مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و درمان مبتنی بر ذهنی سازی بر انطباق و الگوهای ارتباطی در همسران افراد مبتلا به وسواس فکری و عملی

سلیمانی, سهیلا; خانزاده, مصطفی; انصاری شهیدی, مجتبی

doi:10.22034/api.2024.2023644.1013

مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و درمان مبتنی بر ذهنی سازی بر انطباق و الگوهای ارتباطی در همسران افراد مبتلا به وسواس فکری و عملی

نوع مقاله : مقاله پژوهشی

نویسندگان

سهیلا سلیمانی ¹

مصطفی خانزاده ²

مجتبی انصاری شهیدی ¹

¹ گروه روانشناسی، دانشکده علوم انسانی، دانشگاه آزاد اسلامی، نجف آباد، ایران.

² گروه روانشناسی، موسسه آموزش عالی علامه فیض الاسلام، خمینی شهر، ایران.

10.22034/api.2024.2023644.1013

چکیده

وسواس اختلالی است مزمن و ناتوانگر که با پیدایش افکار و رفتارهای تکراری و پایدار همراه با اضطراب شناخته می شود. بنابر نقش خانواده در روند وسواس در افراد خانواده، هدف از این پژوهش مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و درمان مبتنی بر ذهنی سازی بر انطباق و الگوهای ارتباطی در همسران افراد وسواسی بود. روش پژوهش نیمه آزمایشی و دو مرحله ای (پیش آزمون . پس آزمون) در سه گروه آزمایش (گروه پذیرش و تعهد . گروه ذهنی سازی . گروه گواه) بود. نمونه های پژوهشی 45 نفر از همسران افراد دارای اختلال وسواس بود که در سه گروه 15 نفره آزمایشی قرار گرفتند. نتایج نشان داد نمرات الگوهای ارتباطی در پس آزمون گروه ذهنی سازی از گروه پذیرش و تعهد به گونه معنادار کمتر است (05/0>P). اما میان نمرات انطباق در پس آزمون گروه پذیرش و تعهـد و گروه ذهنی سازی تفاوت معنادار نیست (05/0>P). همچنین نمرات انطباق در پس آزمون گروه پذیرش و تعهـد از گروه کنترل به طور معناداری کمتر است (05/0>P). بنابراین نمرات انطباق همسران گروه پذیرش و تعهد و گروه ذهنی سازی تفاوتی ندارد. اما اثربخشی رویکرد ذهنی سازی نسبت به رویکرد پذیرش و تعهد در الگوهای ارتباطی همسران بیشتر است

