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جلد 26، شماره 9 - ( 9-1398 )                   جلد 26 شماره 9 صفحات 47-58 | برگشت به فهرست نسخه ها

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otared N, narimani M, sadeghi G, mahmood alilou M, atadokht A. Explanation of generalized anxiety disorder, social anxiety disorder and major depression disorder based on psychopathological model of acceptance and commitment therapy. RJMS. 2019; 26 (9) :47-58
URL: http://rjms.iums.ac.ir/article-1-5405-fa.html
عطارد نسترن، نریمانی محمد، صادقی گودرز، محمود علیلو مجید، عطادخت اکبر. تبیین اختلال اضطراب فراگیر، اختلال اضطراب اجتماعی و اختلال افسردگی اساسی براساس مدل آسیب‌شناسی روانی در درمان مبتنی بر پذیرش و تعهد. مجله علوم پزشکی رازی. 1398; 26 (9) :47-58

URL: http://rjms.iums.ac.ir/article-1-5405-fa.html


دانشگاه محقق اردبیلی، اردبیل، ایران ، Nastaran.Otared@yahoo.com
چکیده:   (1999 مشاهده)
زمینه و هدف: انعطاف­ناپذیری روانشناختی، به عنوان یک مدل نظری جدید برای آسیب­شناسی روانی، با طیفی از مسائل روانشناختی مرتبط بوده است؛ بنابراین پژوهش حاضر با هدف تبیین اختلال اضطراب فراگیر، اختلال اضطراب اجتماعی و اختلال افسردگی اساسی براساس مدل آسیب­شناسی روانی در درمان مبتنی بر پذیرش و تعهد انجام گرفت.
روش کار: روش پژوهش حاضر از نوع توصیفی- همبستگی بود. جامعه پژوهش را کلیه دانشجویان دانشگاه علوم پزشکی تبریز در سال تحصیلی 97-1396 تشکیل می­دادند. با استفاده از روش نمونه­گیری خوشه­ای چند مرحله­ای، 408 دانشجو انتخاب شدند. برای جمع­آوری داده­ها از پرسشنامه مشخصات جمعیت شناختی، پرسشنامه­ اختلال اضطراب اجتماعی (SPIN)، مقیاس کوتاه اضطراب فراگیر (GAD-7)، پرسشنامه افسردگی بک- ویرایش دوم (BDI-II) و مقیاس ارزیابی جامع فرآیندهای درمان پذیرش و تعهد (compACT) استفاده شد. به منظور تجزیه و تحلیل داده­ها، شاخص­های آمار توصیفی (فراوانی، درصد، میانگین، انحراف استاندارد) و تکنیک معادلات ساختاری مورد استفاده قرار گرفتند. به منظور تجزیه و تحلیل داده­ها از نرم­افزارهای SPSS-22 و Lisrel-8.85 استفاده شد.
یافته‌ها: نتایج مدل­یابی معادلات ساختاری نشان داد که مسیر هم جوشی شناختی و اجتناب تجربه­ای به اختلال اضطراب اجتماعی، اختلال اضطراب فراگیر و اختلال افسردگی اساسی در سطح 01/0> pو مسیر خود مفهوم سازی شده و تسلط گذشته و آینده به اختلال اضطراب فراگیر در سطح 01/0>p معنی­دار بودند. با این حال مولفه فقدان ارزش­ها و عمل متعهدانه هیچ مسیر معنی­داری نداشت و از مدل نهایی حذف شد.
نتیجه‌گیری: بر اساس یافته­های این پژوهش، فرآیندهای آسیب­شناختی مربوط به درمان مبتنی بر پذیرش و تعهد در میان اختلال­های هیجانی، از رویکرد ابعادی به تشخیص و درمان حمایت می­کند.
 
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نوع مطالعه: پژوهشي | موضوع مقاله: روانشناسی بالینی

فهرست منابع
1. 1. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch-Gen Psychiatry. 2005;62:617–27.
2. 2. Brown TA, Campbell LA, Lehman CL, Grisham JR, Mancill RB. Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. J Abnorm Psychol. 2001;110: 585–99.
3. 3. Fava M, Rankin MA, Wright EC, Alpert JE, Nierenberg AA, Pava J , et al. Anxiety disorders in major depression. Compr Psychiatry. 2000; 41: 97–102.
4. 4. Lamers F, van Oppen P, Comijs HC, Smit JH, SpinhovenP, van Balkom, et al. Comorbidity patterns of anxiety and depressive disorders in a large cohort study: the Netherlands study of depression and anxiety (NESDA). J Clin Psychiatry. 2011; 72: 341–48.
5. 5. Moscati A, Flint J & Kendler KS. Classification of anxiety disorders comorbid with major depression; common or distinct influences on risk? Depress Anxiety. 2017; 33 (2): 120- 27.
6. 6. Newman MG, Przeworski A, Fisher AJ, Borkovec, TD. Diagnostic comorbidity in adults with generalized anxiety disorder: impact of comorbidity on psychotherapy outcome and impact of psychotherapy on comorbid diagnoses. Behav Ther. 2010; 41:59–72.
7. 7. Belzer K, Schneier FR. Comorbidity of anxiety and depressive disorders: Issues in conceptualization, assessment, and treatment. J Psychiatr Pract. 2004; 10, 296–306.
8. 8. Kessler RC, DuPont RL, Berglund P, Wittchen HU. Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. Am J Psychiatry. 1999;156:1915–23.
9. 9.Turki M, Ben Thabet J, Charfi N, Mezghanni M, Maalej Bouali M, Zouari N, Zouari L, et al. Generalized anxiety disorder comorbidities: Panic and depressive disorder. Eur Psychiatry. 2017;41:S486.
10. 10. Zhou Y, Cao Z, Yang M, Xi X, Guo Y, Fang M, Cheng L, et al. Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder. Sci Rep. 2017;7:40511.
11. 11. Harvey AG, Watkins E, Mansell W, Shafran R. Cognitive behavioural processes across psychological disorders: a transdiagnostic approach to research and treatment. In: Oxford: Oxford University Press. 2004.
12. 12. American Psychiatric Association, Diagnostic and statistical manual of mental disorders (5th ed.), Arlington, VA: American Psychiatric Publishing; 2013.
13. 13. McNaughton N, Corr PJ. A two-dimensional neuropsychology of defense: Fear/anxiety and defensive distance. Rev Biobehav Neurosci. 2004; 28(3): 285–305.
14. 14. Siegle GJ, Thobpson W, Carter CS, steinhauer SR, Thase ME. Increased amygdala and decreased dorsolateral prefrontal BOLD responses in unipolar depression: related and independent features. Biol Psychiatry. 2007;16(2):198-209.
15. 15. Huppert JD. Anxiety disorders and depression comorbidity. In: M. M. Antony, M. B. Stein (Eds.), Oxford handbook of anxiety and related disorders (pp. 576–586). New York, NY: Oxford University Press. 2009.
16. 16. Krueger RF, Markon KE. Reinterpreting comorbidity: A model-based approach to understanding and classifying psychopathology. Clin Rev Ann. 2006:2111–2133.
17. 17. Mansell W, Harvey A, Watkins E, Shafran R. Conceptual foundations of the transdiagnostic approach to CBT. J Cog Psychother. 2009; 23: 6-19.
18. 18. Mennin DS & Fresco DM. Emotion regulation therapy. In J. J. Gross (Ed.), Handbook of emotion regulation. New York: Guilford Press. 2014. p. 469-490.
19. 19. Clark LA, Watson D. Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. J Abnorm Psychol. 1991; 100: 316-336.
20. 20. Barlow DH, Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Allen LB, et al. The unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. New York: Oxford University Press. 2011.
22. 21. Aldao A, Nolen-Hoeksema S & Schweizer S. Emotion-regulation strategies across psychotherapy: A meta-analytic review. Clin Psychol Rev. 2010; 30, 217-237.
23. 22. Kring AM & Sloan DS. Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment. New York: Guilford Press. 2009.
24. 23. Nolen-Hoeksema S & Watkins ER. A heuristic for developing transdiagnostic models of psychopathology: Explaining multifinality and divergent trajectories. Psychol Perspect. 2011;6:589-609.
