Razi Journal of Medical Sciences

fa هم سنجی اثربخشی آموزش گروهی مبتنی بر درمان هیجان مدار و آموزش گروهی مبتنی بر درمانACT بر دلبستگی، صمیمیت و رضایت جنسی در زنان مبتلا به بی میلی جنسی Evaluation of the effectiveness of group therapy based on emotion therapy and group training based on ACT therapy on attachment, intimacy and sexual satisfaction in women with sexual reluctance روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: پژوهش حاضر با هدف بررسی اثربخشی آموزش گروهی مبتنی بر درمان هیجانمدار و آموزش گروهی مبتنی بر درمان ACT بر دلبستگی، صمیمیت و رضایت جنسی در زنان مبتلا به بیمیلی جنسی در زنان نجفآباد انجام شد. روش: جامعه آماری متشکل از تمامی زنان متاهل شهر نجفآباد در سال 1398 بود که به مرکز مشاوره ماهور شهر نجفآباد مراجعه کرده بودند. تعداد 40 نفر از زنانی که دارای نمره پایینی در مقیاس رابطه جنسی هاگز و استل بوده و تشخیص بیمیلی جنسی برای آنها تأیید شد، با استفاده از نمونهگیری دردسترس انتخاب و بصورت تصادفی در گروهها جایگذاری شدند. ابزار به کار رفته در پژوهش پرسشنامه سبکهای دلبستگی کولینز و رید، پرسشنامه صمیمیت زناشویی تامپسون و واکر و شاخص عملکرد جنسی زنان روزن و همکاران بودند که در پیشآزمون و پسآزمون با رعایت اصول اخلاقی پژوهش بر روی اعضای نمونه پژوهش انجام شد. جهت تحلیل نتایج از آزمون تحلیل کواریانس چند متغیره در سطح معناداری (05/0=α) استفاده شد. یافته‌ها: نتایج بدست آمده نشان داد که مداخلات ارائه شده بر گروههای آزمایش توانسته تاثیر معناداری بر بهبود میانگین صمیمیت زناشویی (001/0>p) و رضایت جنسی (001/0>p) داشته باشد. این مداخلات بر میانگین سبکهای دلبستگی ایمن (001/0>p)، اجتنابی (05/0>p) و دوسوگرا (001/0>p) نیز اثربخشی معناداری داشتند. همچنین مشخص شد که مداخلات ارائه شده بر گروههای آزمایش، تنها در بهبود صمیمیت زناشویی تفاوت معناداری داشتند. نتیجه‌گیری: با توجه به اثربخشی معنادار مداخلات ارائه شده بر متغیرهای پژوهش، به نظر میرسد اجرای این روش گروه درمانی در سطوح گسترده جامعه می تواند سلامت روان زنان جامعه را بهبود بخشد. Background & Aims: The family can be considered as an emotional unit and a network of intertwined relationships that is built from the marital bond of man and woman. Marital satisfaction is very unstable, especially in the early years, and relationships are most at risk. The results of some studies indicate that the satisfaction of the couple is not easily achieved and as a result, marriage can be seriously endangered within the family system. It can be said that the cause of many psychological disorders and marital incompatibilities is due to sexual dissatisfaction and years of neglect of sexual instinct in humans has left irreparable consequences in social and marital relationships and has destroyed the foundation of families. One of the components that is considered in close relationships, especially marital relationships, is sexual satisfaction, an emotional state that is created by fulfilling a person's personal desires within the scope of his sexual life. Sexual issues are among the first issues of a married life in terms of importance, so that marital satisfaction is significantly associated with sexual pleasure, and with increasing sexual pleasure, marital satisfaction also increases. One of the most common sexual problems among couples is sexual desire disorder (sexual dysfunction). Hyperactivity disorder is a lack of emotional response to desire that is accompanied by a lack of intrinsic sexual motivation and lack of pleasure during sexual intercourse, such as responses from actively avoiding sexual contact to engaging in sexual activity with a partner despite the lack It involves sexual desire and sexual activity is very rare). Research has shown that one of the factors that increase sexual satisfaction is the patterns of attachment and ego defenses that affect couples' experiences of intimacy and sexual satisfaction to understand the couple's sexual problems and block the expression of sexual desire and set up barriers. Intimacy is used. Balbi calls his and others' mental representations patterns of introspection. Introspection patterns are the basis of attachment styles, also known as attachment biases or attachment patterns. The aim of this study was to investigate the effect of cognitive stimulus (convenience of service) on cognitive and behavioral reactions (economic value, satisfaction and loyalty) with the role of emotional stimulus (pleasure and arousal) of customers of chain stores in the country. Methods: This research is an applied type with a quasi-experimental method of pre-test-post-test with a control group. The statistical population consisted of all married women in Najafabad in 1398 who referred to Mahour Counseling Center located in Najafabad. A total of 40 women who scored low on the Hoggs & Steele Sex Scale and were diagnosed with sexual reluctance were selected using available sampling method and randomly assigned to groups. Entry and exit criteria are age range 25 to 48 years. Have at least one year of living together. They have reported a history of reluctance or low desire for at least six months and have scored less than 3.3 on the Female Sexual Performance Index questionnaire under the Sexual Reluctance Scale. Diagnosis of sexual anemia is not of physiological origin. Do not receive any other treatment during the training period. The instruments used in this study are: 1) Collins and Reed Attachment Styles Questionnaire: This self-assessment scale has 18 items that are measured by marking on a five-point Likert scale. Each subscale consists of 6 items and is secure attachment, avoidance attachment and ambivalent attachment. The stability of the retest was estimated to be 0.7 and the Cronbach's alpha coefficient for the safe style was 0.629, for the avoidance style was 0.542 and for the ambivalent style was 0.824. 2) Thompson & Walker Marital Intimacy Questionnaire: This questionnaire is a 17-item tool designed to measure marital intimacy. The subject score in this questionnaire is obtained by adding the scores of the questions and dividing it by 17. The range of scores is between 1 and 7, and a higher score is a sign of greater intimacy. This questionnaire was evaluated by a trustee to determine the validity. To determine the content and face validity of this scale, the questionnaire was first reviewed by 15 counseling professors and 15 couples and its face and content validity was confirmed. Also, Khazaei has calculated 0.82 through simultaneous implementation with Bagarozi questionnaire and estimating their correlation coefficient and has reported the total reliability of 0.85 using Cronbach's alpha coefficient. Rosen et al. Female Sexual Performance Index: A measure of female sexual function, which is a suitable tool for measuring sexual function. In Iran, the index of female sexual function was standardized by Mohammadi et al. The reliability of the index was reported for each of the six domains and the whole scale for the control groups and all individuals using the Cronbach's alpha coefficient of 0.85. It was also found that the cut-off points for the whole scale and subscales are: total scale 28, desire 3.3, psychological stimulation 3.4, satisfaction 3.8, sexual pain 3.8. Scores higher than the cut-off point indicate good performance. After performing the pre-test for both groups, ACT-based training based on Goodwin et al. Protocol and group training based on emotion-based therapy based on Johnson protocol were provided to the experimental group members. Did not receive. Results: The results showed that the interventions presented to the experimental groups could have a significant effect on improving the mean of marital intimacy (P <0.001) and sexual satisfaction (P <0.001). These interventions also had a significant effect on the mean of secure attachment styles (P <0.001), avoidance (P <0.05) and ambivalent (P <0.001). It was also found that the interventions presented to the experimental groups were significantly different only in improving marital intimacy. Conclusion: As a result, the research findings have supported the importance and prominent role of marketing activities based on cognitive and emotional stimuli in creating cognitive and behavioral reactions of chain store customers. Focusing on cognitive and emotional stimuli can provoke positive cognitive and behavioral reactions. Also, during emotion-oriented training, reconstruct situations that cause inappropriate emotion, such as rejection or avoidance, or stress and confusion. Due to the taboo nature of sex as a whole for some people, many experiences remain unsaid and suppressed, and the accumulation of these experiences causes disruption and dissatisfaction in the relationship. In the trainings, women were taught to reconstruct the conflicts that caused the relationship to be disturbed, and after exploring and spreading the emotions, to reconstruct them so that they can be reached and developed and in a safe environment by expressing real emotions in different life situations. They show newness and this increases and increases their sexual satisfaction. آموزش گروهی مبتنی بر درمان ACT, صمیمیت زناشویی, رضایت جنسی, سبک‌های دلبستگی Cognitive stimulus, Emotional stimulus, Cognitive reaction and Emotional reaction 13 23 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5516-1&slc_lang=fa&sid=1 Zohre Irannezhad زهره ایران نژاد irannezhadzohreh@gmail.com 3900319475328460060966 3900319475328460060966 No Islamic Azad University, Iran دانشگاه آزاد اسلامی، خمین، ایران Rahim Hamidpour رحیم حمیدی پور R.hamidipour@cfu.ac.ir 3900319475328460060967 3900319475328460060967 Yes Farhangian University, Tehran, Iran دانشکده فرهنگیان، تهران، ایران Hasan Heidari حسن حیدری Heydari.iau@gmail.com 3900319475328460060968 3900319475328460060968 No Khomein Branch, Islamic Azad University دانشگاه آزاد اسلامی، خمین، ایران Hosein Davoudi حسین داوودی Davoudi.ho@gmail.com 3900319475328460060969 3900319475328460060969 No Khomein Branch, Islamic Azad University, Iran دانشگاه آزاد اسلامی، خمین، ایران