Razi Journal of Medical Sciences

fa درمان مبتنی بر پذیرش و تعهد بر انعطاف‌پذیری شناختی، تاب‌آوری و استرس ادراک شده در زنان مبتلا به اختلال افسردگی The effectiveness of treatment based on acceptance and commitment on cognitive flexibility, resilience and perceived stress in women with depressive disorder روان‌پزشکی Psychiatry پژوهشي Research <h1 dir="RTL" style="text-align:justify">مقدمه: افسردگی یکی از شایع ترین اختلالات روانپزشکی است که درمان آن هزینههای مالی بسیاری را بر فرد مبتلا و به تبع خانواده و اجتماع تحمیل مینماید. هدف: هدف پژوهش 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: 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 دوگروه (یک گروه آزمایش و یک گروه کنترل هرکدام 15نفره) کاربندی گردیدند. برای انعطاف‌پذیری شناختی دنیس و واندروال، تاب‌آوری کانرودیویدسون و استرس ادراک شده کوهن و همکاران استفاده شد. همچنین برای تشخیص افسردگی از مصاحبه بالینی اسکید5 استفاده شد. درتجزیه و تحلیل داده ها ازشاخصهای آمارتوصیفی و استنباطی (تحلیل کوواریانس و بررسی پیش فرضهای آن) استفاده شد. یافتهها: نتایج نشان داد درمان مبتنی بر پذیریش و تعهد بر انعطاف پذیری شناختی و استرس ادراک شده بیماران افسرده اثربخش بوده است. نتیجهگیری: نتایج بر اهمیت کارایی این روش درمانی در بیماران افسرده تأکید دارد و میتوان از آن به عنوان یک روش مداخلهای مؤثر استفاده نمود.</h1> Introduction: 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 most common psychiatric disorders, which destroys a person's innate capacity to grow and flourish, causing a disorder in a person's mental health [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]. Objective: the study aimed to evaluate effectiveness acceptance and commitment therapy for cognitive flexibility, resilience and perceived stress among depressed women of Andimeshk. Method: 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. Findings: 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.   استرس ادراک شده؛ افسردگی؛ انعطاف پذیری شناختی؛ تاب آوری؛ درمان مبتنی بر پذیرش و تعهد perceived stress, depression, cognitive flexibility, resilience, acceptance and commitment therapy 1 11 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 3900319475328460090839 3900319475328460090839 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 3900319475328460090840 3900319475328460090840 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 3900319475328460090841 3900319475328460090841 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 3900319475328460090842 3900319475328460090842 No Assistant Professor, Department of Psychology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran. استادیار، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران.