اثربخشی درمان شناختی– رفتاری بر افسردگی و اضطراب جانبازان مبتلا به اختلال استرس پس از سانحه

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روان‌شناسی، واحد بندرعباس، دانشگاه آزاد اسلامی، بندرعباس، ایران.

2 عضو هیئت علمی و دانشیار گروه روان‌شناسی، دانشگاه هرمزگان، بندرعباس، ایران.

3 دانشیار، گروه روان‌شناسی، واحد بندرعباس، دانشگاه آزاد اسلامی، بندرعباس، ایران.

چکیده

مقدمه و هدف: در کنار مشکلات جسمانی، آسیب‌های روانی از عمده‌ترین مشکلاتی هستند که جانبازان با آن درگیر هستند. اختلال استرس پس از سانحه مهم‌ترین مشکل روانی در جانبازان است که موجب بروز مشکلات دیگر در جانبازان می‌گردد؛ به همین منظور پژوهش حاضر به بررسی اثربخشی درمان شناختی– رفتاری بر کاهش افسردگی و اضطراب جانبازان مبتلا به اختلال استرس پس از سانحه پرداخته است.
مواد و روش‌ها: پژوهش حاضر نیمه‌آزمایشی با طرح پیش‌آزمون- پس‌آزمون با گروه گواه بود. جامعه آماری پژوهش شامل جانبازان مبتلا به اختلال استرس پس از سانحه شهر بندرعباس در شش ماهه تابستان و پاییز سال 1398 بود که به مرکز مشاوره شاهد و ایثارگر استان هرمزگان مراجعه کرده بودند. در این پژوهش تعداد 24 جانبازان مبتلا به اختلال استرس پس از سانحه با روش نمونه‌گیری هدفمند انتخاب و با گمارش تصادفی در گروه‌های آزمایش و گواه گمارده شدند (هر گروه 12 جانباز). گروه آزمایش درمان شناختی– رفتاری را طی دو و نیم ماه در 10 جلسه 90 دقیقه‌ای دریافت نمودند. پرسشنامه‌های مورد استفاده در این پژوهش شامل پرسشنامه اضطراب (بک و همکاران، 1988)، پسشنامه افسردگی (بک و همکاران، 1996) و پرسشنامه مشکلات اختلال استرس پس از سانحه (ویدرز و همکاران، 1993) بود. داده‌های حاصل از پژوهش به شیوه تحلیل کوواریانس مورد تجزیه و تحلیل قرار گرفت.
یافته‌ها: نتایج نشان داد که درمان شناختی– رفتاری بر کاهش افسردگی و اضطراب جانبازان مبتلا به اختلال استرس پس از سانحه تأثیر معنادار داشته (p<0/001) و توانسته منجر به کاهش اضطراب و افسردگی در این جانبازان شود.

کلیدواژه‌ها


عنوان مقاله [English]

Efficiency of Cognitive-Behavioral Therapy on the Depression and Anxiety of the Veterans with Post-Traumatic Stress Disorder

نویسندگان [English]

  • Mohadese Darvishi 1
  • Eghbal Zarei 2
  • Kobra Hajalizadeh 3
1 PhD student in Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran.
2 Faculty member and associate professor of psychology, Hormozgan University, Bandar Abbas, Iran.
3 Associate Professor, Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran.
چکیده [English]

Introduction and purpose: Mental damage is one major problem the veterans get engaged with besides physical problems. Posttraumatic stress disorder in one of the most important mental problems of the veterans which bring about other difficulties for them; therefore, the present study addressed investigating the efficiency of cognitive-behavioral therapy on the decrease of depression and anxiety of the veterans with post-traumatic stress disorder.
Material and methods: It was a quasi-experimental study with pretest, posttest and control group design. The statistical population included the veterans with post-traumatic stress disorder in the city of Bandar Abbas in summer and autumn of 2019 who referred to the martyrs and veterans consultation centers in the province of Hormozgan. 24 veterans with post-traumatic stress disorder were selected through purposive sampling method and they were randomly replaced into experimental and control groups (each group of 12 veterans). The experimental group received ten ninety-minute sessions of cognitive-behavioral therapy during two-and-a-half months. The applied questionnaires in the current study included anxiety questionnaire (Beck et.al, 1988), depression questionnaire (Beck et.al, 1996) and the questionnaire of post-traumatic stress disorder (Foa, et.al, 1997). The data from the study were analyzed through ANCOVA method.
Findings: The results showed that the cognitive-behavioral therapy had significant effect on the decrease of depression and anxiety of the veterans with post-traumatic stress disorder (p<0.001) and succeeded in the decrease of their anxiety and depression.

