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Yıl:2017; Cilt: 18; Sayı: 6>> Özet
TAM METİN
Anadolu Psikiyatri Dergisi; 2017;18(6):561-570
Aile içi şiddet mağduru kadınlarda ruhsal dayanıklılık, bağlanma biçimleri, başa çıkma tutumları ve psikopatoloji
Ç Irmak, M Altıntaş
Erenköy Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul
Amaç: Bu çalışmada aile içi şiddete uğrayan ve konukevlerinde kalan kadınlarla, evinde yaşayan kadınların ruhsal dayanıklılık, bağlanma biçimleri, başa çıkma tutumları ve psikopatoloji açısından karşılaştırılması amaçlanmıştır. Yöntem: İstanbul’daki iki kadın konukevinde kalan aile içi şiddet mağduru 100 kadın ve evinde kalan ve halen şiddet gören 50 kadın olmak üzere toplam 150 kadın, Sosyodemografik Veri Formu, Şiddet Veri Formu, Yetişkinler için Psikolojik Dayanıklılık Ölçeği (YİPDÖ), DSM-IV Eksen I Bozuklukları için Yapılandırılmış Klinik Görüşme Formu, Hasta Sağlık Ölçeği-Somatik, Anksiyete ve Depresif Belirtiler (PHQ-SADS) Ölçeği, Erişkin Bağlanma Biçimleri Ölçeği ve Başa Çıkma Tutumları Değerlendirme Ölçeği kullanılarak değerlendirilmiştir. Bulgular: Konukevinde kalan kadınların %76’sı, evinde kalan kadınların %90’ı en az bir psikiyatrik tanıya sahipti. Konukevinde travma sonrası stres bozukluğu (%35), evinde kalan kadınlarda majör depresyon (%66) en sık görülen tanı idi. Evinde kalan grupta majör depresyon, somatizasyon bozukluğu ve yaygın anksiyete bozukluğu diğer gruba göre anlamlı derecede yüksek saptandı. PHQ-SADS Ölçeğine göre evinde kalan grupta, somatizasyon, yaygın anksiyete, panik, depresyon, işlevsellik bozulması alt ölçekleri ve ölçek toplam puanı diğer gruba göre anlamlı derecede yüksek bulundu. YİPDÖ toplam puanı ve kendilik algısı, gelecek algısı, yapısal stil ve aile uyumu alt ölçekleri ise konukevinde kalan grupta anlamlı derecede yüksekti. Aktif başa çıkma alt ölçeği konukevinde kalan kadınlarda, işlevsel olmayan başa çıkma ve davranışsal boş verme alt ölçekleri ise evinde kalanlarda anlamlı olarak yüksek bulundu. İki grubun bağlanma biçimleri arasında fark saptanmadı. Sonuç: Aile içi şiddet, kadınların ruh sağlığını tedavi gerektirecek düzeyde olumsuz etkilemektedir. Evinde kalan ve şiddet gören kadınlara göre konukevlerinde kalan kadınlar, şiddete karşı koymakta koruyucu olan aktif başa çıkma tutumları ve ruhsal dayanıklılık açısından avantajlıdır ve daha az psikopatolojiye sahiptir
The resilience, attachment, coping, and psychopathology of battered women: comparison of sheltered versus in-home women
Objective: To compare the resilience, attachment, coping, and psychopathology of the women exposed to domestic violence who were sheltered to those staying in their home. Methods: One hundred and fifty battered women -100 women staying in two sheltered houses in Istanbul (sheltered group) and 50 women staying in their home (in-home group)- were included in the study and completed the sociodemographic data form, the violence data form, the Scale for Adult Resilience (SAR) the Structured Clinical Interview Form for DSM-IV Axis I Disorders, the Patient Health Questionnaire--Somatic, Anxiety and Depressive Symptoms (PHQ-SADS), the Adult Attachment Scale, and the Coping Strategies Scale. Results: The prevalence of any psychiatric diagnosis was 76% in sheltered group and 90% in in-home group. The most common diagnosis was post-traumatic stress disorder (35%) in in-home group and major depression (66%) in sheltered group. The major depression, somatization disorder and generalized anxiety disorder were significantly more common in in-home group. The total score of the PHQ-SADS scale and subscores of somatization, generalized anxiety, panic, depression, impairment of functioning were significantly higher in-home group. The total score SAR and subscores of self-perception, future perception, structural style, and family resilience were significantly higher in the sheltered group. Among the subscales of the Coping Strategies Scale, score of active coping was significantly higher in sheltered group, as scores of nonfunctional coping and behavioral dismissal were higher in in-home group. There was no difference between the attachment styles of both groups. Discussion: Domestic violence negatively affects the mental health of women necessitating medical treatment. Compared to the women staying at home and living under ongoing violence, the sheltered battered women are advantageous in terms of active coping attitudes and resilience to combat violence, and prevalence of psychopathology

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