با همکاری مشترک دانشگاه پیام نور و انجمن روانشناسی سلامت

نوع مقاله : علمی- پژوهشی

نویسندگان

1 گروه روان شناسی ، دانشکده روانشناسی ، دانشگاه آزاد واحد کرج .استان البرز .ایران

2 گروه روانشناسی بالینی ، دانشگاه علوم بهزیستی ، تهران، ایران

3 استادیار گروه روانشناسی سلامت ، واحد کرج ، دانشگاه آزاد اسلامی ،کرج ، ایران.

4 گروه آموزشی علوم تربیتی ، دانشکده علوم تربیتی ، دانشگاه آزاد واحد رودهن ، روهن ، ایران

5 گروه روان شناسی دانشگاه آزاد واحد کرج ، کرج، ایران

چکیده

مقدمه: هدف این پژوهش بررسی نقش تجارب آسیب­زای جنسی، راهبردهای شناختی تنظیم هیجان و افشاسازی در تبیین علائم جسمی دختران نوجوان آسیب­دیده بود. روش: روش پژوهش همبستگی و جامعه آماری کلیه دانش­آموزان 14 تا 17 سال استان تهران در سال تحصیلی 98-97 بود. با غربالگری دانش­آموزان دارای تجربه آسیب جنسیو حذف پرسشنامه­های ناقص، 273 دانش­آموز در تحلیل شرکت کردند. برای جمع­آوری داده­­ها از چک­لیستتجاربآسیب­زایزندگی نیجن­هویس، وندرهارت و کروگر (2002)، پرسشنامه راهبردهای شناختی تنظیم هیجان گارنفسکیو همکاران (2001)، پرسشنامه سلامتجسمانی گرک (2015)، مقیاس خودافشاسازیپریشانیکانوهسلینگ(2003) استفاده شد و با استفاده از رگرسیون چندگانه تحلیل شد. یافته‌ها: نتایج نشان داد راهبردهای شناختی تنظیم هیجان ناسازگارانهبا (441/0= β  و 01/0>p)، افشاسازی (213/0- = β و 01/0>p)، راهبردهای شناختی تنظیم هیجان سازگارانه (172/0- = β  و 01/0>p)، تجارب آسیب­زا (117/0= β  و 05/0>p) توانایی پیش‌بینی علائم جسمی را دارند. نتیجه‌گیری: نتایج نشان داد می­توان با بررسی تاریخچه تجارب آسیب­زای جنسی، مدیریت راهبردهای تنظیم شناختی هیجان و تسهیل افشاسازی در جهت کنترل علائم جسمی بهره برد.

کلیدواژه‌ها

عنوان مقاله [English]

The Role of Sexual Traumatic Experiences, Cognitive Emotion Regulation Strategies, and Disclosure in somatic Symptoms of Abused adolescent girls

نویسندگان [English]

  • Soheila Etemadi 1
  • Hamid Poursharifi 2
  • Biuok Tajeri 3
  • Mehdi Kalantari 4
  • Nahid Hovassi Soomer 5

1 Department of Psychology,Karaj Branch, Islamic Azad University ,Alborz, Iran

2 Department of Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

3 Assistant Professor of Health Psychology, Department of Health Psychology, Karaj Branch , Islamic Azad University , Karaj , Iran.

4 Department of Educational Sciences Roudehen Branch, Islamic Azad University, Roudehen, Iran

5 Department of Psychology, Karaj Branch, Islamic Azad University

چکیده [English]

