با همکاری مشترک دانشگاه پیام نور و انجمن روانشناسی سلامت

نوع مقاله : علمی- پژوهشی

نویسندگان

1 دانشیار گروه روان شناسی دانشگاه پیام نور.

2 دانشجوی دکتری روانشناسی سلامت دانشگاه پیام نور دبی

3 مربی و دانشجوی دکترای روانشناسی سلامت دانشگاه پیام نور دبی

چکیده

مقدمه: پژوهش حاضر به مقایسه اثربخشی درمان شناختی-رفتارى متمرکز بر تنظیم هیجان و درمان پذیرش و تعهد بر علایم کمر درد، افسردگی و رضایت از زندگی در زنان مبتلا به کمردرد مزمن با اختلال افسردگی اساسی همبود پرداخت. روش: این پژوهش نیمه آزمایشی از نوع پیش آزمون-پس آزمون با گروه کنترل بود. 30 زن دارای کمردرد مزمن با اختلال افسردگی اساسی همبود به صورت تصادفی در دو گروه آزمایش (20 نفر) و یک گروه کنترل (10 نفر) گمارده شدند. یک گروه آزمایش درمان شناختی-رفتاری متمرکز بر تنظیم هیجان و گروه دیگر آزمایش درمان پذیرش و تعهد را دریافت کردند و گروه کنترل در لیست انتظار قرار گرفت. شرکت کنندگان پرسشنامه های درد مک گیل، افسردگی بک و رضایت از زندگی را در پیش آزمون و پس آزمون کامل کردند. برای تجزیه و تحلیل داده ها از تحلیل کوواریانس چند متغیره استفاده شد. یافته­ ها درمان شناختی- رفتاری متمرکز بر تنظیم هیجان و درمان پذیرش و تعهد باعث کاهش علایم درد و افسردگی و افزایش رضایت از زندگی شدند. نتیجه­ گیری: نتایج نشان داد که بین دو روش درمانی تفاوت معناداری مشاهده نشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comparing the effectiveness of emotion regulation- focused cognitive-behavior therapy and acceptance and commitment therapy on reducing the backache symptoms and depression and increasing life satisfaction in women suffering from chronic backache with commorbid major depressive disorder

نویسندگان [English]

  • Mohamad Oraki 1
  • Atousa Mahdizadeh 2
  • Afsaneh Dortaj 3

1 Associate Professor and Faculty Member of Payame Noor University.

2 Ph.D. student of psychology of health at Payame Noor University of Dubai

3 Instructor, and Ph.D. in Psychology of Health at Payame Noor University of Dubai

چکیده [English]

Objective: The aim of this study was to compare the effectiveness of emotion regulation- focused cognitive-behavior therapy (CBT) and acceptance and commitment therapy (ACT) on backache symptoms, depression and life satisfaction in women suffering from chronic backache with comorbid major depressive disorder (MDD).Method: This study was a quasi-experimental research conducted in the form of pretest-posttest with control group. 30 women with chronic backache and comorbid MDD were selected and were included randomly in two experimental groups (n=20) and one control group (n=10). One experimental group received the emotion regulation-focused CBT and another experimental group received the ACT, with control group on a waiting list. Participants completed the McGill Pain Questionnaire, Beck Depression Inventory-II (BDI-II) and Life Satisfaction Questionnaire in the pretest and posttest. The data were analyzed using multi-variable covariance analysis.Results: The Emotion regulation-focused CBT and the ACT reduced backache symptoms and depression, and increased life satisfaction. Conclusion: the results showed no significant differences between the two therapies.

کلیدواژه‌ها [English]

