مقایسه اثربخشی رفتاردرمانی دیالکتیک با درمان پذیرش و تعهد بر انسجام روانی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی، گروه روان‌شناسی، واحد نیشابور، دانشگاه آزاد اسلامی، نیشابور، ایران

2 گروه روان‌شناسی، واحد نیشابور، دانشگاه آزاد اسلامی، نیشابور، ایران (نویسنده مسئول).

3 گروه روان‌شناسی، واحد نیشابور، دانشگاه آزاد اسلامی، نیشابور، ایران.

چکیده

مقدمه: اختلالات خوردن یکی از شایع‌ترین اختلالات روانی/روانی جسمانی است که مشکلات زیادی در سلامت جسمانی، عملکرد ذهنی و کیفیت زندگی ایجاد می‌کند. هدف پژوهش حاضر مقایسه اثربخشی رفتاردرمانی دیالکتیکی با درمان مبتنی بر پذیرش و تعهد بر انسجام روانی بیماران پرخوری بود.
روش کار: پژوهش حاضر از نوع شبه آزمایشی با طرح پیش‌آزمون- پس‌آزمون و پیگیری با گروه کنترل بود. جامعه آماری شامل زنان چاق و دارای اضافه‌وزن 18 تا 45 ساله مبتلا به پرخوری در شهر کرج بود که در سال‌های 1402-1401 به طور مرتب به انجمن پرخوران گمنام شهر کرج مراجعه کرده بودند. از بین جامعه آماری برای انتخاب حجم نمونه با استفاده از روش نمونه‌گیری در دسترس، 60 نفر از آن‌ها انتخاب شدند. آزمودنی‌‌ها از نظر نمرات پرسشنامه پرخوری و تشخیص پزشک به طور مساوی در دو گروه (20 نفر در گروه رفتاردرمانی دیالکتیکی و 20 نفر در گروه درمان مبتنی بر پذیرش و تعهد) و گروه کنترل (20 نفر) قرار گرفتند. پس از انجام پیش آزمون، آزمودنی‌های گروه آزمایش، پروتکل رفتار درمانی دیالکتیکی سافر (2009) طی 12 جلسه 2 ساعته و پروتکل طرح درمان رویکرد پذیرش و تعهد هیز و همکاران (2009) و هیز و همکاران (2010) طی 12 جلسه 2 ساعته دریافت کردند. سپس مرحله پس‌آزمون و سه ماه بعد پیگیری انجام شد. ابزار مورداستفاده در این پژوهش، پرسشنامه انسجام روان‌شناختی فلسنبرگ (1) بود. داده‌‌های به‌دست‌آمده از این تحقیق با استفاده از نرم‌افزار spss-27 مورد تجزیه‌وتحلیل قرار گرفت.
نتایج: نتایج نشان داد که بین اثربخشی دو گروه درمان مبتنی بر پذیرش و تعهد و رفتاردرمانی دیالکتیکی در افزایش سطح انسجام روانی بیماران مبتلا به پرخوری تفاوت معناداری وجود ندارد. نتایج نشان داد که هر دو گروه مؤثر بوده و نتایج پایداری را نشان می‌دهند.
نتیجه‌گیری: با توجه به یافته‌ها می‌توان نتیجه گرفت که درمان مبتنی بر پذیرش و تعهد و رفتاردرمانی دیالکتیکی می‌تواند سطح انسجام روانی بیماران مبتلا به پرخوری را افزایش دهد؛ بنابراین توصیه می‌شود درمانگران از این رویکردها به عنوان درمانی مؤثر برای افزایش انسجام روانی بیماران مبتلا به پرخوری استفاده کنند.

کلیدواژه‌ها

عنوان مقاله [English]

Comparing the Effectiveness of Dialectical Behavior Therapy with Acceptance and Commitment Therapy on Psychological Coherence in Binge Eating Patients

نویسندگان [English]

  • Monica Vakili 1
  • Zahra Bagherzadeh Golmakani 2
  • Mustafa Bolghan-Abadi 3
1 Ph. D student in Psychology, Department of psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran.
2 Department of Psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran. (Corresponding Author)
3 Department of psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran.
چکیده [English]

Introduction: Eating disorders are one of the most common mental/psycho-physical disorders that cause many problems in physical health, mental functioning and quality of life. Despite the fact that binge eating disorder is considered the most common eating disorder, it has not been studied much. The purpose of the present study was to compare the effectiveness of dialectical behavior therapy with acceptance and commitment therapy on psychological coherence in binge eating patients.
Methods: The present study was a quasi-experimental design with a pre-test-post-test and follow-up with a control group. The statistical population included obese and overweight women aged 18 to 45 suffering from overeating in Karaj, who had regularly visited the Overeaters Anonymous Association in Karaj in 2022-2023. From among, using the convenient sampling method, 60 individuals were randomly selected and matched in terms of the scores of the overeating questionnaire and the doctor's diagnosis. They were equally assigned to two groups (20 people in the dialectical behavior therapy group and 20 people in the acceptance and commitment therapy group) and the control group (20 people). After the pre-test, the subjects in the experimental group received the dialectical behavior therapy protocol using the book "Dialectical Behavior Therapy for Binge Eating and Psychotic Anorexia: A Practical Guide for Clinical Experts" written by Debra Safer (2019) during 12 two-hour sessions. They also received the treatment plan protocol of the acceptance and commitment approach based on Hayes, Stroshall, and Wilson (2009), Twohig (2012), and Hayes et al. (2013) during 12 two-hour group sessions. Then the post-test stage and three months later follow-up were conducted. The instrument was Felsenberg's psychological coherence questionnaire (2006). The data obtained from this research were analyzed using SPSS-27 software.
Results: The results showed that there is no significant difference between the effectiveness of two groups of acceptance and commitment therapy and dialectical behavior therapy in increasing the level of psychological coherence. The results showed that both groups were effective and showed stable results.
Conclusion: Considering the findings, it can be concluded that the treatment based on acceptance and commitment and dialectical behavior therapy can increase the level of psychological coherence of patients with binge eating. Therefore, it is recommended that therapists use these approaches as an effective treatment to increase the psychological coherence of patients with binge eating.

کلیدواژه‌ها [English]

  • dialectical behavior therapy
  • acceptance and commitment therapy
  • psychological coherence
  • overeating

مراجع

  1. Flensborg-Madsen T, Ventegodt S, Merrick J. Sense of coherence and physical health. Testing Antonovsky's theory. The Scientific World Journal. 2006;6(1):2212-9.
  2. McCuen-Wurst C, Ruggieri M, Allison KC. Disordered eating and obesity: associations between binge-eating disorder, night-eating syndrome, and weight-related comorbidities. Ann N Y Acad Sci. 2018 Jan;1411(1):96-105. doi: 10.1111/nyas.13467.
  3. Marzilli E, Cerniglia L, Cimino S. A narrative review of binge eating disorder in adolescence: prevalence, impact, and psychological treatment strategies. Adolesc Health Med Ther. 2018 Jan;9:17-30. doi: 10.2147/AHMT.S148050.
  4. Hay P, Ghabrial B, Mannan H, Conti J, Gonzalez-Chica D, Stocks N, et al. General practitioner and mental healthcare use in a community sample of people with diagnostic threshold symptoms of bulimia nervosa, binge-eating disorder, and other eating disorders. Int J Eat Disord. 2020 Jan;53(1):61-8. doi: 10.1002/eat.23174.
  5. Shakerinasab M, Zibaei Sani M, Kazemabadi Farahani Z, Ghalehnovi Z. The relationship between perceived stress and social anxiety with psychological cohesion in pandemic crises, with emphasis on Covid 19 patients discharged from Sabzevar Vasei Hospital. Journal of Clinical Psychology. 2021 Jun 22;13(Special Issue 2):87-96.
  6. Goldberg A, Scharf M, Wiseman H. Sense of coherence and parenting representation among parents of adolescents with type 1 diabetes. J Pediatr Nurs. 2017 Jul;35:3-7. doi: 10.1016/j.pedn.2017.01.011.
  7. Eyni S, Hashemi Z, Tagavi R. Elderly perceived stress: The Predictive role of spiritual well-being, coping strategies, and sense of cohesion. J Gerontol. 2019;4(3):25-34. doi: 10.29252/joge.4.2.25.
  8. Eindor-Abarbanel A, Naftali T, Ruhimovich N, Bar-Gil Shitrit A, Sklerovsky-Benjaminov F, Konikoff F, et al. Important relation between self-efficacy, sense of coherence, illness perceptions, depression and anxiety in patients with inflammatory bowel disease. Frontline Gastroenterol. 2020 Aug 25;12(7):601-7. doi: 10.1136/flgastro-2020-101412.
  9. Vagedes J, Kleih T, Belizer C, Svaldi J, Hautzinger M, von Schoen-Angerer T. Sense of coherence in long-term follow-up of adolescents with anorexia nervosa. Nordic Journal of Psychiatry. 2021 Aug 2;75(6):415-9.
  10. Latzer Y, Weinberger-Litman SL, Spivak-Lavi Z, Tzischinsky O. Disordered eating pathology and body image among adolescent girls in Israel: The role of sense of coherence. Community Ment Health J. 2019 Oct;55:1246-52. doi: 10.1007/s10597-019-00446-0. [Persian].
  11. Khakshor Shandiz F, Shahabizadeh F, Ahi Q, Mujahidi M. The effectiveness of dialectical behavior therapy on stress and cognitive flexibility of women with type 2 diabetes. J Qom Univ Med Sci. 2021;15(5):358-67. doi: 10.32598/qums.15.5.2373.1. [Persian].
  12. Arabzadeh A, Nemati M, Turkman Menesh A, Faramarzi F. The effectiveness of dialectical behavior therapy on increasing self-compassion and psychological well-being and decreasing blood pressure in individuals with substance abuse. Sci Q Res Addict. 2022;15(62):261-88. doi: 10.52547/etiadpajohi.15.62.261. [Persian].
  13. Flynn D, Kells M, Joyce M. Dialectical behaviour therapy: Implementation of an evidence-based intervention for borderline personality disorder in public health systems. Curr Opin Psychol. 2021;37:152-7. doi: 10.1016/j.copsyc.2021.01.002.
  14. Kim H, Yeo J. Impact of sexual attitude and marital intimacy on sexual satisfaction in pregnant couples: An application of the actor-partner interdependence model. Korean J Women Health Nurs. 2017;23(3):201. doi: 10.4069/kjwhn.2017.23.3.201.
  15. Cohen J, Norona JC, Yadavia JE, Borsari B. Affirmative dialectical behavior therapy skills training with sexual minority veterans. Cogn Behav Pract. 2021;28(1):77-91. doi: 10.1016/j.cbpra.2020.05.008.
  16. Shirasawa T, Ochiai H, Nanri H, Nishimura R, Ohtsu T, Hoshino H, Tajima N, Kokaze A. The relationship between distorted body image and lifestyle among Japanese adolescents: a population-based study. Archives of public health. 2015 Dec;73:1-7.
  17. Masrour S, Toozandehjani H. The Effectiveness of Dialectical Behavioral Therapy on Anxiety Sensitivity and Body Image in Female Bulimia Nervosa Patients. J Clin Psychol. 2019;11(1):37-48. doi: 10.22075/jcp.2019.17042.1613. [Persian].