Objective: The purpose of this study was to investigate the role of Traumatic experiences of sexual abuse, cognitive emotion regulation strategies, and disclosure in explaining Somatic Symptoms of adolescent girls. Method: The method of the present study was correlation and statistical population of all students of 14-17 years in Tehran province in the academic year 97-98. By screening students with experience of sexual trauma, and eliminating the incomplete questionnaires273 students were ianalysis. For gathering data,Checklist of Traumatic Experiences of Nigent Huys and Wonder Hart & Kruger (2002), Cognitive emotion regulation strategies questionnaire Garnefsky et al. (2001), Grek's Mental Health Questionnaire (2015), Self-disclosure scale of Kun and Hessling (2003) were used and analyzed using multiple regression. Findings: The results showed maladaptive cognitive emotion regulation strategies (with β = 0.441 and p <0.01), disclosure (β = -0.201 and p <0.01), adaptive cognitive emotion regulation strategies (β = -0.117 and p <0.01), sexual traumatic experiences (β = 0.170, p <0.05), have the ability to predict Somatic symptoms. Conclusion: The results showed that can be used to control Somatic Symptoms by Investigating the history of sexual abuse experiences, Managing Cognitive Emotion Regulation Strategies, and facilitating disclosure

کلیدواژه‌ها [English]

  • Traumatic Experiences of Sexual Abuse
  • Cognitive Emotion Regulation Strategies
  • Disclosure
  • Somatic Symptoms
آذرکلاه، آ؛ ابوالقاسمی، ع؛ ندرمحمدی، م؛ سلوت، ح. (1398). ارتباط حس انسجام، تفکر مثبت و خود افشایی هیجانی با کیفیت زندگی بیماران مبتلا‌به سرطان. فصلنامه علمی پژوهشی روانشناسی سلامت، 8(32)، 24-7.
انجمن روان‌پزشکی آمریکا. (1393). ‏‫راهنمای تشخیصی و آماری اختلال‌های روانی. ترجمه فرزین رضاعی و همکاران. تهران: نشر ارجمند.
اورکی، م؛ مهدی‌زاده، آ؛ درتاج، ا. (1397). مقایسه اثربخشى درمان شناختى رفتارى متمرکز بر تنظیم هیجان و درمان مبتنی بر پذیرش و تعهد بر کاهش علائم کمردرد، افسردگی و افزایش رضایت از زندگی در زنان مبتلابه کمردرد مزمن با اختلال افسردگی اساسی همبود. فصلنامهعلمیپژوهشیروانشناسیسلامت، 7(26)، 43-25.
حسنی، ج. (1390). بررسی اعتبار و روایی فرم کوتاه پرسش‌نامه نظم جویی شناختی هیجان. تحقیقاتعلوم رفتاری، 9(4)، 238-229.
 حسینی، آ؛ خرمایی، ف؛ عصار زادگان، ف؛ حسامی، ا؛ تقوی، م.ر؛ محمدی، ن.ا. (1393). مقایسه راهبردهای تنظیم شناختی هیجان در افراد مبتلا‌به سردرد میگرنی، سردرد تنشی و افراد بهنجار. فصلنامهعلمیپژوهشیروانشناسی سلامت، 3(11)، 101-89.
دیماتئو، رابین (1387). روانشناسی سلامت. ترجمه محمد کاویانی و همکاران. تهران: نشر سمت.
زارع، م؛ لطیفیان، م؛ فولاد چنگ، م. (1392). مدل علّی ابعاد دلبستگی و راهکارهای تنظیم هیجان با واسطه‌گری خودکارآمدی اجتماعی و
خود افشاسازی. پژوهشهای روانشناختی اجتماعی، 3(11): 13-32.
عربی، ا و باقری، م. (1397). نقش میانجیگری راهبردهای تنظیم هیجان بین شدت درد و کیفیت زندگی در بیماران مبتلا به اختلال درد مزمن. فصلنامهعلمیپژوهشیروانشناسیسلامت، 6(22)، 72-87.
گلابی، ن؛ عبدالهی، م.ح؛ شاهقلیان، م. (1395). رابطه تنظیم هیجان و باورهای فراشناختی با مدیریت درد در افراد دچار سردرد مزمن. فصلنامه روانشناسی بالینی و شخصیت، 4(1)، 61-70.
Alcalá, H. E., Keim-Malpass, J., & Mitchell, E. (2017). Colorectal cancer screening and adverse childhood experiences: Which adversities matter? Child Abuse & Neglect, 69, 145-150.
Besharat, M.A., EtemadiNia, M. Farahani, H. (2013).  Anger and major depressive disorder: The mediating role of emotion regulation and anger rumination. Asian Journal of Psychiatry, Volume 6, Issue 1, Pages 35-41.
Brown, RJ., Bouska, JF., Frow, A., Kirkby, A., Baker, GA., Kemp, S., et al. (2013) Emotional dysregulation, alexithymia, and attachment in psychogenic nonepileptic seizures. Epilepsy Behav, 29, 178-183.DOI:10.1016/j.yebeh.2013
Campbell, J. A. Farmer, G. C., Nguyen-Rodriguez, S., Walker, R. & Egede, L.E. (2018). Using path analysis to examine the Relationship between sexual abuse in childhood and diabetes in adulthood in a sample of US adults. Preventive Medicine, 108, 1-7.
Crouch, E., Strompolis, M., Radcliff, E., & Srivastav, A. (2018). Examining exposure to adverse childhood experiences and later outcomes of poor physical and mental health among South Carolina adults. Children and Youth Services Review, 84, 193-197.
Daigneault, I., Vézina-Gagnon, P., Bourgeois, C., Esposito, T., & Hébert, M. (2017). Physical and mental health of children with substantiated sexual abuse: Gender comparisons from a matched-control cohort study. Child Abuse & Neglect, 66, 155-165.
Ehlert, U., Nater, UM., Böhmelt, AH. (2005). High and low unstimulated salivary cortisol levels correspond to different symptoms of functional gastrointestinal disorders. J Psychosom Res; 59:7–10.
Eslami, B., Di Rosa, M., Barros, H., Torres-Gonzalez, F., Stankunas, M., Ioannidi-Kapolou, E., & et al. (2019). Lifetime abuse and somatic  symptoms  among older women and men in Europe. PloS one,  PLoS ONE 14(8): e0220741.
Etienne, G. Krug, Linda L. Dahlberg, James A. Mercy, Anthony B. Zwi and Rafael, L. (2002). World report on violence and health. World Health Organization. Geneva., pp. 59-60.
Garnefski, N., Kraaij, V. & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual differences, 30(8), 1311-1327.
Gierk, B., Kohlmann, S., Toussaint, A., Wahl, I., Brünahl, C. A., Murray, A. M., & Löwe. (2015). Assessing somatic symptom burden: a psychometric comparison of the patient health questionnaire-15 (PHQ-15) and the somatic symptom scale-8 (SSS-8). J Psychosom Res; 78(4): 352-5.
Gross, JJ. )2015). Handbook of Emotion Regulation, Second edition, Guilford Publications.
Heim, C. Ehlert, U. Hellhammer, D. (2000). The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology, 25: 1–35.
Hekmatravan, R., Samsum Shariat, M., Khani, F., Khademi, M. (2012). The relationship between anxiety and depression with Somatization in Blind people of Isfahan city. 4th international congress on psychosomatic. Azad university, Isfahan, Iran. 2012; Oct, 17-19.
Huh, HJ., Kim, KH., Lee, HK., Chae, JH. (2017) The relationship between childhood trauma and the severity of adulthood depression and anxiety symptoms in a clinical sample: The mediating role of cognitive emotion regulation strategies. J Affect Disord; 213: 44-50. DOI: 10.1016/j.jad. 2017.02.009.
Ironson,G. O'Cleirigh, C., Leserman, J., Stuetzle,R., Fordiani,J., Fletcher, M., Schneiderman, N. (2013). Gender-Specific Effects of an Augmented Written Emotional Disclosure Intervention on Posttraumatic, Depressive, and HIV-Disease-Related Outcomes: A Randomized, Controlled Trial. Journal of consulting and clinical psychology, Volume 81, Issue 2, 284 – 298.
Kahn, J. H., & Hessling, R. M. (2001). Measuring the tendency to conceal versus disclose psychological distress. Journal of Social and Clinical Psychology, 20, 41-65.
Kane, N. S., Hoogendoorn, C. J., Tanenbaum, M. L., Gonzalez, J. S. (2018). Physical symptom complaints, cognitive emotion regulation strategies self compassion and diabetesdistressamong adults with Type 2. Diabetic Medicine, Volume 35, Issue 12. 1671 – 1677.
Kano, M., Fukudo, S. (2013). The alexithymic brain: The neural pathways linking alexithymia to physical disorders. BioPsychoSocial Medicine, DOI: 10.1186/1751-0759-7-1.
Kealy, D., Rice, S. M., Ogrodniczuk, J. S., & Spidel, A. (2018). Childhood trauma and somatic symptoms among psychiatric outpatients: Investigating the role of shame and guilt. Psychiatry Research, 268, 169-174.
 Kleinstauber, M., Gottschalk, J., Berking, M., Rau, J., Rief, W. (2016). Enriching cognitive behavior therapy with emotion regulation training for patients with multiple medically unexplained symptoms (ENCERT): Design and implementation of a multicenter, randomized, active-controlled trial. Contemp Clin Trials.; 47: 54–63.
Koechlin, H., Coakley, R., Schechter, N., Werner, C., Kossowsky, J. (2018). The role of emotion regulation in chronic pain: A systematic literature review. J Psychosom Res; 107: 38–45.
Lee, S., Creed, F. H., Ma, Y. L., & Leung, C. M. (2015). Somatic symptom burden and health anxiety in the population and their correlates. Journal of Psychosomatic Research, 78(1), 71–6.
Lees, B. F., Stewart, T. P., Rash, J. K., Baron, S. R., Lindau, S. T., & Kushner, D. M. (2018). Abuse, cancer and sexual dysfunction in women: A potentially vicious, cycle Gynecologic Oncology, 150(1), 166-172.
Lieblich, A., McAdams, D. P., & Josselson, R. (Eds). (2004). Healing plots: The narrative basis of psychotherapy. American Psychological Association (APA).  doi.org/10.1037/10682-000.
Liverant, G. I., Kamholz, B. W., Sloan, D. M., & Brown, T. A. (2011). Rumination in clinical depression: A type of emotional suppression? Cognitive Therapy and Research, 35, 253-265.
Loeb, T. B., Joseph, N. T., Wyatt, G. E., Zhang, M., Chin, D., Thames, A., & Aswad, Y. (2018). Predictors of somatic symptom severity: The role of cumulative history of trauma and adversity in a divers community sample. Psychological Trauma: Theory, Research, Practice, and Policy, 10(5), 491-498.
Luyten, P., van Houdenhove, B., Lemma, A., Target, M., Fonagy, P. (2013). Vulnerability for functional somatic disorders: A contemporary psychodynamic approach. Journal of Psychotherapy Integration. 23: 250–262.
 Marquis, C.,Vabres, N., Caldagues, E., Bonnot, O. (2016). Clinicof somatoform disorders in abused adolescents. Presse medicale (Paris, France: 1983) Volume 45, Issue 4 Pt 1.
Martin, E., Silverstone, P. (2013). How Much Child Sexual Abuse is "Below the Surface," and Can We Help Adults Identify it Early? Frontiers InPsychiatry 4: 58-58.
