Ergenlerde görülen ruhsal bozukluklar ve erken dönem uyumsuz şemalar: Cinsiyetin düzenleyici rolü
Amaç: Bu çalışmada ergenlerde görülen ruhsal bozukluklar ile erken dönem uyumsuz şemalar arasındaki ilişkilerin, erken dönem uyumsuz şemaların ruhsal bozuklukları yordama düzeylerinin ve ruhsal bozuklukları yordayan erken dönem uyumsuz şemaların belirlenmesinde cinsiyetin düzenleyici rolünün incelenmesi amaçlanmıştır. Yöntem: Küme örnekleme yöntemiyle belirlenen katılımcılar 14-18 yaşları arasındaki 230 kız (%55.8), 182 erkek (%44.2) olmak üzere 412 lise öğrencisinden oluşmuştur. Katılımcılara Ergenler için Psikolojik Bozukluklar Envanteri-Psikolojik Bozukluklar Formu (EPBE-PBF) ve Young Şema Ölçeği Kısa Form-3 (YŞÖ-KF3) uygulanmıştır. Bulgular:Regresyon analizi sonuçlarına göre ruhsal bozuklukları en fazla yordayan şema alanları kopukluk/reddedilme, zedelenmiş özerklik/başarısızlık, başkalarına odaklı olmak ve aşırı uyarılma/ketlenme olmuştur. Cinsiyetin düzenleyici rolüne ilişkin yapılan aracılık analizinde kopukluk/reddedilme şema alanının, kızlarda dikkat eksikliği, depresyon, panik, yaygın anksiyete ve obsesif kompulsif bozukluklarının düzeylerini; erkeklerde ise davranım bozukluğu düzeyini artırıcı bir rolünün olduğu belirlenmiştir. Zedelenmiş özerklik/başarısızlık şema alanı da erkeklerde davranım bozukluğunu artıran bir diğer şema alanı olarak bulunmuştur. Sonuç: Bu çalışmada erken dönem uyumsuz şemaların ruhsal bozuklukları yordadığı ve cinsiyetin, ruhsal bozukluklar ve erken dönem uyumsuz şemalar arasındaki ilişkide düzenleyici bir rolünün olduğu görülmüştür. Cinsiyetin düzenleyici rolünün belirlenmesinin ruhsal bozuklukların tedavisinde faydalı olacağı gibi, cinsiyete özgü erken müdahale programlarının hazırlanmasına da katkı sağlayacağı düşünülmektedir.
The psychological disorders and early maladaptive schemas in adolescents: the moderating role of gender
Objective: The aim of this study is to examine the relationship between psychological disorders and early maladaptive schemas, the predictive level of early maladaptive schemas for psychological disorders, and the moderating role of gender in the relationship between early maladaptive schemas and psychological disorders. Methods: The participants determined by the cluster sampling method consisted of 412 high school students, 230 (55.8%) female, 182 (44.2%) male, in the range of 14-18 years. Psychological Disorders for Adolescents-Psychological Disorders Form (PDIA-PDF) and Young Schema Questionnaire-Short Form 3 (YSQ-S3) were applied to participants. Results: According to regression analysis, the schema domains that predict the most for psychological disorders are disconnection/rejection, impaired autonomy/performance, other-directedness, and vigilance/inhibition. In the mediation analysis related to the regulatory role of gender, while the level of disconnection/rejection schema area has a role to increase the level of attention deficit, depression, panic, generalized anxiety and obsessive-compulsive disorders in females; the same scheme area has a role to increase the level of conduct disorder in males. In addition, the impaired autonomy/performance schema area is another schema area that increased conduct disorder in males. Conclusion: In this study, it is detected that early maladaptive schemas predict psychological disorders and gender has a moderating role in the relationship between early maladaptive schemas and psychological disorders. It is thought that determining the moderating role of gender will be beneficial for the treatment of psychological disorders and will contribute to preparing gender specific early intervention programs.
___
- 1. Rutter M. Psychosocial resilience and protective mechanisms. JE Rolf, AS Masten, D Cicchetti, K Nuechterlein, S Weintraub (Eds.), Risk and protective factors in the development of psychopathology. New York: Cambridge University Press, 1990, p.124.
- 2. Hinshaw SP. Developmental psycopathology as a scientific disipline. TP Beauchaine, SP Hinshaw (Eds.), Child and Adolescent Psychopathology. United Kingdom: John Wiley & Sons, 2013.
- 3. Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 2003; 60:837-844.
- 4. Grant KE, Compas BE, Thurm AE, McMahon SD, Gipson PY. Stressors and child and adolescent psychopathology: Measurement issues and prospective effects. J Clin Child Adolesc Psychol 2004; 33: 412-425.
