Psikotik bir hastalık durumunu açıklama ve çare arama davranışında cinsiyetin rolü

Amaç: Bu çalışmada psikotik bir hastanın cinsiyetinin hastalığının algılanmasına, hastalığının yüklendiği nedenlere ve çözüm önerilerine etkisi araştırıldı. Yöntem: Yüz yetmiş iki denek ile yapılan bu kesitsel araştırmada olgu senaryosu yöntemi kullanıldı. Tek bir psikotik hastalık senaryosu, erkek ve kadın deneklere erkek veya kadın hasta şeklinde sunuldu; deneklere hastalık senaryosuna ilişkin açık uçlu sorular yöneltildi. Deneklerin sosyodemografik verileri tanımlayıcı istatistik yöntemleri ile değerlendirildi. Örneklemin toplamında sorulara verilen yanıtların oranı hesaplandı. Senaryodaki hastanın cinsiyeti bağlamında, deneklerin belirtileri algılaması, tabloyu neye yükledikleri ve önerdikleri çareler arasında anlamlı bir ilişki olup olmadığı ki kare testi ile araştırıldı. Bulgular: Deneklerin yanıtları toplu olarak değerlendirildiğinde eğitim düzeyi (11 yıldan çok) ve gelir düzeyi (600 YTL/ay’dan çok) yüksek olanlar senaryodaki kişinin durumunu daha çok yaşantısal sorunlara yüklemişlerdi (p=0.03). Erkek deneklerin %31.4’ü senaryodaki kişinin durumunu hasta, %68.6’sı psikolojik sorunlu şeklinde yanıtlarken; kadın denekler için bu oranlar sırasıyla %41.9 ve %58.1 idi. Her iki denek grubu da, her iki cinsiyetteki olgu için daha yüksek düzeyde “psikolojik sorunlu” yanıtı vermişti. Senaryoda sunulan olgu için sorun kaynağı, hem erkek hem de kadın denekler tarafından kadın olgu için evlilik ve kişiler arası ilişkiler (p=0.00) olarak gösterilmişken, erkekler için iş/ekonomik sorunlar (p=0.00) gösterilmişti. Sonuç: Bu bulgular Malatya örneğinde Türk toplumunun psikotik hastalığı tanımlamasında, hastalık tablosunu bir nedenle ilintilendirmesinde ve çare önermesinde hasta cinsiyetine bir değişken olarak önem verdiğini göstermektedir.

Anahtar Kelimeler:

Duygusal bozukluklar, psikotik, Kesitsel çalışmalar, Algılama, Cinsiyet özellikleri

The role of gender in psychotic illness perception and help-seeking behavior

Objective: The aim of this study was to investigate the role of gender in psychotic illness perception, causal attributions and suggested treatment options. Methods: Case scenario method was used in this cross-sectional study of 172 subjects. A single psychotic illness scenario was presented to male and female subjects as male and female patients, and open-ended questions were asked regarding the illness scenario. Sociodemographic data of subjects were evaluated with descriptive statistical methods. The percentages of responses to questions in the sample were calculated. Chi-square test was utilized to investigate the presence or absence of a statistical significance between subjects’ perceptions of signs, causal attributions and suggested treatment options to the patients on the basis of gender. Results: The condition of the person in the scenario was attributed rather to the life problems by subjects with higher education (>11 years) and income (>600 NTL/month) levels (p=0.03) when both male and female subjects were evaluated together. While the male subjects described the condition of the person in the scenario as “sick” (31.4%) and “having psychological problems” (68.6%), these percentages were 41.9% and 58.1%, respectively, in female subjects. Both of the subject groups described both male and female persons in the scenario mostly as “having psychological problems”. The source of problem in the scenario was attributed, both by male and female subjects, to marriage and interpersonal relationships (p=0.00) for female case, and work/economic problems (p=0.00) for male case. Conclusion: Our findings suggest that Turkish population in Malatya sample considers the patient gender as an important variable in psychotic illness definition, causal attributions and suggesting treatment options.

