Obsesif Kompulsif Bozukluk Tanılı Ergenlerin ve Annelerin Obsesif İnançları ve Çıkarımsal Karmaşaları Arasındaki İlişki

Yıl 2022, , 444 - 452, 29.09.2022

Esengül Ekici , Hesna Gul , Mustafa Dinçer , Kadir Özdel , Ayhan Cöngöloğlu

https://doi.org/10.31832/smj.1081443

Öz

Amaç: Obsesif kompulsif bozukluk(OKB) tanılı ergenlerin ve annelerinin obsesif inançları ve çıkarımsal karmaşaları arasındaki ilişkiyi saptayarak OKB’deki bilişsel değerlendirmeleri araştırmaktır.
Gereç ve Yöntem: Çalışmaya 25 OKB hastası (20 erkek ve 5 kız) ile bu hastaların anneleri dahil edildi. Hastalara Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Şekli (K-SADS-PL) ve Yale-Brown Obsesyon-Kompulsiyon Ölçeği (Y-BOKÖ) uygulandıktan sonra OKB tanısı alan hastalara ve onların annelerine Obsesif İnançlar Ölçeği-44 (OİÖ-44), Çıkarımsal Karmaşa Ölçeği (ÇKÖ), Padua Envanteri (PE) uygulanmıştır. Hastaların ve annelerinin obsesif inançları, çıkarımsal karmaşaları ile obsesif kompulsif belirti puanlarının korelasyonu incelenmiştir.
Bulgular: Ergenler ile annelerin, obsesif inançları ve çıkarımsal karmaşa ölçeği arasında yapılan korelasyon analizlerine göre sadece ergenlerin obsesif inançlardan mükemmeliyetçilik/kesinlik puanları ile annelerin abartılmış sorumluluk/tehlike puanları arasında istatistiksel olarak negatif yönde anlamlı korelasyon bulundu(r = -0.42, p = 0.039).
Sonuç: Bu çalışma OKB tanılı ergenlerdeki obsesif inançlar ve çıkarımsal karmaşa ile ilgili hipotezlerini kısmen destekler. Klinik tedaviler ailelerdeki olası patolojik bilişsel faktörler göz önüne alınarak düzenlenmesi tedavi başarısını artırabilir.

Anahtar Kelimeler

obsesif kompülsif bozukluk, obsesif inançlar, çıkarımsal karmaşa, anne

Kaynakça

• 1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Text Revision. American Psychiatric Association Pres: Washington; 2013.
• 2. D'Alessandro TM. Factors influencing the onset of childhood obsessive compulsive disorder. Pediatr Nurs. 2009;35:43.
• 3. Flay BR, Biglan A, Boruch RF, Castro FG, Gottfredson D, Kellam S, Mo´scicki EK, Schinke S, Valentine JC, Ji P. Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prev Sci. 2005;6:151-175.
• 4. Reynolds S, Reeves J. Do cognitive models of obsessive compulsive disorder apply to children and adolescents? Behav Cogn Psychother . 2008;36:463-71.
• 5. Farrell LJ, Waters AM, Zimmer-Gembeck MJ. Cognitive biases and obsessive-compulsive symptoms in children: Examining the role of maternal cognitive bias and child age. Behav. Ther. 2012;43:593-605.
• 6. Salkovskis PM, Forrester E, Richards C. Cognitive–behavioural approach to understanding obsessional thinking. Br J Psychiatry Suppl. 1998;173:53-63.
• 7. Rachman S. A cognitive theory of obsessions: Elaborations. Behav Res Ther. 1998;36:385-401.
• 8. Obsessive Compulsive Cognitions Working Group. Psychometric validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory: Part I. Behav Res Ther. 2003;41:863-78.
• 9. Salkovskis P, Shafran R, Rachman S, Freeston MH. Multiple pathways to inflated responsibility beliefs in obsessional problems: Possible origins and implications for therapy and research. Behav Res Ther. 1999;37:1055-72.
• 10. Libby S, Reynolds S, Derisley J, Clark S. Cognitive appraisals in young people with obsessive‐compulsive disorder. J Child Psychol Psychiatry. 2004;45:1076-84.
• 11. Coles ME, Wolters LH, Sochting I, De Haan E, Pietrefesa AS, Whiteside SP. Development and initial validation of the obsessive belief questionnaire‐child version (OBQ‐CV). Depress Anxiety. 2010;27:982-91.
• 12. Barrett P, Healy-Farrell L. Perceived responsibility in juvenile obsessive-compulsive disorder: An experimental manipulation. J Clin Child Adolesc Psychol. 2003;32:430-41.
• 13. Rector NA, Cassin SE, Richter MA, Burroughs E. Obsessive beliefs in first-degree relatives of patients with OCD: A test of the cognitive vulnerability model. J Anxiety Disord. 2009;23:145-9
• 14. Taylor S. Etiology of obsessions and compulsions: a meta-analysis and narrative review of twin studies. Clin Psychol Rev. 2011;31:1361-72.
• 15. Pietrefesa AS, Schofield CA, Whiteside SP, Sochting I, Coles ME. Obsessive beliefs in youth with OCD and their mothers. J Cogn Psychother. 2010;24:187-97.
• 16. Farrell LJ, Hourigan D, Waters AM, Harrington MR. Threat interpretation bias in children with obsessive-compulsive disorder: examining maternal influences. J Cogn Psychother. 2015;29:230-52.
• 17. Chorpita BF, Barlow DH. The development of anxiety: the role of control in the early environment. Psychol. Bull. 1998;124:3.
• 18. Field AP. Is conditioning a useful framework for understanding the development and treatment of phobias? Clin. Psychol. Rev. 2006;26:857-75.
• 19. Berman NC, Jacoby RJ, Sullivan AD, Hoeppner S, Micco JA, Wilhelm S. Parent-level risk factors for children's obsessive beliefs, interpretation biases, and obsessive-compulsive symptoms: A cross-sectional examination. J. Obs.-Compuls. Relat. Disord. 2018;18:8-17.
• 20. Aardema F, O’Connor K. Seeing white bears that are not there: Inference processes in obsessions. J Cogn Psychother. 2003;17:23-37.
• 21. Aardema F, O’Connor KP, Emmelkamp PM, Marchand A, Todorov C. Inferential confusion in obsessive–compulsive disorder: the inferential confusion questionnaire. Behav Res Ther. 2005;43:293-308.
• 22. Kaufman J, Birmaher B, Brent D, et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36:980-8.
• 23. Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y. Okul Çaği Çocuklari İçin Duygulanim Bozukluklari ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Şekli-Türkçe Uyarlamasinin Geçerlik ve Güvenirliği. Turk J Child Adolesc Ment Health. 2004.
• 24. Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46:1006-11. 25. Obsessive Compulsive Cognitions Working Group. Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory. Behav Res Ther. 2001;39:987-1006..
• 26. Boysan M, Besiroglu L, Çetinkaya N, Atli A, Aydin A. Obsesif inanislar Ölçegi-44'ün (OIÖ-44) Türkçe Formunun Geçerlik ve Güvenirligi/The Validity and Reliability of the Turkish Version of the Obsessive Beliefs Questionnaire-44 (OBQ-44). Arch Neuropsychitry. 2010;47:216.
• 27. Yorulmaz O, Dirik G, Karaali PO, Üvez PE. Obsessif-kompulsif bozukluk hastalarında Çıkarımsal Karmaşa Ölçeği’nin psikometrik özellikleri. Türk Psikiyatr Derg. 2010;21:135-42.
• 28. Burns GL, Keortge SG, Formea GM, Sternberger LG. Revision of the Padua Inventory of obsessive compulsive disorder symptoms: Distinctions between worry, obsessions, and compulsions. Behav Res Ther. 1996;34:163-73.
• 29. Yorulmaz O, Karancı A, Dirik G, et al. Padua Envanteri-Washington Eyalet Üniversitesi Revizyonu: Türkçe Versiyonunun Psikometrik Özellikleri. Türk Psikol Yazıları. 2007;10:75-85.
• 30. Jacobi DM, Calamari JE, Woodard JL. Obsessive–compulsive disorder beliefs, metacognitive beliefs and obsessional symptoms: relations between parent beliefs and child symptoms. Clin Psychol Psychother. 2006;13:153-62.
• 31. Albayrak ZS, Tarakçıoğlu MC, Kadak MT. Association between cognitive beliefs and obsessive compulsive symptoms in non-clinical population. Med Res Rep 2018;1:46-9.
• 32. Aardema F, Radomsky AS, O'Connor KP, Julien D. Inferential confusion, obsessive beliefs and obsessive–compulsive symptoms: a multidimensional investigation of cognitive domains. Clin Psychol Psychother. 2008;15:227-38.
• 33. Pişgin İ, Özen DŞ. Çocukluktan erişkinliğe obsesif kompulsif bozuklukta hatalı değerlendirme ve inanç alanları. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry. 2010;2:117-31.
• 34. Berman NC, Abramowitz JS, Pardue CM, Wheaton MG. The relationship between religion and thought–action fusion: Use of an in vivo paradigm. Behav Res Ther. 2010;48:670-4.
• 35. Wu MS, McGuire JF, Martino C, Phares V, Selles RR, Storch EA. A meta-analysis of family accommodation and OCD symptom severity. Clin. Psychol. Rev. 2016;45:34-44.
• 36. Alloy LB, Abramson LY, Gibb BE, et al. Developmental antecedents of cognitive vulnerability to depression: Review of findings from the cognitive vulnerability to depression project. J. Cogn. Psychother. 2004;18:115-34.
• 37. Kadak MT, Balsak F, Besiroglu L, Çelik C. Relationships between cognitive appraisals of adolescents with OCD and their mothers. Compr Psychiatry. 2014;55:598-603.
• 38. Yorulmaz O, Gençöz T, Woody S. Vulnerability factors in OCD symptoms: Cross‐cultural comparisons between Turkish and Canadian samples. Clin Psychol Psychother. 2010;17:110-21.
• 39. Nestadt G, Samuels J, Riddle M, Bienvenu III OJ, Liang KY, LaBuda M, Walkup J, Grados M, Hoehn-Saric R. A family study of obsessive-compulsive disorder. Arch Gen Psychiatry. 2000;57:358-63.
• 40. Dias BG, Ressler KJ. Parental olfactory experience influences behavior and neural structure in subsequent generations. Nat. Neurosci. 2014;17:89-96.
• 41. Timpano KR, Abramowitz JS, Mahaffey BL, Mitchell MA, Schmidt NB. Efficacy of a prevention program for postpartum obsessive–compulsive symptoms. J. Psychiatr. Res. 2011;45:1511-7.