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اثربخشی روان درمانی پویشی فشرده کوتاه مدت بر روابط موضوعی، خشم و احساس گناه در زنان با اختلال افسردگی اساسی

نوع مقاله : مقاله پژوهشی

نویسندگان

ابوالفضل سرلکی 1
مونا فرخ زاد 2
فاطمه خان زاده 3
مهسا یونسی سینکی 4
سیده زهرا رضوی مهدییان 5
مجتبی طیارپروین 6

1 دانش آموخته کارشناسی ارشد روان‌شناسی بالینی کودک و نوجوان، گروه روان‌شناسی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه شهید بهشتی تهران، ایران.

2 دانشجوی کارشناسی ارشد روان‌شناسی بالینی، گروه روان‌شناسی، دانشکده علوم پزشکی، واحد گرمسار، دانشگاه آزاد اسلامی، ایران

3 دانش آموخته کارشناسی ارشد روان‌شناسی بالینی، گروه روان‌شناسی، دانشکده علوم انسانی، واحد تهران غرب، دانشگاه آزاد اسلامی، ایران.

4 دانشجوی کارشناسی ارشد روان‌شناسی عمومی، گروه روان‌شناسی، دانشکده علوم تربیتی و روان‌شناسی، واحد رودهن، دانشگاه آزاد اسلامی، ایران

5 دانشجوی کارشناسی ارشد روان‌شناسی عمومی، گروه روان‌شناسی، دانشکده روان‌شناسی و علوم تربیتی، دانشگاه خوارزمی تهران، ایران.

6 دانشجوی کارشناسی ارشد روان‌شناسی بالینی، گروه روان‌شناسی بالینی، دانشکده علوم رفتاری و سلامت روان (انستیتو روانپزشکی تهران)، دانشگاه علوم‌پزشکی ایران، تهران، ایران.

10.22055/psy.2024.44694.3112
چکیده
هدف پژوهش حاضر، تعیین اثربخشی روان درمانی پویشی فشرده کوتاه مدت بر روابط موضوعی، خشم و احساس گناه در زنان با اختلال افسردگی اساسی بود.پژوهش حاضر از نظر هدف در گروه پژوهش‌های کاربردی و از لحاظ روش شناسی، نیمه آزمایشی از نوع پیش آزمون–پس آزمون–پیگیری 3 ماهه و همراه با گروه گواه بود. جامعه آماری شامل تمامی زنان با اختلال افسردگی اساسی مراجعه کننده به مراکز خدمات روانشناختی شهر اصفهان در بهار سال 1402 بود. 32 زن مبتلا به اختلال افسردگی اساسی با نمونه گیری در دسترس انتخاب و به صورت تصادفی در گروه آزمایش ‌(16 نفر) و گروه گواه ‌(16 نفر) گمارده شدند. پروتکل روان درمانی پویشی کوتاه مدت فشرده، تنها برای گروه آزمایش طی 8 جلسه 90 دقیقه‌ای انجام شد و گروه گواه در لیست انتظار قرار گرفتند. آزمودنی‌ها در 3 مرحله با پرسشنامه‌های روابط موضوعی Bell ‌(BORI)، حالت-صفت بیان خشم ‌(STAXI-2)، احساس گناه Kugler and Jones ‌(KJGFQ) و نسخه دوم افسردگی Beck ‌(BDI-II) ارزیابی شدند. تجزیه و تحلیل داده‌ها با آزمون تحلیل واریانس اندازه‌گیری‌های مکرر و آزمون تعقیبی بونفرونی از طریق نرم افزار SPSS-28 انجام شد. نتایج این پژوهش نشان داد که مداخله روان پویشی فشرده کوتاه مدت بر بیگانگی، دلبستگی نا ایمن، نمره کل روابط موضوعی، بروز درونی خشم، کنترل درونی خشم، خصیصه گناه، نمره کل احساس گناه و نشانه‌های افسردگی اثربخش بود و تا 3 ماه بعد از مداخله، پایدار بود ‌(05/0>p). بنابراین، این رویکرد درمانی با ایجاد فضای امن و روابط مبتنی بر همدلی و اعتماد و ترغیب فرد در جهت لمس احساسات اصیل خود در بهبود روابط موضوعی بیماران مبتلا به افسردگی‌ مؤثر است. در رواندرمانی پویشی کوتاه مدت، درمانگر به بیمار کمک می‌کند، تا بتواند با احساس خشم نسبت به ابژه مورد علاقه خود روبرو شود و بتواند آن را دوباره احساس و درک کند و دریابد که خود او نیز آسیب دیده است و از طریق اعمال فشار در جهت حس کردن احساس گناه می‌تواند منجر به کاهش احساس گناه در بیمار و بهبود نشانه‌های افسردگی شود.

