Title ALEKSITIMIJA I ANKSIOZNA OSJETLJIVOST U PANIČNOM POREMEĆAJU
Title (english) Alexithymia and anxiety sensitivity in panic disorder
Author Daniela Šago
Mentor Igor Filipčić (mentor)
Committee member Ivan Požgain (predsjednik povjerenstva)
Granter Josip Juraj Strossmayer University of Osijek Faculty of Medicine Osijek Osijek
Defense date and country 2022-11-04, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Psychiatry
Universal decimal classification (UDC ) 61 - Medical sciences
Abstract Cilj istraživanja: Cilj ovog istraživanja bio je ispitati hipotezu da bolesnici s anksioznom osjetljivošću i izraženom aleksitimijom imaju teži panični poremećaj od bolesnika s anksioznom osjetljivošću bez izražene aleksitimije, neovisno o njihovim sociodemografskim karakteristikama. Nacrt studije: Provedena je presječna studija na susljednom uzorku ambulantnih bolesnika. Bolesnici i metode: U istraživanju je sudjelovalo ukupno 92 ispitanika oba spola u dobi od 18 do 50 godina. Dijagnoza je postavljena psihijatrijskim kliničkim intervjuom prema dijagnostičkim kriterijima MKB-10, i dodatno provjerena primjenom Skale težine paničnog poremećaja (engl. The Panic Disorder Severity Scale – PDSS) za utvrđivanje prisustva i intenziteta simptoma paničnog poremećaja u kliničkoj slici. Korištene su samoocjenske skale; anksiozna osjetljivost mjerena je Indeksom anksiozne osjetljivosti (engl. Anxiety Sensitivity Indeks – ASI), a aleksitimija s TAS-20 (engl. The twenty-item Toronto Alexithymia Scale). Rezultati: Na ovom uzorku prevalencija aleksitimije kod osoba s paničnim poremećajem iznosila je 27,2 %. Rezultati su pokazali zajedničku povezanost anksiozne osjetljivosti i aleksitimije s težinom paničnog poremećaja, kao i međusobnu snažnu povezanost aleksitimije i anksiozne osjetljivosti. Potvrđen je prediktivni doprinos anksiozne osjetljivosti težini paničnog poremećaja koji nije uočen za aleksitimiju čime se hipoteza istraživanja odbacuje. Dodatno je potvrđen medijacijski učinak anksiozne osjetljivosti u objašnjavanju intenziteta paničnog poremećaja na temelju aleksitimije. Stoga se može reći da aleksitimija, indirektno, preko anksiozne osjetljivosti utječe na težinu simptoma paničnog poremećaja. Raspravljan je teorijski koncept anksiozne osjetljivosti i detaljno je razrađen psihoanalitički koncept aleksitimije, kao i njihov mogući utjecaj na nastanak i održavanje simptoma paničnog poremećaja. Aleksitimija se bazira na deficitu nesvjesnih implicitnih osjećaja, stoga se teško obuhvaća eksplicitnim instrumentima kao što je TAS-20. To je potencijalno ograničenje ovog rada kao i nešto slabija psihometrijska karakteristika TAS-20, vodećeg mjernog instrumenta za aleksitimiju, što dijelom objašnjava dobivene rezultate. Zaključak: Panični poremećaj je neadaptivni alarmni sustav u kojem somatski simptomi, moguće zbog deficita psihološke prorade anksioznosti kao posljedice aleksitimije i anksiozne osjetljivosti, nisu afektivno elaborirani. Aleksitimija i anksiozna osjetljivost su međusobno snažno povezane i zajedno utječu na jačinu paničnog poremećaja. Uočen je neovisni doprinos anksiozne osjetljivosti, kao i mogući indirektni utjecaj aleksitimije, preko anksiozne osjetljivosti, na izraženost simptoma paničnog poremećaja. Aleksitimija i anksiozna osjetljivost su značajni teorijski i klinički koncepti koji utječu na afektivnu interpretaciju somatskih simptoma i stoga zaslužuju ozbiljnu pozornost u istraživanju paničnog poremećaja.
Abstract (english) Objectives: The aim of this study was to investigate the hypothesis that patients with anxiety sensitivity and pronounced alexithymia have a more severe panic disorder than patients with anxiety sensitivity without pronounced alexithymia, regardless of their sociodemographic characteristics. Study Design: A cross-sectional study was conducted on a consecutive sample of outpatients. Patients and Methods: A total of 92 subjects of both genders aged 18 to 50 years were included in the study. The diagnosis was made by psychiatric interview according to the diagnostic criteria of ICD-10, and further verified using the Panic Disorder Severity Scale (PDSS) to determine the presence and intensity of panic disorder symptoms. Self-assessment scales were used; anxiety sensitivity was measured by the Anxiety Sensitivity Index (ASI), and alexithymia with TAS-20 (The twenty-item Toronto Alexithymia Scale). Results: In this sample, the prevalence of alexithymia in people with panic disorder was 27.2 %. The results showed correlation of anxiety sensitivity and alexithymia with the severity of panic disorder, as well as the strong interconnectedness of alexithymia and anxiety sensitivity. The study confirmed predictive contribution of anxiety sensitivity to the severity of panic disorder, which was not noticed for alexithymia, thus rejecting the research hypothesis. Mediatory effect of anxiety sensitivity in explaining panic disorder intensity based on alexithymia was also confirmed. It can therefore be said that alexithymia, indirectly, through anxiety sensitivity, affects the severity of panic disorder symptoms. Theoretical concept of anxiety sensitivity was discussed and psychoanalytical concept of alexithymia was elaborated in detail, as well as their possible influence on the formation and duration of panic disorder symptoms. Alexithymia is based on the deficit of unconscious implicit emotions. That is why it is difficult to elucidate it with explicit instruments such as the TAS-20. That is a potential limitation of this work, along with somewhat weaker psychometric characteristics of the TAS-20, leading measuring instrument for alexithymia, which partially explains the obtained results. Conclusion: Panic disorder is a maladaptive alarm system in which somatic symptoms are not emotionally elaborated, possibly due to the deficit of psychological working through anxiety as a result of alexithymia and anxiety sensitivity. Alexithymia and anxiety sensitivity are strongly interconnected and together affect the severity of panic disorder. An independent contribution of anxiety sensitivity was noticed, as well as indirect influence of alexithymia, through anxiety sensitivity, to severity of panic disorder symptoms. Alexithymia and anxiety sensitivity are important theoretical and clinical concepts which affect emotional interpretation of somatic symptoms and earnest serious attention in panic disorder research.
Keywords
aleksitimija
anksiozna osjetljivost
panični poremećaj
Keywords (english)
alexithymia
anxiety sensitivity
panic disorder
Language croatian
URN:NBN urn:nbn:hr:152:270313
Promotion 2023
Study programme Title: University Postgraduate Study Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2023-05-23 12:41:23