اثربخشی روان درمانی پویشی فشرده کوتاه مدت در تجارب تجزیه‌ای، روابط موضوعی و نادیده‌انگاری پاداش تأخیری درافراد مبتلا به اختلالات اعتیادی و مصرف مواد

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی بالینی، دانشگاه شیراز، شیراز، ایران

2 استاد، گروه روانشناسی بالینی، دانشگاه شیراز، شیراز، ایران

3 دانشجوی دکتری روانشناسی، دانشگاه خوارزمی، تهران، ایران

چکیده

چکیده
مقدمه: هدف از پژوهش حاضر بررسی اثربخشی روان‌درمانی پویشی فشرده کوتاه‌مدت (ISTDP) در زمینه تجارب تجزیه‌ای، روابط موضوعی و نادیده‌انگاری پاداش تأخیری درافراد مبتلا به اختلالات اعتیادی و مصرف مواد بود.
روش: طرح پژوهش حاضر نیمه آزمایشی از نوع پیش آزمون- پس آزمون با گروه کنترل بود. نمونه این پژوهش 30 نفر از مردان مبتلا به سوء مصرف مواد در کلینیک‌های ترک اعتیاد شهر مریوان بودند که توسط روان‌پزشک مرکز و مصاحبه ساختار‌یافته انتخاب شدند. شرکت‌کنندگان به صورت تصادفی در دو گروه آزمایش (15) و کنترل(15) گمارده شدند و مقیاس تجارب تجزیه‌ای، روابط موضوعی و پرسشنامه انتخاب پاداش را در پیش آزمون و پس آزمون تکمیل نمودند. گروه آزمایش تحت 15 جلسه 90 دقیقه‌ای گروه درمانی درمان پویشی فشرده کوتاه‌مدت قرار گرفتند. برای تحلیل داده‌ها، از تحلیل کواریانس چند متغیره استفاده شد.
یافته‌ها: یافته‌های این پژوهش نشان داد که روان‌درمانی پویشی فشرده کوتاه‌مدت به شیوه گروهی، پس از 15 جلسه مداخله، اثر معنی داری در کاهش خرده مقیاس‌های تجارب تجزیه‌ای، روابط موضوعی و نادیده‌انگاری پاداش تأخیری گروه آزمایش نسبت به گروه کنترل داشت.
نتیجه‌گیری: نتایج پژوهش حاضر نشان داد که درمان پویشی فشرده کوتاه‌مدت به شیوه گروهی، راهبردی مؤثر در بهبود علائم تجارب تجزیه‌ای، روابط موضوعی و نادیده‌انگاری پاداش تأخیری درافراد مبتلا به اختلالات اعتیادی و مصرف مواد می‌باشد و می‌توان از آن به عنوان روش درمانی مؤثر بهره برد.

کلیدواژه‌ها


عنوان مقاله [English]

the Effectiveness of Intensive Short-Term Dynamic Psychotherapy in dissociative experiences, object relations and delayed reward discounting in patients with substance use disorders and addiction.

نویسندگان [English]

  • Farshad Ahmadi 1
  • Mohammadali Goodarzi 2
  • Seyed ali Kazemi rezaei 3
1 PhD student in Clinical Psychology, Shiraz University, Shiraz, Iran
2 Professor, Department of Clinical Psychology, Shiraz University, Shiraz, Iran
3 PhD student in Psychology, Kharazmi University, Tehran, Iran
چکیده [English]

Abstract
Introduction: The aim of this study was to investigate the Effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) in the domain of dissociative experiences, object relations and delayed reward discounting in patients with substance use disorders and addiction.
Method: This study was a semi-experimental research conducted in the form of pretest-posttest with control group. The sample of this study included 30 males with substance abuse disorder in the addiction treatment clinics in Marivan city of Iran. Patients were selected by an experienced psychiatrist and Structured Clinical Interview. Patients were randomly assigned either experimental (n=15) or control groups (n=15). Participants completed the Dissociative Experiences Scale-II (DES-II), Bell's object relation inventory (BORI) and the Monetary-Choice Questionnaire (MCQ) in the pretest and posttest. The experimental group received the Intensive Short-Term Dynamic Psychotherapy (ISTDP) for fifteen 90-minute sessions. Data were analyzed by multivariate covariance.
Results: The findings of this study showed that Intensive Short-Term Dynamic Psychotherapy (ISTDP) after 15 sessions had significant effects on dissociative experiences, object relations and delayed reward discounting of the experimental group compared to the control group.
Conclusion: The results of the current study showed that Intensive Short-Term Dynamic Psychotherapy (ISTDP) was an effective strategy to improve the symptoms of dissociative experiences, object relations and delayed reward discounting in patients with substance use disorders and addiction and can be used as an effective therapeutic approach.

