Depremin Otizm Spektrum Bozukluğu Olan Çocukların Anneleri Üzerindeki Olumsuz Etkileri

Öz

Travmatik olaylar, yaşamın doğal akışını bozan ve her zaman var olan durumlardır. Bireylerin yaşam serüveni içinde travmatik bir olayla karşılaşma yaygınlığı %21.4 ile %89.6 arasında değişmektedir. Deprem gibi travmatik olaylara tanık olmak, derinlemesine etkileyen, kaygı ve strese yol açan deneyimlerdir. Afetlere maruz kalmak, genel bir sıkıntı hali, endişe, korku, tekrarlayan rahatsız edici anılar ve depresyon belirtilerine yol açabilir. Bu durum, etkilenen bireylerin yaşam kalitesini ve psikososyal işlevselliğini ciddi şekilde bozabilir. Bu araştırmanın amacı, Türkiye’de yaşanan 6 şubat depremi sonrasında, depremin yarattığı olumsuzlukların çocukları otizm spektrum bozukluğuna (OSB) sahip anneler üzerindeki psikolojik etkilerini araştırmaktır. Aynı zamanda araştırma bu annelerin yaşadığı olumsuz durumları ve diğer psikolojik sorunlarını belirlemeyi ve bu sorunlarla başa çıkma stratejilerini anlamayı hedeflemektedir. Niteliksel ve betimleyici bir araştırma yöntemi kullanılmıştır. Veriler, katılımcılarla yapılan derinlemesine görüşmeler ve odak grup tartışmaları yoluyla toplanmıştır. Bu yöntem, katılımcıların yaşadığı duygusal ve bilişsel süreçlerin daha derinlemesine anlaşılmasını ve detaylı bir analiz yapılmasını sağlamıştır. Araştırma, otizm spektrum bozukluğuna sahip çocukları olan annelerin, travma sonrası stres belirtilerinde artma ve diğer ruh sağlığı sorunlarına karşı daha savunmasız olduğunu ortaya koymaktadır. Otizm spektrum bozukluğu olan çocukların özel gereksinimleri sürekli bakım ve gözetim gerektirdiğinden, annelerin uzun vadede stres düzeylerini artırarak psikolojik sorunlar yaşamalarına yol açarken, deprem gibi büyük çaplı bir travmatik olay, çocukların düzen ve istikrar gereksinimi üzerinde olumsuz etkiler yaratarak, annelerin güvenlik ve kontrol duygularını zedeleyerek, travma sonrası stres belirtilerini artırarak ek bir psikolojik yüke neden olmaktadır. Sonuç olarak, bu tür desteklerin sağlanması, afet sonrası psikolojik dayanıklılığı artırmada kritik bir rol oynayabilir.

Anahtar Kelimeler

• otizm spektrum bozukluğu
• travmatik olaylar
• depreme tepkiler

The Negative Effects of the Earthquake on Mothers of Children with Autism Spectrum Disorder

Öz

There have always been events that dislocated the processes of life. The prevalence of experiencing a traumatic event in life has been variably reported from 21.4% to 89.6%. Traumatic events related to earthquakes, as experienced here, are among such experiences which are highly influencing in nature and inducing anxiety and stress. Such a condition may lead to a severe impairment in quality of life and psychosocial functioning. The aim of this research is to investigate the psychological effects of the earthquake on mothers of children with autism spectrum disorder(ASD) after the February 6 earthquake in Turkey. At the same time, the research aims to determine the negative situations and other psychological problems experienced by these mothers and to understand their coping strategies. This is a qualitative and hence descriptive research method. Data collection is through in-depth interviews and focus group discussions with the participants. In this way, one obtains an in-depth understanding and elaborate analysis of the emotional and cognitive processes the participants go through. While the special needs of children with autism spectrum disorder require constant care and supervision, increasing the mothers’ stress levels in the long term and leading them to develop psychological problems, a large-scale traumatic event such as an earthquake causes an additional psychological burden by creating adverse effects on children’s need for order and stability, damaging feelings of security and control of mothers, and increasing symptoms of post-traumatic stress. Finally, such support has the potential to help raise psychological resilience after a disaster.

Anahtar Kelimeler

• autism spectrum disorder
• traumatic events
• reactions to earthguake

Kaynakça

1. Afet ve Acil Durum Yönetimi Başkanlığı (AFAD) (2023) 06 Şubat 2023 Pazarcık (Kahramanmaraş) Mw 7.7 ve Elbistan (Kahramanmaraş) Mw 7.6 Depremlerine İlişkin Ön Değerlendirme Raporu.
2. Aker, T. (2006). 1999 Marmara depremi: Epidemiyolojik bulgular ve toplum ruh sağlığı uygulamaları üzerine bir gözden geçirme. Türk Psikiyatri Dergisi, 17(3), 204-212.
3. Alexander, D. E. (2010). The L’Aquila earthquake of 6 April 2009 and Italian Government policy on disaster response. Journal of Natural Resources Policy Research, 2(4), 325-342. Arlikatti, S., Lindell, M. K., Prater, C. S., & Zhang, Y. (2007). Risk area accuracy and hurricane evacuation expectations of coastal residents. Environment and Behavior, 39(2), 225-248. https:// doi.org/10.1177/0013916506296728
4. Arnold, J. L., Durkin, M. E., & Whitaker, S. (1982). An earthquake disaster in Guatemala: An epidemiologic assessment of the relief effort. Annals of Emergency Medicine, 11(1), 7-13. https:// doi.org/10.1016/S0196-0644(82)80005-3
5. Başoǧlu, M., Şalcioǧlu, E., & Livanou, M. (2002). Traumatic stress responses in earthquake survivors in Turkey. Journal of Traumatic Stress: Official Publication of the International Society for Traumatic Stress Studies, 15(4), 269-276.
6. Benight, C. C., Swift, E., Sanger, J., Smith, A., & Zeppelin, D. (1999). Coping self-efficacy as a mediator of distress following a natural disaster. Journal of Applied Social Psychology, 29(12), 2443-2464.
7. Betts, K.,Williams, G. M., Najman, J. M., Bor,W., & Alati, R. (2012). Pre-trauma verbal ability at five years of age and the risk of post-traumatic stress disorder in adult males and females. Journal of Psychiatric Research, 46(7), 933-939. http://dx.doi.org/10.1016/ j.jpsychires. 2012.04.002
8. Blanchard-Boehm, R. D., & Cook, M. J. (2004). Risk communication and public education in Edmonton, Alberta, Canada on the 10th anniversary of the “Black Friday” tornado. International Research in Geographical and Environmental Education, 13(1), 38-54.

