اثربخشی آموزش راهبردهای نظم جویی فرآیندی هیجان در ناگویی هیجانی افراد مبتلا به پسوریازیس

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد روان‌شناسی بالینی دانشگاه خوارزمی، تهران، ایران

2 دانشیار، گروه روانشناسی بالینی دانشگاه خوارزمی، تهران، ایران

3 دانشیار ،گروه پوست دانشگاه علوم پزشکی، تهران، ایران

چکیده

مقدمه: نقش عوامل روان‌شناختی مانند تجارب هیجانی و به‌ویژه ناگویی هیجانی در سیر بالینی بسیاری از بیماری‌های پوستی مورد تأیید قرار گرفته است. هدف پژوهش حاضر بررسی اثربخشی آموزش راهبردهای نظم‌جویی فرآیندی هیجان بر ناگویی هیجانی افراد مبتلا به پسوریازیس بود.
روش‌: در چارچوب یک طرح‌ تک‌آزمودنی از میان بیماران مبتلا به اختلال‌های پوستی مراکز درمانی تهران، 3 بیمار مبتلا به پسوریازیس به روش نمونه‌گیری در دسترس و بر اساس مصاحبه‌ بالینی ساخت‌یافته برای اختلال‌های محور Iدر DSM-IV (SCID-I) و ملاک‌های ورود و خروج انتخاب شدند و 10 جلسه‌ 1 ساعته آموزش راهبردهای نظم‌جویی فرآیندی هیجان مبتنی بر مدل گروس را دریافت کردند. بیماران 6 بار به وسیله‌ی مقیاس ناگویی هیجانی تورنتو (TAS-20) طی درمان و دوره‌ پیگیری یک و نیم ماهه ارزیابی شدند. به منظور تجزیه و تحلیل داده­ها از شاخص‌های تغییر روند، شیب، بازبینی نمودارها و برای تعیین معناداری بالینی از شاخص درصد بهبودی و اندازه اثر استفاده شد.
یافته‌ها: نتایج تجزیه و تحلیل داده‌ها نشان داد آموزش راهبردهای نظم‌جویی فرآیندی هیجان به طور معناداری در کاهش ناگویی هیجانی و زیر مقیاس‌های آن در بیماران مبتلا به پسوریازیس موثر است.
نتیجه‌گیری: با توجه به نقش عوامل هیجانی به عنوان عوامل مستعدکننده، تسریع‌کننده و تداوم‌بخش در اختلالات پوستی شامل پسوریازیس، آموزش راهبردهای نظم‌جویی فرآیندی هیجان می‌تواند با کاهش ناگویی هیجانی و مدیریت هیجان‌های مثبت و منفی نقش مهمی را به عنوان درمان‌های حمایتی در کنار درمان‌های پزشکی ایفا کند.

کلیدواژه‌ها


عنوان مقاله [English]

Effectiveness of Processing Emotion Regulation Strategies Training (PERST) in Alexithymia of Patient with Psoriasis

نویسندگان [English]

  • M.M Zakeri, 1
  • J Hasani, 2
  • N. Esmaeili, 3
1 دانشجوی کارشناسی ارشد روان‌شناسی بالینی دانشگاه خوارزمی، تهران، ایران
2 دانشیار، گروه روانشناسی بالینی دانشگاه خوارزمی، تهران، ایران
3 دانشیار ،گروه پوست دانشگاه علوم پزشکی، تهران، ایران
چکیده [English]

