Yaygın Anksiyete Bozukluğu Tanısı Alan Hastalarda Yetişkin Ayrılma Anksiyetesi ile Öz Saygı Arasındaki İlişki

Öz

Amaç: Bu çalışmanın amacı, yaygın anksiyete bozukluğu tanısı alan yetişkinlerde benlik saygısı ile hem çocukluk çağı hem de yetişkinlik dönemi ayrılma anksiyetesi arasındaki ilişkiyi incelemek ve benlik saygısının yetişkin ayrılma anksiyetesi üzerindeki yordayıcı etkisini değerlendirmektir. Gereç ve Yöntemler: Çalışma Eylül–Kasım 2022 tarihleri arasında bir eğitim ve araştırma hastanesinin polikliniğine başvuran, DSM-5’e göre yaygın anksiyete bozukluğu tanısı alan 102 hasta ve 102 sağlıklı kontrol ile yürütülmüştür. Tüm katılımcılara sosyodemografik formun yanı sıra Rosenberg Benlik Saygısı Ölçeği, Ayrılma Anksiyetesi Belirti Envanteri ve Yetişkin Ayrılma Anksiyetesi Ölçeği uygulanmıştır. Veriler SPSS 22.0 kullanılarak analiz edilmiş; grup karşılaştırmaları, korelasyon ve regresyon analizleri yapılmıştır. Bulgular: Hasta grubunda RSES puanları kontrol grubuna göre anlamlı düzeyde yüksek bulunmuş, bu da daha düşük benlik saygısına işaret etmiştir. Ayrıca hasta grubunun ASA-27 puanları ve klinik eşik üzerindeki yetişkin ayrılma anksiyetesi oranları belirgin şekilde daha yüksektir (p < 0.001). Çocukluk çağı ayrılma anksiyetesi açısından gruplar arasında anlamlı fark saptanmamıştır. Korelasyon analizleri, düşük benlik saygısının hem çocukluk hem de yetişkin ayrılma anksiyetesi ile pozitif yönde ilişkili olduğunu göstermiştir. Regresyon analizlerinde ise düşük benlik saygısı ve yüksek SASI puanları, yetişkin ayrılma anksiyetesini anlamlı biçimde yordayan iki bağımsız değişken olarak belirlenmiştir. Sonuç: Yaygın anksiyete bozukluğu olan bireylerde benlik saygısı düşüktür ve yetişkin ayrılma anksiyetesi belirgin şekilde yüksektir. Benlik saygısının hem çocukluk hem de yetişkin ayrılma anksiyetesiyle yakından ilişkili olduğu ve yetişkin ayrılma anksiyetesinin önemli bir yordayıcısı olduğu görülmüştür. Bu bulgular, benlik saygısını güçlendirmeye yönelik müdahalelerin ayrılma anksiyetesi belirtilerini azaltmada klinik açıdan değerli bir hedef olabileceğini göstermektedir.

Anahtar Kelimeler

• Ayrılma anksiyetesi
• öz saygı
• anksiyete bozuklukları
• bağlanma davranışı

Destekleyen Kurum

Herhangi bir kurumdan veya kişiden finansal destek alınmamıştır.

Etik Beyan

Çalışma protokolü, Malatya Turgut Özal Üniversitesi Klinik Araştırmalar Etik Kurulu tarafından onaylandı (Tarih: 05.09.2022, Sayı: 2022/124).

Teşekkür

Yok

THE RELATIONSHIP BETWEEN ADULT SEPARATION ANXIETY AND SELF-ESTEEM IN PATIENTS DIAGNOSED WITH GENERALISED ANXIETY DISORDER

Öz

Objective: This study aimed to examine the relationship between self-esteem and both childhood and adult separation anxiety in individuals diagnosed with anxiety disorders, and to evaluate the predictive role of self-esteem on adult separation anxiety. Material and Methods: The study was conducted between September and November 2022 with 102 patients diagnosed with an anxiety disorder according to DSM-5 criteria and 102 healthy controls who presented to the outpatient clinic of a training and research hospital. Participants completed a sociodemographic data form, the Rosenberg Self-Esteem Scale, the Separation Anxiety Symptom Inventory, and the Adult Separation Anxiety Questionnaire. Data were analyzed using SPSS 22.0, and group comparisons, correlation analyses, and regression analyses were performed. Results: Rosenberg Self-Esteem Scale scores were significantly higher in the patient group than in the control group, indicating lower levels of self-esteem. The patient group also showed significantly higher Adult Separation Anxiety Questionnaire scores and a greater proportion of individuals exceeding the clinical cut-off for adult separation anxiety (p < 0.001). No significant difference was found between groups regarding childhood separation anxiety. Correlation analyses revealed that lower self-esteem was positively associated with both childhood and adult separation anxiety. Regression analyses demonstrated that lower self-esteem and higher Separation Anxiety Symptom Inventory scores were significant independent predictors of elevated adult separation anxiety levels. Conclusion: Individuals with anxiety disorders exhibit lower self-esteem and higher adult separation anxiety compared to healthy controls. Self-esteem is closely associated with both childhood and adult separation anxiety and serves as an important predictor of adult separation anxiety. These findings suggest that interventions aimed at enhancing self-esteem may represent a valuable clinical target for reducing separation anxiety symptoms.

