اثربخشی مداخله شناختی-رفتاری ویدئویی بر اضطراب سلامت و حساسیت اضطرابی افراد با سطوح بالای اضطراب کووید-19

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناسی ارشد روانشناسی عمومی، دانشکده روانشناسی و علوم تربیتی، دانشگاه تهران، تهران، ایران

2 کارشناسی ارشد روانشناسی عمومی، دانشکده ادبیات و علوم انسانی، دانشگاه گیلان، رشت، ایران.

3 کارشناسی زبان و ادبیات عربی، دانشگاه شیراز، شیراز، ایران.

4 دانشجو دکتری تخصصی روانشناسی، دانشگاه گیلان، رشت، ایران.

چکیده

مقدمه: مداخلات شناختی-رفتاری به عنوان درمان‌های صف اول در اختلالات اضطرابی شناخته می‌شوند. با این حال، پیچیدگی‌های همچون قرنطینه، ارائه چهره به چهره مداخله را دشوار کرده است. هدف از پژوهش حاضر بررسی اثربخشی مداخله شناختی-رفتاری ویدئویی بر اضطراب سلامت و حساسیت اضطرابی افراد با سطوح بالای اضطراب کووید-19 است. روش: پژوهش حاضر یک مطالعه نیمه آزمایشی با طرح پیش‌آزمون–پس‌آزمون با گروه کنترل بود. بر طبق معیارهای اصول تشخیصی اضطراب سلامت در راهنمای تشخیصی و آماری اختلالات روانی-نسخه پنجم و پرسشنامه اضطراب کووید-19، 138 شرکت‌کننده با سطوح بالای اضطراب کووید-19 به شیوه نمونه‌گیری در دسترس انتخاب و به صورت تصادفی در دو گروه آزمایش (69=n) و کنترل (69=n) گمارده شدند. گروه آزمایش در مقایسه با گروه کنترل، 10 جلسه مداخله شناختی-رفتاری ویدئویی دریافت کردند. ابزارهای پژوهش شامل پرسشنامه اضطراب کووید-19، سنجه کوتاه اضطراب سلامت، و شاخص حساسیت اضطرابی بودند. در نهایت، داده‌ها با استفاده از روش آماری مانکوا تحلیل شدند. یافته‌ها: نتایج این پژوهش نشان داد که مداخله شناختی-رفتاری منجر به کاهش اضطراب سلامت و حساسیت اضطراب شرکت‌کنندگان گروه آزمایش شد (001/0 >p). در این بین، مداخله حاضر برای مؤلفه‌های اضطراب سلامت کارآمدتر بوده است. نتیجه‌گیری: با توجه به اضطراب گسترده جامعه در مورد کووید-19 و همچنین پیچیدگی‌های ارائه چهره به چهره درمان شناختی-رفتاری، استفاده از مداخله شناختی-رفتاری ویدئویی می‌تواند روشی فوری، مختصر و ارزان قیمت بر بهبود سلامت روانی جامعه باشد. .

کلیدواژه‌ها


عنوان مقاله [English]

Effectiveness of Video-Based Cognitive-Behavioral Intervention on Health Anxiety and Anxiety Sensitivity of Individuals with High Levels of COVID-19 Anxiety

نویسندگان [English]

  • Reza Shabahang 1
  • Farzin Bagheri Sheykhangafshe 2
  • Maryam Dadras 3
  • Seyyedeh Zahra Seyed Noori 4
1 M.A in General Psychology, Faculty of Psychology and Educational Sciences, Tehran University, Tehran, Iran.
2 M.A in General Psychology, Faculty of Literature and humanity sciences, University of Guilan, Rasht, Iran.
3 B.A in Arabic Language and Literature, University of Shiraz, Shiraz, Iran.
4 PhD Candidate in Psychology, University of Guilan, Rasht, Iran.
چکیده [English]

Introduction: Cognitive-behavioral interventions are known as first-line treatments for anxiety disorders. However, complexities such as quarantine have made it difficult to provide face-to-face intervention. The aim of the present study was to investigate the effectiveness of video-based cognitive-behavioral intervention on health anxiety and anxiety sensitivity of individuals with high levels of COVID-19 anxiety. Method: The present study was semi-experimental study with pre-test and post-test design with the control group. According to the principles of diagnosis of health anxiety in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition and COVID-19 Anxiety Questionnaire, 138 participants with high levels of COVID-19 anxiety were selected by convenience sampling method and randomly assigned into two groups of experimental (n = 69) and control (n = 69). The experimental group received 10-session video-based cognitive-behavioral intervention compared to the control group. The research instruments included the COVID-19 Anxiety Questionnaire, the Short Health Anxiety Inventory, and the Anxiety Sensitivity Index. At the end, the data were analyzed by using statistical method of MANCOVA. Results: The results of this study showed that cognitive-behavioral intervention led to a reduction in health anxiety and anxiety sensitivity of experimental group participants (p < 0.001). In the meantime, the present intervention has been more effective for the components of health anxiety. Conclusion: Due to the widespread public anxiety about COVID-19 as well as the complexities of face-to-face cognitive-behavioral therapy, the use of video-based cognitive-behavioral intervention can be an immediate, concise, and inexpensive way to improve mental health of the community.

