مقایسه اثربخشی درمان پذیرش و تعهد (اکت) و فراتشخیصی یکپارچه بر اضطراب و نشانه‌های جسمی بیماران لوپوس اریتماتوی سیستمیک

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکترای روانشناسی بالینی، گروه روانشناسی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران

2 دانشیار، گروه روانشناسی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران (نویسنده مسئول)

3 استادیار، گروه روانشناسی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران، گروه داخلی نفرولوژی، دانشکده پژشکی، بیمارستان علی ابن ابی طالب دانشگاه علوم پزشکی، زاهدان، ایران

4 استادیار، گروه روانشناسی، واحد بیرجند، دانشگاه آزاد اسلامی، بیرجند، ایران، گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه بیرجند، ایران

چکیده

مقدمه: بیماران لوپوس اریتماتوی سیستمیک یکی از بیماری‌های مزمن و ناتوان کننده است با ایجاد اضطراب در فرد باعث نگرانی و تنش در پاسخ به شرایط تهدید کتتده می‌گردد. لذا استفاده از رواندرمانی‌های مناسب در جهت کاهش پیامدهای روانشناختی این بیماری اهمیت فراوانی دارد، بر این اساس هدف این پژوهش مقایسه اثر بخشی درمان پذیرش و تعهد (اکت) و فراتشخیصی یکپارچه بر اضطراب و نشانه‌های جسمی بیماران لوپوس اریتماتوی سیستمیک بود.
روش کار:  پژوهش حاضر نیمه آزمایشی با طرح پیش آزمون، پس آزمون با گروه کنترل بود جامعه آماری شامل کلیه بیماران مبتلا به لوپوس اریتماتوی سیستمیک بود که در سال 1399 به کلینیک روماتولوژی بیمارستان امام علی زاهدان و مطب‌های خصوصی روماتولوژی این شهر مراجعه کردند. از بین این افراد 45 نفر به شیوه هدفمند انتخاب و به صورت تصادف در دو گروه آزمایش (اکت و فراتشخیصی) و کنترل گمارده شدند. آن‌ها به پرسشنامه اضطراب بک و پرسشنامه نشانه‌های بیماری لوپوس پرالتا – رامزی و همکاران پاسخ دادند. جهت تحلیل داده‌ها تحلیل واریانس اندازه گیری مکرر به روش آمیخته استفاده شد.
نتایج: نتایج نشان داد که هر دو درمان اکت و فراتشخیصی یکپارچه تاثیر معناداری بر کاهش اضطراب و نشانه‌های بیماری لوپوس بیماران گروه آزمایش داشتند. نتایج همچنین نشان داد که بین اثربخشی دو درمان در کاهش اضطراب و نشانه‌های بیماری لوپوس تفاوت معنی داری وجود نداشت.
نتیجه گیری: درمان‌های اکت و فراتشخیصی یکپارچه نقش مهمی در کاهش اضطراب و نشانه‌های جسمانی بیماری لوپوس دارند، از این رو می‌توان از این روش‌ها در کنار درمان‌های پزشکی استفاده کرد.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the effectiveness of Acceptance and Commitment Therapy (ACT) and Unified Transdiagnostic on anxiety and physical symptoms in patients with systemic lupus erythematosus

نویسندگان [English]

  • Narges Azadmanesh 1
  • Fatemeh Shahabizadeh 2
  • Elham Shahraki 3
  • Mohammad Reza Asadi Yoonesi 4
1 Phd Student, Department of Psychology, Birjand Branch, Islamic Azad University, Birjand, Iran.
2 Associate Professor, Department of Psychology, Birjand Branch, Islamic Azad University, Birjand, Iran. (Corresponding Author)
3 Assistant Professor, Department of Psychology, Birjand Branch, Islamic Azad University, Birjand, Iran Department of Nephrology Internal Medicine Ali ibne Abitaleb Hospital university of medical sciences Zahedan, Iran.
4 Assistant Professor, Department of Psychology, Birjand Branch, Islamic Azad University, Birjand, Iran. Department of psychology, Faculty of educational sciences and psychology, University of Birjand, Iran
چکیده [English]