کلیدواژه‌ها

وسواس

انطباق

الگوهای ارتباطی

درمان مبتنی بر پذیرش و تعهد

درمان مبتنی بر ذهنی سازی

1. Abramowitz JS, Baucom DH, Boeding S, Wheaton MG, Pukay-Martin ND, Fabricant LE, et al. (2013). Treating obsessive-compulsive disorder in intimate relationships: A pilot study of couple based cognitive-behavior therapy. Behavior Therapy. 44(3):395–407. [PubMed: 23768667].
2. Adib Rad N, Mahdavi Hersini E, Adib Rad M, Dehshiri G. (2005). Comparison of communication beliefs of women referring to judicial and women's centers. Willing to continue living together in Tehran. 1(2) 131-138. SID. https://sid.ir/paper/453288/fa
3. Albert U, bogetto F, Maina G, Saracco P, brunatto C, Mataix-Cols D. (2010). Family accommodation in obsessive–compulsive disorder: Relation to symptom dimensions, clinical and family characteristics. Psychiatry Research179, 204-211.
4. Allen JG, Bleiberg G, Haslam-Hopwood T. (2003). Mentalization as a compass for treatment. Bulletin of the Menniger Clinic, Houston, Texas.
5. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed). Washington DC: American Psychiatric Association.
6. Amir N, Freshman M, Foa EB. (2000). Family distress and involvement in relatives of obsessive–compulsive disorder patients. Journal of Anxiety Disorders. 14:209-217. http://dx.doi.org/10.1016/S0887-6185(99)00032-8
7. Barrett-Naylor R, Gresswell DM, Dawson DL. (2018). Effectiveness and acceptability of a guided self-help Acceptance and Commitment Therapy (ACT) intervention for psychogenic nonepileptic seizures. Epilepsy & Behavior. 88:332-340.
8. Bateman A, Fonagy P. (2004). Psychotherapy for borderline personality disorder: mentalization-based treatment. Oxford, UK: Oxford University Press.
9. Bateman A, Fonagy P. (2013). Impact of clinical severity on outcomes of mentalization-based treatment for borderline personality disorder. Br J Psychiatry. 203(3):221–7.
10. Bjorklund DF. (2000). Children’s thinking developmental function and individual differences (3th ed). Belmont, CA: Wadsworth.
11. Calvocoressi L, Lewis B, Harris M, Trufan SJ, Goodman WK, McDougle CJ, Price LH. (1995). Family accommodation in obsessive-compulsive disorder. American Journal of Psychiatry. 152:441– [PubMed: 7864273]
12. Calvocoressi L, Mazure C, Kasl S, Skolnick J, Fisk D, Vegso J, Price LH. et al. (1999). Family Accommodation of Obsessive-Compulsive Symptoms: Instrument Development and Assessment of Family Behavior. Journal of Nervous and Mental Disease. 187:636-642. http://dx.doi.org/10.1097/00005053-199910000-00008
13. Christensen A, Sullaway M. (1984), Communication Patterns Questionnaire, University of California, Los Angeles: Unpublished Manuscript.
14. Collins E, Warren C. (2022). Adaptation to mental disorders: The role of mentalization. Clinical Psychology Review, 74, 101954.
15. Cooper M. (1996). Obsessive-compulsive disorder: Effects on family members. American Journal of Orthopsychiatry. 66:296–304. doi:10.1037/h0080180
16. Crosby JM, Twohig MP. (2016). Acceptance and Commitment Therapy for Problematic Internet Pornography Use: A Randomized Trial, Behavior Therapy. (2016). 47(3):355–366.
17. Fitzpatrick MA. (2004). The family communication patterns theory: Observations on its development and application. The Journal of Family Communication, 4, 167-179.
18. Ghanbari F, Naziri G, Omidvar B. (2022). The Effectiveness of Mentalization-Based Treatment on Empathy among children with Attention Deficit-Hyperactivity Disorder. Razi J Med Sci. 29(4):125-134.
19. Gilbey D, Brealey G, Mateo‐Arriero I, Waters Z, Ansell M, Janse van Rensburg E, Woolard A. (2023). The effectiveness of a day hospital mentalization‐based therapy programme for adolescents with borderline personality traits: Findings from Touchstone—Child and Adolescent Mental Health Service. Clinical Psychology & Psychotherapy.
20. Hayden MC, Müllauer PK, Gaugeler R, Senft B, Andreas S. (2018). Improvements in mentalization predict improvements in interpersonal distress in patients with mental disorders. Journal of Clinical Psychology. 74(12):2276-86. [PMID] [PMCID]
21. Hayes SC. (2005). Get Out of Your Mind & Into Your Life: The new Acceptance and Commitment Therapy. Oakland, CA.: New Harbinger Publications
22. Hayes SC, Strosahl KD, Wilson KG. (1999). Acceptance and commitment therapy: An experiential approach to behavior change: Guilford Press.
23. Hayes SC, Masuda A, Bissett R, Luoma J, Guerrero LF. (2004). DBT, FAP, and ACT: How empirically oriented are the new behavior therapy technologies? Behavior therapy, 35, 35-54.
24. Hertzmann L, Mary T, Hewison D, Polly C, Pasco F, Dana L. (2017). Mentalization-Based Therapy for Parents in Entrenched Conflict: A Random Allocation Feasibility Study. Running head: MENTALIZATION-BASED THERAPY, PARENTS IN ENTRENCHED CONFLICT.
