Duygu Düzenleme Güçlükleri ve Güvensiz Bağlanma Panik Bozukluğunda Dissosiyatif Belirtilerin Şiddetini Artırır mı?

Yıl 2023, Cilt: 10 Sayı: 4, 365 - 371, 28.12.2023

Nur Özge Akçam Nazan Dolapoğlu Şebnem Pırıldar

https://doi.org/10.34087/cbusbed.1355003

Öz

Giriş ve Amaç: Panik bozukluğu hastalarında kaygılı bağlanma örüntüsü yoğunlaştıkça duyguların düzenlenmesinde yaşanan zorluklar ve dissosiyatif belirtilerin şiddeti hastalık yükünü artırmaktadır. Bu çalışmanın amacı panik bozukluğu hastalarında duygu düzenleme, bağlanma örüntüleri ve dissosiyatif belirtiler arasındaki ilişkiyi aydınlatmaktır.
Gereç ve Yöntemler: Çalışmamıza psikiyatri polikliniğinde panik bozukluğu tanısıyla takip edilen, yaşları 18 – 65 arasında değişen 85 hasta dahil edildi. Araştırmaya dahil edilen hastalara DSM-V Eksen Bozukluklarına Yönelik Yapılandırılmış Klinik Görüşme (SCID - I), sosyodemografik veri formu, Panik Bozukluğu Şiddet Ölçeği (PDSS), Duygu Düzenleme Güçlükleri Ölçeği (DERS), Dissosiyatif Deneyimler Ölçeği (DES), Yakın İlişki Deneyimleri Ölçeği (ECR – RS) uygulandı.
Bulgular: Panik bozukluğunun şiddeti ile dissosiyatif belirtilerin şiddeti arasında anlamlı bir ilişki bulundu (p=0,030). DERS toplam puanları ile DES puanları arasında istatistiksel olarak anlamlı korelasyon bulundu (p=0,005). DES puanı ile DERS alt ölçekleri arasındaki ilişkinin değerlendirilmesinde DERS dürtüsellik (p<0,001), DERS netlik (p=0,006), DERS amaç (p<0,001) alt ölçekleri ile DES puanı arasında anlamlı bir ilişki bulunmuştur. ECR – RS kaygı alt ölçeği ile DERS toplam puanı arasında pozitif ve istatistiksel olarak anlamlı bir ilişki bulunmuştur (p<0,001). ECR – RS kaçınma alt ölçeği ile DERS netlik alt ölçeği arasında anlamlı bir korelasyon bulunurken (p=0,011), diğer alt ölçekler ve DERS toplam puanı ile anlamlı bir korelasyon bulunmadı.
Sonuç: Panik bozukluğu hastalarının dissosiyatif deneyimleri, duygularını düzenleyememelerinden kaynaklanan telafi edici bir mekanizma olabilir. Bu bulgular ışığında dissosiyatif belirtiler yaşayan panik bozukluğu hastalarında bilişsel davranışçı terapinin uygulanması duygu düzenleme bozukluğunun yeniden şekillendirilmesi açısından faydalı olacaktır.

Anahtar Kelimeler

Panik Bozukluk, Duygu Düzenleme, Bağlanma, Dissosiyasyon, Anksiyete

Etik Beyan

Ethical approval: Ethics committee approval was received for this study from Ege University Clinical Research Ethics Committee (Approval Date: September, 22, 2014; Approval Number: 14-9/25).

Do Emotion Regulation Difficulties and Insecure Attachment Increase the Severity of Dissociative Symptoms in Panic Disorder?

Öz

Objective: As the anxious attachment pattern intensifies in patients with panic disorder, difficulties in regulating emotions and the severity of dissociative symptoms increase the burden of disease. The aim of this study was to elucidate the relationship between emotion regulation, attachment patterns and dissociative symptoms in patients with panic disorder.
Materials and Methods: A total of 85 individuals aged between 18 – 65 years, who were followed up in the psychiatry outpatient clinic of our institution with the diagnosis of panic disorder were enrolled in our study. Structured Clinical Interview for the DSM- V Axis Disorders (SCID - I), sociodemographic data form, Panic Disorder Severity Scale (PDSS), Difficulties in Emotion Regulation Scale (DERS), Dissociative Experiences Scale (DES), Experiences in Close Relationships – Relationship Structures Scale (ECR – RS) have been applied to patients thay have been included in this research.
Results: A significant correlation was found between the severity of panic disorder and the severity of dissociative symptoms (p=0.030). A statistically significant correlation was found between DERS total scores and DES scores (p=0.005). In the evaluation of the relationship between DES score and DERS subscales, a significant relationship was found between DERS impulsivity (p<0.001), DERS clarity (p=0.006), DERS purpose (p<0.001) subscales and DES score. A positive and statistically significant relationship was found between the ECR – RS anxiety and DERS total score (p<0.001). A significant correlation was found between the ECR – RS avoidance subscale and the DERS clarity subscale (p=0.011), but no significant correlation was found with the other subscales and the DERS total score.
Conclusion: The dissociative experiences of panic disorder patients may be a compensatory mechanism caused by the inability to regulate their emotions. In the light of these findings, the application of cognitive behavioral therapy in panic disorder patients who experience dissociative symptoms will be beneficial in terms of reshaping the disorder in emotion regulation.

Anahtar Kelimeler

Panic disorder, Emotion regulation, Attachment, Dissociation, Anxiety

Etik Beyan

Ethical approval: Ethics committee approval was received for this study from Ege University Clinical Research Ethics Committee (Approval Date: September, 22, 2014; Approval Number: 14-9/25).

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