Psoriazis hastalığı olan ve olmayan bireylerin ayrılma bireyleşme, annenin algılanan reddi ve savunma mekanizmaları açısından karşılaştırılması
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Dosyalar
Tarih
2021
Yazarlar
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Yayıncı
İstanbul Gedik Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Psoriazis hastalığı biyopsikososyal etmenlerle ortaya çıkan, kişinin yaşam kalitesini etkileyen, damgalanmaya, sosyal izolasyona ve sosyal ilişkilerde sorunlara yol açan yaygın bir deri hastalığıdır. Bu araştırmanın temel amacı psoriazis hastaları ile deri hastalığı olmayan bireylerden oluşan iki ayrı grubun altta yatan psikolojik ve gelişimsel değişkenler açısından karşılaştırılmasıdır. Psoriazis hastalarının erken dönem anne bebek ilişkilerinde sorunlar olduğu araştırmalarda gösterilmektedir. Daha önce yapılmış çalışmalarda, erken dönemde annenin yeterince kapsayamaması, anne ile ilişkinin aniden kopması ya da yeterince kurulamaması gibi durumlar, bebeğin ayrılma bireyleşme güçlüğü yaşamasını ve ruhsal yapılanmasında sorunlar ortaya çıkmasını sağlayabilmektedir. Annenin bilinçdışı nefreti ve bebeği reddetmesinin sonucunda bebeğe yeterince dokunamama, kapsayamama ve kucaklayamaması erken dönem iletişim yolu olan deride çeşitli sorunlar ortaya çıkarabilmektedir. Bu çalışmada, anne ile erken dönem ilişkinin etkilerini keşfetmek amacıyla, ayrılma bireyleşme, savunma mekanizmaları ve annenin algılanan reddi açısından psoriazis hastalığı olan ve olmayan iki grup arası farklılıklar araştırılmıştır. Araştırmada şu hipotezler test edilmiştir: (1) Psoriazis hastalığı olan bireylerin olmayan bireylere göre annelerinin reddediciliğine yönelik algısı daha yüksektir; (2) Psoriazis hastası olan bireylerin olmayan bireylere göre ayrılma bireyleşme güçlüğü daha fazladır; (3) Psoriazis hastalığı olan bireylerin olmayan bireylere göre daha fazla immatür (ilkel) ve nevrotik savunma mekanizmaları kullanmaktadır. Araştırmanın evreni psoriazis hastalarından ve bir deri hastalığı olmayan bireylerden oluşmaktadır. Kartopu örnekleme yöntemi ile seçilen katılımcılar çevirim içi link üzerinden anket sorularının yanıtlamışlardır. Çalışma, ''örneklem üzerinde koşulları değiştirici herhangi bir müdahalede bulunmadan mevcut özellikleri ile betimlenmesi" olarak tanımlanan (Karasar, 2016) tarama modelinde yürütülmüştür. 91 psoriazis hastası ve 84 deri hastalığı olmayan bireyin katıldığı bu çalışmaya toplam 175 kişi katılmıştır. Psoriazis hastalarını, Şişli Devlet Hastanesi Psoriazis Kliniği'ne başvuran, dermatologlar tarafından psoriazis tanısı almış hastalar oluştururken, kontrol grubu rastgele şekilde çevreden toplanmıştır. Katılımcılara, Bilgilendirilmiş Onam Formu ve Rıza Formu verilmiştir. Veri toplama araçları olarak Demografik Bilgi Formu, Yetişkin Ebeveyn Kabul-Red Ölçeği – Kısa Formu (EKRÖ), Savunma Biçimleri Testi (SBÖ) ve Ayrılma Bireyleşme Ölçeği (ABÖ) kullanılmıştır. Elde edilen bulguların analizi SPSS 25.0 programı kullanılarak yapılmıştır. Yapılan analizler sonucunda, EKRÖ ortalama puanları incelendiğinde, psoriazis hastası olan bireylerin olmayan bireylere göre istatistiksel olarak anlamlı şekilde annelerini daha reddedici olarak algıladıkları bulunmuştur (p<0.05). ABÖ ortalama puanlar karşılaştırıldığında, psoriazis hastalığı olan bireylerin, hastalığı olmayan bireylere göre ayrılma bireyleşme güçlüklerinin istatistiksel olarak anlamlı bir şekilde daha fazla olduğu görülmüştür (p<0,05). Ayrıca ABÖ'ye göre kesme puanı 190 üstünde olan toplam puan patolojik sınır olarak kabul edilmiş ve gruplar buna göre karşılaştırılmıştır. Psoriazis hastalarında patolojik düzeyde ayrılma bireyleşme güçlüğü yaşayanlar %44 iken kontrol grubunda bu oran %14,3 bulunmuştur ve bu da istatistiksel olarak anlamdır (p<0.05). Savunma biçimleri açısından farklılıklar için, SBÖ'nün matür, nevrotik ve immatür savunmalar olarak ayrılan üç düzeyinin ayrı ayrı ortalama puanları karşılaştırılmış ve matür ve immatür savunmalarda istatistiksel olarak anlamlı farklılık bulunmuştur (p<0.05). Psoriazis hastalığı olanlar, olmayan bireylere göre immatür savunmaları daha fazla kullandıkları; psoriazis hastalığı olmayan bireylerin ise hastalığı olan bireylere göre matür savunma mekanizmalarını daha fazla kullandıkları bulunmuştur ve bu fark istatistiksel olarak anlamlı bulunmuştur. Sosyodemografik değişkenlere bakıldığında, deney ve kontrol grupları psikiyatrik tanı ve ilaç kullanma, psikoterapi alma, bedensel hastalık türü, sigara kullanımı, bağımlılık tanısı, bedensel hastalık oranı, sigara, alkol, madde ve ilaç kullanımı bakımından anlamlı farklılık göstermemiştir. Araştırma sonuçları, araştırmada ele alınan hipotezler, literatürde yer alan çalışma sonuçları ve ortaya atılan kuramlar doğrultusunda tartışılmıştır. Çalışmanın, ortaya atılan kuram ve literatürdeki çalışmalarla desteklendiği bulunmuştur. Bu anlamda çalışmanın hem psikoloji ve dermatoloji alanında uzmanlara ışık tutacağı hem de bu alanda yapılan çalışmalara katkı sağlayacağı düşünülmüştür.