- 5. Grant KE, Compas BE, Thurm AE, McMahon SD, Gipson PY, Campbell AJ, et al. Stressors and child and adolescent psychopathology: Evidence of moderating and mediating effects. Clin Psychol Rev 2006; 26:257-283.
- 6. Romeo RD. The metamorphosis of adolescent hormonal stress reactivity: A focus on animal models. Front Neuroendocrinol 2018; 49:43-51.
- 7. Bos MGN, Wierenga LM, Blankestein NE, Schreuders E, Tamnes CK, Crone EA. Longitudinal structural brain development and externalizing behavior in adolescence. J Child Psychol Psychiatry 2018; 59:1061-1072.
- 8. Enten RS, Golan M. Parenting styles and eating disorder pathology. Appetite 2009; 52:784-787.
- 9. McLeod BD, Wood JJ, Weisz JR. Examining the association between parenting and childhood anxiety: A metaanalysis. Clin Psychol Rev 2007; 27:155-172.
- 10. Majumdar IG, Singh T, Arya YK, Mandal SP, Kumari S. Childhood parental emotional maltreatment: A study of its consequences in adulthood. IJHW 2017; 8:29-34.
- 11. Mullen PE, Martin JL, Anderson, JC, Romans SE, Herbison GP. The long-term impact of physical, emotional and sexual abuse of children: A community study. Child Abuse Negl 1996; 20:7-21.
- 12. Young JE, Klosko JS, Wieshaar ME. Schema therapy a practitioner’s guide. New York: The Guilford Press, 2003, pp. 6-14.
- 13. Jacob G, van Genderen H, Seebauer L. Breaking negative thinking patterns a schema therapy selfhelp and support book. United Kingdom: John Wiley & Sons Ltd., 2015.
- 14. Turner HM, Rose KS, Cooper MJ. Parental bonding and eating disorder symtoms in adolescents: The mediating role of core beliefs. Eat Behav 2005; 6:113-118.
- 15. Van Vlierberghe L, Braet C, Bosmans G, Rosseel Y, Bögels S. Maladaptive schemas and psychopathology in adolescence: On the utility of young’s schema theory in youth. Cognit Ther Res 2010; 34:316-332.
- 16. Makas S, Çelik E. Erken dönem uyumsuz şemalar ile sosyal görünüş kaygısı arasındaki ilişkilerin incelenmesi. Elektronik Sosyal Bilimler Dergisi 2018; 17:926-937.
- 17. Montazeri M, Neshatdoost HT, Abedi MR, Abedi A. Effectiveness of schema therapy on symptoms intensity reduction and anxiety in a special case with obsessive compulsive personality disorder. Zahedan J Res Med Sci 2014; 16:92-94.
- 18. Talee-Baktash S, Yaghoubi H, Yousefi R. Comparing the early maladaptive schemas and cognitive emotion regulation strategies in obsessivecompulsive disorder patients and healthy people. J Kashan Univ Med Sci 2013; 17:471-481.
- 19. Flink N, Honkalampi K, Lehto SM, Viinamaki H, Koivumaa-Honkanen H, Valkonen-Korhonen M, et al. Early maladaptive schemas in chronically depressed patients: A preliminary investigation. Clin Psychol 2019; 23:15-25.
- 20. Haugh JA, Miceli M, DeLorme J. Maladaptive parenting, temperament, early maladaptive schemas, and depression: A moderated mediation analysis. J Psychopathol Behav Assess 2017; 39:103-116.
- 21. Yiğit İ, Kılıç H, Guzey-Yiğit M, Çelik C. Emotional and physical maltreatment, early maladaptive schemas, and internalizing disorders in adolescents: A multi-group path model of clinical and non-clinical samples. Curr Psychol 2018; 1-11. 22. Neacşu VC. Differences in early maladaptive schemes expression. Bull Transylv Univ Braşov 2016; 9:65-73.
- 23. El-Gilany AH, El-Bilsha MA, Ibrahim A. Gender differences in maladaptive cognitive schema in orphans in Dakahlia, Egypt. Sci World J 2013; ArticleID373120:1-5.
- 24. Reid R, Riccio CA, Kessler RH, Dupaul GJ, Power TJ, Anastopoulos AD, et al. Gender and ethnic differences in ADHD as assessed by behavior ratings. J Emot Behav Disord 2000; 8:38-48.
- 25. Niditch LA, Varela RE. A longitudinal study of inhibited temperament, efortful control, gender, and anxiety in early childhood. Child Youth Care Forum 2018; 47:463-479.
