اثربخشی رفتار درمانی گفتگویی بر نگرانی از تصویر بدنی در زنان دارای نشانگان افسردگی
کلمات کلیدی:
رفتار درمانی گفتگویی, نگرانی, نشانگان افسردگی, تصویر بدنیچکیده
زمینه و هدف: عدم درمان افسردگی با اختلال در عملکرد تحصیلی، افزایش شدت افسردگی، سردردهای میگرنی، سوء مصرف الکل و مواد، استرس زیاد، حمایت اجتماعی پایین، احساس حقارت در مدرسه، احساس پوچی و بیارزشی، نشانههای جسمانی و کشمکش با والدین و خطر خودکشی، بار اقتصادی هنگفت برای دولتها همراه خواهد بود بنابراین دستیابی به راههای مؤثر جهت درمان این بیماری بیش از پیش ضروری مینماید. لذا این مطالعه با هدف اثر بخشی رفتار درمانی گفتگویی بر میزان نگرانی از تصویر بدنی زنان دارای نشانگان افسردگی در سال 1402 انجام شد.
روش و مواد: این پژوهش به لحاظ هدف، کاربردی، به لحاظ جمعآوری دادهها از جمله مطالعات کاربردی و به لحاظ روش گردآوری دادهها، کمّی (پرسشنامه) و مبتنی بر رویکرد تجربی و آزمایشی با استفاده از تحلیل واریانس بوده است.
یافتهها: یافتههای آماری حاکی از آن است که رفتار درمانی گفتگویی حداقل از لحاظ یکی از متغیرهای وابسته (افسردگی و نگرانی از تصویر بدنی) میانگین گروه آزمایشی را نسبت به گروه کنترل در مرحله پس آزمون افزایش داده است و بین دو گروه پژوهش در ترکیب خطی متغیرهای افسردگی و نگرانی از تصویر بدنی در مرحله پسآزمون تفاوت معنادای وجود دارد. همچنین یافتههای آماری بیانگر آن است که بین زنان دارای نشانگان افسردگی گروه آزمایشی و گروه کنترل از لحاظ متغیر افسردگی تفـاوت معنیداری وجـود دارد. علاوه بر این یافتهها نشان داد که بین زنان دارای نشانگان افسردگی گروه آزمایشی و گروه کنترل از لحاظ متغیر نگرانی از تصویر بدنی تفـاوت معنیداری وجـود دارد.
نتیجهگیری: علاوه بر یافتههای ذکر شده مهمترین نتیجه مطالعه حاضر این بود که مشخص شد تاثیر مداخله رفتار درمانی گفتگویی بر افسردگی و نگرانی از تصویر بدنی به ترتیب 53 درصد و 47 درصد است که این میزان تاثیرگذاری، مثبت و بالا میباشد.
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مراجع
Afshari, B., Omidi, A., & Sehat, M. (2019). Effect of dialectical behavior therapy on emotion regulation and
mindfulness in patients with bipolar disorder. Feyz, 23(3), 293-300. https://www.magiran.com/paper/2008779
Alacreu-Crespo, A., Hidalgo, V., Girod, C., Olié, E., & Courtet, P. (2022). The impulsiveness level influences the
salivary cortisol response and social stress sensitivity in suicidal patients. Journal of psychiatric research, 156,
159-167. https://doi.org/10.1016/j.jpsychires.2022.10.008
Alavi, K., Modarres Gharavi, M., Amin-Yazdi, S. A., & SalehiFadardi, J. (2011). Effectiveness of group dialectical
behavior therapy (based on core mindfulness, distress tolerance and emotion regulation components) on
depressive symptoms in university students. Journal of Fundamentals of Mental Health, 13(2), 35.
https://www.magiran.com/paper/926963
Amiri, Z., & Amiri, Z. (2016). Assessment of a prediction model of depression based on disease perception and
sleep quality mediated by pain catastrophizing in diabetic patients [Research]. Journal of Diabetes Nursing,
4(2), 48-58. http://jdn.zbmu.ac.ir/article-1-181-en.html
Arab Markadeh, R., & Dehghani, A. (2018). The Effectiveness of Group-Based Dialectic Behavioral Therapy on
Depression and Perceived Stress of Female Students. J-Nurs-Edu, 7(6), 24-30. http://jne.ir/article-1-922-
en.html
Aragonès, E., Piñol, J. L., Labad, A., Masdéu, R. M., Pino, M., & Cervera, J. (2004). Prevalence and Determinants
of Depressive Disorders in Primary Care Practice in Spain. The International Journal of Psychiatry in Medicine,
34(1), 21-35. https://doi.org/10.2190/c25n-w4ny-bn8w-txn2
Balázs, J., Miklósi, M., Keresztény, Á., Hoven, C. W., Carli, V., Wasserman, C., Apter, A., Bobes, J., Brunner, R.,
& Cosman, D. (2013). Adolescent subthreshold‐depression and anxiety: Psychopathology, functional
impairment and increased suicide risk. Journal of Child Psychology and Psychiatry, 54(6), 670-677.
https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/jcpp.12016
Bansal, V., Goyal, S., & Srivastava, K. (2009). Study of prevalence of depression in adolescent students of a public
school. Industrial Psychiatry Journal, 18(1).
