Razi Journal of Medical Sciences

fa اثربخشی درمان مبتنی بر پذیرش و تعهد و روان‌درمانی پویشی فشرده و کوتاه‌مدت بر تنظیم هیجان و احساس شرم افراد مبتلا به سندروم روده تحریک‌پذیر The Effectiveness of Acceptance and Commitment Therapy and Short-Term Intensive Dynamic Psychotherapy on Emotion Regulation and Shame in People with Irritable Bowel Syndrome روان‌پزشکی Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: افراد با اختلال سندروم روده تحریکپذیر، مشکلات روانشناختی مختلفی را تجربه میکنند. از بین عوامل روانشناختی عمده که بر این اختلال تأثیر میگذارد میتوان به تنظیم هیجان و احساس شرم اشاره کرد. ازاینرو، پژوهش حاضر با هدف مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و روان‌درمانی پویشی فشرده و کوتاه‌مدت بر <a name="_Hlk180951634">تنظیم هیجان </a>و احساس شرم افراد مبتلا به سندروم روده تحریک‌پذیر پایین انجام شد. روش کار: این پژوهش یک مطالعه نیمه‌آزمایشی با طرح پیش‌آزمون، پس‌آزمون با گروه آزمایش و گواه و پیگیری 3 ماهه بود. جامعه آماری پژوهش شامل تمامی بیماران مبتلا به سندروم روده تحریک‌پذیر بالای 20 سال شهر شیراز در سال 1400 بود که از میان آنان 45 نفر (15 نفر گروه آزمایشی اول، 15 نفر گروه آزمایشی دوم و 15 نفر گروه گواه) که به روش نمونه‌گیری هدفمند انتخاب شد. گروه آزمایش اول تحت درمان مبتنی بر پذیرش و تعهد (هشت جلسه یک‌ ساعته) و گروه آزمایش دوم تحت روان‌درمانی پویشی فشرده و کوتاه‌مدت (هشت جلسه یک ‌ساعته) قرارگرفتند و گروه گواه مداخله‌ای دریافت نکرد. ابزارهای پژوهش شامل، مقیاس دشواری‌های تنظیم هیجانی گراتز و رومر (2004) و مقیاس احساس شرم درونی شده کوک (1993) بود. یافتهها: نتایج نشان داد، که هر دو مداخله، موجب افزایش تنظیم هیجان و تمامی مؤلفه‌های آن و کاهش احساس شرم گردیده (01/0p<) و این اثر در طول دوره پیگیری نیز حفظ ‌شده است. همچنین یافته‌های پژوهش حاکی‌از آن بود، که بین درمان مبتنی بر پذیرش و تعهد و روان‌درمانی پویشی فشرده و کوتاه‌مدت تفاوت معنی‌دار وجود داشته و روان‌درمانی پویشی فشرده و کوتاه‌مدت در افزایش تنظیم هیجان و تمامی مؤلفه‌های آن و کاهش احساس شرم اثربخش‌تر بوده‌ است. نتیجهگیری: بنابراین تنظیم هیجان و احساس شرم و گناه، متغیرهای مهم و واسطهای برای بیماران مبتلا به سندروم روده تحریکپذیر نیز میتواند قلمداد شود، که با تمرکز بر آن و با فشار جهت تجربه کردن آن میتوان بر انواع اختلالات روانی غلبه نموده و به واقع به درمانهای مهمی منجر شود.  باتوجه به نتایج پژوهش توصیه می‌شود، مشاوران و درمانگران از هر دو رویکرد به‌عنوان روش درمانی مؤثر در جهت کمک به بهبود تنظیم هیجان و کاهش احساس شرم افراد مبتلا به سندروم روده تحریک‌پذیر استفاده نمایند.</div> <div style="text-align: justify;"> Background & Aims: People with irritable bowel syndrome experience various psychological problems. Among the major psychological factors that affect this disorder, we can mention emotion regulation and feeling of shame. therefore, Irritable bowel syndrome is a type of chronic functional disorder of the gastrointestinal tract in which patients experience various digestive symptoms such as abdominal pain, diarrhea, constipation and other intestinal symptoms in the absence of any structural or biological abnormalities. The cause of the disease is unclear, but the possible role of the abnormal activity of the sensory-motor nerves of the intestine, disorders of the central nervous system, mental disorders, stress, and internal factors have been reported (1). The present study was conducted with the aim of comparing the effectiveness of acceptance and commitment therapy and intensive short-term dynamic psychotherapy on emotion regulation and shame in people with irritable bowel syndrome. Methods: This research was a semi-experimental study with a pre-test, post-test design with experimental and control groups and a 3-month follow-up. The statistical population of the research included all patients with irritable bowel syndrome over 20 years old in Shiraz in 2021, among them there were 45 people (15 people from the first experimental group, 15 people from the second experimental group and 15 people from the control group) who were selected by Purposive sampling and randomly assigned to three groups. The first experimental group underwent acceptance and commitment therapy (eight one-hour sessions) and the