25. 24. Hayes-Skelton SA, Orsillo SM & Roemer L. Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder. Behav Res Ther. 2012; 43(3): 238-245.
26. 31. Hayes SC, Wilson KG, Gifford EV, Follette VM & Strosahl K. Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996; 64: 1152–1168.
27. 32. Harris R. ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy. Translated by Anushe Aminzadeh, Tehran: Arjmand Publishing. 2009.
28. 25. Venta A, Sharp C, Hart J. The relation between anxiety disorder and experiential avoidance in inpatient adolescents. Psychol Assess. 2012; 24: 240-248.
29. 26. Levin ME, MacLane C, Daflos S, Seeley J, Hayes SC. Examining psychological inflexibility as a transdiagnostic process across psychological disorders. J Contextual Behav Sci . 2014;3(3):155-163.
30. 27. Kato T. Psychological inflexibility and depressive symptoms among Asian English speakers: A study on Indian, Philippine ,and Singaporean samples. J Psychiatr Res. 2016; 238:1–7.
31. 28. Levin ME, Lillis J, Seeley J, Hayes SC, Pistorello J, Biglan A. Exploring the relationship between experiential avoidance, alcohol use disorders and alcohol-related problems among first-year college students. J Am Coll Health. 2012;60:443-8.
32. 29. Rawal A, Park RJ & Williams MG. Rumination, experiential avoidance, and dysfunctional thinking in eating disorders. Behav Res Ther. 2010; 48:851-9.
33. 30. Goldstone E, Farhall J, Ong B. Life hassles, experiential avoidance and distressing delusional experiences. Behav Res Ther. 2011; 40: 260-266.
34. 33. Mellick W, Vanwoerden S, Sharp C. Experiential avoidance in the vulnerability to depression among adolescent females. J Affect Disord. 2016; 208: 497-502.
35. 34. Schut DM, Boelen PA. The relative importance of rumination, experiential avoidance and mindfulness as predictors of depressive symptoms. J Context Behav Sci . 2017; 6(1):8-12.
36. 35. Bardeen JR, Fergus TA. The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms. J Context Behav Sci . 2016; 5: 1–6.
37. 36. Spinhoven P, Drost J, de Rooji M, van Hemert AM, penninx BW. A longitudinal study of experiential avoidance in emotional disorders. Behav Ther. 2014; 45(6):840-50.
38. 37. Samadifard H. Relationship between cognitive fusion and social anxiety among couples. Third International Conference of psychology, educational sciences and lifestyle. 2016.
39. 38. Akbari M, Mohamadkhani S, Zarghami F. The mediating role of cognitive fusion in explaining the Relationship between emotional dysregulation with anxiety and depression: A Transdiagnostic Factor. IJPCP. 2016; 22(1):17-29.
40. 39. Eustis EH, Hayes-Skelton SA, Roemer L, Orsilo SM. Reductions in experiential avoidance as a mediator of change in symptom outcome and quality of life in acceptance-based behavior therapy and applied relaxation for generalized anxiety disorder. Behav Res Ther. 2016; 87: 188-195.
41. 40. Walser RD, Garvert DW, Karlin BE, Trockel M, Ryu DM, Taylor CB. Effectiveness of acceptance and commitment therapy in treating depression and suicidal ideation in Veterans. Behav Res Ther. 2015;74: 25-31.
42. 41. Folke F, Parling T & Melin L. Acceptance and Commitment Therapy for Depression: A Preliminary Randomized Clinical Trial for Unemployed on Long-Term Sick Leave. Cog Behav Pract. 2012; 19(4): 583-594.
43. 42. Bastami M, Goodarzi N, Dowran B, Taghva A. Effectiveness of treatment acceptance and commitment therapy (ACT) on the reduction of depressive symptoms of military personnel with type 2 diabetes mellitus. Ebnesina. 2016; 18(1): 11-18.
44. 43. Connor KM, Davidson JRT, Churchill LE, Sherweed A, Foa EB, Weisler RH. Psychometric properties of the social phobia (SPIN): A new self rating scale. Br J Psychiatry. 2000; 176: 379-386.
45. 44. Abdi R, Birashk B, Aliloo MM, Asgharnezhad Faried A. Interpretation bias in social phobia disorder. Mod Psychol Res. 2007; 1(4):1-17.
