Razi Journal of Medical Sciences

fa اثربخشی درمان پذیرش و تعهد بر نشانه‌های اختلال وسواس فکری و وسواس عملی شستشو The Effectiveness of Acceptance and Commitment Therapy on the Symptoms of Obsessive Compulsive Disorder and Practical Obsession with Washing روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;"> زمینه و هدف: اختلال وسواس فکری-عملی ازجمله اختلالات ناتوان‌کننده است که عملکرد افراد را تحت تأثیر قرار می‌دهد، لذا مطالعه حاضر باهدف تعیین اثربخشی درمان پذیرش و تعهد بر نشانه‌های اختلال وسواس فکری و وسواس عملی شستشو انجام شد. روش کار: روش پژوهش نیمه آزمایشی با طرح پیش‌آزمون- پس‌آزمون با گروه کنترل بود. جامعه پژوهش شامل تمامی بیماران زن و مرد مراجعه‌کننده به مرکز مشاوره تماشا در منطقه یک شهر اصفهان در فاصله زمانی بهار و تابستان 1401 بودند که از بین آن‌ها 30 نفر به روش نمونه‌گیری هدفمند انتخاب و به‌صورت تصادفی در دو گروه 15 نفره (دو گروه آزمایش و یک گروه کنترل) گمارده شدند. ابزار گردآوری داده‌ها مقیاس وسواس فکری- عملی ییل براون (۱۹۸۹) بود. جلسات درمان پذیرش و تعهد برای گروه آزمایش به مدت ۸ جلسه 9۰ دقیقه‌ای (هفته‌ای دو جلسه) برگزار شد، اما گروه گواه آموزشی دریافت نکرد. جهت تحلیل داده‌ها از نرم‌افزار SPSS نسخه 22 و آزمون تحلیل کوواریانس چند متغیره استفاده شد. یافته‌ها: نتایج مقایسه گروه‌ آزمایش با گروه کنترل نشان داد که نشانگان اختلال وسواس فکری-عملی، در گروه آزمایش نسبت به گروه کنترل به‌طور معناداری کاهش پیداکرده است، به‌نحوی‌که اندازه اثر نشان داد که ۷/۲۵ درصد از تغییرات وسواس فکری و ۱/۳۲ درصد از تغییرات وسواس عملی (شستشو) متأثر از درمان مبتنی بر پذیرش و تعهد است. نتیجه‌گیری: نتایج این مطالعه نشان داد که درمان پذیرش و تعهد در کاهش نشانگان وسواس فکری- عملی (شستشو) مؤثر واقع بود، لذا پیشنهاد می‌شود که در مداخلات بهبود سلامت در کنار سایر روش‌های درمانی از درمان پذیرش و تعهد برای کاهش نشانگان وسواس فکری- عملی استفاده شود.</div> <div style="text-align: justify;">Background & Aims: Obsessive-compulsive disorder is a severe and chronic disorder characterized by obsessions and compulsions or both. Obsessive-compulsive disorder is one of the most debilitating mental disorders characterized by repetitive thoughts, impulses, anxiety-provoking images (obsessions), or behavioral or mental activities that the sufferer feels must perform in a ritualistic manner to reduce or avoid anxiety. It is known to prevent anxiety-provoking consequences. People suffering from this disorder can have obsessive thoughts, obsessive actions or both of them together, as a result of which these obsessive thoughts and actions are very time-consuming and disrupt the person's work, academic and social relations. Among the obsessive disorders, washing obsessive disorder is the most common clinical picture of obsessive compulsive disorder. Obsession with washing is disturbing feelings that the contamination has not been removed despite repeated washing, many sufferers of this disease believe that any accidental contact or exposure to contamination will lead to complete contamination and serious damage. Due to this way of thinking, the patient is constantly worried about protecting himself from pollution, turns to extreme cleaning and washing, but still hardly feels clean. Among the obsessions, pollution obsession is the most common obsession, and the forced behavior of washing and cleaning after checking is the second most practical obsession. Considering the high prevalence of obsessive-compulsive disorder and the need of the society for the intervention and challenge of therapists with these patients, it has directed studies and researches in counseling centers to always look for treatment methods that can be offered as suggestions to psychotherapists. Studies show that various approaches and treatments have been offered to treat obsession and related disorders. A new approach is in the field of acceptance and commitment treatment. In this approach, instead of changing cognitions, one tries to increase the psychological connection of a person with his thoughts and feelings and make people accept, be aware and be observant towards themselves. The main goal of therapy based on acceptance and commitment is to increase cognitive flexibility, which is done through the six main processes of acceptance, cognitive dissonance, self as context, being in the present, values, and committed action. As the