نوع مقاله : مقاله پژوهشی
نویسندگان
1 دانشجوی دکتری مشاوره، واحد علوم و تحقیقات خوزستان، دانشگاه آزاد اسلامی، اهواز، ایران
2 استادیار، گروه مشاوره، واحد اهواز، دانشگاه آزاد اسلامی، اهواز، ایران
3 استادیار، گروه روانشناسی، واحد دزفول، دانشگاه آزاد اسلامی دزفول، ایران
4 استاد، مرکز تحقیقات یائسگی، دانشگاه جندی شاپور اهواز، اهواز، ایران
چکیده
زمینه و هدف: هدف پژوهش حاضر اثربخشی درمان مبتنی بر پذیرش و تعهد (ACT) بر تنظیم هیجان، تحمل پریشانی و انعطافپذیری روانی زنان مبتلا به میگرن بود. طرح پژوهش حاضر نیمهآزمایشی و از نوع پیشآزمون-پسآزمون-پیگیری با گروه کنترل بود. این کارآزمایی بالینی بر روی زنان مراجعهکننده 50-20 ساله مبتلا به بیماری میگرن مراجعهکننده به مراکز درمان دولتی و خصوصی شهر اهواز در سال 1401 بود (100N=)..
مواد و روشها: با استفاده از فرمول نمونهگیری کوکران تعداد 72 نفر بهعنوان حجم نمونه انتخاب و بهصورت تصادفی در دو گروه درمان مبتنی بر پذیرش و تعهد و گروه کنترل (هر گروه 36 نفر) جایگزین شدند. ابزارهای پژوهش مقیاس تنظیم شناختی هیجان گارنفسکی و همکاران (2002)، پرسشنامه انعطافپذیری روانشناختی دنیس و وندروال (2011) و مقیاس تحمل پریشانی سیمون و گاهر (2005) بود. دادهها با استفاده از تحلیل کواریانس تجزیه و تحلیل شدند.
یافتهها: نتایج نشان داد که رویکرد مبتنی بر درمان پذیرش و تعهد باعث بهبود تنظیم منفی هیجانی، افزایش تحمل پریشانی و انعطافپذیری روانی زنان مبتلا به سردرد میگرن شد (05/0< P). همچنین نتایج مرحله پیگیری نشان داد که اثربخشی درمان مبتنی بر پذیرش و تعهد در افزایش تنظیم منفی هیجانی، تحمل پریشانی و انعطافپذیری روانی زنان مبتلا به میگرن پایدار بوده است.
نتیجهگیری: نتایج بر اهمیت کاربرد درمان پذیرش و تعهد در بهبود وضعیت تنظیم منفی هیجانی، تحمل پریشانی و انعطافپذیری روانی زنان دارای سردرد میگرن تأکید دارد.
تازه های تحقیق
https://www.ncbi.nlm.nih.gov/sites/myncbi/farima.foroughi.1/collections/64248403/public/
https://scholar.google.com/citations?hl=fa&user=_DH8tKgAAAAJ
https://www.ncbi.nlm.nih.gov/sites/myncbi/maryam.gholamzadeh%20jofreh.1/collections/64257792/public/
https://scholar.google.com/citations?hl=fa&user=oMwUDJsAAAAJ
https://www.ncbi.nlm.nih.gov/sites/myncbi/1t1gkublfwmIux/collections/64251814/public/
https://scholar.google.com/citations?hl=fa&user=fKNHZcYAAAAJ
https://www.ncbi.nlm.nih.gov/myncbi/parvin.abedi.1/bibliography/public/
کلیدواژهها
موضوعات
عنوان مقاله [English]
Effectiveness of Acceptance and Commitment Therapy (ACT) on Negative Negative Emotion Regulation, Distress Tolerance and Psychological Resilience in Women with Migraine
نویسندگان [English]
- Farima Foroughi 1
- Maryam Gholamzadeh Jofreh 2
- Kobra Kazemian Moghadam 3
- Parvin Abedi 4
1 PhD student in Counseling, Khuzestan Science and Research Unit, Islamic Azad University, Ahvaz, Iran
2 Assistant Professor, Department of Counseling, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
3 Assistant Professor, Department of Psychology, Dezful Branch, Islamic Azad University, Dezful, Iran
4 Full Professor, Menopause Research Center, Jundishapur University, Ahvaz, Iran
چکیده [English]
Introduction: The aim of the present study was to the effectiveness of acceptance and commitment therapy (ACT) on negative emotion regulation, distress tolerance, and psychological flexibility of women with migraine.
