Učestalost raznih oblika autodestruktivnog i heterodestruktivnog ponašanja kod adolescenata i njihova karakteristična obilježja [Frequency of various forms of autodestructive and heterodestrucitve behaviors in adolescents and their characteristic feature]

Dodig-Ćurković, Katarina (2010) Učestalost raznih oblika autodestruktivnog i heterodestruktivnog ponašanja kod adolescenata i njihova karakteristična obilježja [Frequency of various forms of autodestructive and heterodestrucitve behaviors in adolescents and their characteristic feature]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

INTRODUCTION The goal of this study was to investigate the frequency of auto-destructive and heterodestructive behavior in adolescents, and to investigate wether there were differences according to sex and age, as well as explore a number of factors influence the incidence of such behavior, family relationships, socio-economic relations, hereditary factors, traumatic experiences, personality traits of adolescents, consumption of alcohol and psychoactive substances, smoking and comorbid psychiatric disorders. SUBJECTS AND METHODS The study included109 subjects, of which there were 46 male patients middle stage of adolescence (15,39) and 63 female patients, also middle stage of adolescence (15,87) and who were treated during 2009 and 2010 in a Clinical department of child and adolescent psychiatry, Clinical Hospital Center Osijek. The subjects were aged of 11 to 18 years. Diagnosis were established according to DSM-IV classification of diseases. In the study was included one of the parents of subjects. The study was designed as a prospective study. Subjects fulfilled a series of self-assessment scales for assessment of their own aggressiveness, depression, anxiety, assessment of relations with family, relationship with father and to assess internalized and externalized problems. Parents of the patients were fulfilled self-assessment scale for the assessment of relationships within family and unstructured questionnaire to insights into the structure and socio-economic status of family. All self-assessment scales are designed to round up one of our claims. RESULTS Self-destructive forms of behavior were manifested in 46 male patients middle stage of adolescence and 63 female patients, also middle stage of adolescence. It is evident that adolescents of both sexes tend to different types of aggression, manifest a higher incidence of mild anxiety, a grater prevalence of moderate to severe depression and tendency to 117 suicide and suicidal behavior. Male adolescents showed a higher degree of open aggression and impulsivity, female adolescents are more likely to express verbal aggression, impulsive behavior, self-harm by sharp objects and consumption of drugs without the supervision of parents. Both groups tend to consume alcohol and psychoactive substances and smoking. Male adolescents have more frequent suicidal thoughts and female adolescents attempt suicide more often. Mental illness of the father has greater influence on the occurrence of auto-destructive behavior in male adolescents, while mental illness of the mother has influence on both sexes. Disturbed family relationships, history of traumatic experiences, consumption of alcohol and psychoactive substances, abuse by peers, physical violence in the family, a bad socio-economic status of the family and disrupted communication with parents, were identified as a risk factors for these behaviors. Particularly sensitive period according to the results of investigation is middle stage of adolescence, when adolescents are under greater influence of peers and environment. CONCLUSION The results of conducted investigation are realistic indicators of the incidence of autodestructivity and heterodestructivity among adolescents, as well as potential risk factors for their expression. The results of investigation should provide a higher level of competence of parents in identifying and planning strategies of dealing coping with this behavior, to emphasize the need to improve the relationship between parents and adolescents, as well as experts of various profiles that are responsible for the prevention and treatment of these disorders.

Abstract in Croatian

UVOD Cilj istraživanja je bio istražiti učestalost autodestruktivnog i heterodestruktivnog ponašanja kod adolescenata, i istražiti je li postoje razlike s obzirom na spol i dob, kao i istražiti utjecaj niza čimbenika na pojavnost ovakvog ponašanja: odnosi unutar obitelji, socioekonomski odnosi, nasljedni čimbenici, traumatska iskustva, osobine ličnosti adolescenata, konzumiranje alkohola, psihoaktivnih tvari, pušenje, komorbidni psihijatrijski poremećaji. ISPITANICI I METODE u istraživanju je sudjelovalo 109 ispitanika, od čega je 46 ispitanika muškog spola srednje faze adolescencije (15,39) i 63 ispitanice ženskog spola također srednje faze adolescencije (15,87) a koji su liječeni tijekom 2009. i 2010. godine ka Kliničkom odjelu za dječju i adolescentnu psihijatriju, KBC Osijek. Ispitanici su bili u dobi od 11 do 18 godina. Dijagnoze smo postavili prema DSM-IV klasifikaciji bolesti. U istraživanje je bio uključen i jedan od roditelja ispitanika. Istraživanje je bilo koncipirano kao prospektivna studija. Ispitanici su popunjavali niz samoocjenskih ljestvica za procjenu vlastite agresivnosti, depresivnosti, anksioznosti, za procjenu odnosa sa obitelji, odnosa sa ocem i za procjenu internaliziranih i eksternaliziranih poteškoća. Roditelji ispitanika su ispunjavali samoocjensku ljestvicu za procjenu odnosa unutar obitelji i nestrukturirani sociodemografski upitnik s ciljem uvida u strukturu i socioekonomski status obitelji. Sve samoocjenske ljestvice su koncipirane da se zaokruži jedna od ponuđenih tvrdnji. REZULTATI Autodestruktivne oblike ponašanja je ispoljavalo 46 ispitanika muškog spola srednje faze adolescencije i 63 ispitanice ženskog spola također srednje faze adolescencije. Evidentno je da adolescenti oba spola su skloni različitim oblicima agresije, pokazuju veću pojavnost blage anksioznosti, veću pojavnost umjerene do teške depresije i sklonost suicidalnom 115 ponašanju i suicidu. Muški adolescenti češće pokazuju viši stupanj otvorene agresije i impulzivnosti, adolescentice su sklonije izražavanju verbalne agresije, impulzivnom ponašanju, samoozljeđivanju oštrim predmetima i konzumiranju lijekova bez nadzora odnosno dozvole odraslih osoba. Obje skupine su sklone konzumiranju alkohola, psihoaktivnih tvari i pušenju. Muški adolescenti imaju češća suicidalna razmišljanja, a adolescentice češće pokušavaju suicid. Psihička bolest oca ima veći utjecaj na pojavnost autodestruktivnih ponašanja kod muških adolescenata, dok psihička bolest majke ima utjecaj i na muški i na ženski spol. Narušeni obiteljski odnosi, povijest traumatskih iskustava, konzumiranje alkohola i psihoaktivnih tvari, zlostavljanje od strane vršnjaka, fizičko nasilje unutar obitelji, loš socioekonomski status obitelji i narušena komunikacija sa roditeljima su prepoznati kao rizični čimbenici za ovakve oblike ponašanja. Posebno osjetljivo razdoblje prema rezultatima istraživanja je srednja faza adolescencije kada su adolescenti pod većim utjecajem vršnjaka i okoline. ZAKLJUČAK Rezultati provedenog istraživanja su realni pokazatelji pojavnosti autodestruktivnosti i heterodestruktivnosti među adolescentima, kao i potencijalnih rizičnih čimbenika za njihovo ispoljavanje. Rezultati istraživanja bi trebali pružiti veći osjećaj kompetentnosti roditeljima u prepoznavanju i planiranju strategija suočavanja sa ovakvim ponašanjem, ukazati potrebu da se poboljša odnos između roditelja i adolescenata, ali i stručnjacima svih profila koji su odgovorni za sprječavanje i liječenje ovakvih poremećaja.

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