Cüneyt EVREN, Müge BOZKURT, Bilge EVREN, FATMA YEŞİM CAN, Sera YİĞİTER, Alkin YILMAZ

Yatarak tedavi gören erkek eroin bağımlılarında kişilik boyutlarının dürtüsellik ile ilişkisi

Amaç: Bu çalışmanın amacı erkek eroin bağımlılarında kişilik boyutlarının dürtüsellik ile ilişkisini değerlendirmektir. Ayrıca depresyon ve anksiyetenin bu ilişki üzerindeki etkilerini control etmek istedik. Yöntem: Katılımcılar ardışık olarak yatırılan ve yatarak tedavi gören erkek eroin bağımlıları (s=78) ve sağlıklı controllerden (s=63) oluşmaktaydı. Hastalar Barratt Dürtüsellik Ölçeği-versiyon 11, Mizaç ve Karakter Ölçeği ve Belirti Tarama Listesi ile değerlendirildi. Bulgular: Dürtüselliğin ve dürtüselliğin boyutlarının şiddeti eroin bağımlısı olan grupta sağlıklı control grubuna gore daha yüksekti. Dürtüsellik ödül bağımlılığı, sebat etme, kendi kendini yönetme ve işbirliği yapma boyutları ile negatif korelasyon gösterirken, yenilik arayışı zarardan kaçınma, kendi kendini aşma, depresyon ve anksiyete ile pozitif korelasyon saptanmıştır. Düşük kendi kendini yönetme, sebat etme ve yüksek yenilik arayışı puanları yatarak tedavi gören erkek eroin bağımlılarında dürtüselliği belirlemiştir. Sonuç: Her ne kadar depresyon hem dikkatsel, hem de motor dürtüselliği belirlese de, dürtüselliğin alt boyutlarını belirleyen kişilik boyutları farklı bulunmuştur. Bu, eroin bağımlılarında dürtüsellik sorun olduğunda dürtüselliğin tipi ve kişilik boyutEvren ve ark. 9 larının değerlendirilmesi ve tedavinin buna göre şekillendirilmesi gerektiğini düşündürmektedir. ( Anadolu Psikiyatri Derg 2014; 15:8-14)

Relationships of personality dimensions with impulsivity in heroin dependent inpatient men

The aim of this study was to evaluate the relationship of personality dimensions with impulsivity among men with heroin dependence. Also we wanted to control the effect of depression and anxiety symptoms on this relationship. Methods: Participants were consecutively admitted male heroin dependent (n=78) inpatients and healthy controls (n=63). Patients were investigated with the Barratt Impulsiveness Scale, version 11, the Temperament and Character Inventory, and the Symptom Checklist-Revised. Results: Severity of impulsivity and dimensions of impulsivity were higher in heroin dependent inpatients than healthy controls. Impulsivity was negatively correlated with reward dependence, persistence, self directedness, and cooperativeness, whereas positively correlated with novelty seeking, harm avoidance, self transcendence, depression and anxiety. Low selfdirectedness, persistence and high novelty seeking scores predicted impulsivity in heroin dependent male inpatients. Conclusions: Although depression predicted both attentional and motor impulsiveness, personality dimensions that predict impulsivity dimensions differed. This may suggest that when impulsivity is the problem, types of impulsivity and personality dimensions must be evaluated and the treatment should be shaped accordingly for heroin dependents. (Anatolian Journal of Psychiatry 2014; 15:8-14)

