مقایسه اثربخشی درمان فراتشخیصی و مواجه سازی - بازداری پاسخ بر اجتناب تجربه ای و تنظیم شناختی هیجان در مبتلایان به وسواس فکری -عملی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانش آموخته دکتری روان شناسی دانشگاه پیام نور ،تهران،ایران

2 نویسنده مسئول:دانشیار،گروه روان شناسی دانشگاه پیام نور،تهران ،ایران

3 استادیار ،گروه روانپزشکی دانشگاه علوم پزشکی قزوین،قزوین،ایران

4 استاد،گروه روان شناسی دانشگاه پیام نور،تهران،ایران

چکیده

هدف: این پژوهش با هدف بررسی اثربخشی درمان فراتشخیصی بر اجتناب تجربه ای، تنظیم شناختی هیجان، و در بیماران با اختلال وسواسی-جبری (OCD) مقایسه آن با درمان مواجه‌سازی و پیشگیری از پاسخ (ERP) انجام شد.
روش: پژوهش حاضر از نوع نیمه آزمایشی از نوع پیش‌آزمون-پس‌آزمون است. جامعه مورد مطالعه در پژوهش حاضر کلیه افراد مبتلا به OCD مراجعه کننده به مراکز خدمات روانشناختی قزوین در سال 1396 بودند. 40 بیمار با روش نمونه‌گیری هدفمند انتخاب و به طور تصادفی به 2 گروه 20 نفری (گروه اول تحت درمان فراتشخیصی و گروه دوم تحت درمان ERP) گمارش شدند. در این پژوهش متغیرهایی مانند سن و جنس کنترل شد. ابزارهای به کار رفته در پژوهش حاضر عبارت بودند از: پرسش‌نامه وسواس ییل براون (YBOCS)، مصاحبه بالینی ساختاریافته (SCID-I)، ، ، پرسشنامه چندبعدی اجتناب تجربه‌ای (MEAQ))،، مقیاس تنظیم شناختی هیجانی داده های جمع آوری شده با استفاده از نرم افزار SPSS و با استفاده از روش آماری تحلیل کوواریانس و آزمون t زوجی مورد تجزیه و تحلیل قرار گرفت.
یافته‌ها: نتایج به دست آمده نشان داد که درمان فراتشخیصی به طور معناداری باعث کاهش اجتناب تجربه ای و همچنین، بهبود در تنظیم شناختی هیجان در افراد مبتلا به OCD شده است (001/0>p).
نتیجه‌گیری: نتایج به دست آمده با توجه به مطالعات انجام شده در این زمینه و محتوای پروتکل درمان فراتشخیصی و درمان ERP مورد بحث قرار گرفت.

کلیدواژه‌ها


عنوان مقاله [English]

The Effectiveness of Transdiagnostic Treatment on Experiential Avoidance and Cognitive Emotion Regulation in Patients with Obsessive-Compulsive Disorder and its Comparison with Exposure and Prevention Response Therapy

نویسندگان [English]

  • pegah hasanpoor 1
  • Alireza Aghausefi 2
  • OMID Zamir 3
  • Ahmad Alipour 4
1 payam noor univercity,tehran,iran
2 assistant professor ,payam noor university
3 professor of psychiatry,medical science university,qazvin
4 professor of psychology,payam nooe university
چکیده [English]

Objective: The purpose of this study was to investigate the effectiveness of transdiagnostic treatment on experiential avoidance, cognitive emotion regulation in patients with obsessive-compulsive disorder and its comparison with exposure and prevention response therapy
Method: The present study is a pre-test and post-test semi experimental design. The study population in this study was all obsessive compulsive patients referring to Qazvin psychological services centers in 2018. 40 patients were selected by purposeful sampling method and randomly assigned to 2 groups of 20 (the first group was treated with transdiagnostic treatment and the second group was treated with ERP). In this study, variables such as age and sex were controlled. The tools used in the present study were: Yale Brown Obsessive Compulsory Inventory (YBOCS), Structured Clinical Interview (SCID-I), Obsessive-Compulsive Questionnaire, , Multidimensional Experiential Avoidance QuestionnairQ( and cognitive emotional regulation questionnaire (CERQ). The collected data were analyzed by SPSS software and with using covariance analysis and paired t-test.
Results: The results showed that transdiagnostic treatment significantly decreased experiential avoidance and also improved, cognitive emotion regulation, in patients with OCD (p <0.001). On the other hand, the effectiveness of frat diagnostic therapy on these variables (except obsessive thoughts) was different in ERP patients (p <0.05) and transdiagnostic treatment in reducing and experiential avoidance and improvement in, cognitive emotion regulation, are more effective than ERP treatment.
Conclusion: The results of the present study were discussed with regard to the studies conducted in this field and the content of the transdiagnostic treatment protocol and ERP treatment

کلیدواژه‌ها [English]

