مقایسه درمان شناختی - رفتاری، حساسیت‌زدایی با حرکات چشم و پس‌خوراند زیستی بر حملات میگرن، حساسیت اضطرابی، کیفیت خواب و زندگی

محورهای موضوعی : -مدیریت اطلاعات بهداشتی و درمانی

الهه مهرمنش ¹ , فریبا حافظی ² , پروین احتشام زاده ³ , سعید بختیارپور ⁴

1 - گروه روانشناسی سلامت، واحد بین‌المللی خرمشهر، دانشگاه آزاد اسلامی، خرمشهر، ایران
2 - استادیار گروه روانشناسی، واحد اهواز، دانشگاه آزاد اسلامی، اهواز، ایران
3 - دانشیار گروه روانشناسی، واحد اهواز، دانشگاه آزاد اسلامی، اهواز، ایران
4 - دانشیار گروه روانشناسی، واحد اهواز، دانشگاه آزاد اسلامی، اهواز، ایران

تاریخ دریافت : 1402/03/06 تاریخ پذیرش : 1402/05/18 تاریخ انتشار : 1402/07/01

کلید واژه: حساسیت‌زدایی با حرکات چشم, حملات میگرن, حساسیت اضطرابی, کیفیت خواب و زندگی, درمان شناختی - رفتاری, پس‌خوراند زیستی,

چکیده مقاله :

مقدمه: با توجه به پیامدهای روانشناختی منفی میگرن، پژوهش حاضر با هدف مقایسه درمان شناختی - رفتاری، حساسیت‌زدایی با حرکات چشم و پس‌خوراند زیستی بر حملات میگرن، حساسیت اضطرابی، کیفیت خواب و زندگی زنان مبتلا به میگرن انجام شد. روش پژوهش: پژوهش حاضر نیمه‌آزمایشی با طرح پیش‌آزمون، پس‌آزمون و پیگیری همراه با گروه گواه بود. جامعه پژوهش همه زنان مبتلا به سردردهای میگرنی مراجعه‌کننده به کلینیک چشم‌آنداز آینده شهر تهران در سال 1399 بودند که تعداد 60 نفر از آنها با نمونه‌گیری تصادفی ساده انتخاب و به‌صورت تصادفی در چهار گروه مساوی گمارده شدند. گروه درمان شناختی - رفتاری 11 جلسه 90 دقیقه‌ای به‌صورت گروهی، گروه حساسیت‌زدایی با حرکات چشم و بازپردازش 12 جلسه 90 دقیقه‌ای به‌صورت انفرادی، گروه پس‌خوراند زیستی 15 جلسه 45 دقیقه‌ای به‌صورت انفرادی آموزش دید و در این مدت گروه گواه آموزشی ندید. داده‌ها با فرم یادداشت روزانه سردرد، سیاهه حساسیت اضطرابی، شاخص کیفیت خواب پیتزبورگ و پرسشنامه کیفیت زندگی جمع‌آوری و با روش تحلیل واریانس چندگانه در نرم‌افزار SPSS نسخه 25 تحلیل شدند. یافته‌ها: یافته‌ها نشان داد که در هر دو مرحله پس‌آزمون و پیگیری در تعداد و شدت حملات میگرن تاثیر هر سه روش مداخله بیشتر از گروه گواه و تاثیر درمان شناختی - رفتاری بیشتر از حساسیت‌زدایی با حرکات چشم و بازپردازش و پس‌خوراند زیستی بود (0/05>p)، اما بین دو روش حساسیت‌زدایی با حرکات چشم و بازپردزاش و پس‌خوراند زیستی تفاوت معناداری وجود نداشت (0/05<p). در مدت حملات میگرن تاثیر هر سه روش مداخله بیشتر از گروه گواه و تاثیر درمان شناختی - رفتاری بیشتر از حساسیت‌زدایی با حرکات چشم و بازپردازش و پس‌خوراند زیستی و تاثیر حساسیت‌زدایی با حرکات چشم و بازپردازش بیشتر از پس‌خوراند زیستی بود (0/05>p). هم‌چنین، در هر دو مرحله پس‌آزمون و پیگیری در حساسیت اضطرابی و کیفیت خواب تاثیر هر سه روش مداخله بیشتر از گروه گواه بود (0/05>p)، اما بین روش‌ها تفاوت معناداری وجود نداشت (0/05<p). علاوه بر آن، در هر دو مرحله پس‌آزمون و پیگیری در کیفیت زندگی تاثیر هر سه روش مداخله بیشتر از گروه گواه و تاثیر درمان شناختی - رفتاری بیشتر از حساسیت‌زدایی با حرکات چشم و بازپردازش و پس‌خوراند زیستی بود (0/05>p)، اما بین دو روش حساسیت‌زدایی با حرکات چشم و بازپردزاش و پس‌خوراند زیستی تفاوت معناداری وجود نداشت (0/05<p). نتیجه‌گیری: با توجه به نتایج پژوهش حاضر، درمانگران و متخصصان سلامت می‌توانند از هر سه روش درمان شناختی - رفتاری، حساسیت‌زدایی با حرکات چشم و بازپردازش و پس‌خوراند زیستی به‌ویژه درمان شناختی - رفتاری برای بهبود حملات میگرن، حساسیت اضطرابی، کیفیت خواب و کیفیت زندگی زنان مبتلا به میگرن استفاده نمایند.

چکیده انگلیسی:

Introduction: Considering the negative psychological consequences of migraine, this study was conducted with the aim of comparing cognitive-behavioral therapy, desensitization with eye movements and biofeedback on migraine attacks, anxiety sensitivity, and quality of sleep and life of women with migraine. Methods: The present research was semi-experimental with a pretest, posttest and follow-up design with a control group. The research population was all women suffering from migraine headaches who referred to Ayandeh Chashmandaz Clinic of Tehran city in 2020 year, which number of 60 people of them were selected by simple random sampling and randomly assigned to four equal groups. The cognitive-behavioral therapy group received 11 sessions of 90 minutes as a group, the eye movement desensitization and reprocessing group received 12 sessions of 90 minutes as an individual, the biological feedback group received 15 sessions of 45 minutes as an individual, and during this time the group did not receive training. The data were collected with headache diary note form, anxiety sensitivity inventory, Pittsburgh sleep quality index and quality of life questionnaire and were analyzed by multiple variance analysis method in SPSS version 25 software. Results: The findings showed that in both posttest and follow-up stages in number and intensity of migraine attacks the effect of all three intervention methods was greater than the control group, and the effect of cognitive-behavioral therapy was greater than eye movement desensitization and reprocessing and biological feedback (P<0.05), but there was no significant difference between the two methods of eye movement desensitization and reprocessing and biological feedback (P>0.05). In during migraine attacks the effect of all three intervention methods was greater than the control group, and the effect of cognitive-behavioral therapy was greater than eye movement desensitization and reprocessing and biological feedback, and the effect of eye movement desensitization and reprocessing was greater than biological feedback (P<0.05). Also, in both posttest and follow-up stages in anxiety sensitivity and sleep quality the effect of all three intervention methods was greater than that control group (P<0.05), but there was no significant difference between the methods (P>0.05). In addition, in both posttest and follow-up stages in quality of life the effect of all three intervention methods was greater than the control group, and the effect of cognitive-behavioral therapy was greater than eye movement desensitization and reprocessing and biological feedback (P<0.05), but there was no significant difference between the two methods of eye movement desensitization and reprocessing and biological feedback (P>0.05). Conclusion: According to the results of the current research, health therapists and professionals can be use all three methods of cognitive-behavioral therapy, with eye movement desensitization and reprocessing and biological feedback, especially cognitive behavioral therapy to improve migraine attacks, anxiety sensitivity, sleep quality and quality of life of women with Migraine.

منابع و مأخذ:

1- Dogruyol S, Gur STA, Akbas I, Kocak MB, Kocak AO, Ceylan M, Tekyol D. Intravenous ibuprofen versus sodium valproate in acute migraine attacks in the emergency department: A randomized clinical trial. The American Journal of Emergency Medicine, 2022; 55: 126-132. doi: 10.1016/j.ajem.2022.02.046

2- Ozturk M, Turan OE, Karaman K, Bilge N, Ceyhun G, Aksu U, et al. Evaluation of ventricular repolarization parameters during migraine attacks. Journal of Electrocardiology, 2019; 53: 66-70. doi: 10.1016/j.jelectrocard.2018.12.014

3- Chahine S, Wanna S, Salameh P. Migraine attacks among Lebanese university medical students: A cross sectional study on prevalence and correlations. Journal of Clinical Neuroscience, 2022; 100: 1-6. doi: 10.1016/j.jocn.2022.03.039

4- Gokdemir M, Nas C, Gokdemir GS. Pentraxin 3 level in acute migraine attack with aura: Patient management in the emergency department. The American Journal of Emergency Medicine, 2020; 38(1): 38-42. doi: 10.1016/j.ajem.2019.04.004

5- Banaeian A, Jabalameli Sh. Prediction of pain symptoms based on meta-cognitive beliefs in women with migraine in Isfahan city. Journal of Anesthesiology and Pain, 2020; 11(3): 14-27.

6- Balci B, Akdal G. Imbalance, motion sensitivity, anxiety and handicap in vestibular migraine and migraine only patients. Auris Nasus Larynx, 2020; 47(5): 747-751. doi: 10.1016/j.anl.2020.02.015

7- Olthuis JV, Thompson K, Watt MC, Stewart SH. Investigating pathways from anxiety sensitivity to impairment in a treatment-seeking sample. Journal of Affective Disorders, 2023; 324: 455-462. doi: 10.1016/j.jad.2022.12.032

8- Pan X, Palermo CA, Kaplan CS, Harnett NG, Winternitz SR, Kaufman ML, Lebois LAM. Anxiety sensitivity predicts depression severity in individuals with dissociative identity disorder. Journal of Psychiatric Research, 2022; 155: 263-268. doi: 10.1016/j.jpsychires.2022.09.003

9- Wearne TA, Lucien A, Trimmer EM, Logan JA, Rushby JA, Wilson E, et al. Anxiety sensitivity moderates the subjective experience but not the physiological response to psychosocial stress. International Journal of Psychophysiology, 2019; 141: 76-83. doi: 10.1016/j.ijpsycho.2019.04.012

10- Garrigos-Pedron M, Segura-Orti E, Gracia-Naya M, La Touche R. Predictive factors of sleep quality in patients with chronic migraine. Neurologia, 2022; 37(2): 101-109. doi: 10.1016/j.nrleng.2018.11.009

11- Danti R, Gayatri D. Relationship of psychological discomforts of stress, depression, and anxiety to sleep quality in HIV/AIDS patients. Enfermeria Clinica, 2021; 31(2): 428-431. doi: 10.1016/j.enfcli.2020.09.039

12- Lee SY, Ju YJ, Lee JE, Kim YT, Hong SC, Choi YJ, et al. Factors associated with poor sleep quality in the Korean general population: Providing information from the Korean version of the Pittsburgh Sleep Quality Index. Journal of Affective Disorders, 2020; 271: 49-58. doi: 10.1016/j.jad.2020.03.069

13- Sharma VM, Manjunath NK, Nagendra HR, Ertsey C. Combination of Ayurveda and Yoga therapy reduces pain intensity and improves quality of life in patients with migraine headache. Complementary Therapies in Clinical Practice, 2018; 32: 85-91. doi: 10.1016/j.ctcp.2018.05.010

14- Kumar DS, Prakash B, Subhash Chandra BJ, KadKol PS, Arun V, Thomas JJ. An android smartphone-based randomized intervention improves the quality of life in patients with type 2 diabetes in Mysore, Karnataka, India. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2020; 14(5): 1327-1332. doi: 10.1016/j.dsx.2020.07.025

15- Macfarlane VFH, Prentice DA, Walsh MS. The Auckland alcohol detoxification outcome study: Measuring changes in quality of life in individuals completing a medicated withdrawal from alcohol in a detoxification unit. Drug and Alcohol Dependence, 2019; 202: 156-161. doi: 10.1016/j.drugalcdep.2018.11.035

