مقایسه اثربخشی درمان شناختی رفتاری و درمان مبتنی بر پذیرش و تعهد بر کاهش میزان علائم اضطراب اجتماعی
الموضوعات :محمد رضا یابنده 1 , حسین بقولی 2 , سیروس سروقد 3 , مریم کورش نیا 4
1 - دانشجوی دکترای روانشناسی. گروه روانشناسی. واحد مرودشت. دانشگاه آزاد اسلامی. مرودشت. ایران
2 - استادیار دانشگاه آزاد. گروه روانشناسی. واحد مرودشت. دانشگاه آزاد اسلامی. مرودشت. ایران.
3 - استاد دانشگاه آزاد. گروه روانشناسی. واحد مرودشت. دانشگاه آزاد اسلامی. مرودشت. ایران.
4 - استاد دانشگاه آزاد. گروه روانشناسی. واحد مرودشت. دانشگاه آزاد اسلامی. مرودشت. ایران.
الکلمات المفتاحية: اضطراب اجتماعی, درمان شناختی رفتاری, درمان مبتنی بر پذیرش و تعهد,
ملخص المقالة :
پژوهش حاضر با هدف مقایسه اثربخشی درمان شناختی رفتاری ودرمان مبتنی بر پذیرش و تعهد به شیوه گروهی بر کاهش میزان علایم اضطراب اجتماعی در دانشجویان مبتلا به اختلال اضطراب اجتماعی انجام شد. این مطالعه یک طرح نیمه تجربی از نوع پیشآزمون- پسآزمون با گروه کنترل بود. نمونه پژوهش 45 دانشجوی مبتلا به اختلال اضطراب اجتماعی بود که با روش نمونهگیری در دسترس[1] انتخاب و سپس به صورت تصادفی در دو گروه آزمایش و یک گروه کنترل قرار گرفتند و به پرسشنامه اضطراب اجتماعی[2] بهمنظور ارزیابی میزان اضطراب اجتماعی قبل از شروع مداخله و پس از آن پاسخ دادند. نتایج پس از تجزیه و تحلیل با استفاده از آزمون کواریانس نشان داد که تفاوت معناداری میان گروه کنترل و دو گروه آزمایش وجود داشت و هر دو درمان شناختی رفتاری و درمان مبتنی بر پذیرش و تعهد بر کاهش میزان علایم اضطراب اجتماعی در دانشجویان اثربخش بودند و اگرچه میزان اثربخشی رویکرد درمان مبتنی بر پذیرش و تعهد بیش از درمانشناختی رفتاری بود، اما این میزان تفاوت از نظر آماری معنادار نبود. یافتههای پژوهش نشان می دهند که دو شیوه درمانی در کاهش علایم اضطراب اجتماعی اثربخش هستند و درمان مبتنی بر پذیرش و تعهد میتواند جایگزین مناسبی برای درمان شناختی رفتاری در درمان اختلال اضطراب اجتماعی باشد.
[1]- Convenience Sampling
[2]- SPIN
Alavi, Majid Mahmoud, Hashemi, Touraj, Gholizadeh Nusratibad, Azam. (1396). The Effectiveness of Cognitive Therapy-Huffman-Based Humor Therapy on Reducing Fear of Self-Assessed Negative and Self-Focused Attention in Social Anxiety Disorder. Journal of Clinical Psychology, No. 33, p. 101-111
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Psychiatric Disorders, Fifth Edition. (Translation by Rezaei, Farzin, Fakhraei, Ali, Fermand, Atoosa, Niloufari, Ali, Hashemi, Hashemi Azar, Janet, Shamloo, Farhad). Tehran: Arjmand Publications
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th Edition). Arlington, VA: Author.
Barlow David H. (2014). Clinical Handbook of Psychological Disorders, Fifth Edition: A Step-by-Step Treatment Manual 5th Edition. New York: Guilford Press
Blanco C1, Heimberg RG, Schneier FR, Fresco DM, Chen H, Turk CL, Vermes D, Erwin BA, Schmidt AB, Juster HR, Campeas R, Liebowitz MR. (2010). A placebo-controlled trial of phenelzine, cognitive behavioral group therapy, and their combination for social anxiety disorder. Arch Gen Psychiatry. 2010 Mar;67(3):286-95. doi: 10.1001/.2010.11.
