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Yıl:2017; Cilt: 54; Sayı: 3>> Özet
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Nöropsikiyatri Arşivi; 2017;54(3):234-238
Ergen Cinsel İstismar Olgularında Psikopatoloji Gelişiminde 5-HTTLPR Gen Polimorfizmi ve Yılmazlık Bileşeninin Değerlendirilmesi
GÇ Bulut, AR Arman, İ Güney, P Gültepe
Marmara Üniversitesi, İstanbul
Amaç: Çocukların ¼’ünden fazlası, erişkin döneme ulaşana dek beklenmedik ve ürkütücü deneyimlere ve travmalara maruz kalmaktadır. Bu çalışmada, cinsel istismara maruz kalmış olan ergenlerde serotonin taşıyıcı gen polimorfizminin, yılmazlık ekseninde belirti değişkenliğini belirlemede olası rolünün araştırılması amaçlanmıştır. Yöntem: Marmara Üniversitesi Çocuk Psikiyatrisi Adli polikliniğine baş- vuran ve cinsel istismar maruziyeti öyküsü olan, 11-17 yaş arası ergenlere araştırma hakkında bilgi verilmiş ve araştırmaya katılmaya gönüllü olanlar çalışmaya dahil edilmiştir. Psikopatoloji ve işlevsellik değerlendirmeleri klinik görüşme esnasında, Çocuklar için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam boyu Versiyonu-Türkçe Versiyonunu (ÇGDŞ-ŞY-T) ile yapılmıştır. Ayrıca çocukların doldurduğu, “Eysenck Kişilik Envanteri” ve “Stresle Başa Çıkma Tarzları Ölçeği” de değerlendirilmiştir. Bulgular: 16 kız (%88,9) ile 2 erkekten (%11,1) oluşmakta olan örneklemin yaş ortalaması 14,58±1,97 idi. Örneklemde 5-HTT geninin transkripsiyonel kontrol bölgesindeki insersiyon/delesyon polimorfizminin (5-HTTLPR) genotiplenmesi yapıldığında; 8 bireyin (%44,4) LL, 7 bireyin (%38,8) LS ve 3 bireyin (%16,6) SS genotipinde olduğu belirlenmiştir. Yılmazlık alt bileşenleri olan baş etme tarzları ile genetik varyantlar arasındaki ilişki incelendiğinde ise problem odaklı baş etme tarzı sergileyen olguların %87,5’inin (n=7) LL aleli taşıdığı; baş etme tarzları duygu odaklı olanların ise %90’ının (n=9) SS-LS alel taşıyıcısı oldukları saptanmıştır (p=0,003). Sonuç: Çalışmamızın bulguları, 5HTTLPR gen polimorfizminin kişinin stresle baş etme tarzlarının biçimlenmesi üzerine önemli bir etkisinin olduğuna işaret etmektedir. 5HTTLPR gen polimorfizmi ve psikopatoloji gelişimi arasındaki kompleks ilişkide rol oynayan diğer faktörlerin saptanması için daha fazla çalışmaya ihtiyaç duyulmaktadır.
Evaluation of 5-HTTLPR Gene Polymorphism and Resilience Components on the Development of Psychopathology in Adolescent Sexual Abuse Cases
Introduction: More than one-fourth adolescents are exposed to unexpected frightening experiences and traumas until adulthood. In this study, we aimed to determine the potential role of serotonin transporter (5-HTT) gene polymorphism regarding resilience factors in the symptom variability of individuals exposed to sexual abuse. Methods: Adolescents aged 11–17 years, who were admitted to the Marmara University Child Psychiatry Outpatient Clinic Forensic division with sexual abuse experience history, were informed about the research, and volunteers were included in the study. Turkish versions of “Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (K-SADS-PL)” was used to assess the psychopathology and functionality. The evaluation of participants also included self-reports based on “Eysenck Personality Inventory” and “Ways of Coping Inventory” for reflecting the resilience domain. Results: The sample included 16 girls (88.9%) and 2 boys (11.1%), and the mean (±standard deviation) age was 14.58±1.97 years. Genotyping of the insertion/deletion polymorphism (5-HTTLPR) in the 5-HTT gene’s transcriptional control zone was established, and 8 participants (44.4%) were determined to be of the LL genotype, while 7 (38.8%) were LS and 3 (16.6%) were SS carriers. Considering the relationship between coping styles regarding resilience and genetic variants, 87.5% of participants (n=7) exhibiting problem-focused coping style were determined found to carry the LL allele, while 90% (n=9) who exhibited emotion-focused coping styles were the SS-LS allele carriers (p=0.003). Conclusion: Our findings suggest that 5-HTTLPR gene polymorphism has a significant impact on the formation of coping styles. More studies are needed to determine other factors involved in the complex relationship between 5-HTTLPR gene polymorphism and development of psychopathology.

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