Razi Journal of Medical Sciences

fa تأثیر توانبخشی شناختی در بازسازی آسیب تفکر فضایی در لوب آهیانه‌ای بیماران اسکیزوفرنی The Effectiveness of Cognitive Rehabilitation in Reconstructing Spatial Thinking Injury in the Parietal Lobe in Schizophrenic Patients روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: اختلال اسکیزوفرنی از جمله اختلالات مزمن روانپزشکی است و از جمله مشکلات رایج این بیماران افت تواناییهای شناختی است. با توجه به همین امر پژوهش حاضر با هدف بررسی اثربخشی <a name="_Hlk77421940">توانبخشی شناختی در بازسازی آسیب تفکر فضایی در لوب آهیانهای </a>در بیماران <a name="_Hlk77421987">اسکیزوفرنی</a> انجام شد. روش کار: این پژوهش در یک طرح نیمه آزمایشی و طی یک کارآزمایی کنترل شده تصادفی دوگروهی (یک گروه آزمایش و یک گروه کنترل) پژوهشی دو مرحلهای با سنجش در خط پایه و پس از مداخله (پسآزمون) اجرا گردید. از میان جامعه آماری بیماران اسکیزوفرنی تحت درمان و مراقبت در مراکز بهزیستی و بیمارستانهای روانپزشکی شهر اصفهان (1400-1399)، تعداد 30 مددجوی مرد و زن در دو مرکز توان‌بخشی روزانه اعصاب و روان به شیوه نمونهگیری در دسترس انتخاب و به طور تصادفی به گروه آزمایش (15=n: تحت برنامه آموزشی مبتنی بر توانبخشی شناختی طی 8 جلسه گروهی یک بار در هفته) و گروه کنترل (15=n: مداخله یی دریافت نکرد) گمارده شدند. کلیه شرکت کنندگان آزمون کامپیوتری حافظه کاری دیداری <a href="https://vesalcenter.com/tag/کرسی-بلاک">کرسی بلاک</a> برای بررسی صفحه دیداری فضایی حافظه فعال را در دو مرحله خط پایه و پس از اجرای توانبخشی شناختی تکمیل کردند. یافته‌ها: نتایج تحلیل کواریانس نشان داد که برنامه مبتنی بر اثربخشی توانبخشی شناختی پس از مداخله در بازسازی آسیب تفکر فضایی در لوب آهیانهای در بیماران اسکیزوفرنی تأثیر معناداری داشت (01/0>p). نتیجه‌گیری: طبق نتایج این پژوهش، توانبخشی شناختی به شیوه گروهی روش موثری برای بهبود آسیب تفکر فضایی در لوب آهیانهای در بیماران اسکیزوفرنی است.</div> <div style="text-align: justify;">Background & Aims: Schizophrenic disorder is one of the chronic psychiatric disorders and one of the common problems of these patients is the loss of cognitive abilities. The parietal lobe or parietal lobe is one of the four main lobes of the cerebral cortex and the upper middle part of the brain hemisphere, which is located between the frontal lobe and the occipital lobe and above the temporal lobe. Tactile sense (touch), spatial perception, visual perception, recognition of sizes, colors, and shapes from each other, and feeling pain are some of the functions of this lobe (6). The most important specific function of the regional piece is spatial thinking. Spatial thinking is a process through which a new mental representation is created by information transformation and interaction between mental properties, judgment, abstraction, reasoning, and problem-solving. Considering that the anterior part of the parietal lobe is the place to receive skin and depth sensations, it seems logical to process and analyze this information in the communication cortex adjacent to it. Also, all the memories related to these feelings are recorded in this area. Lesions of the right parietal lobe cause problems in integrating complex stimuli. Therefore, such people have problems in multidimensional situations. In the lesions of the right inferior parietal lobe, emotional disorders are created, just like the lesion to the frontal lobe. Research on the brain and its role in psychopathology has grown rapidly. All mental disorders are somehow affected by the brain, But the brain sometimes receives deep influences and at this time, the changes are significant. Most of the neurocognitive disorders are formed in the later years of life. Although antipsychotic drugs are the mainstay of schizophrenia treatment, research has shown that cognitive rehabilitation can enhance clinical improvement. The main approach in cognitive and non-pharmacological treatments is the cognitive rehabilitation approach. In the process of rehabilitation, the process of gradual recovery of abilities and training of social-communication skills are combined with techniques that help people to acquire meaningful interpersonal relationships, correct and clear communication, correct self-evaluation, and reward their adaptive behaviors. Does Rehabilitation for patients with schizophrenia include skill training therapy, individual therapy, communication skills training, and case management which is useful in the management of this disease and helps the patient recover? By performing these treatments, the patient's return to society is provided. Several researches have been conducted on the positive effect of cognitive rehabilitation interventions. Among others, we can mention the impact of cognitive rehabilitation on executive functions in people injured by war post-traumatic stress, and attention-deficit/hyperactivity disorder. In general, it can be said that despite the many reports regarding the effectiveness of cognitive