Razi Journal of Medical Sciences

fa فراتحلیل اثربخشی مداخلات روان‌شناختی بر تکانشگری (1401-1388) Meta-analysis of the Effectiveness of Psychological Interventions on Impulsivity (2009-2022) روانشناسی بالینی Clinical Psychiatry مروري review article <div style="text-align: justify;">زمینه و هدف: تکانشگری از جمله سازههای مهم و چندوجهی است که امروزه مورد توجه بسیاری از پژوهشگران حوزه علوم رفتاری و روانشناسی بالینی قرار گرفته است، لذا پژوهش حاضر با هدف بررسی نظام مند اثربخشی مداخلات مختلف روانشناختی بر کاهش تکانشگری در جامعه ایرانی انجام شد. روش کار: این مطالعه با روش فراتحلیل انجام شد و جامعه آماری شامل پژوهشهای فارسی بود که جهت دستیابی به مقالات از پایگاههای معتبر علمی مجلات فارسی مانند مگیران،SID، پرتال جامع علوم انسانی، گوگل اسکالر، نورمگز تعداد 55 مقاله با توجه به کلیدواژههای مداخلات روانشناختی، رویکرد شناختی-رفتاری، رفتاردرمانی دیالکتیکی، درمان شناختی-تحلیلی، ذهنآگاهی، رفتاردرمانی عقلانی-هیجانی، طرحواره درمانی، درمان مبتنی بر پذیرش و تعهد و تکانشگری در بازه زمانی سال‌های 1401-1388 گزینش گردید، پس از بررسی مقالات براساس ملاکهای ورود و خروج تعداد 25 مقاله خارج گردید و تعداد 30 مقاله مناسب با موضوع پژوهش انتخاب شد. تجزیه و تحلیل داده ها با استفاده از نرمافزار CMA2  انجام گردید. یافته ها: براساس نتایج حاصل شده اندازه اثر رویکردهای مختلف درمان روانشناختی بر کاهش تکانشگری 72/1- بدست آمد. بررسی‌ مقالات نشان داد تکانشگری در بسیاری از اختلالات روانی که منجر به بروز رفتارهای پرخطر و مجرمانه می‌شود نقش کلیدی دارد. نتایج حاکی از آن بود که مداخلات درمانی متمرکز بر نظم ‌بخشی هیجانی، تحمل پریشانی، تغییر ارزیابی‌های شناختی، بینش‌افزایی، خودآگاهی، اصلاح سبک‌های تصمیم‌گیری، خودکنترلی بیشتر، مهارت‌های ارتباطی و ابراز وجود دارای اثربخشی مطلوبی بر کاهش رفتارهای تکانشی است. نتیجه گیری: با توجه به نتایج حاصل شده از این پژوهش میتوان بیان نمود که پژوهشگران حوزه روانشناسی میتوانند نتایج این مطالعه را در بررسی های خود درباره میزان اثربخشی درمانها و رویکردهای مختلف روانشناختی بر متغیر تکانشگری در نظر داشته باشند و همچنین در تحلیل و انتشار یافتههای حاصل از پژوهش های خود دقت نظر بیشتری را اعمال نمایند که منجر به بهبود روند انجام  مداخلات بالینی و کاهش نشانه های رفتار تکانشی در مراجعین و جامعه هدف خواهد شد.</div> <div style="text-align: justify;">Background & Aims: Today, based on the different definitions of behavioral science researchers, impulsivity is considered as one of the multifaceted and important variables in predicting high-risk behaviors in the clinical population (1). Examining many behaviors such as suicide and thoughts related to suicide shows the role of the impulsivity variable (2). Impulsivity as a personality trait is related to interpersonal changes in endocrine function and a physiological response to environmental stress (3). In addition to the mentioned cases, the moderating role of impulsivity in the relationship between stress and reward sensitivity has also been determined in new researches (4). This complex variable has long been the focus of researchers in various fields of psychology, including health, clinical and cognitive psychology, Therefore, without examining and understanding the basic variables of many human actions and behaviors, it is not possible to comment on the effectiveness of various psychological treatments and approaches. A significant point in various researches is the effect of the impulsivity variable on sadistic and aggressive behaviors (5). Sexually risky behavior in young people, which leads to many issues and problems in physical and psychological fields, is due to the important and effective role of impulsivity (6). Studies show the role of impulsivity in substance abuse, unplanned purchases, and also the tendency to gamble (7). Impulsivity has cognitive and behavioral aspects, which can be seen in post-traumatic stress disorder, and both cognitive and behavioral impulsivity are both related to threat sensitivity and hyperarousal (8). Antisocial behavior in certain clinical populations, such as prisoners with violent crimes, is related to impulsivity (9), and by understanding the influential role of this variable, it is possible to better predict criminal and delinquent behaviors in prison and after leaving it. Recently, there are opinions that impulsivity may play a role in the pathogenesis of neuropsychiatric disorders, and for this reason, research studies indicate the role of impulsivity variable in uncontrollable binge eating (10). The theory of planned behavior states that behavioral intention is the strongest determining factor of human behavior and that self-control disorder due to impulsivity leads to unhealthy behaviors such as drinking alcohol and addictive behaviors. Studies should be conducted on the structure of impulsivity and deficit in self-control to better predict unhealthy behaviors (11). Another one of the areas affected by impulsivity is the tendency to smoke cigarettes, according to researches, young people who received higher scores on impulsivity