Anahtar Kelimeler

• Separation anxiety
• self-esteem
• anxiety disorders
• attachment behavior

Destekleyen Kurum

No financial support was received from any institution or person.

Etik Beyan

The study protocol was approved by the Malatya Turgut Ozal University Clinical Research Ethics Committee (Date: 05.09.2022, Number: 2022/124)

Teşekkür

None

Kaynakça

1. Colak M, Sireli O, Dayi A. Adult separation anxiety and childhood traumas: The mediating role of cognitive distortions. J Child Adolesc Trauma. 2023;16(4):973-980.
2. Elbay RY, Gormez A, Kilic A, Avci SH. Separation anxiety disorder among outpatients with major depressive disorder: Prevalence and clinical correlates. Compr Psychiatry. 2021;105:152219.
3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington (DC): American Psychiatric Publishing; 2013.
4. Iannattone S, Spaggiari S, Di Riso D, Bottesi G. Profiles of intolerance of uncertainty, separation anxiety, and negative affectivity in emerging adulthood: A person-centered approach. J Affect Disord. 2024;345:51-58.
5. Shear K, Jin R, Ruscio AM, Walters EE, Kessler RC. Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the National Comorbidity Survey Replication. Am J Psychiatry. 2006;163(6):1074-1083.
6. Pini S, Abelli M, Shear KM et al. The relationship between adult separation anxiety disorder and complicated grief in a cohort of 454 outpatients with mood and anxiety disorders. J Affect Disord. 2012;143(1-3):64-68.
7. Pini S, Abelli M, Mauri M et al. The relationships among separation anxiety disorder, adult attachment style and agoraphobia in patients with panic disorder. J Anxiety Disord. 2014;28(8):741-746.
8. Ozten E, Tufan AE, Eryilmaz G, Hizli Sayar G, Bulut H. Prevalence of adult separation anxiety disorder in a clinical sample of patients with adult attention-deficit/hyperactivity disorder. Anatolian J Psychiatry. 2016;17(6):459-465.

