Algılanan sosyal destek, içselleştirilmiş damgalanma ve çocukluk çağı travmasının şizofreni spektrum bozukluklarında yaşam kalitesi üzerindeki etkisi: aracılık ve düzenleyicilik yaklaşımı

Yıl 2025, Cilt: 8 Sayı: 6, 966 - 974, 25.10.2025

Ulaş Korkmaz , Fatma Gül Helvacı Çelik

https://doi.org/10.32322/jhsm.1750254

Öz

Amaçlar: Bu çalışma, şizofreni spektrum bozuklukları (ŞSB) olan bireylerde semptom şiddeti ile yaşam kalitesi arasındaki ilişkide algılanan sosyal destek ve içselleştirilmiş damgalanmanın aracılık edip etmediğini ve çocukluk çağı travmasının bu ilişkiyi düzenleyip düzenlemediğini belirlemeyi amaçlamaktadır.

Yöntem: Bu kesitsel çalışmada, bir toplum ruh sağlığı merkezine başvuran ve şizofreni, şizoaffektif bozukluk veya tanımlanmamış psikotik bozukluk tanısı almış 258 hasta yer aldı. Yaşam kalitesi, algılanan sosyal destek, içselleştirilmiş damgalanma, çocukluk çağı travma öyküsü ve semptom şiddetini değerlendirmek için standart ölçekler kullanıldı. Semptom şiddetinin yaşam kalitesi üzerindeki dolaylı etkilerini algılanan sosyal destek ve içselleştirilmiş damgalanma aracılığıyla test etmek amacıyla aracılık analizleri yapıldı. Düzenleyicilik analizleri ise çocukluk çağı travmalarının semptom şiddeti ile yaşam kalitesi arasındaki ilişki üzerindeki etkisini inceledi.

Bulgular: Daha yüksek semptom şiddeti, daha düşük algılanan sosyal destek ve daha yüksek içselleştirilmiş damgalanma ile ilişkiliydi. Bu değişkenler ise daha düşük yaşam kalitesini yordadı. Algılanan sosyal destek ve içselleştirilmiş damgalanma, semptom şiddetinin yaşam kalitesi üzerindeki olumsuz etkisinde anlamlı bir aracılık rolü oynadı. Çocukluk çağı travması ise anlamlı bir düzenleyici etki gösterdi. Çocukluk çağı travması öyküsü olan hastalarda semptom şiddeti ile yaşam kalitesi arasındaki olumsuz ilişki daha güçlüydü. Bu etkiler, diğer değişkenler kontrol edildikten sonra da anlamlılığını korudu.

Sonuç: Psikososyal etkenler, ŞSB olan hastalarda yaşam kalitesini önemli ölçüde etkilemektedir. Algılanan sosyal destek ve içselleştirilmiş damgalanma, semptom şiddeti ile yaşam kalitesi arasındaki ilişkiyi aracılık eden temel faktörler olarak öne çıkmıştır. Ayrıca, çocukluk çağı travması öyküsü, semptomların yaşam kalitesi üzerindeki olumsuz etkisini artırmaktadır. Sosyal desteği güçlendiren, içselleştirilmiş damgalanmayı azaltan ve çocukluk travmalarını ele alan müdahaleler, ŞSB grubunda yaşam kalitesini artırmak için kritik öneme sahip olabilir.

Anahtar Kelimeler

Şizofreni spektrum bozuklukları , yaşam kalitesi , algılanan sosyal destek , içselleştirilmiş damgalanma , çocukluk çağı travması

The impact of perceived social support, internalized stigma, and childhood trauma on quality of life in schizophrenia spectrum disorders: a mediation and moderation approach

Öz

Aims: This study aimed to determine whether perceived social support and internalized stigma mediate the association between symptom severity and quality of life (QoL) in individuals with schizophrenia spectrum disorders (SSDs) and whether childhood trauma moderate this relationship.
Methods: A cross-sectional design was used with 258 patients diagnosed with schizophrenia, schizoaffective disorder, or unspecified psychosis at a community mental health center. Standardized scales were administered to assess QoL, perceived social support, internalized stigma, history of childhood trauma, and symptom severity. Mediation analyses were conducted to test the indirect effects of symptom severity on QoL through social support and internalized stigma. Moderation analyses examined the effect of childhood traumas on the relationship between symptom severity and QoL.
Results: Higher symptom severity was associated with lower perceived social support and greater internalized stigma, which in turn predicted worse QoL. Perceived social support and internalized stigma significantly mediated the negative effect of symptom severity on QoL. Childhood trauma had a significant moderating effect: the negative association between symptom severity and QoL was stronger among patients with a history of childhood trauma. These effects remained significant even after controlling for other variables.
Conclusion: Psychosocial factors significantly influence QoL in patients with SSDs. Perceived social support and self-stigma emerged as key mediators linking symptom severity to QoL, and a history of childhood trauma exacerbated the impact of symptoms on QoL. Interventions that strengthen social support, reduce internalized stigma and address childhood traumatic experiences may be crucial for improving QoL in the SSD population.

Anahtar Kelimeler

Schizophrenia spectrum disorders , quality of life , perceived social support , internalized stigma , childhood trauma

Etik Beyan

The Giresun Training and Research Hospital Clinical Research Ethics Committee approved the research, decision number 30.04.2025/02. The research was conducted in accordance with the Declaration of Helsinki.

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