Materials and Methods: The current research design was semi-experimental and pre-test-post-test-follow-up with a control group. This clinical trial was conducted on women aged 20-50 with migraine who were referred to public and private treatment centers in Ahvaz in 2022 (N=100). Using the sampling formula, 72 people were selected as the sample size and were randomly replaced into two treatment groups based on acceptance and commitment and the control group (36 people in each group). The present study was one-way blind so that the data analyst knew how to allocate the studied groups. The research tools were Garneffsky et al.'s Cognitive Emotion Regulation Questionnaire (2002), Dennis and Vanderwaal's Cognitive Flexibility Inventory (2011), and Simon and Gaher's Distress Tolerance Questionnaire (2005). Data were analyzed using analysis of covariance.
Results: The findings showed that the approach based on acceptance and commitment treatment increased emotional regulation, distress tolerance, and psychological flexibility of women with migraine (P< 0.05). Also, the results of the follow-up phase showed that the effectiveness of acceptance and commitment therapy in increasing emotional regulation, distress tolerance, and psychological flexibility of women with migraine was stable.
Conclusion: The results emphasize the importance of using acceptance and commitment therapy in improving the emotional regulation, distress tolerance, and psychological flexibility of women with migraine headaches.
کلیدواژهها [English]
- treatment based on acceptance and commitment
- emotional regulation
- distress tolerance
- psychological flexibility
- pain
- migraine
- Herpertz SC, Herzog W, Taubner S. Prevention of mental and psychosomatic disorders in occupational and training settings. Mental Health & Prevention. 2016; 1(4):1-2. https://doi.org/10.1016/j.mhp.2016.02.004
- [2]. Baldacci F, Lucchesi C, Cafalli M, Poletti M, Ulivi M, Vedovello M, et al. Migraine features in migraineurs with and without anxiety–depression symptoms: A hospital-based study. Clinical Neurology and Neurosurgery. 2015; 132: 74-8. https://doi.org/10.1016/j.clineuro.2015.02.017
- [3]. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. 2018; 38(1):1-211. https://doi.org/10.1177/0333102417738202
- [4]. Radat F. Stress at migraine. Revue neurologique. 2013; 169(5):406-12. https://doi.org/10.1016/j.neurol.2012.11.008
- [5] Edwards RR. Individual differences in endogenous pain modulation as a risk factor for chronic pain. Neurology. 2005;65(3):437-43. https://doi.org/10.1212/01.wnl.0000171862.17301.84.
- [6] D'Antona L, Matharu M. Identifying and managing refractory migraine: barriers and opportunities? J Headache Pain. 2019 Aug 23;20(1):89. https://doi.org/10.1186/s10194-019-1040-x.
- [7] Park JW, Cho SJ, Park SG, Chu MK. Circadian variations in the clinical presentation of headaches among migraineurs: A study using a smartphone headache diary. Chronobiol Int. 2018; 35(4):546-554. https://doi.org/10.1080/07420528.2017.1420076.
- [8] Roth RS, Geisser ME, Theisen-Goodvich M, Dixon PJ. Cognitive complaints are associated with depression, fatigue, female sex, and pain catastrophizing in patients with chronic pain. Arch Phys Med Rehabil. 2005; 86(6):1147-54. https://doi.org/10.1016/j.apmr.2004.10.041.
- [9] Park JW, Chu MK, Kim JM, Park SG, Cho SJ. Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications. PLoS One. 2016 Feb 22;11(2):e0149577. https://doi.org/10.1371/journal.pone.0149577.
- [10] Kim S, Bae DW, Park SG, Park JW. The impact of Pain-related emotions on migraine. Sci Rep. 2021; 11(1):577. https://doi.org/ 10.1038/s41598-020-80094-7.
- [11]. Rhudy JL, Williams AE, McCabe KM, Nguyen MA, Rambo P. Affective modulation of nociception at spinal and supraspinal levels. Psychophysiology. 2005;42(5):579-87. https://doi.org/10.1111/j.1469-8986.2005.00313.x.