Introduction:The role of psychological factors such as emotional experiences especially Alexithymia has been approved in the clinical course of skin diseases. The aim of this study was to examine the effectiveness of processing emotion regulation strategies training (PERST) in alexithymia of patient with psoriasis.
Method: In the frame of single subject design among patients with skin disorders of treatment centers in Tehran, 3 patients with Psoriasis were recruited through convenient sampling and based on structured clinical interview for axis I disorders in DSM-IV (SCID-I) and inclusion and exclusion criteria then received processing emotion regulation strategies training for 10 sessions (each session had 1 hour length). Patients were evaluated 6 times by Toronto Alexithymia Scale-20 (TAS-20) duringtreatment and 1.5 month follow up.  Data were analyzed by using the indices for trend changes, slope and the visual inspection of the charts; the recovery percent index and effect size were used to determine the clinical significance.
Results: The data analysis showed that processing emotion regulation strategies training is significantly effective in reducing alexithymia and its subscales in patient with psoriasis.
Conclusion: According to the role of emotional factors as predisposing, precipitating and continuation of skin disorders including psoriasis education of processing emotion regulation strategies training could reduce alexithymia and manage positive and negative emotions play an important role to support treatment with medical treatment.

کلیدواژه‌ها [English]

  • Processing Emotion Regulation Strategies
  • Alexithymia
  • Skin Diseases
  • Psoriasis
1- Carroll CL BR, Feldman SR, Fleischer AB, Manuel CL. The burden of atopic dermatitis: impact on the patient, family, and society. Pediatr Dermatol. 2005; 22(3): 192-9.
2- Burns DA CN. Introduction and historical bibliography. Oxford: Wiley- Blackwell. 2001; 1(1):
3- Chen SC BA, Soon SL, Aftergut K, Cruz P, Sexton SA. A catalogue of dermatology utilities: a measure of the burden of skin diseases. J Investig Dermatol Symp. 2004; 9: 160-8.
4- Hay R BS, Chen S, Estrada R, Haddix A. Skin diseases. New York: Oxford University Press. 2006; 1(1): 707-22.
5- Walker N L-JM. Quality of life and acne in Scottish adolescent schoolchildren: use of the Children's Dermatology Life Quality Index [CDLQI] and the Cardiff Acne Disability Index [CADI]. J Eur Acad Dermatol Venereol. 2006; 20(1): 45-50.
6- Mease PhJ MA. Quality of life issues in psoriasis and psoriatic arthritis: Outcome measures and therapies from a dermatological perspective. J Am Acad Dermatol. 2006; 54(4): 685-704.
7- Gudjonss JE EJPIWK, Goldsmith LA, Katz S,. Fitzpatrick’s dermatology in general medicine. US: McGraw-Hill. 2008; 1: 169-206.
8- Bolognia JL JJ, Schaffer JV. Textbook of Dermatology. Spain: Mosby Elsevier publishing. 2010; 1.
9- Griffiths CEM BJ. Psoriasis. USA: Blackwell publishi. 2008; 20: 1-20.
10- L N. Epidemiology of psoriasis. Curr Drug Targets Inflamm Allergy. 2004; 1(3(2)): 121-8.
11- Langley RG PA, Hebert AA. Patient-reported outcomes in pediatric patients with psoriasis undergoing etanercept treatment: 12-week results from a phase III randomized controlled trial. J Am Acad Dermatol. 2011; 64(1): 64-70.
12- L F. An Atlas of Psoriasis. New Jersey: USA the Parthenon publishing group Inc. 1997; 1: 1-32.
13- Schmitt J FD. Understanding the relationship between objective disease severity, psoriatic symptoms, illness-related stress, health-related quality of life and depressiven symptoms in patients with psoriasis a structural equations modeling approach. Gen Hosp Psychiatry. 2007; 29(2): 134-40.