46. 45. Spitzer RL, Kroenke K, Williams JBW, Bernd L. A Brief Measure for Assessing Generalized Anxiety Disorder The GAD-7. Arch Int Med. 2006;166 (10): 1092-7.
47. 46. Naeinian M, Shaeiri M, Sharif M, Hadian M. To Study Reliability and Validity for A Brief Measure for Assessing Generalized Anxiety Disorder (GAD-7). CPAP. 2011; 2(4):41-50.
48. 47. Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory- II. The psychological corporation, Harcourt Brace, Company, San Antonio. 1996.
49. 48. Clark LA, Watson D. Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. J Abnorm Child Psychol. 1991; 100: 316-36.
50. 49. Rajabi GH, Karju Kasmai S. Psychometric properties of a Persian language version of the beck depression inventory second edition. J Educ Meas. 2013; 3(10):140-157.
51. 50. Fata L, Birashk B, Atefvahid MK, Dabson KS. Meaning assignment structures/ schema, emotional states and cognitive processing of emotional information: comparing two conceptual frameworks. IJPCP. 2005; 11(3): 312-26.
52. 51. Ferancis A, Dawson D, Golijani- Moghaddam N. The development and validation of the comprehensive assessment of acceptance and commitment therapy processes (compACT J Contextual Behav Sci. 2016; 5(3): 134- 145.
53. 52. Chou CP, Bentler PM. Estimates and tests in structural equation modeling. In Hoyle RH, (Ed.), Structural equation modeling: Concepts, issues and applications. California: Sage. 1995.
54. 53. Kline RB. Principles and practice of structural equation modeling. New York: Guilford; 2011.
55. 54. Chawla N, Ostafin B. Experiential avoidance as a functional dimensional approach to psychopathology: An empirical review. J Clin. Psychol. 2007; 63:871–90.
56. 55. Hayes SC & Smith S. Get out of your mind and into yours life: The new acceptance and commitment therapy. New York: New Harbinger Publications, Inc; 2005.
57. 56. Flaxman EF, Blackledge JT, Bond FW. Acceptance and commitment therapy. London: Routledge; 2011.
58. 57. Jahangiri F, Karimi J, AminAfshari M R. The. Role of metacognitive beliefs and mindfulness skills in prediction of symptom severity in patients with irritable bowel syndrome. Razi J Med Sci. 2017; 24 (4):25-34.
59. 58. Greco LA, Lambert W, Baer RA. Psychological inflexibility in childhood and adolescence: Development and evaluation of the Avoidance and Fear Questionnaire for Youth. Psychol Assess. 2008; 20:93–102.
60. 59. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). New York: Guilford. 2012.
61. 60. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford Press. 1999.
62. 61. Borkovec TD, Alcaine OM, Behar E. Avoidance theory of worry and generalized anxiety disorder. In D. S. Mennin, R. G. Heimberg, & C. L. Turk (Eds.), Generalized anxiety disorder: Advances in research and practice. New York, NY: Guilford Press. 2004. p. 77-108.
63. 62. Wells A, Carter K. Preliminary tests of a cognitive model of generalized anxiety disorder. Behav Res Ther. 1999; 37: 585–594.
64. 63. Hayes-Skelton SA, Orsillo SM, Roemer L. An acceptance-based behavioral therapy for individuals with generalized anxiety disorder. Cog Behav Pract. 2013; 20: 264–81.
65. 64. Zohrabi S, Shairi M R, Heydarinasab L. The effect of mindfulness and acceptance-based group therapy on decreasing fear of negative evaluation in patients with social anxiety disorder. Razi J Med Sci. 2016; 22(140):1-11.
66. 65. Kahrizi S, Taghavi M, Ghasemi R, Goodarzi M. The effectiveness of mindfulness-based cognitive therapy (MBCT) on Depression, Anxiety and Somatic Symptoms in Asthma patients. Razi J Med Sci. 2017; 24(1):27-36.
67. 66. Hadiyan M. Effectiveness of Acceptance & Commitment Therapy (ACT) on separation anxiety disorders in children with type 1 diabetes. Razi J Med Sci. 2018; 24(11):21-34.

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