Relation of emotion regulation and empathy skills with maternal emotion regulation and attachment in children diagnosed with ADHD

Amaç: Dikkat eksikliği hiperaktivite bozukluğu (DEHB), çocukluk çağında en sık görülen nörogelişimsel bozukluklardan biridir. DEHB'li çocukların empati ve duygu düzenleme becerilerindeki güçlükler daha önceki çalışmalarda gösterilmiştir. Anne-çocuk bağlanması, çocukların duygularını düzenleme ve empati yeteneğinin gelişmesi açısından önemlidir. Bu çalışmada DEHB'li olgulardaki duygu düzenleme ve empati becerilerinin annelerindeki duygu düzenleme ve bağlanma özellikleri ile ilişkisinin incelenmesi ve sağlıklı kontroller ile karşılaştırılması amaçlanmıştır. Yöntem: Çalışmaya 8-12 yaşları arasında DEHB tanısı olan 61 çocuk ve DEHB grubu ile yaş ve cinsiyet olarak benzer 87 sağlıklı kontrol alınmıştır. DEHB tanısı ve eşlik eden bozuklukları ortaya koymak için Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu sürümü (ÇDŞG-ŞY) kullanılmıştır. Du Paul Dikkat Eksikliği ve Hiperaktivite Değerlendirme Ölçeği, DEHB'nin şiddetini ölçmek için kullanılmıştır. Duygu Ayarlama Ölçeği (DAÖ), çocukların duygularını düzenlemesini; KASİ Empati Ölçeği çocukların empati becerilerini değerlendirmek için kullanılmıştır, Annelerin duygularını düzenlemesini değerlendirmek için Duygu Düzenleme Güçlüğü Ölçeği (DDGÖ) ve bağlanma özelliklerini değerlendirmek için Yakın İlişkide Yaşantılar Ölçeği-II kullanılmıştır. Sonuçlar: Olgu grubunun duygusal ve bilişsel empati ve toplam empati puanlarında ve duygu düzenleme alanında kontrol grubuna göre istatistiksel açıdan anlamlı düşük puanlar elde ettiği, duygusal değişkenlik alanında ise olgu grubunun kontrol grubuna göre istatistiksel olarak anlamlı düzeyde yüksek puanlar elde ettiği görülmüştür. DEHB'li çocuğu olan anneler hem kaygılı bağlanma, hem kaçıngan bağlanma puanları, hem de DDGÖ tüm alt ölçekleri ve toplam puanında kontrol grubunun annelerine göre istatistiksel açıdan anlamlı düzeyde yüksek puan almışlardır. DEHB belirtileri, KA-Sİ Empati ölçeği, DAÖ, DDGÖ ve bağlanma ölçeği arasındaki ilişki pearson korelasyon analizi ile değerlendirilmiştir. Du Paul Dikkat eksikiliği ve hiperaktivite beliritleri ile bilişsel, duygusal ve toplam empati puanları ve duygu düzenleme alt ölçeği arasında negatif ilişki saptanırken DDGÖ toplam skoru, duygusal değişkenlik, anksiyöz ve kaçıngan bağlanma arasında pozitif ilişki saptanmıştır. Tartışma: Anne-çocuk bağlanması ve annenin duygu düzenleme becerisi de çocukların duygu düzenleme ve empati becerilerine katkı sağlayan anne ile ilişkili etkenlerdendir. Bağlanma, empati, duygu düzenleme becerilerinin nöropsikolojik gelişim süreçlerinin ve birbirleri ile olası ilişkilerinin anlaşılması DEHB'li çocukların tedavisine katkı sağlayabilir.

DEHB'li olgularda empati ve duygu düzenleme becerilerinin annelerinin bağlanma ve duygu düzenleme becerileri ile ilişkisi

Objective: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood neurodevelopmental disorder. Difficulties in the areas of emotion regulation and empathy were found in prior studies. Mother child attachment is important in the development of emotion regulation and empathy. We aimed to examine the relation emotional regulation and empathy skills in children with ADHD and emotion regulation and attachment properties in their mothers and to compare with healthy controls. Methods: The study group consisted of 61 children (8-12 years old) diagnosed with ADHD. The control group (87 children) comprised patients of other clinics at hospital and was matched for gender and age to the ADHD patients. The Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) was used to diagnose ADHD and allowed comorbidities. We evaluated disorder severity at the time of assessment using the DuPaul Attention Deficit and Hyperactivity Disorder Rating Scale. All patients were treatment-naive. Emotional Regulation Checklist (ERC) and KA-SI empathy scale were used to examine children emotional regulation and empathy. Difficulties in Emotion Regulation Scale (DERS) was used to indicate maternal emotional dysregulation status and Experiences in Close Relationship Scale-II was used to evaluate attachment properties in mothers. Results: Children with ADHD had statistical significant lower scores in the areas of affective empathy, cognitive empathy, total empathy score and emotion regulation and cases had statistical significant higher scores in emotion lability. Mothers of children with ADHD had higher scores in anxious and avoidant attachment styles and all subscales of DERS. The correlation between, ADHD symptoms, KA-SI Empathy, ERC, Attachment Scale, and DERS was evaluated by Pearson's correlation analysis. Negative correlation was found between both attention deficit and hyperactivity scores of Du Paul scale and affective, cognitive empathy scores of KA-SI Emphatic Tendency Scale and emotion regulation scores of ERC; a positive correlation was determined between attention deficit and hyperactivity scores of Du Paul scale, mothers' anxious and avoidant attachment andDERS total scores, and emotional lability scores of ERC. Discussion: Mother-child attachment and maternal emotion regulation skills have important roles in the emotion regulation and empathy skills of children. Better understanding of neuropsychologic development process of attachment, empathy and emotion regulation skills and their relations with each other may contribute to the treatment of children with ADHD.

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