Depresyon ve anksiyete tanısı almış çocuklar ile kontrol grubunun anne-babalarının bağlanma stillerine göre evlilik uyumlarının incelenmesi
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Date
2005
Authors
Yıldız, Sibel
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmanın amacı bağlanma stillerine göre evlilik uyumunu depresyon ve anksiyete tanısı alan çocuk ve ergenlerin anne babalarında ve hiçbir psikiyatrik tanı almamış olan çocuk ve ergenlerin anne babalarının belirlemektir. Ayrıca, ailelerin depresyon, anksiyete düzeylerin, problem çözme becerilerinin, ilişki yükleme biçimlerinin bağlanma stillerine göre evlilik ilişkilerini anlamaya yardımcı olacağı düşünülmüştür. Depresyon ve anksiyete tanısı alan ve hiçbir psikiyatrik tanı almamış çocukların anne babalarının bağlanma stillerine göre evlilik uyumlarını karşılaştırmak için yaşları 27 ile 58 arasında değişen toplam 90 çiftle çalışılmıştır. Bursa Uludağ Üniversitesi Tıp Fakültesi Çocuk ve Ergen Ruh Sağlığı Anabilim Dalı’na başvurup depresyon ve anksiyete tanısı almış çocukların anne babalarından (çalışma grubu n=45) oluşan çalışma grubu, Uludağ Üniversitesi Çocuk Sağlığı ve Hastalıkları ABD Genel Polikliniğine başvurup hiçbir psikiyatrik tanısı olmayan çocukların anne babalarıyla karşılaştırılmıştır. Gönüllülüğe dair Aydınlatılmış Onam’lar yazılı olarak alındıktan sonra tüm katılımcılara Yakın İlişkilerde Yaşantılar Envanteri (YİYE), Evlilik Uyum Ölçeği (EUÖ), İlişki Yükleme Ölçeği (İYÖ) Problem Çözme Envanteri (PÇE), Beck Depresyon Ölçeği (BDÖ), Durumluluk ve Süreklilik Kaygı Ölçeği (STAI-I, STAI-II) ve ayrıca bu çalışma için tasarlanmış olan yarı yapılandırılmış görüşme formu uygulanmıştır. Üniversite Etik Kurulu çalışmayı onaylamıştır. Elde edilen veriler istatistik paket programı SPSS 13.0 kullanılarak değerlendirilmiştir. Araştırma sonucunda elde edilenler bulgular şunlardır: A- Çalışma grubu ile kontrol grubunun karşılaştırılması; - Flört ederek evlenenlerin sayısı kontrol grubunda çalışma grubuna göre daha fazladır (p<0,05). - Kontrol grubundaki anne babalar, çalışma grubundaki anne babalara göre eşlerini duygusal olarak daha fazla yakın hissetmektedirler (p<0,05). - Kontrol grubundaki anne babalar, çalışma grubuna göre evliliklerini daha fazla doyum sağlayıcı olarak değerlendirmektedirler (p<0,05). - Kontrol grubundaki anne babalar, çalışma grubuna göre eşlerinin ideallerindeki eşe daha uygun olduğunu belirtmişlerdir (p<0,05). - Kontrol grubundaki anne babalar, çalışma grubuna göre eşlerinin kendilerini fiziksel olarak daha fazla çekici bulduğunu belirtmişlerdir (p<0,05). - Kontrol grubundaki annelerde çalışma grubundaki anneler göre güvenli bağlanma stili daha fazladır (p<0,05); diğer yandan çalışma grubundaki annelerde ise korkulu bağlanma stili daha fazladır (p<0,05). - Depresyon, durumluk anksiyete ve süreklilik anksiyetesi, çalışma grubunda (depresyon ve anksiyete tanısı almış olan çocukların anne babalarında) kontrol grubuna göre daha fazladır (p<0,05). B- 90 çiftte bağlanma stillerinin korelasyonu (çalışma grubu + kontrol grubu) - Güvenli bağlanma stiline sahip anne babaların evlilik uyumu saplantılı, korkulu veya kayıtsız bağlanma stiline sahip anne babalara göre daha yüksektir. (p<0,05). - Korkulu veya saplantılı bağlanma stillerine sahip anne babalar, ilişkideki olumsuzlukları güvenli veya kayıtsız bağlanma stillerine sahip anne babalara göre eşlerine daha fazla yüklemektedirler (p<0,05). - Korkulu bağlanma stiline sahip anne babaların problem çözme becerileri saplantılı, güvenli veya kayıtsız bağlanma stiline sahip anne babalara göre daha az etkilidir. (p<0,05). - Güvenli bağlanma stiline sahip anne babaların depresyon puanı saplantılı, korkulu veya kayıtsız bağlanma stiline sahip anne babalara göre daha düşüktür (p<0,05). - Güvenli bağlanma stiline sahip anne babaların durumluk ve süreklik anksiyetesi saplantılı, korkulu veya kayıtsız bağlanma stiline sahip anne babalara göre daha düşüktür (p<0,05). - Cinsiyete göre bakıldığında ise, kadınlarda depresyon, anksiyete ve evlilikteki olumsuzlukları e şe yükleme eğiliminin daha fazla (p<0,05) ve problem çözme becerilerinin erkeklerden daha iyi (p<0,05) olduğu görülmektedir. Kontrol grubundaki anne babaların eşlerine karşı daha fazla olumlu algıları olmasına rağmen evlilik uyumu açısından gruplar arasında fark bulunmaması şaşırtıcıdır. Bu durum, katılımcıların bilerek veya bilmeyerek evlilik ilişkilerini yanlış değerlendirmelerinden veya çalışmada kullanılan test yöntemlerinin evlilik uyumunu belirlemede yetersiz kalmasından kaynaklanıyor olabilir. Ayrıca kontrol grubundaki anne babalarda görülen ‘eşe karşı olumlu atıflar’ın, bu bireylerin çocuklarında depresyon ve anksiyete bozukluğuna karşı koruyucu olup olamayacağı tartışılabilir. Bağlanma stillerinin, evlilik uyumu, depresyon, anksiyete, problem çözme becerisi ile korelasyonu literatürle uyumlu bulunmuştur. Sonuç olarak; çocukların sağlıklı gelişimi için uygun ortamı sunabilmek amacıyla, anne-baba-çocuk ilişkisini ve anne babaların kendi aralarındaki ilişkiyi daha iyi anlamaya; ayrıca olumsuz anne-baba-çocuk ilişkisinin risk faktörlerini belirlemeye ihtiyaç vardır. Bu bilgiler, alanda önleyici çalışmalara yön vermelidir.
