Procena tipoloških razlika (TCI) obolelih od shizofrenije u odnosu na zdravu populaciju

Abstract

SAŽETAK Klonindžerov psihobiološki model temperamenta i karaktera potvrđuje da je razvoj ličnosti pod uticajem bioloških i psiholoških procesa. Ova studija je imala za cilj da poredi dimenzije ličnosti oboljelih od shizofrenije i zdrave kontrolne grupe, potom da ustanovi koja promenljiva najbolje razdvaja zdrave od bolesnih, te može da bude mogući psihološki marker za pojavu bolesti. U istraživanju je učestvovalo 152 ispitanika, pri čemu oboljelih od shizofrenije je bilo 76, dok je kontrolnih 76 ispitanika bila zdrava populacija, koji su izabrani kroz medicinske intervjue, metodom slučajnog izbora, iz uzorka baziranog na populaciji iz šire društvene zajednice koristeći nezavisne t-testove. Primenjen je upitnik temperamenta i karaktera (TCI), koji je poredio dimenzije ličnosti oboljelih od shizofrenije i zdrave kontrolne grupe. Zavisnost kategorijskih promenljivih je ispitivana pomoću Hi-kvadrat testa i Fišerovog testa, a osetljivost promenljivih na pojavu shizofrenije ispitivana je pomoću univarijantne i multivarijantne binarne logističke regresije. Ova metoda je korištena i za pravljenje matematičkog modela. Istraživanje je sprovedeno u Klinici za psihijatriju Univerzitetskog Kliničkog centra Republike Srpske tokom 2015. godine. Rezultati su pokazali da u odnosu na pol, žene u ovom istraživanju imaju viši ST - selftranscendencija, C - kooperativnost i RD – zavisnost od nagrade. U poređenju sa kontrolnom grupom, oboljeli od shizofrenije pokazuju više skorove na dimenziji izbegavanje kazne (HA) i na dimenziji samo-transcendentnost (ST). Oboljeli od shizofrenije u odnosu na kontrolne ispitanike imaju niže skorove na dimenzijama usmerenost na sebe (SD) i na dimenziji saradljivost (C). Multivarijantna binarna logistička regresija pokazuje da na pojavu shizofrenije utiču visok skor na subskalama stidljivost (HA), odgovornost (SD), svrsishodnost (SD), kooperativnost (C), saosećajnost (C) i samozaboravnost (ST) a niži skor na skali potraga za novim (NS) i zavisnost od nagrade (RD). Potvđene su razlike u temperamentu i karakteru između oboljelih od shizofrenije i zdravih kontrolnih subjekata. Glavni rezultat ovog istraživanja su modeli za razlikovanje oboljelih od shizofrenije od onih koji nisu oboljeli od shizofrenije. Putem binarne logističke regresije napravljena je matematička formula i data nova promenljiva Model, koja je odličan marker za razdvajanje zdravih od bolesnih. Napravljena su tri modela. Sva tri modela su odlični psihološkimarkeri. Model 3 bi, zbog svoje jednostavnosti, mogao lako da se koristi u praksi. Ako je vrednost ovog modela manja od 43,50 on zaslužuje ozbiljnu pažnju psihijatra. Model 2 ima vrlo veliku površinu ispod krive (0,910) i odlično razdvaja oboljele od shizofrenije od zdravih. Ako je vrednost ovog modela za nekog ispitanika veća od 39, postoji ozbiljna indicija da on boluje od shizofrenije ili je sklon oboljevanju od nje. Dobijeni modeli bi se mogli primenjivati u primarnoj zdravstvenoj zaštiti, prvenstveno kroz Centre za zaštitu mentalnog zdravlja, kod mlađih osoba sa pozitivnim porodičnim hereditetom, prvenstveno radi procene rizika

ABSTRACT Cloninger’s psychobiological model of temperament and character indicates that biological and psychological processes influence the development of personality. The aim of this study was to compare personality traits between individuals with schizophrenia and controls. It also focused on which variable best separates controls from patients and serves as a potential psychological marker for susceptibility to schizophrenia. Participants, 76 patients and 76 healthy controls, were recruited through medical interviews from a population-based sample using independent t-tests. TCI questionnaire was used to compare personality traits between individuals with schizophrenia and controls. Chi-square and Fisher’s exact test assessed the differences between categorical variables, while the impact of variables on schizophrenia was examined using univariate and multivariate binary logistic regression. The same approach served to make the mathematical model too. The study was carried out at the Psychiatric Clinic to University Clinical Center of the Republic of Srpska in 2015. Along the gender line, women exhibited significantly higher scores on self-transcendence (ST), cooperativeness (C) and harm avoidance (HA). Patients had significantly higher scores than controls on selftranscendence (ST) and harm avoidance (HA). They also exhibited lower scores on selfdirectedness (SD) and cooperativeness (C) respectively. Multivariate binary logistic regression showed that patients with schizophrenia are highly susceptible to shyness (S), responsibility (SD), self-directedness (SD), cooperativeness (C), compassion (C), selftranscendence (ST), and less susceptible to novelty seeking (NS) and reward dependence (RD). Significant difference was found in temperament and character between patients and controls. The study is based on the models for differentiating between individuals with schizophrenia and controls. Binary logistic regression helped make a mathematical formula that generated a new variable Model, which has proven to be a reliable marker for identifying between patients and controls. Three models were made. All three of them are dependable psychological markers. Model 3 is practically applicable due to its simplicity. If the values on the model rank lower than 43,50 then this needs to be handled by a psychiatrist. Model 2 is just below the curve (0,910) and is an excellent pointer for identifying between individuals with schizophrenia and controls. If the scores on the model rank higher than 39 then the person is highly susceptible to schizophrenia. These models may be used in primary health care, primarily at the Center for the protection of mental health of young persons with positive family heredity, particularly in risk assessments.