14- Gupta AM GK. Evaluation of cutaneous body image dissatisfaction in the dermatology patient. Clin Dermatol. 2013; 31(1): 72-9.
15- Erberk-Ozen N BA, Boratav C, Kocak M. Executive dysfunctions and depression in Behçet's disease without explicit neurological involvement. Psychiatry Clin Neurosci. 2006; 60(4): 465-72.
16- Mercan S K-AI. Psychodermatology: A collaboration between psychiatry and dermatology. Turk Psikiyatri Derg. 2006; 17: 305-13.
17- Ciuluvica C AP, & Fulcheri M. Emotion Regulation Strategies and Quality of Life in Dermatologic Patients. Procedia Soc Behav Sci. 2014; 22(127): 661-5.
18- Chen J XT, Jing J, & Chan RCK. Alexithymia and emotional regulation: A cluster analytical approach. BMC Psychiatry. 2011; 11(1): 33.
19- Dunn LK ONJ, & Feldman SR. Acne in adolescents: quality of life, self-esteem, mood, and psychological disorders. Dermatol Online J. 2011; 17(1): 1.
20- Gee NS ZL, Keuthen N, Kroshinsky D, & Kimball BA. A survey assessment of the recognition and treatment of psychocutaneous disorders in the outpatient dermatology setting: How prepared are we? J Am Acad Dermatol. 2013; 68(1): 47-52.
21- Margalit D B-HL, Brill S, & Vatine JJ. Complex regional pain syndrome, alexithymia, and psychological distress. J Psychosom Res. 2014; 77(4): 273-7.
22- Millard LG CJ. Psychocutaneus disorders. Turin: Blackwell Publishing. 2004; 61: 23-61.
23- Orion E WR. Psychologic factors in the development of facial dermatoses. Clin Dermatol. 2014; 32(6): 763-6.
24- Fortune DG, Helen L. Richards, and Christopher EM Griffiths. Psychologic factors in psoriasis: consequences, mechanisms, and interventions. Clin Dermatol. 2005; 23(4): 681-94.
25- Picardi A ME, Gaetano P, Cattaruzza MS, Baliva G, Melchi CF. Stress, social support, emotional regulation, and exacerbation of diffuse plaque psoriasis. Psychosomatics. 2005; 46(6): 556-64.
26- Picardi A P, P, Cattaruzza, MS, Gaetano P, Melchi CF, Baliva G. Stressful life events, social support, attachment security and alexithymia in vitiligo: A case–control study. Psychother Psychosom. 2003; 72(3): 151-8.
27- Picardi A PP, Cattaruzza MS, Gaetano P, Melchi CF, Baliva, G. Stressfull life events, social support, attachment security, and alexythymia in vitiligo: a case-control study. Psychother Psychosom. 2003; 72(3): 150-8.
28- Picardi A PP, Cattaruzza MS, Gaetano P, Baliva G, Melchi CF. Only limited support for a role of psychosomatic factors in psoriasis: results from a case-control study. J Psychosom Res. 2003; 55(3): 189-96.
29- Picardi A PP, Cattaruzza MS, Gaetano P, Baliva G, Melchi CF. Psychosomatic factors in first-onset alopecia areata. Psychosomatics. (5)44: 20-374
30- PE S. Alexithymia, clinical issues, politics and crime. Psychother Psychosom. 2000; 69(3): 113-6.
31- S K. The psychosemantic approach to alexithymia. Pers Individ Dif. 2002; 33: 393-407.
32- Ciuluvica C AP, & Fulcheri M. Emotion Regulation Strategies and Quality of Life in Dermatologic Patients. Procedia Soc Behav Sci. 2014; 127: 661-5.
33- Campbell-Sills L BD. Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. New York: Guilford Press. 2007; 1: 542-59
34- JJ G. Emotion regulation: Affective, Cognitive, and Social Consequences. J PSYCHOPATHOL BEHAV. 2002; 26: 41-54.
35- Cole PM MS, Dennis TA. Emotion  regulation  as  a  scientific  construct: Methodological  challenges  and  directions  for  child  development  research. Child Dev. 2004; 75(2): 317-33.
36- JJ G. Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology. 2003; 39: 281-91.
37- B M. Interpersonal emotion regulation as a mechanism of social support in depression. Clin Psychol Rev. 2011; 31(8): 1276-90.
