اثربخشی روان درمانی پویشی فشرده و کوتاه مدت بر کاهش علائم و مکانیسم های دفاعی اختلالات شخصیت خوشه C
محورهای موضوعی : بالینیبهمن معظمی گودرزی 1 , نادر منیرپور 2 , حسن میرزاحسینی 3
1 - دانشجوی دکتری روانشناسی،دانشگاه آزاد اسلامی واحد قم،قم،ایران
2 - استادیار گروه روانشناسی دانشگاه آزاد اسلامی واحد قم،قم،ایران
3 - استادیار گروه روانشناسی دانشگاه آزاد اسلامی واحد قم،قم،ایران
کلید واژه: روان‌درمانی پویشی فشرده و کوتاه‌مدت, اختلال شخصیت وسواس-اجباری, مکانیسم‌های دفاعی,
چکیده مقاله :
چکیده این پژوهش با هدف اثربخشی روان‌درمانی پویشی فشرده و کوتاه-مدت (ISTDP) بر کاهش علایم و مکانیسم‌های دفاعی اختلالات شخصیت خوشۀ C انجام شد. این پژوهش در زمرۀ پژوهش‌های شبه‌آزمایشی با طرح تک‌آزمودنی (A-B-A) بود. جامعه آماری این پژوهش را تمامی افراد مبتلا به اختلال‌های شخصیت خوشۀ C در شهر تهران در سال 1398 تشکیل می‌دادند. از میان جامعه آماری فوق، 9 نفر که تشخیص سه اختلال شخصیت وابسته، وسواسی-جبری و اجتنابی را بر اساس سیاهۀ چند محوری بالینی میلون-3 (MCMI-III) و مصاحبۀ روان‌پزشکی بر اساس ملاک‌های DSM-5 دریافت می‌کردند به روش نمونه‌گیری هدفمند انتخاب شدند. ابزار مورد استفاده در این پژوهش عبارت بودند از: سیاهۀ چند محوری بالینی میلون-3 (Millon, 1977)، پرسشنامۀ سبک دفاعی-40 (Andrews, Singh & Bond, 1993) و مصاحبۀ بالینی ساختاریافته برای اختلالات شخصیت DSM (First, Gibbon, Spitzer, Williams & Benjamin, 1997). همچنین، پروتکل ISTDP مطابق با رویکرد دوانلو (1995، 2000) هر هفته یکبار به مدت 15 جلسه و هر جلسه به مدت یک ساعت بر روی نمونۀ پژوهش اجرا شد. سنجش آزمودنی‌ها پس از ارزیابی خط پایه، هر 3 جلسه یکبار صورت گرفت و پس از اتمام جلسات درمانی، 3 ارزیابی پیگیری با فواصل یک‌ماهه انجام شد. داده‌ها با استفاده ازنسخه 24 نرم‌افزار SPSS تجزیه و تحلیل شدند. یافته‌های به دست آمده نشان داد که ISTDP سبب کاهش نشانه‌های اختلالات شخصیت خوشۀ C می-شود. همچنین، اثر این درمان بر کاهش مکانیسم‌های دفاعی ناپخته و نوروتیک و افزایش مکانیسم‌های پخته در این اختلالات معنادار بود (05/0 > p).
This study was conducted to investigate the effect of intensive short-term dynamic psychotherapy (ISTDP) on reducing the symptoms and defensive mechanisms of cluster C personality disorders. This study was a quasi-experimental study with a single-subject A-B-A design. The statistical population of this study consisted of all individuals with cluster C personality disorders in Tehran in 2019. Among the above statistical population, 9 individuals who received diagnoses of three dependent, obsessive-compulsive and avoidant personality disorders based on the Millon Clinical Multiaxial Inventory (MCMI-III) and Structured Clinical Interview for DSM Disorders (SCID-II) was selected by purposive sampling method. The instruments used in this study were: Millon Clinical Multiaxial Inventory (Millon, 1977), Defense Style Questionnaire-40 (Andrews, Singh & Bond, 1993) and Structured Clinical Interview for DSM Disorders (First, Gibbon, Spitzer, Williams & Benjamin, 1997). In addition, the ISTDP protocol was applied to the research sample according to the Davanlo (1995, 2000) approach for 15 sessions once a week and each session for one hour. Subjects were assessed after baseline assessment, once every 3 sessions, and after the treatment sessions, 3 follow-up assessments were performed at one-month intervals. Data were analyzed using Friedman test and SPSS software version 24. Findings showed that ISTDP reduced symptoms of cluster C personality disorder. Also, this treatment had a significant effect on the reduction of, immature, neurotic defensive and in increasing use of mature defensive mechanisms (p <0.05).
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