Romantik İlişkide Görülen Obsesif Kompulsif Belirtiler ve Risk Faktörleri

Öz

Pek çok ilişki bağlamında görülebilen ilişki temalı obsesif kompulsif belirtiler, genellikle romantik ilişkilerde araştırılan bir konu olmuştur. Romantik ilişkilerde görülen obsesif kompulsif belirtiler; ilişki odaklı ve partner odaklı olarak iki boyutta ele alınmaktadır. Bu belirti kümesi, bireylerin yaşamlarını olumsuz yönde etkilediği gibi çift ilişkileri bağlamında da çeşitli zorlanmalara neden olabilmekte ve ilişki kalitesini zedeleyebilmektedir. Bu çalışmanın amacını romantik ilişki temalı obsesif kompulsif belirtilerin temel özelliklerinin incelenmesi oluşturmaktadır. Bu amaç doğrultusunda ilişki odaklı ve partner odaklı olmak üzere ayrı ayrı ele alınan obsesyon ve kompulsiyonlar son on yıl içerisinde gerçekleştirilen güncel görgül araştırmalar aracılığıyla incelenmiştir. Çalışmanın diğer bir amacı ise bu belirti kümesini risk faktörleriyle beraber ele almaktır. Bu kapsamda romantik ilişkilerde görülen obsesif kompulsif belirtilerde risk faktörleri olarak bağlanma tarzları ve bilişsel çarpıtmalar değerlendirilmiştir. Son olarak psikopatoloji alanında araştırma ve uygulama bakımından ilişki temalı obsesif kompulsif belirti kümesinin önemine ve bu konuyla ilgili neler yapılabileceğine dair önerilere yer verilmiştir.

Anahtar Kelimeler

• ilişki temalı obsesif kompulsif belirtiler
• romantik ilişki
• bağlanma tarzları
• bilişsel çarpıtmalar

Obsessive Compulsive Symptoms and Risk Factors Seen in a Romantic Relationship

Öz

Relationship-Related Obsessive-Compulsive Symptoms (ROCD) which can be observed in several relational contexts, are generally investigated in romantic relationships. Relationship Related Obsessive-Compulsive symptoms are addressed in two dimensions as relationship focused and partner focused. This symptom cluster can negatively affect the lives of individuals as well as leading to severe difficulties in the context of the couple relationship, and it may impair the relationship quality. The aim of this study was to examine the basic characteristics of obsessive-compulsive symptoms in the romantic relationship. In line with this purpose, obsessions, and compulsions, which are discussed separately as relationship-focused, and partner focused, have been examined through current empirical studies conducted in the last ten years. Another aim of the study was to examine this symptom cluster together with its risk factors. In this context, attachment styles, and cognitive distortions were evaluated as risk factors. In conclusion, the importance of the relationship related obsessive compulsive symptom cluster and what needs to be done about this subject in terms of psychopathology were mentioned.

Anahtar Kelimeler

• relationship related obsessive compulsive symptoms
• romantic relationship
• attachment styles
• cognitive distortions

