نقش تشخیصی راهبردهای تنظیم شناختی هیجان، همجوشی شناختی و راهبردهای کنترل فکر در اختلال وسواسی–اجباری

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی سلامت دانشگاه خوارزمی، تهران، ایران

2 کارشناس ارشد روانشناسی بالینی دانشگاه خوارزمی، تهران، ایران

3 کارشناس ارشد مشاوره و راهنمایی دانشگاه علوم و تحقیقات، تهران، ایران

4 دانشجوی دکتری روانشناسی دانشگاه آزاد اسلامی واحد کرمانشاه، کرمانشاه، ایران

چکیده

مقدمه: هدف پژوهش حاضر بررسی نقش تشخیصی راهبردهای تنظیم شناختی هیجان، همجوشی شناختی و راهبردهای کنترل فکر در اختلال وسواسی–اجباری و افراد بهنجار بود.
روش: طرح پژوهش حاضر از نوع پژوهش­های علی­-مقایسه­ای بود. جامعه هدف پژوهش حاضر شامل کلیه مراجعه­کنندگان مبتلا به اختلال وسواس فکری-عملی بود که در بازه زمانی مهر تا اسفند سال 1395 به مراکز درمانی شهر تهران مراجعه کرده بودند. از این میان تعداد 50 نفر با روش نمونه­گیری در دسترس انتخاب شدند. سپس از مقیاس وسواسی-اجباری ییل- براون فرم کوتاه پرسشنامه نظم جویی شناختی هیجان، پرسشنامه کنترل فکر و پرسشنامه آمیختگی شناختی برای گردآوری داده­ها استفاده شد. برای تجزیه‌وتحلیل داده­ها از روش تحلیل تابع تشخیصی استفاده شد.
یافته­ها: نتایج تحلیل داده­ها نشان داد که  در کلیه متغیرها به جزء راهبردهای سازگارانه پذیرش و ارزیابی مجدد، همچنین راهبردهای کنترل فکر نگرانی، تنبیه، کنترل اجتماعی و ارزیابی مجدد، میانگین گروه بهنجار به صورت معناداری بیشتر از گروه وسواسی بود. در متغیرهای دیگر میانگین گروه وسواس به صورت معناداری بیشتر از گروه بهنجار بود. همچنین یافته­های این پژوهش بیانگر آن بودند که بر اساس راهبردهای تنظیم شناختی هیجان، همجوشی شناختی و راهبردهای کنترل فکر می­توان عضویت افراد در دو گروه را پیش­بینی کرد.
نتیجه­ گیری: می­توان نتیجه­گیری کرد که فعال شدن باورهای درآمیختگیافکار، ارزیابی­هایی را بر می­انگیزاند که بر اساس آنها استفاده از راهبردهای ناسازگارانه تنظیم هیجان و کنترل فکر بیشتر و متعاقباً فکر وسواسی خطرناک تلقی می­شود. این ارزیابی­ها منجر به بروز احساس ترس، اضطراب، گناه و ناراحتی می­شوند. اگر ارزیابی فرد این باشد که فکر وسواسی نشان­دهنده آن است که اتفاقی خطرناک پیش از این رخ داده است، ممکن است راهبردهای وارسی یا اختلال ذهنی را به کار گیرد. راهبردها باعث می­شوند فرد نتواند در واقعیت این باورها را بیازماید و اعتبار آنها را رد کند.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Diagnostic role of cognitive emotion regulation strategies, cognitive fusion and thought control strategies in Obsessive-Compulsive disorder

نویسندگان [English]

  • S Saeidpoor, 1
  • S.A Kazemi-Rezai, 2
  • E Karbalaei-Esmaeil, 3
  • S.V Kazemi-Rezai, 4
  • F. Ahmadi, 2
1 Kharazmi University
2 Kharazmi University
3 kharazmi University
4 Islamic Azad University of Kermanshah Branch
چکیده [English]

Introduction:This study aimed at comparing the discriminative role of the cognitive emotion regulation strategies, cognitive fusion and thought control strategies in Obsessive-Compulsive disorder and normal groups.
Method: The study was benefit of a causal-comparative research design. The target population included all patients with Obsessive-Compulsive disorder that referred to medical centers in Tehran in October to March 2016. A group of 50 persons that diagnosed with Obsessive-Compulsive disorder were selected by purposive sampling method. Then Data were gathered with the Obsessive-Compulsive Scale Yale-Brown, Short form of Cognitive Emotion Regulation Strategies Questionnaire,Thought Control Questionnaire and Cognitive Fusion Questionnaire. Data analyzed with the diagnostic function analysis.
Results: Result showed that mean scores of normal group significantly was more than obsession group in all dimensions except adaptive Emotion Regulation Strategies (except acceptance and reappraisal) as well as thought control strategies (worry, punishment, social control and reappraisal). The mean scores of obsessive group significantly was more than normal group in other variables. Result of diagnostic analysis showed that, according to the cognitive emotion regulation strategies, cognitive fusion and thought control strategies could be predicted membership in group and make a discrimination among two groups.
Conclusion:We can conclude that the activated cognitive fusion beliefs, disposes assessments that based on increased the thought control and maladaptive emotion regulation strategies, consequently obsession is considered dangerous. These assessments lead to feelings of fear, anxiety, guilt and upset.It used inspection or mental disorder strategies, if these assessments indicates that the obsessive thought is dangerous and happening already. These Strategiescauses that person cannot be tested reality of beliefs and refused them.