PDF

___

1. Eysenck SB, EysenckHJ. The place of impulsiveness in a dimensional system of personality description. Br J Soc Clin Psychol 1977; 16:57-68.
2. Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt Impulsiveness Scale. J Clin Psychol 1995; 51:768-774.
3. Moeller FG, Barratt FS, Dougherty DM, Schmitz JM, Swann AC. Psychiatric aspects of impulsivity. Am J Psychiatry 2001; 158:1783-1793.
4. Brady KT, Myrick H, McElroy S. The relationship between substance use disorders, impulse control disorders, and pathological aggression. Am J Addic 1998; 7:221-230.
5. Vitaro F, Ferland F, Jacques C, Ladouceur R. Gambling, substance use, and impulsivity during adolescence. Psychol Addict Behav 1998; 12:185-194.
6. Petry NM. Delay discounting of money and alcohol in actively using alcoholics, currently abstinent alcoholics, and controls. Psychopharmacology (Berl) 2001; 154:243-250.
7. Simons JS, Carey KB. Risk and vulnerability for marijuana use problems: the role of affect dysregulation. Psychol Addict Behav 2002; 16:72-75.
8. Wills TA, Sandy JM, Yaeger AM. Moderators of the relation between substance use level and problems: test of a selfregulation model in middle adolescence. J Abnorm Psychol 2002; 111:3-21.
9. Simons JS. Differential prediction of alcohol use and problems: the role of biopsychological and social-environmental variables. Am J Drug Alcohol Abuse 2003; 29:861-879.
10. Bjork JM, Hommer DW, Grant SJ, Danube C. Impulsivity in abstinent alcohol-dependent patients: relation to control subjects and type 1- /type 2-like traits. Alcohol 2004; 34:133-150.
11. Kisa C, Yildirim SG, Goka E. Impulsivity and mental disorders. Turk Psikiyatri Derg 2005; 16:46-54.
12. Acton GS. Measurement of impulsivity in a hierarchical model of personality traits: implications for substance use. Subst Use Misuse 2003; 38:67-83.
13. Lane SD, Cherek DR, Rhoades HM, Pietras CJ, Tcheremissine OV. Relationships among laboratory and psychometric measures of impulsivity: implications in substance abuse and dependence. Addict Disord Their Treat 2003; 2:33-40.
14. Miller L. Predicting relapse and recovery in alcoholism and addiction: neuropsychology, personality, and cognitive style. J Subst Abuse Treat 1991; 8:277-291.
15. Nielsen DA, Ho A, Bahl A, Varma P, Kellogg S, Borg L, et al. Former heroin addicts with or without a history of cocaine dependence are more impulsive than controls. Drug Alcohol Depend 2012; 124:113-120.
16. Roozen HG, van der Kroft P, van Marle HJ, Franken IH. The impact of craving and impulsivity on aggression in detoxified cocaine-dependent patients. J Subst Abuse Treat 2011; 40:414-418.
17. Koller G, Preuss UW, Bottlender M, Wenzel K, Soyka M. Impulsivity and aggression as predictors of suicide attempts in alcoholics. Eur Arch Psychiatry Clin Neurosci 2001; 252:155-160.
18. Cuomo C, Sarchiapone M, Giannantonio MD, Mancini M, Roy A. Aggression, impulsivity, personality traits, and childhood trauma of prisoners with substance abuse and addiction. Am J Drug Alcohol Abuse 2008; 34:339-345.
19. Murray HW, Parkar AA, Mannelli P, DeMaria P, Desai AM, Vergare MJ. Relationship of aggression, sensation seeking, and impulsivity, with severity of cocain use. Addict Disord Their Treat 2003; 2:113-121.
20. Dom G, Hulstijn W, Sabbe B. Differences in impulsivity and sensation seeking between earlyand late-onset alcoholics. Addict Behav 2006; 31:298-308.
21. Whiteside SP, Lynam DR. Understanding the role of impulsivity and externalizing psychopathology in alcohol abuse: application of the UPPS impulsive behavior scale. Exp Clin Psychopharmacol 2003; 11:210-217.
22. de Wit H. Impulsivity as a determinant and consequence of drug use: a review of underlying processes. Addic Biol 2009; 14:22-31.
23. Perry JL, Carroll ME. The role of impulsive behavior in drug abuse. Psychopharmacology (Berl) 2008; 200:1-26.
24. Kose S. A psychobiological model of temperament and character: TCI. New Symposium 2003; 41:86-97.
25. de la Rie SM, Duijsens IJ, Cloninger CR. Temperament, character, and personality disorders. J Pers Disord 1998; 12:362-372.
26. Cloninger CR, Svrakic DM. Integrative psychobiological approach to psychiatric assessment and treatment. Psychiatry 1997; 60:120-141.