Kaynakça

1. Abak, E. (2019). Ruminatif düşünme stili, beden algısı ve sosyal görünüş kaygısının romantik ilişki ve partner odaklı obsesif kompulsif semptomlarla ilişkisi. [Yayınlanmamış yüksek lisans tezi]. Ankara Yıldırım Beyazıt Üniversitesi.
2. Abbey, R. D., Clopton, J. R. ve Humphreys, J. D. (2007). Obsessive–compulsive disorder and romantic functioning. Journal of Clinical Psychology, 63(12), 1181–1192. https://doi.org/10.1002/jclp.20423
3. Abramowitz, S. J., Fabricant, E. L. ve Jacoby, J. R. (2013). Obsessive-Compulsive Disorder. İçinde W. E. Craighead, D. J. Miklowitz ve L. W. Craighead (Ed.), Psychopathology: History, diagnosis, and empirical foundations (2. basım) (ss. 80-107). New York: John Wiley & Sons.
4. Abramowitz, S. J. ve Siqueland, L. (2013). Obsessive-Compulsive Disorder. İçinde L. G. Castonguay ve T. F. Oltmanns (Ed.), Psychopathology: From science to clinical practice (ss. 143-171). New York: Guilford Publications.
5. Ainsworth M. D. S. (1989) Attachments beyond infancy. American Psychologist, 44, 709-16. http://dx.doi.org/10.1037/0003-066X.44.4.709
6. Aktaş, M. C. ve Çuhadar, D. (2020). Evaluation Of The Social Adjustment And Quality Of Life In Patients With Obsessive Compulsive Disorder. E-Journal of New World Sciences Academy, 15(2), 55– 70. https://doi.org/10.12739/nwsa.2020.15.2.1b0090
7. Amerikan Psikiyatri Birliği. (2001). DSM-IV-TR Tanı Ölçütleri Başvuru Elkitabı (Yeniden Gözden Geçirilmiş Baskı). (E. Köroğlu, Çev.). Ankara: Hekimler Yayın Birliği.
8. Amerikan Psikiyatri Birliği. (2014). DSM-5 Tanı Ölçütleri Başvuru El Kitabı (5. basım). (E. Köroğlu, Çev.). Ankara: Hekimler Yayın Birliği.

