مقایسه اثربخشی مواجهه درمانی مبتنی بر مدیریت استرس و رفتاردرمانی دیالکتیک بر انعطاف پذیری شناختی و تکانشگری در افرادی با نشانه های صدابیزاری

نوع مقاله : مقاله پژوهشی

نویسندگان

گروه روان شناسی دانشکده ادبیات و علوم انسانی، دانشگاه گیلان، ایران

چکیده

مقدمه: صدابیزاری به‌عنوان یکی از پدیده‌های نوظهور می‌تواند زمینه‌ساز مشکلاتی در کنترل تکانه و کاهش انعطاف‌پذیری شناختی شود. لذا، پژوهش حاضر با هدف مقایسه اثربخشی مواجهه درمانی مبتنی بر مدیریت استرس و رفتاردرمانی دیالکتیک در انعطاف‌پذیری شناختی و تکانشگری در افراد صدابیزار انجام شد.
روش کار: این پژوهش از نوع شبه آزمایشی با طرح تک آزمودنی A-B-A همرا با خطّ پایة و پیگیری چندگانه است. جامعه آماری تمام افراد مبتلا به صدا بیزاری مراجعه کننده به مراکز مشاوره شهر مشهد در طی سال‌های 1402-1403 بودند (83 نفر). نمونه پژوهش8 نفر مبتلا به صدا بیزاری بود که به صورت تصادفی در دو گروه دیالکتیک (4) و مواجهه درمانی مبتنی بر مدیریت استرس (4) قرار گرفتند. داده ها با استفاده از شاخص‌ های درصد بهبودی، تغییر پایا و روش ترسیم دیداری و با نرم افزار spss.27 تحلیل شدند.
نتایج:یافته ها نشان داد هر چند درصد بهبودی انعطاف‌پذیری شناختی گروه رفتاردرمانی دیالکتیک(80/56-) و گروه مواجهه مبتنی بر مدیریت استرس(53/64-)در مرحله پیگیری از لحاظ بالینی معنادار بود؛ اما بهترین درصد بهبودی مربوط به گروه رفتاردرمانی دیالکتیک بود. یافته دوم نیز نشان داد درصد بهبودی تکانشگری آزمودنی های دو گروه درمانی از لحاظ بالینی معنادار نمی‌باشند؛ اما بهترین درصد بهبودی برای تکانشگری مربوط به گروه رفتاردرمانی دیالکتیک (16) در مرحله پیگیری است.
نتیجه گیری: بر اساس نتایج پژوهش، رفتاردرمانی دیالکتیک با تأکید بر پذیرش هیجان و آموزش مهارت‌های تنظیم هیجان، موجب ارتقای انعطاف‌پذیری شناختی و بهبود کنترل تکانه در افراد مبتلا به صدابیزاری می‌شود. این نتایج بیانگر اثربخشی رویکرد دیالکتیکی در بهبود سازگاری شناختی‌ـ‌هیجانی است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comparing the Effectiveness of Exposure Therapy Based on Stress Management and Dialectical Behavior Therapy on Cognitive flexibility and Impulsivity in People with Misophonia Signs.

نویسندگان [English]

  • Zahra Bahrami
  • Abbas Abolghasemi
  • Seyyed Mosa Kafi
Department of Psychology, Faculty of Literature and Humanities, University of Guilan, Iran
چکیده [English]

Introduction:Misophonia, as an emerging psychological phenomenon, can lead to difficulties in impulse control and reduced cognitive flexibility. Therefore, the present study aimed to compare the effectiveness of stress management–based exposure therapy and dialectical behavior therapy (DBT) on cognitive flexibility and impulsivity in individuals with misophonia symptoms.
Method:This study employed a quasi-experimental single-subject design (A-B-A) with a baseline and multiple follow-up phases. The statistical population comprised all individuals with misophonia who visited counseling centers in Mashhad during 2023–2024 (N = 83). Eight participants diagnosed with misophonia were randomly assigned to two groups: dialectical behavior therapy (n = 4) and exposure therapy based on stress management (n = 4). Data were analyzed using improvement percentage indices, reliable change indices, and visual analysis, with SPSS-27 software applied for statistical processing.
Results:The results indicated that although the improvement percentages of cognitive flexibility in both therapeutic groups—dialectical behavior therapy (56.80%) and stress management–based exposure therapy (53.64%)—were clinically significant, the highest level of improvement belonged to the DBT group. Furthermore, the improvement percentages of impulsivity in both therapy groups were not clinically significant; however, the best improvement rate in impulsivity during the follow-up phase was observed in the DBT group (16%).
Conclusion:Based on the findings, dialectical behavior therapy, through its emphasis on emotion acceptance and emotion regulation skills training, enhances cognitive flexibility and improves impulse control in individuals with misophonia. These results highlight the effectiveness of the dialectical approach in improving cognitive–emotional adaptability among individuals experiencing heightened sensitivity to specific sounds.

