تاثیر برنامه آموزش حافظه رقابتی برسوگیری تفسیر دربیماران سرطانی دچاراختلال استرس پس از سانحه

نوع مقاله: مقاله پژوهشی

نویسندگان

1 نویسنده مسئول: دانشجوی دکتری روانشناسی شناختی، دانشگاه شهید بهشتی، پژوهشکده علوم شناختی و مغز، تهران، ایران

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

3 دکتری روانسنجی، عضو هیات علمی پژوهشکده علوم شناختی، گروه روانشناسی شناختی، پردیس، ایران

10.22075/jcp.2020.19781.1826

چکیده

چکیده
مقدمه: بر طبق راهنمای تشخیصی و آماری اختلالات روانی (DSM-5)، بیماری‌های پزشکی مانند سرطان زمانیکه ناگهانی و فاجعه بار باشند به عنوان رویدادی آسیب­زا در نظر گرفته می‌شوند و می‌تواند عاملی برای شروع اختلال استرس پس از سانحه باشد. هدف پژوهش حاضر بررسی تأثیر برنامه آموزش حافظه رقابتی بربهبود عملکرد سوگیری تفسیر در بیماران مبتلا به سرطان که دچار اختلال استرس پس از سانحه شده‌اند، می‌باشد.
روش: با روش پژوهش نیمه­آزمایشی یک نمونه 60 نفری از بیماران با تشخیص تازه سرطان با علایم استرس پس از سانحه انتخاب شد  و به  یک گروه مداخله آموزش حافظه اختصاصی(30 نفر) و گروه دوم شامل مداخله آموزش حافظه رقابتی(30 نفر)، تقسیم  شدند. ارزیابی‌های پیش­آزمون شامل سیاهه فهرست اختلال استرس پس از سانحه (PCL-5)  بود و  مجموعه‌ای از فیلم‌های کوتاه نیز به منظور بررسی سوگیری تفسیر بکار گرفته شد. گروه یک شش جلسه ۴۵ دقیقه‏ای و گروه 2 هفت جلسه ۴۵ دقیقه مداخله انفرادی دریافت کردند. کلیه ارزیابیها در مراحل پس از درمان و نیز پی گیری سه  ماهه اجرا شدند. داده‌ها با استفاده از تحلیل واریانس مختلط بررسی شد.
یافته‌ها: تحلیل نتایج حاکی از اثربخشی معنادار مداخله آموزش حافظه رقابتی در کاهش میزان سوگیری تفسیر  در بیماران سرطانی با علایم استرس پس از سانحه در قیاس با گروه آموزش حافظه رقابتی بود.
نتیجه‌گیری: ما نتیجه گرفتیم که مداخله آموزش حافظه رقابتی می­تواند به عنوان مداخله ای مؤثر در کاهش سوگیری تفسیر در افراد سرطانی دچار اختلال استرس پس از سانحه به کار رود.
 
 

کلیدواژه‌ها


عنوان مقاله [English]

Impacts of Competitive Memory Training Program on Interpretation-bias in Cancer Patients with Post-traumatic Stress Disorder

نویسندگان [English]

  • Sharareh Farahimanesh 1
  • ALIREZA MORADI 2
  • Meysam Sadeghi 3
1 Institute for cognitive science and study. Shahid Beheshti university
2 Tarbiat Modares University
3 Institute for cognitive science and study
چکیده [English]

Abstract
Introduction: According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), serious medical diseases, such as cancer, can be considered as a traumatic event while perceived as unexpected, sudden, and life-threatening. Diagnosis of life-threatening disease like cancer, can lead to the development of post-traumatic stress disorder (PTSD). The aim of the present study was to evaluate the effectiveness of a  competitive memory training (COMET) as an intervention on changing interpretation bias among newly diagnosed cancer patients suffering from PTSD.
Method: By a semi-experimental design a sample size of 60 newly diagnosed cancer patients suffering from PSTD were selected and randomly divided into the COMET group (N = 30) or the MEmory Specificity Training (MEST) group (N = 30). Pre-assessment included a Post-traumatic Stress Disorder Checklist (PCL) and a series of short clips applied to measure interpretation bias in the subjects. The COMET group received 6 weekly 45 min individual sessions, while the MEST group undergone 7 weekly 45 min individual sessions. All the assessments were re-conducted in the post-treatment and three-months follow-up stages. Data were analysed using mixed ANOVA analysis.
Results: The results indicated that COMET intervention significantly reduced the interpretation bias extent in the cancer patients with PTSD symptoms compared to the control  MEST group.
Conclusion: We concluded that COMET intervention can be used as an effective intervention to alleviate the interpretation bias among cancer-related post-traumatic stress disorder patients.

کلیدواژه‌ها [English]

