اثربخشی درمان شناختی- تحلیلی بر بهبود تحمل بلاتکلیفی و کاهش نگرانی و اجتناب تجربه‌ای بیماران مبتلا به اختلال وسواس فکری – عملی

نوع مقاله : مقاله پژوهشی

نویسنده

کارشناس ارشد روانشناسی عمومی، مؤسسه غیرانتفاغی غیردولتی شاندیز، مشهد، ایران.

چکیده

مقدمه: اختلال وسواس فکری- عملی بیماری جدی و ناتوان کننده است که با عوامل روان‌شناختی متعددی همبودی دارد. هدف از پژوهش حاضر، بررسی اثربخشی درمان شناختی- تحلیلی بر عدم تحمل بلاتکلیفی، نگرانی و اجتناب تجربه‌ای بیماران مبتلا به اختلال وسواس فکری – عملی بود.
روش: این پژوهش، نیمه آزمایشی با طرح پیش آزمون- پس آزمون همراه با گروه کنترل بود. جامعه آماری پژوهش شامل همه بیماران مبتلا به اختلال وسواس مراجعه کننده به مراکز مشاوره و مددکاری شهر مشهد در سال 1397 بودند که از بین آنها 30 نفر به‌صورت نمونه‌گیری هدفمند، انتخاب و به‌صورت تصادفی در دو گروه آزمایش 15نفر و کنترل 15نفر گمارده شدند. گروه آزمایش، تحت گروه درمانی شناختی - تحلیلی به مدت 8 جلسه 90 دقیقه‌ای در هرهفته دو جلسه قرار گرفتند. جهت جمع‌آوری داده‌ها از پرسشنامه‌های عدم تحمل بلاتکلیفی، نگرانی و اجتناب تجربه‌ای استفاده شد. داده‌ها با استفاده از آزمون تحلیل کوواریانس چندمتغیره تحلیل شدند.
یافته‌ها: نتایج نشان داد که با کنترل اثر پیش آزمون، بین میانگین نمرات پس‌آزمون گروه‌های آزمایش و گروه کنترل در متغیرهای عدم تحمل بلاتکلیفی، نگرانی و اجتناب تجربه‌ای، تفاوت معناداری وجود داشت.
نتیجه‌گیری: درمان شناختی – تحلیلی بر بهبود عدم تحمل بلاتکلیفی و کاهش نگرانی و اجتناب تجربه‌ای بیماران مبتلا به اختلال وسواس فکری- عملی مؤثر بود. با توجه به نتایج این پژوهش، پیشنهاد می‌شود تا روان‌شناسان و روان‌درمانگران از این درمان به عنوان مداخله‌ای اثربخش در جهت کاهش مشکلات روان‌شناختی بیماران مبتلا به سواس فکری- عملی بهره ببرند.

کلیدواژه‌ها

عنوان مقاله [English]

The effectiveness of cognitive-analytical therapy on improving uncertainty tolerance and reducing anxiety and avoiding experiences of patients with obsessive-compulsive disorder

نویسنده [English]

  • Kamran PourMohammad Ghouchani
MA. General Psychology, Shandiz nongovermental-nonprofit institute of higher education. Mashhad. Iran.
چکیده [English]

Abstract
Introduction: Obsessive compulsive disorder (OCD) is a serious and debilitating illness with a variety of comorbidities of other diseases. The  aim  of  the  present  research  was  to examining the effectiveness of cognitive-analytic therapy on improving intolerance of uncertainty & decreasing worry and experimental avoidance in patients with obsessive compulsive disorder.
Method: A semi-experimental randomized control trial design were choosen. The research population included all OCD patients referred to counseling and social worker centers in Mashhad in 2018. A total sample of 30 subjects were selected by purposive sampling and randomly divided to experimental and control groups(n=15). The experimental group received cognitive-analytic therapy for 8 sessions (two sessions a week). Data was collection by Intolerance of Uncertainty Scale (IUS), Worry and Experiential Avoidance Questionnaires. Data was analysis by Multivariate Analysis of Covariance.
Results: Significantly differences observed in posttest stage between experimental and control groups for intolerance of uncertainty, worry and experiential avoidance .
Conclusion: Cognitive-analytic therapy could effectively improve the intolerance of uncertainty, the worry and experiential avoidance in OCD patients. Application of this treatment to reduce the psychological problems of OCD patients is recommended to therapists and counsellors.

کلیدواژه‌ها [English]

  • Cognitive analytic therapy
  • intolerance of uncertainty
  • worry
  • experiential uncertainty
  • obsession disorder

مراجع

  1. Glass DJ. Factor structure of OCD: toward an evolutionary neuro-cognitive model of obsessive-compulsive disorder. A Thesis Submitted To The Department Of Psychology Of The State University Of New York At New Paltz In Partial Fulfillment Of The Requirements For The Degree Of Master of Arts In Psychology. 2012.
  2. Ranjbar Sudejani Y., Sharifi K., Sayyah SS., Malek Mohamadi Galeh Z. Effectiveness of intensive short-term dynamic psychotherapy on correcting irrational beliefs and reducing cognitive avoidance of people with obsessive compulsive disorder. Journal of Counseling Research. 2017; 16(62):140-169.
  3. Paknia N., Mirzaei A., Jahan J., RanjbarSudejani Y., Sayyah SS. To compare the effectiveness of confrontation / encontur and response prevention model with the dangerous ideation reduction method on reducing alexithymia and cognitive avoidance amonge obsessive disorder patients. Quarterly Journal of Psychological Studies. 2018; 14(1): 109-126.
  4. Nandrino J.L., Gandolphe M., Saloppe X., Daoudi M., Moustafa A., Haj, M. The face of memory: experiential avoidance and facial expressions during the retrieval of autobiographical memories. Journal of Cognitive Psychology.2019; 1(1): 1-30.
  5. Soleimani E., Azmode S., Habibi M. Modeling of cognitive avoidance and rhubarb structural relationships with clinical signs: Non-diagnostic OCD as a mediator. Journal of Arak University of Medical Sciences. 2017; 20(9): 44-33.
  6. Bardeen JR., Fergus TA. The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumaticstress symptoms. Journal of contextual behavioral science. 2016; 5(1): 1-6.
  7. Hershenberg R., Mavandadi S., Wright E., Thase ME. Anhedonia in the daily lives of depressed veterans: A pilot report on experiential avoidance as a moderator of emotional reactivity. Journal of Affective Disorders. 2017; 208(1): 414-417.
  8. Hayes SC., Levin ME., Plumb-Vilardaga J., Villatte JL., Pistorello J. Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy.J Behavior therapy. 2013; 44(2): 180-198.
  9. Levin M.E., Krafft J., Pierce B., Potts S. When is experiential avoidance harmful in the moment? Examining global experiential avoidanceas a moderator. Journal of Behavior Therapy and Experimental Psychiatry. 2018: 4(61): 158-163.
  10. Yarollahi NA., Shairi MR. Investigation the role of experiential avoidance on anticipation general health in non-clinical samples. Shenakht Journal of Psychology and Psychiatry. 2018; 5(3):1-11.
  11. Aftab R. The mediator role of interpersonal difficulties in relationship between experiential avoidancewith depression and anxiety. Journal of Applied Psychology. 2016; 4(40): 523-542.
  12. Abdi R, Kaboudi N. The role of an avoidant moderator in the relationship between anxiety sensitivity and perceived stress in students. Quarterly Journal of Thoughts and Behavior in Clinical Psychology. 2016; 10(40): 66-57.
  13. Bardeen JR, Fergus TA. The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms. Journal of Contextual Behavioral Science. 2016; 5(1): 1-6.
  14. Golmohammadian M., Morovati F., Rashidi A. To Predict the Concern of Body Image Based on Mindfulness, Experiential Avoidance and Metacognition Beliefs in Highschool Students. Iran Journal Health Educ Health Promot. 2018; 6(2): 168-178
  15. Borkovec T. The nature of worry in generalized anxiety disorder: A predominance of thought activity. Behav Res Ther. 1990; 28(2):153-158.
