PERBEDAAN PROPORSI KECENDERUNGAN GANGGUAN KEPRIBADIAN AMBANG PADA SISWA SMA DENGAN PERILAKU SELF-HARM DAN TANPA PERILAKU SELF-HARM DI KOTA YOGYAKARTA

SUSINI RANGKAI SARI, Dr. dr. Ronny Tri Wirasto, Sp.KJ.; dr. Irwan Supriyanto, Ph.D., Sp.KJ

2020 | Tesis-Spesialis | ILMU KEDOKTERAN JIWA

Latar belakang: Gangguan kepribadian ambang (GKA) merupakan gangguan mental berat yang dapat mengakibatkan morbiditas dan angka bunuh diri yang tinggi, namun sulit dikenali akibat tingginya komorbiditas. Individu dengan GKA sering menunjukkan perilaku self-harm. Perilaku self-harm merupakan prediktor untuk percobaan bunuh diri. Populasi tertinggi pelaku self-harm adalah remaja, yaitu sekitar 12% hingga 37,2%. Identifikasi kecenderungan GKA pada remaja dapat menjadi sarana deteksi perilaku self-harm. Penelitian sebelumnya menunjukkan tingginya angka perilaku self-harm di kalangan siswa SMA di Yogyakarta, yaitu sekitar 43%. Oleh karena itu, penting dilakukan penelitian tentang perbedaan proporsi kecenderungan GKA pada remaja dengan perilaku self-harm sehingga dapat dilakukan deteksi dini, intervensi dini, serta menurunkan tingkat bunuh diri akibat perilaku self-harm maupun GKA. Tujuan: Untuk mengidentifikasi perbedaan proporsi kecenderungan GKA pada siswa SMA dengan perilaku self-harm dan tanpa perilaku self-harm di Kota Yogyakarta. Metode: Penelitian cross-sectional dilakukan pada 126 siswa salah satu SMA di Kota Yogyakarta dengan kriteria inklusi siswa kelas X (sepuluh), berusia 14 -18 tahun, dan bersedia untuk berpartisipasi dalam penelitian. Tiga subyek dieksklusi karena mempunyai kecenderungan gangguan mental berat berdasarkan instrumen SRQ-29. Kecenderungan GKA diukur dengan Skala Kepribadian Ambang, sedang perilaku self-harm diukur dengan Self-Harm Inventory (SHI). Analisis dilakukan dengan uji chi-square dan uji regresi logistik multipel. Hasil: Proporsi siswa SMA yang memiliki kecenderungan GKA sebesar 43,9%, perilaku self-harm sebesar 34,1%, dan terdapat perbedaan proporsi yang bermakna kecenderungan GKA pada siswa SMA dengan perilaku self-harm dan tanpa perilaku self-harm di Kota Yogyakarta (X2=16,37; p=<0,001; OR=4,99; CI 95%: 2,23-11,19). Terdapat perbedaan proporsi perilaku self-harm pada subyek yang berjenis kelamin laki-laki dan perempuan yang bermakna secara statistik (X2=9,416; df=1; p=0,002). Kesimpulan: Terdapat perbedaan proporsi yang bermakna kecenderungan GKA pada siswa SMA dengan perilaku self-harm dan tanpa perilaku self-harm di Kota Yogyakarta. Jenis kelamin mempunyai perbedaan proporsi secara bermakna terhadap perilaku self-harm.

Background: Borderline personality disorder (BPD) is a severe mental disorder with high morbidity and mortality rate, but it is difficult to identify due to its high comorbidity. Individuals suffering from this often show self-harm behaviors. The majority of individuals exhibiting self-harm behaviors are teenagers, whose number ranges from 12% to 37.2%. Identifying BPD can be a medium to detect self-harm behaviors. Previous studies showed that 43% of senior high schoolers in Yogyakarta exhibited self-harm behaviors. In light of this finding, it is important to investigate the difference in the proportion of BPD tendency among senior high school students with self-harm behaviors, so that early detection, early interventions can be done and the resulting high rate of suicide rate can be lowered. Objective: This study was aimed at identifying the difference in the proportion of borderline personality disorder tendency among senior high school students with self-harm behaviors and without self-harm behaviors in Yogyakarta City. Methods: A cross-sectional study was conducted on 126 senior high school students in Yogyakarta City, with the inclusion criteria were class X (ten) students, aged 14-18 years, and willing to participate in research. Three of them were excluded due to the tendency of severe mental health problems according to SRQ-29 examination. Their BPD tendency was measured by using Skala Kepribadian Ambang (Borderline Personality Scale) and their self-harm behaviors were measured through Self-Harm Inventory (SHI). The analyses was done through chi-square test and multiple logistic regression test. Results: The proportion of high school students who have a tendency of BPD is 43.9%, the self-harm behavior is 34.1%, and there was a significant difference in the proportion of GKA students with self-harm behavior and without self-harm behavior in Yogyakarta City (X2=16,37; p=<0,001; OR=4,99; CI 95%: 2,23-11,19). There was a statistically significant difference in the proportion of self- harm behavior in male and female subjects (X2=9,416; df=1; p=0,002). Conclusion: There was a significant difference in the proportion of BPD tendency among senior high school students with self-harm behaviors and without self-harm behaviors in Yogyakarta City. Gender had a significant difference in the proportion of self-harm behavior.

Kata Kunci : gangguan kepribadian ambang, self-harm, remaja, borderline personality disorder, self-harm, teenagers