مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد با درمان شناختی-رفتاری بر کیفیت زندگی بیماران مبتلا به کمردرد مزمن

نوع مقاله : مقاله پژوهشی

نویسندگان

1 Ph.D. in clinical psychology, Assistant professor, Department of Psychology, University of Mazandaran, Mazandaran, Iran.

2 Ph.D. in clinical psychology, Assistant professor of clinical psychology, Department of Clinical Psychology, AJA University of Medical Sciences, Tehran, Iran.

3 Ph.D. in clinical psychology, Associate professor of clinical psychology, Tehran Institute of Psychiatry, Mental Health Research Center, University of Medical Sciences, Tehran, Iran.

4 Professor of Shahid Beheshti Medical Sciences University, Department of Anesthesiology and Pain, Shahid Beheshti Medical University, President of Iranian Pain Society (IASP), Tehran, Iran.

5 M.Sc. in clinical psychology, Tehran Institute of Psychiatry, Mental Health Research Center, University of Medical Sciences, Tehran, Iran.

10.22038/JFMH.2024.62173.2971

چکیده

مقدمه: این مطالعه با هدف مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد (ACT) با درمان شناختی-رفتاری (CBT) بر کیفیت زندگی بیماران مبتلا به کمردرد مزمن انجام شد.
روش کار: جامعه آماری شامل تمام بیماران مبتلا به کمردرد مزمن بود که به درمانگاه درد بیمارستان اختر تهران در سال 1400 مراجعه نمودند. تعداد 30 بیمار انتخاب و به صورت تصادفی در یک از دو گروه ACT یا CBT قرار گرفتند. بعد ریزش نمونه ها، در نهایت تعداد 10 نفر در هر گروه باقی ماندند. داده ها توسط شاخص بهزیستی شخصی-بزرگسال جهت بررسی کیفیت زندگی، جمع آوری و با کمک آمار توصیفی، و تستهای ویلکاکسون و یو من-ویتنی غیر پارامتریک تحلیل شدند.
یافته ها: بر اساس نتایج، هر دو مداخله کیفیت زندگی را افزایش دادند اما تفاوت بین دو مداخله معنی دار نبود (05/0; P> 17/1- Z=). اگر چه با توجه به نمرات Z  (84/1- در برابر 17/1-)، ACT موثرتر بوده است.
نتیجه گیری: بر اساس نتایج، هر دو مداخله درمان شناختی-رفتاری و درمان مبتنی بر پذیرش و تعهد بهزیستی و کیفیت زندگی را در بیماران مبتلا به کمردرد مزمن، بهبود می بخشند.