9. Breslau, N., Kessler, R. C., Chilcoat, H. D., Schultz, L. R., Davis, G. C., & Andreski, P. (1998). Trauma and posttraumatic stress disorder in the community: The 1996 detroit area survey of trauma. Archives of General Psychiatry, 55, 626-632.
10. Buyuk H. F. (2023) Turkey: Earthquakes Have Cost Economy $103.6 Billion, Balkan Insight News. https://balkaninsight.com/2023/03/17/turkey-earthquakes-have-cost-economy-103-6-billion. Accessed on 5 April 2023.
11. Charman, T. (2014). Early identification and diagnosis of autism spectrum disorders. In Volkmar, F. R. (Ed.) Encyclopedia of Autism Spectrum Disorders (pp. 1115-1119) Springer.
12. Constans, J. I., Vasterling, J. J., Deitch, E., Han, X., Teten Tharp, A. L., Davis, T. D., et al. (2012). PreKatrina mental illness, post-disaster negative cognitions, and PTSD symptoms in male veterans following Hurricane Katrina. Psychological Trauma: Theory, Research, Practice, and Policy, 4(6), 568-577. http://dx.doi.org/10.1037/ a0027487.
13. Coskun G (2023) 49. Gün. Depremde ölü sayısı ne kadar oldu, güncel yaralı sayısı kaç? CnnTurk News https://www.cnnturk.com/turkiye/49-gun-depremde-olu-sayisi-ne-kadar-oldu-guncel-yarali-sayisikachangi-ilde-kac-bina-yikildi-kac-kisi-oldu Accessed 26 March 2023.
14. Davidson, J. R., Hughes, D., Blazer, D. G., & George, L. K. (1989). Post-traumatic stress disorder in the community: An epidemiological study. Psychological Medicine, 21(3), 713-721.
15. Davitson, J. R. T., John, M. D., & Fairbank, A. (1993). The Epidemiology of posttraumatic stres disorder. In R. T. D. Jonathan, & B. Edna (Eds.), Posttraumatic stress disorder: DSM IV and Beyond (pp. 147-173). American Psychiatric Pub.
16. DiGangi, J. A., Gomez, D., Mendoza, L., Jason, L. A., Keys, C. B., Karestan, C., et al. (2013). Pretrauma risk factors for posttraumatic stress disorder: A systematic review of the literature. Clinical Psychology Review, 33(6), 28-44. https://doi.org/10.1016/j.cpr.2013.05.002
17. Drabek, T. E. (1986). Human System Responses to Disaster: An Inventory of Sociological Findings. Springer-Verlag.
18. Ekman, P. (2004, April). What we become emotional about. In Feelings and emotions: The Amsterdam symposium (pp. 119-135) Cambridge University Press.
19. Evans, S. (2023) Verisk (AIR) pegs Turkey quake economic loss at $20bn+, insured at $1bn+. Artemis BMWeb. https://www.artemis.bm/news/verisk-air-pegs-turkey-quake-economic-loss-at-20bninsuredat-1bn Accessed on 26 March 2023.
20. Fergusson, D. M., Horwood, L. J., Boden, J. M., & Mulder, R. T. (2014). Impact of a major disaster on the mental health of a well-studied cohort. JAMA psychiatry, 71(9), 1025-1031.
21. Fountain, C., Winter, A. S., & Bearman, P. S. (2012). Six developmental trajectories characterize children with autism. Pediatrics, 129(5), e1112-e1120.
22. García, L. F., Gutiérrez, F., García, O., & Aluja, A. (2024). The alternative model of personality disorders: Assessment, convergent and discriminant validity, and a look to the future. Annual Review of Clinical Psychology, 20. https://doi.org/10.1146/annurev-clinpsy-081122-010709.
23. Gill, P., Stewart, K., Treasure, E., & Chadwick, B. (2008). Methods of data collection in qualitative research: interviews and focus groups. British dental journal, 204(6), 291-295.
24. Gledhill, J., & Currie, J. L. (2020). Characteristics of teachers’ recommended social support strategies for primary students with ASD. International Online Journal of Primary Education (IOJPE), 9(1), 18-34.
