پديد آورندگان :
فرياديان، پادرا دانشگاه آزاد اسلامي واحد كرج، كرج، ايران , برماس، حامد دانشگاه آزاد اسلامي واحد كرج، كرج، ايران - گروه روان شناسي , صالحي، مهديه دانشگاه آزاد اسلامي واحد تهران مركز، تهران، ايران - گروه روان شناسي , پاشنگ، سارا دانشگاه آزاد اسلامي واحد كرج، كرج، ايران - گروه روان شناسي
كليدواژه :
تنظيم هيجاني , ذهن آگاهي , سوء مصرف مواد , فراشناخت درماني
چكيده فارسي :
زمينه و هدف: اعتياد امروزه به يكي از جدي‌ترين معضلات جامعهٔ بشري تبديل شده است و مشكلات تنظيم هيجان در افراد معتاد وجود دارد؛ بنابراين پژوهش حاضر با هدف مقايسهٔ اثربخشي درمان ذهن آگاهي گروهي با فراشناخت درماني گروهي بر تنظيم هيجاني در بيماران بهبوديافته از اختلال سوء مصرف مواد، صورت گرفت.
روش بررسي: اين پژوهش به‌روش نيمه آزمايشي با طرح پيش آزمون، پس آزمون با دورهٔ پيگيري و گروه گواه انجام شد. جامعهٔ آماري پژوهش تمامي بيماران بهبود يافته از اختلال سوءمصرف، مراجعهكننده به مراكز ترك اعتياد شهر ورامين در سال 1398 بودند. به‌روش نمونه گيري هدف مند، تعداد 39 نفر انتخاب شدند و در سه گروه درمان ذهنآگاهي، فراشناخت درماني و گواه جايگزين شدند. ابزار پژوهش پرسشنامهٔ تنظيم شناختي هيجاني (گارنفسكي و همكاران، 2001) بود. روش‌هاي درماني ذهنآگاهي (ويليامز و كرفت، 2012) و فراشناختي (ولز، 2009) به‌صورت گروهي هركدام در هشت جلسۀ 90دقيقه‌اي براي گروه‌هاي آزمايش ارائه شد. داده‌ها با استفاده از روش تحليل واريانس مكرر و آزمون تعقيبي بونفروني در نرم‌افزار SPSS نسخۀ 22 در سطح معناداري 0٫05 تحليل شدند.
يافته‌ها: نتايج نشان داد، درمان ذهنآگاهي و فراشناخت‌درماني موجب افزايش ميانگين راهبردهاي مثبت و كاهش ميانگين راهبردهاي منفي تنظيم هيجان در پس‌آزمون و پيگيري در مقايسه با پيش‌آزمون شدند (0٫001>p). همچنين بين ميانگين‌هاي گروه فراشناخت‌درماني و گروه درمان ذهنآگاهي براي متغير راهبردهاي مثبت تنظيم هيجان (0٫246=p) و براي متغير راهبردهاي منفي تنظيم هيجان (0٫858=p) تفاوت معنادار وجود نداشت.
نتيجه‌گيري: براساس يافته‌هاي پژوهش، درمان ذهن آگاهي و فراشناخت‌درماني بر بهبود راهبردهاي تنظيم هيجان بيماران بهبود يافته از سوء مصرف مواد مؤثر هستند.
چكيده لاتين :
Background & Objectives: Substance dependence is among the most serious problems in societies. The current therapies provide a comprehensive working model wherein substance use is viewed as a means of coping with emotion dysregulation. The primary goal of mindfulness is to help patients tolerate uncomfortable states, like craving, and to experience difficult emotions without automatically reacting.
An approach to the etiology and treatment of numerous recently–considered mental disorders is the Wells metacognitive model or the self– regulatory executive function theory model. This approach has paid special attention to metacognition in understanding and treating mental
health disorders. Studies examining metacognitions in substance abusers suggested the main reason for substance abuse to be the regulation of
various cognitions and emotions. The present study aimed to compare the effects of Group Metacognitive Therapy (GMCT) and Mindfulness–
based Group Therapy (MGT) on Emotion Regulation (ER) in recovered patients from Drug Use Disorders (DUDs).
Methods: This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population was all
patients recovered from DUDs referring to DUDs treatment centers in Varamin City, Iran, in 2019. The total number of individuals was unknown
for reasons, like patient confidentiality; however, using targeted and voluntary sampling, 54 individuals who met the inclusion criteria were
selected by Wilson Van Voorhis and Morgan (2007) as the minimum sample size for experimental and quasi–experimental research considering
the odds of sample loss. Then, they were randomly divided into three groups by homogenization. Due to absence from the sessions and sample
dropout, the total number of samples reached 39 (n=13/group). The inclusion criteria of the study were the age of >18 years; the diagnosis of
DUDs based on The Diagnostic and Statistical Manual of Mental Disorders–5 (DSM–5); more than a week past detoxification, and not receiving
pharmacotherapy for other biopsychological illnesses. The exclusion criteria included presenting the symptoms of psychosis and serious suicidal
ideation. The research instrument was the Cognitive Emotion Regulation Questionnaire (Garnefski et al., 2001). GMCT and MGT were presented
in eight 90–minute sessions in 2 months. GMCT and MGT sessions were based on Wells’s metacognitive therapy package (2009) and Williams
and Kraft’s mindfulness package (2012), respectively. The obtained data were analyzed by repeated–measures Analysis of Variance (ANOVA)
and Bonferroni posthoc test in SPSS at the significance level of 0.05.
Results: MGT increased the mean±SD scores of positive ER strategies at posttest (3.10±0.10) and follow–up (3.17±0.21), compared to the
pretest stage (2.73±0.22). GMCT improved the mean±SD scores of positive ER strategies at posttest (2.97±0.11) and follow–up (2.99±0.24),
compared to the pretest stage (2.77±0.010) (p<0.001). MGT reduced the mean±SD scores of negative ER strategies at posttest (3.07±0.14) and
follow–up (3.12±0.24), in comparison to the pretest stage (3.36±0.16). GMCT reduced the mean±SD scores of positive ER strategies at posttest
(3.05±0.21) and follow–up (3.01±0.25), compared to the pretest stage (3.28±0.29) (p<0.001). The mean±SD scores of positive ER strategies
increased at posttest (2.97±0.023) and follow–up (2.96±0.041) stages, in comparison to the pretest stage (2.75±0.028) (p<0.001). The mean±SD
scores of negative ER strategies decreased at posttest (3.16±0.034) and follow–up (3.19±0.048) stages, compared to the pretest stage
(3.33±0.053) (p=0.029). The Bonferroni posthoc test data revealed no significant difference between the mean values of the GMCT and the
MGT groups (p=0.246); there were significant differences between the mean scores of the GMCT and the control groups (p=0.042), and the
MGT and the control groups (p<0.001) concerning positive ER strategies, indicating the positive effect of GMCT and MGT on positive ER
strategies. However, there was no significant difference between the mean scores of the GMCT and MGT groups (p=0.858); there were
significant differences between the mean values of the GMCT and the control groups (p<0.001) as well as the MGT and the control groups
(p=0.028) respecting negative ER strategies, reflecting the positive effects of GMCT and MGT on negative ER strategies. Conclusion: Based on these findings, GMCT and MGT were effective in improving ER strategies in recovered patients from DUDs.