- [12]. Cao M, Zhang S, Wang K, Wang Y, Wang W. Personality traits in migraine and tension-type headaches: A five-factor model Study. Psychopathology. 2002; 35(4):254-8. https://doi.org/10.1159/000063829
- [13]. Garnefski N, Kraaij, V. Relationships between cognitive emotion regulation strategies and depressive symptoms: A comparative study of five specific samples. Personality and Individual differences. 2006; 40(8):1659-69. https://doi.org/10.1016/j.paid.2005.12.009
- [14]. Hamilton NA, Karoly P, Kitzman H. Self-regulation and chronic pain: The role of emotion. Cognit Ther Res. 2004; 28(5):559–76. https://doi.org/10.1023/B:COTR.0000045565.88145.76
- [15]. Seshia SS. Chronic daily headache in children and adolescents. Curr Pain Headache Rep. 2012; 16(1):60–72. https://doi.org/10.1007/s11916-011-0228-9
- [16]. Bener A, Verjee M, Dafeeah EE, Falah O, Al-Juhaishi T, Schlogl J, Sedeeq A, Khan S. Psychological factors: Anxiety, depression, and somatization symptoms in low back pain patients. J Pain Res. 2013; 6:95-101. https://doi.org/10.2147/JPR.S40740
- [17]. Lumley MA, Cohen JL, Borszcz GS, Cano A, Radcliffe AM, Porter LS, Schubiner H, Keefe FJ. Pain and emotion: A biopsychosocial review of recent research. J Clin Psychol. 2011; 67(9):942–68. https://doi.org/10.1016/j.pain.2011.01.003
- [18]. Nester MS, Brand BL, Schielke HJ, Kumar S. An xamination of the relations between emotion dysregulation, dissociation, and self-injury among dissociative disorder patients. European Journal of Psychotraumatology. 2022; 13(1):2031592. https://doi.org/10.1080/20008198.2022.2031592
- [19]. Toubaei S, Farrashbandi H. Assessment of personality characteristics in migraine patients. Studies in Medical Sciences. 2010; 21(2):280-5. http://umj.umsu.ac.ir/article-1-691-fa.html
- [20]. Arabi E, Bagheri M. The mediating role of emotion regulation strategies on the relationship between pain intensity and quality of life in patients with chronic pain disorder. Health Psychology. 2017; 6(22):72-87. Dor:20.1001.1.23221283.1396.6.22.5
- [21]. Khalili Sefat M, Omidi A, Zanjani Z, Daneshvar Kakhaki R. The comparison of quality of life, emotion regulation and distress tolerance of people with and without migraine. Journal of Research in Behavioral Sciences. 2019; 17(3):483-94. https://doi.org/10.52547/rbs.17.3.483
- [22]. Seng KE. Using cognitive behavioral therapy techniques to treat migraine. Journal of Health Service Psychology. 2018; 44: 68-73. https://doi.org/10.1007/BF03544665
- [23]. Khorshidi Nazlou L, Etemadinya M, Chalabianloo G, Khademi A, Khalilzadeh R. The effectiveness of transdiagnostic treatment on pain anxiety, distress intolerance and sleep disorders in psychosomatic patients who suffer from migraine. Shenakht Journal of Psychology and Psychiatry 2022; 9(4) :67-81. 10.32598/shenakht.9.4.67
- [24]. Payne LA, Ellard KK, Farchione TJ, Fairholme CP, Barlow DH. Emotional disorders: A unified transdiagnostic protocol. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual. New York City: The Guilford Press: 2014. https://psycnet.apa.org/record/2014-05860-008
- [25]. Bernstein A, Zvolensky MJ, Vujanovic AA, Moos, R. Integrating anxiety sensitivity, distress tolerance, and discomfort intolerance: A hierarchical model of affect sensitivity and tolerance. Behavior Therapy. 2009; 40(3):291-301. https://doi.org/10.1016/j.beth.2008.08.001
- [26]. Keough ME, Riccardi CJ, Timpano KR, Mitchell MA, Schmidt NB. Anxiety Symptomatology: The association with distress tolerance and anxiety sensitivity. Behavior Therapy. 2010; 41(4):567–74. https://doi.org/10.1016/j.beth.2010.04.002
- [27]. Dindo L, Brandt CP, Fiedorowicz, JG. Cross-sectional relations between psychological inflexibility and symptoms of depression and anxiety among adults reporting migraines or risk factors for cardiovascular disease. Journal of Contextual Behavioral Science. 2019; 13: 1–6. https://doi.org/10.1016/j.jcbs.2019.06.001
- [28]. Gabrys RL, Tabri N, Anisman H, Matheson K. Cognitive control and flexibility in the context of stress and depressive symptoms: The cognitive control and flexibility questionnaire. Front Psychol. 2018; 9: 2219. https://doi.org/10.3389/fpsyg.2018.02219
- [29]. Masuda A, Tully EC. The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a nonclinical college sample. Journal of Evidence-Based Complementary & Alternative Medicine. 2012; 17(1):66-71. https://doi.org/10.1177/2156587211423400
- [30]. Bakhshandeh Larimi N, Zebardast A, Rezaei S. The effectiveness of acceptance and commitment therapy on cognitive flexibility, rumination, and distress tolerance in persons with Migraine headache. Shenakht Journal of Psychology and Psychiatry. 2021; 8(2):74-87. https://doi.org/10.32598/shenakht.8.2.74
- [31]. Rouhi M, Manzari Tavakoli A, Tajrobehkar M. Comparing the effectiveness of acceptance and commitment therapy and dialectical behavioral therapy on coherent self knowledge, emotional regulation and life quality of hemodialysis patients. Shenakht Journal of Psychology and Psychiatry. 2023; 10(2):131-46. https://doi.org/10.32598/shenakht.10.2.131
- [32]. Rao Q, Zeng J, Wang S, Hao J, Jiang M. Chronic pain and quality of life in maintenance hemodialysis patients in China: A multicenter, cross-sectional study. Journal of Pain Research. 2022; 15:147-57. https://doi.org/10.2147/JPR.S345610
- [33]. Coto-Lesmes R, Fernández-Rodríguez C, González-Fernández S. Acceptance and Commitment Therapy in group format for anxiety and depression. A systematic review. J Affect Disord. 2020; 263:107-20. https://doi.org/10.1016/j.jad.2019.11.154.