کلیدواژه‌ها [English]

  • Obsessive-Compulsive disorder
  • cognitive emotion regulation strategies
  • cognitive fusion
  • thought control strategies

1- Babaee M, kbarzade, N , najal Rahim, A,  Poorshahriari, M. The effect of combination therapy, cognitive-behavieral and ideation reduction of risk on obsessive-compulsive disorder in female students. Psychological Studies. 2008; 6(1).

2- Association AP. Diagnostic and statistical manual of mental disorders,(DSM-5®): American Psychiatric Pub. 2013.

3- Wells A, Simons M. Metacognitive therapy: Wiley Online Library. 2009.

4- Mohammadkhani S, Farjad M. The relationship of the metacognitive beliefs and thought control strategies with obsessive–compulsive symptoms in nonclinical population. Journal of Clinical Psychology. 2009; 1(3)(3): 35-55.

5- Scarff JR. The potential application of obsessions to reduce compulsions in individuals with obsessive–compulsive disorder. Medical hypotheses. 2010; 74(2): 216-8.

6- Zettle RD, Hayes SC, Barnes-Holmes D, Biglan A. The Wiley handbook of contextual behavioral science: John Wiley & Sons. 2016.

7- Gaudiano BA, Herbert JD. Believability of hallucinations as a potential mediator of their frequency and associated distress in psychotic inpatients. Behavioural and Cognitive Psychotherapy. 2006; 34(4): 497-502.

8- Dalrymple KL, Herbert JD. Acceptance and commitment therapy for generalized social anxiety disorder: A pilot study. Behavior Modification. 2007; 31(5): 543-68.

9- Twohig MP. Acceptance and commitment therapy for treatment-resistant posttraumatic stress disorder: A case study. Cognitive and Behavioral Practice. 2009; 16(3): 243-52.

10- Herbert JD, Forman EM. Acceptance and mindfulness in cognitive behavior therapy: Understanding and applying the new therapies: John Wiley & Sons. 2011.

11- Hayes S, Lillis  J. Acceptance and Commitment Therapy. Washington DC: American Psychological Association. 2012.

12- Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: The process and practice of mindful change: Guilford Press. 2011.

13- Roemer L, Orsillo SM, Salters-Pedneault K. Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: evaluation in a randomized controlled trial. Journal of consulting and clinical psychology. 2008; 76(6): 1083.

14- Myers SG, Wells A. Obsessive-compulsive symptoms: The contribution of metacognitions and responsibility. Journal of Anxiety Disorders. 2005; 19(7): 806-17.

15- Shareh HA, A. Brain Behavioral Systems, Metacognitive Beliefs, and Thought Control Strategies in Patients with Obsessive-Compulsive Disorder. Journal of Clinical Psychology. 2013; 13(9): 11-22.

16- Myers SG, Wells A. An experimental manipulation of metacognition: A test of the metacognitive model of obsessive-compulsive symptoms. Behaviour research and therapy. 2013; 51(4): 177-84.

17- Wegner DM, Gray K. The mind club: Who thinks, what feels, and why it matters: Penguin. 2017.

18- Wells A, Davies MI. The Thought Control Questionnaire: A measure of individual differences in the control of unwanted thoughts. Behaviour research and therapy. 1994; 32(8): 871-8.

19- Abramowitz JS, Arch JJ. Strategies for improving long-term outcomes in cognitive behavioral therapy for obsessive-compulsive disorder: insights from learning theory. Cognitive and Behavioral Practice. 2014; 21(1): 20-31.

20- Pirkhaefi AT-B, F. Abshari, L. Comparison of Neuropsychological Profile and Cognitive Emotion Regulation in Patients with Obsessive-Compulsive Disorder and Generalized Anxiety. Journal of Clinical Psychology. 2017; 4(32): 11-21.

21- Ahadi B, Azizinezhad,  F, Narimani, M, Berahmand, O. Explaining the role of attachment styles and defensive mechanisms in obsession-compulsion disorder. 2009.

22- Öngen DE. Cognitive emotion regulation in the prediction of depression and submissive behavior: Gender and grade level differences in Turkish adolescents. Procedia-Social and Behavioral Sciences. 2010; 9: 1516-23.

23- Garnefski N, Kraaij, V. . The cognitive emotion regulation questionnaire. European Journal of Psychological Assessment. 2007; 23(3): 141-9.

24- Garnefski N, Kraaij V, Spinhoven P. Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual differences. 2001; 30(8): 1311-27.

25- Vohs KD, Baumeister RF. Handbook of self-regulation: Research, theory, and applications: Guilford Publications. 2016.