rehabilitation on various mental structures, there are few studies on the effect of cognitive rehabilitation on the reconstruction of temporal lobe spatial thinking injuries in schizophrenia patients. It is of particular importance to identify the treatment that has the greatest effect on the reconstruction of the damage of the parietal lobe in patients with schizophrenia. Perhaps the most important reason for this is that the therapists and researchers did not have enough, appropriate and valid specialized treatment research in this field to help these patients. This vacuum itself is one of the most important reasons for the necessity and importance of studies like the present study at the professional and specialized level. Therefore, the present research can be the basis for more attention from health and mental health researchers in this field, especially among people with schizophrenia. Therefore, to fill the existing vacuum, this research is looking for an answer to the question of whether cognitive rehabilitation is an effective method to restore temporal lobe spatial thinking damage in schizophrenia patients. Methods: This research was carried out in a semi-experimental design and during a two-group randomized controlled trial (one experimental group and one control group), two-stage research with measurement at the baseline and after the intervention (post-test). became Among the statistical population of schizophrenic patients under treatment and care in the welfare centers and psychiatric hospitals of Isfahan city (2022-2023), 30 male and female patients were selected in two daily neuropsychological rehabilitation centers using the available sampling method. They were randomly assigned to the experimental group (n=15: under the educational program based on cognitive rehabilitation during 8 group sessions once a week) and the control group (n=15: did not receive any intervention). All participants completed Kersey Block's computerized visual working memory test to assess visual-spatial working memory in two stages: baseline and after cognitive rehabilitation. Results: The results of covariance analysis showed that the program based on the effectiveness of cognitive rehabilitation after the intervention had a significant effect on the restoration of spatial thinking damage in the temporal lobe in schizophrenia patients (p<0.01). Conclusion: According to the results of this research, group-based cognitive rehabilitation is an effective method for improving spatial thinking damage in the temporal lobe in schizophrenia patients. In this research, like other research that is conducted in the field of behavioral sciences and psychology, there were limitations. Among the limitations of the present study was the statistical population that included patients with schizophrenia under treatment, and caution should be taken in generalizing the results to other samples. The available selection of the research sample and lack of examination of the role of background factors in the effectiveness of this intervention are the most important limitations that are important to pay attention to when drawing conclusions from the findings of this study. Finally, another limitation was the lack of a follow-up period to measure the long-term effect of the treatment. Considering the effectiveness of the cognitive rehabilitation program in restoring the damage of spatial thinking in the parietal lobe in schizophrenia patients, it is suggested that this program is a selective treatment method complementary to medical treatment to improve and restore the damage of spatial thinking in the parietal lobe. It should be used in patients with severe schizophrenia and other mental disorders. Also, more researches are needed to repeat such studies in other samples and to scientifically examine some of the questions arising from this study and the research background. </div> توانبخشی شناختی, تفکر فضایی, لوب آهیانه‌ای, اسکیزوفرنی Cognitive Rehabilitation, Spatial Thinking, Parietal Lobe, Schizophrenia 303 313 http://rjms.iums.ac.ir/browse.php?a_code=A-10-6444-1&slc_lang=fa&sid=1 Shakib Johari شکیب جوهری 3900319475328460082006 3900319475328460082006 No Ph.D. Candidate of Psychology, Naein Branch, Islamic Azad University, Naein, Iran. دانشجوی دکتری روانشناسی عمومی، واحد نابین، دانشگاه آزاد اسلامی، نایین، ایران. Mohammad Zare-Neyestanak محمد زارع نیستانک Zarehneyestanak@yahoo.com 3900319475328460082007 3900319475328460082007 Yes Department of Psychology, Naein Branch, Islamic Azad University, Naein, Iran گروه روانشناسی، واحد نایین، دانشگاه آزاد اسلامی، نایین، ایران Elham Foroozandeh الهام فروزنده 3900319475328460082008 3900319475328460082008 No Department of Psychology, Naein Branch, Islamic Azad University, Naein, Iran گروه روانشناسی واحد نایین، دانشگاه آزاد اسلامی، نایین، ایران.