Razi Journal of Medical Sciences

fa اثربخشی درمان مبتنی بر پذیرش و تعهد بر انعطاف‌پذیری شناختی، تاب‌آوری و استرس ادراک شده در زنان مبتلا به اختلال افسردگی Comparison of Finger-Feeding and Cup-Feeding in Preterm Infants at the Time of Exclusive Breast Feeding in Akbarabadi Hospital 2020 روان‌پزشکی Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: افسردگی یکی از شایع‌ترین اختلالات روانپزشکی است که درمان آن هزینههای مالی بسیاری را بر فرد مبتلا و به تبع خانواده و اجتماع تحمیل مینماید. هدف پژوهش حاضر بررسی اثربخشی درمان مبتنی بر پذیرش و تعهد بر انعطاف پذیری شناختی، تاب آوری و استرس ادراک شده در زنان مبتلا به اختلال افسردگی شهرستان اندیمشک بود. روش کار: جامعه آماری پژوهش، کلیه زنان مراجعه کننده به کلینیکهای روان پزشکی شهرستان اندیمشک در بازه زمانی فروردین سال 1400 تا فروردین1401 بود. باتوجه به ملاکهای ورود به پژوهش، 30 نفر از بیمارانی که مایل به همکاری در پژوهش بودند به صورت گمارش تصادفی در دو گروه (یک گروه آزمایش و یک گروه کنترل هرکدام 15 نفره) تقسیم گردیدند. برای انعطاف‌پذیری شناختی دنیس و واندروال، تاب‌آوری کانر و دیویدسون و استرس ادراک شده کوهن و همکاران استفاده شد. همچنین برای تشخیص افسردگی از مصاحبه بالینی اسکید ۵ استفاده شد. در تجزیه و تحلیل دادهها از شاخصهای آمار توصیفی و استنباطی (تحلیل کوواریانس و بررسی پیشفرضهای آن) استفاده شد. یافتهها: تجزیه و تحلیل داده‌ها نشان داد درمان مبتنی بر پذیریش و تعهد بر انعطافپذیری شناختی و استرس ادراک شده بیماران افسرده اثربخش بوده است. همچنین، مقایسه اختلاف میانگینها در مراحل پیش آزمون و پس آزمون گروه آزمایش نشان میدهد که درمان مبتنی بر پذیرش و تعهد توانسته است سبب افزایش انعطاف پذیری شناختی، تاب آوری و نیز کاهش استرس ادارک شده در زنان مبتلا به افسردگی شود. نتیجه گیری: نتایج بر اهمیت کارایی این روش درمانی در بیماران افسرده تأکید دارد و میتوان از آن بهعنوان یک روش مداخلهای مؤثر استفاده نمود.</div> <div style="text-align: justify;">Background & Aims: Depression is one of the most common psychiatric disorders that its treatment imposes large amount of costs on the individual and consequently the family and society. Depression is one of the psychological disorders that has occupied a major part of researches in psychology, psychiatry and neurology (1) and as one of the major health problems, it is predicted that by 2030, it will be the only become the main cause of disease all over the world (2). This serious mood disorder is accompanied by severe symptoms that affect a person's feelings, thoughts and daily life (3). The prevalence rate of depression is higher than other mental disorders and is around 17%. In the Iranian population, the prevalence rate of depression varies between 5.69% and 73%, and among women it is reported to be 1.7 times more than men (4). Depressed patients are part of the group of patients who do not receive adequate treatment and only half of them recover. It seems that the effective management of depression in patients requires more attention to their preferences, treatment needs, and finally the use of more comprehensive treatment packages to maximize patient participation and adequate use of the treatment method(5). However, various treatment challenges, including the return and recurrence of the disease, make it very important to examine the strengths and weaknesses of treatment methods and compare their effectiveness from different dimensions. One of the most widely used non-drug treatments for psychological disorders is the treatment based on acceptance and commitment, which is widely used in the field of depression (6). The main goal of this treatment method is to create the ability of the individual to make a practical choice among different options that are more appropriate to his situation, not that an action is performed only to avoid disturbing thoughts, feelings, or tendencies, or is actually imposed on the individual. In contrast to the different and more traditional forms of cognitive behavioral therapy, therapy based on acceptance and commitment does not force the clients to correct their thoughts and feelings, but rather its purpose is to help the clients, until they are able to provide answers to their thoughts and feelings. and get its change. In this approach, the focus is on changing and improving a person's relationship with his thoughts(6). Recent research on acceptance and commitment therapy has provided satisfactory results and logical reasons for its use in clinical work, especially working with patients with mood disorders including depression and anxiety. Many researches have shown that the use of this therapeutic method in psychiatric disorders including depression is satisfactory. In the following, a part of the study background related to the effectiveness of treatment based on acceptance and commitment in the group of patients suffering from depression is mentioned. the study aimed to evaluate effectiveness acceptance and commitment therapy for cognitive