Block JA. (2012). Acceptance or change of private experiences: A comparative analysis in college students with public speaking anxiety. Dissertation Abstracts International: Section B: The Sciences &Engineering, 63(9-B), 4361.
Bluett EJ1, Homan KJ1, Morrison KL1, Levin ME1, Twohig MP2.(2014). Acceptance and commitment therapy for anxiety and OCD spectrum disorders: an empirical review. J Anxiety Disord. 2014 Aug;28(6):612-24. doi: 10.1016/j.janxdis.2014.06.008. Epub 2014 Jun 23.
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionniare - II: A revised measure of psychological flexibility and experiential avoidance. Behavior Therapy, 42, 676-688
Borge FM1, Hoffart A, Sexton H, Clark DM, Markowitz JC, McManus F.(2008). Residential cognitive therapy versus residential interpersonal therapy for social phobia: a randomized clinical trial. J Anxiety Disord. 2008 Aug;22(6):991-1010. Epub 2007 Oct 13.
Burton M1, Schmertz SK, Price M, Masuda A, Anderson PL. (2013). The relation between mindfulness and fear of negative evaluation over the course of cognitive behavioral therapy for social anxiety disorder. J Clin Psychol. 2013 Mar;69(3):222-8. doi: 10.1002/jclp.21929. Epub 2012 Nov 1.
Butler AC, Chapman JE, Forman EM, Beck AT. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006 Jan;26(1):17-31. Epub 2005 Sep 30.
Clark DM., Ehlers A., McManus F., Hackmann A., Fennell M., Campbell H., Flower T., Davenport C., Louis B.(2003). Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial. J Consult Clin Psychol. 2003 Dec;71(6):1058-67.
Connor KM1, Davidson JR, Churchill LE, Sherwood A, Foa E, Weisler RH.(2000). Psychometric properties of the Social Phobia Inventory (SPIN). New self-rating scale. British Journ Psychiatry. 2000 Apr;176:379-86.
Craske Michelle G., Niles Andrea N., Burkland Lisa J., Wolitzky-Talor Kate B., Vilardaga Jennifer C. Plumb, Arch Jonna G., Saxbe Darby E., Lieberman Mattew D.(2014). Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators. J Consult Clin Psychol. 2006 Aug;74(4):658-70.
Dardash Zadeh Hossein, Ghaarei Banafsheh, Asgharnezhad Ali Asghar (2009). Comparison of the effectiveness of group cognitive-behavioral therapy and therapeutic exposure in reducing the severity of symptoms of social anxiety disorder and investigating the effect of these two treatments on reducing general anxiety and depression associated with this disorder. Journal of Advanced Psychological Research. 2009, No. 15, pp. 105-131
Darlymple, Kristy.(2007) . Acceptance and Commitment Therapy for Generalized Social Anxiety Disorder: A Pilot Study. Philadelphia: Drexel University
Eifert, G. H., & Forsyth, J. P. (2005). Acceptance & Commitment Therapy for anxiety disorders: A practitioner's treatment guide to using mindfulness, acceptance, and values-based behavior change strategies. Oakland, CA: New Harbinger Publications.
Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D., & Geller, P. A. (2007). A randomized controlled effectiveness trial of Acceptance and Commitment Therapy and Cognitive Therapy for anxiety and depression. Behavior Modification, 31(6), 772-799.
Glickman, A.R. & La Greca, A.M. (2004). The Dating Anxiety Scale for Adolescents: Scale Development and Associations With Adolescent Functioning. Journal of Clinical Child and Adolescent Psychology,. 33, 566-578.