Introduction: Systemic lupus erythematosus is a chronic and debilitating disease that is causing anxiety in a person causes anxiety and tension in response to threatening conditions. Therefore, the use of appropriate psychotherapy to reduce the psychological consequences of this disease is very important, Therefore, the aim of this study was to the comparison of effectiveness of Acceptance and Commitment Therapy (ACT) and Unified Transdiagnostic on anxiety and physical symptoms in patients with systemic lupus erythematosus.
Methods: The research method was semi-experimental with pre-test and post-test design with the control group. The statistical population included all people with systemic lupus erythematosus who were referred to the rheumatology clinic of Imam Ali Hospital in Zahedan and the private rheumatology clinics of this city in 2020 year. 45 people were selected by Purposive sampling method and randomly assigned to experimental and control groups. Participants answered the Beck anxiety Inventory and Peralta-Ramírez et al Lupus Symptoms Inventory (LSI). Repeated measurement analysis of variance by mixed method was used to analyze the data.
Results:  The results showed that both act and Unified Transdiagnostic had a significant effect on reducing anxiety and symptoms of lupus in patients in the experimental group. The results also showed that there was no significant difference between the effectiveness of the two treatments in reducing anxiety and symptoms of lupus.
Conclusion: Act and unified trans diagnostic therapies play an important role in reducing the anxiety and symptoms of lupus of patients with systemic lupus erythematosus, so these methods can be used alongside medical therapies.

کلیدواژه‌ها [English]

  • Systemic Lupus Erythematosus
  • Anxiety
  • Physical Symptoms
  • Acceptance And Commitment Therapy (ACT)
  • Unified Transdiagnostic
Nehar-Belaid D, Hong S, Marches R, Chen G, Bolisetty M, Baisch J, Walters L, Punaro M, Rossi RJ, Chung CH,
Huynh RP. Mapping systemic lupus erythematosus heterogeneity at the single-cell level. Nature immunology. 2020;
21(9):1094-106.
Tsokos GC. Autoimmunity and organ damage in systemic lupus erythematosus. Nature immunology. 2020;
21(6):605-614. https://www.nature.com/articles/s41590-020-0677-6
Al-Riyami N, Salman B, Al-Rashdi A, Al-Dughaishi T, Al-Haddabi R, Hassan B. Pregnancy Outcomes in Systemic
Lupus Erythematosus Women: A single tertiary centre experience. Sultan Qaboos Univ Med J. 2021; 21(2): 244-
252.
Suharno S, Salim EM, Apriansyah A, Indrajaya T, Ahmad Z, Bahar E. Relationship between Interleukin 6 Serum
Levels and Degree of Depression in Systemic Lupus Erythematosus Patients Internal Disease in Dr. Moh Hoesin
Palembang. Bioscientia Medicina: Journal of Biomedicine and Translational Research. 2021; 5(3):295-306.
Arnaud L, Mertz P, Amoura Z, Voll RE, Schwarting A, Maurier F, Blaison G, Bonnotte B, Poindron V, Fiehn C,
Lorenz HM. Patterns of fatigue and association with disease activity and clinical manifestations in systemic lupus
erythematosus. Rheumatology. 2021; 60(6):2672-2677.
Cui C, Li Y, Wang L. The Association of Illness Uncertainty and Hope With Depression and Anxiety Symptoms in
Women With Systemic Lupus Erythematosus: A Cross-sectional Study of Psychological Distress in Systemic Lupus
Erythematosus Women. Journal of clinical rheumatology: practical reports on rheumatic & musculoskeletal
diseases. 2020; 27(8): 299-305.
Monahan RC, Beaart-van de Voorde LJ, Eikenboom J, Fronczek R, Kloppenburg M, Middelkoop HA, Terwindt
GM, van der Wee NJ, Huizinga TW, Steup-Beekman GM. Fatigue in patients with systemic lupus erythematosus
and neuropsychiatric symptoms is associated with anxiety and depression rather than inflammatory disease activity.
Lupus. 2021; 30(7):1124-1132.
Hussain K, Gauto-Mariotti E, Cattoni HM, Arif AW, Richardson C, Manadan A, Yadav N. A Meta-analysis and
Systematic Review of Valvular Heart Disease in Systemic Lupus Erythematosus and Its Association With
Antiphospholipid Antibodies. JCR: Journal of Clinical Rheumatology. 2021; 27(8):e525-32.
Barros SM, de Araújo DB, de Carvalho JF. Suicide risk in systemic lupus erythematosus: a narrative review. Revista
de Ciências Médicas e Biológicas. 2020; 19(4):620-624.
Manzano BR, da Silva Santos PS, Bariquelo MH, Merlini NR, Honório HM, Rubira CM. A case-control study of
oral diseases and quality of life in individuals with rheumatoid arthritis and systemic lupus erythematosus. Clinical
Oral Investigations. 2021; 25(4):2081-2092.
Hoffmann D, Rask CU, Hedman-Lagerlöf E, Jensen JS, Frostholm L. Efficacy of internet-delivered acceptance and
commitment therapy for severe health anxiety: results from a randomized, controlled trial. Psychological medicine.
2021; 51(15):2685-2695.
Villatte JL, Vilardaga R, Villatte M, Vilardaga JC, Atkins DC, Hayes SC. Acceptance and Commitment Therapy
modules: Differential impact on treatment processes and outcomes. Behaviour research and therapy. 2016; 77:52-
61.
Hayes SC, Strosahl KD, Wilson KG. Acceptance and Commitment Therapy: The Process and Practice of Mindful
Change. Guilford Press; 2011.
Hiratzka J, Rastegar F, Contag AG, Norvell DC, Anderson PA, Hart RA. Adverse Event Recording and Reporting
in Clinical Trials Comparing Lumbar Disk Replacement with Lumbar Fusion: A Systematic Review. Global spine
journal. 2015; 5(06):486-95.
Mousavi S, Khajevand Khoshli A, Asadi J, Abdollahzadeh H. Comparison of Effectiveness of Compassion-Focused
Therapy (CFT) and Acceptance and Commitment Therapy (ACT) on Self-Compassion and Quality of Life in
Women with Systemic Lupus Erythematosus (SLE). QUARTERLY JOURNAL OF HEALTH PSYCHOLOGY,
2021; 10(37): 83-108. (Persian).
Rezaei A M, Sharifi T, Ghazanfari A, Aflaki E, Bahre Dar M J. The Effectiveness of Acceptance and Commitment
Therapy on Depression and Follow-Up Treatment of Patients with Systemic Lupus. JNKUMS. 2021; 12 (4) :1-9.
(Persian).
Rezaie, A. Effectiveness of Treatment Based on Acceptance and Commitment, Compassion-Based Therapy and
Combination therapy on Anxiety and Dysfunctional Attitudes in Patients With Systemic Lupus. QUARTERLY
JOURNAL OF HEALTH PSYCHOLOGY, 2021; 10(37): 189-206. (Persian).
Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, Bentley KH, ThompsonHollands J, Conklin LR, Boswell JF, Ametaj A. The unified protocol for transdiagnostic treatment of emotional
disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA
psychiatry. 2017; 74(9):875-884.
Barlow DH, Harris BA, Eustis EH, Farchione TJ. The unified protocol for transdiagnostic treatment of emotional
disorders. World Psychiatry. 2020; 19(2):245-246.
Eustis EH, Gallagher MW, Tirpak JW, Nauphal M, Farchione TJ, Barlow DH. The Unified Protocol compared with
diagnosis-specific protocols for anxiety disorders: 12-month follow-up from a randomized clinical trial. General
Hospital Psychiatry. 2020; 67:58-61.
Zemestani M, Davoudi F, Farhadi A, Gallagher MW. A preliminary examination of unified protocol for
transdiagnostic treatment of emotional disorders in patients with panic disorder: a single-case experimental design
in Iran. Anxiety, Stress, & Coping. 2021; 9:1-8.
Alavi S, Rafieinia P, Makvand Hosseini S, Sabahi P. The Effectiveness of Unified Trans diagnostic Treatment on
Social anxiety symptoms and Difficulty in Emotion Regulation: Single-Subject Design. Journal of Psychological
Studies. 2020; 16(2): 7-24. (Persian).
Osma J, Martínez-García L, Quilez-Orden A, Peris-Baquero Ó. Unified Protocol for the Transdiagnostic Treatment
of Emotional Disorders in Medical Conditions: A Systematic Review. International journal of environmental
research and public health. 2021; 18(10):5077.
Nazari N, Sadeghi M, Ghadampour E, Mirzaeefar D. Transdiagnostic treatment of emotional disorders in people
with multiple sclerosis: randomized controlled trial. BMC psychology. 2020; 8(1):1-11.
Cassiello-Robbins C, Rosenthal MZ, Ammirati RJ. Delivering Transdiagnostic Treatment Over Telehealth During
the COVID-19 Pandemic: Application of the Unified Protocol. Cognitive and behavioral practice. 2021; 28(4): 555-
572.
Houser R. Counseling and educational research: Evaluation and application. USA: SAGE; 2009.
Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties.
Journal of consulting and clinical psychology. 1988; 56(6):893-897.
Fata L. Meaning Assignment Structures of Emotional States and Cognitive Processing of Emotional Information:
Comparing two conceptual frameworks. PHD Thesis; Tehran. 2003 .(Persian)
Peralta-Ramírez MI, Verdejo A, Muñoz MA, Sabio JM, Jiménez-Alonso JF, Pérez-García M. Lupus Symptoms
Inventory (LSI): Development and validation of a self-evaluation inventory of the subjective symptoms of systemic
lupus erythematosus. Journal of Clinical Psychology in Medical Settings. 2007; 14(4):344-350.
Izadi R, Abedi MR. Acceptance and Commitment Therapy. 4thed, Tehran, Junglepub. 2015; 73-150. (Persian).
Vujanovic AA, Meyer TD, Heads AM, Stotts AL, Villarreal YR, Schmitz JM. Cognitive-behavioral therapies for
depression and substance use disorders: An overview of traditional, third-wave, and transdiagnostic approaches. The
American journal of drug and alcohol abuse. 2017; 43(4):402-415.