نوع مقاله : مقاله پژوهشی

نویسندگان

• مونا ایسوند ¹
• حسین بقولی ²
• حجت اله جاویدی ²
• مجید برزگر ³

¹ دانشجوی دکتری تخصصی روانشناسی، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران.

² استادیار، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران.

³ استادیار گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران.

چکیده

افسردگی، یکی از اختلالات شایع ناتوان ساز و عود کننده روانی است، که تغییرات آشکاری را در انواع عملکردهای زیستی، شناختی، عصبی و عاطفی افراد مبتلا برجای می‌گذارد. هدف پژوهش مقایسه اثربخشی درمان شناختی رفتاری با درمان مبتنی بر پذیرش و تعهد بر نشخوار فکری، انعطاف پذیری شناختی، تاب آوری و استرس ادراک شده در زنان مبتلا به اختلال افسردگی شهرستان اندیمشک بود. جامعه آماری، شامل کلیه زنان مراجعه کننده به کلینیک‌های روان پزشکی بود. 45 نفر از بیماران به صورت گمارش تصادفی در سه گروه (دو گروه آزمایش و یک گروه کنترل) کاربندی گردیدند. سنجش متغیرهای پژوهش به کمک پرسشنامه نشخوار فکری نولن هوکسما و مارو(1991)، انعطاف‌پذیری شناختی دنیس و واندروال(2010)، تاب‌آوری کانر و دیویدسون (2003) و پرسشنامه استرس ادراک شده کوهن و همکاران (1983)، صورت گرفت. در تجزیه و تحلیل از آزمون تحلیل کوواریانس، واریانس دوطرفه، اندازه‌گیری مکرر و آزمون بن فرونی استفاده شد. نتایج نشان دادند بین اثربخشی پذیرش و تعهد با روش شناختی رفتاری بر نشخوار فکری، تفاوت معناداری وجود دارد. در اثربخشی دو روش بر انعطاف پذیری شناختی و استرس ادارک شده تفاوتی دیده نشد. هیچ‌کدام از درمان‌ها بر تاب آوری مؤثر نبود. هر دو رویکرد شناختی رفتاری و پذیرش و تعهد می‌توانند به عنوان روش‌های کارآمدی جهت کاهش علائم و نشانه‌های افسردگی به کار گرفته شوند اما لازم است تفاوت اثربخشی هر دو روش در متغیرهای مربوط به افسردگی در گروه‌های مختلف نیز مقایسه و ارزیابی گردد.

کلیدواژه‌ها

• افسردگی
• استرس ادراک شده
• انعطاف پذیری شناختی
• تاب آوری
• شناختی رفتاری

عنوان مقاله [English]

Comparing the effectiveness of cognitive behavioral therapy and acceptance and commitment therapy for rumination, psychological flexibility, resilience, and perceived stress among the women suffering from depression

نویسندگان [English]

• Mona Isvand ¹
• Hosein Baghouli ²
• Hojjat Allah Javidi ²
• Majid Barzegar ³

¹ PhD. student, Department of Psychology, Marvdasht branch, Islamic Azad University, Marvdasht, Iran.

² 3- Assistant Professor, Department of Psychology, Marvdasht branch, Islamic Azad University, Marvdasht, Iran.

³ 4- Assistant Professor, Department of Psychology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran.

چکیده [English]

Depression is one of the common disabling and recurring psychological disorders that causes obvious changes in the individual’s different biological, cognitive, nervous and emotional functions .The aim of the present study was to compare effectiveness of cognitive behavioral therapy and acceptance and commitment therapy for rumination, cognitive flexibility, resilience and perceived stress among the women suffering from depression in Andimeshk city. Depression is also considered as the second most common cognitive disorder and therefore it has attracted the attention of many researchers around the world. Among the existing physical and mental diseases, depression is considered one of the most important global issues and problems, which according to the definition of the World Health Organization is the most important mood disorders that include loss of interest, feelings of guilt and worthlessness, sleep and appetite disorders, It is accompanied by a decrease in energy, poor concentration, and a decrease in the patient's mood. Depression is also a common, costly and debilitating disease that imposes a heavy burden on global societies.

Method
The statistical population included all women referred to psychiatric clinics. 45 patients were randomly assigned into three groups (two experimental groups and one control group). Measuring research variables with the help of Nolen-Hoeksema and Morrow’s rumination questionnaire (1991), Dennis and Vanderwaal's (2010) cognitive flexibility, Connor and Davidson's (2003) resilience, and Cohen et al.'s (1983) perceived stress questionnaire were used. At first, after obtaining the necessary permits and coordination with the psychiatric clinics of the city, all women referred to the psychiatric clinics who were suspected of symptoms of depression were screened by a psychiatrist. The initial diagnosis was made by a psychiatrist, and then, to make the diagnosis more certain, the clinical interview of SKID 5 was conducted by the researcher. According to the criteria for entering the research, 30 patients who were willing to cooperate in the research were randomly assigned into two groups (an experimental group of 15 people each and a control group of 15 people).

Results
Analysis was done using analysis of covariance, two-way variance analysis and repeated measures and Ben Ferroni’s follow up test. The results indicated that there was a significant difference between effectiveness of acceptance and commitment therapy compared to cognitive behavioral therapy for rumination; No difference was observed in the effectiveness of the two approaches for cognitive flexibility and perceived stress. The results of the present study indicated that there was no significant difference in the effectiveness of both treatment methods on the three variables of cognitive flexibility, resilience and perceived stress. There was a difference between the two treatments only in the variable of rumination, so that the effectiveness of the treatment based on acceptance and commitment was confirmed. Regarding cognitive behavioral therapy, no evidence was found to confirm its effectiveness.

Discussion
Both approaches can be considered as effective methods for reduction of the symptoms of depression; however it is necessary to evaluate and compare effectiveness of the two methods for depression related variables in different groups as well.

کلیدواژه‌ها [English]

• depression
• perceived stress
• cognitive flexibility
• resilience
• cognitive behavioral therapy