16- Fall E, Chakroun-Baggioni N, Bohme P, Maqdasy S, Izaute M, Tauveron I. Common sense model of self-regulation for understanding adherence and quality of life in type 2 diabetes with structural equation modeling. Patient Education and Counseling, 2021; 104(1): 171-178. doi: 10.1016/j.pec.2020.06.023

17- Kuriakose S, Armand Y. Cognitive behavior therapy: Patient-centered, timely, and effective paradigm. Physician Assistant Clinics, 2021; 6(3): 371-379. doi: 10.1016/j.cpha.2021.02.002

18- Kutana S, Mao JJ, Garland SN. Acupuncture as an adjunct treatment to cognitive-behavioral therapy for insomnia. Sleep Medicine Clinics, 2023; 18(1): 113-122. doi: 10.1016/j.jsmc.2022.10.005

19- Agras WS. Cognitive behavior therapy for the eating disorders. Psychiatric Clinics of North America, 2019; 42(2): 169-179. doi: 10.1016/j.psc.2019.01.001

20- Wu Z, Wang C, Dai Y, Xiao C, Zhang N, Zhong Y. The effect of early cognitive behavior therapy for first-episode treatment-naive major depressive disorder. Journal of Affective Disorders, 2022; 308: 31-38. doi: 10.1016/j.jad.2022.04.008

21- Yunitri N, Kao CC, Chu H, Voss J, Chiu HL, Liu D, et al. The effectiveness of eye movement desensitization and reprocessing toward anxiety disorder: A meta-analysis of randomized controlled trials. Journal of Psychiatric Research, 2020; 123: 102-113. doi: 10.1016/j.jpsychires.2020.01.005

22- Oledzka M, Gryglewicz A, Zaborowska K, Grzybek P, Kiebzak W. The eye movement desensitization and reprocessing approach in pain management – A case report of a patient with paraparesis. Polish Annals of Medicine, 2016; 23(1): 30-33. doi: 10.1016/j.poamed.2015.11.001

23- Sykinioti S. The effectiveness of eye movement desensitisation and reprocessing with refugees experiencing symptoms of posttraumatic stress disorder. European Journal of Trauma & Dissociation, 2019; 3(1): 49-55. doi: 10.1016/j.ejtd.2018.08.001

24- Trznadel A, Grzybek P. Application of eye movement desensitization and reprocessing therapy for cancer patients: A case study. Polish Annals of Medicine, 2017; 24(2): 228-231. doi: 10.1016/j.poamed.2016.11.009

25- Jellestad L, Zeffiro T, Piccirelli M, Malamud J, Klimke BBM, Rauen K, et al. Interfering with fear memories by eye movement desensitization and reprocessing. International Journal of Psychophysiology, 2021; 166: 9-18. doi: 10.1016/j.ijpsycho.2021.04.006

26- Kremer S, Blue T. Biofeedback as an adjunct or alternative intervention to cognitive behavioral therapy for insomnia. Sleep Medicine Clinics, 2023; 18(1): 85-93. doi: 10.1016/j.jsmc.2022.10.003

27- Kopru B, Ergin G, Ebiloglu T, Kibar Y. Does biofeedback therapy improve quality of life in children with lower urinary tract dysfunction: parents' perspective. Journal of Pediatric Urology, 2020; 16(1): 1-38. doi: 10.1016/j.jpurol.2019.11.014

28- Stanton R, Ada L, Dean CM, Preston E. Biofeedback improves performance in lower limb activities more than usual therapy in people following stroke: a systematic review. Journal of Physiotherapy, 2017; 63(1): 11-16. doi: 10.1016/j.jphys.2016.11.006

29- Ferreira S, Pego JM, Morgado P. The efficacy of biofeedback approaches for obsessive-compulsive and related disorders: A systematic review and meta-analysis. Psychiatry Research, 2019; 272: 237-245. doi: 10.1016/j.psychres.2018.12.096

30- Yetwin AK, Mahrer NE, Bell TS, Gold JI. Heart Rate Variability biofeedback therapy for children and adolescents with chronic pain: A pilot study. Journal of Pediatric Nursing, 2022; 66: 151-159. doi: 10.1016/j.pedn.2022.06.008