27. Cloninger CR. A practical way to diagnosis personality disorder: a proposal. J Pers Disord 2000; 4:99-108.
28. Cloninger CR. Assessment of the impulsivecompulsive spectrum of behavior by the sevenfactor model of temperament and character. JM Oldham, E Hollander, AE Skodol (Eds.), Impulsivity and Compulsivity, Washington: American Psychiatric Press, 1996, p.59-95.
29. Favaro A, Zanetti T, Tenconi E, Degortes D, Ronzan A, Veronese A, et al. The relationship between temperament and impulsive behaviors in eating disordered subjects. Eat Disord 2005; 13:61-70.
30. Pierò A. Personality correlates of impulsivity in subjects with generalized anxiety disorders. Compr Psychiatry 2010; 51:538-545.
31. Mulder RT. Alcoholism and personality. Aust N Z J Psychiatry 2002; 36:44-52.
32. First MB, Spitzer RL, Gibbon M, Williams JBW. Stuructured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinical Version. Washington D.C.: American Psychiatric Press, 1997.
33. Corapcioglu A, Aydemir O, Yildiz M, Esen A, Koroglu E. DSM-IV Eksen I Bozuklukları (SCID-I) için Yapılandırılmış Klinik Görüşme, Klinik Versiyon. Hekimler Yayın Birliği, Ankara, 1999. (Turkish)
34. Mitchell SH. Measures of impulsivity in cigarette smokers and non-smokers. Psychopharmacology 1999;146: 455-464.
35. Moeller FG, Dougherty DM, Barratt ES, Oderinde V, Mathias CW, Harper RA, et al. Increased impulsivity in cocaine-dependent subjects independent of antisocial personality disorder and aggression. Drug Alcohol Depend 2002; 68:105- 111. 36. Stanford MS, Greve KW, Boudreaux JK, Mathias CW, Brumbelow JL. Impulsiveness and risktaking behavior: Comparison of high school and college students using the Barratt Impulsiveness Scale. Pers Individ Dif 1996; 21:1073-1075.
37. Gulec H, Tamam L, Gulec MY, Turhan M, Karakus G, Zengin M, et al. Psychometric properties of the Turkish version of the barratt impulsive ness Scale-11. Bulletin of Clinical Psychopharmacology 2008; 18:251-258.
38. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry 1993; 50:975-990.
39. Kose S, Sayar K, Kalelioglu U, Aydin N, Ak I, Kirpinar I, et al. Turkish version of the TCI: reliability, validity, and factorial structure. Bulletin of Clinical Psychopharmacology 2004; 14:107-131.
40. Derogatis LR. SCL-90: Administration, Scoring and Procedure Manual-II for the revised version, Tawson, Clinical Psychometric Research, 1983. 41. Dag I. Reability and validity of Symptom Check List-90-Revised among university students. Turk Psikiyatri Derg 1991; 2:5-12 (Turkish).
42. Martinotti G, Mandelli L, Di Nicola M, Serretti A, Fossati A, Borroni S, et al. Psychometric characteristic of the Italian version of the Temperament and Character Inventory--revised, personality, psychopathology, and attachment styles. Compr Psychiatry 2008; 49:514-522.
43. Verheul R, van den Brink W. The role of personality pathology in the aetiology and treatment of substance use disorders. Curr Opin Psychiatry 2000; 13:163-169.
44. Casillas A, Clark LA. Dependency, impulsivity, and self-harm: traits hypothesized to underlie the association between cluster B personality and substance use disorders. J Pers Disord 2002; 16:424-436.
45. Boisseau CL, Thompson-Brenner H, Eddy KT, Satir DA. Impulsivity and personality variables in adolescents with eating disorders. J Nerv Ment Dis 2009; 197:251-259.
46. Tikkanen R, Holi M, Lindberg N, Virkkunen M. Tridimensional Personality Questionnaire data on alcoholic violent offenders: specific connections to severe impulsive cluster B personality disorders and violent criminality. BMC Psychiatry 2007; 7:36.
47. Basoglu C, Oner O, Ates A, Algul A, Bez Y, Ebrinc S, et al., Temperament traits and psychopathy in a group of patients with antisocial personality disorder. Compr Psychiatry 2011; 52:607-612.
48. Gunderson JG. Borderline personality disorder: ontogeny of a diagnosis. Am J Psychiatry 2009; 166:530-539.
49. Mitchell JM, Fields HL, D’Esposito M, Boettiger CA. Impulsive responding in alcoholics. Alcohol Clin Exp Res 2005; 29:2158-2169.
50. Villeneuve E, Lemelin S. Open-label study of atypical neuroleptic quetiapine for treatment of borderline personality disorder: impulsivity as main target. J Clin Psychiatry 2005;66: 1298- 1303.
51. Congdon E, Canli T. A neurogenetic approach to impulsivity. J Pers 2008; 76:1447-1484.