Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1399
9
1
gregorian
2020
12
1
27
10
online
1
fulltext
fa
مقایسه اثربخشی درمان شناختی- رفتاری با درمان فراتشخیصی بر نشانگان بالینی و تحمل آشفتگی دانشجویان
Comparison of cognitive- behavioral therapy with transdiagnostic treatment on the clinical syndrome and distress tolerance of students
اعصاب و روان
Neurology Psychiatrics
پژوهشي
Research
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">زمینه و هدف:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">عوامل متعددی سلامت روان دانشجویان را بهعنوان آیندهسازان و نیروهای برگزیده کشور به خطر میاندازد. ازاینرو پژوهش حاضر با هدف مقایسه اثربخشی درمان شناختی</span></span></span><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">–</span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> رفتاری با درمان فراتشخیصی بر نشانگان بالینی و تحمل آشفتگی دانشجویان انجام شد.</span></span></span><br>
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">روش کار:</span></span></span></strong><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> پژوهش حاضر نیمه آزمایشی با طرح پیشآزمون- پسآزمون و پیگیری با گروه کنترل بود. جامعه آماری شامل کلیه دانشجویان دانشگاههای شهر مشهد بودند. نمونه پژوهش شامل 45 نفر بود که به روش نمونهگیری در دسترس انتخاب شدند و سپس بهصورت تصادفی در دو گروه آزمایش (هر گروه 15 نفر) و یک گروه کنترل (15 نفر) جایگزین شدند<strong>.</strong> پس از اجرای پیشآزمون، گروههای آزمایش درمان شناختی- رفتاری(فری 2007) و درمان فراتشخیصی(بارلو 2011) قرار گرفتند و سپس پسآزمون و پیگیری انجام شد. ابزار پژوهش شامل مقیاس افسردگی اضطراب استرس لاویبوند و لاویبوند و مقیاس تحمل آشفتگی سیمونز و گاهر بود. دادهها با نرمافزار </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">SPSS</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"> و تحلیل واریانس با ارزیابی مکرر تحلیل شدند</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">.</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;"></span></span></span><br>
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">یافتهها:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">نتایج نشان داد بین میانگین نمره نشانگان بالینی گروههای فراتشخیصی و شناختی- رفتاری با گروه کنترل تفاوت معنادار وجود دارد (05/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">). همچنین بین میانگین نمره نشانگان بالینی گروه فراتشخیصی و شناختی- رفتاری تفاوت معنادار وجود دارد (05/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">). بررسی متغیر تحمل آشفتگی نشان داد که بین گروههای فراتشخیصی و شناختی با گروه کنترل تفاوت معنادار وجود دارد (05/0></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">)، اما بین میانگین نمره تحمل آشفتگی گروه فراتشخیصی و شناختی رفتاری تفاوت معنادار وجود ندارد (05/0<</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">p</span></span></span></span><span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">).</span></span></span><br>
<strong><span style="color:#0070c0;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">نتیجهگیری:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Mitra;"><span style="font-size:10.0pt;">نتایج پژوهش حاضر نشان داد که برای کاهش نشانگان بالینی و افزایش تحمل آشفتگی دانشجویان میتوان از درمان شناختی- رفتاری و درمان فراتشخیصی استفاده نمود. همچنین برای کاهش نشانگان بالینی بهتر است از درمان فراتشخیصی استفاده کرد.</span></span></span><br>
<strong>Background & Aims: </strong>The research shows the prevalence of mental disorders among Iranian students. Lack of familiarity with student environments, distance from family and insufficient welfare facilities are among the conditions leading to various problems such as stress, anxiety, depression and confusion of students. These disorders cause a significant reduction in performance of people in the areas of work, society, family, lack of pleasure and stress and are associated with emotion regulation. Distress tolerance is a common structure of emotion regulation and is associated with the occurrence of high-risk behaviors. One of the most widely used approaches to treating these problems and disorders is cognitive-behavioral therapy. This approach helps people change their distorted thoughts that lead to dysfunctional behavior through regular conversations, cognitive techniques, and organized behavioral tasks. Cognitive-behavioral therapy has been proposed for almost every category of psychological problems and disorders, and numerous studies have confirmed the effectiveness of this treatment on the emotional disorders. Another approach in this field is the transdiagnostic treatment, according to which people face their inappropriate emotional experiences in order to respond to their emotions in a more adaptive way; By regulating emotional habits, their severity and occurrence decreases, and consequently the amount of damage decreases and function increases. Although both approaches are used in the treatment of psychological problems and disorders, it is important to repeat and compare the effectiveness of each. Due to the high prevalence of depression, anxiety and stress among students and its effect on their various functions, the need for new psychotherapy programs and the lack of sufficient research in this area, the present study aimed at comparing the effectiveness of cognitive behavioral therapy with transdiagnostic treatment on the clinical symptoms and distress tolerance of students.<br>
<strong>Methods: </strong>It was an applied quasi-experimental study with a pre-test-post-test design and follow-up with the control group. The statistical population included all students of Mashhad universities in 2019-20. Students were selected after obtaining permission and inserting advertisements in universities using the available sampling method. Among the students who volunteered for the study, 120 scored higher than the cut-off point on the Depression, Anxiety, Stress Scale (DASS-21). Finally, 45 of them were selected and randomly assigned to two experimental groups (A, B) and a control group. Participants completed the DAS-21 scale and the distress tolerance scale (DTS). Then, therapeutic interventions for group A (cognitive-behavioral therapy) and group B (transdiagnostic treatment) were performed for 10 two-hour sessions in groups. Control group participants remained on the waiting list. During the course, there were three cases of miscarriage due to not continuing to participate in treatment sessions in one group, which due to coping with the other two groups, the questionnaires of three participants were randomly deleted. At the end of the treatment period, post-test was conducted and the follow-up test was conducted after 3 months. Inclusion criteria included being a student of Mashhad universities, having an age of 20 to 35 years and a score higher than the average cut-off point in the DASS-21. Exclusion criteria included not having any type of psychotic disorder, bipolar disorder, substance and alcohol use, personality disorder, lack of physical disability and absence of more than two sessions of treatment. Consent to participate in the research, emphasis on confidentiality of information, freedom to leave the research and avoiding any harm were among the ethical considerations of the present study. Research data were analyzed using repeated measures analysis of variance and SPSS software version 26.<br>
<strong>Results:</strong> The mean age of participants in the transdiagnostic treatment, cognitive-behavioral, control and total participants were 21.75±2.006<span dir="RTL">، </span>21.42±1, 21.08±1.73, 21.42±1.61, respectively. In each group, 4 participants were male and 8 were female. There was no significant difference between individuals in three groups in terms of age (p=0.61, F=0.50), education (p=0.47, χ<sup>2</sup>=5.60) and marital status (p=0.60, χ<sup>2</sup>=2.75). There was a statistically significant difference between the mean scores of clinical symptoms (depression, anxiety, stress) in transdiagnostic treatment and cognitive-behavioral groups with control group (p<0.05) and transdiagnostic treatment and cognitive-behavioral groups (p<0.05). The study of distress tolerance variable showed that there was a significant difference between the transdiagnostic and cognitive-behavioral groups with the control group (p<0.05), but there was no significant difference between the mean distress tolerance score of the transdiagnostic and cognitive-behavioral groups (p<0.05).<br>
<strong>Conclusion:</strong> The results showed that the cognitive-behavioral and transdiagnostic therapy were effective in reducing clinical symptoms (depression, anxiety, stress) and increasing students' distress tolerance. Therefore, therapists can use these two treatment approaches to reduce clinical symptoms and increase students' distress tolerance. However, transdiagnostic treatment is more effective in reducing students' clinical symptoms. The difference may be due to special attention to emotions in the transdiagnostic approach designed for comorbidities. Of course, these findings need further investigation. In general, according to the findings of the present study, it is suggested to use a transdiagnostic treatment approach to reduce clinical symptoms. It is also suggested that in order to increase the generalizability of the results, this treatment method should be performed in different samples and at different levels. In this study, both methods of intervention were performed by the main researcher and this issue may have been the cause of individual biases by the researcher. Considering that it was not possible for all students of Khorasan Razavi province to participate in the study and the sample was limited to a specific geographical area and the city of Mashhad, care should be taken in generalizing the results.<br>
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تحمل آشفتگی, درمان شناختی- رفتاری, درمان فراتشخیصی, نشانگان بالینی
Distress Tolerance, Cognitive-Behavioral Therapy, Transdiagnostic Treatment, Clinical Symptoms
1
13
http://rjms.iums.ac.ir/browse.php?a_code=A-10-5235-1&slc_lang=fa&sid=1
Afarin
sadeghi Ordoubadi
آفرین
صادقی اردوبادی
3900319475328460055366
3900319475328460055366
No
Department of Psychology, Neyshabur Branch, Islamic Azad Uniuersity, Neyshabur, Iran
دانشگاه آزاد اسلامی، نیشابور، ایران
Zahra
Bagherzadeh Golmakani
زهرا
باقرزاده گلمکانی
Z.golmakan@gmail.com
3900319475328460055367
3900319475328460055367
Yes
Islamic Azad Uniuersity, Neyshabur, Iran
دانشگاه آزاد اسلامی، نیشابور، ایران
Mehdi
Amiri
مهدی
امیری
3900319475328460055368
3900319475328460055368
No
Department of clinical Psychology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
گروه روانشناسی بالینی، دانشکده علوم پزشکی، دانشگاه علوم پزشکی مشهد،مشهد، ایران
Ahmad
Mansouri
احمد
منصوری
3900319475328460055369
3900319475328460055369
No
Department of Psychology, Neyshabur Branch, Islamic Azad Uniuersity, Neyshabur, Iran
گروه روانشناسی، واحد نیشابور، دانشگاه آزاد اسلامی، نیشابور ، ایران