اثر بخشی درمان فراشناختی به شیوه گروهی بر افسردگی و نشخوار فکری زنان مبتلا به سرطان پستان

نوع مقاله: علمی- پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی سلامت، دانشگاه آزاد اسلامی واحد کرج، کرج، ایران. )نویسنده مسئول 1

2 کارشناس ارشد روانشناسی بالینی، دانشگاه علوم پزشکی لرستان، خرم آباد، ایران.

3 دانشجوی دکتری روانشناسی بالینی، دانشگاه علم و فرهنگ، تهران، ایران.

4 دانشجوی دکتری روانشناسی سلامت، دانشگاه آزاد اسلامی واحد کرج، کرج، ایران.

5 کارشناس ارشد روانشناسی بالینی، دانشگاه آزاد اسلامی واحد علوم تحقیقات تهران، ایران.

چکیده

هدف: توجه به علائم روانشناختی بیماران سرطان پستان به دلیل تاثیر نیرومند بر ابتلا، سیر و پیش­آگهی این بیماری، بسیار مهم است. پژوهش حاضر با هدف  بررسی اثر بخشی درمان فراشناختی به شیوه گروهی بر افسردگی و نشخوار فکری زنان مبتلا به سرطان پستان انجام شد.
روش:  پژوهش حاضر، نیمه­آزمایشی با پیش­آزمون-پس­آزمون و دوره پیگیری (2 ماه و 4 ماه) بود که در اسفند 1391 تا اردیبهشت 1392 انجام شد. در این پژوهش 24  نفر از بیماران مبتلا به سرطان پستان مراجعه­کننده به بیمارستان امام حسین شهر تهران به شیوه نمونه­گیری دردسترس انتخاب شدند و به صورت تصادفی در دو گروه درمان فراشناختی (n=12) و گروه گواه (n=12) قرار گرفتند و با استفاده از مصاحبه ساختار­یافته بالینی (SCID)، پرسشنامه اضطراب، افسردگی و استرس (DASS-21) و پرسشنامه نشخوار فکری (RRS) مورد پیش­آزمون قرار گرفتند. سپس گروه آزمایش به مدت 8 جلسه تحت آموزش درمان فراشناختی قرار گرفت و گروه گواه هیچ مداخله­ایی دریافت نکرد. در پایان هر دو گروه مورد پس­آزمون و 2 مرحله پیگیری (2 ماه و 4 ماه) قرار گرفتند و داده­ها با استفاده از نرم­افزار 20-SPSS و روش تحلیل کوواریانس چند متغیره مورد تجزیه و تحلیل قرار گرفتند.
یافته­ها: پژوهش حاضر نشان داد که بین دو گروه آزمایش و گواه پس از اجرای درمان فراشناختی تفاوت معناداری وجود دارد) 005/0> .(P به طوری­که، میانگین نمره افسردگی و نشخوار فکری گروه آزمایش نسبت به گروه کنترل کاهش یافت.
نتیجه­ گیری: با توجه به نتایج پژوهش که نشان داد درمان فراشناختی در کاهش علائم افسردگی و نشخوار فکری زنان مبتلا به سرطان پستان موثر می­باشد، می­توان پیشنهاد داد که به غربالگری روانشناختی بیماران مبتلا به سرطان پرداخته و بیماران نیازمند مداخله طی کارآزمایی­های بالینی مناسب مورد توجه قرار بگیرند.

کلیدواژه‌ها


عنوان مقاله [English]

Effectiveness of Meta-Cognitive Therapy on Depression and Rumination in Women with Breast Cancer

نویسندگان [English]

  • Soheila Rahmani 1
  • Samaneh Mohammad pour 2
  • Bijan Pirnia 3
  • Eshagh Samekhanian 4
  • Abed Mahdavi 5
2 M.A in psychology, Lorestan Medical Siences University, Khoram abad, Iran.
3 PhD Student of Clinical Psychology
4 Phd Student of Health Psychology, Islamic Azad University, Karaj, Iran.
5 M.A in Psychology, Islamic Azad University, Tehran, Iran.
چکیده [English]

Objective: Attending to the psychological symptom in patient with breast cancer because of strong influence on Incidence, progression and prognosis of this disease is very important. The aim of present study was investigating the Effectiveness of Meta-Cognitive Therapy on Depression and Rumination in Women With Breast Cancer.
 
