مقایسه اثربخشی درمان شناختی رفتاری گروهی و درمان شناختی مبتنی بر ذهن آگاهی بر متغیرهای میانجی اختلال اضطراب فراگیر

نویسندگان

1 استادیار گروه روانشناسی بالینی.دانشگاه علوم بهزیستی و توانبخشی

2 دانشیار گروه روانشناسی بالینی. دانشکده علوم تربیتی و روان شناسی. دانشگاه شهید بهشتی

3 استادیار گروه روانشناسی بالینی. دانشکده علوم تربیتی و روانشناسی. دانشگاه شهید بهشتی

چکیده

هدف پژوهش حاضر مقایسه اثربخشی درمان شناختی- رفتاری (الگوی بورکوک) و درمان شناختی مبتنی بر ذهن‌آگاهی بر متغیرهای میانجی اختلال اضطراب فراگیر بود. این پژوهش به صورت شبه آزمایشی انجام شده و دارای گروه گواه همراه با گمارش تصادفی، پیش­آزمون- پس­آزمون و پی­گیری 4 ماهه بوده است. جامعه پژوهش کلیه زنان مبتلا به اختلال اضطراب فراگیر شهر تهران بود. روش نمونه­گیری به صورت در دسترس و تخصیص شرکت کنندگان در دو گروه به صورت تصادفی بوده است. در این پژوهش از مقیاس 7 سوالی اختلال اضطراب فراگیر، تنظیم هیجانی، پرسشنامه اجتناب شناختی، حل مسئله، مقیاس آگاهی از توجه ذهن­آگاهانه و خودشفقت­ورزی استفاده شد. شرکت­کنندگان در مرحله پیش­آزمون، پس­آزمون و پی­گیری 4 ماهه مقیاس­ها را تکمیل نمودند. جهت تجزیه و تحلیل داده­ها از روش تحلیل واریانس با اندازه­گیری مکرر استفاده شد. نتایج پژوهش حاکی از آن بود که درمان شناختی رفتاری در مقایسه با درمان شناختی مبتنی بر ذهن‌آگاهی اثربخشی بیشتری در کاهش اجتناب شناختی، بهبود تنظیم هیجانی و حل مسئله داشته، و این در حالی است که اثربخشی درمان شناختی مبتنی بر ذهن­آگاهی بر افزایش توجه ذهن­آگاهانه و خودشفقت­ورزی بیشتر بوده است. بنابراین، از نتایج پژوهش فوق استنباط می­شود که هر کدام از دو روش، اثربخشی متفاوتی در خصوص متغیرهای میانجی این اختلال دارند.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the effectiveness between cognitive behavior therapy and mindfulness based cognitive therapy in mediator variables of generalized anxiety disorder

نویسندگان [English]

  • Fereshte Momeni 1
  • Shahriar Shahidi 2
  • Fereshte Mootabi 3
  • Mahmoud Heidari 2
1
2
3
چکیده [English]

The aim of the present study was to compare the effectiveness of Cognitive-Behavior (CBT) therapy (Borkovec model) and mindfulness based cognitive therapy (MBCT) in mediator variables of generalized anxiety disorder. A Semi experimental design using pre and post-test and a four months follow up was conducted. The statistical population comprised of women with generalized anxiety disorder in Tehran. Participants’ selection was based on availability and they were randomly assigned into two groups. In this research, the following measurement tools were used: Generalized Anxiety Disorder Scale (GAD-7), Cognitive Avoidance Scale (CAQ), Problem Solving Inventory (PSI), Dysregulation of Emotion Scale (DERS), Mindfulness Attention Awareness Scale (MAAS) and Self-Compassion Scale (SCS). Participants completed the tools in pre&post test and 4 months follow up. Data were analyzed via repeated measure analysis of variance. Results showed that CBT was effective in reducing cognitive avoidance, improving problem solving and emotion regulation in post-test and follow up compared to MBCT. MBCT was significantly effective in improving mindfulness attention awareness and self-compassion. It is inferred from the results that the effectiveness of the two treatments in mediator variables is different.

