مقایسه اثربخشی دارو درمانی و مدیریت استرس به شیوه ی شناختی- رفتاری بر اجتناب شناختی و ناگویی هیجانی در بیماران مبتلا به سردردهای تنشی.
محورهای موضوعی :
تکتونواستراتیگرافی
سید عبدالله امیری ارجمند
1
,
بهرام میرزاییان
2
,
سید محمد باغبانیان
3
1 - دانشجوی دکتری روانشناسی عمومی، گروه روانشناسی، واحد ساری، دانشگاه آزاد اسلامی، ساری، ایران
2 - دکتری روانشناسی، دانشیار و هیأت علمی گروه روانشناسی، واحد ساری، دانشگاه آزاد اسلامی، ساری، ایران
3 - متخصص مغز و اعصاب، عضو هیأت علمی، گروه علوم پزشکی، واحد ساری، دانشگاه علوم پزشکی مازندران، ساری، ایران
تاریخ دریافت : 1400/02/14
تاریخ پذیرش : 1400/08/05
تاریخ انتشار : 1400/08/01
کلید واژه:
"اجتناب شناختی",
"ناگویی هیجانی",
"مدیریت استرس به شیوه شناختی رفتاری",
چکیده مقاله :
مقدمه: هدف از این پژوهش مقایسه دارودرمانی و مدیریت شناختی رفتاری استرس بر کاهش اجتناب شناختی و ناگویی هیجانی (بعنوان دو سبک مقابله ای ناکارآمد در برابر استرس) در بیماران مبتلا به سردردهای تنشی می باشد.
روش: در این مطالعه کارآزمایی بالینی تعداد 40 نفر از افراد مبتلا به سردرد تنشی شهرستان ساری به شیوه نمونه گیری در دسترس انتخاب و بصورت تصادفی در چهار گروه 10 نفره تقسیم شدند. گروه اول صرفاً درمان با مدیریت شناختی رفتاری استرس دریافت نمودند. گروه دوم صرفاً درمان دارویی شدند، گروه سوم همزمان دو درمان مذکور را دریافت نمودند و گروه چهارم هیچ درمانی دریافت ننمودند. آزمودنی ها قبل و بعد از مداخله، پرسشنامه های اجتناب شناختی و ناگویی هیجانی را تکمیل نمودند.
یافته ها: نتایج با نرمافزار spss و آزمونهای ناپارامتریک تحلیل شدند. یافته ها نشان دادند، گروه اول (مدیریت استرس) و گروه سوم (مدیریت استرس و دارودرمانی) طی آزمون کروسکال والیس بیشترین رتبه را در کاهش اجتناب شناختی و ناگویی هیجانی کسب نمودند. گروه دوم (دارودرمانی) و گروه چهارم (بدون درمان) کمترین رتبه را در کاهش متغیرهای مذکور کسب نمودند. طبق آزمون مان ویتنی مشخص شد تفاوت نمرات دو گروه صدر جدول با گروه های پایین جدول معنادار می باشد.
