Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü

Mutlu, Elif Aktan; Unal, Suheyla; Topaktaş Yıldırım, Özgü

Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü

Süheyla Ünal, (İnönü Üniversitesi, Tıp Fakültesi, Ruh Sağlığı ve Hastalıkları Anabilim Dalı, Malatya, Türkiye)

Elif Aktan Mutlu, (Bursa Şehir Hastanesi Ruh Sağlığı ve Hastalıkları Kliniği, Bursa, Türkiye)

Özgü Topaktaş Yıldırım (Tokat Dr. Cevdet Aykan Ruh Sağlığı ve Hastalıkları Hastanesi, Tokat, Türkiye)

Bağımlılık Dergisi

17 6

Yıl: 2021 Cilt: 22 Sayı: 1 Sayfa Aralığı: 31 - 42 Metin Dili: Türkçe İndeks Tarihi: 24-05-2021

Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü

Öz:

Amaç: Çalışmamızda, olası risk faktörlerinin birikimli etkisinin madde bağımlılığı gelişmesinde tek tek risk faktörlerininvarlığından daha etkili olduğu hipotezi test edilmiştir.Yöntem: Çalışmaya 200 madde bağımlısı, 200 sağlıklı kontrol dahil edilmiştir. Deneklere SCID-I klinik görüşme,sosyodemografik veri formu, Rosenberg Benlik Saygısı Ölçeği, Ebeveynlik Stilleri Ölçeği uygulandı. Aile ve çocukluk yaşamıile ilgili riskleri belirlemek için bir anket formu verildi. Risk faktörü olarak 14 değişken belirlendi. Örneklem yüksek vedüşük risk grubu olarak ikiye ayrıldı.Bulgular: 14 yaşından sonra ebeveyn kaybı ve ebeveynden ayrılık yaşama, aile ilişkilerini “kötü” olarak tanımlama, ailedemadde bağımlılığı varlığı, düşük benlik saygısı, babanın ilgi / kabul eksikliği madde bağımlılarında sağlıklı kontrollere göredaha yaygındı. Sağlıklı kontrollerde 13 yaşından önce ebeveynden ayrılma ve sürekli aile kavgası madde bağımlılarına göredaha yüksek oranda bildirilmişti. Bağımlılığın gelişiminde anne kontrol boyutu, baba kabul boyutu ve benlik saygısınınetkisi yüksek olarak belirlendi.Tartışma: Risk faktörleri tek tek ele alındığında madde bağımlılığı grubu dezavantajlı durumdayken, birikimli risk faktörleribağlamında her iki grupta risk oranı eşitlenmektedir. Bu durum ‘’direngenlik’’ kavramını akla getirmektedir. Sağlıklıkontrollerin madde bağımlılığı geliştirmemeleri, çocukluktan itibaren karşılaştıkları olumsuz yaşam koşullarına karşı uygunbaş etme becerilerini geliştirmiş olabilecekleri şeklinde yorumlanmıştır. Madde bağımlılığının önlenmesinde riskfaktörlerinin azaltılmasının yanı sıra, direngenliği artıracak uygulamalara odaklanmak uygun bir yaklaşım olacaktır.

Anahtar Kelime:

Role of Cumulative Risk Factors in the Development of Substance Abuse

Öz:

Objective: In this study, the hypothesis that the cumulative effect of possible risk factors is more effective in the development of substance addiction was tested. Method: 200 substance addicts and 200 healthy controls were included in the study. SCID-I clinical interview, sociodemographic data form, Rosenberg self-esteem scale, Parenting Styles Scale were applied to the subjects. A questionnaire was given to identify risks related to family and childhood life. 14 variables were considered as risk factors. The sample was divided into high and low risk groups. Results: After the age of 14, parental loss and separation, definition of family relationships as "bad", presence of substance addiction in family members, low self-esteem, and father's lack of interest / acceptance were more common in substance addicts than in healthy controls. Separation from parents before the age of 13 and continuous family quarrels were reported with a higher rate in healthy controls. The effects of mother control dimension, father acceptance dimension and self-esteem were found to be high in the development of addiction. The effects of mother control dimension, father acceptance dimension and self-esteem were found to be high in the development of addiction. Discusion: When the risk factors are considered individually, the substance addiction group is disadvantaged, while the risk ratio is equalized in both groups in terms of cumulative risk factors. This situation brings to mind the concept of "resilience". The fact that healthy controls did not develop addiction was interpreted as that they might have developed appropriate coping skills against the negative living conditions they encountered from childhood. In addition to reducing risk factors in the prevention of substance addiction, it would be an appropriate approach to focus on practices that will increase resilience. .

