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Yıl:2020; Cilt: 21; Sayı: 5>> Özet
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Anadolu Psikiyatri Dergisi; 2020;21(5):453-460
Çocukluk çağı travmaları ve intihar girişimleri arasındaki ilişkide psikolojik acı ve dissosiyasyonun aracı etkisi
ME Demirkol, K Uğur, L Tamam
Çukurova Üniversitesi, Adana
Amaç: Fiziksel, cinsel, duygusal ihmal ve istismarı içeren çocukluk çağı travmaları tüm dünyada yaygın bir sorundur ve çeşitli çalışmalarda intihar ile ilişkilendirilmiştir. Bu çalışmada çocukluk çağı travmaları ve intihar girişimleri arasındaki ilişkide psikolojik acı ve dissosiyasyon kavramlarının aracı etkisinin araştırılması amaçlanmıştır. Yöntem: Bu kesitsel çalışmaya Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi'ne başvuran, DSM-5 tanı ölçütlerine göre majör depresif bozukluk tanısı konan 198 erişkin hasta alınmıştır. Hastalar intihar girişiminde bulunanlar (97 hasta) ve bulunmayanlar (101 hasta) olarak gruplandırılmıştır. Katılımcılara Sosyodemografik Veri Formu, Beck Depresyon Ölçeği (BDÖ), Çocukluk Çağı Travmaları Ölçeği (ÇÇTÖ), Dissosiyatif Yaşantılar Ölçeği (DYÖ) ve Psikolojik Acı Ölçeği (PAÖ) uygulanmıştır. Sonuçlar: İntihar girişimi olan grupta ortalama BDÖ, PAÖ puanları ve ortanca DYÖ, ÇÇTÖ puanları intihar girişimi olmayanlara göre daha yüksek saptanmıştır. Çoklu regresyon analizi sonuçlarına göre dissosiyasyon puanları intihar girişimlerini anlamlı şekilde yordamaktadır. Çocukluk çağı travmaları ve intihar girişimleri arasındaki ilişkide dissosiyasyon ve psikolojik acının tam aracı etkisi gösterilmiştir. Tartışma: Çocukluk çağı travmaları intihar girişimlerinin güçlü bir yordayıcısıdır, psikolojik acı ve dissosiyasyon kavramları bu ilişkide aracı rol üstlenmektedir. Çocukluk çağı travması olan depresif hastalarda psikolojik acı ve dissosiyasyon kavramlarının araştırılması ve özgün tedavi yöntemlerinin uygulanması intihar girişimlerinin önlenmesine yardımcı olacaktır
The mediating effects of psychache and dissociation in the relationship between childhood trauma and suicide attempts
Objective: Childhood maltreatment, including physical, sexual, and emotional abuse and neglect, is a common experience worldwide. The association between childhood maltreatment and suicide has also been well established. This study aimed to investigate the mediator roles of psychache and dissociation in the effect of childhood maltreatment on suicide. Methods: This cross-sectional study included 198 major depressive disorder patients admitted to Çukurova University School of Medicine Balcali Hospital and diagnosed with major depressive disorder according to DSM-5 criteria. The patients were grouped as those who attempted (97 patients) or did not attempt suicide (101 patients). Sociodemographic data form, Beck Depression Inventory (BDI), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale (DES), and Psychache Scale (PS) was used for data collection. Results: The mean BDI, median DES, median CTQ total, and mean PS scores in the suicide group were higher than those in the non-suicide group (p<0.001, for each). In multivariate logistic regression analysis, only DES predicted suicide attempts. Psychache and dissociation were full mediators in the effect of CTQ total score on suicide. Conclusion: Childhood maltreatment is a strong predictor of suicide attempts; psychache and dissociation play mediator roles in this relationship. Searching for psychache and dissociation in depressive patients who had childhood trauma history will help direct specific therapeutic interventions to prevent suicide attempts.

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