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Yıl:2021; Cilt: 58; Sayı: 1>> Özet
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Nöropsikiyatri Arşivi; 2021;58(1):63-67
Sosyal Anksiyete Bozukluğu Hastalarında Zihin Kuramı ve Bağlanma Özellikleri ile Hastalık Şiddeti Arasındaki İlişki
İ Küçükparlak , H Karaş , M Kaşer , EA Yıldırım
Serbest Hekim, İstanbul,
Amaç: Çalışmamızın amacı sosyal anksiyete bozukluğu (SAB) olan hastalarda bağlanma örüntülerinin ve Gözler Testi ile ölçülen zihin kuramı yetisinin sağlıklı kontroller ile karşılaştırılmasıdır. Çalışmamızın bir diğer amacı ise SAB hastalarında bağlanma özellikleri, zihin kuramı yetisi ve hastalık şiddeti arasındaki ilişkileri araştırmaktır. Yöntem: SAB tanısıyla takip edilmekte olan 47 ardışık hasta ile 50 sağlıklı kontrol çalışmaya dahil edildi. Tüm katılımcılara sosyodemografik veri formu, SCID-I Yapılandırılmış Klinik Görüşmesi Hasta Formu, Beck Depresyon Envanteri (BDE), Gözlerden Zihin Okuma Testi (Gözler Testi), Liebowitz Sosyal Anksiyete Ölçeği (LSAÖ), Yakın İlişkilerde Yaşantılar Envanteri (YİYE) ve Durumsal ve Sürekli Kaygı Envanteri (DSKE) uygulandı. Bulgular: SAB grubunun BDE, LSAÖ kaygı ve kaçınma, YIYE kaygı ve kaçınma, DSKE durumsal ve sürekli kaygı skorları kontrollere daha göre yüksek, Gözler Testi skoru ise daha düşük bulundu. BDE, DSKE durumsal ve sürekli kaygı puanları kontrol edildiğinde iki grup arasındaki Gözler Testi puan farklılığının devam ettiği görüldü. SAB grubunda hem YİYE kaygı hem de YİYE kaçınma puanları LSAÖ kaygı ve kaçınma puanlarıyla ilişkili bulundu. Gözler Testi puanı LSAÖ kaygı ve LSAÖ kaçınma puanlarıyla ilişkili bulundu. Regresyon analizinde Gözler Testi, YİYE kaygı ve kaçınma puanlarının hem LSAÖ kaygı hem de LSAÖ kaçınma puanları üzerine etki ettiği görüldü. Sonuç: SAB’da zihin kuramı işlevlerinin sağlıklı kontrollere göre bozuk olduğu ve bu farklılığın anksiyete veya depresyon düzeylerinden bağımsız olduğu görülmüştür. Bağlanmada kaygı ve kaçınma boyutu SAB hastalık şiddetini olumsuz etkilemektedir. Zihin kuramı yetisinin SAB şiddeti ile ters yönde ilişkili bulunması sosyal bilişi geliştirmeye yönelik müdahalelerin SAB’da hastalık şiddetini azaltacağını düşündürmektedir
The Relationship of Theory of Mind and Attachment Characteristics with Disease Severity inSocial Anxiety Disorder
Introduction: The aim of our study is to compare the attachment characteristics and the theory of mind abilities measured by the Eyes Test between social anxiety disorder (SAD) patients and healthy controls. Another aim of our study is to investigate the relationship between attachment characteristics, theory of mind abilities and disease severity in patients with SAD. Method: 47 consecutive patients with SAD and 50 healthy controls were recruited for the study. Sociodemographic data form, SCID-I Structured Clinical Interview form Patient Version, Beck Depression Inventory (BDI), Reading Mind in the Eyes Test (Eye Test), Liebowitz Social Anxiety Scale (LSAS), Experiences in Close Relationship Inventory (ECR) and State-Trait Anxiety Inventory (STAI) were administered to all participants. Results: The BDI, LSAS anxiety and avoidence, ECR and anxiety and avoidance, STAI state and trait anxiety scores of the SAD group were higher than the controls, but the Eyes Test scores were lower. It was observed that the Eyes Test score difference between the two groups survived when controlled for BDI and STAI state and trait anxiety scores. In the SAD group, both ECR anxiety and avoidance scores were associated with LSAS anxiety and avoidance scores. Eyes Test scores were associated with LSAS anxiety and avoidance scores. In regression analysis, it was observed that the Eyes Test, ECR anxiety and avoidance scores effected both the LSAS anxiety and the LSAS avoidance scores. Conclusion: In SAD patients, the theory of mind functions was impaired when compared to healthy controls, and this difference has been found to be independent of anxiety or depression levels. Attachment anxiety and avoidance dimensions have negative effects on SAD disease severity. The fact that the theory of mind ability is inversely related with SAB severity suggests that interventions to improve social cognition might have a potential to decrease the severity of disease in SAD.

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