مقایسه اثربخشی درمان ترکیبی فراتشخیصی، ذهن‌آگاهی، رفتاردرمانی دیالکتیکی با CBT بر انعطاف‌ناپذیری روانشناختی درد افراد مبتلا به درد مزمن | ||
| فصلنامه روانشناسی کاربردی | ||
| دوره 17، شماره 4 - شماره پیاپی 68، 1402، صفحه 169-193 اصل مقاله (852.97 K) | ||
| نوع مقاله: مقاله پژوهشی | ||
| شناسه دیجیتال (DOI): 10.48308/apsy.2023.232064.1503 | ||
| نویسندگان | ||
| مصطفی محسنی* 1؛ مهرداد کلانتری2؛ کوروش نامداری3؛ احمد عابدی4 | ||
| 1دانشجوی دکتری روانشناسی،گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه اصفهان، اصفهان، ایران. | ||
| 2دانشگاه اصفهان-دانشکده روانشناسی و علوم تربیتی | ||
| 3دکتری روانشناسی، استادیار، گروه روانشناسی بالینی، دانشکده علوم تربیتی و روانشناسی، دانشگاه اصفهان، اصفهان، ایران. | ||
| 4دکتری روانشناسی، دانشیار، گروه روانشناسی و آموزش کودکان با نیازهای خاص، دانشکده روانشناسی و علوم تربیتی، دانشگاه اصفهان، اصفهان، ایران. | ||
| چکیده | ||
| هدف: پژوهش حاضر با هدف مقایسة اثربخشی درمان ترکیبی فراتشخیصی، ذهن‌آگاهی و رفتاردرمانی دیالکتیکی با درمان شناختی رفتاری بر انعطاف‌ناپذیری روانشناختی درد در افراد مبتلا به درد مزمن همبود با مشکلات هیجانی انجام شد. روش: روش پژوهش از نوع نیمه آزمایشی با طرح پیش‌‌آزمون- پس‌‌آزمون- پیگیری با گروه گواه بود. روش نمونه‌گیری، هدفمند بود. بدین ترتیب که از میان افراد مبتلا به اختلال درد مزمن همبود با مشکلات هیجانی، تعداد 45 نفر انتخاب شد و سپس در سه گروه درمان ترکیبی، رفتاردرمانی شناختی و گروه گواه گمارده شد. از مقیاس انعطاف‌ناپذیری روانشناختی درد استفاده شد. از روش تحلیل واریانس با اندازه‌گیری مکرر استفاده شد. یافته‌ها: نتایج نشان داد که تأثیر زمان اندازه‌گیری، اثر متقابل بین زمان اندازه‌گیری و گروه، و تأثیر گروه بر میانگین نمرات اجتناب از درد، آمیختگی شناختی و انعطاف‌ناپذیری روانشناختی درد کل معنادار بود. میانگین نمرات اجتناب از درد و انعطاف‌ناپذیری درد کل در گروه‌های درمان ترکیبی و درمان شناختی رفتاری، به طور معناداری کمتر از گروه گواه شدند، اما گروه درمان ترکیبی با گروه درمان شناختی رفتاری تفاوت معناداری نداشت. میانگین نمرات آمیختگی شناختی گروه درمان ترکیبی به طور معناداری کمتر از گروه‌های درمان شناختی رفتاری و گواه شد. نتیجه‌گیری: درمان ترکیبی و درمان شناختی رفتاری را می‌توان به صورت درمان کاربردی برای کاهش انعطاف‌ناپذیری روانشناختی درد در افراد مبتلا به درد مزمن همبود با مشکلات هیجانی استفاده نمود. بنابراین، پیشنهاد می‌شود این درمان‌ها در بیماران مبتلا به درد مزمن به کار گرفته شود. | ||
| کلیدواژه‌ها | ||
| اختلال درد مزمن؛ انعطاف‌ناپذیری روانشناختی درد؛ درمان ترکیبی؛ درمان شناختی رفتاری | ||
| عنوان مقاله [English] | ||
| Comparing effectiveness of combined transdiagnostic, mindfulness, and DBT with CBT on psychological inflexibility of pain in people with chronic pain | ||
| نویسندگان [English] | ||
| Mostafa Mohseni1؛ Mehrdad Kalantari2؛ Kourosh Namdari3؛ Ahmad Abedi4 | ||
| 1Ph.D. Student of Psychology, Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan. Iran. | ||
| 2Department of Psychology, Faculty of Education and Psychologyو University of Isfahan | ||
| 3Assistant Professor of Psychology, Department of Clinical Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran. | ||
| 4Associate Professor of Psychology, Department of Psychology and Education of Children with Special Needs, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran. | ||
| چکیده [English] | ||
| Aim: The aim of this study was to compare the effectiveness of metadiagnostic therapy, mindfulness therapy, dialectical behavior therapy, and cognitive behavioral therapy on psychological inflexibility related to pain in individuals with chronic pain associated with emotional problems. Method: This research employed a semi-experimental design with a pre-test, post-test, and follow-up plan, including a control group. The sampling method was purposive. In the quantitative analysis, repeated measures analysis of variance (ANOVA) was utilized. Results: The results demonstrated significant effects of measurement time, the interaction between measurement time and group, and the group on average scores of pain avoidance, cognitive fusion, and total pain-related psychological inflexibility. The average scores of pain avoidance and total pain