Yaygın Anksiyete Bozukluğu ve Panik Bozuklukta Düşünce Kontrolü ve Obsesif İnanışların İncelenmesi

Öz: Amaç: Obsesif inanışlar ve düşünce kontrolü çoğunlukla Obsesif Kompulsif Bozuklukla ilişkilendirilmiştir. Ancak son zamanlarda literatürde anksiyete bozuklukları ile ilişkisi de araştırılmaktadır. Bu araştırmada Yaygın Anksiyete Bozukluğu ve Panik Bozukluk tanılı hastalarda Obsesif İnanışlar ve Düşünce Kontrolü düzeyleri incelenmiştir. Anksiyete bozukluklarının bilişsel temeli ile ilgili literatüre katkı sağlanması amaçlanmıştır. Gereç ve Yöntem: Araştırmaya DSM 5 tanı kriterlerine göre Yaygın Anksiyete Bozukluğu tanısı alan 71 hasta, Panik Bozukluk tanısı alan 63 hasta ve 63 sağlıklı kontrol grubu dahil edilmiştir. Katılımcılara Düşünce Kontrol Ölçeği ve Obsesif İnanışlar Ölçeği uygulanmıştır. Ayrıca Yaygın Anksiyete Bozukluğu tanısı alan hastalara Beck Anksiyete Ölçeği, Panik Bozukluk tanısı alan hastalara İse Panik Agorafobi Ölçeği uygulanmıştır. Bulgular: Dikkat Dağıtma (F=11.383; p=<0.01; η2=0.105), Sosyal Kontrol (F=9.517; p=<0.01; η2=0.089), Endişe (F=5.589; p=0.004; η2=0.054), Kendini Cezalandırma (F=4.879; p=0.009; η2=0.048), Yeniden Değerlendirme (F=3.916; p=0.021; η2=0.039) alt boyutlarında gruplar arasında istatistiksel olarak anlamlı fark saptanmıştır. Gruplar arasında Sorumluluk/Tehlike Beklentisi (F=9.268; p=<0.01; η2=0.087) ve Mükemmeliyetçilik/ Kesinlik (F=18.557; p=<0.01; η2=0.161) alt boyutlarında gruplar arasında istatistiksel olarak anlamlı fark saptanırken Önem Verme/ Düşünceleri Kontrol Etme (F=0.300; p=0.741; η2=0.003) alt boyutunda istatistiksel olarak anlamlı fark saptanmamıştır. Sonuç: Araştırmamızda Yaygın Ankisiyete Bozukluğu ve Panik Bozukluk tanısı olan hastaların Obsesif İnanışlar ve Düşünce Kontrolü düzeyleri sağlıklı kontrollerden yüksek bulunmuştur. İşlevsel olmayan bu düşünceler anksiyete bozukluklarının gelişiminde risk faktörü olabilir. Anksiyete bozukluklarının etyolojisine yönelik yapılacak araştırmalar literatüre katkı sağlayacaktır.

Anahtar Kelimeler:

obsesif inanışlar, düşünce kontrolü, anksiyete bozukluğu, panik bozukluk

Investigation of Thought Control and Obsessive Beliefs in Generalised Anxiety Disorder and Panic Disorder

Aims: Obsessive beliefs and thought control are often thought to be associated with Obsessive Compulsive Disorder. However, the relationship with anxiety disorders has recently been investigated in the literature. In this study, Obsessive Beliefs and Thought Control levels in patients diagnosed with Generalised Anxiety Disorder and Panic Disorder were investigated. It is aimed to contribute to the literature on the cognitive aspects of anxiety disorders. Material and Method: According to DSM 5 diagnostic criteria, 71 patients diagnosed with Generalised Anxiety Disorder, 63 patients diagnosed with Panic Disorder and 63 healthy controls were included in the study. The participants were applied the Thought Control Questionnaire and Obsessive Beliefs Questionnaire. In addition, Beck Anxiety Scale was applied to patients diagnosed with Generalised Anxiety Disorder and Panic Agoraphobia Scale was applied to patients diagnosed with Panic Disorder. Results: A statistically significant difference was found between the groups in Distraction (F=11.383; p=<0.01; η2=0.105), Social Control (F=9.517; p=<0.01; η2=0.089), Worry ( F=5.589; p=0.004; η2=0.054), Self-Punishment ( F=4. 879; p=0.009; η2=0.048), Reappraisal ( F=3.916; p=0.021; η2=0.039) sub-dimensions. There was a statistically significant difference between the groups in the sub-dimensions of Responsibility/Threat Estimation (F=9.268; p=<0.01; η2=0.087) and Perfectionism/Certainty (F=18.557; p=<0.01; η2=0.161), but there was no statistically significant difference in the subdimension Importance/control of thoughts ( F=0.300; p=0.741; η2=0.003). Conclusion: In our study, Obsessive Beliefs and Thought Control levels of patients with Generalised Anxiety Disorder and Panic Disorder were higher than healthy controls. These dysfunctional thoughts may be a risk factor in the development of anxiety disorders. Research on the aetiology of anxiety disorders will contribute to the literature.

