اثربخشی رفتاردرمانی دیالکتیک بر تحمل پریشانی و اضطراب درد در افراد مبتلا به سندروم روده تحریک‌پذیر

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استاد گروه روان‌شناسی بالینی، دانشگاه شاهد، تهران، ایران.

2 کارشناسی ارشد روان‌شناسی بالینی، گروه روانشناسی، دانشگاه آزاد اسلامی، واحد همدان، همدان، ایران.

3 کارشناسی ارشد روان‌شناسی بالینی، دانشگاه آزاد اسلامی، واحد زنجان، زنجان، ایران.

چکیده

مقدمه
سندروم روده تحریک‌پذیر علاوه بر مشکلات جسمانی، می‌تواند فرایندهای شناختی، هیجانی و روان‌شناختی بیماران را نیز متاثر سازد که ضروری است با بکارگیری درمان‌های روان‌شناختی مناسب نسبت به کاهش این آسیب‌ها اقدام شود. بر همین اساس پژوهش حاضر با هدف بررسی اثربخشی رفتاردرمانی دیالکتیک بر اضطراب درد و افسردگی در افراد مبتلا به سندروم روده تحریک‌پذیر انجام گرفت.
روش کار
پژوهش حاضر نیمه‌آزمایشی با طرح پیش‌آزمون- پس‌آزمون با گروه گواه بود. جامعه آماری این پژوهش مردان و زنان مبتلا به سندرم روده تحریک‌پذیر مراجعه کننده به متخصص­های گوارش در شهر همدان در سه ماهه تابستان سال 1398 بود. در این پژوهش تعداد 30 بیمار مبتلا به سندرم روده تحریک‌پذیر با روش نمونه‌گیری دردسترس انتخاب و با گمارش تصادفی در گروه­های آزمایش و گواه گمارده شدند (هر گروه 15 بیمار). گروه آزمایش مداخله رفتاردرمانی دیالکتیک (لینهان، 2004) را طی دو و نیم ماه در 10 جلسه 75 دقیقه‌ای دریافت نمودند. پرسشنامه‌های مورد استفاده در این پژوهش شامل پرسشنامه اضطراب درد (مک‌کراکن و همکاران، 1992) و افسردگی (بک و همکاران، 1996) بود. داده‌های حاصل از پژوهش به شیوه تحلیل کوواریانس چندمتغیری مورد تجزیه و تحلیل قرار گرفت.
نتایج
نتایج نشان داد که رفتاردرمانی دیالکتیک بر اضطراب درد و افسردگی در افراد مبتلا به سندروم روده تحریک‌پذیر تأثیر معنادار دارد (p<0/001).
نتیجه گیری
بر اساس یافته‌های پژوهش حاضر می‌توان چنین نتیجه گرفت که رفتاردرمانی دیالکتیک با بهره‌گیری از تکنیک‌های تحمل پریشانی، پذیرش و خودنظم‌جویی هیجانی می‌تواند به عنوان یک درمان کارآمد جهت کاهش اضطراب درد و افسردگی در افراد مبتلا به سندروم روده تحریک‌پذیر مورد استفاده گیرد.

کلیدواژه‌ها

عنوان مقاله [English]

The Effectiveness of Dialectic Behavior Therapy on Bearing Distress and Pain Anxiety in the People with Irritable Bowel Syndrome

نویسندگان [English]

  • Rasol Roshan Chesli 1
  • Azam Ashori 2
  • Moslem Mahdikhanloo 3
  • Zahra Parsi Nejad 3
1 Professor, Department of Clinical Psychology, Shahed University, Tehran, Iran.
2 MA of Clinical Psychology, Department of Psychology, Islamic Azad University, Hamadan Branch, Hamadan, Iran.
3 MA of Clinical Psychology, Islamic Azad University, Zanjan Branch, Zanjan, Iran.
چکیده [English]

Introduction: Irritable Bowel Syndrome can influence the patients’ cognitive, emotional and psychological processes in addition to the physical problems that appropriate cognitive therapies should be applied to decrease these damages. therefore the present study was conducted aiming to investigate the dialectic behavior therapy on pain anxiety and depression in the people with Irritable Bowel Syndrome.
Materials and Methods: it was a quasi-experimental study with pretest, posttest with control group. The statistical population of the current study was men and women with Irritable Bowel Syndrome referring to circulatory specialists in the city of Hamedan in the second quarter of 2019. 30 patients with Irritable Bowel Syndrome were selected through available sampling method and they were randomly accommodated into experimental and control groups (each group of 15). The experimental group received dialectic behavior therapy intervention (Linhan, 2004) during two-and-a-half months in ten seventy-five-minute sessions. The applied questionnaires in this study included pain anxiety (Mc Cracken, et.al., 1992) and depression (Beck et.al., 1996). The data from the study were analyzed through MANCOVA method.
Results: the results showed that the dialectic behavior therapy has significant effect on pain anxiety and depression in the people with Irritable Bowel Syndrome (p<0.001).
Conclusion: according to the findings of the present study it can be concluded that the dialectic behavior therapy can be used as an efficient method to decrease pain anxiety and depression in the people with Irritable Bowel Syndrome employing techniques of bearing distress, acceptance and emotional self-regulation.

