrışma bireyselleşme süreci ve bu özelliklerin dayanıklılığa etkisi

Abstract

Amaç: Çalışmamızda ayrılma-bireyleşme özelliklerinin ve psikolojik dayanıklılığın yeme bozukluğu ile ilişkisini incelemek amaçlanmıştır.
Gereç ve Yöntem: Çalışmamıza yeme bozukluğu tanılı, 12 – 18 yaş arası 49 ergen ve aynı yaşlar arasında nörogelişimsel bozukluk tanılı veya herhangi bir psikopatoloji saptanmayan 126 ergen dahil edilmiştir. Olgu grubu ile K-SADS-PL-DSM-5 tanı görüşmesi yapılmıştır. Ergenlerden özbildirim ölçeklerini doldurmaları istenmiştir.
Bulgular: Olgu grubundaki ergenlerde kontrol grubuna göre; boşanmış anne-babaya ve parçalanmış aileye sahip olma, akraba tarafından bakım verilme, anksiyete ve duygudurum bozuklukları eş tanısının olma, anne ve babalarında yeme tutum sorunları, travmatik yaşantı öyküsü oranı daha yüksek, okul başarısı ise daha düşük bulunmuştur. Yeme bozukluğu tanısı bulunan ergenlerin ayrılma-bireyleşme alt ölçeklerinden; ihtiyacı inkar etme, ayrılma anksiyetesi, yutulma anksiyetesi, öğretmene yapışma ve reddedilme beklentisi puanları kontrol grubundaki ergenlere göre daha yüksek saptanmıştır (). Psikolojik dayanıklılık puanları ise olgu grubunda (37.00) kontrol grubuna (48.00) göre daha düşük saptanmıştır. Ayrılma-bireyleşme alt ölçeklerinden bakım arama (r=0.364, p=0.01) ile dayanıklılık arasında pozitif yönde; reddedilme beklentisi (r=-0.447, p<0.01) ve yutulma anksiyetesi (r=-0.283, p=0.48) ile dayanıklılık arasında negatif yönde ilişki gözlenmiştir.
Sonuç: Çalışmamızda ergenlerin olumsuz yaşam olaylarına maruz kalmasının, ayrılma-bireyleşme sürecinde problem yaşamalarının ve dayanıklılık düzeylerinin düşük olmasının yeme bozukluğu ile ilişkili olduğu bulunmuştur. Yeme bozukluklarının gelişimini önlemek için klinik görüşmelerde çocukluk döneminde meydana gelen olumsuz yaşam olaylarının fark edilmesi, ergenler ve ebeveynler ile ayrılma-bireyleşme sürecini sağlıklı atlatmaları açısından çalışılması ve dayanıklılığı arttırmaya yönelik girişimlerde bulunulmasının faydalı olabileceği düşünülmektedir. Gelecekteki araştırmalarda boylamsal çalışmaların yapılması neden-sonuç ilişkisi kurabilmek için faydalı olacaktır.

Keywords

Ayrılma-bireyleşme, ergenler, psikolojik dayanıklılık, yeme bozuklukları, olumsuz yaşam olayları

Ethical Statement

The study protocol was approved by Kocaeli University Medical Faculty Non-Interventional Clinical Research Ethics Committee. Informed consent was obtained from all participants and their families.

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