  • Emotion regulation-focused cognitive-behaviour therapy
  • Acceptance and Commitment Therapy
  • Pain
  • Life Satisfaction
  • Major depressive disorder
بهروز، بهروز؛ بوالی، فاطمه؛ حیدری زاده، نسرین؛ فرهادی، مهران. (1393). اثربخشی درمان مبتنی بر پذیرش و تعهد بر علائم روانشناختی، سبکهای مقابلهای و کیفیت زندگی بیماران دیابتی نوع II. مجله سلامت و بهداشت، 7(2): 253-236.
خسروی، مهنوش؛ صدیقی، صنمبر؛ مرادی علمداری، شقایق؛ زنده دل، کاظم. (1392). پرسش‌نامه فارسی درد مک‌گیل؛ ترجمه، انطباق و پایایی در بیماران مبتلا به سرطان: گزارش کوتاه. مجله دانشکده پزشکی، دانشگاه علوم پزشکی تهران، 71(1): 58-53.
صبور، سهیلا؛ کاکابرایی، کیوان. (1395). اثربخشی گروه درمانی پذیرش و تعهد بر میزان علائم افسردگی، استرس و شاخص های درد در زنان مبتلا به درد مزمن. مجله پژوهش توانبخشی در پرستاری، 2(4): 8-2.
عبدالقادی، ماریه؛ کافی، سید موسی؛ صابری، عالیا؛ آریاپوران، سعید. (1392). اثر بخشی شناخت درمانی مبتنی بر ذهن آگاهی و درمان شناختی-رفتاری بر کاهش درد، افسردگی و اضطراب بیماران مبتلا به کمر درد مزمن. مجله علمی پژوهشی دانشگاه علوم پزشکی شهید صدوقی یزد، 21(6): 807-795.
مظفری، شهباز. (1382). همبسته های روان شناختی شادکامی ذهنی. پایان نامه کارشناسی ارشد، روان شناسی بالینی، شیراز، دانشگاه شیراز.
موسوی، مرضیه؛ محمدخانی، پروانه؛ کاویانی، حسین؛ دلاور، علی. (1385). اثر بخشی زوج درمانی سیستمی رفتاری بر کارکرد خانواده و اعتماد به نفس زنان مبتلا به اختلال افسردگی. فصلنامه خانواده پژوهی، 2: 19-5
Al-Akour, N., Khader, Y. S., & Shatnawi, N. J. (2010). Quality of life and associated factors among Jordanian adolescents with type 1 diabetes mellitus. Journal of Diabetes and its Complications, 24(1), 43-47.
 Allen, L. B., McHugh, R. K., & Barlow, D. H. (2009). Emotional Disorder. Clinical Handbook of Psychological Disorder. A step-by-step, Treatment Manual David H Barlow. New York : The Guilford Press; London: PP. 216-49.
Beck, A. T., Steer, R. A., & Carbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical psychology Review, 8(1), 77-100.
Beck, A. T., Steer, R. A., Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation.
Berking, M., Ebert, D., Cuijpers, P., & Hofmann, S. G. (2013). Emotion regulation skills training enhances the efficacy of inpatient cognitive behavioral therapy for major depressive disorder: a randomized controlled trial. Psychotherapy and Psychosomatics, 82(4), 234-245.
Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. European Journal of Pain, 10(4), 287-287. Buhrman, M., Fredriksson, A., Edström, G., Shafiei, D., Tärnqvist, C., Ljótsson, B., ... & Andersson, G. (2013). Guided Internet‐delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: Randomized controlled trial. European Journal of Pain, 17(5), 753-765.
 Burrows, C. J. (2013). Acceptance and commitment therapy with survivors of adult sexual assault: A case study. Clinical Case Studies, 12(3):246-59.
 Burton, A. K., Tillotson, K. M., Main, C. J., & Hollis, S. (1995). Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine, 20(6), 722-728.
Cisler, J. M., & Olatunji, B. O. (2012). Emotion regulation and anxiety disorders. Current Psychiatry Reports, 14(3), 182-187.
Currie, S. R., & Wang, J. (2004). Chronic back pain and major depression in the general Canadian population. Pain, 107(1), 54-60.
Dersh, J., Gatchel, R. J., & Polatin, P. (2001). Chronic spinal disorders and psychopathology: research findings and theoretical considerations. The Spine Journal, 1(2), 88-94.
Diener, E. D., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49(1), 71-75. Dindo, L., Recober, A., Marchman, J. N., Turvey, C., & O'Hara, M. W. (2012). One-day behavioral treatment for patients with comorbid depression and migraine: a pilot study. Behaviour Research and Therapy, 50(9), 537-543.
Dworkin, R. H., Turk, D. C., Revicki, D.A., Harding, G., Coyne,  K.S., Peire-sandner,  S., & et al (2009). Development and initial validation of an expanded and revised version of the short-form McGill pain Questionaire (sf-mpq-2). Pain, 144(1-2): 35-42.
Fleurmond, J. (2005). Is it all in the head? The Psychological effects of chronic pain and the effectiveness of modern therapies. Ethnicity & Disease, 15(3), 47-48.
Garnefski, N., Legerstee, J., Kraaij, V., van den Kommer, T., & Teerds, J. A. N. (2002). Cognitive coping strategies and symptoms of depression and anxiety: A comparison between adolescents and adults. Journal of Adolescence, 25(6), 603-611.
Gatchel, R. J., & Rollings, K. H. (2008). Evidence-informed management of chronic low back pain with cognitive behavioral therapy. The Spine Journal, 8(1), 40-44.
Gatchel, R. J., Polatin, P. B., & Mayer, T. G. (1995). The dominant role of psychosocial risk factors in the development of chronic low back pain disability. Spine, 20(24), 2702-2709.
Goodwin, C. L., Forman, E. M., Herbert, J. D., Butryn, M. L., & Ledley, G. S. (2011). A pilot study examining the initial effectiveness of a brief acceptance-based behavior therapy for modifying diet and physical activity among cardiac patients. Behavior Modification, 36(2):199-217.
