مقایسه اثربخشی درمان دلبستگی با درمان انگیزشی در کاهش لغزش، عود، ولع و تداوم پرهیز مصرف مواد در بیماران اختلال شخصیت مرزی وابسته به مواد
محورهای موضوعی : تربیتیحجت اله طهماسبیان 1 , وحید احمدی 2 , شهرام مامی 3
1 - دانشجوی دکتری روانشناسی عمومی، واحد ایلام، دانشگاه آزاد اسلامی، ایلام، ایران
2 - استادیار، دکتری تخصصی روانشناسی سلامت، واحد ایلام، دانشگاه آزاد اسلامی، ایلام، ایران.
3 - استادیار، دکتری تخصصی روانشناسی عمومی، واحد ایلام، دانشگاه آزاد اسلامی، ایلام، ایران
کلید واژه: اختلال شخصیت مرزی, لغزش و عود, درمان انگیزشی, و ولع وتداوم پرهیز, درمان دلبستگی, افراد وابسته به مواد,
چکیده مقاله :
هدف از انجام این پژوهش مقایسه اثربخشی درمان دلبستگی با درمان انگیزشی در کاهش لغزش، عود، ولع و تداوم پرهیز مصرف مواد در بیماران اختلال شخصیت مرزی وابسته به مواد بوده است. این پژوهش مداخله‌ای با روش نیمه‌آزمایشی طرح پیش‌آزمون- پس‌آزمون با گروه گواه و پیگیری سه ماهه انجام شد. جامعه آماری کلیه افراد وابسته به مواد دارای اختلال شخصیت مرزی مراجعه کننده به مراکز ترک اعتیاد شهر کرمانشاه که 60 نفر ازآنها به روش نمونه‌گیری در دسترس به عنوان نمونه انتخاب شدند. از پرسشنامه‌های دلبستگی بزرگسالان راس (RASS Adult Attachment, 1996)، اختلال شخصیت مرزی گشتاسبی اصل و همکاران (Gashtasbi asl et al., 2017)، مراحل آمادگی تغییر رفتار و انگیزش برای درمان پروین (Parvin, 2015)، افکار اعتیاد مک مولین (McMullen Addiction Thoughts,1990)، پرسشنامه محقق ساخته عود، ولع، لغزش و پرهیز، پروتکل درمانی مداخله انگیزش مدل فرانظری تغییر (Motivational intervention of trans-theoretical model of change) (Procheska and Clemente, 1990) و پروتکل درمان دلبستگی (Jahanbakhsh et al., 2011) استفاده شد. داده‌ها توسط آزمون تحلیل کوواریانس چندمتغیره تحلیل شد. نتایج نشان داد درمان دلبستگی و درمان انگیزشی، میزان لغزش، عود و ولع بیماران را به طور معنی داری کاهش و تداوم پرهیز را افزایش می‌دهند (05/0P<). درمان دلبستگی و درمان انگیزشی بر میزان لغزش، عود، ولع و تداوم پرهیز بیماران در آزمون پیگیری ماندگاری داشته است (05/0P<). میزان تغییرات نمرات لغزش، عود، ولع و پرهیز افرادی که درمان دلبستگی را دریافت کرده‌اند بیشتر از افرادی که تحت درمان انگیزشی قرار گرفته‌اند، بوده است (05/0P<). درمان دلبستگی در مقایسه با درمان انگیزشی بر کاهش لغزش، عود، ولع و تداوم پرهیز مصرف مواد در بیماران تاثیر بیشتری دارد (05/0P<). نتایج نشان داد هر دو روش مداخله در بهبود مصرف افراد دارای اختلال شخصیت مرزی تأثیرگذار بودند. با این حال تأثیر درمان مبتنی بر درمان اعتیاد در افراد دارای اختلال شخصیت مرزی به شیوه درمان مبتنی بر دلبستگی موثرتر از درمان انگیزشی می‌باشد.
The aim of this study was to compare the effectiveness of attachment therapy with motivational therapy in reducing slippage, recurrence, craving and continued substance abstinence in patients with substance-dependent borderline personality disorder. The present study was a quasi-experimental interventional study with pre-test post-test design with control group and 3-month follow-up. The statistical population of all substance abusers with borderline personality disorder referred to addiction treatment centers in Kermanshah city, 60 of whom were selected by convenience sampling method. Ross Adult Attachment Questionnaire (RASS Adult Attachment, 1996), Gashtasbi Asl et al.’s Borderline Personality Disorder (2017), Miller and Tonikan’s Stages of Change Readiness and Treatment Eagerness (1996), McMullen Addiction Thoughts (1990), researcher-made questionnaire on recurrence, craving, slip and abstinence, Motivational intervention of Transtheoretical model of change (Procheska and D. Clemente, 1990) and Attachment treatment protocol (Jahanbakhsh et al., 2011) was used. Data were analyzed by multivariate analysis of covariance. The results showed that attachment therapy and motivational therapy significantly decreased the slip, recurrence and craving of patients and increased the continuity of abstinence. Attachment therapy and motivational therapy had an effect on the rate of slip, relapse, craving and persistence of patients in the follow-up test. The rate of changes in slip, relapse, craving and abstinence scores was higher in those who received attachment therapy than those who received motivational therapy. Attachment therapy is more effective in reducing slip, relapse, craving, and continued drug use than motivational therapy. The results showed that both intervention methods were effective in improving the consumption of people with borderline personality disorder. However, the effect of addiction treatment-based therapy in people with borderline personality disorder is more effective than attachment therapy than motivational therapy.
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