اثربخشی درمان مبتنی بر پذیرش و تعهد بر نشانه‌های پُرخوری، افسردگی و تَن‌انگاره در مبتلایان به پُرخوری عصبی

نوع مقاله : مقاله پژوهشی

نویسنده

مربی، گروه علوم تربیتی دانشگاه پیام ‌نور، ایران

چکیده

مقدمه: پُرخوری عصبی نوع خاصی از اختلالات خورد و خوراک است که با مواد غذایی و تَن‌انگاره فرد رابطه دارد. لذا پژوهش حاضر با هدف، بررسی اثربخشی درمان مبتنی بر پذیرش و تعهد بر نشانه‌های پُرخوری، افسردگی و تَن‌انگاره در مبتلایان به پُرخوری عصبی انجام شد.

روش: تحقیق از نوع نیمه‌تجربی با طرح پژوهش پیش‌آزمون و پس‌آزمون با گروه گواه بود. جامعۀ آماری شامل کلیۀ زنان مبتلا به پُرخوری عصبی از مراجعه­کنندگان به مرکز روان‌پزشکی فارابی کرمانشاه بود؛ براساس معیارهای ورود به پژوهش، تشخیص روان‌پزشک و پرسشنامه‌های عادات خوردن (EHQ)، شدت پُرخوری (BES)، نگرانی از تَن‌انگاره (BIS)، و افسردگی بِک- فُرم کوتاه بیمارانی که دارای بالاترین نمرات بودند، با روش نمونه‌گیری در دسترس انتخاب و به صورت تصادفی به گروه های آزمایش و گواه تقسیم شدند. گروه آزمایشی 8 جلسه مداخلة درمانی 120 دقیقه­ای طی دو جلسه در هفته را دریافت نمود؛ اما گروه گواه مداخله­ای دریافت نکرد. اطلاعات به‌ دست ‌آمده با تحلیل کوواریانس چندمتغیریتحلیل شد.

یافته‌ها: نتایج پژوهش نشان داد کهتفاوت معناداری بین گروه‌های آزمایش و گواه در کاهش شدت نشانگان پُرخوری عصبی و عادات خوردن وجود دارد. همچنین، در تَن‌انگاره و افسردگی تفاوت معناداری بین گروه‌ها مشاهده گردید.

نتیجه‌گیری: با توجه به یافته‌های پژوهش می‌توان بیان کرد که درمان مبتنی بر پذیرش و تعهد موجب کاهش نشانگان پُرخوری عصبی، افسردگی و بهبود تَن‌انگاره در افراد تحت درمان شده است. استفاده از این روش درمانی برای مبتلایان به پُرخوری عصبی در جامعۀ بیماران پیشنهاد می‌شود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The effectiveness of acceptance and commitment therapy (ACT) on bulimia symptoms, depression and body image in bulimia nervosa patients

نویسنده [English]

  • H Boloorsaz-Mashhadi,
Academic member, University of PayameNoor, Tehran, Iran
چکیده [English]

 

Introduction:Bulimia nervosa is a particular type of feeding and eating disorderswhich affects the person’s relationship with food and their body. This study was examined the effectiveness of acceptance and commitment therapy on symptoms of bulimia, depression and body image in bulimia nervosapatients.

Method: The research design was a semi-experimental one with pretest-posttest and control group format.The sample included all patients with bulimia nervosa who referred to Farabi Hospital of Kermanshah city in 2016,whowere assessed based on psychiatrists definitive diagnosis, Eating Habits Questionnaire, Binge Eating Scale, Body Image Scale and Beck depression short inventory Questionnaires; Those with higher scores were selected via available sampling method and the study subjects were randomly divided into experimental and control groups.The experimental group was exposed to 8 sessions of two hours ACT. The data was analyzed using descriptive statistics and multivariate analysis of covariance.

