پیش¬بینی آلکسی تایمیا بر اساس طرحواره‌های ناسازگار اولیه با نقش میانجی راهبردهای تنظیم شناختی هیجان در بیماران مبتلا به اختلال شخصیت مرزی
محورهای موضوعی : روانشناسینیکی ناز ضرابیان 1 , محمد کاظم ضرابیان 2 , نسرین متین نیا 3
1 - کارشناس ارشد روانشناسی بالینی، گروه روانشناسی بالینی ، دانشکده علوم پزشکی، واحد سنندج ، دانشگاه آزاد اسلامی ، سنندج، ایران E mail: nikinaz.zarabian@gmail.com,
2 - (نویسنده مسئول) دکتری تخصصی روانشناسی، مرکز تحقیقات اختلالات رفتاری و سوء مصرف مواد، دانشگاه علوم پزشکی همدان، همدان، ایران E mail: h93zarabian@gmail.com
3 - استادیار، دکتری تخصصی بهداشت جامعه، گروه پرستاری، دانشکده علوم پزشکی، واحد همدان، دانشگاه آزاد اسلامی ، همدان، ایران E mail: nmatinnia@yahoo.com
کلید واژه: آلکسی تایمیا, اختلال شخصیت مرزی, راهبردهای تنظیم شناختی هیجان, طرحواره‌های ناسازگار اولیه,
چکیده مقاله :
چکیده مقدمه: با توجه به شیوع بالا و تأثیرات منفی اختلالات شخصیت مرزی بر فرد مبتلا و جامعه، اهمیت شناخت هر چه بیشتر این اختلال و شناسایی عوامل و متغیرهای پیش¬بینی کننده این اختلالات احساس می¬شود. پژوهش حاضر با هدف پیش¬بینی آلکسی تایمیا بر اساس طرحواره‌های ناسازگار اولیه با نقش میانجی راهبردهای تنظیم شناختی هیجان در بیماران مبتلا به اختلال شخصیت مرزی انجام شد. روش پژوهش: مطالعه از نظر هدف کاربردی، از نظر زمان مقطعی، از نظر داده‌ها کمی و از نظر روش تحقیق توصیفی از نوع همبستگی است. جامعه¬ آماری بیماران مبتلا به اختلال شخصیت مرزی مراحعه کننده به مراکز مشاوره شهر همدان از اسفند ماه 1400 تا پایان خرداد 1401 بود. نمونه بر اساس فرمول فیدل و تاباچنیگ 107 نفر و به لحاظ احتیاط به 120 نفر افزایش یافت. روش نمونه¬گیری در دسترس و هدفمند بود. ابزار پژوهش سه پرسشنامه آلکسی تایمیا بگبی، پارکر و تیلور (1994)، طرحواره‌های ناسازگار اولیه یانگ (1999) و راهبردهای تنظیم شناختی هیجان گارنفسکی و کرایج (2006) بود. جهت آزمون فرضیه از روش تحلیل مسیر استفاده شد. یافته¬ها: نتایج نشان داد مسیر گاما در حوزه بریدگی و طرد، خودگردانی و عملکرد مختل و گوش به زنگی بیش از حد/ بازداری به آلکسی تایمیا معنادار است. مسیر گاما از محدودیت¬های مختل به متغیرهای میانجی تنظیم هیجانی مثبت و مسیر گاما از بریدگی و طرد، محدودیت¬های مختل و دیگر جهت¬مندی به متغیرهای میانجی تنظیم هیجانی منفی معنادار است. مسیر بتا از مسیر تنظیم هیجانی مثبت و همچنین تنظیم هیجانی منفی به آلکسی تایمیا معنادار است. نتیجه گیری: طرحواره‌های ناسازگار اولیه و راهبردهای تنظیم هیجان منفی می¬توانند زمینه¬ساز الکسی تایمیا در افراد مبتلا به اختلال شخصیت مرزی شوند.
Abstract Introduction: Considering the high prevalence and negative effects of borderline personality disorders on the affected person and the society, the importance of knowing this disorder as much as possible and identifying the predictors and variables of these disorders is felt. The present study was conducted with the aim of predicting alexithymia based on primary maladaptive schemas with the mediating role of cognitive emotion regulation strategies in patients with borderline personality disorder. Methods: It is an applied, cross-sectional, quantitative and descriptive correlational study. The statistical population was patients with borderline personality disorder Who Referred to counseling centers in Hamedan city from February 2022 to the end of May 2022. Based on the formula of Fidel and Tabachnig (2007), the sample was 107 people and increased to 120 people as a precaution. The sampling method was available and targeted. The research tools were three alexithymia questionnaires by Bagby, Parker and Taylor (1994), Yang's primary maladaptive schemas (1999) and Garnevsky and Kraij's (2006) cognitive emotion regulation strategies. Path analysis method was used to test the hypothesis. Findings: The results showed that the gamma pathway is significant in the field of cut and rejection, impaired self-management and performance, and excessive tinnitus/inhibition to alexithymia. The gamma path from impaired limitations to mediating variables of positive emotional regulation and the gamma path from cut and rejection, impaired limitations and other orientations to mediating variables of negative emotional regulation are significant. The beta pathway from positive emotional regulation pathway as well as negative emotional regulation pathway is significant to alexithymia. Conclusion: Early maladaptive schemas and negative emotion regulation strategies can cause alexithymia in people with borderline personality disorder.