کلیدواژه‌ها [English]

  • Substance Use
  • Dissociative experiences
  • Object relations
  • delayed reward discounting
  • intensive short-term dynamic psychotherapy
منابع
1. ­American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5th ed. Arlington, (VA): American Psychiatric Publishing; 2013.
2. ­Spears CA, Hedeker D, Li L, Wu C, Anderson NK, Houchins SC, et al. Mechanisms underlying mindfulness-based addiction treatment versus cognitive behavioral therapy and usual care for smoking cessation. Journal of Consulting and Clinical Psychology. 2017;85:1029–40.
3. ­Sweet AD. Aspects of internal self and object representations in disorganized attachment: clinical considerations in the assessment and treatment of chronic and relapsing substance misusers. British Journal of Psychotherapy.2013; 29 (2), 154–167.
4. Elizabeth F. H. Itzkowitz, S. The Dissociative Mind in Psychoanalysis: Understanding and Working with Trauma. Relational Perspectives Book Series: New York: Routledge. Exploring dissociation and dissociative identity disorder: A roundtable discussion؛ 2016.
5. ­Craparo G, Schimmenti A, Caretti V. Traumatic experiences in childhood and psychopathy: a study on a sample of violent offenders from Italy. European Journal of Psycho traumatology. 2013; 4: 10.3402/ejpt. v4i0.21471.
6. Najavits, L, Walsh M. Dissociation, PTSD, and Substance Abuse: An Empirical Study. J Trauma Dissociation. 2012; 13(1): 115–126.
7. Somer E, Altus L, Ginzburg K. Dissociative psychopathology among opioid use disorder patients: exploring the “chemical dissociation” hypothesis. Comprehensive Psychiatry. 2010; 51(4): 419–425.
8. Frederickson, J. J., Messina, I., & Grecucci, A. Dysregulated Anxiety and Dysregulating Defenses: Toward an Emotion Regulation Information Dynamic Psychotherapy. Frontier in Psychology. 2018; 9: 1-9.
9. Vonasch, A. J., Maranges, H. M., & Baumeister, R. F. Self-regulation, controlled processes, and the treatment of addiction. 2017.
10. Coffey, K. The Relationship between Attachment and Addiction. In New Directions in Treatment, Education, and Outreach for Mental Health and Addiction (pp. 73-79). Springer, Cham. Compulsivity. Psychopharmacology؛ 2018; 219(2): 251–252.
11. Waska, R. Addictions and the quest to control the object. Journal of the American Psychoanalytic Association؛ 2006; 66: 43–62.
12. Madden, G. J., & Bickel, W. K. (Eds). Impulsivity. The behavioral and neurological science of discounting (p. 453). Washington, DC: American Psychological Association. 2009.
13. MacKillop, J., Amlung, M. T., Few, L. R., Ray, L. A., Sweet, L. H., & Munaf, M. R. Delayed reward discounting and addictive behavior. A meta-analysis. Psycho pharmacology؛ 2011;216(3): 305–321.
14. Ahmadi F, Sarafraz M R, kazemi rezaei A. The Diagnostic Role of Object Relations and Defensive Mechanisms in Patients with Opioid abuse, Stimulant Users and Normal Individuals. 2020; 14(55): 192-169. [In Persian].
15. Kirby, K. N., Petry, N. M., & Bickel, W. K. Heroin addicts have higher discount rates for delayed rewards than non-drug-using controls. Journal of Experimental Psychology. General. 1999; 128(1): 78–87.
16. Robbins, T. W., Curran, H. V., & de Wit, H. Special issue on impulsivity and compulsivity. Psychopharmacology. 2012;219(2):251–252.
17. Vonasch, A. J., Maranges, H. M., & Baumeister, R. F. Self-regulation, controlled processes, and the treatment of addiction. In N. Heather & G. Segal (Eds.), Addiction and choice: Rethinking the relationship. 2017; 286–303. Oxford University Press.
18. Davanloo, H. Unlocking the Unconscious, selected papers of Habib Davanloo. New York: john Wiley & Sons. 1995.
19. Driessen, E., Cuijpers, P., Matt, S.C.D., Abbass, A.A., Jonghe, F.D., & Dekker, J.J.M. The efficacy of short-term psychodynamic psychotherapy for depression: meta-analysis. Department of Clinical Psychology.Clinical Psychology Review؛ 2009; (30):25–36.