Psoriasis is a common skin disease that occurs with biopsychosocial factors, affects the quality of life of the person, causes stigma, social isolation and problems in social relations. The main purpose of this study is to compare two separate groups consisting of psoriasis patients and individuals without skin disease in terms of underlying psychological and developmental variables. Studies have shown that psoriasis patients have problems in early mother-infant relationships. In previous studies, situations such as the mother's inability containment of the child in the early period, the sudden rupture of the relationship with the mother or the inability to establish sufficient bonding may cause the infant to have separation-individuation difficulties and problems in his/her mental structuring. As a result of the mother's unconscious hatred and rejection of the baby, the inability to adequately touch, contain and hold the baby can cause various problems in the skin, which is the early communication way. In this study, the differences between the two groups with and without psoriasis were investigated in terms of separation individuation, defense mechanisms and perceived rejection of the mother in order to explore the effects of early relationship with the mother. The following hypotheses were tested in the study: (1) Individuals with psoriasis have more perceived maternal rejection than those without psoriasis; (2) Individuals with psoriasis have more separation-individuation difficulties than individuals without psoriasis; (3) Individuals with psoriasis use more immature (primitive) and neurotic defense mechanisms than individuals without psoriasis. The population of the study consists of psoriasis patients and individuals who do not have a skin disease. Participants selected by the snowball sampling method answered the survey questions via the online link. The study was carried out in the survey model (Karasar, 2016), which is defined as "describing the sample with its existing features without any intervention that changes the conditions". A total of 175 people participated in this study, in which 91 patients with psoriasis and 84 individuals without skin disease participated. The psoriasis patients consisted of patients who applied to Şişli State Hospital Psoriasis Clinic and were diagnosed with psoriasis by dermatologists, while the control group was randomly collected from the environment. Participants were given an Informed Consent Form and Consent Form. Demographic Information Form, Adult Parental Acceptance-Rejection Scale-Short Form (PARS), Defense Style Questionnaire (DSQ), and Separation Individuation Inventory (SII) were used as data collection tools. The analysis of the obtained findings was made using the SPSS 25.0 program. As a result of the analysis, when the mean PARQ scores were examined, it was found that individuals with psoriasis perceived their mothers as more rejecting than individuals without psoriasis with a satistically significant difference (p<0.05). When the mean SII scores were compared, it was observed that individuals with psoriasis had statistically significantly more separation-individuation difficulties than individuals without the disease (p<0.05). In addition, individuals with a total score above 190 considered as pathological according to the SII, and the groups were compared based on this cut-off point. While 44% of psoriasis patients had pathological separation and individuation difficulties, this rate was 14.3% in the control group, which is statistically significant (p<0.05). For differences in defense mechanisms styles, the mean scores of the three levels of DSQ, which are divided into mature, neurotic and immature defenses, were compared and statistically significant differences were found in mature and immature defenses (p<0.05). Sample with psoriasis use immature defenses more than those without psoriasis; It was found that individuals without psoriasis used mature defense mechanisms more than individuals with the disease, and this difference was found to be statistically significant. Considering the sociodemographic variables, the experimental and control groups did not differ significantly in terms of psychiatric diagnosis, drug use, psychotherapy, type of physical illness, smoking, addiction diagnosis, rate of somatic disease, smoking, alcohol, substance and drug use. The results of the research were discussed in line with the hypotheses put forward in the research, the results of the studies in the literature and the theories. It has been found that the study is supported by the theories and studies in the literature. In this sense, it is thought that the study will both shed light on the experts in the field of psychology and dermatology and contribute to the studies in this field.