flexibility, resilience and perceived stress among depressed women of Andimeshk. Methods: Statistical population included all the women referring to psychiatric clinics of Andimeshk from March 2021 to March 2022. According to the inclusion criteria, 30 patients who were willing to participate in the research were randomly assigned into two groups (experiment group and control group, 15 people each). to Morrow’s questionnaire was used; for cognitive flexibility, Dennis and Vander Wal’s questionnaire and for resilience, Connor-Davidson Scale and for perceived stress, Cohen, Kamarck & Mermelstein were applied. To diagnose depression the clinical interview SCID5 was applied. The data were analyzed using analysis of covariance and evaluation of its assumptions. Results: The results indicated that acceptance and commitment therapy affected the depressed patients’ cognitive flexibility and perceived stress. Inferential findings showed that the treatment based on acceptance and commitment to reflection, cognitive flexibility, resilience and perceived stress of depressed patients had a significant effect. In order to align the obtained results with the research background, it can be said that the treatment based on acceptance and commitment, relying on its therapeutic principles, including the principle of acceptance, as the most basic principle of treatment, by increasing the patient's psychological acceptance of his thoughts and feelings, has been able to reduce ineffective control actions such as perceived stress are effective. Because during the above treatment method, a person learns to accept them without any internal or external reactions in order to eliminate the above reactions, then the above acceptance by the patient makes him able to act independently of such negative experiences. This has been able to lead to a reduction in and a more logical evaluation of stressful situations by the person, and this is how the perceived stress of patients has decreased. Also, by increasing the psychological and mental acceptance of the person, the above treatment has increased the patient's cognitive flexibility by actively and effectively confronting his thoughts and feelings and avoiding any avoidance. Conclusion: The results emphasized the efficiency of this therapy for depressed patients and that it can be used as an effective interventional procedure. Treatment based on acceptance and commitment in depressed patients has resulted in their ability to use effective coping strategies. This ability causes people to have a more logical approach to the conditions of different life situations and when problems arise, they deal with them by solving the appropriate problem, and in this way, their resilience has increased. Treatment based on acceptance and commitment instead of changing cognitions increases the psychological connection of a person with his thoughts and feelings. It also increases the capacity to accept psychological experiences and commitment, meaningful, flexible, adaptive activities without considering the content of obvious experiences (60). By clarifying values and paying them and determining the important goals of life, instead of dealing with symptoms and everyday issues, people including depressed patients learn to deal with values and what is more important in life instead of physical and mental responses. It causes a decrease in the attention and excessive sensitivity of the person to the complications of the disease.</div> استرس ادراک شده, افسردگی, انعطاف‌پذیری شناختی, تاب آوری, درمان مبتنی بر پذیرش و تعهد Perceived Stress, Depression, Cognitive Flexibility, Resilience, Acceptance and Commitment Therapy 1 14 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7609-2&slc_lang=fa&sid=1 Mona Isvand مونا ایسوند baghooli@miau.ac.ir 3900319475328460091243 3900319475328460091243 No PhD. student, Department of Psychology, Marvdasht branch, Islamic Azad University, Marvdasht, Iran. دانشجوی دکتری تخصصی روانشناسی، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران. Hossein Baghooli حسین بقولی monaisvand4@gmail.com 3900319475328460091244 3900319475328460091244 Yes Assistant Professor, Department of Psychology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran. استادیار، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران. Hojjat Allah Javidi حجت اله جاویدی javid952@hotmail.com 3900319475328460091245 3900319475328460091245 No Assistant Professor, Department of Psychology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran. استادیار، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران. Majid Barzegar مجید برزگر mbarzegar55@gmail.com 3900319475328460091246 3900319475328460091246 No Assistant Professor, Department of Psychology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran. استادیار، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران.