Emsal ŞAN, SEZEN KÖSE, Burcu ÖZBARAN, Cahide AYDIN

DEHB'li ergenlerde toplumsal biliş ve duygu düzenleme

Amaç: Çalışmamızda dikkat eksikliği hiperaktivite bozukluğu (DEHB) tanısı konan ergen olguların duygu tanıma ve düzenleme becerilerinin değerlendirilmesi ve bulguların sağlıklı kontrol olguları ile karşılaştırılması amaçlanmıştır. Yöntem: Çalışmamıza 11-18 yaşları arasında, DEHB'li 63 olgu ve hasta gruplarına benzer sosyodemografik özelliklere sahip 32 kontrol olgusu alınmıştır. Psikiyatrik tanı değerlendirmesi için tüm olgulara 'Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Şekli Türkçe Uyarlaması' (ÇDŞG-ŞY-T) uygulanmıştır. Ek olarak tüm olgularda 4-18 Yaş Çocuk ve Gençler için Davranış Değerlendirme Ölçeği (ÇDDÖ), Turgay Dikkat Eksikliği ve Yıkıcı Davranış Bozuklukları için DSM-IV'e Dayalı Tarama ve Değerlendirme Ölçeği (T-DSM-IV-Ö), Duygu Düzenlemede Güçlükler Ölçeği (DDGÖ) ve toplumsal biliş özelliklerinin değerlendirilmesi amacıyla Yüzler Testi, Gözlerden Zihin Okuma Testi (GZOT), Beklenmeyen Sonuçlar Testi (BST) ve Anlamı ve İlişkileri Kavrayabilme Testi (AİKT) kullanılmıştır. Bulgular: DEHB'li ergenlerin duygu tanıma ve düzenleme becerilerini değerlendiren test puanları sağlıklı kontrollere göre daha düşük saptanmıştır. Tartışma: DEHB'li ergen olguların duygu tanıma ve düzenleme becerilerindeki sorunların daha iyi anlaşılması, bu konuda ne tür girişimlere (toplumsal beceri eğitimi gibi) gereksinim duyabileceklerini anlamada yararlı olabilir.

Social cognition and emotion regulation in adolescents with ADHD

Objective: In our study, it's aimed to evaluate the emotion recognition and regulation skills of adolescents with attention deficit and hyperactivity disorder (ADHD) and to compare the results to healthy control cases. Methods: To our study, 63 ADHD diagnosed and 32 control cases with similar sociodemographic characteristics to patient group aged 11-18 years were included. 'Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version' (K-SADS-PL) was applied to all cases in order to psychiatric evaluatıon. In all cases Child Behavior Checklist (CBCL), Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S), Difficulties in Emotion Regulation Scale (DERS) and to evaluate social cognitive properties Faces Test, Reading the Mind in the Eyes Test (RMET), The Unexpected Outcomes Test (UOT) and Comprehension Test are applied. Results: The scores of tests evaluating emotion recognition and regulation abilities in adolescents with ADHD were lower than control group. Conclusion: The better understanding of the problems in emotion recognition and regulation abilities of the adolescents with ADHD may be helpful in determining the required interventions (social skill training etc.) in this respect.

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1. Polanczyk G, Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007; 164:942-948. 2. Barkley RA. Child Psychopathology. Second ed., New York: Guilford Press, 2003, p.75-143.
3. Hodgens JB, Cole J, Boldizar J. Peer-based differences among boys with ADHD. J Clin Child Psychol 2000; 29:443-452.
4. Wellman HM, Lagattuta KH. Theory of mind for learning and teaching: the nature and role of explanation. Cog Dev 2004; 19:479-497.
5. Gander MJ, Gardiner HW. Çocuk ve Ergen Gelişimi. A Dönmez, N Çelen (Çev.), Ankara: İmge Kitabevi, 2015.
6. Cutting AL, Dunn J. The cost of understanding other people: social cognition predicts young children's sensitivity to criticism. J Child Psychol Psychiatry 2002; 43:849-860.
7. Smith ER, Semin GR. Situated social cognition. Curr Dir Psychol Sci 2007; 16:132-135.
8. Demurie E, De Corel M, Roeyers H. Empathic accuracy in adolescents with autism spectrum disorders and adolescents with ADHD. Res Autism Spectr Disord 2011; 5:126-134.
9. Dyck MJ, Ferguson K, Shochet IM. Do autism spectrum disorders differ from each other and from non-spectrum disorders on emotion recognition tests? Eur Child Adolesc Psychiatr 2001; 10:105-116.
10. Sinzig J, Morsch D, Lehmkuhl G. Do hyperactivity, impulsivity and inattention have an impact on the ability of facial affect recognition in children with autism and ADHD? Eur Child Adolesc Psychiatry 2008; 17:63-72.
11. Corbett B, Glidden H. Processing affective stimuli in children with attention-deficit hyperactivity disorder. Child Neuropsychol 2000; 6:144-155.
12. Pelc K, Kornreich C, Foisy ML, Dan B. Recognition of emotional facial expressions in attentiondeficit hyperactivity disorder. Pediatr Neurol 2006; 35:93-97.
13. Yuill N, Lyon J. Selective difficulty in recognising facial expressions of emotion in boys with ADHD. General performance impairments or specific problems in social cognition? Eur Child Adolesc Psychiatry 2007; 16:398-404.
14. Ayaz AB, Ayaz M, Yazgan Y. Dikkat eksikliği ve hiperaktivite bozukluğunda sosyal cevaplılıkta görülen değişiklikler. Turk J Psychiatry 2013; 24:101-110.
15. www.who.int/topics/adolescent_health
16. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for affective disorders and schizophrenia for schoolage children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997; 36:980-988.
17. Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y. Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi- Şimdi Ve Yaşam Boyu Şekli-Türkçe uyarlamasının geçerlik ve güvenirliği. Turk J Child Adolesc Ment Health 2004; 11:109-116.
18. Turgay A. Çocuk ve Ergenlerde Yıkıcı Davranış Bozuklukları için DSM-IV'e Dayalı Tarama ve Değerlendirme Ölçeği. Integrative Therapy Institute, Toronto, Kanada, 1995.
19. Ercan ES, Amado S, Somer O, Çıkoğlu S. Dikkat eksikliği hiperaktivite bozukluğu ve yıkıcı davranım bozuklukları için bir test bataryası geliştirme çabası. Turk J Child Adolesc Ment Health 2001; 8:132-144.
20. Achenbach TM, Edelbrock C. Manual for the Child Behavior Checklist/ 4-18 and Revised Child Behavior Profile. University of Vermont, Department of Psychiatry, Burlington VT, 1983.
21. Erol N, Arslan LB, Akçakın M. The adaptation and standardization of the Child Behavior Checklist among 6-18 year old Turkish Children. European Approaches to hiperkinetic disorders Zurich, 1995, Egg:109-113.
22. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess 2004; 26:41-54.
23. Sarıtaş D, Gençöz T. Adolescents emotion regulation and its relation with their mothers emotion regulation and parental rearing behaviors. Turk J Child Adolesc Ment Health 2011; 18:117-126.
24. Bora E. Theory of mind in schizophrenia spectrum disorders. Turk J Psychiatry 2009; 20:269-281.
25. Bora E, Gökçen S, Veznedaroğlu B. Empathic abilities in people with schizophrenia. Psychiatr Res 2008; 160:23-29.
26. Baron-Cohen S, Ring H, Wheelwright S, Bullmore ET, Brammer MJ, Simmons A, et al. Social intelligence in the normal and autistic brain: an fMRI study. Eur J Neurosci 1999; 11:1891-1898
27. Girli A. Psychometric properties of the Turkish child and adult form of 'Reading the Mind in the Eyes Test'. Psych, 2014; 5:1321-1337.
28. Biederman J, Faraone SV. Attention-deficit hyperactivity disorder. Lancet 2005, 366:2237-2248.
29. Cormier E. Attention deficit hyperactivity disorder: a review and update. J Pediatr Nurs 2008; 23:345- 357.
30. Barkley RA, Edwards G, Laneri M, Fletcher K, Metevia L. Executive functioning, temporal discounting and sence of time in adolescents with ADHD and ODD. J Abnorm Child Psychol 2001; 29:541-556
31. Bauermeister JJ, Matos M, Reina G, Salas CC, Martinez JV, Cumba E, et al. Comparison of the DSM-IV combined and inattentive types of ADHD in a school-based sample of Latino/Hispanic children. J Child Psychol Psychiatry 2005; 46:166- 179.
32. Mary A, Slama H, Mousty P, Massat I, Capiau T, Drabs V, et al. Executive and attentional contributions to Theory of Mind deficit in attention deficit/ hyperactivity disorder. Child Neuropsychol 2015; 22:345-365.
33. Bunford N, Evans SW, Langberg JM. Emotion dysregulatin is associated with social impairment among young adolescents with ADHD. J Atten Disord 2014 Mar 29. [Epub ahead of print].
34. Sobanski E, Banaschewski T, Asherson P, Buitelaar J, Chen W, Franke B, et al. Emotional lability in children and adolescents with ADHD: clinical correlates and familial prevalence. J Child Psychol Psychiatry 2010; 51:915-923.
35. Anastopoulos AD, Smith TF, Garrett ME, Marrissey-Kane E, Schatz NK, Sommer JL, et al. Selfregulation of emotion, functional impairment and comorbidity among children with ADHD. J Atten Disord 2011; 15:583-692.
36. Spencer TJ, Faraone SV, Surman C, Petty C, Clarke A, Batchelder H. Toward defining deficient emotional self-regulation in children with ADHD using the CBCL: a controlled study. Postgrad Med 2011; 123:50-59.
37. Strine TW, Lesesne CA, Okoro CA, McGuire LC, Chapman DP, Balluz LS. Emotional and behavioral difficulties and impairments in everyday functioning among children with a history of ADHD. Prev Chron Dis 2006; 3A52.
38. Becker A, Steinhausen HC, Baldursson G, Dalsgaard S, Lorenza MJ, Ralston SJ, et al. Psychopathological screening of children with ADHD: Strengths and Difficulties Questionnaire in a pan-European study. Eur Child Adolesc Psychiatry 2006; 15:56-62.
39. Greene RW, Biederman J, Faraone SV, Cheryl A, Ouelette BA, Courtney Penn BA, et al. Toward a new psychometric definition of social disability in children with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1996; 35:571-578.