ERKEN VE GEÇ BAŞLANGIÇLI ALKOL BAĞIMLILIĞI TİPLERİNDE HAYATA KÜSME BOZUKLUĞU

Öz

Amaç: Erken çocukluk çağı travmaları ve haksızlığa maruz kalmaya ilişkin yaşam olaylarının erken ve geç başlangıçlı alkol bağımlılığında travma sonrası hayata küsme bozukluğunun gelişimi ile ilişkisini gözden geçirmekti. Yöntem: Araştırmaya seçkisiz ardışık örneklemle 18-65 yaş aralığında 89 hasta dahil edildi. Hastalara sosyodemografik bilgi formu, Travma Sonrası Hayata Küsme Bozukluğu Ölçeği, Olayların Merkeziliği Ölçeği, Olayların Etkisi Ölçeği ve Temel İnanç Envanteri uygulandı. Bulgular: Örneklemimizin Travma Sonrası Hayata Küsme Bozukluğu Ölçeğinde kesme puanı üstünde değer alan %79.5’lik grupta geç başlangıçlıların %87.1’i, erken başlangıçlıların %85.4’ü haksızlığa maruz kaldığını belirtti. Erken başlangıçlı alkol bağımlılığı grubunun hayata küsme bozukluğu ölçeği puanları anlamlı düzeyde yüksekti (p<0.001). Haksızlığa maruz kalınan olayların erken ve geç başlangıçlı alkol bağımlıları açısından karşılaştırılmasında geç başlangıçlı alkol bağımlısı grubun anne/babanın kardeşler arası ayrımcılık yapması maddesi anlamlı fark oluşturdu (p=0.045). Sonuç: Erken başlangıçlı alkol bağımlılığı grubunda travma sonrası hayata küsme puanlarının belirgin düzeyde yüksek olması, tehdit oluşturan travmatik olayın erken yaşlarda hayatın beklenen seyrini bozarak kişinin dünyanın adilliği, kendisi ve diğerleri hakkındaki inançlarını fazlaca sarsmış olabileceğini düşündürmektedir. Geç başlangıçlı alkol bağımlısı grubunda kendisine kardeşlerinden farklı davranıldığı algısının daha yüksek düzeyde olması, kardeşler arasında çocukluktan beri yaşanan rekabetin ileri yaşlarda yeniden şiddetlenerek hayata küsmeye neden olabileceğini akla getirmektedir.

Anahtar Kelimeler

• Hayata Küsme Bozukluğu
• Alkol
• Bağımlılık
• Erken Başlangıç
• Geç Başlangıç

EMBITTERMENT DISORDER IN EARLY AND LATE ONSET ALCOHOL DEPENDENCE

Öz

Objective: To review the relationship between early childhood traumas and life events related to exposure to injustice and the development of post-traumatic embitterment in early and late-onset alcohol dependence. Method: 89 patients aged 18-65 years were included in the study with a random sample. Sociodemographic information form, Post Traumatic Embitterment Scale, Centrality of Events Scale, Effect of Events Scale and Core Belief Inventory were applied to the patients. Results: In the 79.5% group, which scored above the cut-off point in the Post-Traumatic Embarrassment Disorder Scale of our sample, 87.1% of the late-onset group and 85.4% of the early-onset group stated that they were exposed to injustice. The embitterment disorder scale scores of the early-onset alcohol addiction group were significantly higher (p<0.001). In the comparison of the incidents exposed to injustice in terms of early and late alcohol addicts, the item of the late-onset alcohol addicted group's parents' discrimination between siblings made a significant difference (p=0.045). Conclusion: Significantly higher post-traumatic embitterment scores in the early-onset alcohol addiction group suggest that the traumatic event may have disrupted the expected course of life at an early age, and may have shaken the person's beliefs about the fairness of the world. The higher perception that parents treat them differently from their siblings in the late-onset alcohol dependent group suggests that the rivalry between siblings from childhood may re-intensify at later ages, leading to resentment.

