اثربخشی درمان تدوینی اجتناب متضاد از نگرانی و درمان شناختی-رفتاری هیجان مدار بر کنترل عاطفی در زنان مبتلا به اختلال اضطراب فراگیر

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه روانشناسی، ، دانشکده ادبیات و علوم انسانی، دانشگاه لرستان، لرستان، ایران

2 استادیار و عضو هیئت ‌علمی گروه روانشناسی، دانشکده ادبیات و علوم انسانی، دانشگاه لرستان،

چکیده

پژوهش حاضر با هدف مقایسه اثربخشی درمان تدوینی اجتناب متضاد و درمان شناختی-رفتاری هیجان‌مدار بر کنترل عاطفی در زنان مبتلا به اختلال اضطراب فراگیر انجام گرفت. پژوهش حاضر نیمه آزمایشی با طرح پیش‌آزمون‌پس‌آزمون با گروه گواه انجام گرفت. نمونه آماری شامل 45 زن مبتلا به اختلال اضطراب فراگیر بود که به صورت در دسترس در سال 1398 انتخاب شدند و به صورت تصادفی در دو گروه‌ آزمایشی و یک گروه گواه جایگزین شدند، درمان تدوینی و درمان شناختی-رفتاری هیجان‌مدار هر کدام به طور جداگانه در 12 جلسه 90 دقیقه‌ای برگزار شد و برای گروه گواه هیچ گونه آموزشی اعمال نشد و ابزار این پژوهش مقیاس کنترل عاطفی ویلامز و همکاران (1998)بود که شرکت کنندگان در پیش‌آزمون و پس‌آزمون به سؤالات آن پاسخ دادند و از آزمون تحلیل کواریانس چند متغیره برای تجزیه و تحلیل داده‌ها استفاده شد. یافته‌ها نشان داد که درمان تدوینی اجتناب متضاد و درمان شناختی-رفتاری هیجان‌مدار باعث بهبود کنترل عاطفی در زنان مبتلا به این اختلال می‌شوند (01/0>p). و درصد بهبودی آن بیشتر از آزمودنی‌های گروه گواه می‌باشد (01/0>p). ولی دو گروه آزمایشی تفاوت معناداری با هم نداشتند (05/0< p). درمان تدوینی اجتناب متضاد و درمان شناختی رفتاری هیجان‌مدار موجب بهبود کنترل عاطفی زنان مبتلا به این اختلال می‌شود، درمان تدوینی متمرکز بر تجربه‌ی فیزیولوژیکی و هیجانی مراجعه است تا مراجعه بتواند با تجربه‌ی تقابل هیجانی مواجهه شود، که این ممکن است یکی از علل زیربنایی این اختلال باشد اثربخشی این درمان ممکن است در اختلالات روانی که زیربنایی هیجانی دارند، نیز مؤثر واقع شود.

کلیدواژه‌ها


عنوان مقاله [English]

Effectiveness of the Newly Developed Treatment Contrast avoidance of worry and Emotion-focused Cognitive Behavioral Therapy in Affective control in Women with Generalized Anxiety Disorder

نویسندگان [English]

  • masumeh shafiei 1
  • fatemeh rezaei 1
  • Masoud Sadeghi 2
1 PhD Student, Psychology, Faculty of Literature and Humanities, Lorestan University, Khoramabad
2 Ph.D., Assistant Professor, Psychology, Faculty of Literature and Humanities, Lorestan University, Khoramabad, Iran.
چکیده [English]

The aim of this study was to compare the effectiveness of thenewly developed Contrast avoidance of worry and Emotion-focused Cognitive Behavioral Therapy in the affective control in women with generalized anxiety disorder. The present study was a quasi-experimental one with pre- and post-test design including control group. 45 women with generalized anxiety disorder were selected as the study sample through convenient sampling method in 2019, and were assigned into one of the experimental and control groups. The Newly developed Treatment Contrast avoidance of worry and Emotion-focused Cognitive Behavioral Therapy were held separately in 12 sessions and each session took about 90-minutes. No training was applied for the control group. The Affective control scale of Williams et al. (1998) was applied as the measuring tool in which subjects completed in pre- and post-test evaluations. Data were analyzed using Multivariate Analysis of Covariance. Findings showed that the developmental treatment contrast avoidance of worry and Emotion-focused Cognitive Behavioral Therapy improved the affective control (p <0.01), and the improvement rate was higher than the subjects of the control group (p <0.01); however, the two experimental groups did not differ significantly (P <0.05).  The Newly developed treatment contrast avoidance of worry and Emotion-focused Cognitive Behavioral Therapy improved the affective controlin women with generalized anxiety disorder. Developmental therapy focuses on the physiological and emotional experiences of the client so that they could experience the emotional contrast, which may be considered as one of the fundamental causes of generalized anxiety disorder. This approach may also be effective in treating mental disorders that have an emotional basic.

