The effectiveness of Behavioral Activation on mental rumination, emotion regulation and psychological symptoms in female patients with high blood pressure in the health care industry of the northwestern oil industry

Subject Areas : Woman and family

Alireza Agdamibaher ¹ ( PhD Student in Psychology, Faculty of Human Sciences, Urmia Branch, Islamic Azad University, Urmia, Iran. )
Ali Khademi ² ( Associate Professor, Department of Psychology, Faculty of Human Sciences, Urmia Branch, Islamic Azad University, Urmia, Iran. [e-mail] )
Ali Shaker Dolag ³ ( Assistant Professor, Department of Psychology, Faculty of Human Sciences, Urmia Branch, Islamic Azad University, Urmia, Iran. )

Received: 2022-10-28 Accepted : 2023-02-20 Published : 2024-09-21

Keywords: emotion regulation, Hypertension, Behavioral activation, mental rumination, psychosomatic symptoms,

Abstract :

Research has shown that hypertension is a medical condition which adversely affects the patients’ psychological charecteristics. Furthermore, the relevant studies have indicated that behavioral activation may have a beneficial impact on the psychological well-being of patiens who suffer from different medical conditions. Notwithstanding, there is a lack of research on the effect of this approach on the psychological charecteristics of hypertensive patients.The present study strived to determine the effect of behavioral activation on hypertensive patienst’ mental rumination, emotion regulation, and psychosomatic symptoms.This study adopted a pretest-tretament-posttest quasi-experimental design to attain its objectives. More specifically, first, the researchers selected a sample of 30 hypetensive female patiennts from among the female patients who referred to Petroleum Industry Health Organization in Tabriz (Iran). Second, they randomly assigned the participants to an experimental group and a control group.Third, they administered Ruminative Response Scale (Nolen-Hoeksema & Morrow, 1991), Psychosomatic Complaints Scale (Tanaka & Sakata, 2004), and Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004) to the groups of the study as pretests. Fourth, the researchers provided the experimental group with behavioral activation treatment during 10 sessions. Fifth, they administered the relevant questionnaires of the study to the groups anew as posttests. Finally, they performed the data analysis using SPSS 23. Based on the results, behavioral activation significantly reduced hypertensive patients’ mental rumination, alleviated their psychosomatic symptoms, and improved their emotion regulation (p<0.05).  It was concluded that behavioral activation can be used to improve the psychological well-being of female hypertensive patients.

References:

ابراهیمی، س.، سجادیان، ا. (1399). تأثیردرمان فعال سازی رفتاری بر نشخوار فکری و اضطراب مرتبط با درد در زنان مبتلا به سرطان پستان. مجله سلامت جامعه، 20 (3)، 36-26.

باقری نژاد، م.، صالحی فدردی، ج.، طباطبایی، م. (1389). رابطه بین نشخوار فکری و افسردگی در نمونه ای از دانشجویان ایرانی. مطالعات تربیتی و روانشناسی، 11 (1)، 38-21.

تیمورپور، س.، اکبری ، م. (1397). بررسی مکانیسم اثربخشی درمان فعال سازی رفتاری (BA) از طریق انعطاف پذیری شناختی و انعطاف پذیری هیجانی بر علائم زنان مبتلا به اختلال افسردگی اساسی (MDD). مجله روانشناسی شناختی، 6 (4)،13-1.

حاجلو، نادر. (1391). ویژگیهای روان سنجی مقیاس شکایات روان تنی تاکاتا و ساکاتا در بین دانشجویان دانشگاه محقق اردبیلی. تحقیقات علوم رفتاری، 10(3)، 212-204.

رضاپور، پ.، بختیاری، م.، مسجدی آرانی، ع.، و کیانی مقدم، ا. (1399). اثربخشی درمان گروهی فعال سازی رفتاری بر علایم افسردگی، اضطراب و کیفیت زندگی دانشجویان پزشکی (گزارش کوتاه). فصلنامه علمی-پژوهشی ابن سینا، 22 (2)، 94-90.

رهبران، ر.،کرمی، ر.، و شاه محمدی، م. (1398). اثربخشی درمان فعال­سازی رفتاری برکاهش نشخوارفکری و اختلال افسردگی در نوجوانان. اندیشه و رفتار در روان شناسی بالینی، 14(52)، 26-17.

زمستانی، م.،  داودی، آ.،  مهرابی زاده هنرمند، م.، و  زرگر، ی. (1392). اثربخشی درمان فعال­سازی رفتاری گروهی بر علائم افسردگی، اضطراب و نشخوار فکری در بیماران مبتلا به افسردگی و اضطراب. مجله روانشناسی بالینی، 5 (4)، 84-73.