20. Johnson, M. W., & Bickel, W. K. Within-subject comparison of real and hypothetical money rewards in delay discounting. Journal of the Experimental Analysis of Behavior. 2002; 77(2): 129–146.
21. Frederickson, J. J., Messina, I., &Grecucci, A. Dysregulated Anxiety and Dysregulating Defenses: Toward an Emotion Regulation Information Dynamic Psychotherapy. Frontier in Psychology. 2018;9:1-9.
22. Pennebaker, J. W. Opening up: the healing power of expressing emotion. New York: Guilford. Psychoanalytic Perspectives. 1997; 12(1): 39–79.
23. Driessen, E., Cuijpers, P., Matt, S.C.D., Abbass, A.A., Jonghe, F.D., Dekker, J.J.M. The efficacy of short-term psychodynamic psychotherapy for depression: meta-analysis. Department of Clinical Psychology. 2009.
24. Abbass, A., Hancock, JT., & Kisely, S. Short term psycho dynamic psychotherapies for common mental disorders. Systematic Reviews in Pharmacy Journal. 2006.;18(4): CD004687.
25. Shedler, J. The efficacy of psychodynamic psychotherapy. American Psychologist Journal. 2010; 65(2): 98-109.
26. Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. Journal of nervous and mental disease. 1986.
27. Hosseinzadeh A, Taghizadeh M E. Mind simulation model; an effective treatment to decreasing dissociative experiences caused by traumatic events in adult with stuttering disorder. Shenakht Journal of Psychology and Psychiatry. 2020; 7 (1):90-102. [In Persian].
28. Körlin D, Edman G, Nybäck H. (Reliability and validity of a Swedish version of the Dissociative Experiences Scale (DES-II). Nordic Journal of Psychiatry. 2007; 61 (2): 126-42.
29. Olsen SA, Beck JG. The effects of dissociation on information processing for analogue trauma and neutral stimuli: A laboratory study. Journal of anxiety disorders. 2012; 26(1): 225-32.
30. Bell, M. D. Bell Object Relations Inventory for Adolescents and Children: Reliability, validity, and factorial invariance. Journal of Personality Assessment. 2003; 80 (1): 19-25.
31. Zarrati I, bermas H, Sabet M. Correlation between Childhood Trauma and Suicidal Ideation by Mediation of Mental Pain and Object Relations. JHPM. 2020; 9 (3):34-48. [In Persian].
32. Bell, M. D. Bell Object Relations and Reality Testing Inventory (BORRTI) manual. LosAngeles: Western Psychological Services. 1995.
33. Overall, J. E., & Gorham, D. R. The Brief Psychiatric Rating Scale. Psychological Reports. 1962; 10: 799- 812.
34. Ahmadi F, Hasani J, Moradi A, saeidpoor S. The diagnostic role of delayed reward discounting and sensation seeking in substance use stimulant and opiate disorders. 2017; 10(40): 201- 216. [In Persian].
35. Ahmadi F, Hasani J, Saeidpoor S. The Diagnostic Role of Delayed Reward Discounting and Cognitive Emotion Regulation Strategies in Individuals with Stimulant Abuse, Opiate Abuse, and Smoking Disorders. 2018; 12 (45):71-90. [In Persian].
36. Johansson, R., Town, J. M., & Abbas, A. Davanloo's intensive short-term dynamic psychotherapy in a tertiary psychotherapy service: overall effectiveness and association between unlocking the unconscious and outcome. Peer Journal. (2014); 2(1): 1-20.
37. Lagorio, C. H., & Madden, G. J. Delay discounting of real and hypothetical rewards III. Steady-state assessments, forced-choice trials, and all real rewards. Behavioral Processes. (2005); 69(2):173–187.
38. Robbins, T. W., Curran, H. V., & de Wit, H. Special issue on impulsivity and compulsivity. Psychopharmacology؛ (2012); 219(2): 251–252.
39. Brewer JA, Elwafi HM, Davis JH. Craving to quit: psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions. Psychology of Addictive Behaviors. 2013; 27(2): 366-79.
40. Kim, H. S., & Hong, M. PO-13: the addiction and attachment characteristics of runaway adolescents in Korea. Journal of Behavioral Addictions. 2016; 5(S1): 51-52.
41. Abbass A. The emergence of psychodynamic psychotherapy for treatment resistant patients: intensive short-term dynamic psychotherapy. Psychodynamic Psychiatry. 2016; 44:245–280.