اثربخشی درمان شناختی رفتاری متمرکز بر اندیشناکی بر خودارزیابی منفی و افکار خودکشی دختران افسرده 14 تا 19 سال، اقدام کننده به خودکشی درمقایسه با شناخت درمانی مبتنی بر توجه آگاهی؛ پیگیری دو ماهه
محورهای موضوعی : بالینی
هادی ایزانلو
1
,
فاطمه شهابی زاده
2
,
سید کاوه حجت
3
,
سید عبدالمجید بحرینیان
4
1 - دانشجوی دکتری روانشناسی بالینی، دانشگاه آزاد اسلامی، واحد بیرجند، بیرجند. ایران.
2 - دانشیار دانشگاه آزاد اسلامی، واحد بیرجند، بیرجند. ایران.
3 - دانشیار روانپزشکی، مرکز تحقیقات روانپزشکی و علوم رفتاری، گروه روانشناسی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران.
4 - استاد روانشناسی بالینی، گروه روانشناسی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران.
کلید واژه: افسردگی, خود ارزیابی منفی, درمان شناختی مبتنی بر توجه آگاهی, دختران 14-19 سال, درمان شناختی رفتاری متمرکز بر اندیشناکی, افکار خودکشی,
چکیده مقاله :
اقدام به خودکشی در بین دختران نوجوان بدلیل شناخت های منفی در حال افزایش است، بنابراین هدف این پژوهش بررسی اثر بخشی درمان شناختی رفتاری متمرکز بر اندیشناکی در مقابل درمان شناختی مبتنی بر توجه آگاهی بر خود ارزیابی منفی و افکار خودکشی در بین دختران نوجوان 14 تا 19 سال، افسرده قدام کننده به خودکشی بود. روش این پژوهش نیمه آزمایشی، با پیش آزمون- پس آزمون و یک گروه کنترل بود. 33 دختر نوجوان که با مشکل اقدام به خودکشی به واحد اورژانس بیمارستان ثامن الائمه و امام حسن(ع) بجنورد از اول آبان تا پانزدهم اسفند 1398 مراجعه کرده بودند، پس از داشتن ملاک‌های ورود، به روش هدفمند انتخاب شدند و سپس به طور تصادفی در سه گروه (هر گروه 10 نفر) درمان شناختی رفتاری متمرکز بر اندیشناکی، شناخت درمانی مبتنی بر توجه آگاهی (10 جلسه انفرادی) و کنترل قرار گرفتند. ابزارهای پژوهش پرسشنامه های افسردگی (Beck & Steer, 1993) و احتمال خودکشی (Cull & Gill, 1989) بودند. نتایج تحلیل کوواریانس نشان داد هر دو مداخله اثر معناداری بر کاهش خودارزیابی منفی و افکار خودکشی (05/0p<) داشته است و این اثر در طول دوره پیگیری دو ماهه نیز پایدار بوده است. بنابراین هر دو مداخله می‌توانند با شیوه‌های متفاوتی (کاهش اندیشناکی و افزایش توجه آگاهی) اما بدون برتری، سطح خود ارزیابی منفی و عقاید خودکشی را کاهش دهند، بنابراین استفاده از این دو مداخله در زمان افسردگی و در دوره بحران خودکشی پیشنهاد می‌شود.
Suicide attempt is on the rise among adolescent girls due to negative cognitions, so the aim of this study was to investigate the effect of Rumination-Focused Cognitive Behavioral Therapy (RFCBT) versus Mindfulness Based Cognitive Therapy (MBCT) on negative self-evaluation, and suicidal ideation among depressed girls adolescents aged 14 to 19 attempting suicide. This study was a quasi-experimental design with pre-test and post-test with a control group. Thirty-three depressed adolescent girls attempting suicide who were referred to the emergency department of Samen Al-Aeme and Imam Hassan Hospitals in Bojnourd from October 23, 2019 to March 5, 2020, after having the inclusion criteria, were selected with targeted sampling method, then randomly divided into three groups of rumination-focused cognitive behavioral therapy, mindfulness-based cognitive therapy (10 individual sessions) and control. The research tools included Depression Inventory-2 (Beck & Steer, 1993) and Suicide Probability Scale (Cull & Gill, 1989). Findings obtained from Analysis of covariance showed that both interventions had a significant effect on reducing negative self-evaluation and suicidal ideation at the time of post-test (p <0.001) and follow-up (p <0.05), and this effect was stable during the two-month follow-up period. Therefore, both interventions can reduce negative self-evaluation and suicidal ideation in different ways (decreased rumination and increased mindfulness) but without superiority, so it is recommended to use these two interventions in times of depression and in times of suicidal crisis.
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