31- Kharazi Nutash H, Khademi A, Babapour J, Alivandi Vafa M. The effectiveness of cognitive-behavioral therapy on signs of migraine headaches and pathological worry in female nurses. Journal of Nursing Education, 2020; 8(6): 18-25. doi: 10.21859/jne-080603

32- Ahangari E, Bablkakami M. The effectiveness of virtual cognitive-behavioral group therapy on anxiety sensitivity and emotional regulation during the COVID-19 pandemic. Research in Clinical Psychology and Counseling, 2022; 12(1): 100-113. doi: 10.22067/tpccp.2022.67313.0

33- Hedayat S, Arefi M. The effect of cognitive-behavioral therapy on improving sleep quality in the elderly. Knowledge & Research in Applied Psychology, 2015; 16(2): 60-68.

34- Mohammadi Z, Khalaatbari J, Ghahari Sh, Zarenezhad M, Mahmoodi N, Kalani N. The effectiveness of cognitive behavioral therapy on quality of life in schizophrenic patients. Medical Journal of Mashad University of Medical Sciences, 2021; 64(4): 3868-3876. doi: 10.22038/mjms.2021.20170

35- Jelveh M. The effectiveness of eye movement desensitization and reprocessing (EMDR) in reducing anxiety in COVID-19 patients admitted to ICU. Journal of Assessment and Research in Applied Counseling, 2021; 3(2): 27-37. doi: 10.52547/jarcp.3.2.27

36- Ranjbaripour T, Hashemian K, Ahadi H, Rezabakhsh H, Farrokhi NA. The effectiveness of eye movement desensitization and reprocessing (EMDR) therapy on primary insomnia. Clinical Psychology Studies, 2015; 4(15): 127-140.

37- Jahan F, Merafzonn D, Hosseini Sh. Exploring the effect of eye movement desensitization and reprocessing (EMDR) on emotion regulation, defense mechanisms, and quality of life of female students with social anxiety. Psychological Methods and Models, 2019; 9(33): 51-70.

38- Safarinia M, Bagherian-Sararoudi R, Aliakbari M, Shahandeh M. The effectiveness of psychosocial therapy and biofeedback on improvement of migraine attacks and headache disability. Journal of Research in Behavioural Sciences, 2016; 14(2): 137-45.

39- Nori L, Saedi S, Sadeghi M. The comparison of effectiveness of cognitive-behavioral therapy, biofeedback therapy and integrating therapy on sleep quality in women with generalized anxiety disorder. Iranian Journal of Psychiatric Nursing, 2022; 9(6): 49-64.

40- Zarrabi S, Rezaei O, Ebrahimi Daryani N. Effectiveness of biofeedback on quality of life in patients with dyssynergic defecation disorder. Govaresh, 2014; 19(3): 182-190.

41- Kelly AM. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emergency Medicine Journal, 2001; 18(3): 205-207. doi: 10.1136/emj.18.3.205

42- Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 1986; 24(1): 1-8. doi: 10.1016/0005-7967(86)90143-9

43- Shams S. Predicting Coronavirus anxiety based on cognitive emotion regulation strategies, anxiety sensitivity, and psychological hardiness in nurses. Quarterly Journal of Nursing Management, 2021; 10(2): 25-36.

44- Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research, 1989; 28(2): 193-213. doi: 10.1016/0165-1781(89)90047-4

45- Sanagouye Moharer G, Kia S, Akbarizadeh A, Erfani M. Effect of hope therapy on sleep quality, subjective well-being and health hardiness among cancer patients with breast evacuation. Iranian Journal of Rehabilitation Research in Nursing, 2019; 6(2): 66-73. doi: 10.21859/ijrn-06208

46- WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Journal of Psychological Medicine, 1998; 28(3): 551-558. doi: doi: 10.1017/s0033291798006667

47- Hamid N, Bordbar M, Marashy SA. The effectiveness of habit reversal training with cognitive behavior therapy on quality of life and symptoms of trichotillomania patients. Medical Journal of Tabriz University of Medical Sciences, 2022; 44(2): 116-126. doi: 10.34172/mj.2022.021.