25. Goren M (2023) Depremin Maliyeti Ne Olacak? https://sanayigazetesi.com.tr/depremin-maliyeti-neolacak/Accessed on 5 April 2023 Hamengku Buwono X. (2008). Learning from the 27 May 2006 earthquake. In D. Karnawati (Ed.)The Yogyakarta earthquake of May 27, 2006. Star, pp. xi-xviii.
26. Hammond, K. W., Scurfield, R. M., & Risse, S. C. (1993). Post-Traumatic stress disorder. In D. L. Dunner (Ed.) Current psychiatric therapy. W.B. Sounders, pp. 288-295.
27. Heckhausen, J. (2002). Developmental regulation of life-course transitions: A control theory approach. In L. Pulkkinen, & A. Caspi (Eds.) Paths to successful development: Personality in the life course CUP, pp. 257-280.
28. Hobfoll, S. E. (2002). Social and psychological resources and adaptation. Review of General Psychology, 6(4), 307-324.
29. Hobfoll, S. E., Schroder, K. E. E., Wells, M., & Malek, M. (2002). Communal versus individualistic construction of sense of mastery in facing life challenges. Journal of Social and Clinical Psychology, 21(4), 362-399.
30. Huang, S. K., Lindell, M. K., & Prater, C. S. (2017). Multistage model of hurricane evacuation decision: Empirical study of hurricanes Katrina and Rita. Natural Hazards Review, 18(3), 04017003. https:// doi.org/10.1061/(ASCE)NH.1527-6996.0000244
31. Jiang, N., Cheng, J., Ni, Z., Ye, Y., Hu, R., & Jiang, X. (2021). Developing a new individual earthquake resilience questionnaire: A reliability and validity test. PloS one, 16(1), e0245662.
32. Johnstone, M. L. (2017). Depth interviews and focus groups. Formative research in social marketing: Innovative methods to gain consumer insights, 67-87.
33. Jon, K., Smith, H., & Doe, J. (2016). Emotional Responses during Earthquakes: An Assessment Using the Mood Adjective Checklist. Journal of Disaster Research, 11(2), 101-112.
34. Kaplan, H. I., & Sadock, B. J. (1998). Anxiety disorders. In H. I. Kaplan & B. J. (Eds.) Sadock’s Synopsis of Psychiatry. Williams & Wilkins Co., pp.581-628.
35. Kar, N., & Bastia, B. K. (2006). Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster: A study of comorbidity. Clinical Practice and Epidemiology in Mental Health, 2, 1-7.
36. Krueger, R. A., & Casey, M. A. (2015). Focus group interviewing. In Handbook of practical program evaluation (pp. 506–534). Wiley. https://doi.org/10.1002/9781119171386.ch20
37. Lambert, S. D., & Loiselle, C. G. (2008). Combining individual interviews and focus groups to enhance data richness. Journal of advanced nursing, 62(2), 228-237.
38. Liang, Y., Cheng, J., Ruzek, J. I., & Liu, Z. (2019). Posttraumatic stress disorder following the 2008 Wenchuan earthquake: A 10-year systematic review among highly exposed populations in China. Journal of affective disorders, 243, 327-339.
39. Lindell, M. K. (1994). Perceived risk, actual risk, and behavior: A methodological critique. In R. E. Dunlap, W. Michelson, & G. E. Stout (Eds.) Advances in Environmental Psychology, 4, Academic.
40. Lindell, M. K. (2018). The Dynamics of Disaster Risk Perception and Mitigation. Risk Analysis, 38(1), 99-117.
41. Lindell, M. K., & Perry, R. W. (2004). Communicating environmental risk in multiethnic communities. Sage.
42. Lindell, M. K., Arlikatti, S., & Prater, C. S. (2016). Risk Perception and Protective Actions during Earthquakes: A Cross-Cultural Comparison. Journal of Cross-Cultural Psychology, 47(3), 393-411.
43. Lindell, M. K., Prater, C. S., & Perry, R. W. (2015). Earthquake Risk Perception and Preparedness in the U.S. Pacific Northwest. International Journal of Disaster Risk Reduction, 12, 123-134.
