اثربخشي درمان مديريت استرس به‌ شيوۀ شناختي- رفتاري بر علائم سندرم پيش از قاعدگي و ناگويي خلقي- هيجاني در دانشجويان

Cognitive-Behavioral Stress Management Therapy on Premenstrual Syndrome Symptoms and Alexithymia in Students

زمينه و هدف: به‌ دليل مواجههٔ افراد داراي سندرم پيش از قاعدگي با مشكلات متعدد روان‌شناختي و جسمي، هدف از انجام اين پژوهش بررسي اثربخشي درمان مديريت استرس به‌شيوۀ شناختي-رفتاري بر علائم سندرم پيش از قاعدگي و ناگويي خلقي-هيجاني بود. روش‌بررسي: پژوهش حاضر آزمايشي از نوع نيمه‌تجربي، به‌صورت پيش‌آزمون و پس‌آزمون و پيگيري يك‌ماهه بود. جامعۀ آماري را تمامي دانشجويان ساكن در خوابگاه ايران‌زمين شهر زاهدان در سال 1396 تشكيل دادند. بدين‌منظور 83 نفر به‌روش نمونه‌گيري هدف‌مند انتخاب شدند. سپس 26 نفر كه نمرهٔ بيشتري را در پرسش‌نامۀ سنجش علائم سندرم پيش از قاعدگي و ناگويي خلقي-هيجاني كسب كردند، به‌صورت تصادفي در دو گروه يكسان آزمايش و گواه جايگزين شدند. گروه آزمايشي به‌مدت ده جلسهٔ 120تا150دقيقه‌اي تحت درمان مديريت استرس به‌شيوۀ شناختي-رفتاري قرار گرفت؛ اما گروه گواه هيچ‌مداخله‌اي دريافت نكرد. براي جمع‌آوري داده‌ها از پرسش‌نامۀ سنجش علائم سندرم پيش از قاعدگي دل‌آرا و ناگويي خلقي-هيجاني بگبي (TAS) استفاده شد. داده‌هاي به‌دست‌آمده با نرم‌افزار SPSS نسخهٔ 23 و روش آماري تحليل واريانس اندازه‌گيري‌هاي مكرر و سطح معناداري (0٫05=α) بررسي شدند. يافته‌ها: يافته‌ها نشان داد كه نمرات پيش‌آزمون علائم روحي-رفتاري و جسمي سندرم پيش از قاعدگي و علائم ناگويي خلقي-هيجاني گروه آزمايش پس از آموزش مديريت استرس به‌شيوۀ شناختي-رفتاري، درمقايسه با گروه گواه به‌صورت معناداري كاهش يافته است (0٫001>p). نتيجه‌گيري: بنابر يافته‌هاي اين مطالعه، آموزش مداخلهٔ مديريت استرس به‌شيوۀ شناختي-رفتاري بر كاهش علائم روحي-رفتاري و جسمي سندرم پيش از قاعدگي و ناگويي خلقي-هيجاني دانشجويان داراي سندرم پيش از قاعدگي مؤثر واقع شده است.

Background & Objectives: Premenstrual syndrome is among the most prevalent disorders in reproductive age, which significantly disrupts women’s lives. Thus, it is necessary to explore this issue further. Females with premenstrual syndrome have to cope with numerous biopsychological; accordingly, some stress–coping approaches could improve these people’s ability to reduce stress and adapt to stressful situations. One of these approaches is Cognitive–Behavioral Stress Management (CBSM) therapy that includes cognitive–behavioral therapy, coping skills training, techniques for improving social support, and training various relaxation techniques, like meditation. Previous studies supported the effectiveness of CBSM therapy on promoting various negative psychological symptoms, such as depression, anxiety, and stress. Therefore, this study aimed to evaluate the effects of CBSM therapy on premenstrual syndrome symptoms and alexithymia. Methods: This was a quasi–experimental study with a pretest–posttest and a one–month follow–up, as well as a control group design. The study population consisted of students living in Iran Zamin females dormitory in Zahedan City, Iran, in October 2017 (N=115 people). In total, 83 subjects were selected using a targeted sampling method (based on the study inclusion criteria). The premenstrual syndrome scale was presented during two consecutive monthly cycles for diagnosis purposes; only 67 people received a diagnosis of the premenstrual syndrome. Finally, after implementing the alexithymia questionnaire as a pretest and a screening test, scores higher than the average (≥61), and examining the study inclusion criteria, 26 people were selected as the final sample. Then, they were randomly assigned to two identical groups of test and control (each including 13 people). The study inclusion criteria were obtaining average to severe levels (scores 33 to 96) on both questionnaires, having a minimum age of 18–40 years, having at least a diploma degree, not having any specific biopsychological conditions, not taking any hormonal and psychiatric drugs, having regular menstrual cycles, and providing consent forms to participate in the study. After selecting the study subjects, the study purpose was explained to them to observe ethical considerations. Besides, they were assured that the information relating to them would remain completely confidential. The experimental group received 10 sessions of the CBSM therapy with a mean time of 120–150 minutes (two sessions per week); however, the control group received no interventions. The Delara Premenstrual Syndrome Scale and the Bagby Toronto Alexithymia Scale (TAS) were used to collecting data. The obtained data were analyzed in SPSS using a repeated–measures Analysis of Variance (ANOVA) at α=0.05. Results: The mean and standard deviation age of the experimental and control groups were 26.15±5.713 and 28±6.311 years, respectively. Furthermore, 8(61.5%) subjects in the experimental group and 6 (46.2%) in the control group had undergraduate degrees, 5 (38.5%) individuals in the experimental group and 6 (46.2%) in the control group had master’s degrees, and only 1 (7.7%) person in the control group had a doctorate. The pretest scores of psycho–behavioral and physical symptoms of premenstrual syndrome and alexithymia in the experimental group significantly decreased after receiving the CBSM therapy, compared to the controls (p<0.001). Such a decrease in the mean scores of the intervention group over time indicated the effectiveness of this intervention on improving the psycho–behavioral and physical symptoms of premenstrual syndrome and alexithymia. Conclusion: The obtained data suggested the effectiveness of CBSM therapy on reducing the premenstrual syndrome symptoms and alexithymia in students. Thus, CBSM therapy is an effective intervention to reduce the biopsychological symptoms of premenstrual syndrome and alexithymia. Therefore, due to drug complications and drug dependence in these women, it is recommended that this intervention be used for people with this syndrome by referring them to counseling and psychological centers.