- 26. Bilge Y, Bilge Y. The examination of the relationship between gender and socio-economic level factors with psychological disorders in adolescents in Turkey. Global Journal of Psychology Research: New Trends and Issues 2017; 7:100- 110.
- 27. Shorey RC, Anderson SE, Stuart GL. Gender differences in early maladaptive schemas in a treatment-seeking sample of alcohol-dependent adults. Subst Use Misuse 2012; 47:108-116.
- 28. Bilge Y. Ergenler için Psikolojik Bozukluklar Envanterinin revizyon çalışması-I: Psikolojik Bozukluklar Formu. Anadolu Psikiyatri Derg 2018; 19:49-58.
- 29. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5. Ed.) Arlington: American Psychiatric Association, 2013.
- 30. Soygüt G, Karaosmanoğlu A, Çakır Z. Erken dönem uyumsuz şemaların değerlendirilmesi: Young Şema Ölçeği Kısa Form-3’ün psikometrik özelliklerine ilişkin bir inceleme. Türk Psikiyatri Derg 2009; 20:75-84.
- 31. Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A RegressionBased Approach. New York, NY: Guilford Pub., 2017.
- 32. Arntz A, Jacob G. Uygulamada Şema Terapi: Şema Mod Yaklaşımına Giriş Rehberi. G Soygüt (Çev.), Ankara: Nobel Akademik Yayıncılık, 2016.
- 33. Bruni A, Carbone EA, Pugliese V, Aloi M, Calabro G, Cerminara G, et al. Childhood adversities are different in schizophrenic spectrum disorders, bipolar disorder and major depressive disorder. BMC Psychiatry 2018; 18:391.
- 34. Levitan RD, Parikh SV, Lesage AD, Hegadoren KM, Adams M, Kennedy SH, et al. Major depression in individuals with a history of childhood physical or sexual abuse: Relationship to neurovegatative features, mania, and gender. Am J Psychiatry 1998; 155:1746-1752.
- 35. McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC. Childhood adversities and first onset of psychiatric disorders in a national sample of US adolescents. Arch Gen Pscyhiatry 2012; 69: 1151-1160.
- 36. Dargis M, Newman J, Koenigs M. Clarifying the link between childhood abuse history and psychopathic traits in adult criminal offenders. Personal Disord 2016; 7:221-228.
- 37. Paliziyan A, Honarman MM, Arshadi N. Symptoms of oppositonal defiant in students: The predicting role of emotion regulation, schema, and vandalism. Int J High Risk Behav Addict 2018; 7:e67691.
- 38. Simon L, Zsolt U, Fogd D, Czobor P. Dysfunctional core beliefs, perceived parenting behavior and psychopathology in gender identity disorder: A comparison of male-to-female, female-to-male transsexual and nontranssexual control subjects. J Behav Ther Exp Psychiatry 2011; 42:38-45.
- 39. Walcott CM, Landau S. The relation between disinhibition and emotion regulation in boys with attention deficit hyperactivity disorder. J Clin Child Adolesc Psychol 2004; 33(4): 772-782.
- 40. Miklósi M, Máté O, Somogyi K, Szabó M. Adult attention deficit hyperactivity symptoms, perceived stress and well-being the role of early maladaptive schemata. J Nerv Ment Dis 2016; 5:364-369.
- 41. Shorey RC, Elmquist J, Anderson S, Stuart GL. The relation between early maladaptive schemas, depression and generalized anxiety among adults seeking residential treatment for substance use disorders. J Psychoactive Drugs 2015; 47:230- 238.
- 42. Thiel N, Tuschen-Caffier B, Herbst N, Külz AK, Nissen C, Hertenstein E, et al. The prediction of treatment outcomes by early maladaptive schemas and schema modes in obsessive-compulsive disorder. BMC Psychiatry 2014; 14:362.
- 43. Rafaeli E, Bernstein DP, Young J. Schema therapy distinctive features. New York: Routledge, 2011.
- 44. Dauvilliers Y, Lopez R, Ohayon M, Bayard S. Hypersomnia and depressive symptoms: Methodological and clinical aspects. BMC Med 2013; 11:78.
- 45. Seganfredo AC, Torres M, Salum GA, Blaya C, Acosta J, Eizirik C, et al. Gender differences in the associations between childhood trauma and parental bonding in panic disorder. Braz J Psychiatry 2009; 31:314-321.
- 46. Mącik D, Sas E. Therapy of anorexia and Young’s early maladaptive schemas. Longitudinal Study. Current Issues ın Personality Psychology 2015; 3:203-213.
- 47. Naz F, Kausar R. Parental rejection and comorbid disorders in adolescents with somatization disorder. Journal of Behavioral Science 2012; 22:125- 142.