کلیدواژه‌ها [English]

  • Misophonia
  • exposure therapy-based stress management. Dialectical behavior therapy
  • Cognitive flexibility
  • Impulsivity

مراجع

  1. McGuire JF, Wu MS, Storch, EA. Cognitive-behavioral therapy for 2 youths with misophonia. Journal of Clinical Psychiatry. 2015; 76(5): 573-574.
  2. Jager I, de Koning P, Bost T, Denys D, Vulink N. Misophonia: Phenomenology, comorbidity and demographics in a large sample. PloS one.2020; 15(4): 231-390.
  3. Brout JJ, Edelstein M, Erfanian M, Mannino M, Miller LJ, Rouw R, et al. Investigating misophonia: A review of the empirical literature, clinical implications, and a research agenda. Front Neurosci. 2018;12:36.
  4. Wang Q, Vitoratou S, Uglik-Marucha N, Gregory J. Emotion processes predicting outbursts and functional impact in misophonia. Frontiers in Psychology. 2022; 13, 9031-42.
  5. Vitoratou S, Wang J, Hayes C, Wang Q, Stefanatou P, Gregory J. Evidence of Cross-Cultural Consistency of the S-Five Model for Misophonia: Psychometric Conclusions Emerging From the Mandarin Version. Frontiers in Psychology. 2022;13: 879-881.
  6. Neacsiu AD, Szymkiewicz V, Galla JT, Li B, Kulkarni Y, Spector CW. The neurobiology of misophonia and implications for novel, neuroscience-driven interventions. Front Neurosci. 2022;16:893-903.
  7. Jacques S, Zelazo PD. On the possible roots of cognitive flexibility. In B. D. Homer & C. S. Tamis-LeMonda (Eds.), the development of social cognition and communication. Mahwah, NJ: Lawrence Erlbaum.2005
  8. Martin M, Staggers S, Anderson C. The Relationships Between Cognitive Flexibility with Dogmatism, Intellectual Flexibility, Preference for Consistency, and Self-Compassion.
    Communication Research Reports.     2011; 28(3): 275-280.
  9. Koesten J, Schrodt P, Ford D. Cognitive Flexibility as a Mediator of Family Communication Environments and Young Adults' Well-Being. Health Communication. 2009; 24(1): 82-94.
  10. Eijsker N, Schröder A, Smit DJ, Van Wingen G, Denys D. Neural basis of response bias on the stop signal task in misophonia. Frontiers in psychiatry. 2019; 10: 765.
  11. Frank B, Roszyk M, Hurley L, Drejaj L, McKay. DInattention in misophonia: Difficulties achieving and maintaining alertness. Journal of Clinical and Experimental Neuropsychology.2020; 42(1): 66-75.
  12. Frank B, McKay, D. The suitability of an inhibitory learning approach in exposure when habituation fails: A clinical application to misophonia. Cognitive and Behavioral Practice.2019; 26(1): 130-142.
  13. Jastreboff PJ. The Neurophysiological Model of Tinnitus and Decreased Sound Tolerance. In: Schlee W, Langguth B, De Ridder D, Vanneste S, Kleinjung T, Møller, AR. (eds) Textbook of Tinnitus. Springer, Cham. 2024.
  14. Möllmann A, Heinrichs N, Illies L, Potthast N, Kley H. The central role of symptom severity and associated characteristics for functional impairment in misophonia. Frontiers in Psychiatry.2023; 14: 1112472.
  15. Swedo SE, Baguley DM, Denys D, Dixon LJ, Erfanian M, Fioretti A,... Raver SM. Consensus definition of misophonia: a delphi study. Frontiers in neuroscience.2022; 16: 841816.
  16. Foa EB, Hembree EA, Rothbaum BO. Prolonged exposure therapy for PTSD: emotional processing of traumatic experiences, Therapist Guide. New Yourk: Oxford University Press.2007; 45-76.
  17. Spencer SD, McKay D, Mangen K. H, Rabasco A. A Pilot Clinical Trial Examining Exposure and Stress Management Therapy for Adults With Misophonia. Journal of psychiatric practice.2025; 31(5): 251–259.
  18. Elbert Th, Shauer M, Ruf M, Weirestall R, Neuner F, Rockstroh B, Junghofer M. The Tortured Brain Imaging Neural Representations of Traumatic Stress Experiences Using RSVP With Affective Pictorial Stimuli. J. Psychol.2011; 219(3): 167–74.