Goldin Philippe R. , Ziv Michal , Jazaieri Hooria , Weeks Justin , Heimberg Richard G. , Gross James J. (2014). Impact of Cognitive-Behavioral Therapy for Social Anxiety Disorder on the Neural Bases of Emotional Reactivity to and Regulation of Social Evaluation. Behav Res Ther. 2014 Nov; 62: 97–106. Published online 2014 Aug 21. doi: 10.1016/j.brat.2014.08.005
Gültekin BK1, Dereboy IF.(2011). The prevalence of social phobia, and its impact on quality of life, academic achievement, and identity formation in university students. Turk Psikiyatri Derg. 2011 Fall;22(3):150-8.
Hayes S. C., Strosahl k., Wilson K. G., Bissett R. T., Pistorello J., Toarmino D., MaCurry S. M.(2004). Measuring Experiential Avoidance: A Perliminary Test of a Working Model. Psychological Record, 54,533-578
Hayes SA1, Orsillo SM, Roemer L.(2010).Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder. Behav Res Ther. 2010 Mar;48(3):238-45. doi: 10.1016/j.brat.2009.11.006. Epub 2009 Nov 18.
Hayes, L., Boyd, C.P. & Sewell, J. Mindfulness (2011) 2: 86. https://doi.org/10.1007/s12671-011-0046-5
Hayes, S. C. (2006). Acceptance and Commitment Therapy: Model, processed and outcomes. New York: Guilford Press
Hayes, S. C., & Smith, S. (2005). Get out of your mind and into your life: The new Acceptance and Commitment Therapy. Oakland, CA: New Harbinger Publication
Hayes, S. C., Follette, V. M., & Linehan, M. M. (Eds.). (2004). Mindfulness and acceptance: Expanding the cognitive-behavioral tradition. New York: Guilford Press
Hayes, S. C., Luoma, J., Bond, F., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes, and outcomes. Behaviour Research and Therapy, 44(1), 1-25
Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behavior change. New York: Guilford Press.
Herbert JD1, Gaudiano BA, Forman EM.(2013).The importance of theory in cognitive behavior therapy: a perspective of contextual behavioral science. Behav Ther. 2013 Dec;44(4):580-91. doi: 10.1016/j.beth.2013.03.001. Epub 2013 Mar 13.
Hill, M. L., Masuda, A., Melcher, H., Morgan, J., & Twohig, M. P. (2015) Acceptance and commitment therapy for women diagnosed with binge eating disorder: A case-series study. Cognitive and Behavioral Practice. http://dx.doi.org/10.1016/j.cbpra.2014.02.005
Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A.(2012).The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res. 2012 Oct 1;36(5):427-440. Epub 2012 Jul 31.
Hofmann SG, Smits JA.(2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry. 2008 Apr;69(4):621-32.
Hofmann Stefan G.(2007).Cognitive Factors that Maintain Social Anxiety Disorder: a Comprehensive Model and its Treatment Implications.Cogn Behav Ther. 2007; 36(4): 193–209. doi: 10.1080/16506070701421313
Hofmann Stefan G., Otto Michael W. (2008). Cognitive Behavioral Therapy for Social Anxiety Disorder. New York: Routledge Press
Kampmann IL, Emmelkamp PM, Hartanto D, Brinkman WP, Zijlstra BJ, Morina N(2016) Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial. Behav Res Ther. 2016 Feb;77:147-56. doi: 10.1016/j.brat.2015.12.016. Epub 2015 Dec 29.
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE.)2005).Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):593-602
Klaus Ranta, et al. Age and Gender Differences in Social Anxiety Symptoms During Adolescence: The Social Phobia Inventory (SPIN) as a Measure. 153(3): Psych Research 261-270. December 2007.
Kocovski NL., Fleming JE., Hawley LL., Huta V., Antony MM.(2013). Mindfulness and acceptance-based group therapy versus traditional cognitive behavioral group therapy for
Lappalainen R1, Lehtonen T, Skarp E, Taubert E, Ojanen M, Hayes SC. .(2007) The impact of CBT and ACT models using psychology trainee therapists: a preliminary controlled effectiveness trial. Behav Modif. 2007 Jul;31(4):488-511.
Leahy, R. L., Holland, S. J., & McGinn, L. K. (2012). Treatment plans and interventions for depression and anxiety disorders (2nd ed.). New York: Guilford Press.