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Lynskey MT, Spooner C, Hall W. Structural Determinants of Youth Drug Use. New South Wales: Australian National Council on Drugs, 2001.
2. Raviv T, Taussig HN, Culhane SE, Garrido EF. Cumulative risk exposure and mental health symptoms among maltreated youth placed in out-of-home care. Child Abuse Negl 2010; 34: 742–751.
3. Appleyard K, Egeland B, Dulmen MHM, Alan Sroufe L. When more is not better: the role of cumulative risk in child behavior outcomes. J Child Psychol Psychiatry 2005; 46: 235–245.
4. Deater-Deckard K, Dodge KA, Bates JE, Pettit GS. Multiple risk factors in the development of externalizing behavior problems: group and individual differences. Dev Psychopathol 1998;10: 469–493.
5. Rauer AJ, Karney BR, Garvan CW, Hou W. Relationship risks in context: a cumulative risk approach to understanding relationship satisfaction. J Marriage Fam 2008;70: 1122–1135.
6. Burt KB, Van Dulmen MHM, Carlivati J, et al. Mediating links between maternal depression and offspring psychopathology: the importance of independent data. J Child Psychol Psychiatry 2005; 46: 490-499.
7. Evans GW, Li D, Whipple SS. Cumulative risk and child development. Psychol Bull 2013; 139: 1342–1396.
8. Wanner NM, Colwell ML, Faulk C. The epigenetic legacy of illicit drugs: developmental exposures and late-life phenotypes. Environ Epigenet 2019; 5: dvz022.
9. Kreek MJ, Nielsen DA, Butelman ER, LaForge KS. Genetic influences on impulsivity, risk taking, stress responsivity and vulnerability to drug abuse and addiction. Nat Neurosci 2005; 8: 1450–1457.
10. Nielsen DA, Kreek MJ. Common and specific liability to addiction: Approaches to association studies of opioid addiction. Drug Alcohol Depend 2012; 123 (Suppl 1): S33–S41.
11. Goldman D, Oroszi G, Ducci F. The genetics of addictions: uncovering the genes. Nat Rev Genet 2005; 6: 521– 532.
12. Li MD, Burmeister M. New insights into the genetics of addiction. Nat Rev Genet 2009; 10: 225–231.
13. Pedersen CA. Biological aspects of social bonding and the roots of human violence. Ann N Y Acad Sci 2004; 1036: 106-127.
14. McLaughlin KA, Sheridan MA, Gold AL, et al. Maltreatment exposure, brain structure, and fear conditioning in children and adolescents. Neuropsychopharmacology 2016; 41: 1956–1964.
15. McLaughlin KA, Sheridan MA. Beyond cumulative risk: A dimensional approach to childhood adversity. Curr Dir Psychol Sci 2016; 25: 239–245.
16. Charalampous KD, Ford BK, Skinner TJ. Self-esteem in alcoholics and nonalcoholics. J Stud Alcohol 1976; 37: 990–994.
17. Uba I, Yaacob SN, Talib MA, et al. Effect of self-esteem in the relationship between stress and substance abuse among adolescents: A mediation outcome. Int J Soc Sci Humanit 2013; 3: 214–217.
18. Pinquart M, Gerke DC. Associations of parenting styles with self-esteem in children and adolescents: a metaanalysis. J Child Fam Stud 2019; 28: 2017–2035.
19. Aremu TA, John-Akinola YO, Desmennu AT. Relationship between parenting styles and adolescents' selfesteem. Int Q Community Health Educ 2019; 39: 91-99.
20. Bircan S, Erden G, Vatansever M. Self-esteem, perceived parental acceptance-rejection and parenting styles of adolescents with substance use disorder: A comparative study. Nesne Psikoloji Dergisi 2019; 7(14): 52–67.
21. Becoña E, Martínez Ú, Calafat A, et al. Parental styles and drug use: A review. Drugs (Abingdon Engl) 2012; 19: 1–10.
22. Calafat A, García F, Juan M, et al. Which parenting style is more protective against adolescent substance use? Evidence within the European context. Drug Alcohol Depend 2014; 138: 185–192.
23. Luthar SS. Methodological and conceptual issues in research on childhood resilience. J Child Psychol Psychiatry 1993; 34: 441–453.
24. Beam MR, Gil-Rivas V, Greenberger E, Chen C. Adolescent problem behavior and depressed mood: risk and protection within and across social contexts. J Youth Adolesc 2002; 31: 343–357.