کلیدواژه‌ها


  1. Michna GA, Trudel SM, Bray MA, Reinhardt J, Dirsmith J, Theodore L, et al. Best practices and emerging trends in assessment of trauma in students with autism spectrum disorder. Psychol Sch 2022; 22(1): 1-16.
  2. Rabito-Alcón MF, Baile JI, Vanderlinden J, Rabito-Alcón MF, Baile JI, Vanderlinden J. Mediating factors between childhood traumatic experiences and eating disorders development: A systematic review. Children 2021; 8(2): 114.
  3. Zhang Z, Dang J, Li J, He Y, Huang S, Wang Y, et al. Childhood trauma and self-control: The mediating role of depletion sensitivity. J Child Fam Stud 2021; 30(6): 1599-606.
  4. Mikaeili N, Zamanloo K. [A study of the prevalence of child abuse and its prediction from parents’ depression and anxiety, attachment styles and mental health of their adolescent boys]. Psychology of exceptional individuals 2012; 2(5): 145-66. (Persian)
  5. Cho Y, Kim D, Kim S-H, Cho Y, Kim D, Kim S-H. Prevalence and clinical correlates of childhood trauma among inpatients diagnosed with bipolar disorder: A matched comparison with schizophrenia. Psychosis 2021; 13(1): 13-23.
  6. Franke LK, Miedl SF, Danböck SK, Liedlgruber M, Grill M, Kronbichler M, et al. Pain after psychological trauma: The role of classical conditioning. Revision in pain 2021; 28(1): 1-53.
  7. Möhrle D, Hofmeier B, Amend M, Wolpert S, Ni K, Bing D, et al. Enhanced central neural gain compensates acoustic trauma-induced cochlear impairment, but unlikely correlates with tinnitus and hyperacusis. Neuroscience 2019; 407(1): 146-69.
  8. Kouvelis G, Kangas M. Evaluating the association between interpersonal trauma and self-identity: A systematic review. Traumatology 2021; 27(2): 118-48.
  9. Rosen AL, Handley ED, Cicchetti D, Rogosch FA, Handley ED, Cicchetti D. The impact of patterns of trauma exposure among low income children with and without histories of child maltreatment. Child Abuse Negl 2018; 80(1): 301-11.
  10. Dorri Mashhadi N, Shirkhani M, Mahdavian M, Mahmoudi S. Predicting the severity of obsessive-compulsive syndrome based on perceived parenting style: The mediating role of obsessive beliefs. Journal of fundamentals of mental health 2022; 24(1): 29-37.
  11. Young JC, Widom CS. Long-term effects of child abuse and neglect on emotion processing in adulthood. Child Abuse Negl 2014; 38(8): 1369-81.
  12. Lähdepuro A, Savolainen K, Lahti-Pulkkinen M, Eriksson JG, Lahti J, Tuovinen S, et al. The impact of early life stress on anxiety symptoms in late adulthood. Sci Rep 2019; 19(1): 1-19.
  13. Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci 2022; 22(1): 327-35.
  14. Kesebir P. A quiet ego quiets death anxiety: Humility as an existential anxiety buffer. J Pers Soc Psychol 2014; 106(4): 610-23.
  15. Asghari Ebrahim Abad MJ, Shirkhani M, Mazloomzadeh M, Maghsoudi S, Salayani F, Mazloomzadeh M. Relationship between fear of coronavirus and death anxiety: Mediating role of behavioral inhibition system. Journal of fundamentals of mental health 2021; 23(3): 171-80.
  16. Pinciotti C, Riemann B, Wetterneck C. Trauma type and obsessive-compulsive symptom domains: The unique relationship between indirectly experienced trauma and just right symptoms. J Obsessive Compuls Relat Disord 2021; 29(1): 106-24.
  17. Şar V, Türk T, Öztürk E. Fear of happiness among college students: The role of gender, childhood psychological trauma, and dissociation. Indian J Psychiatry 2019; 61(4): 389-94.
  18. Shirkhani M, Aghamohammadian Sharbaf H, Moeenizadeh M. [Predicting the severity of obsessive-compulsive symptoms based on traumatic childhood experiences: The mediating role of shame]. Rooyesh-e-Ravanshenasi journal 2022; 11(4): 39-48. (Persian)
  19. Malinauskaite I, Slapikas R, Courvoisier D, Mach F, Gencer B, Courvoisier D, et al. The fear of dying and occurrence of posttraumatic stress symptoms after an acute coronary syndrome: A prospective observational study. J Health Psychol 2017; 22(2): 208-17.
  20. Menzies RE, Zuccala M, Sharpe L, Dar-Nimrod I. Subtypes of obsessive-compulsive disorder and their relationship to death anxiety. J Obsessive Compuls Relat Disord 2020; 27(1): 157-72.
  21. Templer DI. The construction and validation of a death anxiety scale. J Gen Psychol 1970; 82(2): 165-77.
  22. Zuccala M, Menzies RE, Hunt CJ, Abbott MJ. A systematic review of the psychometric properties of death anxiety self-report measures. Death Stud 2022; 46(2): 257-79.
  23. Rajabi G, Bohrani M. [Factor analysis of death anxiety question]. Journal of psychology 2001; 20(2): 322-44. (Persian)
  24. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl 2003; 27(2): 169-90.
  25. Ebrahimi H, Dejkam M, Seghatoleslam T. [Childhood traumas and suicide attempt in adulthood]. Iranian journal of psychiatry and clinical psychology 2014; 19(4): 275-82 (Persian)
  26. Obsessive Compulsive Cognitions Working Group. Psychometric validation of the Obsessive Beliefs Questionnaire and Interpretation of Intrusions Inventory—Part 2: Factor analysis and testing of a brief version. Behav Res Ther 2005; 43(1): 1527-42.
  27. Shams G, Karanghadiri N, Ebrahimkhani N. [Validation and reliability assessment of the Persian version of obsessive beliefs questionnaire-44]. Advances in cognitive science 2004; 6(1): 23-46. (Persian)
  28. Russell DW, Russell CA. The stress bias in mental health reporting: Death anxiety biases mental health self-assessments amongst deployed soldiers. Psychol Serv 2021; 18(2): 237.
  29. McKay MT, Cannon M, Chambers D, Conroy RM, Coughlan H, Dodd P, et al. Childhood trauma and adult mental disorder: A systematic review and meta‐analysis of longitudinal cohort studies. Acta Psychiatr Scand 2021; 143(3): 189-205.
  30. Patel S, Sayeed N, Das B. Efficacy of group based compassion focused therapy in male obsessive compulsive disorder: A pilot study. International journal of behavioral sciences 2022; 15(4): 275-81.
  31. Verin RE, Menzies RE, Menzies RG. OCD, death anxiety, and attachment: What’s love got to do with it? Behav Cogn Psychother 2022; 50(2): 131-41.
  32. Moreton SG, Burden-Hill A, Menzies RE. Reduced death anxiety and obsessive beliefs as mediators of the therapeutic effects of psychedelics on obsessive compulsive disorder symptomology. Clin Psychol 2022; 27(2): 1-16.
  33. Aghajani M, Valiee S, Tol A. [Death anxiety amongst nurses in critical care and general wards]. Iranian journal of nursing 2010; 23: 59-68. (Persian)