McEvoy PM, Grove R, Slade T.(2011). Epidemiology of anxiety disorders in the Australian general population: findings of the 2007 Australian National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry. 2011 Nov;45(11):957-67. doi: 10.3109/00048674.2011.624083.
Mikhaili, Farzaneh, Nowroozi, Mozdeh, Isisadegan, Ali (1395). Prevalence of social anxiety disorder in college students. Urology Medical Journal, 27, pp. 166-155
National Collaborating Centre for Mental Health (UK).(2013). Social Anxiety Disorder: Recognition, Assessment and Treatment. Leicester (UK): British Psychological Society;2013 National Institute for Health and Care Excellence: Clinical Guidelines
Osman, A., Barrios, F.X., Aukes, D. (2007). Psychometric evaluation of the Social Phobia and Anxiety Inventory in college students. Journal of Clinical Psychology, 51, 235-243.
Ozsaker, M.,Muslu, G. K., Kahraman, A., Beytut, D., Yardimci,. F., & Basbakkal, Z. (2015). A study on the effects of.loneliness, depression and perceived social support on. problematic Internet use among university students. Anthropologist
Ponniah K1, Hollon SD.(2008). Empirically supported psychological interventions for social phobia in adults: a qualitative review of randomized controlled trials. Psychol Med. 2008 Jan;38(1):3-14. Epub 2007 Jul 20.
Pourfareh Omran, Majid (2011). The Effectiveness of Group Therapy on Acceptance and Commitment to Students' Social Phobia, Journal of Knowledge and Health, No. 2, pp. 1-5
Rahimi, Ali, Sohrabi, Nadareh, Rezaei, Azarmidehkht, Sarvghad, Sirous (1396). Comparison of the Effectiveness of Cognitive-Behavioral Group Therapy and Group Therapy Based on Acceptance and Commitment on Cognitive Thyroid Regulation in Patients Consuming Stimulants. Journal of Methods and Psychological Models, No. 30, pp. 53-68
Rapee RM1, Heimberg RG.(1997). A cognitive-behavioral model of anxiety in social phobia. Behav Res Ther. 1997 Aug;35(8):741-56.
Rodebaugh TL1, Holaway RM, Heimberg RG.(2004). The treatment of social anxiety disorder. Clin Psychol Rev. 2004 Nov;24(7):883-908.
Roemer L., Orsillo SM., Salters-Pedneault K.(2008).Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: evaluation in a randomized controlled trial.J Consult Clin Psychol. 2008 Dec;76(6):1083-9. doi: 10.1037/a0012720.
Ruscio AM, Brown TA, Chiu WT, Sareen J, Stein MB, Kessler RC.(2008) Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychol Med. 2008 Jan;38(1):15-28. Epub 2007 Nov 2.
Safi Khani Gholizadeh, Sima, Mahmoudi, Armin, Marpour, Alireza (1396) The Effect of Wales Metacognitive Therapy on the Quality of Life of Students with Social Anxiety Disorder, Journal of Psychological Methods and Models, No. 30, pp. 89-104
Stewar, Soghra, Razavi, Asghar (2013). Psychometric Properties of Social Anxiety Scale for Adolescents for Use in Iran. Journal of Psychological Methods and Models. Number 12 pp. 69-78
Talaei, Azadeh, Holaiari, Abbasali, Azad Falah, Parviz, Ashtiani, Ali Fathi, Mullani, Mahdiyeh, Sahragerd, Mehdi. (1391). Validity and Reliability of the Fars Version of Anxiety Scale in Social Interactions. Journal of Psychiatry and Clinical Psychology, 2012, No. 3, pp. 222-227
Twohig MP1, Hayes SC, Masuda A.(2006). Increasing willingness to experience obsessions: acceptance and commitment therapy as a treatment for obsessive-compulsive disorder.Behav Ther. 2006 Mar;37(1):3-13. Epub 2006 Feb 21.
Weeks JW., Howell AN., Goldin PR.(2013). Gaze avoidance in social anxiety disorder. Depress Anxiety. 2013 Aug;30(8):749-56. doi: 10.1002/da.22146. Epub 2013 Jun 24.
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