9. Aytaç, M., Köse Karaca, B. ve Karaosmanoğlu, A. (2020). Turkish adaptation of the short schema mode inventory. Clinical Psychology & Psychotherapy, 27(3), 346-363. https://doi.org/10.1002/cpp.2432
10. Basile, B., Tenore, K., Luppino, O. I. ve Mancini, F. (2017). Schema therapy mode model applied to OCD. Clinical Neuropsychiatry, 14(6), 407-414.
11. Boeding, S. A., Paprocki, C. M., Baucom, D. H., Abramowitz, J. S., Wheaton, M. G., Fabricant, L. E. ve Fischer, M. S. (2013). Let me check that for you: Symptom accommodation in romantic partners of adults with Obsessive-Compulsive Disorder. Behaviour Research and Therapy. 51, 316-322. https://doi.org/10.1016/j.brat.2013.03.002
12. Boysan, M. ve Çam, Z. (2016). An investigation into the role of attachment insecurities in obsessive-compulsive symptoms. British Journal of Guidance & Counselling, 46(5), 566–581. https://doi.org/10.1080/03069885.2016.1262533
13. Bowlby, J. (1973). Attachment and loss: Volume 2. Separation: Anxiety and anger. New York: Basic Books.
14. Bowlby, J. (1988). A secure base: Clinical applications of attachment theory. London: Routledge.
15. Braithwaite, S. R., Delevi, R. ve Fincham, F. D. (2010). Romantic relationships and the physical and mental health of college students. Personal Relationships, 17(1), 1–12. https://doi.org/10.1111/j.1475-6811.2010.01248.x
16. Brandes, O., Stern, A. ve Doron, G. (2020). “I just can't trust my partner”: Evaluating associations between untrustworthiness obsessions, relationship obsessions and couples violence. Journal of Obsessive-Compulsive and Related Disorders, 24. https://doi.org/10.1016/j.jocrd.2019.100500
17. Cerea, S., Ghisi, M., Bottesi, G., Carraro, E., Broggio, D. ve Doron, G. (2020). Reaching reliable change using short, daily, cognitive training exercises delivered on a mobile application: The case of Relationship Obsessive Compulsive Disorder (ROCD) symptoms and cognitions in a subclinical cohort. Journal of Affective Disorders, 276, 775-787. https://doi.org/10.1016/j.jad.2020.07.043
18. Cicek, E., Cicek, I. E., Kayhan, F., Uguz, F. ve Kaya, N. (2013). “Quality of life, family burden and associated factors in relatives with obsessive–compulsive disorder”. General Hospital Psychiatry, 35(3), 253-258. https://doi.org/10.1016/j.genhosppsych.2013.01.004
19. Cherian, A. V., Pandian, D., Math, S. B., Kandavel, T. ve Janardhan Reddy, Y. C. (2014). Family accommodation of obsessional symptoms and naturalistic outcome of obsessive-compulsive disorder. Psychiatry Research, 215(2), 372-378. https://doi.org/10.1016/j.psychres.2013.11.017
20. Clark, D. A., ve Purdon, C. (1993). New Perspectives for a Cognitive Theory of Obsessions. Australian Psychologist, 28(3), 161– 167. https://doi.org/10.1080/00050069308258896
21. Doron, G. ve Derby, D. (2017). Assessment and treatment of relationship-related OCD symptoms (ROCD): A modular approach. İçinde J. S. Abramowitz, D. McKay ve E. A. Storch (Ed.), The Wiley Handbook of Obsessive Compulsive Disorders (ss. 547-564). Hoboken, NJ: Wiley- Blackwell.
22. Doron, G., Derby, D. S. ve Szepsenwol, O. (2014a). Relationship obsessive compulsive disorder (ROCD): A conceptual framework. Journal of Obsessive-Compulsive and Related Disorders, 3(2), 169– 180. https://doi.org/10.1016/j.jocrd.2013.12.005
23. Doron G., Derby, D. S. ve Szepsenwol, O. (2017). “I can’t stop thinking about my child’s flaws”: An investigation of parental preoccupation with their children’s perceived flaws. Journal of Obsessive-Compulsive and Related Disorders, 14, 106-111. https://doi.org/10.1016/j.jocrd.2017.06.007
24. Doron, G., Derby, D., Szepsenwol, O., Nahaloni, E. ve Moulding, R. (2016). Relationship Obsessive–Compulsive Disorder: Interference, symptoms, and maladaptive beliefs. Frontiers in Psychiatry, 7(12). https://doi.org/10.3389/fpsyt.2016.00058