Results: The results showed significant difference between experimental and control groups in abatement bulimia nervosa intensity and eating habits.Significant difference were found between groups in body image and depression as well (P

کلیدواژه‌ها [English]

  • acceptance and commitment therapy
  • Bulimia Nervosa
  • depression
  • Body Image
1- Giordano S. Eating disorders and the media. Current opinion in psychiatry. 2015;28(6):478-82.
2- Sadock BJ SVRP. Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. In: Edition t, editor. Translated by; Farzin Rezaei. Tehran: Arjmand Publication Company; 2016 p. 111-27.
3- Mond JM. Classification of bulimic-type eating disorders: from DSM-IV to DSM-5. Journal of eating disorders. 2013;1(1):33.
4- Lunn S, Daniel SI, Poulsen S. Psychoanalytic psychotherapy with a client with bulimia nervosa. Psychotherapy. 2016;53(2):206.
5- Jordan J, McIntosh VV, Carter JD, Rowe S, Taylor K, Frampton C, et al. Bulimia nervosa‐nonpurging subtype: Closer to the bulimia nervosa‐purging subtype or to binge eating disorder? International Journal of Eating Disorders. 2014;47(3):231-8.
6- Ganji MG, H. Abnormal Psychology Based on DSM-5. 4th Edition. Tehran: Savalane Publication Company; 2014.
7- Kinasz K, Accurso EC, Kass AE, Le Grange D. Does Sex Matter in the Clinical Presentation of Eating Disorders in Youth? Journal of Adolescent Health. 2016;58(4):410-6.
8- Felpen EPG, Claumann GS, Sacomori C, Daronco LSE, Cardoso FL, Pelegrini A. Sociodemographic factors and body image among high school students/Fatores sociodemograficos e imagem corporal em adolescentes do ensino medio. Ciência & Saúde Coletiva. 2015;20(11):3329-38.
9- Dion J, Blackburn M-E, Auclair J, Laberge L, Veillette S, Gaudreault M, et al. Development and aetiology of body dissatisfaction in adolescent boys and girls. International journal of adolescence and youth. 2015;20(2):151-66.
10- Shirasawa T, Ochiai H, Nanri H, Nishimura R, Ohtsu T, Hoshino H, et al. The relationship between distorted body image and lifestyle among Japanese adolescents: a population-based study. Archives of Public Health. 2015;73(1):32.
11- Rodgers RF, Lowy AS, Halperin DM, Franko DL. A Meta‐Analysis Examining the Influence of Pro‐Eating Disorder Websites on Body Image and Eating Pathology. European Eating Disorders Review. 2016;24(1):3-8.
12- Sanderson CA. Health Psychology. 3th Edition. al. TbJae, editor. Tehran: Sarfaraz Publication Company; 2015.
13- Oberne A, DeBate R. Self-induced vomiting as a function of bulimia nervosa increases the risk for oral health issues. Journal of Evidence Based Dental Practice. 2014;14(4):195-6.
14- Modan‐Moses D, Levy‐Shraga Y, Pinhas‐Hamiel O, Kochavi B, Enoch‐Levy A, Vered I, et al. High prevalence of vitamin D deficiency and insufficiency in adolescent inpatients diagnosed with eating disorders. International Journal of Eating Disorders. 2015;48(6):607-14.
15- Sato Y, Fukudo S. Gastrointestinal symptoms and disorders in patients with eating disorders. Clinical journal of gastroenterology. 2015;8(5):255-63.
16- Westmoreland P, Krantz MJ, Mehler PS. Medical complications of anorexia nervosa and bulimia. The American journal of medicine. 2016;129(1):30-7.
17- Mancuso SG, Newton JR, Bosanac P, Rossell SL, Nesci JB, Castle DJ. Classification of eating disorders: comparison of relative prevalence rates using DSM-IV and DSM-5 criteria. The British Journal of Psychiatry. 2015;206(6):519-20.
18- Smink FR, Hoeken D, Oldehinkel AJ, Hoek HW. Prevalence and severity of DSM‐5 eating disorders in a community cohort of adolescents. International Journal of Eating Disorders. 2014;47(6):610-9.
19- Dryer R, Uesaka Y, Manalo E, Tyson G. Cross‐cultural examination of beliefs about the causes of bulimia nervosa among Australian and Japanese females. International Journal of Eating Disorders. 2015;48(2):176-86.
20- Pisetsky EM, Wonderlich SA, Crosby RD, Peterson CB, Mitchell JE, Engel SG, et al. Depression and personality traits associated with emotion dysregulation: correlates of suicide attempts in women with bulimia nervosa. European Eating Disorders Review. 2015;23(6):537-44.
