Razi Journal of Medical Sciences

fa مقایسه درمان مبتنی بر پذیرش و تعهد با دارو درمانی در بهبود روابط بین فردی و تفکر کمال گرایانه به وسواس شهر یزد Comparison of Treatment Based on Acceptance and Commitment with Drug Therapy in the Study of Interpersonal Relationships and Perfectionistic Thinking in the City of Yazd روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: اختلال وسواس- اجبار یکی از مشکلات جدی سلامت روان شناختی بوده که بر همه جوانب روابط بین فردی تأثیرگذار میباشد؛ بنابراین هدف از پژوهش حاضر مقایسه درمان مبتنی بر پذیرش و تعهد با دارو درمانی در بهبود روابط بین فردی و تفکر کمال گرایانه مبتلایان به وسواس شهر یزد بود. <div style="text-align: justify;">روش کار: روش پژوهش آزمایشی با طرح پیش آزمون- پس آزمون با گروه کنترل و دوره پیگیری دو ماهه بود. جامعه آماری پژوهش حاضر شامل کلیه‌ بیماران وسواسی شهر یزد بود که با شیوه نمونه گیری در دسترس 45 نفر از بیماران وسواس بر اساس ملاکهای ورود و خروج پژوهش انتخاب و در دو گروه آزمایشی (15 نفر تحت درمان دارویی و 15 نفر تحت درمان مبتنی بر پذیرش و تعهد) و گروه کنترل (15 نفر) به طور تصادفی گمارده شدند. ابزار پژوهش پرسشنامه وسواس فکری- عملی مادزلی (1977) و روابط بین فردی رمپل و هولمز (1986) بود. داده‌ها با استفاده از تحلیل واریانس با اندازه گیری مکرر تجزیه و تحلیل شدند. </div> <div style="text-align: justify;">یافته‌ها: یافته‌ها نشان داد که درمان مبتنی بر پذیرش و تعهد و دارو درمانی در بهبود روابط بین فردی و تفکر کمال گراینه مبتلایان به وسواس شهر یزد تأثیر معنیداری را دارد (01/0>P). همچنین یافته ها نشان داد بین درمان مبتنی بر پذیرش و تعهد و دارو درمانی تفاوت معنادار وجود دارد (01/0>P). </div> نتیجه‌گیری: به طور کلی میتوان نتیجه گرفت که درمان مبتنی برپذیرش و تعهد اثر بخشی بیشتری را نسبت به دارو درمانی در بهبود روابط بین فردی و تفکر کمال گرایانه دارد.   <div style="text-align: justify;">Background & Aims: Obsessive-compulsive disorder is one of the serious psychological health problem and imposes huge economic and social costs on society every year. Problems associated with obsession and its debilitating symptoms disrupt interpersonal functioning, job, and life. In obsessive-compulsive disorder, a person's mind is filled with uncontrollable and persistent thoughts and is forced to repeat specific actions that cause helplessness and disruption in his daily functioning. Excessive and negative perfectionism can become the basis of obsessive-compulsive disorder. Perfectionism is motivated by the fear of failure, and as a result, perfectionists are almost always worried about achieving high-level and unrealistic goals. Treatment studies about this disorder are generally focused on three areas: drug therapy, behavioral therapy, cognitive therapy, and the combination of cognitive-behavioral therapy with drug therapy. Therapy based on acceptance and commitment is basically context-oriented therapy and tries to change the socio-verbal context of the behavior instead of changing the clinical content of the behavior. In this treatment, instead of changing cognitions and challenging them, it is tried to increase the psychological connection of the person with his thoughts and feelings. It means that painful thoughts and feelings should be changed from the old form, i.e. abnormal traumatic symptoms that prevent a meaningful and rich life, to a newer form, i.e. natural human experiences that are parts of a rich and meaningful life. The main goal of treatment is to create psychological flexibility. Acceptance and commitment therapy directly targets emotional distress by accepting unpleasant thoughts and emotions. The goal of treatment based on acceptance and commitment is to improve a person's performance and reduce his emotional distress by increasing psychological flexibility. Psychological flexibility, from the point of view of this psychotherapy approach, means the ability to fully communicate with the present and change or maintain behavior in the service of valuable and important life goals. Therapy based on acceptance and commitment has six central processes that lead to psychological flexibility. Each of these processes affects a person's language act. Some of these processes weaken the function of verbal regulation of cognition and some others increase the function of behavioral activation. These processes are related to each other and have a mutual effect on each other for psychological flexibility. Commitment and acceptance of therapy is an approach based on mindfulness. Mindfulness-based approaches increase the acceptance of internal experiences such as thoughts, emotions, perceptions, and physiological feelings that can strengthen and sustain many complaints and clinical problems. In this regard, studies have shown that acceptance and commitment therapy has been effective in reducing the severity of symptoms of obsessive-compulsive disorder and depression. Despite the many types of research that have been conducted regarding the effectiveness of acceptance and commitment therapy in the field of obsession and other related disorders and its effectiveness has been confirmed; However, there has been no research comparing this intervention with drug therapy, so in this research, the researcher is looking for an answer to the question of whether there is a difference between the effectiveness of acceptance and commitment-based therapy with drug therapy in improving interpersonal relationships and perfectionism of patients with Is there a significant difference?</div> <div style="text-align: justify;">Methods: The research method was experimental with a pre-test-post-test design with a control group and a two-month follow-up period. The statistical population of the present study included all obsessive-compulsive patients in Yazd city, and 45 obsessive-compulsive patients were selected based on the inclusion and exclusion criteria of the study and divided into two experimental groups (15 people under drug treatment and 15 people under medical treatment) on acceptance and commitment) and the control group (15 people) were randomly assigned. The research tool was Maudsley's obsessive-compulsive questionnaire (1977) and Rempel and Holmes' (1986) interpersonal relationships. The data were analyzed using analysis of variance with repeated measures.</div> <div style="text-align: justify;">Results: The findings showed that treatment based on acceptance and commitment and drug therapy has a significant effect on improving interpersonal relationships and perfectionistic thinking of obsessive-compulsive patients in Yazd city (P<0.01). Also, the findings showed that there is a significant difference between treatment based on acceptance and commitment and drug therapy (P<0.01).</div> <div style="text-align: justify;">Conclusion: In general, it can be said that therapy based on acceptance and commitment is more effective than drug therapy in improving interpersonal relationships and perfectionistic thinking. Therefore, it is suggested that the treatment based on acceptance and commitment be used by clinicians as an effective treatment in the treatment of obsessions and improving interpersonal relationships and the perfectionistic thinking of people with obsessions. Paying attention to drug side effects in the long term, patients refuse to take medicine and this issue causes recurrence of disease symptoms. If the treatment is based on acceptance and commitment with the method of accepting the person's self and negative thoughts and mindfulness, which shows the obsessive patient himself, can be effective in treating and controlling the signs and symptoms of obsession and perfectionism. An obsessive person with perfectionism can also reduce obsessive actions.</div> درمان مبتنی بر پذیرش و تعهد, دارو درمانی, تفکر کمال گرایانه, روابط بین فردی, وسواس Acceptance and commitment therapy, Drug therapy, Perfectionist thinking, Interpersonal relationships, Obsession 461 469 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7496-2&slc_lang=fa&sid=1 Taybeh Dahoui Qoriya Musa طیبه دهویی قریه موسی 3900319475328460073731 0009-0004-0294-8249 No Department of Clinical Psychology, Anar Branch, Azad Islamic University, Anar, Iran گروه روانشناسی بالینی، واحد انار، دانشگاه آزاد اسلامی، انار، ایران Azam Mohammad Hosseini Anari اعظم محمد حسینی اناری 3900319475328460073732 3900319475328460073732 No Department of Clinical Psychology, Anar Branch, Azad Islamic University, Anar, Iran گروه روانشناسی بالینی، واحد سیرجان، دانشگاه آزاد اسلامی، سیرجان، ایران Elham Khorshid Talab الهام خورشید طلب 3900319475328460073733 0009-0006-2396-3530 No Senior Group of Family Counseling, Tehran Khatam Branch, Azad Islamic University, Tehran, Iran گروه ارشد مشاوره خانواده، واحد خاتم تهران، دانشگاه آزاد اسلامی، تهران، ایران Soheila Moradzadh Khorasani سهیلا مرادزاده خراسانی 3900319475328460073734 0009-0005-4856-9815 No Department of Psychology, Semnan Branch, Islamic Azad University, Semnan, Iran گروه روانشناسی، واحد سمنان، دانشگاه آزاد اسلامی، سمنان، ایران Motahareh Isarizadeh مطهره ایثاری زاده Isarizadeh.motahar@gmail.com 3900319475328460073735 0009-0008-5986-9778 Yes Department of Clinical Psychology, Sirjan Branch, Azad Islamic University, Sirjan, Iran گروه روانشناسی بالینی، واحد سیرجان، دانشگاه آزاد اسلامی، سیرجان، ایران