اثر بخشی درمان شناختی مبتنی بر مدل داگاس بر عدم تحمل بلاتکلیفی، اجتناب شناختی و باورهای مثبت نگرانی در بیماران مبتلا به اختلال اضطراب فراگیر

نوع مقاله: مقاله پژوهشی

نویسندگان

1 کارشناس ارشد روانشناسی بالینی دانشگاه آزاد اسلامی واحد علوم و تحقیقات تهران (خراسان رضوی)، نیشابور، ایران

2 دکتری روانشناسی

3 دانشگاه علوم پزشکی کردستان، سنندج، ایران

4 استادیار، گروه روان پزشکی دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

مقدمه: اختلال اضطراب فراگیر (GAD)، در دهه گذشته، با پیشرفت و گسترش نظریه های مختلف درباره "نگرانی"، به عنوان یک مؤلفه شناختی بنیادین در این اختلال، بیش از پیش مورد توجه قرار گرفته است. اختلال اضطراب فراگیر، به عنوان یک اختلال مزمن، اغلب چندین سال قبل از افسردگی بروز می کند. امّا مطالعات اندکی درخصوص سبب شناسی و مداخلات درمانی این اختلال صورت گرفته است. هدف پژوهش حاضر، بررسی اثر بخشی درمان شناختی  مبتنی بر مدل داگاس بر عدم تحمل بلاتکلیفی ، اجتناب شناختی و باورهای مثبت نگرانی در بیماران مبتلا به اختلال اضطراب فراگیر بود.
روش: در این پژوهش از طرح تک آزمودنی از نوع خط پایه چندگانه استفاده گردید. نمونه این پژوهش، پنج نفر بیمار مبتلا به اختلال اضطراب فراگیر بود که ملاک های ورود و خروج را دارا بودند. نمونه گیری پژوهش به صورت در دسترس انتخاب شد. تأیید تشخیص اختلال اضطراب فراگیر  بر اساس مصاحبه بالینی ساختار یافتهSCID-I) ) و  تشخیص روانشناس بالینی انجام شد. برای سنجش و ارزیابی قبل و بعد از مداخله شناختی مبتنی بر مدل داگاس از مقیاس عدم تحمل بلاتکلیفی (IUS)، پرسشنامة نگرانی ایالت پنسیلوانیا (PSWQ)، پرسشنامه اجتناب شناختی (CAQ)، پرسشنامه چرا نگرانی (WWQ-II) استفاده شد. به منظور تجزیه و تحلیل داده ها از درصد بهبودی و اندازه اثر استفاده شد.
 یافته­ها: نتایج حاصل از تجزیه و تحلیل داده ها نشان داد که اندازه اثر محاسبه شده در مقیاس عدم تحمل بلا تکلیفی 72/0، اجتناب شناختی 79/0 و باورهای مثبت در مورد نگرانی 66/0 بود.
 نتیجه­گیری: از یافته های پژوهش نتیجه گیری می شود که شناخت درمانی به شیوه داگاس توانسته بر روی عدم تحمل بلاتکلیفی، باورهای مثبت در مورد نگرانی و اجتناب شناختی اثر مثبتی داشته باشد و باعث کاهش علائم شده است. همچنین این درمان می تواند یکی از گزینه های مؤثر در کاهش علائم اختلال اضطراب فراگیر (GAD) در کنار سایر مداخلات دارویی باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Effectiveness of Cognitive Therapy Based on Dougas Model on Intolerance of Uncertainty, Cognitive Avoidance and Positive Beliefs about worry in Generalized Anxiety Disorder

نویسندگان [English]

  • hossein sherafati 1
  • E Taheri, 2
  • sirvan asmaee majd 3
  • M Amiri, 4
3 kurdistan university of medical sciences, sanandaj, iran
4 استادیار، گروه روان پزشکی دانشگاه علوم پزشکی مشهد، مشهد، ایران
چکیده [English]

 
Introduction: Generalized anxiety disorder (GAD) is taken into consideration more than ever in the past decade, by progress and development of many theories about "worry" as fundamental cognitive component in this disorder. Generalized anxiety disorder, as a chronic disorder, mostly occurs several years before depression. However, few studies have been conducted on the etiology and treatment of this disorder. This study aimed to investigate cognitive therapy model based on Dougas on intolerance of uncertainty, cognitive avoidance and positive beliefs about worry in patients with generalized anxiety disorder.
Method: In this study, single case experimental design with multiple baselines was used. The sample group included five patients with generalized anxiety disorder who were having inclusion and exclusion criteria. Sampling was conducted based on voluntary and convenience method. Diagnosis of Generalized Anxiety Disorder was done according to the Structured Clinical Interview (SCID-I) and clinical psychologist. Intolerance of uncertainty scale (IUS), Penn State Worry Questionnaire (PSWQ), Cognitive Avoidance Questionnaire (CAQ) and Why Worry Questionnaire (WWQ-II) were used as measures in the pre and post intervention. Effect size and cure rate were used to analyze data.
Results: The results showed that effect size in intolerance of uncertainty was 0.72, cognitive avoidance was 0.79 and a positive belief about worry was 0.66.
Conclusion: Results of this study indicates that cognitive therapy model based on Dougas has positive effect on intolerance of uncertainty, cognitive avoidance and positive beliefs about worry and lead to reduce them. Also this treatment besides of pharmacotherapy could be used as one of effective options in reducing GAD symptoms.

کلیدواژه‌ها [English]

  • Cognitive Therapy Model based on Dougas
  • Generalized Anxiety Disorder
  • Intolerance of Uncertainty
  • Cognitive Avoidance
  • Positive Beliefs About Worry

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