کلیدواژه‌ها [English]

  • The New Developed Treatment Contrast avoidance of worry
  • Emotion-focused Cognitive Behavioral Therapy
  • Affective control
  • Generalized Anxiety Disorder
منابع
دهش، زهرا (1388). تأثیر تلفیقی رفتاری و هیجان محور بر کنترل عواطف در نوجوانان دختر شهر کشکوئیه رفسنجان، پایان نامه کارشناسی ارشد، دانشگاه آزاد اسلامی واحد مرودشت.
سرمد، زهره ؛ بازرگان، عباس ؛ حجازی، الهه. ( 1393 ). روشهای تحقیق در علوم رفتاری، نشر آگه، تهران، چاپ بیست و ششم.
شفیعی، معصومه.، رضایی، فاطمه.،  صادقی، مسعود (1398). تدوین مدل اجتناب متضاد اختلال اضطراب فراگیر: مقایسه اثربخشی درمان مبتنی بر این مدل و درمان شناختی رفتاری هیجان مدار بر علایم اضطراب، شدت هیجان و کنترل عاطفی زنان مبتلا به اختلال اضطراب فراگیر. پایان نامه دکتری، دانشگاه لرستان. 
 
Bagheri Yazdi S, Bolhari J, Peyravi H.(2006). Mental health status of newly admitted students toTehran University academic year. (Andeesheh Va Raftar).. Iranian Journal of Psychiatry and Clinical Psychology.4 (1): 30-9.
Berking, M., & Whitley, B. (2014). Emotion regulation: Definition and relevance for mental health. In Affect Regulation Training (pp. 5-17). Springer, New York, NY.
Boswell, J. F., Farchione, T. J., Sauer-Zavala, S., Murray, H. W., Fortune, M. R., & Barlow, D. H. (2013). Anxiety sensitivity and interoceptive exposure: A transdiagnostic construct and change strategy. Behavior therapy44(3), 417-431.
Cavicchioli, F. L., Maes, M., Roomruangwong, C., Bonifacio, K. L., Barbosa, D. S., Anderson, G., ... & Nunes, S. O. V. (2018). Associations between severity of anxiety and clinical and biological features of major affective disorders. Psychiatry research, 260, 17-23.
Crouch, T. A., Lewis, J. A., Erickson, T. M., & Newman, M. G. (2017). Prospective investigation of the contrast avoidance model of generalized anxiety and worry. Behavior therapy, 48(4), 544-556.
DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized anxiety disorder. Annals of internal medicine170(7), ITC49-ITC64.
Evers, C. (2018). Emotion regulation and self-control: Implications for health behaviors and wellbeing.
Godbee, M., & Kangas, M. (2019). The relationship between flexible perspective-taking and emotional well-being: A systematic review of the ‘Self-As-Context’component of Acceptance and Commitment Therapy (ACT). Behavior Therapy.
Hall, K. A. A., Joormann, J., Siemer, M., & Timpano, K. R. (2018). The impact bias in self and others: Affective and empathic forecasting in individuals with social anxiety. Behaviour research and therapy, 106, 37-46.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy44(1), 1-25.
Kneeland, E. T., Dovidio, J. F., Joormann, J., & Clark, M. S. (2016). Emotion malleability beliefs, emotion regulation, and psychopathology: Integrating affective and clinical science. Clinical psychology review45, 81-88.
Lipsitz, J. D., Markowitz, J. C., & Cherry, S. (1997). Manual for interpersonal psychotherapy of social phobia. Unpublished Manuscript. Columbia University College of Physicians and Surgeons.
Llera, S. J., & Newman, M. G. (2017). Development and validation of two measures of emotional contrast avoidance: The contrast avoidance questionnaires. Journal of anxiety disorders, 49, 114-127.
Mennin, D. S., Fresco, D. M., O'Toole, M. S., & Heimberg, R. G. (2018). A randomized controlled trial of emotion regulation therapy for generalized anxiety disorder with and without co-occurring depression. Journal of consulting and clinical psychology, 86(3), 268.
