Razi Journal of Medical Sciences

fa مقایسه اثربخشی درمان فراشناخت و پذیرش و تعهد بر تحمل پریشانی و احساس تنهایی زنان مبتلا به سندرم پیش از قاعدگی Comparison of the Effectiveness of Metacognition and Acceptance and Commitment Therapy on Distress Tolerance and Loneliness in Women with Premenstrual Syndrome روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: یکی از اختلالاتی که علاوه بر نشانه‌های جسمی، تأثیرات روانشناختی زیادی دارد و زنان بسیاری از آن رنج می‌برند سندرم پیش از قاعدگی است. هدف از پژوهش حاضر مقایسه اثربخشی درمان فراشناخت و پذیرش و تعهد بر احساس تنهایی و تحمل پریشانی در دانشجویان دختر دارای سندرم پیش از قاعدگی بود. روش کار: پژوهش حاضر نیمه آزمایشی از نوع پیش آزمون-پس آزمون با گروه کنترل ناهمسان است. جامعه پژوهش شامل تمامی دانشجویان دختر مبتلا به سندرم پیش از قاعدگی در دانشگاه آزاد اسلامی شهرستان دورود در سال تحصیلی 1401-1400 به تعداد 140 نفر بود که از بین آنها تعداد 45 نفر با روش نمونه گیری در دسترس انتخاب شدند و در سه گروه فراشناخت، پذیرش  و تعهد و کنترل (هرگروه 15 نفر)به صورت تصادفی جایگزین گردیدند. ابزارهای این پژوهش شامل پرسشنامه غربالگری پیش از قاعدگی استینر و همکاران(2003)، مقیاس احساس تنهایی راسل (1996) و مقیاس تحمل پریشانی (DTS) سیمونز و گاهر(2005) بود که در سه مرحله پیش آزمون، پس آزمون و پیگیری بر روی مشارکت کنندگان اجرا شدند. روش تحلیل این پژوهش آزمون تحلیل واریانس با اندازه گیری مکرر با استفاده از نرم افزار آماری SPSS نسخه 22 بود. یافته‌ها: نتایج نشان داد گروه پذیرش و تعهد و گروه فراشناخت به شکل معناداری نسبت به گروه کنترل سبب کاهش احساس تنهایی و تحمل پریشانی شده اند، اما از این دو گروه، گروه فراشناخت نسبت به گروه پذیرش و تعهد در متغیر احساس تنهایی بهتر عمل کرده بود، اما در متغیر تحمل پریشانی تفاوت معناداری بین مداخله های مذکور وجود نداشت.  نتیجه‌گیری: این پژوهش نشان داد که روش فراشناخت و پذیرش و تعهد نقش موثری در بهبود احساس تنهایی و تحمل پریشانی دختران دارای سندرم پیش از قاعدگی دارد و از این دو درمان می توان در مراکز روانشناختی جهت کاهش نشانه های سندرم پیش از قاعدگی استفاده کرد. </div> <div style="text-align: justify;">Background & Aims: One of the important and relatively common diseases that most women of reproductive age are dealing with during their menstruation is premenstrual syndrome. This syndrome is characterized by physical and psychological symptoms that occur in the luteal phase of the menstrual cycle and subside with menstruation (3). Usually, the symptoms start shortly after ovulation, gradually intensify and reach a maximum about 5 days before the start of menstruation. The most common symptoms of premenstrual disorder include physical and mental disorders such as weight gain, appetite changes, heartache, backache, muscle cramps and joint pain, migraine headaches, sensitivity, lethargy, reduced efficiency, changes in daily activities and psycho-emotional disorders such as irritability, impaired concentration, increased mental pressure, mood swings and behavioral changes such as decreased motivation, avoidance of society, crying, depression, anxiety, irritability, anger restlessness, aggressive behavior, despair, suicidal tendencies and sleep changes (7). One of the psychological symptoms of premenstrual syndrome, which is caused by the mental and mood changes of women suffering from this syndrome, is the feeling of loneliness. Researches show that women suffering from premenstrual syndrome disorder feel lonelier during this period (9). Another psychological characteristic of women with premenstrual syndrome is distress tolerance, which can be affected by the condition of premenstrual disorder (14). Distress tolerance is conceptualized as a meta-emotional concept and is considered as a trait, not an emotional state, and means the capacity to experience and tolerate negative psychological states. Researches show that according to the family structure, physiological characteristics and individual characteristics, one of the most important factors that can lead to the reduction of pain and psychological problems in women with premenstrual syndrome is their ability to bear distress (16, 17). Therefore, premenstrual syndrome can affect the psychological characteristics of affected women, such as feeling lonely and enduring distress. Hence, any factor or intervention that can affect the above variables and improve them, will create better conditions for the psychological condition of affected women and will lead them to deal more appropriately with this disorder.  