اثربخشی مداخله درمانی اصلاح سوگیری‌های شناختی (CBM) بر ترک سیگار

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشگاه سمنان

2 دانشگاه فردوسی مشهد

چکیده

پژوهش حاضر با هدف بررسی اثربخشی مداخله اصلاح سوگیری‌های شناختی (سوگیری توجه و گرایش به سیگار) بر کاهش وابستگی به سیگار در افراد سیگاری اجرا شد. طرح پژوهش کارآزمایی تصادفی کنترل‌شده با پیش آزمون، پس‌آزمون و پیگیری‌های یکماهه و دوماهه بود. جامعه پژوهش کلیه مردان سیگاری در تابستان سال 1395 در شهر گرگان بودند. تعداد 60 نفر افراد سیگاری واجد شرایط تعیین و به‌گونه تصادفی به گروه آزمایش و گروه کنترل گمارده شدند. پرسشنامه سنجش وابستگی به سیگار (فاگرستروم) و تکالیف سنجش شناخت‌های ناآشکار (تکلیف گرایش-اجتناب، سنجش سوگیری توجه و تکلیف تداعی ضمنی) بر روی افراد هر دو گروه اجرا شد. سپس به گروه آزمایشی تکالیف مربوط به بازآموزی شناخت‌های ناآشکار (تکلیف بازآموزی گرایش- اجتناب و اصلاح سوگیری توجه) در طی 10 جلسه آموزش داده شد، درحالیکه گروه کنترل تنها مداخله‌هایی دارونما دریافت کردند. نتایج آزمون تحلیل کوواریانس چندمتغیری تفاوت‌های معنی‌داری بین دو گروه در میانگین نمره‌های وابستگی به سیگار (فاگرستروم) و نیز تکالیف گرایش-اجتناب و سوگیری توجه در پس‌آزمون، پیگیری یکماهه و دوماهه نشان داد، اما در تداعی ناآشکار تفاوتی ایجاد نشد. مداخله درمانی اصلاح سوگیری‌های شناختی از طریق تاثیر بر اصلاح شناخت‌های ناآشکار گرایش- اجتناب و اصلاح سوگیری توجه افراد سیگاری منجر به کاهش وابستگی به سیگار در بزرگسالان سیگاری می‌گردد و می‌توان از این مداخله در برنامه‌های ترک سیگار به گونه موثر بهره جست.

کلیدواژه‌ها


American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington: American Psychiatric Association.

Ashare, R., Strasser, A. A., Wileyto, E. P., Cuevas, J., & Audrain-McGovern, J. (2014). Cognitive deficits specific to depression-prone smokers during abstinence. Experimental and clinical psychopharmachology, 22 (4), 323-331.

Attwood, A. S., Williams, T., Adams, S., McClernon, F. J., & Munafo, M. R. (2014). Effects of varenicline and cognitive bias modification on neural response to smoking-related cues: Study protocol for a randomized controlled study. Trials, 15, 391. doi: 10.1186/1745-6215-15-391

Attwood, Angela S., O'Sullivan, Hayley, Leonards, Ute, Mackintosh, Bundy, & Munafò, Marcus R. (2008). Attentional bias training and cue reactivity in cigarette smokers. Addiction, 103 (11), 1875-1882. doi: 10.1111/ j.1360-0443.2008.02335.x

Bardin, B., Perrissol, S., Py, J., Launay, C., & Escoubes, F. (2014). Personalized SC-IAT: A possible way of reducing the influence of societal views on assessments of implicit attitude toward smoking. Psychological Reports, 115 (1), 13-25.

Begh, R., Munafo, M. R., Shiffman, S., Fergusen, S. G., Nichols, L., Mohammed, M. A., … Aveyard, P. (2013). Attentional bias retraining in cigarette smokers attemting smoking cessation (ARTS): study protocol for a double blind randomiased controlled trial. BMC Public Health, 13, 1176.

Begh, R., Munafo, M. R., Shiffman, S., Ferguson, S. G., Nichols, L., Mohammed, M. A., . . . Aveyard, P. (2015). Lack of attentional retraining effects in cigarette smokers attempting cessation: a proof of concept double-blind randomised controlled trial. Drug and Alcohol Dependence, 149, 158-165.

Boutelle, Kerri N., Kuckertz, Jennie M., Carlson, Jordan, & Amir, Nader. (2014). A pilot study evaluating a one-session attention modification training to decrease overeating in obese children. Appetite, 76, 180-185. doi: http://dx.doi.org/10.1016/j.appet.2014.01.075

Christiansen, P., Schoenmakers, T. M., & Field, M. (2015). Less than meets the eye: Reappraising the clinical relevance of attentional bias in addiction. Addictive Behaviors, 44, 43-50.

Clerkin, E. M., Magee, J. C., Wells, T. T., Beard, C., & Barnett, N. P. (2016). Randomized controlled trial of attention bias modification in a racially diverse, socially anxious, alcohol dependent sample. Behaviour Research and Therapy, 87, 58-69. doi: 10.1016/j.brat.2016.08.010

Eberl, C., Wiers, R. W., Pawelczack, S., Rinck, M., Becker, E. S., & Lindenmeyer, J. (2013). Approach bias modification in alcohol dependence: do clinical effects replicate and for whom does it work best? Developmental Cognitive Neuroscience, 4, 38-51. doi: 10.1016/j.dcn. 2012.11.002

Ekpu, V. U., & Brown, A. K. (2015). The economic impact of smoking and of reducing smoking prevalence: Review of evidence. Tobacco Use Insights, 8, 1-35.