The aim of this study was to determine the marital adjustment according to attachment styles in parents of children and adolescents with a diagnosis of depression and anxiety as compared to parents of children without a psychiatric disorder. It was also proposed that information about parental rate of depression and anxiety, type of problem solving skills and relationship attribution would help to understand the marital relationships as well as attachment styles. Ninety couples aged between 27 – 58 years were studied in order to compare the marital adjustment according to attachment styles of parents of children with depression and anxiety as compared to parents of children without a psychiatric disorder. The study group consisting of parents whose children were admitted to Bursa Uludag University Department of Child and Adolescent Psychiatry and diagnosed with depression and anxiety (Study Group; n = 45 couples) was compared to parents of children without a psychiatric disorder who were admitted to Uludag University Department of Pediatrics (Control Group; n = 45 couples). Experiences in Close Relationships Inventory, Marital Adjustment Measure, Relationships Attribution Measure, Problem Solving Inventory, Beck Depression Inventory and State-Trait Anxiety Inventory as well as a semi-structured interview designed for this study were applied to all participants after written consent had been obtained. The institutional ethics committee had approved the study. Data have been evaluated using SPSS version 13.0. Results of the study are as follows: A – Comparison of Study Group versus Control Group: - More couples in the Control Group dated before marriage than couples in the Study Group (p<0.05). - Parents in the Control Group feel emotionally closer to their spouses than parents in the Study Group (p<0.05). - Parents in the Control Group consider their marriage more satisfying than the Study Group (p<0.05). - Parents in the Control Group find their spouse more similar to their concept of an ideal partner than parents in the Study Group (p<0.05). - The belief that their spouse finds them attractive, is stronger in the Control Group than in the Study Group (p<0.05). - More mothers in the Control Group show a secure attachment style (p<0.05) while more mothers in the Study Group show a fearful attachment style (p<0.05). - Depression, state anxiety and trait anxiety are higher in parents of children with depression and anxiety (Study Group) than in the Control Group (p<0.05). B – Correlation of attachment styles in all 90 couples (Study Group + Control Group): - Marital adjustment is higher in parents with secure attachment style than in parents with either preoccupied, fearful or dismissing attachment style (p<0.05). - Attribution of negative aspects of the relationship to the spouse is higher in parents with fearful or preoccupied attachment styles than in parents with secure or dismissing attachment styles (p<0.05). - Parents with fearful attachment style are less effective in problem solving than parents with either secure, preoccupied or dismissing attachment style (p<0.05). - Depression is less in parents with secure attachment style than in parents with either preoccupied, fearful or dismissing attachment style (p<0.05). - State and trait anxiety are lower in parents with secure attachment style than in parents with either preoccupied, fearful or dismissing attachment style (p<0.05). - With regard to gender, women are more depressed and more anxious and attribute negative aspects of the relation more to their spouse than men (p<0.05). On the other hand, women are better in problem solving than men (p<0.05). It is surprising, that marital adjustment did not differ significantly between the two groups, despite the fact that parents in the Control Group had a more positive perception of their spouse. This may have resulted from the interviewees knowingly or unknowingly misinterpreting their marital relationship or from inadequacy of the applied test tools to determine marital adjustment. On the other hand, it could be discussed whether positive attributions to the spouse as seen in the Control Group form a protective factor against depression and anxiety disorder in the children of these individuals. The correlation of attachment styles with marital adjustment, depression, anxiety and problem solving skills have been found parallel to previous publications. In conclusion, to provide an environment adequate for the healthy development of children, there is a need for a better understanding of the parent-child relationship and the relationship of the parents among themselves; to determine risk factors of an unfavorable parent-child relationship; which should lead to preventive efforts in the field.
