پديد آورندگان :
جمشيدي، صفورا دانشگاه فردوسي مشهد، مشهد، ايران , اصغري ابراهيم آباد، محمدجواد دانشگاه فردوسي مشهد، مشهد، ايران , رسول زاده طباطبايي، كاظم دانشگاه فردوسي مشهد، مشهد، ايران - دانشگاه تربيت مدرس، تهران، ايران
چكيده فارسي :
زمينه و هدف: دربارهٔ سبب شناسي اعتياد اخيراً به علت‌هاي شناختي توجه ويژه‌اي شده است؛ بنابراين، پژوهش حاضر با هدف بررسي نقش طرحواره‌هاي ناسازگار اوليه در پيش‌بيني خطر عود به اعتياد انجام گرفت.
روش بررسي: طرح پژوهش حاضر توصيفي‌همبستگي بود و از روش رگرسيون چندگانه استفاده شد. جامعهٔ آماري پژوهش حاضر تمامي معتادان 20تا 45ساله در شهرستان مشهد به تعداد 3555 نفر در سال 98-1397 بودند. از بين آن‌ها تعداد 689 نفر كه حداقل شش ماه از دورهٔ پاكي‌شان گذشته بود با استفاده از روش نمونه‌گيري دردسترس انتخاب شدند. براي جمع‌آوري داده‌ها از پرسشنامه‌هاي طرحوارهٔ يانگ (1998) و شناسايي افراد درمعرض خطر اعتياد (انيسي، 1392) استفاده شد. تجزيه‌وتحليل داده‌هاي به‌دست‌آمده از پژوهش به وسيلهٔ ضريب همبستگي پيرسون و آناليز رگرسيون صورت گرفت.
يافته‌ها: نتايج تحليل همبستگي پيرسون نشان داد كه بين تمامي طرحواره‌هاي شكست (0٫685)، نقص/شرم (0٫627)، محروميت هيجاني (0٫569)، خويشتن‌داري (0٫771)، آسيب‌پذيري نسبت به ضرر يا بيماري (0٫548)، استحقاق (0٫470)، خودتحول‌نيافته/گرفتار (0٫522)، بي‌اعتمادي (0٫579)، بازداري هيجاني (0٫491)، انزواي اجتماعي (0٫679)، ازخودگذشتگي (0٫330)، رهاشدگي (0٫487)، اطاعت (0٫649)، معيارهاي سرسختانه (0٫662) و وابستگي (0٫474) و خطر عود به اعتياد ضرايب همبستگي معنادار است (0٫001>p). نتايج تحليل رگرسيون به‌روش هم‌زمان مشخص كرد كه خرده‌مقياس‌هاي خويشتن‌داري/خودانضباطي ناكافي، اطاعت، وابستگي/بي‌كفايتي، شكست، بازداري هيجاني و نقص/شرم، توان پيش‌بيني خطر عود اعتياد را دارند (0٫001>p).
نتيجه‌گيري: باتوجه به يافته‌هاي اين پژوهش در زمينهٔ ارتباط طرحواره‌هاي ناسازگار اوليه و خطر عود اعتياد، متخصصان حوزهٔ اعتياد مي‌توانند اين يافته‌ها را در پيشگيري از عود و درمان معتادان مدنظر قرار دهند.
چكيده لاتين :
Background & Objectives: Substance dependence is a reversible brain disorder. Research studies indicated that >75% of individuals with drug use disorders experienced a relapse within one year after treatment. Relapse prevention is a strategy to reduce the odds and severity of relapse
after stopping or reducing harmful behaviors. Concerning the etiology of substance abuse relapse, special attention has recently been paid to cognitive causes. Considering the essential role of cognition in substance abuse relapse, the present study aimed to determine the relationship
between early maladaptive schemas and the risk of substance abuse relapse.
Methods: The present descriptive–correlational study used multiple regression analysis methods. The statistical population of the present study
included all patients with substance dependence aged 20 to 45 years in Mashhad City, Iran, in 2018–2019. To select the study sample, of the
total 3555 clients of substance dependence treatment camps and clinics, 689 individuals who were diagnosed with a drug use disorder and had
an experience of >6 months past relapse since their abstinence were selected using the convenience sampling method. The Young Schema
Questionnaire (1998) and Identifying People in Risk of Addiction (I.P.R.A) Questionnaire (Anisi, 2012) were employed for data collection. The
correlation coefficients for the subscales of early maladaptive schemas were obtained to fall in the range of 60% to 85% for test reliability.
Furthermore, its content validity was reported to be 0.42 using the test–retest method. Cronbach's alpha coefficient of 0.97 was reported for the
I.P.R.A questionnaire. This instrument also presented desirable validity and reliability. A written informed consent form was received from all
study participants. Besides, they were informed that participation in the present research project is voluntary. Their identity and all the
information obtained from them remained confidential by the researcher. The ethical principles of the American Psychiatric Association were
also observed at all study stages. The collected data were analyzed by descriptive statistics, as well as multiple correlations and regression tests
in SPSS. In addition, p<0.05 was considered as statistically significant.
Results: The Pearson’s correlation coefficient data suggested a significant correlation between the risk of substance abuse relapse (p<0.001) and
all of the early maladaptive schemas, including failure (0.685), defectiveness/shame (0.627), emotional deprivation (0.569), insufficient self–
control/self–discipline (0.771), vulnerability to harm or illness (0.548), entitlement/grandiosity (0.470), enmeshment/undeveloped self (0.522),
mistrust (0.579), emotional deprivation (0.491), social isolation/alienation (0.679), self–sacrifice (0.330), abandonment/instability (0.487),
subjugation (0.649), unrelenting standards/hyper criticalness (0.662), and dependency/incompetence (0.474). Accordingly, the variables of the
early maladaptive schemas could all together predict 72% of the variance in the risk of substance abuse relapse. The concurrent regression
analysis results indicated that the subscales of failure, insufficient self–control/self–discipline, emotional deprivation, subjugation,
dependency/incompetence, and dependence/incompetence could predict the risk of substance abuse relapse (p<0.001).
Conclusion: Considering the association between early maladaptive schemas and the risk of substance abuse relapse, addiction experts could
use these findings in preventing relapse and substance dependence treatment. Coping with early maladaptive schemas in childhood and adolescence before leading to substance abuse and other problems may reduce the subsequent need for the treatment of drug and alcohol use.
