مقایسه ذهن­ آگاهی و بدتنظیمی هیجانی در افراد مبتلا به اختلال اضطراب فراگیر و عادی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس ارشد روان­شناسی بالینی. مرکز مشاوره و خدمات روان­شناختی علامه امینی بهزیستی

2 دکتری تخصصی روان­شناسی بالینی. استاد دانشگاه تبریز، تبریز، ایران

چکیده

هدف پژوهش حاضر ، تعیین تفاوت ذهن آگاهی و  بدتنظیمی هیجانی در افراد مبتلا به اختلال اضطراب فراگیر و عادی بود. آزمودنی‏های پژوهش شامل دو گروه بود که گروه بالینی را 20 فرد مبتلا بهGAD  تشکیل می‏دادند که به شیوه نمونه­گیری در دسترس از بیماران مراجعه کننده به کلینیک روانپزشکی بزرگمهر و مراکز مشاوره شهر تبریز  و گروه کنترل نیز به همان تعداد بعد از همتاسازی از بین همراهان مراجعان مراکز مشاوره انتخاب شدند. آزمودنی ها به مقیاس دشواری­های تنظیم هیجانی(DERS)، پرسشنامه نگرانی پن استیت (PSWQ) و مقیاس توجه آگاهی هشیارانه (MAAS) پاسخ دادند. برای تحلیل داده­ها از روش تحلیل واریانس چندمتغیره  (MANOVA) و تحلیل ممیز استفاده شد. یافته­ها نشان داد که بین گروه بهنجار و گروه اضطراب فراگیر، در تنظیم هیجانی و خرده مقیاس های آن تفاوت معناداری وجود داشت (01/0>p ). همچنین بین گروه بیمار و گروه سالم از نظر میزان ذهن آگاهی تفاوت معنی­دار وجود داشت (01/0>p )، تحلیل ممیز نیز نشان داد که ذهن آگاهی پایین و مشکل تنظیم هیجانی به خوبی می توانند عضویت و یا عدم عضویت یک فرد در گروه کنترل و یا گروه اضطراب فراگیر را پیش بینی کنند. به طور کلی ذهن آگاهی و بدتنظیمی هیجانی بعنوان دو عامل فراتشخیصی احتمالا می توانند در پدیدآیی اختلال اضطراب فراگیر نقش داشته باشند.
ند.

کلیدواژه‌ها


عنوان مقاله [English]

The Mindfulness and Emotional Dysregulation as Transdiagnostic Factors in Patient with Generalized Anxiety Disorder

نویسندگان [English]

  • Somayeh Javidfar 1
  • Majid Mahmood Alilo 2
  • Abbas Bakhshipour 2
1 M.A, Clinical Psychology, Counseling and Psychological Center of Allame Amini Email: somayeh.javidfar@gmail.com (Corresponding Author)
2 Ph.D, Professor, Clinical Psychology, University of Tabriz, Tabriz, Iran
چکیده [English]

ABSTRACT
The aim of this study was to compare mindfulness and emotional dysregulation between patients with GAD and healthy group. Research subjects included two groups that subjects of clinical group were patients (n=20) with GAD selected by purposive sampling methodfrom consecutive referees to psychiatric and psychological clinics of Tabriz. The control group (n=20) was selected among people who were accompanying the patients. All patients were asked to complete the Difficulties in Emotion Regulation Scale (DERS), Mindful Attention Awareness Scale (MAAS) and Penn State Worry Questionnaire (PSWQ). Data were analyzed by Multivariate Analysis of Variance (MANOVA) and discriminant analysis. Results showed that There was a significant difference between patients with GAD and  healthy group in emotion regulation subscales (P<0/01). Also there was a significant difference between both groups in mindfulness. (P<0/01). Besides, Discriminant analysis indicated that low mindfulness and emotion dysregulation could correctly classified cases either GAD or healthy group. Overall, mindfulness and emotional dysregulation as two transdiagnostic factors probably have a role in development of GAD.