44. Mahmut, E. (2023). Deprem Sonrası Dönemde Erişkin Kişilerin Post Travmatik Stres Bozukluğu, Psikolojik Dayanıklılık ve İlişkili Durumlar Yönünden Değerlendirilmesi. [Yayımlanmamış yüksek lisans tezi] Sağlık Bilimleri Üniversitesi Adana Tıp Fakültesi Aile Hekimliği Kliniği.
45. Matthews, G., Jones, D. M., & Chamberlain, A. G. (1990). Refining the Measurement of Mood: The Mood Adjective Checklist (MACL) Revised. Personality and Individual Differences, 12(3), 287-297.
46. Mawson, A. R. (2005). Understanding mass panic and other collective responses to threat and disaster. Psychiatry, 68(2), 95-113.
47. Mileti, D. S., & Fitzpatrick, C. (1992). The causal sequence of risk communication in the Parkfield earthquake prediction experiment. Public Entity Risk Institute.
48. Mileti, D. S., & Peek, L. (2000). The social psychology of public response to warnings of a nuclear power plant accident. Journal of Hazardous Materials, 75(2-3), 181-194. https://doi.org/10.1016/ S0304-3894(00)00179-5
49. Morgan, D. L. (1996). Focus groups. Annual review of sociology, 22(1), 129-152.
50. Nazeer, A., & Ghaziuddin, M. (2012). Autism spectrum disorders: Clinical features and diagnosis. Pediatric Clinics, 59(1), 19-25.
51. Neuendorf, K. A. (2018). The content analysis guidebook. Sage.
52. Orçan, G., & Karaaziz, M. (2024). Depremi yaşamış yetişkinlerde travma sonrası stres bozukluğu ve travma sonrası büyüme arasındaki ilişkide stresle başa çıkma tarzlarının yordayıcı rolü. International Journal of Social Sciences (IJSS)/ Uluslararasi Sosyal Bilimler Dergisi, 8(34). https://doi.org/10.52096/usbd.8.34.08
53. Orr, S. P., Lasko, N. B., Macklin, M. L., Pineles, S. L., Chang, Y., & Pitman, R. K. (2012). Predicting post-trauma stress symptoms from pre-trauma psychophysiologic reactivity, personality traits and measures of psychopathology. Biology of Mood & Anxiety Disorders, 2(1), 1-12.
54. Özçetin, A., Maraş, A., Ataoğlu, A., & İçmeli, C. (2008). Deprem sonucu gelişen travma sonrası stres bozukluğu ile kişilik bozuklukları arasında ilişki. Duzce Medical Journal, 10(2), 8-18.
55. Özgen, F. ve Aydın, H. (1999). Travma sonrası stres bozukluğu. Klinik Psikiyatri, 1, 34-41.
56. Peek, L., & Mileti, D. S. (2002). The history and future of disaster research. In R. A. Stallings (Ed.) Methods of Disaster Research. Xlibris, pp. 5-18.
57. Perkonigg, A., Kessler, R. C., Storz, S., & Wittchen, H. U. (2000). Traumatic events and post‐traumatic stress disorder in the community: prevalence, risk factors and comorbidity. Acta psychiatrica scandinavica, 101(1), 46-59. https://doi.org/10.1034/j.1600-0447.2000.101001046.x
58. Prati, G., Catufi, V., & Pietrantoni, L. (2012). Emotional Responses to Earthquakes: A Survey of Affective Risk Perceptions. Journal of Environmental Psychology, 32(1), 42-50.
59. Quarantelli, E. L., & Dynes, R. R. (1977). Response to social crisis and disaster. Annual Review of Sociology, 3, 23-49.
60. Rabiee, F. (2004). Focus-group interview and data analysis. Proceedings of the nutrition society, 63(4), 655-660.
61. Resnick, H. S., Foy, D. W., Donahoe, C. P., & Miller, E. N. (1989). Antisocial behavior and posttraumatic stress disorder in Vietnam veterans. Journal of Clinical Psycholog, 45, 860-866.
62. Reyes, G., & Jacobs, G. A. (Eds.). (2006). Handbook of international disaster psychology. Fundamentals and Overview, 4, Praeger.