Keywords:

obsessive beliefs, thought control, anxiety disorder, panic disorder,

PDF

___

1. Cognitive assessment of obsessive-compulsive disorder. Obsessive Compulsive Cognitions Working Group. Behav Res Ther 1997;35(7):667-81.
2. Janoff-Bulman R. Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social cognition 1989;7(2):113-36.
3. Konkan R, Şenormanci Ö, Güçlü O, Aydin E, Sungur MZ. Obsesif kompulsif bozukluk ve obsesif inançlar. Anatolian Journal of Psychiatry 2012;13(2):91-6.
4. Wegner DM, Zanakos S. Chronic thought suppression. J Pers 1994;62(4):616-40.
5. Wells A, Davies MI. The Thought Control Questionnaire: a measure of individual differences in the control of unwanted thoughts. Behav Res Ther 1994;32(8):871-8.
6. Mellman TA, Uhde TW. Obsessive-compulsive symptoms in panic disorder. Am J Psychiatry 1987;144(12):1573-6.
7. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56(6):893-7.
8. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of cognitive psychotherapy 1998;12(2):163-72.
9. Bandelow B. Assessing the efficacy of treatments for panic disorder and agoraphobia. II. The Panic and Agoraphobia Scale. Int Clin Psychopharmacol 1995;10(2):73-81.
10. Tural U, Fidaner H, Alkin T, Bandelow B. Validity and reliability of the Turkish version of the Panic and Agoraphobia Scale. Turk Psikiyatri Derg. 2000;11(1):29-39.
11. Yorulmaz O, Gençöz T. Obsessif-Kompulsif Bozukluk Semptomların Değerlendirilmesinde Kullanılan İstem Dışı Düşünceleri Yorumlama Envanteri, Obsessif İnanışlar Ölçeği ve Düşünceleri Kontrol Etme Ölçeği’nin Türk Örnekleminde İncelenmesi. Türk Psikoloji Yazıları 2008;11(22):1-13.
12. Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory--Part 2: Factor analyses and testing of a brief version. Behav Res Ther 2005;43(11):1527-42.
13. Boysan M, Besiroglu L, Çetinkaya N, Atli A, Aydin A. The Validity and Reliability of the Turkish Version of the Obsessive Beliefs Questionnaire-44 (OBQ-44). Archives of Neuropsychiatry 2010;47(3):216-22.
14. Rhéaume J, Freeston MH, Dugas MJ, Letarte H, Ladouceur R. Perfectionism, responsibility and obsessive-compulsive symptoms. Behav Res Ther 1995;33(7):785-94.
15. Wu KD, Cortesi GT. Relations between perfectionism and obsessive-compulsive symptoms: examination of specificity among the dimensions. J Anxiety Disord 2009;23(3):393-400.
16. Miegel F, Daubmann A, Moritz S, Balzar A, Yassari AH, Jelinek L. Obsessive-Compulsive Symptom Dimensions and Their Relationships with Obsessive Beliefs: A Structural Equation Modeling Analysis. Psychiatr Q 2023.
17. Fergus TA, Wu KD. Is worry a thought control strategy relevant to obsessive-compulsive disorder? J Anxiety Disord 2010;24(2):269-74.
18. Amir N, Cashman L, Foa EB. Strategies of thought control in obsessive-compulsive disorder. Behav Res Ther 1997;35(8):775-7.
19. Tolin DF, Worhunsky P, Maltby N. Are "obsessive" beliefs specific to OCD? a comparison across anxiety disorders. Behav Res Ther 2006;44(4):469-80.
20. Coles ME, Heimberg RG. Thought control strategies in generalized anxiety disorder. Cogn Ther Res 2005; 29:47-56.
21. Frost RO, Steketee G. Perfectionism in obsessive-compulsive disorder patients. Behav Res Ther 1997;35(4):291-6.
22. Ladouceur R, Gosselin P, Dugas MJ. Experimental manipulation of intolerance of uncertainty: a study of a theoretical model of worry. Behav Res Ther 2000;38(9):933-41.
23. MacLeod AK, Williams JM, Bekerian DA. Worry is reasonable: the role of explanations in pessimism about future personal events. J Abnorm Psychol 1991;100(4):478-86.
24. Abramowitz JS, Tolin DF, Street GP. Paradoxical effects of thought suppression: A meta-analysis of controlled studies. Clin Psychol Rev 2001;21(5):683-703.
25. Pilecki B, Arentoft A, McKay D. An evidence-based causal model of panic disorder. J Anxiety Disord 2011;25(3):381-8.
26. McEvoy PM, Carleton RN. The wonder and angst of exploring the unknown: Introduction to the special issue on intolerance of uncertainty. J Anxiety Disord 2016:41;1-4.
27. Moore EL, Abramowitz JS. The cognitive mediation of thought-control strategies. Behav Res Ther 2007;45(8):1949-55.
28. Wells A, King P. Metacognitive therapy for generalized anxiety disorder: An open trial. J Behav Ther Exp Psychiatry 2006;37(3):206-12.