Materials and Methods: Twenty patients with GAD were selected nonrandomly from consecutive referees to psychiatric and psychological clinics of Tabriz. The control group of 20 people was selected from patient’s accompanying. All patients were asked to complete the Difficulties in Emotion Regulation Scale (DERS), Mindful Attention Awareness Scale (MAAS) and Penn State Worry Questionnaire (PSWQ).
Results: There is a significant difference (p < 0/01) between GAD with healthy group in emotion regulation total score and in all subscales. Also there is a significant difference (p < 0/05) between the GAD with healthy group in mindfulness. Discriminant analysis indicated that low mindfulness and emotion regulation difficulties could correctly classified cases either GAD or health group.
Conclusion: Overall, mindfulness and emotional dysregulation as two transdiagnostic factors probably have a role in development of GAD.

کلیدواژه‌ها [English]

  • Keywords: Generalized Anxiety Disorder
  • emotional dysregulation
  • mindfulness
منابع فارسی:
بخشی پور رودسری، عباس؛ دژکام، محمود  و مهریار، امیرهوشنگ (1383). روابط ساختاری میان ابعاد اختلال های اضطرابی و افسردگی DSM-IV و ابعاد الگوی سه بخشی. فصلنامه روانپزشکی و روانشناسی بالینی ایران، شماره 36، 76- 63.
عبدی، سلمان (1386). بررسی رابطه دیدگاه گیری، تجربه ناراحتی، جهت گیری جنسی، خود بازبینی، تمایلات اجتماع پسندانه با همدلی بین دانشجویان دانشگاه تبریز. پایان نامه کارشناسی ارشد روانشناسی عمومی، دانشکده علوم تربیتی و روانشناسی. دانشگاه تبریز.
عزیزی، علیرضا؛ میرزایی، آزاده و شمس، جمال (1389). بررسی رابطه تحمل آشفتگی و تنظیم هیجانی با میزان وابستگی دانشجویان به سیگار. مجله پژوهشی حکیم، دوره سیزدهم، شماره اول، 18- 11 .
منابع انگلیسی:
Aldao, A., Gee, D. G., De Los Reyes, A., & Seager, I. (2016). Emotion regulation as a transdiagnostic factor in the development of internalizing and externalizing psychopathology: Current and future directions. Development and Psychopathology, 28, 927–946.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Publication.
Amstadter, A. (2007).  Emotion Regulation and Anxiety Disorders. Journal of Anxiety Disorders, 22 (2): 211-221.
Baer, R. A., Smith, G. T., & Allen, K. B. (2004). Assessment of mindfulness by self-report: The Kentucky Inventory of Mindfulness Skills. Assessment, 11(3), 191–206.
Barlow, D. H. (Ed.). (2014). Clinical handbook of psychological disorders: A step-by-step treatment manual. Guilford Publications.
Barlow, D. H., Allen, L. B. & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205-230.
Barlow, D. H., Durand, V. M., & Hofmann, S. G.,  (2018). Abnormal Psychology: An Integrative Approach  (8th ed). Wadsworth: Cengage Learning.
Behar, E., DiMarco, I. D., Hekler, E. B., Mohlman, J., & Staples, A. M. (2009). Current theoretical models of generalized anxiety disorder (GAD): Conceptual review and treatment implications. Journal of Anxiety Disorders, 23(8), 1011-1023.
Bishop, S.R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., & Carmody, J. (2003). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–41.
Borkovec, T. D. (2002). Life in the future versus life in the present. Clinical Psychology: Science and Practice, 9, 76–80.
Borkovec, T.D., Alcaine, O.M., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder . In R. G. Heimberg , C. L. Turk , & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp:77 – 108 ). New York: Guilford Press.
Boswell, J. F., Anderson, L. M., & Barlow, D. H. (2014). An idiographic analysis of change processes in the unified transdiagnostic treatment of depression. Journal of Consulting and Clinical Psychology, 82(6), 1060–1071.
Brown, K. W., & Ryan, R. M. (2000). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848.
Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110(4), 585–599.
Cicchetti, D., Ackerman, B. P., & Izard, C. E. (1995). Emotions and emotion regulation in developmental psychopathology. Development and Psychopathology, 7, 1–10.
Craske, M. G., & Barlow, D. H. (2007). Mastery of your anxiety and panic (MAP-4): Therapist guide for anxiety, panic, and agoraphobia (4th ed.). New York, NY: Oxford University Press.
Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 22, 716-721.
Giluk, T. L. (2009).Mindfulness, Big Five personality, and affect: Ameta-analysis. Personality and Individual Differences, 47(8), 805–811.
Goldberg, D. P., Krueger, R. F., Andrews, G., & Hobbs, M. J. (2009). Emotional disorders: Cluster 4 of the proposed meta-structure for DSM-V and ICD-11: Paper 5 of 7 of the thematic section:‘A proposal for a meta-structure for DSM-V and ICD-11’.Psychological Medicine, 39(12), 2043–2059.
Gratz K.M., & Roemer, L. (2004). Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26 (1): 41-54.
Gross, J. J., & John, O. P. (2003). Individual differences in tow emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348-362.
Harvey, A. G., Watkins, E., Mansell, W., & Shafran, R. (2004). Cognitive behavioural processes across psychological disorders. Oxford, UK: Oxford University Press.
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 Therapy, 44, 1–25.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: an experiental approach to behavior change. New York: Guilford Press.
Hayes, S.C., Wilson , K.G., Gifford , E.V., Follette, V.M., & Strosahl , K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168.
Kabat-Zinn, J. (1990). Full catastrophe living: The program of the Stress Reduction Clinic at the University of Massachusetts Medical Center. New York: Delta.
Kashdan, T. B., Breen, W. E., Afram, A., & Terhar, D. (2010). Experiential avoidance in idiographic, autobiographical memories: Construct validity and links to social anxiety, depressive, and anger symptoms. Journal of Anxiety Disorders, 24, 528–534.
Kring, A. M., & Bachorowski, J. A. (1999). Emotions and psychopathology. Cognition & Emotion, 13(5), 575–599.
Kring, A. M., & Werner, K. H. (2004). Emotion regulation and psychopathology. In Philippot, P. & Feldman, R. S. (Eds.), The regulation of emotion, (pp. 359-385). Mahwah, NJ: Lawrence Erlbaum Associates.
Kring, A. M., & Sloan, D. M. (Eds.). (2010). Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment. The Guilford Press.
Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behaviour Research and Therapy, 43, 1281–1310.
Mennin, D. S., Turk, C. L., Heimberg, R.G., & Carmin, C. N. (2004). Focusing on the regulation of emotion: A new direction for conceptualizing and treating generalized anxiety disorder. In M. A. Reinecke & D. A. Clark (Eds.), Cognitive therapy across the life span: Evidence and practice (pp:60 – 89). NewYork: Cambridge University Press.
Mennin, D.S., McLauflin, K.A., & Flanagan, T.J. (2009). Emotion regulation deficits in eneralized anxiety disorder, social anxiety disorder, and their co-occurrence. Journal of Anxiety Disorders, 23: 866–871.
Roemer, L., & Orsillo, S. M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/ acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology: Science and Practice, 9, 54–68.
Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008). Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: Evaluation in a randomized controlled trial. Journal of Consulting and Clinical Psychology. 76 (6): 1083-1089.
Schmidt, N. B., Wollaway-Bickel, K. Trakowski, J., Santiago, H., Storey, J., Koselka, M., & Cook, J. (2000). Dismantling cognitive-behavioral treatment for panic disorder: Questioning the utility of breathing retaining. Journal of Consulting and Clinical Psychology, 68, 417-424.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness based cognitive therapy for depression: A new approach to preventing relapse. New York: Guildford Press.
Thayer, J. F., & Lane, R. D. (2000). A model of neurovisceral integration in emotion regulation and dysregulation. Journal of Affective Disorders, 61, 201-216.
Wagner, A. W., & Linehan, M. M. (1999). Facial expression recognition ability among women with borderline personality disorder: implications for emotion regulation. Journal of Personality Disorders, 13, 329–344.