  • Post Traumatic Stress Disorder
  • cancer
  • interpretation bias
  • competitive memory training
  • memory specificity training
منابع
1. Devine, K. A., Reed-Knight, B., Loiselle, K. A., Fenton, N., & Blount, R. L. (2010). Posttraumatic growth in young adults who experienced serious childhood illness: A mixed-methods approach. Journal of Clinical Psychology in Medical Settings, 17(4), 340-348.
2. Gurevich, M., Devins, G. M., & Rodin, G. M. (2002). Stress response syndromes and cancer: conceptual and assessment issues. Psychosomatics, 43(4), 259-281.
3. Wachen, J. S., Patidar, S. M., Mulligan, E. A., Naik, A. D., & Moye, J. (2014). Cancer‐related PTSD symptoms in a veteran sample: association with age, combat PTSD, and quality of life. PsychoOncology23(8), 921-927.
4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition: DSM-5. Arlington, VA: American Psychiatric Association. https://doi.org/10.1176/appi. books.97808 90425 596.
5. Ogińska-Bulik, N., & Michalska, P. (2019). The Relationship Between Emotional Processing Deficits and Posttraumatic Stress Disorder Symptoms Among Breast Cancer Patients: The Mediating Role of Rumination. Journal of Clinical Psychology in Medical Settings, 1-11.
6. Lepore, S. J. (2001). A social–cognitive processing model of emotional adjustment to cancer. In A. Baum & B. L. Andersen (Eds.), Psychosocial interventions for cancer (p. 99–116). American Psychological Association.
7. Horowitz, M. J. (1993). Stress-response syndromes. In International handbook of traumatic stress syndromes (pp. 49-60). Springer, Boston, MA.
8. Mathews, A., & MacLeod, C. (2005). Cognitive vulnerability to emotional disorders. Annu. Rev. Clin. Psychol., 1, 167-195.
9. Beck, A. T., & Clark, D. A. (1988). Anxiety and depression: An information processing perspective. Anxiety Research, 1(1), 23-36.
10. Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103(4), 670.
11. Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319-345.
12. Foa, E. B., Steketee, G., & Rothbaum, B. O. (1989). Behavioral/cognitive conceptualizations of post-traumatic stress disorder. Behavior Therapy, 20(2), 155-176.
13. Litz, B. T., & Keane, T. M. (1989). Information processing in anxiety disorders: Application to the understanding of post-traumatic stress disorder. Clinical Psychology Review, 9(2), 243-257.
14. Kimble, M. O., Kaufman, M. L., Leonard, L. L., Nestor, P. G., Riggs, D. S., Kaloupek, D. G., & Bachrach, P. (2002). Sentence completion test in combat veterans with and without PTSD: preliminary findings. Psychiatry Research, 113(3), 303-307.
15. Woud, M. L., Holmes, E. A., Postma, P., Dalgleish, T., & Mackintosh, B. (2012). Ameliorating intrusive memories of distressing experiences using computerized reappraisal training. Emotion, 12(4), 778.
16. Schartau PE, Dalgleish T, Dunn BD. Seeing the bigger picture: training in perspective broadening reduces self-reported affect and psychophysiological response to distressing films and autobiographical memories. Journal of abnormal psychology. 2009 Feb;118(1):15.
17. Berg AO. Treatment of posttraumatic stress disorder: an assessment of the evidence. Institute of Medicine.
18. Brewin CR. Understanding cognitive behaviour therapy: A retrieval competition account. Behaviour research and therapy. 2006 Jun 1;44(6):765-84.
19. Korrelboom K, Peeters S, Blom S, Huijbrechts I. Competitive memory training (COMET) for panic and applied relaxation (AR) are equally effective in the treatment of panic in panic-disordered patients. Journal of Contemporary Psychotherapy. 2014 Sep 1;44(3):183-90.
20. Hack TF, Pickles T, Ruether JD, Weir L, Bultz BD, Mackey J, Degner LF. Predictors of distress and quality of life in patients undergoing cancer therapy: impact of treatment type and decisional role. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer. 2010 Jun;19(6):606-16.
21. Sharifi V, Asadi SM, Mohammadi MR, Amini H, Kaviani H, Semnani Y, Shabanikia A, Shahrivar Z, Davari Ashtiani R, Hakim Shoushtari M, Sedigh A. Reliability and feasibility of the Persian version of the structured diagnostic interview for DSM-IV (SCID). Advances in cognitive science. 2004 Apr 10;6(1):10-22.
22. Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The ptsd checklist for dsm-5 (pcl-5). Scale available from the National Center for PTSD at www. ptsd. va. gov, 10.
23. Elwood LS, Williams NL, Olatunji BO, Lohr JM. Interpretation biases in victims and non-victims of interpersonal trauma and their relation to
 
symptom development. Journal of Anxiety Disorders. 2007 Jan 1;21(4):554-67.
24. Korrelboom K, de Jong M, Huijbrechts I, Daansen P. Competitive memory training (COMET) for treating low self-esteem in patients with eating disorders: A randomized clinical trial. Journal of consulting and clinical psychology. 2009 Oct;77(5):974.
25. Raes F, Williams JM, Hermans D. Reducing cognitive vulnerability to depression: A preliminary investigation of MEmory Specificity Training (MEST) in inpatients with depressive symptomatology. Journal of behavior therapy and experimental psychiatry. 2009 Mar 1;40(1):24-38.
26. Schneider, B. C., Wittekind, C. E., Talhof, A., Korrelboom, K., & Moritz, S. (2015). Competitive Memory Training (COMET) for OCD: a self-treatment approach to obsessions.Cognitive Behaviour Therapy, 44(2), 142-152.
27. Ekkers, W., Korrelboom, K., Huijbrechts, I., Smits, N., Cuijpers, P., & van der Gaag, M. (2011). Competitive Memory Training for treating depression and rumination in depressed older adults: A randomized controlled trial. Behaviour Research and Therapy, 49(10), 588-596.
28. Goddard L, Dritschel B, Burton A. The effects of specific retrieval instruction on social problem ‐ solving in depression. British Journal of Clinical Psychology. 2001 Sep; 40(3): 297-308
29. Jing HG, Madore KP, Schacter DL. Preparing for what might happen: An episodic specificity induction impacts the generation of alternative future events. Cognition. 2017 Dec 1; 169: 118-28.