- [34]. Mousavi S M, Khajevand Khoshli A, Asadi J, Abdollahzadeh H. Comparison of the effectiveness of compassion-focused therapy and acceptance and commitment therapy on distress tolerance in women with systemic lupus erythematosus. J Psychological Science. 2021; 20(99), 453-60. 20.1001.1.17357462.1400.20.99.8.9
- [35]. Ghezelseflo M, nejatifar S, aghaziarati A. The efficacy of unified transdiagnostic treatment on distress tolerance and emotion regulation of students with internalized behavioral problems. J Psychol Sci. 2022; 21(111): 525-42. doi:10.52547/JPS.21.111.525
- [36]. Rostampour Brenjestanaki M, Abbasi G, Mirzaian B. Effectiveness of compassion-focused therapy on psychological flexibility recovery and self-criticism decrease in mothers with mentally retarded children. Biannual J Applied Counsel. 2020; 10(2):1-18. https://doi.org/ 10.22055/jac.2020.33836.1749
- [37]. Tilaki M, Taher M, Mojarrad A, Jafari Sani, B. Efficacy of acceptance and commitment therapy on psychological flexibility and alexithymia of women with chronic pain. J Psychological Studies. 2018; 14(3):163-78. https://doi.org/10.22051/psy.2018.15798.1433
- [38]. Gooding H, Stedmon J, Crix D. 'All these things don't take the pain away but they do help you to accept it': making the case for compassion-focused therapy in the management of persistent pain. Br J Pain. 2020;14(1):31-41. https://doi.org/10.1177/2049463719857099.
- [39]. Lee EB, An W, Levin ME, Twohig MP. An initial meta-analysis of Acceptance and commitment therapy for treating substance use disorders. Drug Alcohol Depend. 2015; 155(4):1-7. https://doi.org/10.1016/j.drugalcdep.2015.08.004
- [40]. Gentili C, Zetterqvist V, Rickardsson J, Holmstrom L, Simons LE, Wicksell RK. ACTsmart: Guided smartphonedelivered acceptance and commitment therapy for chronic pain-a pilot trial. Pain Med. 2021; 22(2):315-28. https://doi.org/10.1093/pm/pnaa360
- [41]. Luoma JB, Vilardaga JP. Improving therapist psychological flexibility while training acceptance and commitment therapy: A pilot study. Cognitive Behaviour Therapy. 2013; 42(1):1-8. https://doi.org/10.1080/16506073.2012.701662
- [42]. Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior Therapy. 2013; 44(2):180-98. https://doi.org/10.1016/j.beth.2009.08.002
- [43]. Quinlan E, Deane FP, Crowe T. Pilot of an acceptance and commitment therapy and schema group intervention for mental health carer's interpersonal problems. Journal of Contextual Behavioral Science. 2018; 9: 53-62. https://doi.org/10.1016/j.jcbs.2018.06.006
- [44]. Hayes SC. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy. 2004; 35(4):639-65. https://doi.org/10.1016/S0005-7894(04)80013-3
- [45]. Zhang CQ, Leeming E, Smith P, Chung PK, Hagger, MS, Hayes SC. Acceptance and commitment therapy for health behavior change: A contextually-driven approach. Frontiers in Psychology. 2018; 8: 2350. https://doi.org/10.3389/fpsyg.2017.02350
- [46]. Smout MF, Longo M, Harrison S, Minniti R, Wickes W, White JM. Psychosocial treatment for methamphetamine use disorders: A preliminary randomized controlled trial of cognitive behavior therapy and acceptance and commitment therapy. Substance Abuse. 2010; 312(2):98-107. https://doi.org/10.1080/08897071003641578
- [47]. Gharaei Ardakani Sh, Azadfalah P, Tolai SA. The effectiveness of the acceptance and commitment therapy approach in reducing the intensity of pain experience in women with chronic headache disorder (Scientific article of the Ministry of Science). Clinical psychology. 2013; 4(2):39-50. https://jcp.semnan.ac.ir