  16. Alexander JR., Houghton DC., Twohig, MP., Franklin, , Saunders SM., Neal-Barnett AM. Clarifying the relationship between Trichotillomania and anxiety. Journal Obsessive Compuls Relat Disord. 2017; 13: 30-34.
  17. Williams MO., Mathews A., Hirsch CR.Verbal worry facilitates attention to threat in high-worriers. Journal Behav Ther Exp Psychiatry. 2014; 45(1): 8-14.
  18. Stumper A., Danzig AP., Dyson MW., Olino TM., Carlson GA., Klein DN. Parents’ behavioral inhibition moderates association of preschoolers’ BI with risk for age 9 anxiety Journal Affect Disord. 2017; 2(10): 35-42.
  19. Ottaviani C., Borlimi R., Brighetti G., Caselli G., Favaretto E., Giardini I. Worry as an adaptive avoidance strategy in healthy controls but not in pathological worriers. Int Journal Psychophysiol. 2014; 93(3): 349-355.
  20. Peter, Lawrence DC., Murayama K., Creswell C. Systematic review and meta-analysis: Anxiety and depressive disorders in offspring of parents with anxiety disorders. Journal Am Acad Child Adolesc Psychiatry. 2019; 58(1): 46–60.
  21. Barlow DH. Clinical handbook of psychological disorders: A step-by-step treatment manual (4thed.). New York: Guilford Press. 2008.
  22. Lawrence PJ., Rooke SM., Creswell C. Review: prevention of anxiety among at-risk children and adolescentsea systematic review and meta-analysis. Child Adolesc Ment 2017; 22(3): 118-130.
  23. Abdolpour G., Hashemi T., Shairi MR., Alizadeh F. The relationship of the Intolerance of uncertainty and worry and metacognitive beliefs in people with depressive symptoms. Shenakht Journal of Psychology and Psychiatry. 2018; 5(2):15-26
  24. Chen S., Yao N., Qian M. The influence of uncertainty and intolerance of uncertainty on anxiety. Journal of Behavior Therapy and Experimental Psychiatry. 2018; 61(7): 60-65.
  25. Dugas MJ., Buhr K., Ladouceur R. The role of intolerance of uncertainty in etiology and maintenance. In: R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.). Generalized anxiety disorder: Advances in research and practice. New York: Guilford Press. 2004.
  26. Dar KA., Iqbal N., Mushtaq A. Intolerance of uncertainty, depression, and anxiety: Examining the indirect and moderating effects of worry. Asian Journal Psychiatry. 2017; 29(2): 129-133.
  27. Hirsch CR., Mathews AA. Cognitive model of pathological worry. Behav Res Ther. 2012; 50(10): 636- 646.
  28. Jensen D., Kind AJ., Morrison AS., Heimberg RG. Intolerance of uncertainty and immediate decision-making in high-risk situations. Journal Exp Psychopathol. 2014; 5(2):178-190.
  29. Gary I. The effect of worrying on intolerance of uncertainty and positive and negative beliefs about worry. Journal of Behavior Therapy and Experimental Psychiatry. 2019; 62(7): 65-71.
  30. Dabashi L., Najafi M., Rahimian Booger I. The effectiveness of cognitive-analytical group therapy on impulsivity and decomposition experiences in patients with borderline personality disorder. Journal of Clinical Psychology. 2018; 10(2): 15-27.
  31. Ryle A., Low J. Cognitive analytic therapy. Handbook of Psychotherapy Integration (Oxford Series in Clinical Psychology).
  32. Kellett, Stockton C., Marshall H., Hall J., Jennings C., Delgadillo J. Efficacy of narrative reformulation during cognitive analytic therapy for depression: Randomized dismantling trial. Journal of Affective Disorders. 2018; 239(15): 37-47.
  33. McCutcheon KL., Kerr AB., Chanen AM. Chapter 6 - Cognitive Analytic Therapy: A Relational Approach to Young People With Severe Personality Disorder. Journal of Case Formulation for Personality Disorders. 2019; 33(12): 95-111.
  34. Yosefi A., Rahimian-Boogar , Mohammad Rezaei A. The effectiveness of cognitive analytic therapy on mental health of patients with obsessive-compulsive disorder. Journal of Clinical Psychology. 2013; 5(3): 1-12.
  35. Thompson AR., Powis J., Carradice A. Community Psychiatric Nurses' experience of working with people who engage in deliberate self-harm. International Journal of Mental Health Nursing. 2008; 17(3): 153-161.
  36. Ganbari Hashem Abadi B., Chagosaz M., Ghaseminiaii F., Akbari Klor S., Mosavi S., Jadidi S. The effectiveness of cognitive-analytical group therapy on experiential avoidance and rumination in students with major depressive disorder. Journal of Psychological Studies. 2019: 15(3): 0-0. doi: 10.22051/psy.2019.25261.1876
  37. Rayner K, Thompson AR, Walsh S. Clients' experience of the process of change in cognitive analytic therapy. Psychology and Psychotherapy: Theory, Research and Practice. 2011; 84(3): 299-313.
  38. Bateman AW., Ryle A., Fonagy P., Kerr IB. Psychotherapy for borderline personality disorder: mentalization based therapy and cognitive analytic therapy compared. International Review of Psychiatry. 2007; 19(1): 51-62.
  39. Ryle A., Kerr I. Introducing cognitive analytic therapy: principles and practice. Chichester: John Wiley & Sons. 2002.
  40. Kellett S., Bennett D., Ryle T., Thake A. Cognitive analytic therapy for
    borderline personality disorder: Therapist competence and therapeutic effectiveness in nroutine practice. Clinical Psychology Psychotherapy. 2013; 20(3): 216-225.
  41. Freeston MH., Rheauma J., Litarte H., Dugas, MJ., Ladouceur R. Why do people worry?. Personality and Individual Difference. 1994; 17(6): 791- 802
  42. Buher K., Dugas MJ. The intolerance of uncertainty scale: Psychometric properties of the English version. Journal of Behave Research Therapy. 2002; 40(8): 931–945.
  43. Ebrahimzadeh Z. The study of cognitive beliefs perfectionism and social problem solving ability according to uncertainty levels among OCD and MDD. Dissertation in MA, Ardabil University. 2006.
  44. Molina S., Borkovec TD. The penn state worry questionnaire: psychometric properties and associated characteristics. Journal of Nervous and Mental Disease. 1994; 185(5): 314-319.
  45. R, Golzari M., Borjali A., Sohrabi F. Psychometrics particularity of farsi version of pennsylvania state worry questionnaire for college students. Journal of Clinical Psychology. 2010; 1(4): 67-75.
  46. Bond FW., Hayes SC., Baer R A., Carpenter KM., Guenole N., Orcutt HK., Zettle RD. Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy. 2011; 42(4): 676-688.
  47. Hayes SC., Strosahl K., Wilson KG., Bisset RT., Pistrollo J., Toarmino D., et al. Measuring experiential avoidance:A preliminary test of a working model. The Psychological Record. 2004; 54: 553-578.
  48. Abasi, E., FtiR L., Molodi R., Zarabi H. Psychometric properties of Persian Version of Acceptance and Action Questionnaire –II. Journal of Psychological Models and Methods. 2013; 2(10): 65-80.
  49. Ryle A., Kerr IB. Introducing cognitive analytic therapy. John Wiley & Sons Ltd. Sharma, R. 2012. Ego-strength in relation to adjustment of collegegoing students. Indian Streams Res J. 2011; 2(1): 1-4.

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  • تاریخ دریافت: 11 اردیبهشت 1399
  • تاریخ بازنگری: 05 خرداد 1400
  • تاریخ پذیرش: 02 تیر 1400

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