Sınır kişilik bozukluğunda dürtüsellik, kendine zarar verme ve intihar davranışlarının yordayıcıları

Amaç: Bu çalışmanın amacı sınır kişilik bozukluğu (SKB) olan ve SKB olmayan (kontrol) gruplarda depresif belirtile- rin ve çocukluk çağı ruhsal travmalarının dürtüsellik, kendine zarar verme ve intihar davranışları üzerindeki yordayı- cı rolünü incelemektir. Yöntem: Araştırmanın örneklemini, İstanbul’da üniversite ve kamu hastanesi psikiyatri klinik- lerinde ayakta tedavi gören SKB olgu grubu (n1=72) ve sağlıklı gönüllülerden oluşan kontrol grubu (n2=71) oluştur- maktadır. Tüm katılımcılar Sosyodemografik Bilgi Formu, Sınırda Kişilik Envanteri (SKE), Beck Depresyon Ölçeği (BDÖ), Hamilton Depresyon Ölçeği (HAM-D), Barratt Dürtüsellik Ölçeği-11 (BDÖ-11), Çocukluk Çağı Ruhsal Trav- ma Ölçeği (ÇÇRTÖ), Kendine Zarar Verme Davranışı Değerlendirme Envanteri (KZVDDE) ve İntihar Davranışı Ölçeği (İDÖ) kullanılarak değerlendirilmiştir. Elde edilen sonuçlar istatistiksel olarak analiz edilmiştir. Bulgular: Hiyerarşik regresyon analizinde, ilk olarak SKB grubunda BDÖ ve ÇÇRTÖ duygusal istismar puanının, kontrol grubunda ise HAM-D puanının dürtüsellik davranışının anlamlı yordayıcısı olduğu bulunmuştur. İkinci olarak, SKB grubunda ÇÇRTÖ duygusal istismar puanı, kontrol grubunda ise ÇÇRTÖ fiziksel ihmal ve HAM-D puanının kendine zarar verme davranışının anlamlı yordayıcısı olduğu bulunmuştur. Üçüncü olarak, SKB grubunda BDÖ ve ÇÇRTÖ cinsel istismar puanı, kontrol grubunda ise ÇÇRTÖ duygusal istismar ve fiziksel istismar puanının intihar davranışı- nın anlamlı yordayıcısı olduğu bulunmuştur. Sonuç: SKB’de, ÇÇRT alt türlerinden duygusal ve cinsel istismar ve depresif belirtilerin (BDÖ) dürtüsel, kendine zarar verme ve intihar davranışları açısından önemli risk etkeni olduğu görülmüştür. (Anadolu Psikiyatri Derg 2019; 20(4):341-349)

The predictors of impulsive, self-injuring, and suicidal behaviors in borderline personality disorder

Objective: The aim of this study was to analyze the predictive role of depressive symptoms and childhood psycho- logical trauma on impulsive, self-injuring, and suicidal behaviors in groups diagnosed and not diagnosed (control group) with borderline personality disorder (BPD). Methods: The study sample included a diagnosis group (n1=72) that was followed by the psychiatry clinics of a university hospital and a public hospital in İstanbul, Turkey, along with a control group (n2=71) that included healthy volunteers who participated in the study. All study participants were evaluated using the Sociodemographic Information Form, Borderline Personality Inventory (BPI), Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAM-D), Barratt Impulsivity Scale (BIS-11), Child- hood Trauma Questionnaire (CTQ), Inventory of Statements about Self-injury (ISAS), and Suicide Behavior Ques- tionnaire (SBQ). The study results were analyzed statistically. Findings: First, the hierarchical regression analysis revealed that the BDI and emotional abuse scores in the diagnosis group and the HAM-D in the control group were significant predictors based on the Barratt Impulsiveness Scale. Secondly, the emotional abuse score in the diagnosis group and physical neglect and HAM-D score in the control group were significant predictors of self-injury behavior inventory scores. Thirdly, BDI and sexual abuse scores in the diagnosis group and the emotional and physical abuse scores in the control group were found to be the significant predictors of suicide behavior. Con- clusion: Emotional and sexual abuse during childhood and depressive symptoms (BDI) were found to be signi- ficant risk factors in terms of impulsive, self-injury and suicidal behaviors in BPD. (Anatolian Journal of Psychiatry 2019; 20(4):341-349)

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