کلیدواژه‌ها [English]

  • COVID-19
  • cognitive-behavioral therapy
  • Video-based intervention
  • Health anxiety
  • Anxiety Sensitivity
منابع
1. Huang X, Wei F, Hu L, Wen L, Chen K. Epidemiology and Clinical Characteristics of COVID-19. Archives of Iranian medicine. 2020;23(4):268-71.
2. Shigemura J, Ursano RJ, Morganstein JC, Kurosawa M, Benedek DM. Public responses to the novel 2019 coronavirus (2019-nCoV) in Japan: Mental health consequences and target populations. Psychiatry and clinical neurosciences. 2020;74(4):281-2.
3. Sederdahl BK, Williams JV. Epidemiology and Clinical Characteristics of Influenza C Virus. Viruses. 2020;12(1).
4. Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: An overview. Journal of the Chinese Medical Association: JCMA. 2020;83(3):217-20.
5. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. General psychiatry. 2020;33(2):e100213.
6. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. International journal of environmental research and public health. 2020;17(5).
7. Marcus DK, Gurley JR, Marchi MM, Bauer C. Cognitive and perceptual variables in hypochondriasis and health anxiety: a systematic review. Clinical psychology review. 2007;27(2):127-39.
8. Abramowitz JS, Deacon BJ, Valentiner DP. The Short Health Anxiety Inventory: Psychometric Properties and Construct Validity in a Non-clinical Sample. Cognit Ther Res. 2007;31(6):871-83.
9. Abramowitz JS, Schwartz SA, Whiteside SP. A contemporary conceptual model of hypochondriasis. Mayo Clinic proceedings. 2002;77(12):1323-30.
10. Wheaton MG, Abramowitz JS, Berman NC, Fabricant LE, Olatunji BO. Psychological predictors of anxiety in response to the H1N1 (swine flu) pandemic. Cognit Ther Res. 2012;36(3):210-8.
11. Jones JH, Salathe M. Early assessment of anxiety and behavioral response to novel swine-origin influenza A(H1N1). PloS one. 2009;4(12):e8032.
12. Barr M, Raphael B, Taylor M, Stevens G, Jorm L, Giffin M, et al. Pandemic influenza in Australia: using telephone surveys to measure perceptions of threat and willingness to comply. BMC infectious diseases. 2008;8:117.
13. Cowling BJ, Ng DM, Ip DK, Liao Q, Lam WW, Wu JT, et al. Community psychological and behavioral responses through the first wave of the 2009 influenza A(H1N1) pandemic in Hong Kong. The Journal of infectious diseases. 2010;202(6):867-76.
14. Saadatian-Elahi M, Facy F, Del Signore C, Vanhems P. Perception of epidemic's related anxiety in the general French population: a cross-sectional study in the Rhone-Alpes region. BMC public health. 2010;10:191.
15. Bults M, Beaujean DJ, de Zwart O, Kok G, van Empelen P, van Steenbergen JE, et al. Perceived risk, anxiety, and behavioural responses of the general public during the early phase of the Influenza A (H1N1) pandemic in the Netherlands: results of three consecutive online surveys. BMC public health. 2011;11:2.
16. Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushal V. Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian J Psychiatr. 2020;51:102083-.
17. Benítez CIP, Shea MT, Raffa S, Rende R, Dyck IR, Ramsawh HJ, et al. Anxiety sensitivity as a predictor of the clinical course of panic disorder: a 1-year follow-up study. Depress Anxiety. 2009;26(4):335-42.
18. Mantar A, Yemez B, Alkin T. Anxiety sensitivity and its importance in psychiatric disorders. Turk psikiyatri dergisi = Turkish journal of psychiatry. 2011;22(3):187-93.
19. Olatunji BO, Wolitzky-Taylor KB, Elwood L, Connolly K, Gonzales B, Armstrong T. Anxiety Sensitivity and Health Anxiety in a Nonclinical Sample: Specificity and Prospective Relations with Clinical Stress. Cognit Ther Res. 2009;33(4):416-24.
20. Brand J, McKay D, Wheaton MG, Abramowitz JS. The relationship between obsessive compulsive beliefs and symptoms, anxiety and disgust sensitivity, and Swine Flu fears. J Obsessive Compuls Relat Disord. 2013;2(2):200-6.
21. Leonidou C, Panayiotou G. How do illness-anxious individuals process health-threatening information? A systematic review of evidence for the cognitive-behavioral model. Journal of psychosomatic research. 2018;111:100-15.
