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Tanılar Üstü Yaklaşım ve Obsesif Kompulsif Bozukluk

Yıl 2023, Cilt: 15 Sayı: 2, 307 - 322, 30.06.2023
https://doi.org/10.18863/pgy.1110989

Öz

Psikiyatrik bozuklukların açıklanmasında geleneksel psikiyatrik nozolojinin kategorik yaklaşımı uzunca bir süredir hakim yaklaşım olmuş ve bozukluklar belirtilere dayalı tanı kategorileriyle tanımlanmıştır. Ancak son yıllarda geleneksel tanı sınırlarının ötesine uzanan yeni sınıflandırma sistemi olan "transdiagnostic" yani “tanılar üstü” yaklaşımın önemi giderek artmaktadır. Yaklaşım, psikopatolojileri gözlemlenebilir belirtilere göre sınıflandıran kategorik yaklaşımdan uzaklaşıp boyutsal olarak pek çok psikopatolojinin altında yatan ortak bilişsel, davranışsal, kişilerarası ve biyolojik süreçlerin incelenmesini amaçlamaktadır. Belirtilerin ötesinde bozuklukların altında yatan ortak süreçler ve risk faktörleri üzerinden tedavi etmeyi böylelikle heterojen ve eştanı belirtileri daha iyi ele alabilmeyi ve tedavi sırasında değişebilen tanı kategorilerinden uzak kalmayı hedeflemektedir. Bu derleme makalesi ile sınıflandırmaya dayalı tanı konmasındaki mevcut sorunların ne olduğu ve alandaki boşluklar incelenmiş, yaklaşımın kendisi bir çözüm önerisi olarak sunulmuştur. Bu kapsamda psikiyatrik bozukluklar için yeni bir sınıflandırma sistemi girişimi olan RDoC (Research Domain Criteria - Araştırma Alanı Ölçütleri); genetik, sinirbilim ve davranış bilimlerindeki modern araştırma yaklaşımlarını kullanarak yeni yapı ortaya koymuştur. Bu çalışmada tanılar üstü yaklaşımın tanımı ve ortaya çıkışı, tanılar üstü yaklaşım bağlamında obsesif kompulsif bozukluk ve RDoC, tanılar üstü tedavi yaklaşımı aktarılmıştır. Bu derleme çalışmasının tanılar üstü yaklaşım çerçevesinde hem temel psikopatoloji araştırmalarında hem de tedavi yöntemlerinin geliştirilmesinde kaynak olması amaçlanmıştır.

Kaynakça

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Transdiagnostic Approach and Obsessive Compulsive Disorder

Yıl 2023, Cilt: 15 Sayı: 2, 307 - 322, 30.06.2023
https://doi.org/10.18863/pgy.1110989

Öz

The categorical approach of traditional psychiatric nosology has been a forceful approach for a very long time for explaining psychological disorders which are defined by symptom based diagnostic categories. However, in recent years, the importance of the "transdiagnostic" approach which is a new classification system is increasing. The transdiagnostic approach aims to examine dimensionally the common cognitive, behavioral, interpersonal and biological processes underlying many psychopathologies away from the categorical approach that classifies psychopathologies according to observable symptoms. This approach intends to treat the disorders through the common underlying processes and risk factors, thus heterogeneous and comorbid symptoms are better addressed and diagnostic categories that may change during treatment are avoided. In this review study, the current problems in diagnosing based on classification and gaps in the field were examined, and the approach itself was proposed as a solution. RDoC (Research Domain Criteria) which is a new classification system for psychiatric disorders within the scope of the approach, has created a new structure using modern research approaches in genetics, neuroscience and behavioral sciences. In the present study, the definition and emergence of the transdiagnostic approach, obsessive compulsive disorder and RDoC in the context of transdiagnostic approach and transdiagnostic treatment are explained. This review is intended to be a resource for both basic psychopathology research and the development of treatment methods within the framework of a transdiagnostic approach.

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  • Ruscio A.M , Stein, D.J., Chiu, W.T. , Kessler, R.C. (2010). The epidemiology of obsessive- compulsive disorder in the National Comorbidity Survey Replication . Mol Psychiatry, 15 (1), 53 – 63 . 13. DOI: 10.1038/mp.2008.94
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  • Sauer-Zavala, S., Gutner, C. A., Farchione, T. J., Boettcher, H. T., Bullis, J. R. ve Barlow, D. H. (2017). Current definitions of “transdiagnostic” in treatment development, A search for consensus. Behavior Therapy, 48(1), 128 – 138. https://doi.org/10.1016/j.beth.2016.09.004
  • Selby, E. A., Anestis, M., Bender, T. ve Joiner, T. E. (2009). An exploration of the emotional cascade model in borderline personality disorder. Journal of Abnormal Psychology, 118(2), 375–387 https://doi.org/10.1037/a0015711
  • Selby, E. A. ve Joiner, T. E. (2009). Cascades of emotion, The emergence of borderline personality disorder from emotional and behavioral dysregulation. Review of General Psychology, 13(3), 219–229. https://doi.org/10.1037/a0015687
  • Selby, E. A. ve Joiner, T. E. (2013). Emotional cascades as prospective predictors of dysregulated behaviors in borderline personality disorder. Personality disorders, Theory, research, and treatment, 4(2), 168–174. https://doi.org/10.1037/a0029933
  • Shafran, R., Cooper, Z. ve Fairburn, C. G. (2002). Clinical perfectionism, A cognitive–behavioural analysis. Behaviour Research and Therapy, 40(7), 773-791. doi:10.1016/s0005-7967(01)00059-6
  • Shafran, R. ve Mansell, W. (2001). Perfectionism and psychopathology, A review of research and treatment. Clinical Psychology Review, 21, 879−906. doi:10.1016/s0272-7358(00)00072
  • Shafran, R., Wade, T., Egan, S., Kothari, R., Allcott-Watson, H., Carlbring, P., ... Andersson, G. (2017). Is the devil in the detail? A randomized controlled trial of guided internet-based CBT for perfectionism. Behaviour Research and Therapy. Doi: 10.1016/ j.brat.2017.05.014
  • Shoan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H. ve Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders, A systematic review. Clinical Psychology Review, 57, 141-163. doi:10.1016/j.cpr.2017.09.002
  • Steil, R. ve Ehlers, A. (2000). Dysfunctional meaning of posttraumatic intrusions in chronic PTSD. Behaviour Research and Therapy, 38(6), 537–558. doi:10.1016/s0005-7967(99)00069-8
  • Stiles, W. B., Barkham, M., Mellor-Clark, J. ve Connell, J. (2008). Effectivesss of cognitivebehavioural, person-centered, and psychodynamic therapies in UK primary care routinepractice, Replicationwith a larger sample. PsychologicalMedicine, 38, 677−688. doi: 10.1017/S0033291707001511
  • Storch, E. A., Wu, M. S., Small, B. J., Crawford, E. A., Lewin, A. B., Horng, B. ve Murphy, T. K. (2014). Mediators and moderators of functional impairment in adults with obsessive– compulsive disorder. Comprehensive Psychiatry, 55, 489–496. Doi:10.1016/j.comppsych.2013.10.014
  • Svaldi, J., Grie enstroh, J., Tuschen-Caffier, B. ve Ehring, T. (2012). Emotion regulation deficits in eating disorders, A marker of eating pathology or general psychopathology? Psychiatry Research, 197(1-2):103-11. doi:10.1016/ j.psychres.2011.11.009.
  • Swets, M., Dekker, J., van Emmerik-van Oortmerssen, K., Smid, G.E., Smit, F., de Haan, L., Schoevers, R.A. (2014). The obsessive compulsive spectrum in schizophrenia, a meta-analysis and meta-regression exploring prevalence rates. Schizophrenia Research 152, 458–468. Doi:10.1016/j.schres.2013.10.033
  • Şahin, A.E. (2001) Eğitim araştırmalarında Delphi tekniği ve kullanımı. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi, 20(20).
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  • Titov, N., Andrews, G., Johnston, L., Robinson, E. ve Spence, J. (2010). Transdiagnostic internet treatment for anxiety disorders, A randomized controlled trial. Behaviour Research and Therapy, 48, 890–899. Doi:10.1016/j.brat.2010.05.014
  • Tolin, D. F., Worhunsky, P. ve Maltby, N. (2006). Are “obsessive” beliefs specific to OCD?, A comparison across anxiety disorders. Behaviour Research and Therapy, 44(4), 469-480. https://doi.org/10.1016/j.brat.2005.03.007
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  • Weissman, M.M., Bland, R.C., Canino, G.J., Greenwald, S., Hwu, H.G., Lee, C.K., … Wickramaratne, P.J. (1998). Crossnational epidemiology of obsessive- compulsive disorder . CNS Spectrums . 3, 6–9 . DOI: https://doi.org/ 10.1017/S1092852900007136
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  • Zavos, H. M. S., Rijsdijk, F. V. ve Eley, T. C. (2012). A longitudinal, genetically informative, study of associations between anxiety sensitivity, anxiety and depression. Behavior Genetics, 42, 592–602. https://doi.org/10.1007/s10519-012-9535-0
Toplam 172 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Psikoloji
Bölüm Derleme
Yazarlar

Emre Özdemir 0000-0003-4999-2656

A. Bikem Hacıömeroğlu 0000-0001-7133-740X

Erken Görünüm Tarihi 30 Haziran 2023
Yayımlanma Tarihi 30 Haziran 2023
Kabul Tarihi 8 Ekim 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 15 Sayı: 2

Kaynak Göster

AMA Özdemir E, Hacıömeroğlu AB. Transdiagnostic Approach and Obsessive Compulsive Disorder. Psikiyatride Güncel Yaklaşımlar. Haziran 2023;15(2):307-322. doi:10.18863/pgy.1110989

Creative Commons Lisansı
Psikiyatride Güncel Yaklaşımlar Creative Commons Atıf-Gayriticari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.