Keywords:

Affective Disorders, Psychotic, Cross-Sectional Studies, Perception, Sex Characteristics,

PDF

___

1. Gitlin MJ, Pasnau RO. Psychiatric syndromes linked to reproductive function: a review of current knowledge. Am J Psychiatry 1989; 146:1413-1422.
2. Astbury J. Crazy for you: The making of women's madness. Melbourne, Oxford University Press, 1996.
3. Kasapoğlu MA. Sağlık Sosyolojisi: Türkiye’den Araştırmalar. Ankara, Sosyoloji Derneği Yayınları, 1999.
4. Giddens A. Sosyoloji. H Özel, C Güzel (çev.), Ankara, Ayraç Yayınevi, 2000, s.102.
5. Weber M. Essays in Sociology. Oxford, Oxford University Press, 1946.
6. Hochschild AR. Emotion work, feeling rules, and social structure. Am J Sociol 1979; 85:551-575.
7. Eagly AH, Wood W. Explaining sex differences in social behavior: a meta-analytic perspective. Pers Soc Psychol Bull 1991; 17:306-315.
8. Beutel AM, Marini MM. Gender and values. Am Sociol Rev 1995; 60:436-448.
9. Oldham JM, Morris LB. The Personality Self. Portrait. New York, Bantam Books, 1990.
10. Jack D. Silencing the Self. Cambridge, Harvard University Press, 1991.
11. Rosenfield S. Gender Stratification, Stress, and Mental Illness Rutgers University www.mhsip.org/pdfs/rosenfield.pdf. Erişim tarihi:07.06.2006
12. United Nations Development Program: Human Development Report. New York, Oxford University Press, United Nations, 1997.
13. Ashmore RD, Del Boca FK, Wohlers AJ. Gender stereotypes. RD Ashmore, FK Del Boca (eds.), The social psychology of male-female relations: A critical analysis and central concepts. Orlando, Academic Press, 1986, s.69-119.
14. Terman LM, Miles CC. Sex and Personality: Studies in Masculinity and Femininity. New York, Russell & Russell, 1936.
15. Angermeyer MC, Matschinger H, Riedel-Heller SG. Whom to ask for help in case of a mental disorder? Preferences of the lay public. Soc Psychiatry Psychiatr Epidemiol 1999; 34:202-210.
16. Corrigan PW, Watson AC. Understanding the impact of stigma on people with mental illness. World Psychiatry 2002; 1:16-20.
17. Hoffman C, Hurst N. Gender stereotypes: Perception or rationalization? J Pers Soc Psychol 1990; 58:197-208.
18. Amancio L. Stereotypes as ideologies: The case of gender categories. Revista Psicol Soc 1993;8:163-170.
19. Pilgrim D, Rogers A. Mental disorder and violence: an empirical picture in context. J Ment Health 2003; 7-19.
20. Cormack S, Furnham A. Psychiatric labelling, sex role stereotypes and beliefs about the mentally ill. Int J Soc Psychiatry 1998; 44:235-247.
21. Melbourne Consumer Consultants’ Group. MCCG: The ultimate exit survey. Survivors of psychiatric services speak out. Melbourne, Author, 1997.
22. Perkins R, Repper J. Dilemmas in community mental health practice. Abingdon, Radcliffe Medical Press, 1998.
23. Hansen FJ, Reekie LJ. Sex differences in clinical judgements of male and female therapists. Sex Roles 1990; 23:51-64.
24. Leong FTL, Zachar P. Gender and opinions about mental illness as predictors of attitudes toward seeking professional help. Br J Guid Counsel 1999; 27:123-132.
25. Morrison M, deMan AF, Drumheller A. Correlates of socially restrictive and authoritarian attitudes toward mental patients in university students. Soc Behav Personal 1993; 21:333-338.
26. Granello DH, Hinkelman L. Biological sex, adherence to traditional gender roles, and attitudes toward persons with mental illness: an exploratory investigation. J Ment Health Counsel 2003; 25:259-270.
27. O'Neil JM. Gender role conflict and strain in men's lives: Implications for psychiatrists, psychologists, and other human service providers. K Solomon, NB Levy (eds.), Men in Transition, New York, Plenum Press, 1982, s.5-40.