inflexibility in both the combined treatment and cognitive-behavioral therapy groups were significantly lower than those in the control group. However, the combined treatment group showed superior improvement compared to the cognitive-behavioral therapy group. Additionally, the mean cognitive fusion scores of the combined therapy group were significantly lower than those of the cognitive-behavioral therapy group. Conclusion: Both combined therapy and cognitive-behavioral therapy were found to be effective in reducing the psychological inflexibility of pain in individuals with chronic pain and emotional problems. The combined therapy, which includes metadiagnostic therapy, mindfulness therapy, and dialectical behavior therapy, may be particularly beneficial for addressing cognitive fusion associated with pain. Therefore, these therapeutic approaches are recommended for individuals suffering from chronic pain. | ||
| کلیدواژه‌ها [English] | ||
| Chronic Pain Disorder, Psychological Inflexibility Of Pain, Combined Therapy, Cognitive Behavioral Therapy | ||
| مراجع | ||
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Aghayousefi, A., Tarkhan, M., Mohammadi, N., & Afshar, H. (2017). The role of psychological inflexibility and pain acceptance in predicting of resiliency in chronic pain patients. Health psychology, 5(17), 23-38. [Link] Akbari, M., Mohamadkhani, S., & Zarghami, F. (2016). The mediating role of cognitive fusion in explaining the relationship between emotional dysregulation with anxiety and depression: A transdiagnostic factor. Iranian Journal of Psychiatry and Clinical Psychology. [Link] Bardeen, J.R., Fergus, T.A. (2016). The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms. J Contextual Behav Sci, 5(1):1-6. [Link] Barlow, D. H. (2013). Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic. Guilford Publications. [Link] Barlow, D. H., Sauer-Zavala, S., Carl, J. R., Bullis, J. R., & Ellard, K. K. (2014). The Nature, Diagnosis, and Treatment of Neuroticism: Back to the Future. Clinical Psychological Science, 2(3), 344–365. [Link] Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006). Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorder. Behaviour Research and Therapy, 44, 1251-1263.[Link] Feigenbaum, J. (2007). Dialectical behaviour therapy: An increasing evidence base. Journal of Mental Health, 16(1), 51–68. [Link] Feldner, M. T., Hekmat, H., Zvolensky, M. J., Vowles, K. E., Sechrist, Z. & Leen- Feldner, E. W. (2006). The role of experiential avoidance in acute pain tolerance: A laboratory test. Journal of Behavior Therapy and Experimental Psychiatry, 37, 146−158. [Link] Frisvold, M. H., Lindquist, R., & McAlpine, C. P. (2012). Living life in the balance at midlife: Lessons learned from mindfulness. Western Journal of Nursing Research, 34(2), 265–278. [Link] Gillanders, D., Bolderston, H., Bond, F.W., Dempster, M., Flaxman, P., Campbell, L., Kerr, S., Tansey, L., Noel, P., Ferenbach, C., Masley, S., Roach, L., Lloyd, J., May, L., Clarke, S., Remington, B. (2014). The Development and Initial Validation of the Cognitive Fusion Questionnaire. Behav Ther. 43(0):25–010. [Link] Goldstein, B., Bradley, B., Ressler, K.J., Powers, A. (2017). Associations Between Posttraumatic Stress Disorder, Emotion Dysregulation, and Alcohol Dependence Symptoms Among Inner City Females. J Clin Psychol, 73(3):319-30. [Link] Hadi, M.A., McHugh, G.A., Closs, S.J. (2019). Impact of Chronic Pain on Patients' Quality of Life: A Comparative Mixed-Methods Study. J Patient Exp, 6(2): 133-141. [Link] Hayes, S. (2004). Improving Diabetes Self-Management Through Acceptance, Mindfulness, and Values: A Randomized Controlled Trial. Journal of Consulting and Clinical Psychology, 5(2): 336–43. [Link] Hayes, S., Strosahl, K.D., Banink, F., Thohig, L. & Wilson, K.G. (2006). Measuring experiential avoidance: a preliminary test of a working model. Psychol Rec, (54): 553-578. [Link] Kingston, J., Chadwick, P., Meron, D., Skinner, T.C. (2007). A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity. J