شاره، ح. (1395) اثربخشی درمان فعالسازی رفتاری به شیوه گروهی بر سبکهای اسنادی، افسردگی و کیفیت زندگی زنان مبتلا به سرطان پستان، مجله ی اصول بهداشت روانی، 18(4)، 188-179.

شبه ، ز.،  فیضی ، آ.، افشار، ح .، حسن زاده کشتلی، ع .، و ادیبی، ا. (1395). شناسایی نیم رخ های اختلالات روان تنی و ارتباط آن با مشکلات روانی در یک جمعیت بزرگسال ایرانی. مجله دانشگاه علوم پزشکی مازندران ، 26(137)، 82-94.

صید، ح.، رجائی، ع.، برجعلی، م. (1399). اثربخشی درمان فعال سازی رفتاری گروهی بر افسردگی و بحران هویت بیماران مبتلا به مولتیپل اسکلروزیس. مجله علوم روانشناختی، 19 (95)، 1517-1507.

عطایی مغانلو، ر.، عطایی مغانلو، و.، باباپور خیرالدین، ج.، پورشریفی، ح.، و پیشوایی، م. (1393). اثربخشی امیددرمانی گروهی بر بهزیستی ذهنی، پذیرش و نشخوار فکری بیماران HIV مثبت. مجله دانشگاه علوم پزشکی کرمانشاه، 18 (5)، 274-265.

فرشیدفر، ز.، رحیمیان بوگر، ا.، اسدی، ج.، و ایزدپناهی، پ. (1399). اثربخشی درمان فعال­سازی رفتاری گروهی بر تهوع و استفراغ ناشی از شیمی درمانی زنان مبتلا به سرطان پستان. مجله ارمغان دانش، 25 (3)، 292-275.

قدرتی، س.، وزیری نکو، ر. (1397). اثربخشی فعالسازی رفتاری بر بهزیستی روانشناختی و انعطاف پذیری روانشناختی دانش آموزان دختر دوره متوسطه شهر تهران. علمی سازمان نظام پزشکی جمهوری اسلامی ایران، 36 (4)،240-233.

قدرتی اصفهانی، ز.، مرادی، ا. (1399). مقایسه اثربخشی آموزش سرمایه های روان شناختی و فعال سازی رفتاری بر افسردگی در دانشجویان دختر خوابگاهی. مجله ایرانی آموزش در علوم پزشکی، 20 (83)، 268-260.

محمود علیلو، م.، هاشمی نصرت آباد، ت.، و هاشمی، زهره. (1390). اثربخشی درمان فراشناختی در کاهش علائم افسردگی، اضطراب و افکار ناکارآمد در اختلال افسردگی. مجله دانشگاه علوم پزشکی تبریز، 33(6)، 94-89..

موسوی، س.، مهدی زادگان، ا.، و آقایی، اصغر. (1393). رابطه رضایت زناشویی و شکایات روان تنی با بهزیستی روان شناختی دبیران زن دوره متوسطه شهرستان شهرکرد. زن و مطالعات خانواده، 7 (23)، 160-145.

Chartier, I. S., & Provencher, M. D. (2013). Behavioural activation for depression: Efficacy, effectiveness and dissemination. Journal of Affective Disorders, 145(3), 292-299

Dimidjian, S. Goodman, S. H. Sherwood, N. E. Simon, G. E. Ludman, E. Gallop, R, Hubley, S. (2017). A pragmatic randomized clinical trial of behavioral activation for depressed pregnant women. Journal of consulting and clinical psychology, 85 (1), 2631.

Kanter, J. W., Manos, R.C., Bowe, W. M., Baruch, D.E., Busch, A. M, Rusch, L.C. (2010). What is behavioral activation? A review of the empirical literature. Clini Psychol Rev, (30): 608–620.

Lee, J., Ford, C. G., McCluskey, D. L., Hopkins, P. D., McNeil, D. W., & Shook, N. J. (2022).  Testing the Effectiveness of Brief Behavioral Activation Treatment for Depression—Revised: Changes in Depression, Anxiety, Dysfunctional Attitudes, and Mindfulness. Journal of Psychopathology and Behavioral Assessment, 44, 456–468.

Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2010). Behavioral Activation for Depression: A Clinician's Guide. Guilford Press.

Moshier, S. J., & Otto, M. W. (2017). Behavioral activation treatment for major depression: a randomized trial of the efficacy of augmentation with cognitive control training. Journal of Affective Disorder, 210, 265-8.

Mazzucchelli, T. G., Kane, R. T., & Rees, C. S. (2010).  Behavioral  activation interventions  for well-being:  A  meta-analysis. The  journal  of Positive Psychology, 5(2), 105-121.