Methods: This research was semi-experimental with pretest-posttest and follow-up (2 & 4 Month) from February to May in 2013. In this study 24 Patient with breast cancer who attended to Imam Hosein Hospital in Tehran city were selected by convenience sampling method and randomly were assigned in 2 experimental group (n=12) and control group (n=12) and Structured Clinical Interview (SCID), Depression Anxiety and Stress Scale (DASS-21) and Ruminative Response Scale were administrated as pretest. In the end, post-test and 2 step follow-up (2 & 4 month) was administrated on two groups and data were analyzing with SPSS-20 software and multivariate covariance analysis.
 
Results: The results of the present study indicated that after administrated Meta-Cognitive Therapy there were significant differences between the control and experimental groups (p.
 
Conclotion: Considering the result of study that showed Meta-cognitive therapy in reduction of depression and rumination is effective, can be recommended that psychological screening in patient with breast cancer and attention to appropriate clinical trials for patient. 

کلیدواژه‌ها [English]

  • Meta-Cognitive Therapy
  • Depression
  • rumination
  • breast cancer
Bagheri Nezhad M, Salehi Fadardi J, Tabatabyi M. Correlation between rumination and depression  in Iranian student sample. stud in Education and Psychol. 2010;(1)11:21-38.[Persian].

BanhoferT, CraneC, HarguseE, AmrasingheM, WinderR, Williams JMG. Mindfulness - based cognitive therapy as a treatment for chronic depression: A preliminary study. Behav Res Ther 2009; 47(3): 366-73.

Bergersen H, Foslie F, SunnerhagenKS, SchankAK. Anxiety, depression, and psychological well-being 2 to 5 years post stroke. J Stroke Cerebrovasc Dis 2011; 23(2): 1-6.

Brandao, T., Tavares, R., Schulz, M.S & Mena-Matos, P. (2016). Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review. Clinical Psychology Review. 43: 114-127.

First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B.W.,& Benjamin, L.Structured Clinical Interviewfor DSM-IV Axis II Disorders (SCID-II). Washington,DC: American Psychiatric Association 1997.

Fissher, P & Wells, A. (2008). Meta-cognitive therapy for obsessive – compulsive disorder: Acase series. J Behav Ther Exp Psychiatry. 2008: 39; 117-32.

Hasanvandi, S., Valizade, M & Mehrabizadeh Honarmand, M. (2013). Effect of group metacognitive therapy on depression symptoms and rumination. Journal Of Fundamentals Of Mental Health. 15 (57): 71-81.

Henry J D, and Crawford J R. The short-form version of the depression anxiety stress scales (Dass-21): Construct validity and normative data in a large non-clinical sample. Brit J Clin Psychol. 2005; 44 (2), 227-239.

Kuyken W, Hayes R, Barrett B, Byng R, Dalgleifh T, Kessler D. Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. The Lancet. 2015; Published online April 21, 2015 http://dx.doi.org/10.1016/S0140-6736 (14)62222-4.

Lengacher C, Barta M, JacobsenP, KipK, Shelton M, BudhraniP, et al. Feasibility of a Mindfulness-Based Stress Reduction Program for Early-Stage Breast Cancer Survivors. J Holist Nurs. 2011; 29(1):107-117.

Lerner R, KiblerJ, Zeichner S. Relationship between Mindfulness-Based Stress Reduction and Immune Function in Cancer and HIV/AIDS. Nova Southeastern University, Fort Lauderdale, U Cancer and Clinical Oncology.2013; 2: 1.

Ma, S.F & Teasdale JD. Mindfulness-based cognitive therapy for depression: Replication andexploration of differential relapse prevention effects. J Consult ClinPsychol 2004; 72(3): 31-40.

McFarland, DC., Andreotti, C., Harris, K., Mandeli, J., Tiersten A & Holland J. (2016). Early Childhood Adversity and its Associations With Anxiety, Depression, and Distress in Women With Breast Cancer. Psychosomatics. 57 (2): 174-184.

Mendlowicz M, Stein M. Quality of life in individuals with anxiety disorders. Am J Psychiatry. 2000:157; 669-82.

Mohamadpour, S., Rahimian Boogar, I & Rezaei AM. (2014). The Role of Defense Styles and Alexithymia on Predicting Quality of Life in Patients with Coronary Heart Disease. Zanjan University of Medical Sciences. 23 (97): 48-60.

Mohammad khani P, Jokar M, Jahanitabesh O, Tamanaefar Sh. Clinical Structured Interview for DSM-IV-TR Disorders. Tehran: Welfare and Rehabilitation Sciences; 2011. [Persian]

Nolen-Hoeksema S, Morrow J. A prospective study of depressionand posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. J PersSocPsychol 1991; 61(2):115-21.

Papageorgiou C, Wells A. An empirical test of a clinical Meta – cognitive model of rumination anddepression. Cognitive Therapy and Research 2003: 27; 261-73.

Parhoon, H., Moradi, A., Hatami, M & Parhoon, K. (2013). Comparison of the Brief Behavioral Activation Treatment and Meta-cognitive Therapy in the Reduction of the Symptoms and in the Improvement of the Quality of Life in the Major Depressed Patients. rph. 2013; 6 (4) :36-52.

RoelofsJ, PapageorgiouC, GerberaR., HuibersM,PeetersF,Arntza, A. On the links between self – discrepancies, rumination, Meta- cognitions, and symptoms of depression in undegraduates. Behav Res Ther, 2007: 45;1295-1305.

Siegal G, GHINASSI F., ThaseM.Neurobehavioral Therapies in The 21st Century: Summary of An Emegiing Feld And An Example of Cognitive Control Training for Depression. Cognitive Thrapy and research 2007:31; 235- 62.

Singer, A. R., andDobson, K. S. (2009). The Effect Of The Cognition Style Of Acceptance On Negative Mood In A Recovered Depressed Samle. Depression And Anxiety 26:471- 479.

taimory S, ramezani F, mahjob N. The Effectiveness of Mindfulness-Based Group Cognitive Therapy in Reducing Depression and Obsessive Rumination among Women under Methadone Treatment. Journal of Research no Addiction. 2015; 9 (34): 145-159.

Wells A.Meta-Cognitive therapy for anxiety and depression. New York, the Guilford Press. 2009

Wells A, fisher p, Myers S., Wheatle J, pateelT, chris R. Metacognitive therapy in treat ment- resistant depression: A Plat form trial. Behav Res Ther 2012; 45: 367-373.

World health organization. Breast cancer: prevention and control. Available 2010.

Yaghobi AsgharAbad, E., bassak nejad, S., Mehrabi zade honarmand, M & Zamiri nejad S. Effectiveness of metacognitive therapy (MCT) on depressed addicts under methadone Maintenance treatment (MMT) in city mashhad of Iran. Journal of North Khorasan University of Medical Sciences. 2013: 5 (1): 167-174.

Zhang, J., Xu, R., Wang, B & Wang, J. (2016). Effects of mindfulness-based therapy for patients with breast cancer: A systematic review and meta-analysis. Complementary Therapies in Medicine. 26: 1-10.

Mahmodi, G.H., SepahMansour, M., Hasani, F., MohamadKhani, P & Larijani, Z,S. (2014). A comparison of the Effectiveness of Mindfulness based cognitive therapy and Metacognitive therapy on depressive symptoms,positive and negative beliefs about rumination and experiential avoidance in students. Psychological Research. 10 (2): 27-50.