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Yıl:2019; Cilt: 3; Sayı: 1>> Özet
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Klinik Psikoloji Dergisi; 2019;3(1):26-33
Bipolar bozuklukta çevresel stres türleri ve sosyal destek
A Saleh, K Kuşçu, K Kora
Children’s National Health Center, Washington, D.C.
Bu çalışmada stresli yasam olaylarının ve zorlukların Bipolar Duygu Durum Bozukluklarındaki (BDB) etkisinin araştırılması amaçlanmıştır. Hastalığın öncesi ve sonrasındaki yaşam olaylarının ve zorlukların türlerinde ve şiddetinde, ayrıca kişiye verilen destekte değişiklik olup olmadığına bakılmıştır. Çalışmaya, çalışmanın başlangıç tarihinden üç yıl öncesine kadar BDB tip I ve/ya tip II tanısı almış 24 hasta katılmıştır. Yaşam Olayları ve Zorlukları Listesi (Life Events and Difficulties Schedule-LEDS) kullanarak, BDB tanısı konulmadan önceki yıl ve sonrasındaki yasam olaylarının (bir aydan kısa süren çevresel stres) ve zorluklarının (bir aydan uzun süren çevresel stres) sayısı, türü, şiddet derecesi, kişiye verilen olumlu ve olumsuz tepkiler ölçülmüştür. Ayrıca, yaş, cinsiyet ve eğitim seviyesi eşit olan 24 kişiden oluşturulmuş bir kontrol grubu da araştırmaya dâhil edilmiştir. Hasta grubunun, kontrol grubuna göre, daha çok stresli yaşam olayı ve zorluğuna maruz kaldığı görülmüştür. Ayrıca sorunların daha çok eğitim, iş ve tıbbi alanlarda; partnerle olan ilişkide ve kişiler arası ilişkilerde yoğunlaştığı bulunmuştur. Yasam olaylarının tehdit derecesi, BDB tanısı konulmadan önce, çok daha yüksek bulunmuştur. Her iki grup, stresli olaylarda eşit derecede olumlu destek almışlardır. Buna rağmen, BDB olan hastalar, özellikle hastalığın başlangıcından sonra, stresli yaşam olaylarının sonucunda daha çok olumsuz tepkiye maruz kalmışlardır. BDB başlamasında, stresli yasam olaylarının ve zorluklarının önemli bir role sahip olduğu görülmektedir. Ayrıca, olumsuz tepkilerin BDB açısından önemli bir sebep olabileceği düşünülmüştür.
Types of environmental stressors and social support in bipolar disorder
Environmental Stressors (ES) are among the triggering factors of mood fluctuations in Bipolar Disorder (BD). This study explored the types and intensity of ESs causing mood fluctuations and whether perceived support had an influence on that relationship. In this descriptive study, 24 patients, who were diagnosed with BD type I or II within the three years prior to current study were included; and 24 Healthy Controls (HC) were matched in terms of age, sex and educational level. Life Events and Difficulties Schedule (LEDS) was used to screen for numbers, domains, and threat level of life events (stressors < 1 month) and difficulties (stressors > 1 month), as well as positive support, and negative reactions to each stressor. Screening period included one year before the first manic or hypomanic episode. Compared to HC, BD patients reported higher numbers of total life events and difficulties particularly in education, work, medical health, partner and interpersonal relationships domains. Patients were exposed to greater negative reactions from others, especially after the onset of BD. There were no differences between the groups regarding perceived social support from others. Findings highlighted the triggering effect of severe ES on BD onset, types of ES, and perceived social reaction.

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