25. Gerard JM, Buehler C. Cumulative environmental risk and youth maladjustment: the role of youth attributes. Child Dev 2004; 75: 1832–1849.
26. Rose EJ, Picci G, Fishbein DH. Neurocognitive precursors of substance misuse corresponding to risk, resistance, and resilience pathways: implications for prevention science. Front Psychiatry 2019; 10: 399.
27. First MB, Spitzer RL, Gibbon M. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Clinical Version. Washington D.C.: American Psychiatric Press, 1992.
28. Çorapçıoğlu A, Aydemir Ö, Yildiz M, Esen-Danaci A, Köroğlu E. DSM-IV Eksen I Bozuklukları (SCID-I) İçin Yapılandırılmış Klinik Görüşme, Klinik Versiyon. Ankara: Hekimler Yayın Birliği, 1999.
29. Rosenberg M. Society and the Adolescent Self-Image. Princeton: Princeton University Press, 1965.
30. Çuhadaroğlu F. Adölesanlarda benlik saygısı. Uzmanlık Tezi, Hacettepe Üniversitesi Tıp Fakültesi, Ankara. 1986.
31. Maccoby EE, Martin JA. Socialization in the context of the family: Parent–child interaction. In: P. H. Mussen & E. M. Hetherington, editor. Handbook of Child Psychology: Socialization, Personality and Social Development. New York: Wiley; 1983.
32. Lamborn SD, Mounts NS, Steinberg L, Dornbusch SM. Patterns of competence and adjustment among adolescents from authoritative, authoritarian, indulgent, and neglectful families. Child Dev 1991; 62: 1049- 1065..
33. Sümer N, Güngör D. Çocuk yetiştirme stillerinin bağlanma stilleri, benlik değerlendirmeleri ve yakın ilişkiler üzerindeki etkisi. Türk Psikoloji Dergisi 1999; 14: 35–63.
34. Merline AC, O’Malley PM, Schulenberg JE, et al. Substance use among adults 35 years of age: prevalence, adulthood predictors, and impact of adolescent substance use. Am J Public Health 2004; 94: 96–102.
35. Barrett AE, Jay Turner R. Family structure and substance use problems in adolescence and early adulthood: examining explanations for the relationship. Addiction 2006; 101: 109–120.
36. Waaktaar T, Kan KJ, Torgersen S. The genetic and environmental architecture of substance use development from early adolescence into young adulthood: a longitudinal twin study of comorbidity of alcohol, tobacco and illicit drug use. Addiction 2018; 113: 740–748.
37. Spooner C, Hall W, Lynskey M. Structural Determinants of Youth Drug Use. Woden, Australia: Australian National Council on Drugs; 2001.
38. Patrick ME, Wightman P, Schoeni RF, Schulenberg JE. Socioeconomic status and substance use among young adults: a comparison across constructs and drugs. J Stud Alcohol Drugs 2012; 73: 772–782.
39. Shah V, Watson J. Relationship between substance use and socioeconomic variables in Pennsylvania adolescents: 2009–2017. Subst Use Misuse 2020; 55: 1856–1866.
40. Luster T, Dubow E. Predictors of the quality of the home environment that adolescent mothers provide for their school-aged children. J Youth Adolesc 1990;19: 475–494.
41. Demo DH. Review of growing up with a single parent: what hurts, what helps by Sara McLanahan and Gary Sandefur. Fam Relat 1996; 45: 244.
42. Giordano GN, Ohlsson H, Kendler KS, et al. Unexpected adverse childhood experiences and subsequent drug use disorder: a Swedish population study (1995-2011). Addiction 2014; 109: 1119–1127.
43. Emler N. The costs and causes of low self-esteem. Youth Studies Australia 2002; 21(3): 45-48.
44. Schroeder DS, Laflin MT, Weis DL. Is there a relationship between self esteem and drug use? Methodological and statistical limitations of the research. J Drug Issues 1993; 23: 645–665.
45. Fuentes MC, Garcia OF, Garcia F. Protective and risk factors for adolescent substance use in Spain: Selfesteem and other indicators of personal well-being and ill-being. Sustainability 2020; 12: 5962.
46. Bitancourt T, Tissot MCRG, Fidalgo TM, et al. Factors associated with illicit drugs’ lifetime and frequent/heavy use among students results from a population survey. Psychiatry Res 2016; 237: 290–295.