© 2020 The Author(s). This work is published by family and health as an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.
References:
1. Seyed Mohammadi YTe. Diagnostic and Statistical Manual of Mental Disorders (5th Edition). Tehran smooth publication. 2014. [ Persian]
2. Bohus M, Haaf B, Simms T, Limberger MF, Schmahl C, Unckel C, et al. Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: a controlled trial. Behaviour research and therapy. 2004;42 (5):487-99. doi:10.1016/S0005-7967(03)00174-8
3. Arnaud Arntz HvK, Translator: Hossein Zirak HH. schema therapy for borderline personality disorder Publisher: Arjmand Publications. 2009
4. Paris J. Differential diagnosis of borderline personality disorder. Psychiatric Clinics. 2018;41 (4):575-82. doi.org/10.1002/cpp.2591
5. Pluta A, Kulesza M, Grzegorzewski P, Kucharska K. Assessing advanced theory of mind and alexithymia in patients suffering from enduring borderline personality disorder. Psychiatry research. 2018; 261:436-41. doi.org/10.1016/j.psychres.2018.01.003
6. Asma MAsmKKMRSMRHS. mediating role of emotion regulation difficulty in the relationship between early maladaptive psychological constructs and emotional dyslexia writers Publication: Psychological Methods and Models 2016; 17 (1):183-206. doi.org/10.1037/a0016604
7. Di Tella M, Ghiggia A, Tesio V, Romeo A, Colonna F, Fusaro E, et al. Pain experience in Fibromyalgia Syndrome: The role of alexithymia and psychological distress. Journal of affective disorders. 2017; 208: 87-93. doi.org/10.1016/j.jad.2016.08.080
8. Gillespie SM, Garofalo C, Velotti P. Emotion regulation, mindfulness, and alexithymia: Specific or general impairments in sexual, violent, and homicide offenders? Journal of Criminal Justice. 2018; 58: 56-66. doi.org/10.1016/j.jcrimjus.2018.07.006
9. Fowler JC, Madan A, Allen JG, Oldham JM, Frueh BC. Differentiating bipolar disorder from borderline personality disorder: Diagnostic accuracy of the difficulty in emotion regulation scale and personality inventory for DSM-5. Journal of affective disorders. 2019; 245:856-60. DOI:10.1016/j.jad.2018.11.079
10. Glenn CR, Klonsky ED. Emotion dysregulation as a core feature of borderline personality disorder. Journal of personality disorders. 2009; 23 (1):20-8. doi:10.1016/j.dcn.2015.07.006
11. Bornovalova MA, Gratz KL, Daughters SB, Nick B, Delany-Brumsey A, Lynch TR, et al. A multimodal assessment of the relationship between emotion dysregulation and borderline personality disorder among inner-city substance users in residential treatment. Journal of Psychiatric Research. 2008; 42 (9):717-26. DOI:10.1016/j.jpsychires.2007.07.014
12. Alves MJV, Manita C, Caldas IM, Fernández-Martinez E, Gomes da Silva A, Magalhães T. Evolution and analysis of cultural and cognitive factors related with domestic violence against women. Journal of interpersonal violence. 2019; 34 (3):621-41. doi.org/10.1017/ S0954579419000658
13. Kench S, Irwin HJ. Alexithymia and childhood family environment. Journal of clinical psychology. 2000;56 (6):737-45. DOI:10.1002/(SICI)1097-4679(200006)56:63.0.CO;2-U.
14. FaramarziRad B, Robat Milli M., Aboulmaali-Alhosini Kh, Zare Bahramabadi M. A structural model for predicting alexithymia based on early maladaptive schemas with the mediation of emotional self-disclosure. Journal of Psychological Science. 2023; 22(123): 539-555. https://psychologicalscience. ir/article-1-1823-fa.html
15. Dolcos F, Iordan AD, Dolcos S. Neural correlates of emotion–cognition interactions: A review of evidence from brain imaging investigations. Journal of Cognitive Psychology. 2011; 23(6):669-94. doi.org/10.1016/j.neubiorev.2019.08.017
16. Young JK, Jeanette and Vishar, Marjorie. Schema therapy (a practical guide for clinical professionals). Translated by Hassan Hamidpour and Zahra Indoz (2014), sixth edition, Tehran: Arjmand. 2003.