نتیجه گیری: وجود مدیریت استرس در گروههای صدر جدول و وجود تفاوت معنادار بین گروه های صدر جدول و گروه های پایین جدول نشان دهنده تاثیر مثبت مدیریت استرس بر کاهش اجتناب شناختی و ناگویی هیجانی می باشد. این نتیجه برای روانشناسان و مبتلایان به سردردهای تنشی مهم است چراکه از روش مدیریت شناختی رفتاری استرس می توان به اصلاح برخی سبک های مقابله ای ناکارآمد درمقابل استرس پرداخت و از آن طریق به درمان سردردهای تنشی اقدام نمود
چکیده انگلیسی:
Introduction: The aim of this study was to compare drug therapy and cognitive-behavioral management of stress on reducing cognitive avoidance and alexithymia (as two inefficient coping styles against stress) in patients with tension headaches. Method: In this clinical trial study, 40 people with tension headache in Sari city were divided into four groups of 10 by convenience sampling. The first group received only cognitive-behavioral stress management, the second group received only medication, the third group received the two treatments together, and the fourth group received no treatment. They completed cognitive avoidance and alexithymia questionnaires before and after the intervention. Results: The results were analyzed by SPSS software and nonparametric tests. The results showed that the first group (stress management) and the third group (stress management and medication) had the highest rank in reducing cognitive avoidance and emotional distress during Kruskal-Wallis test. The second group (drug therapy) and the fourth group (without treatment) had the lowest rank. According to Mann-Whitney test, the difference between the scores of the two groups at the top of the table and the groups at the bottom of the table is significant. Conclusion: The presence of stress management in the top groups of the table shows its positive effect on reducing cognitive avoidance and emotional dysphoria. This result is important for psychologists because the method of cognitive-behavioral stress management can correct some inefficient coping styles against stress and through it to treat tension headaches.
منابع و مأخذ:
1- Moghaddam N, Asl Fattahi B, Taghizadeh H. The effectiveness of stress management training on mental health, job satisfaction and sleep quality of shift workers and day workers of Tabriz Petrochemical Company. Journal: Productivity Management (Beyond Management). Issue: Winter 2013, Volume 7, Number 27; Page 133 to Page 152.
2- Anthony M, Ironson G, Schneiderman N. A practical guide to cognitive-behavioral stress management. Translation: Javad Al-Mohammad, Solmaz Jokar and Hamid Taher Neshatdoost, 2009, Isfahan: University Jihad Publications.
3- Olatunji M, Zlomke K. Linking cognitive avoidance and GAD symptoms: The mediating role of fear of emotion. Behavi Res Ther. 2010; 435-41.
4- Abolghasemi A, Jafari I, Ahmadi, M. Comparison of perfectionism, aggression and coping styles of patients with tension headache, migraine and normal people. Journal of Kerman University of Medical Sciences, Volume 21, Number 2; Page 162 to Page 173.
5- Basak Nejad S, Moeini N, Mehrabizadeh M. The relationship between post-event processing and cognitive avoidance with social anxiety in students. Journal: Behavioral Sciences »Winter 2010, Volume 4 - Number 4 Scientific-Research / ISC (6 pages - from 335 to 340).
6- Lavy E, van den Hout M. Cognitive avoidance and attentional bias: Causal relationships. Cogn Ther Res. 1994; 18(2), 179-191.
7- Fehm L. Margraf J. Thought suppression: specify in agrophobia versus broad impairement in social phobia? Behav Res Ther, 2002, 40,57-66
8- Kashdan T, Roberts J. Social anxiety, depression and post event rumination: Affective consequences and social contextual influences. J of Anxi Disord. 2004; 21: 284-301.
9- Purdon C. Thought suppression and psychopathology. Behavior Research and Therapy 1999; 37, 1029–1054.
10- Freeston M, Ladouceur R. What do patients do with their obsessive thought? Behav. Res. Ther 1997; Vol. 35, No. 4, pp. 335-348.
11- Khayeri B, Mirmahdi R ,Akuchekian SH. The Effectiveness of Emotion-Focused Therapy on Obsessive-Compulsive Symptoms, Rumination and Cognitive Avoidance of Women Patients with Obsessive-Compulsive Disorder, Volume 20, Number 9 (Serial Number 126), December 2017, 33-34.
12- Sharafati H, Taheri E, Asmaei Majd S, Amiri M. The effectiveness of Dougas model based cognitive therapy on intolerance of uncertainty, cognitive avoidance and positive beliefs of anxiety in patients with generalized anxiety disorder.
13- Belloch A, Morillo C, Lucero M, Cabedo E, Carrio C. Intrusive thoughts in non-clinical subjects: the role of frequency and unpleasantness on appraisal ratings and control strategies. Clinical Psychology and Psychotherapy 2004; 11,100-110.