26- Gratz KL, Tull MT. Emotion regulation as a mechanism of change in acceptance-and mindfulness-based treatments. Assessing mindfulness and acceptance processes in clients: Illuminating the theory and practice of change. 2010; 107-33.

27- Garnefski N, Kraaij V. Specificity of relations between adolescents’ cognitive emotion regulation strategies and symptoms of depression and anxiety. Cognition and Emotion. 2016; 1-8.

 

28- Khosravi M, Mehrabi H, Azizimoghadam M. A comparative study of obsessive-rumination component on obsessive-compulsive and depressive patients. Koomesh. 2008; 10(1): 65-72.

29- Legerstee JS, Garnefski N, Verhulst FC, Utens EM. Cognitive coping in anxiety-disordered adolescents. Journal of adolescence. 2011; 34(2): 319-26.

30- Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review. 2010; 30(2): 217-37.

31- Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Archives of general psychiatry. 1989; 46(11): 1006-11.

32- Kim SW, Dysken MW, Kuskowski M. The Yale-Brown obsessive-compulsive scale: a reliability and validity study. Psychiatry Research. 1990; 34(1): 99-106.

33- Andooz Z. Efficacy of the wells model of meta cognitive therapy in treatment of one case with obsessive compulsive disorder. Andishe va rafter 2004; 12(1): 56-66.

34- Garnefski N, Kraaij V, Spinhoven P. Manual for the use of the Cognitive Emotion Regulation Questionnaire. Leiderdorp, The Netherlands: DATEC. 2002.

35- Hasani J. The reliability and validity of the short form of the cognitive emotion regulation questionnaire. 2011.

36- Reynolds M, Wells A. The Thought Control Questionnaire–psychometric properties in a clinical sample, and relationships with PTSD and depression. Psychological Medicine. 1999; 29(5): 1089-99.

37- Goodarzi M, Esmaieli Torkanbori Y. The relation between intrusive thoughts control strategies and severity of obsessive-compulsive symptoms. Hakim Research Journal. 2006; 8(4): 44-51.

38- Gillanders DT, Bolderston H, Bond FW, Dempster M, Flaxman PE, Campbell L, et al. The development and initial validation of the cognitive fusion questionnaire. Behavior therapy. 2014; 45(1): 83-101.

39- Akbari M, Roshan R, Shabani A, Fata L, Shairi MR, Zarghami F. Transdiagnostic treatment of co-occurrence of anxiety and depressive disorders based on repetitive negative thinking: A case series. Iranian journal of psychiatry. 2015; 10(3): 200.

40- Welsh P, Cartwright‐Hatton S, Wells A, Snow L, Tiffin PA. Metacognitive beliefs in adolescents with an at‐risk mental state for psychosis. Early intervention in psychiatry. 2014; 8(1): 82-6.

41- De Putter LM, Van Yper L, Koster EH. Obsessions and compulsions in the lab: A meta-analysis of procedures to induce symptoms of obsessive-compulsive disorder. Clinical psychology review. 2017.

42- Morrison AP, Shryane N, Fowler D, Birchwood M, Gumley AI, Taylor HE, et al. Negative cognition, affect, metacognition and dimensions of paranoia in people at ultra-high risk of psychosis: a multi-level modelling analysis. Psychological medicine. 2015; 45(12): 2675-84.

43- Coles ME, Schubert JR, Heimberg RG, Weiss BD. Disseminating treatment for anxiety disorders: step 1: recognizing the problem as a precursor to seeking help. Journal of anxiety disorders. 2014; 28(8): 737-40.

44- Myers G FL, Wells A. An empirical test of the metacognitive model of obsessive-compulsive symptoms: fusion beliefs, beliefs about rituals, and stop signals. . Journal of anxiety disorders. 2009; 23: 436-42.

45- Papageorgiou C, Wells A. Group metacognitive therapy for severe antidepressant and CBT resistant depression: A baseline-controlled trial. Cognitive Therapy and Research. 2015; 39(1): 14-22.

46- Steketee G. Individual cognitive and behavioral treatment for hoarding.  The Oxford handbook of hoarding and acquiring: Oxford, NY. 2014; 260-73.

47- Clark DA, Abramowitz J, Alcolado GM, Alonso P, Belloch A, Bouvard M, et al. Part 3. A question of perspective: The association between intrusive thoughts and obsessionality in 11 countries. Journal of obsessive-compulsive and related disorders. 2014; 3(3): 292-9.

48- Salkovskis PM, Millar JF. Still cognitive after all these years? Perspectives for a cognitive behavioural theory of obsessions and where we are 30 years later. Australian Psychologist. 2016; 51(1): 3-13.

49- Lambert AE, Hu Y, Magee JC, Beadel JR, Teachman BA. Thought suppression across time: Change in frequency and duration of thought recurrence. Journal of obsessive-compulsive and related disorders. 2014; 3(1): 21-8.

50- Rachman S. The evolution of behaviour therapy and cognitive behaviour therapy. Behaviour research and therapy. 2015; 64: 1-8.