کلیدواژه‌ها [English]

  • Generalized anxiety disorder
  • Cognitive Behavior Therapy
  • Mindfulness Based Cognitive Therapy
  • Mediator variables
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, D.C.
Baldwin, D. S., Anderson, I. M., Nutt, D. J., Bandelow, B., Bond ,A., Davidson , J. R. (2005). Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology. J Psychopharmacology, 19(6):567-96.
Borkovec, T. D. Newman, M. G., Pincus, A. L., & Lytles, R. (2002). A component analysis of cognitive behavioral therapy for general lized anxiety disorder and the role of interpersonal problems. Journal of consulting and clinical psychology, 70, 2,288-298.
Craigie, M. A., Ree, C. S., Marsh, A. (2008). Mindfulness-based Cognitive Therapy for Generalized Anxiety Disorder: A Preliminary Evaluation. Behavioural and Cognitive Psychotherapy, 36, 553–568.
Cuijpers, P., Sijbrandij, M., Koole, S., Huibers, M., Berking, M., & Andersson, G. (2014). Psychological treatment of generalized anxiety disorder: a meta-analysis.
Clinical Psychology Review, 34, 130-140.
Dehghani, M., Javadipour, M., Eslamdoost, S. (2015).The Relationship between Metacognitive and Self-Efficacy of Teachers and their Professional Qualifications. Journal of Applied Psycology Research, 5(4), 51-68. doi:10.22059/japr.2015.52756.
Dugas, M. J., Savard, P., Gaudet, A., Turcotte, J., Laugesen, N., Robichaud, M., et al. (2007). Can the components of a cognitive model predict the severity of
generalized anxiety disorder? Behavior Therapy, 38, 169-178.
Dugas, M. J., Laugesen, N., & Bukowski,W. M. (2012). Intolerance of uncertainty, fear of anxiety, and adolescent worry. Journal of Abnormal Child Psychology, 40, 863-870.
Evans, S., Ferrando, S., Findler, M., Stowell , C., Smart , C., Haglin , D.(2008). Mindfulness based cognitive therapy for generalized anxiety disorder. J Anxiety Disorder, 22, 716-721.
Fava .G. A., Ruini, C., Rafanelli, C. , Finos , L., Salmaso, L. ,Mangelli, L. (2005). Well-being therapy of generalized anxiety disorder. Psychotherapy Psychosom, 74(1), 26-30.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26, 41–54.
Hakimzade, R., Masoudlavasani, GH., Norouzi, S. (2015).The Effectiveness of Cognitive-Behavior Trainings in Decreasing Students, Procrastination. Journal of Applied Psycology Research, 5(4), 81-88. doi:10.22059/japr.2015.52757.
Hanrahan, F., Field, A. P., Jones, F. W., & Davey, G. C. L. (2013). A meta-analysis of cognitive therapy for worry in generalized anxiety disorder. Clinical Psychology Review, 33, 120-132.
Heppner, P. (1988). Manual for the Problem Solving Inventory.Palo Alto, CA: Consulting Psychologist press.
Hoffman, D. L., E. M. Dukes, et al. (2008). "Human and economic burden of generalized anxiety
disorder." Depression and anxiety 25(1): 72-90.
Kabat-Zinn, J. (2013). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Bantam Books.
Kessler, R. C., Avenevoli, S., McLaughlin, K. A., Green, J. G., Lakoma,M. D., Petukhova, M., Merikangas, K. R. (2012).Lifetime co-morbidity of DSM-IV disorders in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A).
Kim, Y. W., Lee, S. H., Choi, T.K., Suh, S.Y., Kim, B., Kim, C. M., Cho, S. J., Kim, M. J., Yook, K., Ryu, M., Song, S. K., Yook, K. H. )2009(. Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depression and Anxiety, 26, 601–606.