22. Rimes KA, Salkovskis PM, Jones L, Lucassen AM. Applying a cognitive behavioral model of health anxiety in a cancer genetics service. Health psychology: official journal of the Division of Health Psychology, American Psychological Association. 2006;25(2):171-80.
23. Taylor S. Understanding and treating health anxiety: A cognitive-behavioral approach. Cognitive and Behavioral Practice. 2004;11(1):112-23.
24. Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. The Journal of clinical psychiatry. 2008;69(4):621-32.
25. Hofmann SG, Wu JQ, Boettcher H. Effect of cognitive-behavioral therapy for anxiety disorders on quality of life: a meta-analysis. Journal of consulting and clinical psychology. 2014;82(3):375-91.
26. Mollanorouzi H, Issazadegan A, soleymany E. The Comparison of Adlerian Treatment and Cognitive-Behavioral Therapy (CBT) on Clinical Symptoms in Generalized Anxiety Disorder (GAD). Journal of Sabzevar University of Medical Sciences. 2019;25(6):865-73.
27. Barsky AJ, Ahern DK. Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. Jama. 2004;291(12):1464-70.
28. Greeven A, van Balkom AJ, Visser S, Merkelbach JW, van Rood YR, van Dyck R, et al. Cognitive behavior therapy and paroxetine in the treatment of hypochondriasis: a randomized controlled trial. The American journal of psychiatry. 2007;164(1):91-9.
29. Hedman E, Axelsson E, Andersson E, Lekander M, Ljotsson B. Exposure-based cognitive-behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: randomised controlled trial. The British journal of psychiatry: the journal of mental science. 2016;209(5):407-13.
30. Seivewright H, Green J, Salkovskis P, Barrett B, Nur U, Tyrer P. Cognitive-behavioural therapy for health anxiety in a genitourinary medicine clinic: randomised controlled trial. The British journal of psychiatry: the journal of mental science. 2008;193(4):332-7.
31. Sorensen P, Birket-Smith M, Wattar U, Buemann I, Salkovskis P. A randomized clinical trial of cognitive behavioural therapy versus short-term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis. Psychological medicine. 2011;41(2):431-41.
32. Sumathipala A, Siribaddana S, Abeysingha MRN, De Silva P, Dewey M, Prince M, et al. Cognitive-behavioural therapy v. structured care for medically unexplained symptoms: randomised controlled trial. The British journal of psychiatry: the journal of mental science. 2008;193(1):51-9.
33. Alimehdi m, Ehteshamzadeh P, Naderi F, Eftekhaesaadi Z, Pasha R. The effectiveness of cognitive-behavioral therapy on intolerance of uncertainty and anxiety sensitivity in patients with generalized anxiety disorder. Thoughts and Behavior in Clinical Psychology. 2016;10(38):77-86.
34. Alimehdi M, Ehteshamzadeh P, Naderi F, Eftekharsadi Z, Pasha R. A Comparative Study of the Effectiveness of Cognitive Behavioral Therapy and Mindfulness Based Stress Reduction on Anxiety Sensitivity and Symptoms of Generalized Anxiety Disorder. Middle Eastern Journal of Disability Studies. 2017;7(0):73-.
35. Narimani M, Taklavi S, Abolghasemi A, Mikaili N. The effectiveness of applied relaxation training based on mindfulness and cognitive-behavioral therapy on anxiety sensitivity of women with generalized anxiety disorder. 2014.
36. Smits JA, Berry AC, Tart CD, Powers MB. The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: a meta-analytic review. Behaviour research and therapy. 2008;46(9):1047-54.
37. Watt MC, Stewart SH, Lefaivre MJ, Uman LS. A brief cognitive-behavioral approach to reducing anxiety sensitivity decreases pain-related anxiety. Cognitive behaviour therapy. 2006;35(4):248-56.
38. Savard J, Ivers H, Savard MH, Morin CM. Long-Term Effects of Two Formats of Cognitive Behavioral Therapy for Insomnia Comorbid with Breast Cancer. Sleep. 2016;39(4):813-23.
39. Hedman E, Lindefors N, Andersson G, Andersson E, Lekander M, Ruck C, et al. Predictors of outcome in Internet-based cognitive behavior therapy for severe health anxiety. Behaviour research and therapy. 2013;51(10):711-7.
40. Edition F. Diagnostic and statistical manual of mental disorders. Am Psychiatric Assoc. 2013.
41. Nourisaeid A, Shabahang R, Bagheri Sheykhangafshe F, Saeedi M, Mousavi M. Comparison of Online Health Information Utilization, Online Shared Identity, and Online Shared Information Usage in Different Levels of COVID-19 Anxiety. Journal of Research in Psychological Health. 2020;14(1):28-39.
42. Shabahang R, Aruguete M, McCutcheon L. Video-based cognitive-behavioral intervention for COVID-19 anxiety: A randomized controlled trial. Trends in psychiatry and psychotherapy. In press.
43. Alberts NM, Hadjistavropoulos HD, Jones SL, Sharpe D. The Short Health Anxiety Inventory: a systematic review and meta-analysis. Journal of anxiety disorders. 2013;27(1):68-78.
44. nargesi f, izadi f, kariminejad k, rezaii sharif a. The investigation of the reliability and validity of Persian version of Health anxiety questionnaire in students of Lorestan University of Medical Sciences. Quarterly of Educational Measurement. 2017;7(27):147-60.
45. Taylor S, Zvolensky MJ, Cox BJ, Deacon B, Heimberg RG, Ledley DR, et al. Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3. Psychological assessment. 2007;19(2):176-88.
46. Petrocchi N, Tenore K, Couyoumdjian A, Gragnani A. The Anxiety Sensitivity Index-3: Factor structure and psychometric properties in Italian clinical and non-clinical samples. BPA-Applied Psychology Bulletin (Bollettino di Psicologia Applicata). 2014;62(269).
47. Foroughi AA, Mohammadpour M, Khanjani S, Pouyanfard S, Dorouie N, Parvizi Fard AA. Psychometric properties of the Iranian version of the Anxiety Sensitivity Index-3 (ASI-3). Trends in psychiatry and psychotherapy. 2019;41(3):254-61.
48. Tyrer P, Cooper S, Tyrer H, Salkovskis P, Crawford M, Green J, et al. CHAMP: Cognitive behaviour therapy for health anxiety in medical patients, a randomised controlled trial. BMC psychiatry. 2011;11:99.
49. Salkovskis PM, Warwick HM, Deale AC. Cognitive-Behavioral Treatment for Severe and Persistent Health Anxiety (Hypochondriasis). Brief Treatment & Crisis Intervention. 2003;3(3).
50. Rachman S. Health anxiety disorders: a cognitive construal. Behaviour research and therapy. 2012;50(7-8):502-12.
51. Surawy C, McManus F, Muse K, Williams JM. Mindfulness-Based Cognitive Therapy (MBCT) for Health Anxiety (Hypochondriasis): Rationale, Implementation and Case Illustration. Mindfulness. 2015;6(2):382-92.
52. Warwick HM, Salkovskis PM. Hypochondriasis. Behaviour research and therapy. 1990;28(2):105-17.
53. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci. 2015;17(3):337-46.
54. Asghari E, Faramarzi M, Mohammmadi AK. The Effect of Cognitive Behavioural Therapy on Anxiety, Depression and Stress in Women with Preeclampsia. J Clin Diagn Res. 2016;10(11):QC04-QC7.
55. Lotfi Kashani F, Behzadi S, Yari M. The efficacy of cognitive-behavior group therapy on quality of life and anxiety among patients with irritable bowel syndrome. MEDICAL SCIENCES JOURNAL. 2013;22(4):301-6.
56. Feldner MT, Zvolensky MJ, Stickle TR, Bonn-Miller MO, Leen-Feldner EW. Anxiety sensitivity-physical concerns as a moderator of the emotional consequences of emotion suppression during biological challenge: an experimental test using individual growth curve analysis. Behaviour research and therapy. 2006;44(2):249-72.
57. Nowakowski ME, Rowa K, Antony MM, McCabe R. Changes in Anxiety Sensitivity Following Group Cognitive-Behavior Therapy for Social Anxiety Disorder and Panic Disorder. Cognit Ther Res. 2016;40(4):468-78.
58. Ebert DD, Nobis S, Lehr D, Baumeister H, Riper H, Auerbach RP, et al. The 6-month effectiveness of Internet-based guided self-help for depression in adults with Type 1 and 2 diabetes mellitus. Diabetic medicine: a journal of the British Diabetic Association. 2017;34(1):99-107.
59. Etzelmueller A, Radkovsky A, Hannig W, Berking M, Ebert DD. Patient's experience with blended video- and internet based cognitive behavioural therapy service in routine care. Internet Interv. 2018;12:165-75.
60. Savard J, Ivers H, Savard MH, Morin CM. Is a video-based cognitive behavioral therapy for insomnia as efficacious as a professionally administered treatment in breast cancer? Results of a randomized controlled trial. Sleep. 2014;37(8):1305-14.
61. Buntrock C, Ebert DD, Lehr D, Cuijpers P, Riper H, Smit F, et al. Evaluating the efficacy and cost-effectiveness of web-based indicated prevention of major depression: design of a randomised controlled trial. BMC psychiatry