Anahtar Kelimeler

• Embitterment Disorder
• Alcohol
• Addiction
• Early-Onset
• Late-Onset

Kaynakça

1. Devor EJ, Cloninger CR. Genetics of alcoholism. Annu Rev Genet. 1989;23(1):19-36.
2. Cloninger CR. Neurogenetic adaptive mechanisms in alcoholism. Science. 1987;236(4800):410-416.
3. Cloninger CR, Sigvardsson S, Bohman M. Type I and type II alcoholism: an update. Alcohol Health Res World. 1996;20(1):18-23.
4. Emiliussen J, Nielsen AS, Andersen K. Identifying risk factors for late-onset (50+) alcohol use disorder and heavy drinking: a systematic review. Subst Use Misuse. 2017;52(12):1575-1588.
5. Waldrop AE, Santa Ana EJ, Saladin ME, McRae AL, Brady KT. Differences in early onset alcohol use and heavy drinking among persons with childhood and adulthood trauma. Am J Addict. 2007;16(6):439-442.
6. Englund MM, Egeland B, Oliva EM, Andrew Collins W. Childhood and adolescent predictors of heavy drinking and alcohol use disorders in early adulthood: a longitudinal developmental analysis. Addiction. 2008;103:23-35.
7. Colman I, Garad Y, Zeng Y, et al. Stress and development of depression and heavy drinking in adulthood: moderating effects of childhood trauma. Soc Psychiatry Psychiatr Epidemiol. 2013;48(2):265-274.
8. Evren C, Sar V, Dalbudak E, et al. Lifetime PTSD and quality of life among alcohol-dependent men: impact of childhood emotional abuse and dissociation. Psychiatry Res. 2011;186(1):85-90.

