Evren Cuneyt, Cicekci Elvan, Umut Gokhan, Evren Bilge, Durmus Cicek Kubra
Research, Treatment and Training Center for Alcohol and Drug Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey.
Department of Psychiatry, Kahta State Hospital, Adiyaman, Turkey.
Iran J Psychiatry. 2021 Jul;16(3):281-289. doi: 10.18502/ijps.v16i3.6253.
The first objective of this research was to examine the association of the symptom severity of social anxiety with the adult attention deficit hyperactivity disorder (ADHD) symptom severity in Turkish patients with alcohol use disorder (AUD). The second objective was to examine if harm avoidance and self-esteem mediated this relationship. This cross-sectional analysis was performed among 151 inpatients with AUD at the Bakirkoy/AMATEM, a treatment center for substance use disorder, in Istanbul. Patients were examined with the Liebowitz Social Anxiety Scale (LSAS), the Adult ADHD Self-Report Scale (ASRS), the Rosenberg Self-Esteem Scale (SES), and the temperament dimension of Harm Avoidance (HA). Using SPSS-20 software, the data was analyzed using Pearson correlations, multivariate analysis of covariance (MANCOVA), and multiple linear regressions. The scales scores were mildly correlated with each other. The low self-esteem and high HA were related with the inattentive (IN) dimension of ADHD, whereas low self-esteem solely predicted hyperactivity/impulsivity (HI) dimension of ADHD in MANCOVA. In the linear regression analysis, the severity of social anxiety, particularly avoidance dimension, was associated with the symptom severity of ADHD. In the second step of the analysis, together with the avoidance dimension of social anxiety, self-esteem was associated with the symptom severity of ADHD. However, in the third step, after including HA as an independent variable in the analysis, the avoidance dimension of social anxiety was no longer associated with the severity of adult ADHD symptoms, whereas self-esteem together with HA (particularly "anticipatory worry and pessimism" [HA-1], and "asthenia and fatigability" [HA-4]) predicted. Findings of the present study shows that although the symptom severity of social anxiety is associated with the severity of ADHD symptoms among inpatients with AUD, among dimensions of social anxiety, the avoidance dimension plays a main role in this relationship. Also, while the self-esteem partially mediates this relationship, HA seems to have a full mediator effect on this relationship.
本研究的首要目标是，在患有酒精使用障碍（AUD）的土耳其患者中，考察社交焦虑症状严重程度与成人注意力缺陷多动障碍（ADHD）症状严重程度之间的关联。第二个目标是检验回避伤害和自尊是否介导了这种关系。这项横断面分析是在伊斯坦布尔一家物质使用障碍治疗中心——巴基尔柯伊/AMATEM的151名AUD住院患者中进行的。使用莱博维茨社交焦虑量表（LSAS）、成人ADHD自陈量表（ASRS）、罗森伯格自尊量表（SES）以及回避伤害气质维度（HA）对患者进行检查。运用SPSS - 20软件，通过Pearson相关性分析、多变量协方差分析（MANCOVA）和多元线性回归对数据进行分析。各量表得分之间存在轻度相关性。低自尊和高HA与ADHD的注意力不集中（IN）维度相关，而在MANCOVA中，仅低自尊可预测ADHD的多动/冲动（HI）维度。在多元线性回归分析中，社交焦虑的严重程度，尤其是回避维度，与ADHD的症状严重程度相关。在分析的第二步中，连同社交焦虑的回避维度一起，自尊与ADHD的症状严重程度相关。然而，在第三步中，在分析中纳入HA作为自变量后，社交焦虑的回避维度不再与成人ADHD症状的严重程度相关，而自尊与HA（特别是“预期性担忧和悲观”[HA - 1]以及“虚弱和易疲劳”[HA - 4]）共同具有预测作用。本研究结果表明，尽管社交焦虑症状严重程度与AUD住院患者的ADHD症状严重程度相关，但在社交焦虑的各维度中，回避维度在这种关系中起主要作用。此外，虽然自尊部分介导了这种关系，但HA似乎对这种关系具有完全中介效应。