Field, M., Duka, T., Tyler, E., & Schoenmakers, T. (2009). Attentional bias modification in tobacco smokers. Nicotine & Tobacco Research, 11 (7), 812-822.

Gavrownski, B., & Payne, K. (2010). Handbook of implicit social cognition, measurement, theory and applications. New York: The Guilford Press.

Hajek, P., Stead, L. F., West, R., Jarvis, M., & Lancaster, T. (2009). Relapse prevention interventions for smoking cessation. The Cochrane Database of Systematic Reviews (8).

Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The Fagerstrom Test for Nicotine Dependence: A revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86 (9), 1119-1127.

Heydari, GhR. (2009). Good Time for Starting Smoking Cessation Programs. Pajoohandeh Journal, 14 (2), 53-57. [Persian].

Hofmann, W., Gawronski, B., Gschwendner, T., Le, H., & Schmitt, M. (2005). A meta-analysis on the correlation between the implicit association test and explicit self-report measures. Personality & Social Psychology Bulltin, 31 (10), 1369-1385. doi: 10.1177/0146167205275613

Hofmann, W., Friese, M., & Wiers, R. W. (2008). Impulsive versus reflective influences on health behavior: a theoretical framework and empirical review. Health Psychology Review, 2 (2), 111-137.

Houben, K., & Wiers, R. W. (2008). Measuring implicit alcohol associations via the Internet: Validation of Web-based implicit association tests. Behavior Research Methods, 40 (4), 1134-1143. doi: 10.3758/brm.40.4. 1134.

Hughes, J. R., & Naud, Sh. (2016). Perceived role of motivation and self-efficacy in smoking cessation: A secondary data analysis. Addictive Behaviors,61, 58-61.

Jones, A., McGrath, E., Houben, K., Nederkoorn, C., Robinson, E., & Field, M. (2014). A comparison of three types of web-based inhibition training for the reduction of alcohol consumption in problem drinkers: Study protocol. BMC Public Health, 14, 796. doi: 10.1186/1471-2458-14-796

Karami, J. (2013). The relationship between metacognitive beliefs and social acceptance with addiction potential in university students. Journal of Psychology Achievement, 19 (2), 1-14.

Lindgren, K. P., Neighbors, C., Gasser, M. L., Ramirez, J. J., & Cvencek, D. (2017). A review of implicit and explicit substance self-concept as a predictor of alcohol and tobacco use and misuse. The American Journal of Drug and Alcohol Abuse, 43 (3), 237-246.

Lopes, F. M., Pires, A. V., & Bizarro, L. (2014). Attentional bias modification in smokers trying to quit: A longitudinal study about the effects of number of sessions. Journal of Substance Abuse Treatment, 47 (1), 50-57.

Machulska, A., Zlomuzica, A., Adolph, D., Rinck, M., & Margraf, J., (2015). “A cigarette a day keeps the goodies away”: Smokers show automatic approach tendencies for smoking - but not for food-related stimuli. PLoS ONE10(2): e0116464. https://doi.org/10.1371/journal.pone.0116 464.

Machulska, A., Zlomuzica, A., Rinck, M., Assion, H. J., & Margraf, J. (2016). Approach bias modification in inpatient psychiatric smokers. Journal of Psychiatric Research, 76, 44-51.

Macy, Jonathan T., Chassin, Laurie, Presson, Clark C., & Sherman, Jeffrey W. (2015). Changing implicit attitudes toward smoking: Results from a web-based approach-avoidance practice intervention. Journal of Behavioral Medicine, 38 (1), 143-152. doi: 10.1007/s10865-014-9585-2

Mar'ashi, S. A., Mehrabian, T., & Tabibi, H. (2014). Investigating the relationship between personality characteristic (Big Five), life satisfaction, and spiritual intelligence to drug abuse potential in personel of a industerial company in Mehran city. Journal of Psychology Achievement, 21 (1), 203-222.

Robinson, M. D., Meier, B. P., Zetocha, K. J., & McCaul, K. D. (2005). Smoking and the implicit association test: When the contrast category determines the theoretical conclusions. Basic and Applied Social Psychology, 27 (3), 201-212. doi: 10.1207/s15324834 basp2703_2

Stacy, A., & Wiers, R. W. (2010). Implicit cognition and addiction: a tool for explaining paradoxical behavior. Annual Review of Clinical Psychology, 6, 551-575.

Stippekohl, B., Winkler, M., Mucha, R. F., Pauli, P., Walter, B., Vaitl, D., & Stark, R. (2010). Neural responses to BEGIN- and END-stimuli of the smoking ritual in nonsmokers, nondeprived smokers, and deprived smokers. Neuropsychopharmacology, 35 (5), 1209-1225.

Strack, F., & Deutsch, R. (2004). Reflective and impulsive determinants of social behavior. Personality and Social Psychology Review, 8 (3), 220-247.

Waters, A. J., Carter, B. L., Robinson, J. D., Wetter, D. W., Lam, C. Y., & Cinciripini, P. M. (2007). Implicit Attitudes to Smoking are Associated with Craving and Dependence. Drug and Alcohol Dependence, 91 (2-3), 178-186.

Wiers, R. W., Boelema, S. R., Nikolaou, K., & Gladwin, T. E. (2015). On the development of implicit and control processes in relation to substance use in adolescence. Current Addiction Reports, 2 (2), 141-155.

Wittekind, C. E., Feist, A., Schneider, B. C., Moritz, S., & Fritzsche, A. (2015). The approach-avoidance task as an online intervention in cigarette smoking: A pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 46, 115-120.

World-Health-Organization. (2015). Who report on the global tobacco epidemic, country profile: Iran, World Health Organization.