Mctavish, J.R., Wekerle,ch. (2019). Child Sexual Abuse, Disclosure and PTSD: A Systematic and Critical Review. Child Sexual Abuse, Disclosure & PTSD. DOI: 10.1016/j.chiabu.2019.04.006.
Morina, N., Kuenburg, A., Schnyder, U., Bryant, R. A., Nickerson, A., & Schick, M. (2018). The Association of Post-traumatic and Post migration Stress with Pain and Other Somatic Symptoms: An Explorative Analysis in Traumatized Refugees and Asylum Seekers. Pain Medicine, 19(1), 50-59.
Näring, G., Nijenhuis, ER. (2005). Relationships between self-reported potentially traumatizing events, psychoform and somatoform dissociation, and absorption, in two non-clinical populations. Australian and New Zealand, Journal of Psychiatry, 39(11-12), 982-988. DOI: 10.1111/j.1440-1614.2005 .01 701.x.
Nijenhuis, E. R., Van der Hart, O., & Kruger, K. (2002). The psychometric characteristics of the Traumatic Experiences Checklist (TEC): First findings among psychiatric outpatients. Clinical Psychology & Psychotherapy, 9(3), 200-210.
Okur Güney, Z.E., Sattel, H. Witthöft, M. & Henningsen, P. (2019). Emotion regulation in patients with somatic symptom and related disorders: A systematic review. Published: PloS one; 14(6): e0217277.
Otterpohl, N., Stranghoener, D., Vierhaus, M., Schwinger, M. (2017). Anger regulation and school-related somatic complaints in children with special educational needs: A longitudinal study. Learning and Individual Differences, Volume 56. 59 – 67.
Palo, AD. & Gilbert, BO. (2015). The Relationship Between Perceptions of Response to Disclosure of Childhood Sexual Abuse and Later Outcomes. Journal of Child Sexual Abuse, 24: 5, 445-463,
Schutze, R., Rees, C., Slater, H., Smith, A., Sullivan, P. O. (2017). I call it stinkin thinkin: A qualitative analysis of metacognition in people with chronic low back pain and elevated catastrophizing. British Journal ofHealth Psychology, 22, 463–480.
Sloan, D. M., & Marx, B. P. (2006). Exposure through written emotional disclosure: Two case examples. Cognitive and Behavioral Practice, 13, 227-234.
Steine, I. M., Winje, D., Krystal, J. H., Bjorvatn, B., Milde, A. M., Grønli, J., & et al. (2017). Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse. Child Abuse & Neglect, Volume 65.
Thurston, R. C., Chang, Y., Barinas-Mitchell, E., von Känel, R., Jennings, J. R., Santoro, N., Matthews, K. A. (2017). Child Abuse and Neglect and Subclinical Cardiovascular Disease Among Midlife Women: Psychosomatic Medicine, 79(4), 441-449.
Townsend. C. (2013). Prevalence and consequences of CSA compared with other childhood http.:// missourikidsfirst.org/wpcontent/uploads/2013/08/Comparison of Child Sexual Abuse to Other Adverse Experiences-8-6.
Ullman, SE., Filipas, HH. (2001). Predictors of PTSD symptom severity and social reactions in sexual assault victims. Journal of Traumatic Stress; 14(2): 369–389.
Van Geelen, S. M., & Hagquist, C. (2016). Are the time trends in adolescent psychosomatic problems related to functional impairment in daily life? A 23-year study among 20,000 15–16 year olds in Sweden. Journal of Psychosomatic Research, 87, 50-56.
Vanaelst, B., Huybrechts, I., De Bourdeaudhuij, I., Bammann, K., Hadjigeorgiou, Ch.Eiben, G. De Henauw, S. (2012). Prevalence of negative life events and chronic adversities in European pre- and primary-school children: results from the IDEFICS study. Archives of Public Health, 70(1). 26.
Xiong N, Fritzsche K, Wei J, Hong X, Leonhart R, Zhao X, Nolte S. (2015). Validation of patient health questionnaire (PHQ) for major depression in Chinese outpatients with multiple somatic symptoms: A multicenter cross-sectional study. Journal of affective disorders 174, 636- 643. DOI: 10.1016/ j.jad.2014 .12.042.
Ziadni, MS., Carty, JN., Doherty, HK., Porcerelli, JH., Rapport, LJ., Schubiner, H., & et al. (2018). A life-stress, emotional awareness, and expression interview for primary care patients with medically unexplained symptoms: A randomized controlled trial. Health Psychol ; 37(3): 282-290. doi: 10.1037/hea0000566.