کلیدواژه‌ها [English]

  • dialectic behavior therapy
  • pain anxiety
  • depression
  • Irritable Bowel Syndrome

مراجع

  1. Toumi ML, Merzoug S, Boulassel MR. Does sickle cell disease have a psychosomatic component? A particular focus
    on anxiety and depression. Life Sciences, 2018; 210: 96-105.
    2. Defrees DN, Bailey J. Irritable Bowel Syndrome: Epidemiology, Pathophysiology, Diagnosis, and Treatment.
    Primary Care: Clinics in Office Practice, 2017; 44(4): 655-671.
    3. Laskaratos FM, Goodkin O, Thoua,NM, Murray CD. Irritable bowel syndrome. Medicine, 2015; 43(5): 266-270.
    4. Vicario M, Alonso C, Guilarte M, Serra J, Martinez C, Gonzalez- Castro AM. Chronic Psychosocial Stress Induces
    reversible mitochondrial damage and corticotropin-releasing factor receptor type-1 upregulation in the rat
    intestine and IBS-Iike gut dysfunction. Psychoneuroendocrinology, 2012; 37: 65-77.
    5. Singh R, Salem A, Nanavati J, Mullin GE. The Role of Diet in the Treatment of Irritable Bowel Syndrome: A
    Systematic Review. Gastroenterology Clinics of North America, 2018; 47(1): 107-137.
    6. Tosic-Golubivic S, Miljkovic S, Nagorni A, Lazarevic D, Nikolic G. Irritable bowel syndrome, anxiety, depression
    and personality charcteristics. Psychiatry Danub, 2010; 22(3): 418-242.
    7. Porcelli P, De Carne M, Leandro G. The role of alexithymia and gastrointestinal-specific anxiety as predictors of
    treatment outcome in irritable bowel syndrome. Comprehensive Psychiatry, 2017; 73: 127-135.
    8. Wu M, Yang Y, Chen Y. The effect of anxiety and depression on the risk of irritable bowel syndrome in migraine
    patients. Journal of Clinical Neuroscience, 2017; 44: 342-345.
    9. Knowles S, Austin D, Sivanesan S, Tye-Din J, Leung C, Wilson J, Castle D, Kamm M, Macrae F, Hebbard G.
    Relation between symptom severity, illness perceptions, visceral sensivity, coping strategies and well-being in
    irritable bowel syndrome guided by the common sense model of illness. Psychology, Health & Medicine,
    2016; 22(5): 1354-8506.
    10. Boerma K, Linton SJ. Psychological processes underlying the development of a chronic pain problem: A
    prospective study of the relationship between profiles of Psychological variable in fear avoidance model in
    disability. Clinical Journal of pain, 2006; 22: 160-166.
    11. Park S, Na SH, Oh J, Lee JS, Oh S, Kim J, Park JW. Pain and anxiety and their relationship with medication doses
    in the intensive care unit. Journal of Critical Care, 2018; 47: 65-69.
    12. Asmundson G, Antony M, McCabe R. Pain relate anxiety and anxiety sensitivity across anxiety and depressive
    disorders. Journal of anxiety disorder, 2009; 23: 791-798.
    13. Lefter R, Ciobica A, Guenne S, Compaore M, Kiendrebeogo M, Stanciu C, Trifan A. Characterization of memory,
    anxiety, depression and social behaviour in a rat model of irritable bowel syndrome generated by chronic stress
    contention. European Neuropsychopharmacology, 2019; 29: 526-530.
    14. Geng Q, Zhang Q, Wang F, Zheng W, Ng CH, Ungvari GS, Wang G, Xiang Y. Comparison of comorbid depression
    between irritable bowel syndrome and inflammatory bowel disease: A meta-analysis of comparative studies.
    Journal of Affective Disorders, 2018; 237: 37-46.
    15. Lee SK, Yoon DW, Lee S, Kim J, Choi K, Shin C. The association between irritable bowel syndrome and the
    coexistence of depression and insomnia. Journal of Psychosomatic Research, 2017; 93: 1-5.
    16. Banerjee A, Sarkhel S, Sarkar R, Dhali GK. Anxiety and Depression in Irritable Bowel Syndrome. Indian Journal of
    Psychology Medicine, 2017; 39(6): 741–745.
    17. Meerveld BG, Johnson AC. Mechanisms of Stress-induced Visceral Pain. Journal of Neurogastroenterol Motil,
    2018; 24(1): 7–18.
    18. Fawzy M, Hamed SA. Prevalence of psychological stress, depression and anxiety among medical students in Egypt.
    Psychiatry Research, 2017; 255: 186-194.
    19. Katon W, Lin EHB, Kroenke K. The association of depression and anxiety with medical symptom burden in
    patients with chronic medical illness. Gen. Hosp. Psychiatry, 2007; 29: 147–155.
    20. Ganji H. Psychopathology based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders,
    Tehran: Arasbaran Publications.2013. [Persian].
    21. Peymannia B, Hamid N, Mehrabizadehhonarmand M, Mahmoudalilu M. The Effectiveness of Dialectic Behavioral
    Therapy - Family and child Skills Training (DBT-FST) on Impulsivity and quality of life in girls with selfharm behaviors. IJRN. 2018; 4(3): 8-17. [Persian].
    22. Sheikh Sajjadieh M., Atashpour SH. The Effectiveness of Dialectical Behavioral Therapy Training in Group
    Method on Psychological Distress of Infertile Women in Isfahan, Knowledge and Research in Applied
    Psychology, 2017; 18(1): 23-29. [Persian].
  2. 23. Aghayousefi A, Tarkhan M, Ghorbani T. The Impact of Dialectic Behavior Therapy on the Reduction of
    Impulsiveness in Women with Comorbidity of Borderline Personality Disorder and Substance Abuse.
    Addiction Research Quarterly, 2015; 9(34): 79-97. [Persian].
    24. Alizadeh A, Alizadeh E, Mohamadi A. Effectiveness of individual dialectical behavior therapy skills training on
    major depression. IJPN. 2013; 1 (2) :62-69. [Persian].
    25. DeCou RC, Comtois KA, Landes SJ. Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal
    Behavior: A Meta-Analysis. Behavior Therapy, 2019; 50(1): 60-72.
    26. Lang CM, Edwards AJ, Mittler MA, Bonavitacola L. Dialectical Behavior Therapy With Prolonged Exposure for
    Adolescents: Rationale and Review of the Research. Cognitive and Behavioral Practice, 2018; 25(3): 416-426.
    27. Lois BH, Miller AL. Stopping the Nonadherence Cycle: The Clinical and Theoretical Basis for Dialectical Behavior
    Therapy Adapted for Adolescents With Chronic Medical Illness (DBT-CMI). Cognitive and Behavioral
    Practice, 2018; 25(1): 32-43.
    28. Zalewski M, Lewis J, Martin CG. Identifying novel applications of dialectical behavior therapy: considering
    emotion regulation and parenting. Current Opinion in Psychology, 2018; 21: 122-126.
    29. Robinson S, Lang JE, Hernandez AM, Holz T, Cameron M, Brannon B. Outcomes of dialectical behavior therapy
    administered by an interdisciplinary team, Archives of Psychiatric Nursing, 2018; 32(4): 512-516.
    30. Eisner L, Eddie D, Harley R, Jacobo M, Nierenberg AA, Deckersbach T. Dialectical Behavior Therapy Group Skills
    Training for Bipolar Disorder. Behavior Therapy, 2017; 48(4): 557-566.
    31. Thabane M, Kottachchi DT, Marshall KJ. Systematic review and meta- analysis: The incidence and prognosis of
    post- infectious irritable bowel syndrome. Alimentary Pharmacology and Therapeutics, 2007; 26(4): 535-544.
    32. McCracken LM, Dhingra L. A short version of the Pain Anxiety Symptom Scale (PASS-20): Preliminary
    development and validity, Pain res mange, 2002; 7: 45-50.
    33. Davoodi I, Zargar Y, Mozaffaripour Sisakht E, Nargesi F, Mola K. The Relationship between Pain Catastrophizing,
    Pain Anxiety, Neuroticism, Social Support, and Strategies for Coping with Functional Disability in Rheumatic
    Patients, Journal of Health Psychology, 2012; 1(1): 54-67. [Persian].
    34. Aminpoor H, Afshinfa J, Mostafaei A, Ostovar S. Validation of Goldberg's Depression Scale in academic and nonacademic peoples. Annals of Biological Research, 2012; 3(9): 4564-4573.
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 63، شماره 2
خرداد و تیر 1399
صفحه 2436-2445

فایل ها

هم رسانی

ارجاع به این مقاله

آمار