Document Type : Scientific Research
Authors
Abstract
Objective: Antisocial personality disorder (ASPD) is the most common comorbid disorder with substance dependency disorders, especially heroin among identified psychiatric disorders and ASPD predicts weak outcomes in treatment of substance dependency disorders. Purpose of this study is was to examine the efficacy of dual focus schema therapy on reduction of severity of dependency in antisocial personality disordered opioid dependent men. Method: Three antisocial personality disordered opioid dependent men were selected using Millon Clinical Multiaxial Inventory (MCMI-III) and Structured Clinical Interview for DSM-IV (SCID) based on disorders axis II and purposeful sampling. Multiple baseline experimental single case study was used as the method of the present study. The treatment program was carried out for 24 week and 28 sessions, with a follow-up period of 3 months subsequent to treatment termination. Subjects completed Severity of Dependence Scale (SDS) and Young Schema Questionnaire (YSQ-SF). Results: Results showed that dual focus schema therapy is significantly effective on reduction of severity of psychological dependency and primary maladaptive schemas. Conclusion: Dual focus schema therapy has appropriate efficacy on reduction of severity of dependency in antisocial personality disordered opioid dependent men.
Keywords
بازرگان، ع (1389). مقدمه‌ای بر روش‌های تحقیق کیفی و آمیخته. تهران، نشر دیدار. چاپ دوم.
حمیدپور، ح (1388). «کارایی و اثربخشی طرح‌واره درمانی در درمان زنان مبتلا به اختلال اضطراب فراگیر». پایان‌نامه دکتری، دانشگاه علوم بهزیستی و توان‌بخشی.
جعفری، ع (1388). «اثربخشی آموزش مهارت‌های مقابله‌ای مبتنی بر مدل مارلات در پیشگیری از عود و افزایش تاب‌آوری در افراد وابسته به مواد». رساله دکتری. دانشگاه علامه طباطبایی.
خانیپور، ح (1389). «اثربخشی درمان شناختی مبتنی بر حضور ذهن بر روی نشانههای افسردگی و اندیشناکی در افراد باسابقه یک دوره افسردگی اساسی: طرح تک موردی». رساله کارشناسی ارشد دانشگاه علامه طباطبایی.
ریزو، ال و همکاران. (2007). طرح‌واره‌های شناختی و باورهای بنیادین در مشکلات روان‌شناختی. ترجمه سیما احمدی و رضا مولودی. (1390). چاپ اول. انتشارات ارجمند.
شریفی، ع (1381). «هنجاریابی آزمون بالینی چند محوری میلون ـ 3 در شهر اصفهان». رساله کارشناسی ارشد دانشگاه اصفهان.
مولوی، پ و همکاران. (1387). «بررسی اختلالات شخصیتی در میان افراد دارای اختلال سوءمصرف مواد مخدر مراجعه کننده به مرکز مرجع ترک اعتیاد استان اردبیل». مجله علمی پژوهشی دانشگاه علوم پزشکی اردبیل. دوره نهم، شماره چهارم، زمستان 1388، صفحات 325 الی 333.
یانگ، جی؛ کلوسکو، جی و ویشار، ام (2003). طرح‌واره درمانی: راهنمای کاربردی برای متخصصان بالینی. ترجمه حسن حمیدپور و زهرا اندوز. (1386). چاپ اول، تهران: انتشارات ارجمند.
یانگ، جی (1994). شناخت درمانی اختلالات شخصیت: رویکرد طرح‌واره محور. ترجمه علی صاحبی و حسن حمیدپور. (1383). تهران: انتشارات ارجمند
Ball, S. A. (1998). "Manualized treatment for substance abusers with personality disorders: Dual focus schema therapy". Addictive Behaviors, 23, 883–891.
Ball, S. A. & Young, J. E. (2000). "Dual focus schema therapy for personality disorder and substance dependence: Case study results". Cognitive and Behaviour Practice, 7, 270–281.
Ball, S. A. (2004). Treatment of personality disorders with co-occurring substance Dual focus schema therapy. In: J. Magnavita (Ed.), Handbook of personality disorders: Theory and practice. New York: John Wiley.
Ball, S. A., Cobb-Richardson, P., Connolly, A. J., Bujosa, C. T., & O'Neall, T. W. (2005). "Substance abuse and personality disorders in homeless drop-in center clients: Symptom severity and psychotherapy retention in a randomized clinical trial". Comprehensive Psychiatry, 46, 371-379.
Ball, S. A. (2007). "Comparing individual therapies for personality disordered opioid dependent patients". Journal of Personality Disorders, 21: 305-321.
Ball, S. A. & Rounsaville, B. J. (2006). Refinishing without rebuilding: Dual focus schema therapy for personality disorder and addiction. In R. L. Spitzer, M. B. First, J. B. W. Williams, & M. Gibbon (Eds.), Treatment companion to the DSM-IV-TR casebook (2nd ed., pp. 53-65). Washington, DC: American Psychiatric Association.
Barlow, D. H. & Hersen, D. (1984). Single case experimental designs: Strategies for studying behavior change. New York: Pergamon.
Birbaumer, N. & et al. (2005). "Deficient fear conditioning in psychopathy". Archives of General Psychiatry, 62, 799–805.
Blacker, D. (2005). Psychiatric Rating Scales. In B. J. Sadock & V. A. Sadock (Eds.), Comprehensive textbook of psychiatry (Eight Edition, pp. 929-954). Philadelphia, Lippincott Williams & Wilkins.
Blanchard, E. B. & Schwarz, S. P. (1988). "Clinically significant changes in behavioral medi-cine". Behavioral Assessment, 10, 171-188.
Castillo & et al. (2010). "Estimation of cutoff for the severity of dependence scale (SDS) for opiate dependence by ROC analysis". Actas ESP Psiquiatr; 38(5): 270-277.
Compton, W. M., Cottler, L., Jacobs, J.L., Ben-Abdallah, A. & Spitznagel, E.L. (2003). "The role of psychiatric disorders in predicting drug dependence treatment outcomes". The American Journal of Psychiatry, 160, 890-895.
Compton, W. M. & et al. (2005). "Prevalence, Correlates, and Comorbidity of DSM-IV Antisocial Personality Syndromes and Alcohol and Specific Drug Use Disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions". Journal of Clinical Psychiatry, Vol 66(6), Jun 2005, 677-685.
Galen, L.W. & et al. (2000). "Sociopathy, gender, and treatment outcome among outpatient substance abusers". Drug and Alcohol Dependence 61, 23–33.
Gossop, M. & et al. (1995). "The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users". Journal of Addiction. 90(5): 607-14.
Jacobson, N. S. & Truax, P. (1991). "Clinical significance: a statistical approach to defining meaningful change in psychotherapy-research". Journal of Consulting and Clinical Psychology, 59 12-19.
Sadock, B. J & Sadock, V. A. (2007). Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/ Clinical Psychiatry. Lippincott Williams & Wilkins; Tenth, North American Edition edition.
Kokkevi, A. & et al. (1998). "Personality disorders in drug abusers: prevalence and their association with AXIS I disorders as predictors of treatment retention". Addictive Behaviors, Vol. 23, No. 6, pp. 841–853.
Maffei, C. and et al. (1997). "Interrater Reliability and Internal Consistency of the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), Version 2.0". Journal of Personality Disorders: Vol. 11, No. 3, pp. 279-284.
Martin, P. R. & et al. (2007). Healing addiction: An integrated pharmaco-psychosocial approch to treatment. United States of America. John Wiley & Sons.P3.
Verheul, R. & et al. (1998). "Personality disorders predict relapse in alcoholic patients". Addictive Behaviors, Vol. 23, No. 6, pp. 869–882.
Rounsaville, B. J. and et al. (1998). "Personality disorders in substance abusers: Relation to substance abuse". Journal of Nervous and Mental Diseases, 186, 87–95.
Ross, S., & et al. (2003). "A comparison between dually diagnosed inpatients with and without Axis II co-morbidity and the relationship to treatment outcome". The American Journal of Drug and Alcohol Abuse, 29, 263-279.
Verheul, R., & et al. (2005). Substance abuse. In: J. M. Oldham, A. E. Skodol, & D. S. Bender (eds.), Textbook of Personality Disorders (pp. 463–476). Washington, DC: American Psychiatric Publishing.
Waller, G., & et al. (2001). "Psychometric properties of the long and short versions of the Young Schema Questionnaire: Core beliefs among bulimic and comparison women". Cognitive Therapy and Research, 25, 137 – 147.
Walter, mark & et al. (2011). "Affective reactivity in heroin-dependent patients with antisocial personality disorder". Psychiatry Research. Volume 187, Issues 1–2, 15 May 2011, Pages 210–213.
Xie, Haiyi. & et al. (2005). "Substance Abuse Relapse in a Ten-Year Prospective Follow-up of Clients with Mental and Substance Use Disorders". Psychiatric Services, Vol. 56 No. 10. pp 1282-1287.
)