  19. Leahy RL, Holland SJ. Treatment plans and Intervention for Depression and Anxiety Disorders. New York, NY: Guilford.2000; 212-215.
  20. Rabasco A, McKay D. Exposure therapy for misophonia: concepts and procedures. J Cogn Psychother. 2021;35(3):156–66.
  21. Moore KE, Oberleitner L, Smith KM, Maurer K, McKee SA. Feasibility and effectiveness of continuing methadone maintenance treatment during incarceration compared with forced withdrawal. Journal of Addiction Medicine.2018; 12(2): 156-162.
  22. Schneider RL, Arch JJ. Potential treatment targets for misophonia. Gen. Hosp. Psychiatry.2015; (37): 370-371.
  23. Ciesinski NK, Sorgi-Wilson KM, Cheung J. C, Chen EY, McCloskey MS. The effect of dialectical behavior therapy on anger and aggressive behavior: A systematic review with meta-analysis. Behaviour research and therapy.2022; (154): 104-122.
  24. Vijayapriya CV, Tamarana R. Effectiveness of dialectical behavior therapy as a transdiagnostic treatment for improving cognitive functions: a systematic review. Research in Psychotherapy: Psychopathology, Process, and Outcome.2023; 26 (2):662.
  25. Neacsiu AD, Rizvi SL, Linehan MM. Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behav Res Ther. 2010;48(9):832–9.
  26. Hernandez-Bustamante M, Cjuno J, Hernández RM, Ponce-Meza JC. Efficacy of dialectical behavior therapy in the treatment of borderline personality disorder: A systematic review of randomized controlled trials. Iranian Journal of Psychiatry.2024; 19(1): 119.
  27. Cavicchioli M, Movalli M, Bruni A, Terragni R, Elena GM, Borgia E, ….Ogliari A. The initial efficacy of stand-alone DBT skills training for treating impulsivity among individuals with alcohol and other substance use disorders. Behavior Therapy.2023; 54(5): 809-822.
  28. Wu MS, Lewin AB, Murphy TK, Storch EA. Misophonia: incidence, phenomenology, and clinical correlates in an undergraduate student sample. J Clin Psychol. 2014; 70(10):994–1007.
  29. Mehrabizadeh Honarmand MT, Roshani Kh. Investigating the psychometric properties of the sound aversion questionnaire. Journal of Healing Khatam.2019; 7(2): 13-23.
  30. Dennis JP, Vander-Wal JS. The cognitive flexibility inventory: Instrument development and estimates of reliability and validit, Cogn Ther Res.2010; 34: 241-253.
  31. Masuda A, Tully EC. The Role of Mindfulness and Psychological Flexibility in Somatization, Depression, Anxiety, and General Psychological Distress in a Nonclinical College Sample. Journal of Evidence-Based Complementary & Alternative Medicine.2012; 17 (1): 66-71.
  32. Fazeli M, Eteshamzadeh P, Hashemi Sheikh-Shaibani SA. The effectiveness of cognitive-behavioral therapy on cognitive flexibility in depressed individuals. Thought and Behavior.2014;9 (34): 36-27.
  33. Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology.1995; 51 (6): 768–74.
  34. Someya T, Sakado K, Seki T, Kojima M, Reist C, Tang SW, et al. The Japanese version of the Barratt impulsiveness scale, 11th version (BIS-11): Its reliability and validity. Psychiatry and Clinical Neurosciences.2001; 55, 111–114.
  35. Basaknejad S, Alikordi B, Mehrabizadeh M. The effectiveness of mindfulness-based stress reduction on impulsivity and anxiety sensitivity in students with gastric ulcers. Journal of Sabzevar University of Medical Sciences.2019; 26 (4): 9-453.
  36. Linehan MM. Skills training manual for treating borderline personality disorder. Guilford press. 1993.
  37. Kazdin AE. Single-case research designs: Methods for clinical and applied settings (2nded). 2011. New York: NY: Oxford University Press.
  38. Mousavi M, Jokar B, Babaei M. Comparative efficacy of Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy on reducing anxiety and depression in patients with Generalized Anxiety Disorder. Journal of Health Psychology. 2016;5(2):173–87.
  39. Noferesti M. Research Methods in Behavioral Sciences. Tehran: Hirmand Publications; 2003.
  40. Horning S, Davis HP. Aging and cognition. Encyclopedia of Human Behavior.2012; 44-52.
  41. Dajani DR, & Uddin LQ. Demystifying cognitive flexibility: Implications for clinical and developmental neuroscience. Trends in Neurosciences.2015; 38(9): 571-578.
  42. Carbonella JY, Timpano KR. Examining the link between hoarding symptoms and cognitive flexibility deficits. Behavior therapy.2016; 47(2): 262-273.
  43. Mohammadi A, Dabbaghi P, Ahmadi-Tahor-Soltani M. The effectiveness of dialectical behavior therapy (DBT) on emotion regulation and impulsivity control in soldiers with a history of self-harm. Nurse and Physician in War.2019; 8(28): 12-23.
  44. Nadimi M. The effectiveness of dialectical behavior therapy (based on skills training) on ​​reducing impulsivity and increasing emotional regulation in methamphetamine-dependent women. Rouyesh-e-Rasvaneshani.2016; 5 (1): 47-74.
  45. Vardikhan SKI, Hassanzadeh R, Emadian SO. Examining the Effectiveness of Dialectical Behavior Therapy on Impulsivity, Emotion Regulation, Rumination, and Self-Criticism in Individuals with Trichotillomania. Health Nexus.2024; 2(1): 57-65.
  46. Jamilian HR, Malekirad AA, Farhadi M, Habibi M, Zamani N. Effectiveness of group dialectical behavior therapy (based on core distress tolerance and emotion regulation components) on expulsive anger and impulsive behaviors. Global journal of health science.2014; 6(7): 116.
  47. Cusack SE, Cash TV, Vrana SR. An examination of the relationship between misophonia, anxiety sensitivity, and obsessive-compulsive symptoms. Journal of Obsessive-Compulsive and Related Disorders. 2018; 18: 67-72.
  48. Schröder A, Vulink N, Denys D. Misophonia: diagnostic criteria for a new psychiatric disorder. PloS One. 2013; 8(1):54706.
  49. Brout JJ, Edelstein M, Erfanian M, Mannino M, Miller LJ, Rouw R, ....Rosenthal MZ. Investigating misophonia: A review of the empirical literature, clinical implications, and a research agenda. Frontiers in neuroscience.2018; 12: 36.
  50. Bernstein RE, Angell KL, Dehle CM. A brief course of cognitive behavioural therapy for the treatment of misophonia: a case example. The Cognitive Behaviour Therapist.2013; 6, e10.
  51. Schadegg MJ, Clark HL, Dixon LJ. Evaluating anxiety sensitivity as a moderator of misophonia and dimensions of aggression. Journal of Obsessive-Compulsive and Related Disorders.2021; 30: 100657.
  52. Dozier TH, Grampp L, Lopez M. Misophonia: Evidence for an elicited initial physical response. Universal journal of psychology.2020; 8(2): 27-35.
  53. Mednicoff SD, Barashy S, Gonzales D, Benning SD, Snyder JS, Hannon EE. Auditory affective processing, musicality, and the development of misophonic reactions. Front Neurosci. 2022;16:924806.
  54. Ferrer-Torres A, Giménez-Llort L. Misophonia: A systematic review of current and future trends in this emerging clinical field. Int J Environ Res Public Health. 2022;19(11):6790.
  55. Soler J, Elices M, Pascual JC, Martín-Blanco A, Feliu-Soler A, Carmona C. Effects of mindfulness training on different components of impulsivity in borderline personality disorder: results from a pilot randomized study. Borderline personality disorder and emotion dysregulation. 2016; 3 (1): 1-10.
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 69، شماره 1
فروردین1405
فروردین 1405
صفحه 93-109

فایل ها

هم رسانی

ارجاع به این مقاله

آمار