اثربخشی درمان مبتنی بر شفقت بر افسردگی، اضطراب و تنظیم هیجان در بیماران مبتلا به کرونر قلبی

نوع مقاله: مقاله پژوهشی

نویسندگان

1 کارشناسی ارشد روانشناسی، دانشگاه آزاد اسلامی واحد اصفهان(خوراسگان)، اصفهان، ایران

2 استادیار گروه روانشناسی بالینی، دانشگاه آزاد اسلامی واحد اصفهان(خوراسگان)، اصفهان، ایران

چکیده

مقدمه
این پژوهش با هدف تعیین اثربخشی درمان مبتنی بر شفقت بر افسردگی، اضطراب و تنظیم هیجان در بیماران مبتلا به کرونر قلب انجام شد.
روش کار
 روش پژوهش نیمه آزمایشی از نوع پیش‌آزمون- پس‌آزمون با گروه کنترل و پیگیری 45روزه بود. بدین منظور 30 بیمار مبتلا به بیماری کرونر قلب به شیوه نمونه‌گیری در دسترس انتخاب و به شیوه‌ی گمارش تصادفی در 2 گروه آزمایش و کنترل جایگزین شدند. ابزار اندازه­گیری پرسشنامه اضطراب و افسردگی و پرسشنامه تنظیم هیجان بود، که توسط شرکت‌کنندگان تکمیل گردید. همچنین در گروه آزمایش درمان مبتنی بر شفقت طی 8 جلسه‌ی 90 دقیقه­ای اجرا شد.
نتایج
نتایج تحلیل کواریانس داده­ها نشان داد، که درمان مبتنی بر شفقت خود ‌افسردگی، اضطراب و تنظیم هیجانی در بیماران مبتلا به کرونر قلب را در گروه آزمایش در مرحله پس‌آزمون و پیگیری بهبود داده است (05/0> p). به عبارت دیگر درمان مبتنی بر شفقت در بهبود متغیرهای پژوهش مؤثر بوده و نتایج درمان در طول زمان پایداری خود را حفظ نمود.
نتیجه گیری
 نتایج نشان می­دهد، که تحصیلات با تنظیم هیجانی منفی و مثبت رابطه معناداری دارد (05/0>p). همچنین رابطه این سه متغیر جمعیت‌شناختی با سایر متغیرهای پژوهش غیر‌معنادار بوده است. بنابراین در بررسی­های مربوط به تنظیم هیجانی علاوه بر پیش‌آزمون متغیر تحصیلات کنترل گردیده است.

کلیدواژه‌ها


عنوان مقاله [English]

The Effectiveness of Compassion-Focused Therapy on Depression, Anxiety and Emotion Regulation in Patients with Coronary Heart Disease

نویسندگان [English]

  • Nooshin Adibizadeh 1
  • Ilnaz Sajjadian 2
1 M.A of general psychology, Department of Psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
2 Assistant Professor Department of psychology, Isfahan(Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
چکیده [English]

Introduction: The purpose of the present study was to     determine the effectiveness of compassion focused therapy on depression,    anxiety and emotion regulation in patients with coronary heart disease.
Methods: A quasi-experimental design including pretest, posttest and follow-up assessments with control group was used in the study. For this purpose, 30 patients with coronary heart disease were      selected using available sampling method and were randomly       assigned to two experimental and control groups. The instrument for measuring Anxiety and depression scale and emotion regulation questionnaire which was completed by the participants. In the experimental group, Compassion-focused therapy was performed in 8   sessions of 90 minutes.
Results: The results of covariance analysis showed that               self-compassion therapy improved the scores of depression, anxiety and emotional regulation in patients with coronary heart disease in the experimental group in the post-test and follow up (P <0.05). In other words, compassion-focused therapy was effective in improving the variables of the study and the results of the therapy remained stable over time.
Discussion and Conclusion: The results show that education has a significant positive correlation with negative and positive emotional regulation (P <0.05). Also, the relationship between these three demographic variables with other research variables has been irrational. Therefore, in the study of emotional regulation, in addition to the pre-test, the variable of education has been controlled.

کلیدواژه‌ها [English]

  • Depression
  • Anxiety
  • Emotion regulation
  • compassion-focused therapy
  • Coronary Heart Disease

References

1-       Piepoli, MF. Hoes, AW. Agewall, S. Albus, C. Brotons, C. Catapano, AL. et al. (2016). European Guidelines on cardiovascular disease prevention in clinical practice:The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on CardiovascularDisease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR).European Heart Journal. 37 (29): 2315-2381.

2-       Braunwald, E. (2012). Coronary Artery Diseas. In: Bonow, RO. Mann, DL. Zipes, DP. (editors). Heart disease: A textbook of cardiovascular medicine. 9th ed. Philadelphia: WB. Elsevier Saunders. P. 294-302.

3-       Ebadi A, Moradian ST,Faizi F, Asiabi M. Comparison of Hospital Anxiety and Depression in Patients with Coronary Artery Disease. Quarterly Iranian Journal Of Critical Care Nursing. 1390; 4(2):97-102

4-       Costa, MA. Trentini, CA. Schafranski, MD. Pipino, O. Gomes, RZ. Reis, ES. (2015). Factors Associated with the Development of Chronic Post-Sternotomy Pain: a Case-Control Study. Braz J Cardiovasc Surg. 30 (5):552-556.

5-       Greenwood, M. (2015). Essentials of medical history-taking in dental patients. Dent Update. 42 (4):308-310.

6-       Fathi Ashtiyani A. Psychological tests: personality assessment and mental health. Tehran. Besat.(Persian)

7-       Leung, YW. Flora, DB. Gravely, S. Irvine, J. Carney, RM. Grace, S. L. (2012). The impact of premorbid and postmorbid depression onset on mortality and cardiac morbidity among patients with coronary heart disease: metaanalysis. Psychosomatic Medicine. 74 (8): 786–801.

8-       Jain, A. Bhadauria, D. (2013). Evaluation of efficacy of fluoxetine in the management of major depression and arthritis in patients of rheumatoid arthritis. Indian J Rheumatol. 8 (6): 165- 169.

9-       Baker, TA. Buchanan, NT. Small, BJ. Hines, RD. Whitfield, KE. (2011). Identifying the relationship between chronic pain, depression, and life satisfaction in older African Americans. Res Aging. 33 (4):426-443.

10-   Huffman, JC. Celano, CM. Beach, SR. Motiwala, SR. Januzzi, JL. (2013). Depression and cardiac disease: epidemiology, mechanisms, and diagnosis. Cardiovascular psychiatry and neurology, retrieved from http://dx.doi.org/10.1155/2013/695925.

11-   Gilbert, P. Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: over view and pilot study of a group therapy approach. Clinical Psychology Psychotherapy. 13 (6): 353-379.

12-   Ganji M. DSM-based psychopathology. Tehran. Savalan. (Persian)

13-   Watkins, LL. Koch, GG. Sherwood, A. Blumenthal, JA. Davidson, JRT. O’Connor, C. et al. (2013). Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease.  American Heart Association's. 2 (2):e000068.

14-   Thompson, B. (2006). The relationship between the expectation of pain and pre-competitive anxity Msc Thesis, Fiorida State Univercity, United States of America.

15-   Asmundson, GJG. Collimore, KC. Bernstein, A. Zvolensky, MJ. Hadjistavropoulos, HD. (2007). Is the latent structure of fear of pain continuous or discontinuous among pain patients? Taxometric analysis of the pain anxiety symptoms scale. The Journal of Pain. 5: 387-395.

16-   Tamir, M. (2016). Why Do People Regulate Their Emotions? A Taxonomy of Motives in Emotion Regulation. Personality and social psychology review. 20(3):199-222.

17-   Goldenberg, A. Halperin, E. van Zomeren, M. Gross, JJ. (2016). The Process Model of Group-Based Emotion: Integrating Intergroup Emotion and Emotion Regulation Perspectives. Personality and social psychology review. 20(2):118-141.

18-   Grandey, AA. Melloy, RC. (2017). The state of the heart: Emotional labor as emotion regulation reviewed and revised. J Occup Health Psychol. 22(3):407-422.

19-   Diedrich, A. Grant, M. Hofmann, S.G. Hiller, W. Berking, M. (2014). Self-compassion as an emotion regulation strategy in major depressive disorder. Behaviour research and therapy. 58: 43-51.

20-   Alen, AB. Leary, MR. (2010). Self- compassion, stress and coping. Social and Personality Psychology Compass. 4 (2): 107-118.

21-   Kriger, T. Hermann, H. Zimmermann, J. Holtforth, MG. (2015). Associations of self-compassion and global self-esteem with positive and negative affect and stress reactivity in daily life. Personality and Individual Differences. 87: 288-292.

22-   Terry, LM. Leary, RM. (2011). Self- compassion, self requlation and health. Journal of Self and Identity. 10 (3): 352-362.

23-   Ashworth, F. Gracey, F. Gilbert, P. (2011). Compassion focused therapy after traumatic brain injury:Theoretical foundations and a case illustration. Brain Impairment. 12(02):128-139.

24-   Depue, RA. Morrone-Strupinsky, JV. (2005). A neurobehavioral model of affiliative bonding: implications for conceptualizing a human trait of affiliation. Behav Brain Sci. 28(3):313–350.

25-   Gilbert, P. (2013). The Compassionate Mind Approach to Mindful Compassion. Constable-Robinson, London.

26-   Lincoln, TM. Hohenhaus, F. Hartmann, M. (2013). Can paranoid thoughts be reduced by targeting negative emotions and self-esteem? An experimental investigation of a brief compassion-focused intervention. Cognitive Therapy and Research. 37(2):390-402.

27-   Heriot-Maitland, C. Vidal, JB. Ball, S. Irons, C. (2011). Acompassionate-focused therapy group approach for acute inpatients: Feasibility, initial pilot outcome data, and recommendations. Br JClin Psychol. 53(1):78-94.

28-   Boersma, K. Håkanson, A. Salomonsson, E. Johansson, I. (2015). Compassion focused therapy to counteract shame, self-criticism and isolation. A replicated single case experimental study for individuals with social anxiety. Journal of Contemporary Psychotherapy. 45(2):89–98.

29-   Gilbert, P. (2009). Introducing compassion-fucused therapy. Advances in Psychiatric Treatment. 15: 199-208.

30-   Arimitsu, K. Hofman, SG. (2015). Cognitions as mediators in the relationship between self-compassion and affect. Personality and Individual Differences. 74: 41-48.

31-   Neff, KD. (2003a). Development and validation of a scale to measure self-compassion. Self and Identity. 2: 223-250.

32-   Neff, KD. (2011). Self-compassion, self-esteem and well-being. Social and Personality Psychology Compass. 5 (1): 1-12.

33-   Alicke, MD. Sedikides, C. (2009). Self-enhancement and self-protection: what they are and what they do. European Review of Social Psychology. 20: 1-48.

34-   Lee, Wk. (2013). Self- compassion as a moderator of the relationship between academic burn- out and psychological health in Korean cyber university students. Personality and Individual Differences. 54 (18): 899-902.

35-   Van Dam, NT. Sheppard, SC. Forsyth, J. Earleywine, M. (2011). Self- compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders. 25 (1): 123-130.

36-   Ruiz, F. J. (2010). A review of acceptance and commitment therapy (ACT) empirical evidence: Correlational, Experimental Psychopathology, Component and Outcome Studies. International Journal of Psychology and Psychological Therapy. 10 (1): 125-162.

37-   Zigmond, AS. Snaith, RP. (1983). The hospital anxiety and depression scale.Acta Psychiatr Scand .67: 361-70.

38-   Kuijpers, PM. Denollet, J. Lousberg, R. Wellens, HJ. Crijns, H. Honig, A. (2003). Validity of the hospital anxiety and depression scale for use with patients with noncardiac chest pain. Psychosomatics. 44: 329-35.

39-   López-Alvarenga, JC. Vázquez-Velázquez, V. Arcila-Martínez, D, Sierra-Ovando, AE. González-Barranco, J. Salín-Pascual, RJ. (2002). Accuracy and diagnostic utility of the Hospital Anxiety andDepression Scale (HAD) in a sample of obese Mexican patients. RevInvest Clin.54: 403-409.

40-   Kaviani H, Seyfourian H, Sharifi V, Ebrahimkhani N. Reliability and Validity of Iranian Anxiety and Depression Hospital Scale for Depressed and Anxiety Iranian Patients. Tehran Journal of Medical Sciences. 5(67):379-385.

41-   Garnefski, N., Kraaij, V., & Spinhoven, Ph. (2001). Negative life events, cognitive emotion regulation and depression. Personality and Individual Differences, 30, 1311–1327.

42-   Samani S, Sadeghi L. Psychometric Properties of the Cognitive Emotion Regulation Questionnaire. Journal Management System. 1(1): 51-62

43-   Neff, K. Germer, C. (2013). Self-Compassion in Clinical Practice. Journal of clinical psychology. 69(8): 1–12.