9. Brennan PL, Schutte KK, Moos RH. Reciprocal relations between stressors and drinking behavior: a three-wave panel study of late middle-aged and older women and men. Addiction. 1999;94(5):737-749.
10. Park T, Thompson K, Wekerle C, et al. Posttraumatic stress symptoms and coping motives mediate the association between childhood maltreatment and alcohol problems. J Trauma Stress. 2019;32(6):918-926.
11. Anda RF, Felitti VJ, Bremner JD, et al. The enduring effects of abuse and related adverse experiences in childhood. Eur Arch Psychiatry Clin Neurosci. 2006; 256(3):174-186.
12. Keyes KM, Hatzenbuehler ML, Hasin DS. Stressful life experiences, alcohol consumption, and alcohol use disorders: the epidemiologic evidence for four main types of stressors. Psychopharmacology. 2011;218(1):1-17.
13. Dawson DA, Grant BF, Li T-K. Impact of age at first drink on stress-reactive drinking. Alcohol Clin Exp Res. 2007;31(1):69-77.
14. Widom CS. Posttraumatic stress disorder in abused and neglected children grown up. Am J Psychiatry. 1999;156(8):1223-1229.
15. Dansky BS, Roitzsch JC, Brady KT, Saladin ME. Posttraumatic stress disorder and substance abuse: use of research in a clinical setting. J Trauma Stress. 1997;10(1):141-148.
16. Miller BA, Downs WR, Testa M. Interrelationships between victimization experiences and women’s alcohol use. J Stud Alcohol, Suppl. 1993;11:109-117.
17. Bülau NI, Kessemeier F, Petermann F, Bassler M, Kobelt A. Evaluation of Contextual Factors in Psychosomatic Rehabilitation. Rehabil. 2016;55(06):381-387.
18. Znoj H, Abegglen S, Buchkremer U, Linden M. The embittered mind. J Indiv Differences. 2016;37:213-222.
19. Linden M, Arnold CP. Embitterment and posttraumatic embitterment disorder (PTED): an old, frequent, and still underrecognized problem. Psychother Psychosom. 2021;90(2):73-80.
20. Linden M. Posttraumatic embitterment disorder. Psychother Psychosom. 2003;72(4): 195–202.
21. Linden M, Noack I. Suicidal and aggressive ideation associated with feelings of embitterment. Psychopathology. 2018;51(4):245-251.
22. Linden M, Baumann K, Lieberei B, Lorenz C, Rotter M. Treatment of posttraumatic embitterment disorder with cognitive behaviour therapy based on wisdom psychology and hedonia strategies. Psychother Psychosom. 2011;80(4):199-205.
23. McLellan AT, Thomas McLellan A, Kushner H, et al. The fifth edition of the addiction severity index. J Subst Abuse Treat. 1992;9(3):199-213.
24. Ögel K, Evren C, Karadağ F, Gürol DT. The development, validity, and reliability of the Addiction Profile Index (API). Turk Psikiyatri Derg. 2012;23(4):263-275.
25. Linden M, Baumann K, Lieberei B, Rotter M. The Post-Traumatic Embitterment Disorder Self-Rating Scale (PTED Scale). Clin Psychol Psychother. 2009;16(2):139-147.
26. Ünal S, Güney S, Kartalcı Ş, Reyhani İ. The study of the reliability and validity of the Turkish version of post traumatic embitterment disorder self–rating scale (PTED self-rating scale). Dusunen Adam: J Psychiat and Neurol Sci. 2011;24(1):32-37.
27. Berntsen D, Rubin DC. The centrality of event scale: a measure of integrating a trauma into one’s identity and its relation to post-traumatic stress disorder symptoms. Behav Res Ther 2006;44(2):219-231.
28. Boyacıoğlu İ, Aktaş Ç. Centrality of Events Scale--Turkish adaptation. PsycTESTS Dataset, 2019.
29. Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979;41(3):209-218.
30. Weiss DS, Marmar CR. Impact of Event Scale-Revised. PsycTESTS Dataset 2016.
31. Çorapcıoğlu A, Yargıç İ, Geyran P, Kocabaşoğlu N. Olayların Etkisi Ölçeği (IES-R) Türkçe versiyonunun geçerlik ve güvenilirliği. New/Yeni Symposium: Psikiyatri, Nöroloji ve Davranış Bilimleri Derg. 2006;44(1):14-22.
32. Cann A, Calhoun LG, Tedeschi RG, Kilmer RP, Gil-Rivas V, Vishnevsky T, Danhauer SC. The Core Beliefs Inventory: a brief measure of disruption in the assumptive world. Anxiety, Stress & Coping. 2010;23(1):19-34.
33. Haselden M. Üniversite öğrencilerinde travma sonrası büyümeyi yordayan çeşitli değişkenlerin Türk ve Amerikan kültürlerinde incelenmesi: Bir model önerisi. 2014; Ankara.
34. Widom CS, White HR, Czaja SJ, Marmorstein NR. Long-term effects of child abuse and neglect on alcohol use and excessive drinking in middle adulthood. J Stud Alcohol Drugs. 2007;68(3):317-326.
35. Baumann K, Linden M. Weisheitstherapie. Verhaltenstherapiemanual. 2015;443-447.
36. Berntsen D, Rubin DC. When a trauma becomes a key to identity: enhanced integration of trauma memories predicts posttraumatic stress disorder symptoms. Appl Cogn Psychol. 2007;21(4):417-431.
37. Berntsen D, Rubin DC. Centrality of Event Scale. PsycTESTS Dataset 2012.
38. Jensen AC, Whiteman SD, Fingerman KL, Birditt KS. “Life still isn’t fair”: parental differential treatment of young adult siblings. J Marriage Fam. 2013;75(2):438-452.
39. Young L, Ehrenberg MF. Siblings, parenting, conflict, and divorce. J Divorce & Remarriage .2007;47(3-4):67-85.
40. Suitor JJ, Gilligan M, Peng S, Jung JH, Pillemer K. Role of perceived maternal favoritism and disfavoritism in adult children's psychological well-being. J Gerontol B Psychol Sci Soc Sci. 2017;72(6):1054-1066.
41. Boll T, Ferring D, Filipp S-H. Effects of parental differential treatment on relationship quality with siblings and parents: justice evaluations as mediators. Soc Justice Res. 200518(2):155-182.
42. Boll T, Ferring D, Filipp S-H. Perceived parental differential treatment in middle adulthood: curvilinear relations with ındividuals’ experienced relationship quality to sibling and parents. J Fam Psychol. 2003;17(4):472-487.
43. Suitor JJ, Jill Suitor J, Gilligan M, Pillemer K. Continuity and change in mothers’ favoritism toward offspring in adulthood. J Marriage Fam. 2013;75(5):1229-1247.
44. Ihinger M. The referee role and norms of equity: A contribution toward a Theory of Sibling Conflict. J Marriage Fam. 1975;37:515.
45. Rauer AJ, Volling BL. Differential parenting and sibling jealousy: developmental correlates of young adults’ romantic relationships. Pers Relatsh. 2007;14(4):495-511.
46. Richmond MK, Stocker CM, Rienks SL. Longitudinal associations between sibling relationship quality, parental differential treatment, and children’s adjustment. J Fam Psychol. 2005;19(4):550-559.
47. Ng CSM, Chiu MM, Zhou Q, Heyman G. The impact of differential parenting: study protocol on a longitudinal study investigating child and parent factors on children's psychosocial health in Hong Kong. Front Psychol. 2020;11:1656.
48. Long EC, Aggen SH, Gardner C, Kendler KS. Differential parenting and risk for psychopathology: a monozygotic twin difference approach. Soc Psychiatry Psychiatr Epidemiol. 2015;50(10):1569-1576.
49. Festinger L. A Theory of social comparison processes. Hum Relat. 1954;7(2):117-140.
50. Loeser MK, Whiteman SD, McHale SM. Siblings’ perceptions of differential treatment, fairness, and jealousy and adolescent adjustment: a moderated indirect effects model. J Child and Fam Stud. 2016;25(8):2405-2414.
51. Heinonen K, Räikkönen K, Keltikangas-Järvinen L. Self-esteem in early and late adolescence predicts dispositional optimism–pessimism in adulthood: a 21-year longitudinal study. Pers Individ Dif. 2005;39(3):511-521.