The aim of this study was to determine the marital adjustment according to attachment styles in parents of children and adolescents with a diagnosis of depression and anxiety as compared to parents of children without a psychiatric disorder. It was also proposed that information about parental rate of depression and anxiety, type of problem solving skills and relationship attribution would help to understand the marital relationships as well as attachment styles. Ninety couples aged between 27 – 58 years were studied in order to compare the marital adjustment according to attachment styles of parents of children with depression and anxiety as compared to parents of children without a psychiatric disorder. The study group consisting of parents whose children were admitted to Bursa Uludag University Department of Child and Adolescent Psychiatry and diagnosed with depression and anxiety (Study Group; n = 45 couples) was compared to parents of children without a psychiatric disorder who were admitted to Uludag University Department of Pediatrics (Control Group; n = 45 couples). Experiences in Close Relationships Inventory, Marital Adjustment Measure, Relationships Attribution Measure, Problem Solving Inventory, Beck Depression Inventory and State-Trait Anxiety Inventory as well as a semi-structured interview designed for this study were applied to all participants after written consent had been obtained. The institutional ethics committee had approved the study. Data have been evaluated using SPSS version 13.0. Results of the study are as follows: A – Comparison of Study Group versus Control Group: - More couples in the Control Group dated before marriage than couples in the Study Group (p<0.05). - Parents in the Control Group feel emotionally closer to their spouses than parents in the Study Group (p<0.05). - Parents in the Control Group consider their marriage more satisfying than the Study Group (p<0.05). - Parents in the Control Group find their spouse more similar to their concept of an ideal partner than parents in the Study Group (p<0.05). - The belief that their spouse finds them attractive, is stronger in the Control Group than in the Study Group (p<0.05). - More mothers in the Control Group show a secure attachment style (p<0.05) while more mothers in the Study Group show a fearful attachment style (p<0.05). - Depression, state anxiety and trait anxiety are higher in parents of children with depression and anxiety (Study Group) than in the Control Group (p<0.05). B – Correlation of attachment styles in all 90 couples (Study Group + Control Group): - Marital adjustment is higher in parents with secure attachment style than in parents with either preoccupied, fearful or dismissing attachment style (p<0.05). - Attribution of negative aspects of the relationship to the spouse is higher in parents with fearful or preoccupied attachment styles than in parents with secure or dismissing attachment styles (p<0.05). - Parents with fearful attachment style are less effective in problem solving than parents with either secure, preoccupied or dismissing attachment style (p<0.05). - Depression is less in parents with secure attachment style than in parents with either preoccupied, fearful or dismissing attachment style (p<0.05). - State and trait anxiety are lower in parents with secure attachment style than in parents with either preoccupied, fearful or dismissing attachment style (p<0.05). - With regard to gender, women are more depressed and more anxious and attribute negative aspects of the relation more to their spouse than men (p<0.05). On the other hand, women are better in problem solving than men (p<0.05). It is surprising, that marital adjustment did not differ significantly between the two groups, despite the fact that parents in the Control Group had a more positive perception of their spouse. This may have resulted from the interviewees knowingly or unknowingly misinterpreting their marital relationship or from inadequacy of the applied test tools to determine marital adjustment. On the other hand, it could be discussed whether positive attributions to the spouse as seen in the Control Group form a protective factor against depression and anxiety disorder in the children of these individuals. The correlation of attachment styles with marital adjustment, depression, anxiety and problem solving skills have been found parallel to previous publications. In conclusion, to provide an environment adequate for the healthy development of children, there is a need for a better understanding of the parent-child relationship and the relationship of the parents among themselves; to determine risk factors of an unfavorable parent-child relationship; which should lead to preventive efforts in the field.
Description
Keywords
Klinik psikoloji, Çocuk psikiyatrisi, Çocuk, Ergen, Aile, Bağlanma, Bağlanma stilleri, Evlilik, Evlilik uyumu, Depresyon, Anksiyete, İlişki yükleme biçimi, Clinical psychology, Child psychiatry, Child, Adolescent, Parent, Attachment, Attachment style, Marriage, Marital adjustment, Depression, Anxiety, Problem solving, Relationship attribution style, Problem çözme
Citation
Yıldız, S. (2005). Depresyon ve anksiyete tanısı almış çocuklar ile kontrol grubunun anne-babalarının bağlanma stillerine göre evlilik uyumlarının incelenmesi. Yayınlanmamış yüksek lisans tezi. Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.