most common obsessive disorder, obsessive-compulsive disorder is one of the serious psychological health problems, besides causing considerable anxiety or confusion in the individual, it imposes huge economic and social costs on the society every year. Therefore, the present study was conducted with the aim of determining the effectiveness of acceptance and commitment therapy on the symptoms of obsessive compulsive disorder and practical obsession with washing. Methods: The research method was semi-experimental with a pre-test-post-test design with a control group. The research population included all male and female patients who referred to the Tamasha counseling center in one district of Isfahan city in the spring and summer of 2022, from which 30 people were randomly selected by purposeful sampling into two groups of 15 people (two groups of experimental and a control group) were assigned. The inclusion criteria were having diagnostic criteria for obsessive-compulsive disorder based on DSM-5; Confirmation of OCD diagnosis by the psychiatrist and psychologist in charge of the treatment center, willingness and informed consent to participate in the research, having at least middle school education, age between 20-60 years. In addition, non-participation in other treatment programs at the same time, non-receipt of individual counseling or drug therapy, and absence of more than two sexes were the exclusion criteria of this study. The data collection tool was the Yale Brown Obsession Scale (1989). Acceptance and commitment therapy sessions were held for the experimental group for 8 sessions of 90 minutes (two sessions per week), but the group did not receive a training certificate. In this research, it was tried to observe ethical considerations, including before holding the workshop, necessary explanations were given to the people about the goals and content of the meetings, participation in the workshop was free and optional, people were told their personal information and all the materials during the meetings. , will remain confidential and only the statistical data of the questionnaires will be used without mentioning names and only for research purposes. Also, SPSS version 22 software and multivariate covariance analysis were used to analyze the data. Results: According to the results, 25 of the subjects (83.3%) were women and 5 (16.7%) were men. 9 people (30%) had a bachelor's degree, 10 people (33.3%) had a diploma, 10 people (33.3%) had a bachelor's degree, and one person (3.3%) had a master's degree. The results of the comparison between the experimental group and the control group showed that the symptoms of obsessive-compulsive disorder in the experimental group were significantly reduced compared to the control group, so that the effect size showed that 25.7% of obsessive-compulsive changes and 32.1% of Changes in obsessive compulsive behavior (washing) are affected by acceptance and commitment therapy. Conclusion: The results of this study showed that acceptance and commitment therapy was effective in reducing obsessive-compulsive symptoms (washing), so it is suggested to use acceptance and commitment therapy in health improvement interventions to reduce obsessive-compulsive symptoms. be used practically.</div> درمان پذیرش و تعهد, وسواس فکری, وسواس عملی شستشو Acceptance and Commitment Therapy, Thought Obsession, Washing Practical Obsession 442 449 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7574-1&slc_lang=fa&sid=1 Maryam Ashorion مریم عشوریون 3900319475328460077990 3900319475328460077990 No MA, Clinical Psychology, Najaf Abad Branch, Islamic Azad University, Najaf Abad, Iran. کارشناسی ارشد، روانشناسی بالینی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران. Razieh Izadi راضیه ایزدی r_izady@yahoo.com 3900319475328460077991 0009-0005-7330-8000 Yes Assistant Professor, Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran استادیار، گروه روانشناسی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران Sayed Abbas Haghayegh سیدعباس حقایق 3900319475328460077992 0009-0007-9654-8204 No Assistant Professor, Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran. استادیار، گروه روانشناسی، واحد نجف آباد، دانشگاه آزاد اسلامی، نجف آباد، ایران