63. Rousseau, D. M., Sitkin, S. B., Burt, R. S., & Camerer, C. (2002). Not so different after all: A crossdiscipline view of trust. Academy of Management Review, 23(3), 393-404.
64. Sagbas, G., Sheikhi Garjan, R., Sarikaya, K., & Deniz, D. (2024). Field reconnaissance on seismic performance and functionality of Turkish industrial facilities affected by the 2023 Kahramanmaras earthquake sequence. Bulletin of Earthquake Engineering, 22(1), 227-254. https://doi.org/10.1007/ s10518-023-01741-8
65. Sisto, A., Vicinanza, F., Campanozzi, L. L., Ricci, G., Tartaglini, D., & Tambone, V. (2019). Towards a transversal definition of psychological resilience: A literature review. Medicina, 55(11), 745. https://doi.org/10.3390/medicina55110745
66. Slovic, P. (2004). What’s fear got to do with it-It’s affect we need to worry about. Mo. L. Rev., 69, 971.
67. Sorensen, J. H. (2000). Hazard warning systems: Review of 20 years of progress. Natural Hazards Review, 1(2), 119-125. https://doi.org/10.1061/(ASCE)1527-6988(2000)1:2(119)
68. Sorensen, J. H., & White, S. E. (1980). Risk perception and risk communication for nuclear power plant accidents. Journal of Environmental Psychology, 10(4), 363-377.
69. Sönmez, M. B. (2022). Depremin psikolojik etkileri, psikolojik destek ve korkuyla baş etme. Totbid Dergisi, 21(3), 337-343. https://doi.org/10.5578/totbid.dergisi.2022.46
70. Stewart, M., Reid, G., & Mangham, C. (1997). Fostering children’s resilience. Journal of pediatric nursing, 12(1), 21-31.
71. Şahin, N. H., Batıgün, A. D., & Yılmaz, B. (2007). Psychological symptoms of Turkish children and adolescents after the 1999 earthquake: Exposure, gender, location, and time duration. Journal of Traumatic Stress: Official Publication of the International Society for Traumatic Stress Studies, 20(3), 335-345. https://doi.org/10.1002/jts.20217
72. Takuma, T. (1972). A Study of Human Behavior in Panic Situations. Reports of the National Research Institute of Police Science, 15(1), 1-14.
73. Thorne, S. (2016). Interpretive description: Qualitative research for applied practice. Routledge.
74. Tierney, K. J., Lindell, M. K., & Perry, R. W. (2001). Facing the Unexpected: Disaster Preparedness and Response in the United States. Joseph Henry Press.
75. Ungar, M., & Theron, L. (2020). Resilience and mental health: How multisystemic processes contribute to positive outcomes. The Lancet Psychiatry, 7(5), 441-448.
76. Wei, X., Smith, H., & Jones, R. (2017). Assessing Affective Responses to Earthquake Risks: A Study Using the Mood Adjective Checklist. Journal of Risk Research, 20(6), 732-747.
77. Wilson, M. (1997). Focus Groups: A Practical Guide for Applied Research. Sage Publications.
78. Wu, J. Y., Lindell, M. K., & Prater, C. S. (2015). Logistics of hurricane evacuation in hurricanes Katrina and Rita. Transportation Research Part F: Traffic Psychology and Behaviour, 29, 108-123. https:// doi.org/10.1016/j.trf.2015.01.005
79. Yaşar, A. B. (2024). Kişilik Bozukluklarında Etiyoloji ve Epidemiyoloji. Turkiye Klinikleri PsychiatrySpecial Topics, 17(2), 7-16.
80. Yıldız, C. D., & Öztürk, E. D. (2023). Eğitim ve Çocuk Özelinde Kahramanmaraş Depremleri. Sosyal, Beşeri ve İdari Bilimler Dergisi, 6(12), 1649-1664. https://doi.org/10.26677/TR1010.2023.1337
81. Zaumseil, M., & Schwarz, S. (2014). Understandings of coping: A critical review of coping theories for disaster contexts. Cultural psychology of coping with disasters: The case of an earthquake in Java, Indonesia, 45-83. https://doi.org/10.1007/978-1-4614-9354-9_2