An intervention that can be effective in this field is metacognitive therapy. Metacognitive therapy helps women with premenstrual syndrome to experience their inner experiences as a thought and instead of responding to them, they focus on the values of life and things that are important to them (21). Therefore, this treatment can help them reduce the psychological symptoms of the syndrome, such as loneliness and psychological distress. Researches show that acceptance and commitment therapy, also, can be effective in reducing psychological distress and feelings of loneliness in women with premenstrual syndrome (22,23,24,25). The goal of acceptance and commitment therapy, which was formed from the development of cognitive-behavioral therapy (28), is to create psychological flexibility, identify and reduce cognitive error, problem control, and logical analysis of problems (29). Each of these methods has been investigated in psychological research to improve or promote the health of women with PMS, but the comparison of the effectiveness of these two treatment methods on the feeling of loneliness and tolerance of distress of women with this syndrome has not been investigated so far. Therefore, the present study was conducted to compare the effectiveness of acceptance and commitment therapy and metacognitive therapy on female students with premenstrual syndrome in Islamic Azad University, Durood branch. Methods: The present research is a semi-experimental pre-test-post-test study with a heterogeneous control group. The research population included all female students suffering from premenstrual syndrome in the Islamic Azad University of Dorud city in the academic year of 1400-1401 with the total number of 140 people, among whom 45 persons were selected by available sampling method and assigned randomly in three metacognitive, acceptance and commitment, and control groups(15 in each group). The tools of this research included premenstrual screening questionnaire by Steiner et al. (2003), Russell's Loneliness Scale (1996) and Distress Tolerance Scale (DTS) by Simmons and Gaher (2005) which were performed on the participants in three stages: pre-test, post-test and follow-up. The method of analysis of this research was analysis of variance test with repeated measurement using statistical software spss version 22. Results: The results showed that the acceptance and commitment group and the metacognitive group significantly reduced the feeling of loneliness and distress tolerance compared to the control group, but of these two groups, the metacognitive group performed better than the acceptance and commitment one in the loneliness variable but there was no significant difference between the mentioned interventions in the variable of distress tolerance. Conclusion: This research showed that the metacognitive and acceptance and commitment interventions have an effective role in improving the feeling of loneliness and distress tolerance of women with premenstrual syndrome, and these two therapies can be used in psychological centers to reduce the symptoms of premenstrual syndrome.</div> سندرم پیش از قاعدگی, درمان فراشناخت, درمان پذیرش و تعهد, احساس تنهایی, تحمل پریشانی Premenstrual Syndrome, Metacognitive Therapy, Acceptance and Commitment Therapy, Loneliness Feeling, Distress Tolerance 1 13 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7685-1&slc_lang=fa&sid=1 Azadeh Niroomand آزاده نیرومند 3900319475328460090612 3900319475328460090612 No PhD Student, Department of Psychology, Borujerd Branch, Islamic Azad University, Borujerd, Iran دانشجوی دکتری، گروه روانشناسی، واحد بروجرد، دانشگاه آزاد اسلامی، بروجرد، ایران Kourosh Goodarzi کورش گودرزی k.goodarzy@gmail.com 3900319475328460090613 3900319475328460090613 Yes Assistant Professor, Department of Psychology, Borujerd Branch, Islamic Azad University, Borujerd, Iran استادیار، گروه روانشناسی، واحد بروجرد، دانشگاه آزاد اسلامی، بروجرد، ایران Mehdi Roozbahani مهدی روزبهانی 3900319475328460090614 3900319475328460090614 No Assistant Professor, Department of Motor Behavior, Borujerd Branch, Islamic Azad University, Borujerd, Iran استادیار، گروه رفتار حرکتی، واحد بروجرد، دانشگاه آزاد اسلامی، بروجرد، ایران Zahra Tanha زهرا تنها 3900319475328460090615 3900319475328460090615 No Assistant Professor, Department of Psychology, Khorramabad Branch, Islamic Azad University, khorramabad, Iran استادیار، گروه روانشناسی، واحد خرم آباد، دانشگاه آزاد اسلامی، خرم آباد، ایران