نوع مقاله : علمی- پژوهشی

نویسندگان

• هنگامه بلورساز مشهدی ¹
• عیسی جعفری ²
• فرشته پورمحسنی کلوری ³

¹ مربی، دانشکده علوم تربیتی و روان‌‌شناسی، دانشگاه پیام نور، تهران، ایران.

² دانشیار، گروه روان‌شناسی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه پیام نور، تهران، ایران.

³ دانشیار، گروه روان‌شناسی، دانشکده علوم تربیتی و روان‌‌شناسی، دانشگاه پیام نور، تهران، ایران.

چکیده

مقدمه: سندرم روده تحریک‏پذیر علاوه بر مشکلات جسمانی، می‏تواند فرایندهای شناختی - هیجانی بیماران را نیز متأثر سازد، که ضروری است با به‏کارگیری درمان‏های کوتاه‏مدت روان‏شناختی نسبت به کاهش این آسیب‏ها اقدام شود. لذا پژوهش حاضر با هدف بررسی اثربخشی شناخت‏درمانی مبتنی بر ذهن‏آگاهی بر بدتنظیمی هیجانی و شاخص‏های درد در مبتلایان به سندرم روده تحریک‏پذیر انجام گرفت.
روش: روش پژوهش، نیمه‏آزمایشی با طرح پیش‏آزمون و پس‏آزمون با گروه کنترل و مرحله پیگیری بود. جامعه آماری شامل کلیه بیماران مرد مبتلا به سندرم روده تحریک‏پذیر مراجعه‏کننده به بیمارستان محب تهران در سال 1404 بود. با روش نمونه‏گیری در دسترس تعداد 30 نفر انتخاب و در دو گروه مساوی (هر گروه 15 نفر) گمارش شدند. گردآوری داده‏ها با استفاده از پرسش‏نامه بدتنظیمی هیجانی، پرسش‏نامه پذیرش درد و پرسش‏نامه فاجعه‏پنداری درد انجام شد. شناخت‏درمانی مبتنی بر ذهن‏آگاهی با توجه به پروتکل سگال طی 8 جلسه(هفته‏ای دو جلسه و هر جلسه به‏مدت 1 ساعت) برای گروه‏ آزمایش اعمال شد. داده‏ها با آنالیز واریانس با اندازه‏گیری مکرر و آزمون تعقیبی بن‏فرونی تحلیل شد.
یافته‌ها: نتایج نشان داد که شناخت‏درمانی مبتنی بر ذهن‏آگاهی توانست باعث کاهش بدتنظیمی هیجانی و فاجعه‏پنداری درد در بیماران سندرم روده تحریک‏پذیر شود(05/0>p). شناخت‏درمانی مبتنی بر ذهن‏آگاهی بر افزایش پذیرش درد و مؤلفه‏های آن در آزمودنی‏های گروه آزمایش برخلاف گروه کنترل مؤثر بود و تأثیرات درمان تا دو ماه پس از مداخله ماندگار بود(05/0>p).
نتیجه‌گیری: مطالعه حاضر نشان داد که شناخت‏درمانی مبتنی بر ذهن‏آگاهی بر تنظیم هیجان و مدیریت درد مبتلایان به سندرم روده تحریک‏پذیر مؤثر است. بنابراین، استفاده از این رویکرد جهت بهبود شاخص‏های درد و تنظیم هیجان توصیه می‏شود.

کلیدواژه‌ها

• شناخت‏درمانی مبتنی بر ذهن‏آگاهی
• بدتنظیمی هیجان
• درد
• سندرم روده تحریک‏پذیر

موضوعات

• 1. فرایندهای روانشناختی و اجتماعی مرتبط با علائم بیماری ها

عنوان مقاله [English]

The Effectiveness of Mindfulness-Based Cognitive Therapy on Emotional Dysregulation and Pain Indices (Acceptance-Catastrophizing) in Patients with Irritable Bowel Syndrome

نویسندگان [English]

• Hengameh Boloorsaz Mashhadi ¹
• Eisa Jafari ²
• Fereshteh Fereshteh Pourmohseni koluri ³

¹ Faculty of Educational Sciences and Psychology, Payame Noor University, Tehran, Iran

² Associate Professor of Psychology, Faculty of Educational Sciences and Psychology, Payame Noor University, Tehran, Iran

³ Associate Professor of sychology, Faculty of Educational Sciences and Psychology, Payame Noor University, Tehran, Iran.

چکیده [English]

Objective: Irritable bowel syndrome is the most common diagnosis among functional gastrointestinal disorders and is the cause of 25 to 50 percent of referrals to gastroenterologists (Frozanfar et al., 2023). In a review study, the prevalence of this syndrome in Iran was reported to be between 1.1 and 25 percent (Sheykhan and Goudarzi 2024). People with this syndrome report significant symptoms of psychological disorders and emotional disturbances. Among the symptoms that may be important in this disease, emotional dysregulation can be mentioned (Khoshchin Gol et al., 2021). A review of scientific reports over the past decade clearly shows that emotional dysregulation is of particular importance in the field of physical diseases (Boloorsaz Mashhadi et al., 2025). Irritable bowel syndrome does not lead to dangerous conditions in most patients, but due to side effects such as chronic pain and fatigue, it can increase the patient's medical costs and increase the patients' absence from work (Liu et al., 2025). In this context, Qian and Zhang (2024) showed in a study that stress and emotional dysregulation affect digestive function by activating the brain-gut axis, hormonal changes, and neuroimmune pathways, and thus, one of the most common health problems that causes patients with digestive disorders to seek medical care and treatment is abdominal pain. A review of the findings shows that sensitivity to pain and anxiety-related experiences are higher in patients with irritable bowel syndrome than in other digestive disorders (Prospero et al., 2025; Erfan et al., 2021). Because irritable bowel syndrome reduces the strength of the patient's immune system and muscles, the person may report high muscle and abdominal pain during the disease. For this reason, patients may sometimes experience greater pain intensity for various reasons, such as pain catastrophizing, which should be evaluated (Bagheri Sheykhangafshe et al., 2024). Various pharmacological and non-pharmacological treatments have been used for patients with irritable bowel syndrome. According  to research evidence, one of the non-pharmacological treatments to reduce adverse psychological effects in these patients is mindfulness-based cognitive therapy, a type of cognitive therapy. This treatment, which uses mindfulness and includes various meditations, stretching yoga, education about stress management, anxiety, anger, and depression, and cognitive therapy practice (Seng et al., 2025). For example, Reilly et al (2025) concluded in a systematic review and meta-analysis that mindfulness-based cognitive therapy reduced perceived pain intensity and symptoms of depression and anxiety in patients with spinal cord injury. The present study aimed to investigate the effectiveness of mindfulness-based cognitive therapy on emotional dysregulation and pain indicators (acceptance-catastrophizing) in patients with irritable bowel syndrome. Method: The research method was a quasi-experimental study with a pre-test and post-test design with a control group and a two-month follow-up. All male patients with irritable bowel syndrome who referred to the internal medicine clinic of Moheb Hospital, Tehran, in 1404 constituted the statistical population of the study. For experimental and quasi-experimental studies, 15 people were recommended for each of the experimental and control groups. The Dysregulation of Emotion Questionnaire (DERS), Pain Acceptance Questionnaire (CPAQ), and Pain Catastrophizing Questionnaire (PCS) were among the instruments used in the present study. The statistical method used for data analysis was two-way analysis of variance with repeated measures. Before statistical analysis, the assumptions of parametric statistics related to analysis of variance were first examined and confirmed. Results:  According to the results of Table 1, since the significance level related to time is less than 0.05, it can be accepted that there is a significant difference between the mean scores of emotional dysregulation and its components, as well as between the mean scores of pain acceptance, pain catastrophizing and their components in different stages of measurement (pre-test-post-test and follow-up).Conclusion: The present study was conducted with the aim of investigating the effectiveness of mindfulness-based cognitive therapy on emotional dysregulation and pain indices in patients with irritable bowel syndrome. The results showed that participating in mindfulness-based cognitive therapy sessions reduced emotional dysregulation in patients with irritable bowel syndrome, and this effect remained stable during the follow-up period. Another result of the study showed that participating in mindfulness-based cognitive therapy sessions increased pain acceptance in patients with irritable bowel syndrome, and this effect remained stable during the follow-up period. The final finding of the study indicated that participating in mindfulness-based cognitive therapy sessions reduced pain catastrophizing in patients with irritable bowel syndrome, and this effect remained stable during the follow-up period.

کلیدواژه‌ها [English]

• Mindfulness-based Cognitive Therapy
• Emotion Dysregulation
• Pain
• Irritable Bowel Syndrome