Nolen-Hoeksema, S., & Morrow, J. (1993). Effects of rumination and distraction on naturally occurring depressed mood. Cognition and Emotion, 7, 561-570.

Pavlov, S. V., Reva, N. V., Loktev, K. V., Tumyalis, A. V., Korenyok, V. V., & Aftanas, L. I. (2014). The temporal dynamics of cognitive reappraisal: Cardiovascular consequences of downregulation of negative emotion and upregulation of positive emotion. Psychophysiology, 51(2):178-86.

Radstaak, M ., Geurts, S. A., Brosschot, J. F., Cillessen, A. H., & Kompier, M. A. (2011). The role of affect and rumination in cardiovascular recovery from stress. International Journal of Psychophysiology, 18(3), 44-237. 

Ryff, C.D., Singer, B. (1998). The contours of positive human health. Psychological inquiry,9 (1), 1-28.

Trudel-Fitzgerald, C., Gilsanz, P., Mittleman, M. A., & Kubzansky, L.D. (2015). Dysregulated blood pressure: Can regulating emotions help? Curr Hypertens Rep. 17(12): 92.

Walsh, S., Moseley, G. L., Gray, R. G., Gillam, M., Gunn, K. M., Barker, T., Tran, K., Eshetie, T., & Jones, M. (2022). Use of behavioural activation to manage pain: a systematic scoping review. doi: 10.1136/bmjopen-2021-056404.

Zinchenko, Y. P., Pervichko, E.I, Ostroumova, O.D. (2013).Psychophysiological mechanisms of mental stress reactions in patients with “hypertension at work and patients with essential hypertension: a comparative analysis. Psycho in Russia: State of the Art. 6(3): 77-93.

Ataei Moghanlou, R., Ataei Moghanlou, V., Babapour Khairuddin, J., Poursharifi, H., & Pishwayi, M. (2013). The effect of group-hope therapy on mental well-being, acceptance, and rumination of HIV positive patients. Journal of Kermanshah University of Medical Sciences, 18 (5), 265-274. [In Persian]

Bagherinezhad, M., Salehi Fadardi, J., & Tabatabayi, S. (2010). The relationship between rumination and depression in a sample of Iranian student. Research in Clinical Psychology and Counseling, 11 (1), 22-38. [In Persian]

Ebrahimi, S., & Sajjadoan, I. (2020). The effect of behavioral activation therapy on rumination and pain–related anxiety in women with breast cancer. Community Health Journal, 14 (3), 26-36. [In Persian]

Farshidfar, Z., Rahimian Bogar, I., Asadi, J., & Izadpanahi P. (2020). The effectiveness of group behavioral activation therapy on chemotherapy-induced nausea and vomiting in women with breast cancer. Armaghan-e-Danesh, 25(3), 275-292. [In Persian]

Ghodrati, S., & Vaziri Nekoo, R. (2018). The effectiveness of behavioral activation (BA) on psychological well-being and psychological flexibility in female students. Journal of Medical Council of Iran, 36 (4), 233-240. [In Persian]

Ghodrati Isfahani, Z., & Moradi, A. (2020). Examining and comparing the effectiveness of psychological capital training and behavioral activation therapy on depression among female dormitory students. Iranian Journal of Medical Education, 20, 260-268. [In Persian]

Hajlou, N. (2012). Psychometric properties of Takata and Sakata’s psychosomatic complaints scale among Iranian university students. RBS, 10 (3), 204-212. [In Persian]

Mahmoodalilu, M., Hashemi, T., & Hashemi, Z. (2012). Effectiveness of metacognitive therapy in reduction of depression symptoms, anxiety symptoms and dysfunctional atitudes in major depression disorder. Medical Journal of Tabriz University of Medical Scences, 33 (6), 89-94. [In Persian]

Mousavi, S., Mahdizadeghan, I., & Aghayi, A. (2014). The relationship between marital satisfaction, psychosomatic complaints, and psychological well-being of secondary school female teachers in Shahrekord city. Journal of Woman and Study of Family, 7 (23), 145-160. [In Persian]

Rahbaran, R., Karami, R., Shahmohammadi, M. (2019). The effectiveness of behavioral activation therapy on rhubarb and depression disorders in adolescents. Thoughts and Behavior in Clinical Psychology, 14 (52), 17-26. [In Persian]

Rezapour, P., Bakhtiari, M., Masjedi-Arani, A., Kiani-Moghadam, A. (2020). The effectiveness of behavioral activation group therapy on the symptoms of depression, anxiety, and quality of life in medical students. Ebnesina, 22 (2), 90-94. [In Persian]

