Cüneyt EVREN, Mine DURKAYA, Rabia ÇELİK, ERCAN DALBUDAK, Duran ÇAKMAK, Barbara FLANNERY

Yatarak tedavi gören erkek alkol bağımlısı hastalarda alkol aşermesinin aleksitimi ve dissosiyasyon ile ilişkisi

Amaç: Bu araştırmanın amacı, yatarak tedavi gören erkek alkol bağımlılarında alkol aşermesi ile aleksitimi ve dissosiyasyon arasındaki ilişkiyi belirlemektir. Yöntem: Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, Alkol-Madde Araştırma, Tedavi ve Eğitim Merkezi'ne (AMATEM) Temmuz 2007-Şubat 2008 tarihleri arasında yatarak tedavi gören hastalar çalışma kapsamına alındı. Çalışmanın örneklemini DSM-IV tanı ölçütlerine göre alkol bağımlılığı tanısı konan 103 hasta oluşturdu. Hastalar sosyodemografik soru formunun yanı sıra, Penn Alkol Aşerme Ölçeği (PAAÖ), Toronto Aleksitimi Ölçeği (TAS-20), Dissosiyatif Yaşantılar Ölçeği (DYÖ), Belirti Tarama Listesi'nin (SCL-90) anksiyete ve depresyon alt ölçekleri ve Michigan Alkolizm Tarama Testi (MATT) ile değerlendirildi. Sonuçlar: PAAÖ toplam puanı, TAS-20 ve TAS-20'nin birinci ve ikinci faktörü, DYÖ, anksiyete, depresyon ve MATT puanları ile pozitif korelasyon gösterdi. Aleksitimik grupta PAAÖ toplam ve beş maddesinin ortalama puanları aleksitimik olmayanlara göre yüksekti. Benzer şekilde dissosiyatif grupta PAAÖ toplam ve üçüncü madde dışında diğer dört madde ortalama puanları dissosiyatif olmayanlara göre yüksekti. Linear regresyonda aşerme puanını belirleyenler DYÖ ve depresif belirtiler toplam puanları olmuştur. Univariat kovaryans analizi, aşerme şiddetinin aleksitiminin varlığı ve dissosiyatif yaşantıların şiddeti ile ilişkili olduğunu göstermiş, ancak anksiyete, depresyon ve MATT puanları da kovariant olarak değerlendirilmeye alındığında bu ilişkiler ortadan kalkmıştır. Değerlendirme: Çalışmanın bulguları, birbiriyle de ilişkili ancak farklı yapılar olan aleksitimi ve dissosiyasyonun aşerme ile olan ilişkilerinin olumsuz affekt üzerinden olabileceğini düşündürmektedir. Aleksitimi ve dissosiyasyon gibi aşerme de, kendi duygusal enformasyonunu uygun bir şekilde ele alamayan kişilerin negatif affekte doğal tepkilerini yansıtıyor olabilir.

Relationship of alcohol craving with alexithymia and dissociation in male alcohol dependent inpatients

Objective: The aim of this study was to determine the relationship of alcohol craving with alexithymia and dissociation in alcohol dependent male inpatients. Methods: The study was conducted with hospitalized patients between July 2007 and February 2008 in Bakırköy State Hospital for Mental Health and Neurological Disorders, AMATEM (Alcohol and Drug Research, Treatment and Education Center) in Istanbul. One hundred three inpatients diagnosed as having alcohol use disorder' were included in the study. They were given socio-demographic form, Penn Alcohol Craving Scale (PACS), Toronto Alexithymia Scale (TAS-20), Dissociative Experiences Scale (DES) anxiety and depression subscales of the Symptom Checklist-Revised (SCL-90-R) and Michigan Alcohol Screening Test (MAST). Results: PACS total score showed positive correlation with TAS-20 and first and second subscales of TAS-20, DES, anxiety, depression and MAST. Alexithymic group had higher PACS total and item scores of PACS than group without alexithymia. Similarly, mean scores of PACS total and four PACS items other than the third item were higher among dissociative group than non-dissociative group. In linear regression model DES total and depression symptoms scores predicted severity of craving. A univariate analysis of covariance demonstrated that severity of the craving was related to severity of dissociative experiences and presence of alexithymia, whereas this relation was not determined in a model when anxiety, depression, and MAST were also included in the analyses as covariant. Discussion: Results of this study showed that relationship of craving with alexithymia and dissociation, which are related but different constructs, might be mediated by negative affect. This suggests that, as alexithymia and dissociation, craving might be a natural response to negative affect in persons who do not treat their own emotional information properly.

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