25. Doron, G., Derby, D. S., Szepsenwol, O. ve Talmor, D. (2012a). Tainted love: Exploring relationship- centered obsessive compulsive symptoms in two non-clinical cohorts. Journal of Obsessive- Compulsive and Related Disorders, 1(1), 16–24. https://doi.org/10.1016/j.jocrd.2011.11.002
26. Doron, G., Derby, D. S., Szepsenwol, O. ve Talmor, D. (2012b). Flaws and all: Exploring partner- focused obsessive-compulsive symptoms. Journal of Obsessive-Compulsive and Related Disorders, 1(4), 234–243. https://doi.org/10.1016/j.jocrd.2012.05.004
27. Doron, G., Mizrahi, M., Szepsenwol, O. ve Derby, D. (2014b). Right or Flawed: Relationship Obsessions and Sexual Satisfaction. The Journal of Sexual Medicine, 11(9), 2218–2224. https://doi.org/10.1111/jsm.12616 Doron, G., Moulding, R., Kyrios, M., Nedeljkovic, M. ve Mikulincer, M. (2009). Adult attachment insecurities are related to obsessive compulsive phenomena. Journal of Social and Clinical Psychology, 28, 1022-1049.
28. Doron, G., Moulding, R., Nedeljkovic, M., Kyrios, M., Mikulincer, M. ve Sar-El, D. (2011). Adult attachment insecurities are associated with obsessive compulsive disorder. Psychology and Psychotherapy: Theory, Research and Practice, 85(2), 163–178. https://doi.org/10.1111/j.2044-8341.2011.02028.x
29. Doron, G., Sar-El, D. ve Mikulincer, M. (2012c). Threats to moral self-perceptions trigger obsessive compulsive contamination-related behavioral tendencies. Journal of Behavior Therapy and Experimental Psychiatry, 43(3), 884–890. https://doi.org/10.1016/j.jbtep.2012.01.002
30. Doron, G. ve Szepsenwol, O. (2015). Partner-focused obsessions and self-esteem: An experimental investigation. Journal of Behavior Therapy and Experimental Psychiatry, 49, 173–179. https://doi.org/10.1016/j.jbtep.2015.05.007
31. Doron, G., Szepsenwol, O., Karp, E. ve Gal, N. (2013). Obsessing about intimate- relationships: Testing the double relationship-vulnerability hypothesis. Journal of Behavior Therapy and Experimental Psychiatry, 44(4), 433–440. https://doi.org/10.1016/j.jbtep.2013.05.003
32. Fang, A., Steketee, G., Keshaviah, A., Didie, E., Phillips, K. A. ve Wilhelm, S. (2020). Mechanisms of change in Cognitive Behavioral Therapy for Body Dysmorphic Disorder. Cognitive Therapy and Research, 44, 596-610. https://doi.org/10.1007/s10608-020-10080-w
33. Fontenelle, I. S., Fontenelle, L. F., Borges, M. C., Prazeres, A. M., Rangé, B. P., Mendlowicz, M. V. ve Versiani, M. (2010). Quality of life and symptom dimensions of patients with obsessive– compulsive disorder. Psychiatry Research, 179(2), 198–203. https://doi.org/10.1016/j.psychres.2009.04.005
34. Gomes, J. B., Noppen, B. V., Pato, M., Braga, D. T., Meyer, E., Bortoncello, C. F. ve Cordioli, A. V. (2014). Patient and family factors associated with family accommodation in obsessive- compulsive disorder. Psychiatry and Clinical Neurosciences, 68(8), 621-630. https://doi.org/10.1111/pcn.12172
35. Greenberg, J. L., Falkenstein, M., Reuman, L., Fama, J., Marques, L. ve Wilhelm, S. (2013). The phenomenology of self-reported body dysmorphic disorder by proxy. Body Image, 10(2), 243- 246. https://doi.org/10.1016/j.bodyim.2013.01.001
36. Hisli Şahin, N. ve Yaka, A. İ. (2010). Yakın İlişkilerde Yaşantılar Envanteri'nin (YİYE-I), kendilik algısı, olumsuz otomatik düşünceler ve psikopatolojik belirtiler bağlamında incelenmesi. Türk Psikoloji Yazıları, 13(26), 64-76.
37. Izadi, R., Asgari, K., Neshatdust, H., ve Abedi, M. (2012). Assessment of obsessive beliefs in individuals with obsessive-compulsive disorder in comparison to healthy sample. International Journal of Psychology and Counselling, 4(7), 81-85. https://doi.org/10.5897/IJPC12.010
38. Kabiri, M., Neshat-Doost, H. T. ve Mehrabi, H. A. (2017). The mediating role of relationship obsessive-compulsive disorder in relation to attachment styles and marital quality in woman. Journal of Research & Health, 7(5), 1065-1073.