  • Obsessive-compulsive disorder
  • transdiagnostic treatment
  • exposure and prevention response therapy
منابع
1. Association, A. P. Diagnostic and statistical manual of mental disorders (DSM-5), American Psychiatric Pub. 2013.
2. Steketee, G. The Oxford Handbook of Obsessive Compulsive and Spectrum Disorders. Oxford University Press. 2011.
3. Kashdan, T. B., V. Barrios, J. P. Forsyth an.d M. F. Steger. Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies.Behaviour research and therapy. 2006; 44(9): 1301-20
4. Fledderus, M., E. T. Bohlmeijer and M. E. Pieterse Does experiential avoidance mediate the effects of maladaptive coping styles on psychopathology and mental health? Behavior modification. 2010; 34(6): 503-19.
5. Gross, J. J. and O. P. John. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of personality and social psychology. 2003; 85(2): 348.
6. Ochsner KN1Gross JJ. The cognitive control of emotion. Trends Cogn Sci. 2005; 9(5): 242-9
7. Campbell-Sills, L., & Barlow, D. H. (2007). Incorporating Emotion Regulation into Conceptualizations and Treatments of Anxiety and Mood Disorders. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 542-59). New York, NY, US: The Guilford Press.
8. Garnefski, N., Kraaij, V., & Spinhoven, P. Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual Differences.2001; 30(8), 1311-27.
9. Eddy, K. T., L. Dutra, R. Bradley & D. Westen. A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. Clinical psychology Review. 2004; 24(8): 1011-30.
10. Gillan, C., N. Fineberg and T. Robbins. A trans-diagnostic perspective on obsessive-compulsive disorder."Psychological medicine. 2017. 47(9): 1528-48.
11. Leonardo F. Fontenelle, Murat Y ü cel, A Transdiagnostic Approach to Obsessions, Compulsions and Related Phenomena, University Printing House, Cambridge CB2 8BS, United Kingdom. 2019.
12. Goodman, W., L. Price, S. Rasmussen, C. Mazure, R. Fleischmann, C. Hill, G. Heninger and D. Charney.Yale-brown obsessive compulsive scale (Y-BOCS).Arch gen psychiatry. 1989. 46: 1006-11.
13. Rajezi Esfahani S, Motaghipour Y, Kamkari K, Zahiredin A, Janbozorgi M. Reliability and Validity of the Persian Version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). IJPCP. 2012; 17 (4):297-303
14. Gámez, W., M. Chmielewski, R. Kotov, C. Ruggero and D. Watson.Development of a measurof experiential avoidance: The Multidimensional Experiential Avoidance Questionnaire. Psychological Assessment. 2011; 23(3): 692.
15. Esmaeilian, N؛ Dehghani, M؛ Akbari؛ Hasanvand, M. Evaluation of psychometric and factor structural properties of Experiential Avoidance multidimensional questionnaire.. Thought & Behavior in Clinical Psychology. 2016; (39)10: 57-66. [In Persian].
16. Hasani J. Reliability and validity of the short form of the cognitive emotion regulation questionnaire. Journal of Behavioral Sciences. 2011; 9: 229-40. [In Persian].
17. Frank, R. I., & Davidson. The transdiagnostic road map to case formulation and treatment planning: Practical guidance for clinical decision-making. Oakland, CA, US: New Harbinger Publications. 2014.
18. Stekette GS. Treatment of obsessive-compulsive disorder. Trans. Abbas Bakhshipoor and Majid Mahmood Aliloo. Tehran: Ravan Pooya Publication. 1997. [Persian].
19. Bakhshipour Roodsari, A؛ Aliloo, M, Farnam; Abdi, R, Efficacy Evaluation of Unified Transdiagnostic Treatment in Symptoms Reduction of Patients with Generalized Anxiety Disorder and a Comorbid Emotional Disorder. JMRP, 2013; 32(8): 41-74. [In Persian].
20. Saed, O. Comparing the efficacy of Trans-diagnostic Cognitive Behavior therapy versus pharmacological therapy on reducing symptoms severity of OCD with co-occurring anxiety and mood disorders (Dissertation). Shahid Beheshti University of Medical Sciences. 2015; 158-65. [In Persia].
21. Bilek, E. L.An Open Trial Investigation of Emotion Detectives: A Transdiagnostic Group Treatment for Children with Anxiety and Depression. 2011.
22. Ewing, D. L., J. J. Monsen, E. J. Thompson, S. Cartwright-Hatton and A. Field)A meta-analysis of transdiagnostic cognitive behavioural therapy in the treatment of child and young person anxiety disorders. Behavioural and cognitive psychotherapy. 2015; 43(5): 562-77.
23. Newby, J. M., A. McKinnon, W. Kuyken, S. Gilbody and T. Dalgleish. Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clinical psychology review. 2015; 40: 91-110.
24. Hooman, F., M. Mehrabizadeh Honarmand, Y. Zargar and I. Davodi. The Effectiveness of Transdiagnostic Therapy on Anxiety, Depression, Cognitive Strategies of Emotional Regulation, and General Performance in Women with Comorbid Anxiety and Depression. Journal of Fasa University of Medical Sciences. 2016; 5(4): 563-51. [In Persian].
25. Mohammadi, A., B. Birashk and B. Gharraee (2014). Comparison of the Effect of Group Transdiagnostic Treatment and Group Cognitive Therapy on Emotion Regulation. Iranian Journal of Psychiatry and Clinical Psychology. 2014; 19(3): 187-94. [In Persian].
26. M McEvoy, P.., M. L. Moulds and A. E. Mahoney. Mechanisms driving pre-and post-stressor repetitive negative thinking: Metacognitions, cognitive avoidance, and thought control." Journal of behavior therapy and experimental psychiatry. 2013; 44(1): 84-93.
27. Akbari M, Roshan R, Shabani A, Fata L, Shairi M R, Zarghami F. The Comparison of the Efficacy of Transdiagnostic Therapy Based on Repetitive Negative Thoughts with Unified Transdiagnostic Therapy in Treatment of Patients with Co-occurrence Anxiety and Depressive Disorders. A Randomized Clinical Trial. IJPCP. 2015; 21(2): 88-107. [In Persian].
28. Abdi, R, Bakhshi, A, Aliloo,M. Efficacy of Unified Transdiagnostic Treatment on Reduction of Transdiagnostic Factors and Symptoms Severity in Emotional Disorders. Journal management system.13(4): 1-27. [In Persian].