9. Gesi C, Abelli M, Cardini A et al. Adult separation anxiety disorder in complicated grief: An exploratory study on frequency and correlates. Compr Psychiatry. 2017;72:6-12.
10. Aaronson CJ, Shear K, Goetz RR et al. Predictors and time course of response among panic disorder patients treated with cognitive-behavioral therapy. J Clin Psychiatry. 2008;69(3):418-424.
11. Kirsten LT, Grenyer BFS, Wagner R, Manicavasagar V. Impact of separation anxiety on psychotherapy outcomes for adults with anxiety disorders. Couns Psychother Res. 2008;8(March):36-43.
12. Miniati M, Calugi S, Rucci P et al. Predictors of response among patients with panic disorder treated with medications in a naturalistic follow-up: The role of adult separation anxiety. J Affect Disord. 2012;136:675-679.
13. Iancu I, Bodner E, Ben-Zion IZ. Self-esteem, dependency, self-efficacy and self-criticism in social anxiety disorder. Compr Psychiatry. 2015;58:165-171.
14. Sowislo JF, Orth U. Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychol Bull. 2013;139(1):213-240.
15. Manna G, Giorgio F, Sonia I, Como MR, De Santis S. The relationship between self-esteem, depression and anxiety: Comparing vulnerability and scar model in the Italian context. Mediterr J Clin Psychol. 2016;4(3):1-16.
16. Doron J, Thomas-Ollivier V, Vachon H, Fortes-Bourbousson M. Relationships between cognitive coping, self-esteem, anxiety and depression: A cluster-analysis approach. Pers Individ Differ. 2013;55(5):515-520.
17. Moksnes UK, Moljord IEO, Espnes GA, Byrne DG. The association between stress and emotional states in adolescents: The role of gender and self-esteem. Pers Individ Differ. 2010;49(5):430-435.
18. Trzesniewski KH, Donnellan MB, Moffitt TE, Robins RW, Poulton R, Caspi A. Low self-esteem during adolescence predicts poor health, criminal behaviour, and limited economic prospects during adulthood. Dev Psychol. 2006;42(2):381-390.
19. Sumer N, Sendag MA. Attachment to parents, self-concept, and anxiety in middle childhood. Turk Psikoloji Derg. 2009;24(63):86-101.
20. Luo J, Wang LG, Gao WB. The influence of the absence of fathers and the timing of separation on anxiety and self-esteem of adolescents: A cross-sectional survey. Child Care Health Dev. 2011;38(5):723-733.
21. Ge XJ, Natsuaki MN, Conger RD. Trajectories of depressive symptoms and stressful life events among male and female adolescents in divorced and nondivorced families. Dev Psychopathol. 2006;18:253-273.
22. McCormick CB, Kennedy JH. Father-child separation, retrospective and current views of attachment relationship with father, and self-esteem in late adolescence. Psychol Rep. 2000;86:827-834.
23. Silove D, Manicavasagar V, O’Connell D, Blaszczynski A, Wagner R, Henry J. The development of the separation anxiety symptom inventory (SASI). Aust N Z J Psychiatry. 1993;27(3):477-488.
24. Rosenberg M. Society and the adolescent self-image. Princeton (NJ): Princeton University Press; 1965.
25. Cuhadaroglu F. Self-esteem in adolescents (thesis). Ankara: Hacettepe University Faculty of Medicine; 1986.
26. Topsakal C, Merey Z, Kece M. A qualitative study on the right to education and educational problems of children from migrant families. International Journal of Social Research. 2013;6(27):546-556.
27. Dirioz M, Alkin T, Yemez B, Onur E, Eminagaoglu PN. Validity and reliability of the Turkish versions of the separation anxiety symptom inventory and the adult separation anxiety questionnaire. Turk Psikiyatri Derg. 2012;23(2):108-116.
28. Manicavasagar V, Silove D, Wagner R. A self-report questionnaire for measuring separation anxiety in adulthood. Compr Psychiatry. 2003;44:146-153.
29. Baxter A, Scott K, Vos T, Whiteford H. Global prevalence of anxiety disorders: A systematic review and meta-regression. Psychol Med. 2013;43(5):897-910.
30. Blanco C, Rubio J, Wall M, Wang S, Jiu CJ, Kendler KS. Risk factors for anxiety disorders: Common and specific effects in a national sample. Depress Anxiety. 2014;31(9):756-764.
31. Sokol Y, Rosensweig C, Levin C, Linzer M. Anxiety and temporal self-appraisal: How people with anxiety evaluate themselves over time. J Affect Disord. 2022;296:309-314.
32. Fennell M. Overcoming low self-esteem: A self-help guide using cognitive behavioural techniques. London: Hachette UK; 2016.
33. Lee JY, Patel M, Scior K. Self-esteem and its relationship with depression and anxiety in adults with intellectual disabilities: A systematic literature review. J Intellect Disabil Res. 2023;67(6):499-518.
34. Staring ABP, Van den Berg DPG, Cath DC, Schoorl M, Engelhard IM, Korrelboom CW. Self-esteem treatment in anxiety: A randomized controlled crossover trial of eye movement desensitization and reprocessing (EMDR) versus competitive memory training (COMET) in patients with anxiety disorders. Behav Res Ther. 2016;82:11-20.
35. Şahin EM. Ayrılma anksiyetesi, benlik saygısı ve kaygı düzeyleri arasındaki ilişki (Tez). Erzurum. Atatürk Üniversitesi; 2022.
36. Maldonado L, Huang Y, Chen R, Kasen S, Cohen P, Chen H. Impact of early adolescent anxiety disorders on self-esteem development from adolescence to young adulthood. J Adolesc Health. 2013;53(2):287-292.
37. Lee A, Hankin BL. Insecure attachment, dysfunctional attitudes, and low self-esteem predicting prospective symptoms of depression and anxiety during adolescence. J Clin Child Adolesc Psychol. 2009;38:219-231.
38. Baldwin MW, Main KJ. The cued activation of relational schemas in social anxiety. Pers Soc Psychol Bull. 2001;27:1637-1647.
39. Cakal AG, Tastan N. Interpersonal sensitivity and other related psychological variables. Kirikkale University Journal of Social Sciences. 2023;13(2):659-678.