39. Kasalova, P., Prasko, J., Ociskova, M., Holubova, M., Vanek, J., Kantor, K., Minarikova, K., Hodny, F., Slepecky, M. ve Barnard, L. (2020). Marriage under control: Obsessive compulsive disorder and partnership. Neuroendocrinology Letters, 41(3), 134-145.
40. Konkan, R., Şenormancı, Ö., Güçlü, O., Aydın, E. ve Sungur, M. Z. (2012). Obsesif kompulsif bozukluk ve obsesif inançlar. Anadolu Psikiyatri Dergisi, 13, 91-96.
41. Köse Karaca, B. ve Gürsoy, M. (2019). Mükemmeliyetçiliği şema terapiyle ele almak: Bir vaka üzerinden anlatım. Ayna Klinik Psikoloji Dergisi, 6(3), 312-333.
42. Kwak, K. H. ve Lee, S. J. (2015). A comparative study of early maladaptive schemas in obsessive– compulsive disorder and panic disorder. Psychiatry Research, 230, 757-762.
43. Lombardi, A. ve Rodriguez, C. (2019). Enhancing exposure and response prevention treatment in an individual with relationship obsessive-compulsive disorder: A case report. Journal of Cognitive Psychotherapy: An International Quarterly, 33(3), 185-195. http://dx.doi.org/10.1891/0889- 8391.33.3.185
44. Lebowitz, E. R., Omer, H. ve Leckman, J. F. (2011). Coercive and disruptive behaviors in pediatric obsessive-compulsive disorder. Depression and Anxiety, 28(10), 899-905. https://doi.org/10.1002/da.20858
45. Lebowitz, E. R., Panza, K. E. ve Bloch, M. H. (2016). Family accommodation in obsessive- compulsive and anxiety disorders: A five-year update. Expert Review of Neurotherapeutics, 16(1), 45-53. https://doi.org/10.1586/14737175.2016.1126181
46. Mahapatra, A., Kuppili, P. P., Gupta, R., Deep, R. ve Khandelwal, S. K. (2020). Prevelance and predictors of family accommodation in obsessive-compulsive disorder in an Indian setting. Indian Journal of Psychiatry, 62(1), 43-50. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_299_17
47. McCubbin, R. A. ve Sampson, M. J. (2006). The relationship between obsessive-compulsive symptoms and appraisals of emotional states. Journal of Anxiety Disorders, 20, 42-57. https://doi.org/10.1016/j.janxdis.2004.11.008
48. Melli, G., Bulli, F., Doron, G. ve Carraresi, C. (2018). Maladaptive beliefs in relationship obsessive compulsive disorder (ROCD): Replication and extension in a clinical sample. Journal of Obsessive-Compulsive and Related Disorders, 18, 47–53. https://doi.org/10.1016/j.jocrd.2018.06.005
49. Mikulincer, M. ve Shaver, P. R. (2007). Attachment in adulthood structure, dynamics, and change. New York: Guilford Press.
50. Moulding, R., Coles, M. E., Abramowitz, J. S., Alcolado, G. M., Alonso, P., Belloch, A., Bouvard, M., Clark, D. A., Doron, G., Fernandez-Alvarez, H., Garcia-Soriano, G., Ghisi, M., Gomez, B., Inozu, M., Radomsky, A. S., Shams, G., Sica, C., Simos, G. ve Wong, W. (2014). Part 2. They scare because we care: The relationship between obsessive intrusive thoughts and appraisals and control strategies across 15 cities. Journal of Obsessive-Compulsive and Related Disorders, 3(3), 280-291. https://doi.org/10.1016/j.jocrd.2014.02.006
51. Newth, S. ve Rachman, S. (2001). The concealment of obsessions. Behaviour Research and Therapy, 39(4), 457–464. https://doi.org/10.1016/s0005-7967(00)00006-1
52. Oguz, G., Celikbas, Z., Batmaz, S., Cagli, S. ve Sungur, M. Z. (2019). Comparison between obsessive compulsive disorder and panic disorder on metacognitive beliefs, emotional schemas, and cognitive flexibility. International Journal of Cognitive Therapy, 12(9), 157- 178. https://doi.org/10.1007/s41811-019-00047-5
53. Parlapan Baş, E. (2019). Association of relationship obsessive-compulsive symptoms with depression, anxiety and stress: Marriage and child related factors as moderators. [Yayınlanmamış yüksek lisans tezi]. Bolu Abant İzzet Baysal Üniversitesi.
54. Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35(9), 793 –802.
55. Rachman, S. (1998). A cognitive theory of obsessions: Elaborations. Behaviour Research and Therapy, 36(4), 385 – 401.
56. Remmerswaal, K., Batelaan, N., Smit, J., Oppen, P. V. ve Balkom, A. V. (2016). Quality of life and relationship satisfaction of patients with Obsessive Compulsive Disorder. Journal of Obsessive-Compulsive and Related Disorders, 11, 56–62. https://doi.org/10.1016/j.jocrd.2016.08.005