17. Vander Velde J, van Tol M-J, Goerlich-Dobre KS, Gromann PM, Swart M, de Haan L, et al. Dissociable morphometric profiles of the affective and cognitive dimensions of alexithymia. Cortex. 2014; 54:190-9. DOI:10.1016/j.cortex.2014.02.017
18. Penley JA, Tomaka J. Associations among the Big Five, emotional responses, and coping with acute stress. Personality and individual differences. 2002; 32 (7): 1215-28. DOI:10.1016/S0191-8869(01)00087-3
19. Bagby RM, Taylor GJ. Affect dysregulation and alexithymia. Disorders of affect regulation: Alexithymia in medical and psychiatric illness. 1997:26-45. DOI:10.1016/j.clinph.2015.07.036
20. Chapman AL, Rosenthal MZ, Leung DW. Emotion suppression in borderline personality disorder: An experience sampling study. Journal of personality disorders. 2009; 23 (1):29-47. DOI:10.1556/Mental.15.2014.004
21. Taylor GJ, Bagby RM, Parker JD. Disorders of affect regulation: Alexithymia in medical and psychiatric illness: Cambridge University Press; 1999.
22. Young JE, Klosko JS, Weishaar ME. Schema Therapy: A Practitioner's Guide. 2003
23. Garnefski N, Kraaij V. Cognitive emotion regulation questionnaire–development of a short 18-item version (CERQ-short). Personality and individual differences. 2006; 41 (6):1045-53. DOI:10.1016/j.paid.2006.04.010
24. Bidari F, Haji Alizadeh K. Effectiveness of schema therapy on cognitive strategies of emotion, distress bearing and alexithymia in the patients suffering from borderline personality disorder. Journal of Psychological Studies. 2019; 15(2): 165-180. doi: 10.22051/psy.2019.19858.1626
25. Rostamifar RaS, Parinaz. Investigating the role of thought control, mindfulness, distress tolerance and dyslexia in predicting the symptoms of borderline personality disorder in female secondary school students. Fifth National Conference of Psychology (Life Science). 2021.
26. Shadara ZD. The role of emotional dysregulation and its components in predicting distress tolerance of people with borderline personality disorder syndrome, Second International Conference on Psychology, Counseling, Education and Training, Mashhad. 2017. [ Persian]
27. Kouchi S, Mami S, Ahmadi V. The mediating role of cognitive emotion regulation strategies and social self-efficacy in the relationship between early maladaptive schemas and social anxiety in adolescent girls. Journal of Psychological Science. 2012; 20(102): 953-966. URL: http://psychologicalscience.ir/article-1-1156-en.html
28. Azizi T, Amiri H, Afsharinia K. Structural Equation Modeling of Parent-Adolescent Conflict Relationship with Emotional Disorder in Adolescents: The Mediating Role of Experience Avoidance. Islamic-Iranian Family Studies Journal, 2022; 1(2): 99-114. doi: 10.30495/iifs.2022.1943597.1015
29. Sasanpour M, Azizi A. Correlation of Alexithymia and Positive Cognitive Emotion Regulation Strategies in Prisoners . JPMed 2017; 6 (3): 161-166. URL: http://jpmed.ir/article-1-535-en.html [ Persian]
30. Gorji M, Rowhany NS, Seyed Mousavi M, Azizi M, samimi Z. Prediction of Social Anxiety Based on Early Maladaptive Schemas and Resilience of Girl Students. Journal of Psychological Studies. 2019; 15(3): 23-38. doi: 10.22051/psy.2019.23657.1804
31. Christoforou R, Boyes M, Hasking P. Emotion profiles of university students engaging in non-suicidal self-injury: Association with functions of self-injury and other mental health concerns. Psychiatry research. 2021; 305:114253. DOI:10.1016/j.psychres.2021.114253
32. McCuaig Edge HJ, Lee JE. The mediating role of alexithymia in the association between adverse childhood experiences and postdeployment mental health in Canadian Armed Forces personnel. Journal of Traumatic Stress. 2020;33 (6):1029-38. DOI:10.1002/jts.22547
33. Saariaho AS, Saariaho TH, Mattila AK, Karukivi MR, Joukamaa MI. Alexithymia and depression in a chronic pain patient sample. General hospital psychiatry. 2013;35 (3):239-45. doi.org/10.1016/j.genhosppsych.2012.11.011