Seid, S. H., Rajaei, A., & Borjali, M. (2021). The effectiveness of group behavioral activation therapy on depression and identity crisis in patients with multiple sclerosis. Journal of Psychological Science, 19 (1), 1507-1518. [In Persian]

Shabbeh, Z., Feizi, A., Afshar, H., Hassanzade Kashtali, A., & Adibi P. (2016). Identifying the profiles of psychosomatic disorders in an Iranian adult population and their relation to psychological problems. Journal of Mazandaran University of Medical Sciences, 26 (137), 82-94. [In Persian]

Shareh, H. (2016). Effectiveness of behavioral activation group therapy on attributional styles, depression, and quality of life in women with breast cancer. Journal of Fundamentals of Mental Health, 18 (4), 179-188. [In Persian]

Teymoorpur, S., Akbari, M., & Hasani, J. (2019). The evaluation of mechanism of effectiveness of behavioral activation therapy (BA) through cognitive flexibility and emotional flexibility on symptoms of women with major depressive disorders. Journal of Cognitive Psychology, 6 (4), 1-13. [In Persian]

Zemestani, M., Davoodi, I., Mehrabi-Zadeh Honarmand, M.,&  Zargar, Y. (2013). Effectiveness of group behavioral activation on depression, anxiety and rumination in patients with depression and anxiety. Journal of Clinical Psychology, 5 (4), 73-84. [In Persian]

Chartier, I. S., & Provencher, M. D. (2013). Behavioural activation for depression: Efficacy, effectiveness and dissemination. Journal of Affective Disorders,145 (3), 299-292.

Dimidjian, S. Goodman, S. H. Sherwood, N. E. Simon, G. E. Ludman, E. Gallop, R, Hubley, S. (2017). A pragmatic randomized clinical trial of behavioral activation for depressed pregnant women. Journal of consulting and clinical psychology, 85 (1),26-31.

Kanter, J. W., Manos, R.C., Bowe, W. M., Baruch, D.E., Busch, A. M, Rusch, L.C. (2010). What is behavioral activation? A review of the empirical literature. Clini Psychol Rev, (30): 608–620.

Lee, J., Ford, C. G., McCluskey, D. L., Hopkins, P. D., McNeil, D. W., & Shook, N. J. (2022).  Testing the Effectiveness of Brief Behavioral Activation Treatment for Depression—Revised: Changes in Depression, Anxiety, Dysfunctional Attitudes, and Mindfulness. Journal of Psychopathology and Behavioral Assessment, 44, 456–468.

Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2010). Behavioral Activation for Depression: A Clinician's Guide. Guilford Press.

Mazzucchelli, T. G., Kane, R. T., & Rees, C. S. (2010).  Behavioral  activation interventions  for well-being:  A  meta-analysis. The  journal  of Positive Psychology, 5 (2), 105-121.

Moshier, S. J & Otto, M. W. (2017). Behavioral activation treatment for major depression: a randomized trial of the efficacy of augmentation with cognitive control training. Journal of Affective Disorder, 210, 265-8.

Nolen-Hoeksema, S., & Morrow, J. (1993). Effects of rumination and distraction on naturally occurring depressed mood. Cognition and Emotion, 7, 561-570.

Pavlov, S. V., Reva, N. V., Loktev, K. V., Tumyalis, A. V., Korenyok, V. V., & Aftanas, L. I. (2014). The temporal dynamics of cognitive reappraisal: Cardiovascular consequences of downregulation of negative emotion and upregulation of positive emotion. Psychophysiology, 51 (2):178-86.

Radstaak, M., Geurts, S. A., Brosschot, J. F., Cillessen, A. H., & Kompier, M. A. (2011). The role of affect and rumination in cardiovascular recovery from stress. International Journal of Psychophysiology, 18 (3), 44-237. 

Ryff, C.D., Singer, B. (1998). The contours of positive human health. Psychological inquiry,9 (1), 1-28.

Trudel-Fitzgerald, C., Gilsanz, P., Mittleman, M. A., & Kubzansky, L.D. (2015). Dysregulated blood pressure: Can regulating emotions help? Curr Hypertens Rep. 17(12): 92.

Walsh, S., Moseley, G. L., Gray, R. G., Gillam, M., Gunn, K. M., Barker, T., Tran, K., Eshetie, T., & Jones, M. (2022). Use of behavioural activation to manage pain: a systematic scoping review. doi: 10.1136/bmjopen-2021-056404.

Zinchenko, Y. P., Pervichko, E.I, Ostroumova, O.D. (2013). Psychophysiological mechanisms of mental stress reactions in patients with “hypertension at work and patients with essential hypertension: a comparative analysis. Psycho in Russia: State of the Art. 6(3): 77-93.