57. Rodriguez, L. M., DiBello, A. M., Øverup, C. S. ve Neighbors, C. (2015). The price of distrust: Trust, anxious attachment, jealousy, and partner abuse. Partner Abuse, 6(3), 298- 319. https://doi.org/10.1891/1946-6560.6.3.298
58. Røsand, G.-M. B., Slinning, K., Eberhard-Gran, M., Røysamb, E. ve Tambs, K. (2012). The buffering effect of relationship satisfaction on emotional distress in couples. BMC Public Health, 12(1). https://doi.org/10.1186/1471-2458-12-66
59. Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23(5), 571-583. https://doi.org/10.1016/0005- 7967(85)90105-6
60. Smith, A. H., Wetterneck, C. T., Hart, J. M., Short, M. B. ve Björgvinsson, T. (2012). Differences in obsessional beliefs and emotion appraisal in obsessive compulsive symptom presentation. Journal of Obsessive-Compulsive and Related Disorders, 1(1), 54-61. https://doi.org/10.1016/j.jocrd.2011.11.003
61. Starcevic, V. ve Brakoulias, V. (2017). Current understanding of the relationships between obsessive-compulsive disorder and personality disturbance. Current Opinion in Psychiatry, 30(1), 50–55. https://doi.org/10.1097/yco.0000000000000291 Sümer, N., Ünal, S., Selçuk, E., Kaya, B., Polat, R. ve Çekem, B. (2009). Bağlanma ve psikopatoloji: Bağlanma boyutlarının depresyon, panik bozukluk ve obsesif kompulsif bozuklukla ilişkisi. Türk Psikoloji Dergisi, 24(63), 38-45.
62. Szepsenwol, O., Shahar, B. ve Doron, G. (2016). Letting it linger: Exploring the longitudinal effects of relationship-related obsessive-compulsive phenomena. Journal of Obssesive-Compulsive and Related Disorders, 11, 101-104. https://doi.org/10.1016/j.jocrd.2016.10.001
63. Toroslu, B. (2020). Erken dönem uyum bozucu şemalar ile romantik ilişki ve partner odaklı obsesif kompulsif belirtiler arasındaki ilişkide mükemmeliyetçilik ve belirsizliğe tahammülsüzlüğün aracı rolü. [Yayınlanmamış yüksek lisans tezi]. Başkent Üniversitesi.
64. Torres, A. R., de Abreu Ramos-Cerqueira, A. T., Torresan, R. C., de Souza Domingues, M., Hercos, A. C. R. ve Guimarães, A. B. C. (2007). Prevalence and associated factors for suicidal ideation and behaviors in obsessive-compulsive disorder. CNS Spectrums, 12(10), 771-778. https://doi.org/10.1017/S1092852900015467
65. Trak, E. ve Inozu, M. (2019). Developmental and self-related vulnerability factors in relationship- centered obsessive compulsive disorder symptoms: A moderated mediation model. Journal of Obsessive-Compulsive and Related Disorders, 21, 121– 128. https://doi.org/10.1016/j.jocrd.2019.03.004
66. Vatan, S. (2016). Obsesif kompulsif bozuklukta bağlanma, obsesif inançlar ve duygu düzenleme zorlukları: Klinik ve klinik olmayan örneklem karşılaştırması. Nesne Psikoloji Dergisi, 4(7), 41- 57.
67. Yıldırım, B. (2018). Beliren yetişkinlikte romantik ilişki temalı ve eş odaklı obsesif kompülsif belirtilerin gelişimsel yordayıcıları: Özerklik, bağlanma ve mükemmeliyetçilik. [Yayınlanmamış yüksek lisans tezi]. Hacettepe Üniversitesi.
68. Yorulmaz, O., Baştuğ, G., Tüzer, V. ve Göka, E. (2013). Obsesif-kompülsif bozukluğu olan hastalarda yorumlama, inançlar ve düşünce kontrol yöntemleri. Anadolu Psikiyatri Dergisi, 14, 183-191.
69. Weingarden, H. ve Renshaw, K. D. (2015). Shame in the obsessive compulsive related disorders: A conceptual review. Journal of Affective Disorders, 171, 74–84.
70. Wilhelm, S., Berman, N. C., Keshaviah, A., Schwartz, R. A. ve Steketee, G. (2015). Mechanisms of change in cognitive therapy for obsessive compulsive disorder: Role of maladaptive beliefs and schemas. Behaviour Research and Therapy, 65, 5-10. https://doi.org/10.1016/j.brat.2014.12.006
71. Wu, M. S., McGuire, J.F., Martino, C., Phares, V., Selles, R. R. ve Storch, E. A. (2016). A meta-analysis of family accommodation and OCD symptom severity. Clinical Psychology Review, 45, 34-44.