47. Lee CG, Seo DC, Torabi MR, et al. Longitudinal trajectory of the relationship between self-esteem and substance use from adolescence to young adulthood. J Sch Health 2018; 88: 9–14.
48. Miller NB, Cowan PA, Cowan CP, Mavis Hetherington E. Externalizing in preschoolers and early adolescents: A cross-study replication of a family model. Dev Psychol 1993; 3–18.
49. Shek DTL. Paternal and maternal influences on the psychological well-being, substance abuse, and delinquency of Chinese adolescents experiencing economic disadvantage. J Clin Psychol 2005; 61: 219–234.
50. Schwartz SJ, Zamboanga BL, Ravert RD, et al. Perceived parental relationships and health-risk behaviors in college-attending emerging adults. J Marriage Fam 2009; 71: 727–740.
51. Weymouth BB, Fosco GM, Feinberg ME. Nurturant-involved parenting and adolescent substance use: Examining an internalizing pathway through adolescent social anxiety symptoms and substance refusal efficacy. Dev Psychopathol 2019; 31: 247–260.
52. Shakya HB, Christakis NA, Fowler JH. Parental influence on substance use in adolescent social networks. Arch Pediatr Adolesc Med 2012; 166: 1132–1139.
53. Walters GD. Prosocial Peers as Risk, Protective, and promotive factors for the prevention of delinquency and drug use. J Youth Adolesc 2020; 49: 618–630.
54. Dingle GA, Cruwys T, Frings D. Social identities as pathways into and out of addiction. Front Psychol. 2015; 6: 1795.
55. Soy İT, Kocataş S. Madde bağımlılığı tanısı almış bireylerde benlik saygısı ve sosyal dışlanma algıları arasındaki ilişki. Ege Üniversitesi Hemşirelik Fakültesi Dergisi 2020; 36: 73–86.
56. Young SE, Rhee SH, Stallings MC, et al. Genetic and environmental vulnerabilities underlying adolescent substance use and problem use: general or specific? Behav Genet 2006; 36: 603-615.
57. Milne BJ, Caspi A, Harrington H, et al. Predictive value of family history on severity of illness: the case for depression, anxiety, alcohol dependence, and drug dependence. Arch Gen Psychiatry 2009; 66: 738–747.
58. Enoch MA. The influence of gene-environment interactions on the development of alcoholism and drug dependence. Curr Psychiatry Rep 2012; 14: 150-158.
59. Kosty DB, Farmer RF, Seeley JR, et al. The number of biological parents with alcohol use disorder histories and risk to offspring through age 30. Addict Behav 2020; 102: 106196.
60. Goldberg LR, Gould TJ. Multigenerational and transgenerational effects of paternal exposure to drugs of abuse on behavioral and neural function. Eur J Neurosci 2019; 50: 2453–2466.
61. Masten AS. Ordinary magic: resilience processes in development. Am Psychol 2001; 56: 227–238.
62. Rutter M. Psychosocial resilience and protective mechanisms. Am J Orthopsychiatry 1987; 57: 316–331.
63. Braverman M. Applying Resilience Theory to the Prevention of Adolescent Substance Abuse. Davis, CA, The University of California , Davis, 2001.
64. DuMont KA, Widom CS, Czaja SJ. Predictors of resilience in abused and neglected children grown-up: the role of individual and neighborhood characteristics. Child Abuse Negl 2007; 31: 255–274.
65. Bonanno GA, Galea S, Bucciarelli A, Vlahov D. What predicts psychological resilience after disaster? The role of demographics, resources, and life stress. J Consult Clin Psychol 2007; 75: 671–682.
66. Wright MO, Fopma-Loy J, Fischer S. Multidimensional assessment of resilience in mothers who are child sexual abuse survivors. Child Abuse Negl 2005; 29: 1173–1193.
67. Wills TA, Filer M. Stress-Coping Model of Adolescent Substance Use. In: Ollendick TH, Prinz RJ. (editors) Advances in Clinical Child Psychology. Boston, MA: Springer, 1996.
68. Modabbernia, A, Janiri D, Doucet GE, et al. Multivariate patterns of brain-behavior-environment associations in the adolescent brain and cognitive development (ABCD) Study. Biol Psychiatry 2020; 10.1016/j.biopsych.2020.08.014.