Graham, C. D., Gillanders, D., Stuart, S., & Gouick, J. (2014). An acceptance and commitment therapy (ACT) based intervention for an adult experiencing post-stroke anxiety and medically unexplained symptoms. Clinical Case Studies, 13(3), 230-248.
Halgin, R. P., & Whitbourne, S. K. (2010). Abnormal psychology. McGraw-Hill Higher Education.
Hansen, Z., Daykin, A., & Lamb, S. E. (2010). A cognitive-behavioural programme for the management of low back pain in primary care: a description and justification of the intervention used in the Back Skills Training Trial (BeST; ISRCTN 54717854). Physiotherapy, 96(2), 87-94.
Hayes, S.C., & Strosahl, K.D. (2010). A Practical Guide to Acceptance and Commitment Therapy. New York: Springer Science and Business, Media Inc.
Hayes, S.C., Levin, M.E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior Therapy, 2013, 44(2), 180-198.
Janz, N. K., Hawley, S. T., Mujahid, M. S., Griggs, J.J., Alderman, A., Hamilton, A. S., & et al.
(2011). Correlates of worry about recurrence in a multiethnic population-based sample of women with breast cancer. Cancer, 117(9), 1827-1836.
Keefe, F. J., & Williams, D. A. (1990). A comparison of coping strategies in chronic pain patients in different age groups. Journal of Gerontology, 45(4), 161-165.
Keogh, E., Bond, F. W., Hanmer, R., & Tilston, J. (2005). Comparing acceptance-and control-based coping instructions on the cold-pressor pain experiences of healthy men and women. European Journal of Pain, 9(5), 591-598.
 Long, D. M., Erickson, D., Campbell, J., & North, R. (1981). Electrical stimulation of the spinal cord and peripheral nerves for pain control. Stereotactic and Functional Neurosurgery, 44(4), 207-217.
Lunde, L. H., & Nordhus, I. H. (2009). Combining acceptance and commitment therapy and cognitive behavioral therapy for the treatment of chronic pain in older adults. Clinical Case Studies, 8(4), 296-308.
Mason, V. L., Mathias, B., & Skevington, S. M. (2008). Accepting low back pain: is it related to a good quality of life?. The Clinical Journal of Pain, 24(1), 22-29.
McCracken, L. M., & Turk, D. C. (2002). Behavioral and cognitive–behavioral treatment for chronic pain: outcome, predictors of outcome, and treatment process. Spine, 27(22), 2564-2573.
Morley, S., Eccleston, C., & Williams, A. (1999). Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain, 80(1), 1-13.
Pampallona, S., Bollini, P., Tibaldi, G., Kupelnick, B., & Munizza, C. (2004). Combined pharmacotherapy and psychological treatment for depression: a systematic review. Archives of General Psychiatry, 61(7), 714-719.
 Pincus, T., Burton, A. K., Vogel, S., & Field, A. P. (2002). A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine, 27(5), E109-E120.
Prevedini, A. B., Presti, G., Rabitti, E., Miselli, G., & Moderato, P. (2011). Acceptance and commitment therapy (ACT): the foundation of the therapeutic model and an overview of its contribution to the treatment of patients with chronic physical diseases. G Ital Med Lav Ergon, 33(1), A53-A63.
Sinel, M. D., Dearalorff, W. W., & Goldstein, T. B. (1996).Win the battle Against Back pain: an integrated mind-body approach. New York: Bantam-Doubleday Dell.
Smeets, R. J., Vlaeyen, J. W., Kester, A. D., & Knottnerus, J. A. (2006). Reduction of pain catastrophizing mediates the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. The Journal of Pain, 7(4), 261-271.
Sperry, S., Knox, B., Edwards, D., Friedman, A., Rodriguez, M., Kaly, P., & et al. (2014). Cultivating healthy eating, exercise, and relaxation (CHEER): a case study of a family-centered and mindfulness based cognitive behavioral intervention for obese adolescents at risk for diabetes and cardiovascular disease.Clinical Case Studies, 13(3), 218-230.
Sullivan, M. J., Reesor, K., Mikail, S., & Fisher, R. (1992). The treatment of depression in chronic low back pain: review and recommendations. Pain, 50(1), 5-13.
Tan, E. P., Tan, E. S., & Ng, B. Y. (2009). Efficacy of cognitive behavioural therapy for patients with chronic pain in Singapore. Annals Academy of Medicine Singapore, 38(11), 952.
Turk, D. C, Monarch, E. S. (2006). Chronic pain. In: Kennedy P, Llewelyn S, editors. The Essentials of Clinical Health Psychol US: Wiley. pp. 111-134.
Turk, D. C. (2001). Management of pain: best of times, worst of times?. The Clinical Journal of Pain, 17(2), 107-109.
Turk, D. C., & Gatchel, R. J. (Eds.). (2013). Psychological approaches to pain management: a practitioner's handbook. Guilford publications.
Van Son, J., Nykllcek, I., Pop, V.J., Blonk, M.C., Erdtsieck, R.J., Spooren, P.F & et al. (2013). The effects ofa mindfulness-based intervention on emotionaldistress, quality of life, and HbA (1c) in outpatients with diabetes (DiaMind): a randomized controlledtrial. Diabetes Care, 36(4), 823-830.
 Waddell, G. (1992). Biopsychosocial analysis of low back pain. Baillière's Clinical Rheumatology, 6(3), 523-557.
Wicksell, R. K., Dahl, J., Magnusson, B., & Olsson, G. L. (2005). Using acceptance and commitment therapy in the rehabilitation of an adolescent female with chronic pain: a case example. Cognitive and Behavioral Practice, 12(4), 415-423.