Madani, Y., Hojati, S. (2015).The effect of mindfulness-based cognitive therapy on marital satisfaction and quality of life in couples. Journal of Applied Psycology Research, 6(2), 39-60. doi:10.22059/japr.2015.54564.
McEvoy, P., R. Grove, et al. (2011). "Epidemiology of Anxiety Disorders in the Australian General Population: Findings of the 2007 Australian National Survey of Mental Health and Wellbeing. ." Australian and New Zealand Journal of Psychiatry 45: 957-967.
Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder.
Behaviour Research and Therapy, 43, 1281-1310.
Moin Al-Ghorabaiee, F., Karamloo, S., & Noferesti, Azam. (2017). Metacognitive Components in Patients With Generalized Anxiety Disorder, Obsessive-
Compulsive Disorder and Depressed Mood Disorder. Iranian Journal of Psychiatry and Clinical Psychology, 23(2), 164-177.
Momeni, F., Shahidi, SH., Mootabi, F., Heidari, M. (2013). Psychometric Properties of the Persian Version of Self-Compassion Scale. : Contemporary Psychology : 8 (2), 27-40.
Narimani, M., Abolghasemi, A., Ahadi, B., Narimani, M. (2015). The Relationship of Obsessive-Compulsive Subgroups, Inferential Confusion and Emotion Regulation Strategies with Obsessive Beliefs in Women. Journal of Applied Psycology Research, 6(1), 137-150. doi:10.22059/japr.2015.54575.
Nayinian, M.R., Shoori, M. R., Sharifi, M., Hadiyan, M.(2011). Reliability and Reliability of the Scale of Generalized Anxiety Disorder (GAD-7). Daneshvar Behavior. 3(4), 41-50.
Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2, 223–250.
Roemer, L., Lee, J. K., Salters-Pedneault, K., Erisman, S. M., Orsillo, S. M., &Mennin, D. S. (2009). Mindfulness and emotion regulation difficulties in
generalized anxiety disorder: preliminary evidence for independent and overlapping contributions. Behavior Therapy, 40, 142-154.
Roemer, L. and Orsillo, S. M. (2003). Mindfulness: a promising intervention in need of further study. Clinical Psychology: Science and Practice, 10, 172–178.
Sexton, K. A & Dugas, M. J. (2004). An Investigation of Factor Leading to Cognitive in Worry . Poster Presented at the 38th annual Convention for the Association for Advancement Behavior Therapy: New Orleans, L. A. November 17-20.
Shokuhiyekta, M., Akbarizardkhane, S., Shahabi, R. (2015).Teaching Problem Solving for Parents: Effects on Resolving Family Conflicts and Parenting Style. Journal of Applied Psycology Research, 5(4), 1-12. doi:10.22059/japr.2015.52753
Spitzer, R, L., Kroenke, K.; Williams, J. B. W.; and Bernd, Lo¨we (2006). A Brief Measure for Assessing Generalized Anxiety Disorder The GAD-7. ARCH INTERN MED. 166
Wells, A. & Papa Georgiou, C. (1995). Worry and the incubation of intrusive image flowing stress. Behavior Research and Therapy, 33, 579-583.
Whiteford, H. A., L. Degenhardt, et al. (2013). "Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010." The Lancet 382(9904): 1575-1586.
Williams JB, Gibbon M, First MB, Spitzer RL, Davies M, Borus J, et al. The structured clinical interview for DSM-III-R (SCID): II. Multisite test-retest reliability. Archives of general psychiatry. 1992;49(8):630-6
دوره 8، شماره 1
اردیبهشت 1396
صفحه 49-66
  • تاریخ دریافت: 26 فروردین 1395
  • تاریخ بازنگری: 01 تیر 1396
  • تاریخ پذیرش: 19 دی 1395
  • تاریخ اولین انتشار: 01 اردیبهشت 1396
  • تاریخ انتشار: 01 اردیبهشت 1396