APA	Unal S, Mutlu E, Topaktaş Yıldırım Ö (2021). Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. , 31 - 42.
Chicago	Unal Suheyla,Mutlu Elif Aktan,Topaktaş Yıldırım Özgü Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. (2021): 31 - 42.
MLA	Unal Suheyla,Mutlu Elif Aktan,Topaktaş Yıldırım Özgü Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. , 2021, ss.31 - 42.
AMA	Unal S,Mutlu E,Topaktaş Yıldırım Ö Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. . 2021; 31 - 42.
Vancouver	Unal S,Mutlu E,Topaktaş Yıldırım Ö Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. . 2021; 31 - 42.
IEEE	Unal S,Mutlu E,Topaktaş Yıldırım Ö "Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü." , ss.31 - 42, 2021.
ISNAD	Unal, Suheyla vd. "Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü". (2021), 31-42.

APA	Unal S, Mutlu E, Topaktaş Yıldırım Ö (2021). Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. Bağımlılık Dergisi, 22(1), 31 - 42.
Chicago	Unal Suheyla,Mutlu Elif Aktan,Topaktaş Yıldırım Özgü Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. Bağımlılık Dergisi 22, no.1 (2021): 31 - 42.
MLA	Unal Suheyla,Mutlu Elif Aktan,Topaktaş Yıldırım Özgü Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. Bağımlılık Dergisi, vol.22, no.1, 2021, ss.31 - 42.
AMA	Unal S,Mutlu E,Topaktaş Yıldırım Ö Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. Bağımlılık Dergisi. 2021; 22(1): 31 - 42.
Vancouver	Unal S,Mutlu E,Topaktaş Yıldırım Ö Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü. Bağımlılık Dergisi. 2021; 22(1): 31 - 42.
IEEE	Unal S,Mutlu E,Topaktaş Yıldırım Ö "Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü." Bağımlılık Dergisi, 22, ss.31 - 42, 2021.
ISNAD	Unal, Suheyla vd. "Madde Bağımlılığının Gelişiminde Birikimli Risk Faktörlerinin Rolü". Bağımlılık Dergisi 22/1 (2021), 31-42.