کلیدواژه‌ها

روان درمانی پویشی
روابط موضوعی
خشم
احساس گناه
افسردگی

عنوان مقاله English

Effectiveness of Intensive Short-Term Dynamic Psychotherapy on Object Relations, Anger, and Guilt in Women with Major Depressive Disorder

نویسندگان English

Abolfazl Sarlaki 1
Mona Farokhzad 2
Fatemeh Khanzadeh 3
Mahsa Younesi sinaki 4
Seyedeh Zahra Razavi Mahdiian 5
Mojtaba Tayyar Parvin 6
1  M.Sc. Graduate in Child and Adolescent Clinical Psychology, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran
2 M.A. student in clinical psychology, Department of Psychology, Faculty of Medical Sciences, Garmsar Branch, Islamic Azad University, Iran.
3 M.A. Graduate in Clinical Psychology, Department of Psychology, Faculty of Humanities, West Tehran Branch, Islamic Azad University, Iran.
4 M.A. student in General Psychology, Department of Psychology, Faculty of Educational Sciences and Psychology, Roudehen Branch, Islamic Azad University, Iran.
5 M.A. student in General Psychology, Department of Psychology, Faculty of Psychology and Educational Sciences, Kharzmi University, Tehran, Iran.
6 M.Sc. Student in Clinical Psychology, Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
چکیده English

According to the psychodynamic theory, major depressive disorder (MDD) is caused by a perceived real loss in relationships, leading to anger and guilt towards the other person. Short-term intensive dynamic psychotherapy aims to help patients bring their unconscious emotions to the conscious level, known as "Unlocking the Unconscious". This study aimed to determine the effectiveness of short-term intensive dynamic psychotherapy on objective relationships, anger, and guilt in women with MDD. Regarding the purpose, the present study was of applied type, and in terms of methodology, it was semi-experimental with pre-test - post-test - 3-month follow-up design with a control group. The statistical population consisted of all women with MDD who were referred to counseling centers and psychological services in Isfahan in the spring of 2023. A total of 32 women with MDD were selected via available sampling and randomly assigned to the experimental group (16 people) and the control group (16 people). Dovanloo's (1995) ISTDP protocol was performed only for the experimental group along 8 sessions of 90 minutes weekly, while the control group was placed on the waiting list. Subjects were evaluated in 3 stages (pre-test, post-test, and 3-month follow-up) through Bell's Object Relation Inventory (BORI), State-Trait Anger Expression Inventory 2 (STAXI-2), kugler and Jones Guilty Feelings ‘S Questionnaire (KJGFQ), and Beck Depression Inventory-II (BDI-II). Data analysis was undertaken via repeated measures analysis of variance and the Bonferroni post hoc test using SPSS-28 software. According to the results, ISTDP was effective on alienation, insecure attachment, the total score of subjective relationships, internal occurrence of anger, internal control of anger, trait guilt, as well as the total score of guilt and depression symptoms, and up to 3 months after the intervention was stable (p>0/05). ISTDP had the greatest impact on depression symptoms (ηp2=0.543), anger internalization ‌(ηp2=0.436), and anger internal control (ηp2=0.412). ISTDP enables patients with depression to access and re-experience repressed anger toward attachment figures. Through this process, along with therapeutic pressure to confront guilt, patients can amend their object relations, reduce guilt, and alleviate depressive symptoms.

کلیدواژه‌ها English

dynamic psychotherapy
object relations
anger
feel guilty
depression
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  • تاریخ دریافت 14 شهریور 1402
  • تاریخ بازنگری 26 خرداد 1405
  • تاریخ پذیرش 02 بهمن 1402

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