  18. Hayes S, Strosahl KD, Wilson K. Acceptance and Commitment Therapy: Second edition, the process and practice of mindful change. New York: Guilford; 2012.
  19. Radmehr S, Jadidi M, Golestanipour M. The effectiveness of treatment based on acceptance and commitment on emotion regulation and blood pressure reduction in people with coronary heart disease. J Psychol Sci. 2023 Nov;22(128). doi: 10.52547/JPS.22.128.1619. [Persian].
  20. Ashrafi S, Bahrainian A, Hajializadeh K, Delavar A. The Effectiveness of Acceptance and Commitment Therapy on Bulimia Nervosa in Overweight Women. RBS. 2020;18(2):182-91. doi: 10.52547/rbs.18.2.182. [Persian].
  21. Erfani E, Rafiepoor A, Ahadi M, Sarami Foroushani G. The effectiveness of acceptance and commitment-based therapy on emotion regulation and psychological well-being in men with bulimia nervosa. Med J Mashhad Univ Med Sci. 2022;65(1):116-25. doi: 10.22038/mjms.2022.63361.3714. [Persian].
  22. Gormally JI, Black S, Daston S, Rardin D. The assessment of binge eating severity among obese persons. Addictive behaviors. 1982 Jan 1;7(1):47-55.
  23. Molodi R, Dejkam M, Muttabi F, Omidre N. Comparison of primary maladaptive schemas in obese individuals with binge eating disorder and without binge eating disorder. J Behav Sci. 2010;4(2):109-14.
  24. Alipour A, Sharif N. Validity and reliability of the Sense of Coherence (SOC) questionnaire in university students. Pajoohande. 2012;17(1):50-6. Available from: http://pajoohande.sbmu.ac.ir/article-1-1276-fa.html [Persian].
  25. Hayes SA, Orsillo SM, Roemer L. Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder. Behaviour research and therapy. 2010 Mar 1;48(3):238-45.
  26. Safer DL, Telch CF, Chen EY. Dialectical behavior therapy for binge eating and bulimia. Guilford Press; 2009 May 20.
  27. Basirifar M, Mosavinezhad SM. Effectiveness of Acceptance and Commitment Therapy in Distress Tolerance and Sense of Coherence in Infertile Women in Mashhad. J Health Res Commun. 2022;8(1):81-92. doi: 10.1001.1.24236772.1401.8.1.8.1. [Persian].
  28. Faizykhah F, Hassanzadeh R, Abbasi AA. Comparing the effectiveness of acceptance and commitment therapy with resilience training on the sense of personal cohesion and emotional divorce in women seeking divorce. Soc Health. 2021;8:152-66. doi: 10.22037/ch.v8i2.31342. [Persian].
  29. Hoseinzad A, Khademi A, Tasbihsazan R, Khalilzadeh R. Effectiveness of Acceptance and Commitment Therapy in the Sense of Coherence and Self-compassion of Women with Multiple Sclerosis. Avicenna J Nurs Midwifery Care. 2023;31(3):208-16. doi: 10.32592/ajnmc.31.3.208. [Persian].
  30. Sarizadeh MS, Rafieinia P, Sabahi P, Tamaddon M. Effectiveness of acceptance and commitment therapy on subjective well-being among hemodialysis patients: A randomized clinical trial study. Koomesh. 2019; 21(1): 61-66.
  31. Kaviani Z, Bakhtiarpour S, Heydari A, Asgari P, Iftikhar Saadi Z. Investigating the effect of Acceptance and Commitment Therapy (ACT) on resilience and dysfunctional attitudes of women with MS in Tehran. Knowl Res Appl Psychol. 2019;21(1):84-92. doi: 10.30486/jsrp.2019.581585.1627. [Persian].
  32. Han J, Zhang L, Liu Y, Zhang C, Zhang Y, Tang R, et al. Effect of a group-based acceptance and commitment therapy programme on the mental health of clinical nurses during the COVID-19 sporadic outbreak period. J Nurs Manag. 2022 Oct;30(7):3005-12. doi: 10.1111/JONM.13696.
  33. Pahlavan F, Ramezani K, Rasouli Y. The Effectiveness of Dialectical Behavior Therapy on Basic Psychological Needs and Health Hardiness in Patients with Type 2 Diabetes. J Health Promot Manag. 2022 Oct;11(5):66-79. doi: 10.22034/JHPM.11.5.66. [Persian].
  34. Rouhi M, Manzari Tavakoli A, Tajrobehkar M. Comparing the effectiveness of acceptance and commitment therapy and dialectical behavioral therapy on coherent self-knowledge, emotional regulation and life quality of hemodialysis patients. Shenakht J Psychol Psychiatry. 2023;10(2):131-46. doi: 10.325. [Persian].
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 67، شماره 2
خرداد-تیر1403
خرداد و تیر 1403
صفحه 556-570

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