Nasiri, F., Mashhadi, A., Bigdeli, I., Chamanabad, A. G., & Ellard, K. K. (2020). Augmenting the unified protocol for transdiagnostic treatment of emotional disorders with transcranial direct current stimulation in individuals with generalized anxiety disorder and comorbid depression: A randomized controlled trial. Journal of Affective Disorders262, 405-413.
Newman, M. G., & Llera, S. J. (2011). A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry. Clinical psychology review, 31(3), 371-382.
Newman, M. G., Llera, S. J., Erickson, T. M., & Przeworski, A. (2014). Basic science and clinical application of the Contrast Avoidance model in generalized anxiety disorder. Journal of Psychotherapy Integration, 24(3), 155.
Nielsen, S. K. K., Hageman, I., Petersen, A., Daniel, S. I. F., Lau, M., Winding, C., ... & Vangkilde, S. (2019). Do emotion regulation, attentional control, and attachment style predict response to cognitive behavioral therapy for anxiety disorders?–an investigation in clinical settings. Psychotherapy Research29(8), 999-1009.
O'Brien, K., O'Keeffe, N., Cullen, H., Durcan, A., Timulak, L., & McElvaney, J. (2019). Emotion-focused perspective on generalized anxiety disorder: A qualitative analysis of clients’ in-session presentations. Psychotherapy Research29(4), 524-540.
Poulin, L. E., Button, M. L., Westra, H. A., Constantino, M. J., & Antony, M. M. (2019). The predictive capacity of self-reported motivation vs. early observed motivational language in cognitive behavioural therapy for generalized anxiety disorder. Cognitive behaviour therapy48(5), 369-384.
Rappaport, B. I., Pagliaccio, D., Pine, D. S., Klein, D. N., & Jarcho, J. M. (2017). Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment-and non-treatment-seeking youth. Journal of anxiety disorders51, 22-31.
Roberton T, Daffern M, Bucks RS. (2012). Emotion regulation and aggression. Aggression Violent Behav, 17(1), 72-82.
Robichaud, M., Koerner, N., & Dugas, M. J. (2019). Cognitive behavioral treatment for generalized anxiety disorder: From science to practice. Routledge.
Stefan S, Cristea IA, Szentagotai Tatar A, David D. Cognitive‐behavioral therapy (CBT) for generalized anxiety disorder: Contrasting various CBT approaches in a randomized clinical trial. Journal of clinical psychology. 2019 Jul;75(7):1188-202.
Suveg, C., Jones, A., Davis, M., Jacob, M. L., Morelen, D., Thomassin, K., & Whitehead, M. (2018). Emotion-focused cognitive-behavioral therapy for youth with anxiety disorders: A randomized trial. Journal of abnormal child psychology, 46(3), 569-580.
Tiirikainen, K., Haravuori, H., Ranta, K., Kaltiala-Heino, R., & Marttunen, M. (2019). Psychometric properties of the 7-item Generalized Anxiety Disorder Scale (اختلال اضطراب فراگیر-7) in a large representative sample of Finnish adolescents. Psychiatry research272, 30-35.
Totzeck, C., Teismann, T., Hofmann, S. G., von Brachel, R., Zhang, X. C., Pflug, V., & Margraf, J. (2018). Affective Styles in Mood and Anxiety Disorders–Clinical Validation of the “Affective Style Questionnaire”(ASQ). Journal of affective disorders.
Walker, J., Liddle, J., Jordan, K. P., & Campbell, P. (2017). Affective concordance in couples: a cross-sectional analysis of depression and anxiety consultations within a population of 13,507 couples in primary care. BMC psychiatry, 17(1), 190.
Williams , K . E . Chambless , D . L & Ahrens , A . H .(1997). Are emotion frightening? Anextension of the fear consept . Behaviour Research and therapy. 35, 239 – 245 .
Williams, I. A., Howlett, S., Levita, L., & Reuber, M. (2018). Changes in emotion processing following brief augmented psychodynamic interpersonal therapy for functional neurological symptoms. Behavioural and cognitive psychotherapy46(3), 350-366.