با همکاری مشترک دانشگاه پیام نور و انجمن روانشناسی سلامت

نوع مقاله : علمی- پژوهشی

نویسندگان

1 استاد گروه روان‌شناسی تربیتی، دانشکده علوم تربیتی و روانشناسی، دانشگاه الزهرا، تهران، ایران.

2 کارشناس ارشد روانشناسی عمومی، دانشگاه پیام نور، تهران، ایران.

چکیده

مقدمه: مطالعه‌ی حاضر با هدف پیش‌بینی سوگ پیچیده بر اساس انعطاف‌پذیری شناختی با نقش میانجی تنظیم شناختی هیجان در بازماندگان کووید 19صورت گرفت.
روش: این مطالعه توصیفی از نوع همبستگی با روش تحلیل مسیر بود. جامعه‌ی آماری شامل کلیه‌ی افراد داغداری بود که از ابتدای شیوع کرونا در سال ۱۳۹۸ تا  ۱۴۰۰یکی از بستگان نزدیک یا اعضای خانواده‌ی خود را به‌دلیل ابتلا به کرونا از دست دادند. بر این اساس ۲۰۰ فرد بازمانده و عزادار نمونه‌ی پژوهش را تشکیل داد. در این مطالعه از سه پرسشنامه؛ تنظیم شناختی- هیجانی گارنفسکی و همکاران، انعطاف‌پذیری شناختی دنیس ووندروال و تجربه سوگ بارت و اسکات استفاده شد. آمار استنباطی به منظور تحلیل روابط همبستگی توسط نرم‌‌افزار SPSS-26 انجام شد و برای ارزیابی دستیابی به مدل برازش شده از نرم‌افزار ایموس نسخه‌ی 24 استفاده شد.
یافته‌ها: نتایج نشان داد که بین انعطاف‌پذیری شناختی و تجربه‌ی سوگ بازماندگان کووید 10 رابطه‌ی معنادار منفی وجود دارد. بین ابعاد انعطاف‌پذیری شناختی و ابعاد راهبردهای سازش‌نایافته‌ی تنظیم شناختی هیجان بازماندگان کرونا رابطه معنادار  منفی وجود دارد (01/0>P). همچنین انعطاف‌پذیری شناختی از طریق نقش میانجی تنظیم شناختی هیجان بر سوگ پیچیده‌ی بازماندگان کرونا تاثیر معنادار  دارد (01/0>P). نتیجه‌گیری: در سوگ پیچیده‌ی ناشی از حوادثی مانند کووید 19عوامل روان‌شناختی و شناختی گوناگونی مانند انعطاف‌پذیری شناختی و تنظیم شناختی هیجان دخیل هستند که روان‌درمان‌گران خصوصاً درمان‌گران شناختی-رفتاری باید به این موارد توجه و بر عوامل مثبت تاثیرگذار بر کاهش سوگ پیچیده تمرکز کنند و روند درمان بیماران را با استفاده از این عوامل به بهترین صورت مدیریت نمایند.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Predicting complicated grief based on cognitive flexibility with the mediating role of cognitive regulation of emotion in survivors of the COVID-19

نویسندگان [English]

  • Hossein Zare 1
  • Azadeh Sabeti 2

1 Professor. Department of Educational Psychology, Faculty of Education and Psychology, Alzahra University, Tehran. Iran.

2 M.Sc. in Psychology. Payame Noor University, Tehran. Iran

چکیده [English]

Objective: The aim of the present study was to predict complicated grief based on cognitive flexibility with the mediating role of cognitive regulation of emotion in survivors of the COVID-19.
Method: This descriptive study was fundamental-applicative and correlation type with path analysis in terms of method. The statistical population included all the bereaved people who lost one of their close relatives or family members due to the corona virus since 2018 to 1400. Therefore 200 survivors and mourners formed the research sample.
Three questionnaires included cognitive-emotional regulation by Garnevsky et al. (2009), cognitive flexibility by Dennis Vonderwall (2010), and grief experience by Barrett and Scott (1998) were used and completed online by the participants. SPSS-26 software was used to analyze statistical correlation relationships and Imus software version 24 was used to evaluate the achievement of the fitted model.
Results: The results showed that the direct effect of cognitive flexibility with beta coefficient on compromised strategies is positive (Beta=0.655), and on uncompromised strategies (Beta=-0.628) and the experience of bereavement (Beta=-0.387) is negative and significant (P<01.1). Also, the direct effect of emotion-cognitive compromise strategies with the standard coefficient on bereavement experience (Beta=0.254) is positively significant and the adaptive cognitive strategies of emotion are negatively significant on the experience of bereavement (Beta=-0.327).The correlation coefficient between the variables showed that cognitive flexibility has a positive correlation with emotional cognitive strategies (r=0.66) and a negative correlation with bereavement experience (r=-0.75) and  a negative correlation with non-compromised emotional cognitive strategies (P<0.1). In other words, as survivors' cognitive flexibility increases, their mourning decreases. Also, the experience of bereavement is more in the survivors who use non-compromised strategies of emotional cognition (r=0/66) and less in those who use compromised cognitive strategies of emotion (r=-0.71).The results of the Bootstrap test for indirect ways showed that the indirect way of cognitive flexibility to the experience of bereavement with the mediating role of cognitive regulation of uncompromising emotion has an effect size -0.14, as well as the indirect way of cognitive flexibility to the experience of bereavement with the mediating role of cognitive regulation of compromising emotion has an effect size-0.18, that is significant at the level of less than 0.05.
Conclusion: Cognitive regulation of emotion has a mediating role between cognitive flexibility and bereavement experience of survivors. In general, the use of cognitive regulation of uncompromised emotion enhances the experience of bereavement and the use of cognitive regulation of compromised emotion reduces it. There is a significant negative relationship between cognitive flexibility and bereavement experience of corona survivors. There is a significant negative relationship between the dimensions of cognitive flexibility and the dimensions of uncompromising cognitive emotion regulation strategies of corona survivors. Also, cognitive flexibility has a significant effect on the complex grief of corona survivors through the mediating role of cognitive emotion regulation. In complicated grief caused by events such as Covid-19, various psychological and cognitive factors such as cognitive flexibility, cognitive regulation of emotion are involved, and psychotherapists, especially cognitive-behavioral therapists, should pay attention to these issues and focus on the positive factors influencing the reduction of complex bereavement and the treatment process.
Due to the lack of funeral rituals and traditional mourning interactions which play an important role in facilitating the mourning process, the levels of resolving the painful emotions become more difficult. Greater flexibility will allow individuals to focus more on alternative ways of cognitive changes, therefore, in traumatic situations and psychological distress, they will have better control over their emotions.

کلیدواژه‌ها [English]

  • Complicated grief
  • Cognitive flexibility
  • Cognitive regulation of emotion
  • survivors of the COVID-19
Arici-Ozcan, N., Cekici, F. & Arslan, R. (2019). The relationship between resilience and distress tolerance in college students: The mediator role of cognitive flexibility and difficulties in emotion regulation. International Journal of Educational Methodology, 5, 525-533.Doi: 10.12973/ijem.5.4.525
Asadi Medikhanmahalle N, Zebardast A, Rezaei S. (2021). The Explanation of Regrets in Frist Degree Survivors of Cancer Patients with Early Death. QUARTERLY JOURNAL OF HEALTH PSYCHOLOGY. 22;10(39):7-28.Doi: 10.30473/hpj.2021.57376.5102(in Persian).
Akbari Chermahini S, Molaei Yasavoli M, Nazarifar M, Shahrjerdi S. (2022). Cognitive Biases During the Coronavirus Outbreak in Iranian Society. Health Psychology. 20;10(40):47-62.Doi:10.30473/hpj.2022.58706.5195(in Persian).
Barrett, T. & Scott, T. (1989). Development of the grief experience questionnaire. Journal of Suicide and Life‐Threatening Behavior, 19, 201-215.Doi: 10.1111/j.1943-278X.1989.tb01033.x
BOZICEVIC, L., DE PASCALIS, L., SCHUITMAKER, N., TOMLINSON, M., COOPER, P. J. & MURRAY, L. (2016). Longitudinal association between child emotion regulation and aggression, and the role of parenting: a comparison of three cultures. Psychopathology, 49, 228-235.Doi: 10.1159/000447747
Dennis, J.P., Vander Wal, J.S. (2010) The Cognitive Flexibility Inventory: Instrument Development and Estimates of Reliability and Validity. Cogn Ther Res 34, 241–253.https://doi.org/10.1007/s10608-009-9276-4.
Diolaiuti, F., Marazziti, D., Beatino, M. F., Mucci, F., & Pozza, A. (2021). Impact and consequences of COVID-19 pandemic on complicated grief and persistent complex bereavement disorder. Psychiatry Research, 300, 113916.https://doi.org/10.1016/j.psychres.2021.113916
Soltani, E. Shareh, H. Bahrainian, A. Farmani, S.(2013). The mediating role of cognitive flexibility in correlation of coping styles and resilience with depression. pajoohande; 18 (2) :88-96(in Persian).
Fayyazi Bordbar M R, Chalaki Nia N, Alizadeh Jouimandi F, Delshad Noghabi, Hoseini S T, Moharari F, et al. (2021). Relationship between Spiritual Health and the Effects of Grief in Bereaved Survivors of COVID-19 in Mashhad, Iran 2020. J Mazandaran Univ Med Sci; 31 (198):109-118(in Persian).
Garnefski, N. MSc, PhD, Kraaij, V. MSc, PhD, Schroevers, M. J. MSc, PhD, Aarnink, J. MSc, van der Heijden, D. J. MD, van Es, S. M. MSc, PhD, van Herpen, M.  MSc & Somsen, G. A.  MD, PhD (2009) Cognitive Coping and Goal Adjustment After First-Time Myocardial Infarction: Relationships With Symptoms of Depression, Behavioral Medicine, 35:3, 79-86,Doi: 10.1080/08964280903232068
Gesi, C., Carmassi, C., Cerveri, G., Carpita, B., & Cremone, I. M. (2020). Complicated Grief: What to Expect After the Coronavirus Pandemic. Frontiers in Psychiatry, 11.https://doi.org/10.3389/fpsyt.2020.00489
Gupta, S. & Bonanno, G. A. (2011). Complicated grief and deficits in emotional expressive flexibility. Journal of abnormal psychology, 120, 635.Doi: 10.1037/a0023541.
Hasani J. (2010). The psychometric properties of the cognitive emotion regulation questionnaire (CERQ). Journal of clinical psychology. Sep 23;2(3):73-84.Doi: 10.22075/JCP.2017.2031(in Persian).
Huang, Y., Hsu, L., Chao, P., Mu-Hsuan Shang, C., Tsai, S., & Wu, C. W. (2021). Mindfulness based cognitive therapy on bereavement grief: Alterations of resting-state network connectivity associate with changes of anxiety and mindfulness. Human Brain Mapping, 42(2), 510-520.https://doi.org/10.1002/hbm.25240
Johnco, C., Wuthrich, V., & Rapee, R. (2013). The role of cognitive flexibility in cognitive restructuring skill acquisition among older adults. Journal of Anxiety Disorders, 27(6), 576-584.https://doi.org/10.1016/j.janxdis.2012.10.004
Kumar, R. M. (2021). The Many Faces of Grief: A Systematic Literature Review of Grief During the COVID-19 Pandemic. Illness, Crisis & Loss.https://doi.org/10.1177/10541373211038084
Kossigan, C., & Nieves, M. (2021). Editorial: New Perspectives in Bereavement and Loss: Complicated and Disenfranchised Grief Along the Life Cycle. Frontiers in Psychology, 12.https://doi.org/10.3389/fpsyg.2021.691464
Lauren J. Breen, Vincent O. Mancini, Sherman A. Lee, Emily A. Pappalardo & Robert A. Neimeyer (2022) Risk factors for dysfunctional grief and functional impairment for all causes of death during the COVID-19 pandemic: The mediating role of meaning, Death Studies, 46:1, 43-52,Doi: 10.1080/07481187.2021.1974666
Momeni J, Sahab Negah S. (2020) A review on grief process: Complication of grief during COVID-19 pandemic. Navid No. 21;23(Supplement,):51-64.Doi: 10.22038/NNJ.2020.48585.1208(in Persian).
Rosner, R., Rimane, E., Vogel, A. (2018)Treating prolonged grief disorder with prolonged grief-specific cognitive behavioral therapy: study protocol for a randomized controlled trial. Trials 19, 241.https://doi.org/10.1186/s13063-018-2618-3
Smith, K. V., Wild, J. & Ehlers, A. (2020). The masking of mourning: social disconnection after bereavement and its role in psychological distress. Clinical Psychological Science, 8, 464-476.Doi: 10.1177/2167702620902748
Raeisi Sarteshneizy Z, Lotfi M, Pirmoradi M, Asghar Nejad Farid A. (2020). redictive Role of Self-efficacy in Emotional Regulation and Cognitive Flexibility on Reducing Emotional Distress in University Students. J Mazandaran Univ Med Sci; 30 (189) :164-169
Ravanpoor J, Mahmoudian L, Bagheri P, Babajani Gavzan J. (2022) The effectiveness of reality therapy on the experience of grief and psychological resilience among the families of the deceased of Coronavirus. Journal of Applied Family Therapy. 20;2(9):203-14.Doi: 10.22034/AFTJ.2022.325318.1355(in Persian).
Salehi H, Hosseinian S, Yazdi SM. (2021). The relationship between cognitive flexibility and successful marriage: The mediating role of cognitive emotion regulation. Rooyesh-e-Ravanshenasi Journal (RRJ). Nov 10;10(8):93-102. (in Persian).
Vatankhah Amjad F, Shams S, Rashtiani F, Mohammadi S. (2022) The Relationship between Behavioral Brain Systems and Difficulty in Emotion Regulation with Depressive Symptoms in People with Type 2 Diabetes: The Mediating Role of Cognitive Flexibility. Rooyesh-e-Ravanshenasi Journal (RRJ). 10;10(11):241-56. (in Persian).