38- Gross JJ TR. Emotion Regulation, Conceptual Foundation. Handbook of Emotion Regulation. New York: Guilford Press. 2007; 1: 3-24.
39- Bagby RM PJ, & Taylor GJ. The twenty-item Toronto Alexithymia Scale: I Item selection and cross-validation of the factor structure. J Psychosom Res. 1994; 38(1): 23-32.
40- M TGB. New trends in alexithymia research. Psychother Psychosom. 2004; 73(1): 68-77.
41- Palmer BR GG, Manocha R, & Syough C. A psychometric evaluation of the Mayer-Salovey-Caruso Emotional Intelligence Test Version 2.0. Intelligence. 2004; 33: 285-305.
42- Parker JDA TG, & Bagby RM. The relationship between emotional intelligence and alexithymia. Pers Individ Dif. 2001; 30: 107-15.
43- Parker JDA TG, & Bagby RM. The 20-item Toronto Alexithymia Scale: III reliability and factorial validity in a community population. J Psychosom Res. 2003; 55: 269-75.
44- Taylor GJ BM. An overview of the alexithymia construct. San Francisco: Jossey-Bass. 2000; 1: 263-76.
45- MA B. Reliability and factorial validity of Farsi version of the Toronto Alexithymia Scale with a sample of Iranian students. Psychol Re. 2007; 101(1): 209-20.
46- First MB S, RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV Axis I Disorders [SCID-I], Clinitian Version. Washington, DC: American Psychiatric Association. 1997; 1: 1.
47- G G-M. Handbook of psychological assessment. Hoboken, New Jersey: John Wiley & Sons. 2009; 1: 1.
48- Zanarini MC VA, Parachini EA, Boulanger JL, Frankenburg FR, Hennen J. Zanarini Rating Scale for Borderline Personality Disorder [ZAN-BPD]: a continuous measure of DSM-IV borderline psychopathology. J Pers Disord. 2003; 17(3): 233-42.
49- Sharifi V AM, Amini H, Kaviani H, Semnani Y, Shabani A, Shahrivar Z, Davari Ashtiani R, Hakim Shoshtari M, Seddigh A, & Jalali Roodsari M. Reliability and applicability of the Persian version of the diagnostic structured interview for DSM-IV [SCID]. J Cognitive Neurosci. 2003; 6(1&2): 10-22.
50- Hasani J HM, & Ghaedniay Jahromi A. Complete package of processing emotion regulation strategies training [PERST] based on Gross Model. unpublished. 2011.
51- Cooper JO HT, & Heward WL. Applied behavior analysis. 2007: 37-46.
52- Garnefski N BN, Kraaij V. Psychological distress and cognitive emotion regulation strategies among farmers who fell victim to the foot-and-mouth crisis. Pers Individ Dif. 2005; 38: 1317-27.
53- Kamphuis JH TM. Effects of distraction and guided threat reappraisal on fear reduction  during exposure based treatments for specific fears. Behav Res Ther. 2000; 38: 1163-81.
54- Dubey A PR, & Mishra K. Role of emotion regulation difficulties and positive/negative affectivity in explaining alexithymia-health relationship: An overview. J Soc Sci Res. 2012; 7(1): 20-31.
55- Aldao A N-HS, & Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review. 2010; 30: 237-17.
56- Cisler JM OB, Feldner MT, & Forsyth JP. Emotion regulation and the anxiety disorders: an integrative review. J Psychopathol Behav Assess. 2010; 1(32): 68-82.
57- Garnefski N KV. Cognitive emotion regulation questionnaire development of a short 18- item version (CERQ-short). Pers Individ Dif. 2009; 41: 1045-53.
58- Grynberg D LO, Corneille O, Grezes J, & Berthoz S. Alexithymia in the interpersonal domain:
A general deficit of empathy? Personality and Individual Differences. 2010; 49: 845-50.
59- Gross JJ JO. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol. 2003; 85: 348-62.
60- Garnefski N KV. Relationship between cognitive emotion regulation strategies and depressive symptoms: A comparative study of five specific samples. Personality and Individual Differences. 2006; 40: 1659-69.
61- Alloy LB RJ. Cognitive vulnerability to emotional disorders. Routledge. 2006; 1: 1.