28. Levant RF. Psychological services designed for men: a psychoeducational approach. Psychotherapy 1990; 27:309-315.
29. Blazina C, Watkins CE. Masculine gender role conflict: effects on college men's psychological well-being, chemical substance usage, and attitudes toward help-seeking. J Counsel Psychol 1996; 4:461-465.
30. Moller-Leimkuhler AM. Men and depression: gender-related help-seeking behavior. Fortschr Neurol Psychiatr 2000; 68:489-495.
31. Ünal S, Küey L, Güleç C, Bekaroğlu M, Evlice YE, Kırlı S. Depresif bozukluklarda risk etkenleri. Klinik Psikiyatri 2002; 5:8-15.
32. Rickwood DJ, Braithwaite VA. Social-psychological factors affecting help-seeking for emotional problems. Soc Sci Med 1994; 39:563-572.
33. Lauber C, Nordt C, Falcato L, Rossler W. Do people recognise mental illness? Factors influencing mental health literacy. Eur Arch Psychiatry Clin Neurosci 2003; 253:248-251.
34. Lauber C, Nordt C, Falcato L, Rössler W. Lay recommendations on how to treat mental disorders. Soc Psychiatry Psychiatr Epidemiol 2001; 36:553–556.
35. Norenzayan A, Choi I, Nisbett RE. Cultural similarities and differences in social inference: Evidence from behavioral predictions and lay theories of behavior. PSPB 2002; 28:109-120. www.psych.ubc.ca/~ara/Manuscripts/PSPB2002.pdf http://www-personal.umich.edu/~nisbett/cultsim.pdf.
36. Tanaka G, Inadomi H, Kikuchi Y, Ohta Y. Evaluating community attitudes to people with schizophrenia and mental disorders using a case vignette method. Psychiatry Clin Neurosci 2005; 59:96-101.
37. Ünal S, Kaya B, Yalvaç HD. Psikotik hastalarda hastalık açıklama modeli ve çare arama davranışı. (2006, Değerlendirme aşamasında)
38. Dein S. Transcultural psychiatry. Br J Psychiatry 2002; 181:535-536.
39. Bhui K, Bhugra ?. Correspondence. Br J Psychiatry 2003; 183:170.
40. Kirmayer LJ, Franzp HM. The future of cultural psychiatry: an international perspective. Can J Psychiatry 2000; 45:438-446.
41. Angermeyer MC, Matschinger H. What to do about mental disorder--help-seeking recommendations of the lay public. Acta Psychiatr Scand 2001; 103:220-225.
42. de Toledo E, Peluso P, Blay SL. Community perception of mental disorders A systematic review of Latin American and Caribbean studies. Soc Psychiatry Psychiatr Epidemiol 2004; 39:955-961.
43. Jorm AF, Mackinnon A, Christensen H, Griffiths KM. Structure of beliefs about the helpfulness of interventions for depression and schizophrenia. Results from a national survey of the Australian public. Soc Psychiatry Psychiatr Epidemiol 2005; 40:877-883.
44. Wolff G, Pathare S, Craig T, Leff ??. Community attitudes to mental illness. Br J Psychiatry 1996; 168:183-190.
45. Granello DH, Paulley P. Television viewing habits and their relationship to tolerance toward people with mental illness. J Ment Health Counsel 2000; 22:162-175.
46. Hoye A, Rezvy G, Hansen V, Olstad R. The effect of gender in diagnosing early schizophrenia: an experimental case simulation study. Soc Psychiatry Psychiatr Epidemiol 2006;41:549-555.
47. Ilfeld FW. Current social stressors and symptoms of depressions. Am J Psychiatry 1977; 134:161-166.
48. Heikkinen M, Aro H, Lönnqvist J. Life events and social support in suicide. Suicide Life Threat Behav 1993; 23:343-358.
49. Jordan J, Kaylan A, Surrey JL. Women's Growth in Connection: Writings from the Stone Centre. New York, Guilford Publications, 1991.
50. Jackson LA, Hodge CN, Ingram JM. Gender and self-concept: a reexamination of stereotypic differences and the role of gender attitudes. Sex Roles 1994; 30:615-630.