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Yıl:2012; Cilt: 49; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2012;49(4):286-293
Alkol Bağımlısı Olguların Sağlıklı Kontrollerle Emosyonel Şemalar Yönünden Karşılaştırılması ve Klinik Özelliklerle İlişkisi
A Ekinci, O Ekinci, H Türkçarpar, H Özbay
Yozgat Devlet Hastanesi, Yozgat, Türkiye
Amaç: Duygusal şemaların bilişsel-davranışcı terapi (BDT) sürecinde terapotik değişime direncle yakın ilişkili olduğu one sürülmüş ve ozellikle anksiyete bozukluklarında işlevsel olmayan duygusal şemaların terapiye direncteki rolü vurgulanmıştır. Bu bağlamda terapi sürecinde değişime direnç gösterdiği iyi bilinen alkol bağımlısı olguların işlevsel olmayan emosyonel şemalarının açığa çıkarılması önemli olabilir. Dolayısı ile bu çalışmada, alkol bağımlılığı tanısı alan hastalarda işlevsel olmayan emosyonel şemaları saptamayı ve bazı klinik özelliklerle şemalar arasındaki ilişkileri incelemeyi amaçladık. Yöntem: Bu çalışmaya 2005-2009 yılları arasında DSM-IV’e göre alkol bağımlılığı tanısı almış ve yoksunluk tedavisi için yatırılmış 60 hasta ile yaş, cinsiyet ve eğitim düzeyleri ile uyumlu 40 sağlıklı kontrol dahil edilmiştir. İki gruba disfonksiyonel şema aktivasyonlarını belirlemek için Leahy Emosyonel Şema Ölçeği, Alkol İsteği İle İlgili İnançlar Ölçeği, relaps riskini belirlemek için Relaps Öngörme Ölçeği, Beck Depresyon Envanteri ve Beck Anksiyete Envanteri uygulandı. Bulgular: Alkol bağımlısı olguların “Suçluluk”, “Ruminasyon”, “Suçlama”, “Duygulara Yalın Bakış” ve “Süreklilik” emosyonel alt şema puanlarından anlamlı olarak daha yüksek puan aldıkları bulundu . Diğer yandan “Anlaşılırlık”, “Uzlaşı”, “Kontrol Edilemezlik” ve “Duyguları Kabullenme” emosyonel alt şema puanlarından ise anlamlı olarak kontrol grubundan daha düşük puan aldıkları saptandı. Alkol inanç ölçeği puanlarının anlaşılırlık, suçluluk ve suçlama ile anlamlı ilişkili olduğu bulundu. Ayrıca bazı emosyonel şema alanlarının depresyon, anksiyete düzeyleri ve relaps olasılığı ölçek skorları ile anlamlı ilişkileri olduğu bulundu. Sonuç: Çalışmamız alkol bağımlısı bireylerin sağlıklı bireylerden farklı bazı uyum bozucu duygusal şema alanlarına sahip olduğuna işaret etmektedir. Ayrıca alkol bağımlısı bireylerde bazı emosyonel şema alanlarının alkol ile ilgili inançlarla, depresyon, anksiyete düzeyleri ve relaps olasılığı ölçek skorları ile ilişkili olması dikkate değer görünmektedir. Bu alanda yapılacak geniş örneklemli, ileriye dönük ve tedavi odaklı çalışmalar alkol bağımlılığının etyolojisi ve tedavisine anlamlı katkılar sağlayabilir
Emotional Schemas and Their Relationship with Clinical Characteristics in Patients with Alcohol Dependence
Background:The emotional schemes were closely linked to the resistance to change during cognitive behavioral therapy and emphasized the role of dysfunctional schemes in the resistance to therapy, particularly in anxiety disorders. In this regard, it may be important to clarify the emotional schemes of patients with alcohol dependence who are well-known for their resistance to therapy. Thus, we aimed to determine the dysfunctional emotional schemes and to investigate the relationships between schemas and some clinical features in patients with alcohol dependence. Methods: Sixty patients diagnosed as having alcohol dependence according to the DSM-IV and admitted to inpatient clinic between 2005-2009 for the treatment of withdrawal and 30 age-, gender-, and education-matched healthy volunteers were included in the study. The Leahy Emotional Schema Scale for determination of dysfunctional schema, the Scale of Beliefs About Alcohol Request, Relapse Prediction Scale for determination of risk of relapse, as well as the Beck Depression Inventory and the Beck Anxiety Inventory were used. Results: Alcohol-dependent patients scored significantly higher than the control group on "Guilt", "Rumination", "Blame", "Simplistic View of Emotion" and "Duration" emotional sub-schemas. On the other hand, the scores of “Comprehensibility ", "Consensus", "Uncontrollability" and "Feelings of Acceptance" emotional subschemas were found to be significantly lower than those in the control group. Significant associations were observed between the scores of Scale of Beliefs about Alcohol Request and Comprehensibility, Guilty and Blame. In addition, there were significant associations between depression and anxiety severity, Relapse Prediction Scale and some emotional scheme dimensions. Conclusion: Our study indicates that individuals with alcohol dependence have some different maladaptive schemas from healthy controls. In addition, the presence of significant associations between some emotional schemas and depression and anxiety levels, the scores of Relapse Prediction Scale and Scale of Beliefs about Alcohol Request seems to be important. Future prospective and larger sample studies focused on the treatment of addiction in this area may provide meaningful contributions to the etiology and treatment of alcohol dependence

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