second experimental group underwent intensive short-term dynamic psychotherapy (eight one-hour sessions) and the control group did not receive any intervention. Research tools included Gratz and Roemer's (2004) emotional regulation difficulty scale and Cook's internalized shame scale (1993). After receiving a letter from the university and presenting it to the medical centers, including internal specialists, and also distributing notices in these centers, the patients were invited to participate in the research. After selecting the subjects, they were first explained about the purpose of the research, its duration and the benefits of participating in it. They were told that they would participate in a research study and that all information received from them would remain confidential. Then a written consent was obtained from them. It was also explained to the witness group that after the end of the research work, treatment sessions will be held for them as well. In the following, therapy sessions based on acceptance and commitment and short-term dynamic psychotherapy were held for the subjects of the experimental group along with assignments during the sessions and related assignments. Results: The results of analysis of covariance and analysis of variance with repeated measurements showed that both interventions increased emotion regulation and all its components and decreased feelings of shame (p<0.01) and this effect was maintained during the follow-up period. Also, the findings of the research indicated that there is a significant difference between the acceptance and commitment therapy and intensive short-term dynamic psychotherapy, and intensive short-term dynamic psychotherapy has been more effective in increasing emotion regulation and all its components and reducing feelings of shame. It shows the results of repeated measures analysis of variance. The F value obtained for the within-group effect of the time factor in the variable of emotion regulation and feeling of shame is significant, so there is a significant difference between the three stages of measurement (pre-test, post-test and follow-up). The F value obtained for the between-group effect in the dependent variables of emotion regulation and shame is also significant; That is, there is a significant difference between the scores of the test groups of acceptance and commitment therapy and short-term intensive psychodynamics and the control group in the follow-up phase. Also, the interaction effect of time on the groups was also significant. Conclusion: According to the results of the research, it is recommended that counselors and therapists use both approaches as an effective treatment method to help improve emotional regulation and reduce shame in people with irritable bowel syndrome. In general, according to the findings of the present research, it can be said that despite the difference in the effectiveness of two treatments based on acceptance and commitment and intensive and short-term dynamic psychotherapy on the regulation of emotions and feelings of shame in patients with irritable bowel syndrome, both therapeutic interventions have tried their best.</div> درمان, تنظیم هیجان, احساس شرم, سندروم روده تحریک‌پذیر Treatment, Emotion Regulation, Shame, Irritable Bowel Syndrome 1 17 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8224-2&slc_lang=fa&sid=1 Nooshin Barahimi نوشین براهیمی 3900319475328460090150 3900319475328460090150 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 Majid Barzegar مجید برزگر majidbarzgarr@gmail.com 3900319475328460090151 3900319475328460090151 Yes Assistant Professor, Department of Psychology, Marvdasht branch, Islamic Azad University, Marvdasht, Iran استادیار، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران Maryam Kuroshnia مریم کوروش نیا 3900319475328460090152 3900319475328460090152 No Assistant Professor, Department of Psychology, Marvdasht branch, Islamic Azad University, Marvdasht, Iran استادیار، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران