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Yıl:2016; Cilt: 6; Sayı: 2>> Özet
TAM METİN
Journal of Mood Disorders; 2016;6(2):63-70
Marital harmony and childhood psychological trauma in child marriage
M Güneş, H Selçuk, S Demir, AO İbiloğlu, M Bulut, MC Kaya, A Yılmaz, A Atlı, A Sır
Dicle Üniversitesi, Diyarbakır
Amaç: Çocuk evliliği yapan kadınların işlevselliklerini bozan birçok problemlerle karşılaştıkları bildirilmiştir. Çocuk evliliği yapan kadınların çocukluk çağında daha fazla ruhsal travmaya maruz kalmış olabileceğini ve çift uyumlarının daha fazla bozulmuş olabileceği düşü- nülmektedir. Bu çalışmada çocuk evliliği yapan kadınlarda çocukluk çağı ruhsal travmasını ve çift uyumunu araştırmayı amaçladık. Yöntem: Çalışmanın örneklemi 2013 yılı Temmuz–Ağustos ayları arasında Dicle Üniversitesi Kadın Doğum ve Hastalıkları Polikliniğine rutin gebelik kontrolü için başvuran gebe kadınlardan seçildi. Çalışma grubu rutin gebelik kontrolü için başvuran 83 gebe arasından çalışma kriterlerini sağlayan 50 çocuk evliliği (18 yaşından önce evlenmiş) yapmış olan gebe kadın seçilerek oluşturuldu. Kontrol grubu ise 18 yaşından sonra evlenmiş 87 gebe kadın arasından çalışma kriterlerini sağlayan sağlıklı 50 gebe kadın seçilerek oluş- turuldu. Tüm katılımcılar psikiyatrist tarafından standardize edilmiş görüşme aracı olan SCID kullanılarak değerlendirildi. Araştırmacılar tarafından oluşturulan sosyodemografik veri formu, Çocukluk Çağı Ruhsal Travma Ölçeği (ÇÇRTÖ), Çift Uyum Ölçeği (ÇUÖ) ve Arizona Cinsel Yaşantılar Ölçeği (ACYÖ) uygulandı. Bulgular: Çift uyumu eşler arası birliktelik boyutu (EABB) ve duygulanım ifade boyutu (DİB) alt ölçek puanları çalışma grubunda kontrol grubuna kıyasla istatistiksel olarak anlamlı düzeyde daha düşük bulunmuştur (sırasıyla p=0.015, p=0.003). Çift uyumunu en sık çocukluk çağı ruhsal travması, evlenme yaşı, ilk gebelik yaşı, cinsel istismar ve cinsel şiddete maruz kalma gibi faktörlerin etkilediği bulundu. ÇÇRTÖ’de emosyonel istismar (p=0.04) ve fiziksel ihmal (p=0.035) puanları çalışma grubunda kontrol grubuna kıyasla istatistiksel olarak anlamlı düzeyde daha yüksek bulunmuştur. Ayrıca çalışma grubunda kontrol grubuna kıyasla evliliğin ilk yıllarında fiziksel (p=0.001) ve cinsel şiddete (p=0.007) maruz kalma oranları istatistiksel olarak anlamlı düzeyde daha yüksek bulunmuştur. Cinsel istek, cinsel uyarılma ve ACYÖ toplam puanı çalışma grubunda kontrol grubuna kıyasla istatistiksel olarak anlamlı derecede farklı bulunmuştur (sırasıyla p=0.012, p=0.034, p=0.048). Sonuç: Çalışmamız çocuk evliliği yapanlarda çift uyumu ile çocukluk çağı travması ve cinsel işlevlerin birlikte değerlendirildiği ilk çalış- madır. Çalışmamızda çocuk evliliği yapanların çift uyumunun bozulmuş olduğu ve buna en fazla çocukluk çağı ruhsal travması, erken yaşta evlenme, çocuk yaşta gebe kalma, cinsel istismar ve cinsel şiddete maruz kalmanın neden olduğu belirlenmiştir. Çalışmamızda çocuk evliliği yapanların çocukluk çağında daha fazla emosyonel istismar, fiziksel ihmale / şiddet ve cinsel şiddete maruz kaldıkları tespit edilmiştir. Ayrıca çocuk evliliği yapan kadınların cinsel işlevlerinin önemli oranda bozulduğu tespit edilmiştir.
Çocuk evliliği yapan kadınlarda çift uyumu ve çocukluk çağı ruhsal travması
Objective: As it known, the problem of child marriage is increasing in last years and primarily affect girls. Worldwide, child marriage is most often occurs in poor, rural communities, as in some regions of Turkey. Unfortunately, the child marriage may have been affected the negative way of functionality which emerging the many problem. For instance, child marriages are twice as likely to be victims of domestic violence with impaired marital harmony than their peers who marry later. A further stronger effect of child marriage that is higher rates of witnessing to domestic violence for thier children. The aim of this study was to investigation of childhood psychological traumas with marital harmony in women who had married as child. Method: The study population was consisted the two women groups. First group was including the 50 women who had married before the ages of 18, whereas the second (namely, control) group was including the 50 of 87 women who had meets the inclusion criteria of our study and married after the ages of 18. Our participants were admitted to outpatient unit of Department of Gynecology and Obstetrics, Faculty of Medicine University of Dicle for the examination of routine pregnancy, between the months July 2013 and august 2013, in Turkey. All participants were examined by a trained psychiatrist (with SCID assessment). After then, the sociodemographic data form which prepared by the study authors based on the sociodemographic features of region, Arizona sexual experience scale (ASES), dyadic adjustment scale (DAS), and childhood trauma questionnaire (CTQ) were applied. Results: Dyadic cohesion (degree to which respondent and partner participate in activities together) and affection expression (degree to respondent agrees with partner regarding emotional affection) subscale scores were found significantly lower in the study group (respectively, p=0.015, p=0.003). Also, marital harmony was mostly affected by the childhood traumas, age of marriage, age of first pregnancy, sexual abuse and violence. We found that the scores of emotional (p=0.04) and physical abuse (p=0.035) subscales in CTQ were significantly higher in study group than the control group. Also, we found that the sexual and physical violence were significantly higher in study group than the control group, particularly during the early years of marriage (respectively, p=0.007, p=0.001). The sexual desire, sexual arousal and ASES total scores were significantly different among the three groups (respectively, p=0.012, p=0.034, p=0.048). Conclusions: As far as we know that, our study is the first study for evaluating in a combination of the childhood trauma, sexual functionality, and marital harmony in the child marriage. We found here; marital harmony was significantly impaired in child marriage. Particularly, it was determined that the childhood traumas, married in early ages, sexual abuse and violence with become pregnant as a child. Consequently, we demonstrated that childhood marriage was significantly associated with higher rate of emotional abuse, physical and sexual violence. Also, sexual functions were mostly impaired in women who had married in childhood.

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