14- Armstrong T, Zald D, Olatunji B. Attentional control in OCD and GAD: Specificity and associations with core cognitive symptoms. Journal of Anxiety Disorders 2016; 44, 63–72.
15- Mokhtari S, Khosravi S, Rescuer A. Comparison of uncertainty intolerance, anxiety, cognitive avoidance and negative problem orientation in people with generalized anxiety disorder, major depressive disorder and normal people, Journal of Behavioral Sciences Research, Summer 2015 - Issue 40 (ISC) 20 pages ( From 188 to 207).
16- Barghi z, bagian M; Ali Sari Nasirloo K, Bakhti, M. The role of cognitive avoidance and decision procrastination in predicting social anxiety of students of the National Congress of Social Psychology of Iran Scientific Associations, Iranian Society of Social Psychology, 2013, Volume 2.
17- Dugas M, RobbiChavd M. Cognitive behavior therapy for generalized anxiety disorder, translated by Akbari M chini frushan M, Abedian A. arjmand publication. Tehran: the mighty; 2013.
18- Besharat, M. alexithymia and interpersonal problems. Educational and Psychological Studies of Ferdowsi University, (1386). 10 (1), 129-145.
19- https://www.psychiatry.org/psychiatrists/practice/dsm5
20- Poursoltany H, Alvandi R, Sayadfar, M. Alexithymia, the Emotional Blindness among Stroke Survivors: Preliminary Study. International Neuropsychiatric Disease Journal, (2016). 6(1), 1-11.
21- Kathryn D, Timmerman L. Accomplishing romantic relationship. In: Greene JO, Burleson BR, editors. Handbook of communication and social interaction skills Mahwah. Lawrence Erlbaum Associates 2003; 685–90.
22- Yum Y, Canary DJ. Maintaining relationships in Korea and the United States: Features of Korean culture that affect relational maintenance beliefs and behaviors. Maintaining relationships through communication 2003;277–96
23- Sprecher S, Metts S, Burleson B, Hatfield E, Thompson A. Domains of expressive interaction in intimate relationships: Associations with satisfaction and commitment. Fam Relat 1995; 44: 203-10.
24- Mattila A, Ahola K, Honkonen T, Salminen J, Huhtala H, Joukamaa M. Alexithymia and occupational burnout are strongly associated in working population. J Psychosomatic Res 2007; 62 (6): 657-65.
25- Humphreys T, Wood L,Parker, J. Alexithymia and satisfaction in intimate relationships. Personality and Individual Differences. (2009). 46: 43-47
26- De Rick A, Vanheule S. Alexithymia and DSM-IV personality disorder traits in alcoholic inpatients: A study of the relation between both constructs. Pers Individ Dif 2007; 43 (1): 119–29.
27- Horowitz L. Pschemas,.psychopathology, and psychotherapy research. Psychotherapy Res 1994; 4: 1-19.
28- Marino E, Fanny B, Lorenzi C, Pirovano A, Franchini L, Colombo C, Bramanti P, Smeraldi E. Genetic bases of co morbidity between mood disorder and migraine: Possible role of serotonin transporter gene. Neuro Science, (2010). 31, 387-91.
29- Headache Society (IHS) The International Classification of Headache Disorders, 3rd Edition Cephalalgia . 2018 Jan;38 (1):2411-1. doi: 10.1177/0333102417738202.
30- Davis P, Holm J, Myers T, Suda K. Stress, headache and physiological disregulation: a time –series analysis of stress in the laboratory. Headache. 1998; 38 (2): 116-21
31- Linden W, Moseley J. The efficacy of behavioral treatments for hypertension. Appl Psychophysiol Biofeedback, 2006; 31(1), 51
32- Sexton K.Dugas M. An investigation of the factors leading to cognitive avoidance in worry. Concordia University, (2008). Quebec, Canada.
33- Alilo M. Dialectical Behavior Therapy for Borderline Personality Disorder, Tehran, Psychology Center, University of Tehran. (2011),
34- Bagby R, Taylor G, Parker J. The twenty item Toronto Alexithymia Scale II. Convergent, discriminant, and concurrent validity. J Psychoso Res 1994; 38(3): 33-40.
35- Akbari M,Sabet M. Comparison of the effectiveness of cognitive-behavioral therapy focused on ambiguity intolerance and drug therapy on the components of anxiety, ambiguity intolerance and cognitive avoidance in patients with generalized psychiatric anxiety disorder and clinical psychology in Iran Volume 24 No. 3 (consecutive 94) 240-255.
36- Haji Aqrari L, Asadi F, Javazi S, Atef V. The effectiveness of acceptance and commitment-based therapy on behavioral inhibition and cognitive-behavioral avoidance in women with generalized anxiety disorder: (1397). p. 31-38.
37- Ahmadi Z, Mirzaeian B, Praise M. The effectiveness of mindfulness-based cognitive therapy on anxiety and cognitive avoidance in anxiety students, Quarterly Journal of New Psychological Ideas. .(1395).
38- Mirza Hosseini H, Pourabdol S, Sobhi Gharamaleki N. Saravani Shahzad. The effectiveness of acceptance and commitment based therapy on reducing cognitive avoidance in students with special learning disabilities. Iranian Journal of Psychiatry and Psychology. .(1395).
39- Paknejad F, Salimi M, Movahedzadeh B, Goledar N, Dinparast O, Aziz Mohammadi Z. The effectiveness of group therapy of behavioral activation on reducing the symptoms of depression, cognitive-behavioral avoidance of families of control and self-sacrificing students. Military Psychology, (1398). Volume 7, Number 28, Page 75-
40- Sharafati H, Taheri E, Asmaei Majd S, Amiri M. The effectiveness of Dougas model based cognitive therapy on intolerance of uncertainty, cognitive avoidance and positive beliefs of anxiety in patients with generalized anxiety disorder. (1396).
41- Darwish Baseri L, Dasht-e Bozorgi Z. The effectiveness of acceptance and commitment group therapy on cognitive emotion regulation and emotional dysphoria in patients with type 2 diabetes. Journal of Psychiatric Nursing, (1396). 5 (1): 14-7.
42- Izadi F, Ashrafi E, Fathi A. The effectiveness of emotional schema therapy on reducing negative emotional schemas, emotional dysphoria and symptoms in patients with physical symptoms. Behavioral Science Research. (1398).
43- Bayegan K. The effectiveness of group dialectical behavior therapy intervention on reducing the symptoms of emotional distress, stress and symptoms of diabetes in patients with type 2 diabetes. Diabetes Nursing Quarterly .(2016).
44- Pirani Z, Abbasi M, Kalvani M, Nourbakhsh P. The effect of acceptance and commitment therapy on sexual self-esteem, mood dysphoria and marital adjustment in veterans' spouses. Journal of Veteran Medicine. (1396).
45- Nourizadeh M. The effectiveness of emotion regulation-based intervention on emotional cognitive regulation strategies and emotional dysphoria in patients with coronary heart disease. Journal of New Developments. (1396).
46- Nash J, Thebarge R. Understanding psychological stress, its biological processes, and impact on primary headache. Headache. 2006 Oct; 46(9): 1377-86.
47- Nicholson R, Houle T, Rhudy J, Norton P. Psychological risk factors in headache. Headache. 2007; 47(3): 413-26.
48- Breslau N, Schultz L, Lipton R, Peterson L,Welch K. Migraine headaches and suicide attempt, Headache. (2012); 52(5):723-731
49. Atasoy H, Atasoy N, Unal A. Psychiatric co morbidity in medication overuse headache patients with preexisting headache type of episodic tension-type headache. European Journal of Pain, (2005). 9(3), 285-91.
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