کلیدواژه‌ها [English]

  • Post-traumatic stress disorder
  • depression
  • anxiety
  • cognitive-behavioral therapy
Dutton, E., et al., Brain drain in Syria's ancient capital: No Flynn Effect in Damascus, 2004–2013/14.
Personality and Individual Differences, 2018. 125: p. 10-13.
2. Ramezani, S., et al., Effectiveness of Cognitive- Behavioral Therapy on Emotional Control and Signs of
Suicide in Veterans with PTSD. Iranian Journal of War and Public Health, 2018. 10(1): p. 1-7.
3. Tolabi, Z. and F. Ghanbari, Veterans’ life experiences: A phenomenological study. Journal of qualitative
Research in Health Sciences, 2015 :)3(4 .p. 266-279.
4. Harbertson, J., et al., Missed opportunity to screen and diagnose PTSD and depression among deploying
shipboard US military personnel. BJPsych open, 2016. 2(5): p. 314-317.
5. Ghorbani, S. and H. Kazemi Zahrani, Effectiveness of Metacognitive Therapy to Improve Verbal and
Working Memories in PTSD Veterans. Iranian Journal of War and Public Health, 2015. 7(2): p. 107-113.
6. Noohi, S., A. Miraghaie, and A. Arabi, The Effectiveness of Neurofeedback on Anxiety, Depression, and
War Post-Traumatic Stress Disorder Symptoms. J Res Behav Sci, 2016. 14(2): p. 195-203 (In Persian).
7. Teten, A.L., et al., Intimate partner aggression perpetrated and sustained by male Afghanistan, Iraq, and
Vietnam veterans with and without posttraumatic stress disorder. Journal of Interpersonal Violence, 2010.
25(9): p. 1612-1630.
8. Sonboli, S., A. Farhangi, and T. Tizdast, Comparative the effectiveness of cognitive-behavioral based
mindfulness therapy group and mindfulness in reduction symptoms and improve the irritability and focus of
chemical veterans with PTSD in Tehran state. Journal of military Psychology, 2016. 7(26): p. 33-45 (In
Persian).
9. Mohamadipoor, M. and M. Falahati, Effectiveness of Life Skills Training on Mental Health of Spouses of
Veterans with Affective Disorders. Iranian Journal of War and Public Health, 2016. 8(1): p. 25-32.
10. Brackbill, R.M., et al., Chronic physical health consequences of being injured during the terrorist attacks
on World Trade Center on September 11, 2001. American journal of epidemiology, 2014. 179(9): p. 1076-
1085.
11. Goodwin, L. and R.J. Rona, PTSD in the armed forces: What have we learned from the recent cohort
studies of Iraq/Afghanistan?, 2013, Taylor & Francis.
12. McNally, R.J. and B.C. Frueh, Why are Iraq and Afghanistan War veterans seeking PTSD disability
compensation at unprecedented rates? Journal of anxiety disorders, 2013. 27(5): p. 520-526.
13. Voloshin, V.M., (The typology of chronic posttraumatic stress disorder). Zhurnal nevrologii i psikhiatrii
imeni S.S. Korsakova, 2004. 104(1): p. 17-23.
14. Ray, S.L. and M. Vanstone, The impact of PTSD on veterans’ family relationships: An interpretative
phenomenological inquiry. International Journal of Nursing Studies, 2009. 46(6): p. 838-847.
15. Javadi ,M.K., et al., Relationship among depression, anxiety, stress and personality in veterans' children.
Iranian Journal of War and Public Health, 2010. 3(9): p. 9-16 (In Persian).
16. Hawamdeh, Z.M., Y.S. Othman, and A.I. Ibrahim, Assessment of anxiety and depression after lower
limb amputation in Jordanian patients. Neuropsychiatr Dis Treat, 2008. 4(3): p. 627-33.
17. Pacella, M.L., B. Hruska, and D.L. Delahanty, The physical health consequences of PTSD and PTSD
symptoms: A meta-analytic review. Journal of Anxiety Disorders, 2013. 27(1): p. 33-46.
18. Moradi, A., M. Salimi, and A. Fathi-Ashtiani, Memory performance among Iranian veterans with
posttraumatic stress disorder. Journal of Behavioral Sciences, 2011. 4(4): p. 269-276.
19. Shokofeh, R., et al., Comparison study of memory status in war-PTSD veterans with depression and nonveterans depressed patients. Tehran University Medical Journal, 2012. 69(12): p. 787-792.
20. Mikaeili, N., et al., Effectiveness of Emotion Focused Therapy on Emotional Dysregulation,
Hopelessness and Suicidal Ideation in Post-Traumatic Stress Disorder Veterans. Iranian Journal of War and
Public Health, 2017. 9(3): p. 111-117.
21. Rozanski, A., et al., The epidemiology, pathophysiology, and management of psychosocial risk factors in
cardiac practice: the emerging field of behavioral cardiology. Journal of the american college of cardiology,
2005. 45(5): p. 637-651.
22. Asghari, P., A. Mashhadi, and Z. Sepehri Shamloo, Effect of group cognitive behavioral therapy based
on Hofmann model on anxiety symptoms and brain behavioral systems in adults suffering from social
anxiety disorder. Journal of Fundamentals of Mental Health, 2014. 17(1): p. 38-45
23. Jones SL, Hadjistavropoulos HD, Soucy JN. A randomized controlled trial of guided internet-delivered
cognitive behavior therapy for older adults with generalized anxiety, Journal of Anxiety Disorders, 2016; 37:
1–9.
24. Li C, Xu D, Hu M, Tan Y, Zhang P, Li G, Chen L. A systematic review and meta-analysis of
randomized controlled trials of cognitive behavior therapy for patients with diabetes and depression, Journal
of Psychosomatic Research, 2017; 95: 44–54.
25. Kishita N, Laidlaw K. Cognitive behavior therapy for generalized anxiety disorder: Is CBT equally
efficacious in adults of working age and older adults?, Clinical Psychology Review, 2017; 52: 124–136.
26. Warwick H, Reardon T, Cooper P, Murayama K, Reynolds S, Wilson C, Creswell C. Complete recovery
from anxiety disorders following Cognitive Behavior Therapy in children and adolescents: A meta-analysis,
Clinical Psychology Review, 2017; 52: 77–91.
27. Holman, E.A. and P.G. Zimbardo, The Social Language of Time: The Time Perspective–Social Network
Connection. Basic and Applied Social Psychology, 2009. 31(2): p. 136-147.
28. Shahraki, R., et al., Comparing the Effectiveness of Time Perspective and Cognitive Behavioral Therapy
on Reducing Posttraumatic Stress Disorder in War Veterans. Journal of Research in Bihavioural Sciences,
2017. 15(2): p. 246-252 (In Persian).
29. Clapp, J.D. and J.G. Beck, Treatment of PTSD in Older Adults: Do Cognitive-Behavioral Interventions
Remain Viable? Cognitive and Behavioral Practice, 2012. 19(1): p. 126-13.5
30. Dunne, R.L., J. Kenardy, and M. Sterling, A Randomized Controlled Trial of Cognitive-behavioral
Therapy for the Treatment of PTSD in the Context of Chronic Whiplash. The Clinical Journal of Pain, 2012.
28(9): p. 755-765.
31. Weathers FW, Litz BT, Herman DS, Huska JA, Keane T. The PTSD Cheklist (PCL).Reliability. Validity
& diagnostic utility. Presented at the 9 Th Annual Meeting of the Inernational Society for Traumatic Seress
Hissre Studies. 1993.
32. Blanchard EB, Alexander JJ, Buckley TC, Forneris A. Psychometric properties of the PTSD checklist
(PCL). Behavior, Research and Therapy,1996; 34(8): 669-673
33. Goodarzi, MA. Evaluation of Validity and Validity of Stress Disorder Scale after Mississippi Trauma,
Journal of Psychology, 2003; 7 (2): 1-10. (Persian)
34. Kazemi A S, Banijamali S A, Ahadi H, Farrokhi N. Evaluation of effectiveness of training cognitive
behavioral strategies in the secondary traumatic stress disorder (STSD) symptoms and psychological
problems among devotees' wives with chronic PTSD due to war. Medical Sciences 2012; 22(2): 122-129.
(Persian)
35. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric
properties. Journal Consulting Clinical Psychology, 1988; 56: 893-897.
36. Shafiee Sang Atash S, Rafiei Nia P, Najafi M. The effectiveness of metacognitive therapy on anxiety and
metacognitive components in patients with generalized anxiety disorder, Journal of Clinical Psychology,
2012; 4(4): 19-31. (Persian)
37. Nikkhah M. The Effectiveness of Admission and Commitment Therapy on Anxiety and Mental Health of
Students with Exam Anxiety, Master Thesis, Islamic Azad University, Isfahan Branch (Khorasgan). 2014.
(Persian)
38. Fathi A, Hatami Varzaneh A, Asli Azad M, Farhadi T. The effect of self-forgiveness group training
based on Quranic concepts on depression in male high school students, New Educational Thoughts, 2015;
12(3): 110-130.
39. Reisian A, Golzari M, Borjali A. The effectiveness of hope therapy on reducing depression and relapse
prevention in women addicted to drug addicts. Addiction Research Quarterly, 2011; 5(17): 40-21. (Persian)
40. Balochi D, Atashpour H, Golparvar M. The effectiveness of cognitive-behavioral therapy on
interpersonal problems of people with gender identity disorder, Journal of Cognitive Analytical Psychology,
2019; 10(38): 49-59. (Persian)