25. Heidariyan A, Asadpour A, Mohsenzadeh F, Zahrakar k. (2020). Effect of group intervention based on acceptance and commitment therapy on quality of life and communication patterns in patients with breast cancer and their spouses. 13(1):25-34.
26. Jeims M, Savery L. New self. Circle Publication. (2006).
27. Kalleklev J, Karterud S. (2018). A comparative study of mentalization-based versus psychodynamic group therapy. Group Analysis. 51(1):44–60.
28. Kaplan M, Maddux JE. (2002). Goals and marital satisfaction: Perceived support for personal goals and collective efficacy for collective goals. 21(2):157-64.
29. Karimi F, Farahbakhsh K, Salimi Bajestani H, Moatamedi A. (2020). The Effectiveness of Mentalization Based Therapy (MBT-A) on Increasing the Quality of Family Relationships and Reducing Self harm in Teenage Girls. JOURNAL OF SABZEVAR UNIVERSITY OF MEDICAL SCIENCES, 27(2), 265-257. SID. https://sid.ir/paper/376560/en
30. Lance M, Mc Cracken L, Sato A, Taylor G. (2013). A Trial of a Brief Group-Based Form of Acceptance and Commitment Therapy (ACT) for Chronic Pain in General Practice: Pilot Outcome and Process Results, The Journal of Pain, Vol 14, No 11 (November): 1398-1406.
31. Larmar S, Wiatrowski S, Lewis-Driver S. (2014). Acceptance & Commitment Therapy: An Overview of Techniques and Applications. JSSM 7(03):216-21.
32. Mc Cann D. (2022). Thinking under fire: Mentalization-based couple therapy for high conflict and domestically abusive couples, J Clin Psychol;78(1), 67-79
33. Moosavi F. Investigating the predictors of marital interaction components and confict resolution styles. Biannual journal of applied counseling. (2016). 7(1):81-100. [Persian]
34. Mousavi M, Bakhshipour A, Mahdian H. (2023). Comparing the Effectiveness of Acceptance and Commitment Therapy and Compassion-Focused Therapy and Compassion-Enriched Acceptance and Commitment Therapy on Communication Patterns of Married Women Suffering from Depression and Marital Conflicts. JOURNAL OF HEALTH PROMOTION MANAGEMENT (JHPM), 12(1), 95-112. SID. https://sid.ir/paper/1094998/en
35. Oliveira CD, Rahioui H, Smadja M, Gorsane MA, Louppe F. (2017). Mentalization based treatment and borderline personality disorder. Encephale. 43(4):340-5.
36. Peterson BD, Eifert GH, Feingold T, Davidson S. (2009). Using acceptance and commitment therapy to treat distressed couples: a case study with two couples. Cognitive Behavior Practical. 16(4):430-42.
37. Pleger M, Treppner K, Diefenbacher A, Schade C, Dambacher C, Fydrich T. (2018). Effectiveness of Acceptance and Commitment Therapy compared to CBT+: Preliminary results. The European Journal of Psychiatry. 32(4):166-173.
38. Piacentini J, Bergman RL, Jacobs C, Mc Cracken JT, Kretchman J. (2002). Open Trial of Cognitive Behavior Therapy for Childhood Obsessive – Compulsive Disorder. Journal of Anxiety Disorders. 16:207–219.
39. Pinto A, Van Noppen B, Calvocoressi L. (2012). Development and preliminary psychometric evaluation of a self-rated version of the Family Accommodation Scale for Obsessive-Compulsive Disorder. Journal of Obsessive-Compulsive and Related Disorders.
40. Salarifar M, Dasht Bozorgi Z, Jadidi M. (2022). Comparing the Effectiveness of Imagotherapy Psychological Training and Acceptance and Commitment Therapy on Improving the Communication Patterns of Couples Seeking Divorce. Rooyesh. 11(8): 79-90
41. Seyd Mohamadi R, Abdi M. Yasbolaghi M. (2022). Investigating the effectiveness of therapy based on acceptance and commitment on adaptability and family solidarity in incompatible couples. Iranian Journal of Psychiatry. 14(2). 1-15.
42. Sharp C. (2014). The social-cognitive basis of BPD: A theory of hyper mentalizing. In C. Sharp & JL. Tackett (Eds.), Handbook of borderline personality disorder in children and adolescents. New York, NY: Springer.
43. Steketee G. (1997). Disability and Family Burden in Obsessive-Compulsive Disorder. Canadian Journal of Psychiatry. 42:919-928.
44. Stengler-Wenzke K, Trosbach J, Dietrich S, Angermeyer MC. (2004). Experience of Stigmatization by Relatives of Patients with Obsessive Compulsive Disorder. Archives of Psychiatric Nursing, 18, 88-96. http://dx.doi.org/10.1016/j.apnu.2004.03.004
45. Thompson-Hollands J, Edson A, Tompson MC, Comer JS. (2014). Family involvement in the psychological treatment of obsessive compulsive disorder: A meta-analysis. J Fam Psychol. June. 28(3):287–298. http://dx.doi.org/10.1037/a0036709
46. Twohig MP, Abramowitz JS, Smith BM, Fabricant LE, Jacoby RJ, Morrison KL, et al. (2018). Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial. Behaviour Research and Therapy, 108: 1-9.
47. Van Noppen B, Rasmussen SA, Eisen J, Mc Cartney L. (1991). A multifamily group approach as an adjunct to treatment of obsessive compulsive disorder. In Pato MT, Zohar J (Eds) Current Treatments of Obsessive Compulsive Disorder. American Psychiatric Press, Washington, DC. pp:115-134.