21- Papadomarkaki E, Portinou S. Clinical perfectionism and cognitive behavioral therapy. Psychiatrike= Psychiatriki. 2012;23(1):61-71.
22- Daniel SIF, Poulsen S, Lunn S. Client attachment in a randomized clinical trial of psychoanalytic and cognitive-behavioral psychotherapy for bulimia nervosa: Outcome moderation and change. Psychotherapy. 2016;53(2):174.
23- Behrouz B. The Effectiveness of Group-Based Acceptance and Commitment Therapy on Post-Traumatic Stress Disorder, Coping Styles, and Self-Efficacy in Girls with Abnormal Grief. Journal of Clinical Psychology. 2015;7(4):81-92.
24- Eilenberg T, Fink P, Jensen J, Rief W, Frostholm L. Acceptance and commitment group therapy (ACT-G) for health anxiety: a randomized controlled trial. Psychological medicine. 2016;46(1):103-15.
25- Molander P, Hesser H, Weineland S, Bergwall K, Buck S, Jäder Malmlöf J, et al. Internet-based acceptance and commitment therapy for psychological distress experienced by people with hearing problems: a pilot randomized controlled trial. Cognitive Behaviour Therapy. 2017:1-16.
26- Juarascio A, Shaw J, Forman E, Timko CA, Herbert J, Butryn M, et al. Acceptance and commitment therapy as a novel treatment for eating disorders: an initial test of efficacy and mediation. Behavior modification. 2013;37(4):459-89.
27- Berman M, Boutelle K, Crow S. A case series investigating acceptance and commitment therapy as a treatment for previously treated, unremitted patients with anorexia nervosa. European Eating Disorders Review. 2009;17(6):426-34.
28- Coker S, Roger D. The construction and preliminary validation of a scale for measuring eating disorders. Journal of Psychosomatic Research. 1990;34(2):223-31.
29- Abolghasemi AJ, E. . The effectiveness of dialectical behavior therapy on body image self-efficacy in girls with bulimia nernosa. Journal of Clinical Psychology. 2012;4(2):29-38.
30- McElroy SL, Mitchell JE, Wilfley D, Gasior M, Ferreira‐Cornwell MC, McKay M, et al. Lisdexamfetamine dimesylate effects on binge eating behaviour and obsessive–compulsive and impulsive features in adults with binge eating disorder. European Eating Disorders Review. 2016;24(3):223-31.
31- Moloodi R DM, Mootabi F & Omidvar N. . Comparison of early maladaptive schema in obese binge eaters and obese non-binge eaters. Journal of Behavioral Science. Journal of Behavioral Science. 2010;4(2):109-14.
32- Pooravari M, Habibi M, Parija HA, Tabar SHSA. Psychometric properties of body image concern inventory in adolescent. Pajoohandeh Journal. 2014;19(4):189-99.
33- Behrouz B HN, Jalalian S & Bavali F. . The Effectiveness of Acceptance and Commitment Therapy on Decreasing the Intensity of the Symptoms of Trichotillomania and Depression: A Single Case Study. Community Health Journal. 2015;9(3):18-28.
34- Rajabi G. Psychometric properties of Beck Depression Inventory Short Form Items (BDI-13). Journal of Iranian Psychologists. 2005;1(4):291-8.
35- Godfrey KM, Gallo LC, Afari N. Mindfulness-based interventions for binge eating: a systematic review and meta-analysis. Journal of Behavioral Medicine. 2015;38(2):348-62.
36- Abolghasemi AJE. The Effectiveness of dialectical behavior therapy on body image and self-efficacy in girls with bulimia nervosa. Journal of Clinical Psychology. 2012;2(14):29-37.
37- Mohamadali M Sedaghat M. The Effectiveness of Group Acceptance and Commitment Therapy (ACT) on Life Satisfaction among Mother of Children with Cancer. Clinical Phsycology Journal. 2017;9(2):29-36.
38- Nasiri S Ghorbani M, Adibi P. . The Effectiveness of Group Acceptance and Commitment Therapy in Quality of Patients with Functional Gastro Intesinal Disorder. . Clinical Phsycology Journal 2015;7(4):93-105.
39- Schmidt S, Gmeiner S, Schultz C, Löwer M, Kuhn K, Naranjo JR, et al. Mindfulness-based Stress Reduction (MBSR) as Treatment for Chronic Back Pain-an Observational Study with Assessment of Thalamocortical Dysrhythmia. Complementary Medicine Research. 2015;22(5):298-303.
40- Banth S, Ardebil MD. Effectiveness of mindfulness meditation on pain and quality of life of patients with chronic low back pain. International journal of yoga. 2015;8(2):128.