scales had more dependence and a tendency to use tobacco and smoke cigarettes based on the Fagerstrom test for nicotine dependence (12). Based on the definitions, impulsivity is defined as a preference for immediate rewards, a desire for adventure, searching for new issues and problems, finding available ways, a lack of perseverance, and generally unplanned behavior. (13). In autism spectrum disorder, research shows that with drug interventions, impulsive aggression can be reduced in clients with this diagnosis, which can help improve the mood and emotional state of the patient (14). The mentioned materials and researches point to the role of impulsivity in a variety of mental and behavioral disorders, therefore, the present study, using the meta-analysis method, seeks to investigate the effectiveness of psychological interventions on impulsivity during the years 2009-2022, and the results of the analysis are as follows. It helps therapists and researchers in the preparation and planning for more effective implementation of therapeutic interventions. Methods: The present research is of the meta-analysis type and was approved by the jury of the psychology department of Ferdowsi University of Mashhad in the meeting dated 28 February 2022 with the code 3/57500. The statistical population includes articles published in reliable domestic scientific publications that were conducted from 2009 to 2022 in the field of the effectiveness of psychological interventions on impulsivity. 55 articles were selected from Magiran, SID, a comprehensive portal of humanities, Google Scholar, and Noormagz, according to the Inclusion and Exclusion criteria, 30 articles were selected and the rest due to not having the criteria of a valid scientific article, such as not having a clear title, lack of protocol and treatment steps, lack of coherent structure of the article, unclear research method, conference articles, lack of using scientific theories, valid treatment reference books, and incompatibility of the body of the article with its title were removed from the review process. Results: According to the findings, it can be stated that psychological interventions with an effect size of -1.72 at the 0.001 level indicate that the independent variable affects the impulsivity variable, therefore psychological interventions at a meaningful level can modify or reduce this feature is likely to be effective. Conclusion: According to the obtained results, it can be stated that the size of the effect of psychological interventions on impulsivity in domestic research has been significant in adjusting or reducing this important variable, scientific studies show a kind of Malfunction in decision-making systems, Cognitive evaluation, response inhibition, self-control, and regulation of emotions in people who show impulsive behaviors (15-18). In many studies to reduce and modify high-risk behaviors in teenagers, young people and adults, and people with personality disorder, especially borderline personality disorder, psychological interventions are focused on the impulsivity variable (19). The effectiveness of treatment based on acceptance and commitment to various aspects of impulsivity has been investigated in the clinical population (20), also in another study, the effect of mindfulness therapy on impulsivity in substance-dependent men has been observed (21). The effectiveness of emotional therapy schema in reducing impulsivity in women with bipolar disorder has been investigated (22,23). In general, common cognitive components and elements in many psychological treatments can help to improve the condition of clients and reduce impulsive behaviors.</div> مداخلات روانشناختی, روان‌درمانی, تکانشگری Psychological Interventions, Psychotherapy, Impulsivity 1 10 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7297-1&slc_lang=fa&sid=1 Kasra Sharifi کسری شریفی 3900319475328460089926 3900319475328460089926 No : PhD Student, Department of Psychology, Psychology and Educational Science Faculty, Ferdowsi University of Mashhad, Mashhad, Iran دانشجوی دکتری روان‌شناسی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه فردوسی مشهد، مشهد، ایران Bahram Ali Ghanbari Hashem Abadi بهرامعلی قنبری هاشم آبادی ghanbarih@um.ac.ir 3900319475328460089927 3900319475328460089927 Yes Professor, Department of Psychology, Psychology and Educational Science Faculty, Ferdowsi University of Mashhad, Mashhad, Iran استاد، گروه روان‌شناسی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه فردوسی مشهد، مشهد، ایران Mohammad Javad Asghari Ebrahimabad محمد جواد اصغری ابراهیم آباد 3900319475328460089928 3900319475328460089928 No Associate Professor, Department of Psychology, Psychology and Educational Science Faculty, Ferdowsi University of Mashhad, Mashhad, Iran دانشیار، گروه روان‌شناسی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه فردوسی مشهد، مشهد، ایران