Psychosom Res, 62(3): 297-300. [Link] Larsson, A., Hooper, N., Osborne, L.A., Bennett, P., McHugh, L. (2016). Using Brief Cognitive Restructuring and Cognitive Defusion Techniques to Cope with Negative Thoughts. Behav Modif, 41(5):438-28. [Link] Lynch, T.R., Chapman, A.L., Rosenthal, M.Z., Kuo, J.R., Linehan, M.M. (2006). Mechanisms of change in dialectical behavior therapy: theoretical and empirical observations. J Clin Psychol, 62(4): 459-80. [Link] Mackey, S., Kao, M.C. (2019). Managing twin crises in chronic pain and prescription opioids. BMJ, 364: l917. [Link] Martin, L. R., DiMatteo, M. R., & Lepper, H. S. (2001). Facilitation of patient involvement in care: Development and validation of a scale. Behavioral Medicine, 27(3), 111–120. [Link] Masuda, A., Hayes, S.C., Twohig, M.P., Drossel, C., Lillis, J., Washio, Y. (2009). A parametric study of cognitive defusion and the believability and discomfort of negative self-relevant thoughts. Behavior Modification; 55(8): 831-68. [Link] Masuda, A., Price, M., Latzman, R. D. (2012). Mindfulness Moderates the Relationship Between Disordered Eating Cognitions and Disordered Eating Behaviors in a Non-Clinical College Sample. J Psychopathol Behav Assess, 34(1): 107-115. [Link] Masuda, A., Tully, E. C. (2012). The Role of Mindfulness and Psychological Flexibility in Somatization, Depression, Anxiety, and General Psychological Distress in a Nonclinical College Sample. Journal of Evidence-Based Complementary & Alternative Medicine, 17(1):66-71. [Link] McCracken, L. M., Gutiérrez-Martínez, O., & Smyth, C. (2013). “Decentering” reflects psychological flexibility in people with chronic pain and correlates with their quality of functioning. Health Psychology, 32(7), 820–823. [Link] McCracken, L. M., Vowles, K. E. (2014). Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. Am Psychol, 69(2): 178-87. [Link] McCracken, L. M., Williams, J. L., Tang, N. K. (2011). Psychological flexibility may reduce insomnia in persons with chronic pain: a preliminary retrospective study. Pain Med, 12(6): 904-12. [Link] McHugh, R. K., Whitton, S. W., Peckham, A. D., Welge, J. A., Otto, M. W. (2013). Patient preference for psychological vs pharmacologic treatment of psychiatric disorders: a meta-analytic review. J Clin Psychiatry, 74(6): 595-602. [Link] McKay, M., Fanning, P., & Zurita Ona, P. E. (2011). Mind and Emotions: A Universal Treatment for Emotional Disorders. Oakland, CA: New Harbinger. [Link] Niazi, A. K., Niazi, S. K. (2011). Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses. N Am J Med Sci, 3(1): 20-3. [Link] Ruiz, F. J., & Odriozola-González, P. (2017). A longitudinal comparison of metacognitive therapy and acceptance and commitment therapy models of anxiety disorders. Anales de Psicología, 33(1), 7–17. [Link] Schuster, D. P. (2010). Obesity and the development of type 2 diabetes: the effects of fatty tissue inflammation. Diabetes Metab Syndr Obes, 3: 253-62. [Link] Smith, B. W., Tooley, E. M., Montague, E. Q., Robinson, A. E., Cosper, C. J., Mullins, P. G. (2009). The role of resilience and purpose in life in habituation to heat and cold pain. J Pain. 10:493–500. [Link] Vaegter, H. B., Christoffersen, L. O., Enggaard, T. P., Holdggard, D. E. M., Lefevre, T. N., Eltved, R., Reisenhus, C. H., Licht, T. W., Laustsen, M. M., Hansson, S. H., Jensen, P. F., Larsen, T. R. F., Alpiger, S., Mogensen, B. G., Høybye, M. T. (2021). Socio-Demographics, Pain Characteristics, Quality of Life and Treatment Values Before and After Specialized Interdisciplinary Pain Treatment: Results from the Danish Clinical Pain Registry (PainData). J Pain Res, 14: 1215-1230. [Link] Wicksell, R.K., Renofalt, J., Olsson, G.L., Bond, F.W. & Melin, L. (2008). "Avoidance and cognitive fusion-central components in pain related disability? Development and preliminary validation of the psychological inflexibility in pain scale (PIPS)". European Journal of Pain, 12, 491–500. [Link] | ||
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