Psoriasis is a common skin disease that occurs with biopsychosocial factors, affects the quality of life of the person, causes stigma, social isolation and problems in social relations. The main purpose of this study is to compare two separate groups consisting of psoriasis patients and individuals without skin disease in terms of underlying psychological and developmental variables. Studies have shown that psoriasis patients have problems in early mother-infant relationships. In previous studies, situations such as the mother's inability containment of the child in the early period, the sudden rupture of the relationship with the mother or the inability to establish sufficient bonding may cause the infant to have separation-individuation difficulties and problems in his/her mental structuring. As a result of the mother's unconscious hatred and rejection of the baby, the inability to adequately touch, contain and hold the baby can cause various problems in the skin, which is the early communication way. In this study, the differences between the two groups with and without psoriasis were investigated in terms of separation individuation, defense mechanisms and perceived rejection of the mother in order to explore the effects of early relationship with the mother. The following hypotheses were tested in the study: (1) Individuals with psoriasis have more perceived maternal rejection than those without psoriasis; (2) Individuals with psoriasis have more separation-individuation difficulties than individuals without psoriasis; (3) Individuals with psoriasis use more immature (primitive) and neurotic defense mechanisms than individuals without psoriasis. The population of the study consists of psoriasis patients and individuals who do not have a skin disease. Participants selected by the snowball sampling method answered the survey questions via the online link. The study was carried out in the survey model (Karasar, 2016), which is defined as "describing the sample with its existing features without any intervention that changes the conditions". A total of 175 people participated in this study, in which 91 patients with psoriasis and 84 individuals without skin disease participated. The psoriasis patients consisted of patients who applied to Şişli State Hospital Psoriasis Clinic and were diagnosed with psoriasis by dermatologists, while the control group was randomly collected from the environment. Participants were given an Informed Consent Form and Consent Form. Demographic Information Form, Adult Parental Acceptance-Rejection Scale-Short Form (PARS), Defense Style Questionnaire (DSQ), and Separation Individuation Inventory (SII) were used as data collection tools. The analysis of the obtained findings was made using the SPSS 25.0 program. As a result of the analysis, when the mean PARQ scores were examined, it was found that individuals with psoriasis perceived their mothers as more rejecting than individuals without psoriasis with a satistically significant difference (p<0.05). When the mean SII scores were compared, it was observed that individuals with psoriasis had statistically significantly more separation-individuation difficulties than individuals without the disease (p<0.05). In addition, individuals with a total score above 190 considered as pathological according to the SII, and the groups were compared based on this cut-off point. While 44% of psoriasis patients had pathological separation and individuation difficulties, this rate was 14.3% in the control group, which is statistically significant (p<0.05). For differences in defense mechanisms styles, the mean scores of the three levels of DSQ, which are divided into mature, neurotic and immature defenses, were compared and statistically significant differences were found in mature and immature defenses (p<0.05). Sample with psoriasis use immature defenses more than those without psoriasis; It was found that individuals without psoriasis used mature defense mechanisms more than individuals with the disease, and this difference was found to be statistically significant. Considering the sociodemographic variables, the experimental and control groups did not differ significantly in terms of psychiatric diagnosis, drug use, psychotherapy, type of physical illness, smoking, addiction diagnosis, rate of somatic disease, smoking, alcohol, substance and drug use. The results of the research were discussed in line with the hypotheses put forward in the research, the results of the studies in the literature and the theories. It has been found that the study is supported by the theories and studies in the literature. In this sense, it is thought that the study will both shed light on the experts in the field of psychology and dermatology and contribute to the studies in this field.
Açıklama
Lisansüstü Eğitim Enstitüsü, Psikoloji Ana Bilim Dalı, Klinik Psikoloji Bilim Dalı
Anahtar Kelimeler
Ayrılma Bireyleşme, Annenin Algılanan Reddi, Savunma Mekanizmaları, Psoriazis, Separation-Individuation, Perceived Maternal Rejection, Defense Mechanisms, Psoriasis, Separation-Individuation, Perceived Maternal Rejection, Defense Mechanisms, Psoriasis