Barani, H., & Fooladchang, M. (2022). The Efficacy of Teaching Dialectical Behavior Therapy Skills on Anxiety
and Depression Symptoms in Students. Journal of Applied Psychological Research, 13(1), 287-304.
https://doi.org/10.22059/japr.2022.311088.643658
Batmaz, S., Ulusoy Kaymak, S., Kocbiyik, S., & Turkcapar, M. H. (2014). Metacognitions and emotional schemas:
a new cognitive perspective for the distinction between unipolar and bipolar depression. Comprehensive
Psychiatry, 55(7), 1546-1555. https://www.sciencedirect.com/science/article/pii/S0010440X14001345
Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996). Comparison of Beck Depression Inventories-IA and-II
in Psychiatric Outpatients. Journal of Personality Assessment, 67(3), 588-597.
https://doi.org/10.1207/s15327752jpa6703_13
Bromet, E., Andrade, L. H., Hwang, I., Sampson, N. A., Alonso, J., de Girolamo, G., de Graaf, R., Demyttenaere,
K., Hu, C., Iwata, N., Karam, A. N., Kaur, J., Kostyuchenko, S., Lépine, J.-P., Levinson, D., Matschinger, H.,
Mora, M. E. M., Browne, M. O., Posada-Villa, J., . . . Kessler, R. C. (2011). Cross-national epidemiology of
DSM-IV major depressive episode. BMC Medicine, 9(1), 90. https://doi.org/10.1186/1741-7015-9-90
Byrne, G., Ghráda, Á. N., O’Mahony, T., & Brennan, E. (2021). A systematic review of the use of acceptance and
commitment therapy in supporting parents. Psychology and Psychotherapy: Theory, Research and Practice,
94(S2), e12282. https://doi.org/10.1111/papt.12282
Demir, T., Karacetin, G., Demir, D. E., & Uysal, O. (2011). Epidemiology of depression in an urban population of
Turkish children and adolescents. Journal of affective disorders, 134(1), 168-176.
https://doi.org/10.1016/j.jad.2011.05.041
Dilsaver, S. C., & Akiskal, H. S. (2004). Preschool-onset mania: incidence, phenomenology and family history.
Journal of affective disorders, 82, S35-S43.
https://www.sciencedirect.com/science/article/pii/S0165032704002022
Fang, Y., Boelens, M., Windhorst, D. A., Raat, H., & van Grieken, A. (2021). Factors associated with parenting
self-efficacy: A systematic review. Journal of Advanced Nursing, 77(6), 2641-2661.
https://doi.org/10.1111/jan.14767
Fatiregun, A. A., & Kumapayi, T. E. (2014). Prevalence and correlates of depressive symptoms among in-school
adolescents in a rural district in southwest Nigeria. Journal of adolescence, 37(2), 197-203.
https://doi.org/10.1016/j.adolescence.2013.12.003
Fitzpatrick, S., Bailey, K., & Rizvi, S. L. (2020). Changes in Emotions Over the Course of Dialectical Behavior
Therapy and the Moderating Role of Depression, Anxiety, and Posttraumatic Stress Disorder. Behavior therapy,
51(6), 946-957. https://doi.org/10.1016/j.beth.2019.12.009
Fleischhaker, C., Böhme, R., Sixt, B., Brück, C., Schneider, C., & Schulz, E. (2011). Dialectical Behavioral Therapy
for Adolescents (DBT-A): a clinical Trial for Patients with suicidal and self-injurious Behavior and Borderline
Symptoms with a one-year Follow-up. Child and adolescent psychiatry and mental health, 5(1), 3.
https://doi.org/10.1186/1753-2000-5-3
Ghorbanikhah, E., Mohammadyfar, M. A., Moradi, S., & Delavarpour, M. (2023). The Effectiveness of
Acceptance-and-Commitment-Based Parenting Training on Mood and Anxiety in Children and Self-
compassion in Parents. PCP, 11(1), 81-92. https://doi.org/10.32598/jpcp.11.1.860.1
Goldberg, X., Serra-Blasco, M., Vicent-Gil, M., Aguilar, E., Ros, L., Arias, B., Courtet, P., Palao, D., & Cardoner,
N. (2019). Childhood maltreatment and risk for suicide attempts in major depression: a sex-specific approach.
European Journal of Psychotraumatology, 10(1), 1603557. https://doi.org/10.1080/20008198.2019.1603557
Hajiyousef, H., dehestani, m., & darvish molla, m. (2022). The Mediating Role of Emotion Regulation Difficulties
in the Relationship between Abuse Experiences and Body Image Dissatisfaction among Adolescent Girls.
Journal of Applied Psychological Research, 13(1), 327-344.
https://doi.org/10.22059/japr.2022.321110.643801
Jabraeili, S., Babapour Kheraddin, J., & Mahmoodaliloo, M. (2014). Efficacy of Dialectical Behavior Therapy in
Reducing Symptoms of Suicidal Behavior and Mood Instability Measures of Borderline Personality Disorder.
Journal of Modern Psychological Researches, 8(32), 75-88. https://psychologyj.tabrizu.ac.ir/article_4296.html
Jaiswal, A., Manchanda, S., Gautam, V., Goel, A. D., Aneja, J., & Raghav, P. R. (2020). Burden of internet
addiction, social anxiety and social phobia among University students, India. Journal of Family Medicine and
Primary Care, 9(7).
px
Köck, P., & Walter, M. (2018). Personality disorder and substance use disorder – An update. Mental Health &
Prevention, 12, 82-89. https://doi.org/10.1016/j.mhp.2018.10.003
Krauss, S., Orth, U., & Robins, R. W. (2020). Family environment and self-esteem development: A longitudinal
study from age 10 to 16
Lammers, M. W., Vroling, M. S., Crosby, R. D., & van Strien, T. (2022). Dialectical behavior therapy compared to
cognitive behavior therapy in binge-eating disorder: An effectiveness study with 6-month follow-up.
International Journal of Eating Disorders, 55(7), 902-913. https://doi.org/10.1002/eat.23750
Leahy, R. L. (2007a). Emotional Schemas and Resistance to Change in Anxiety Disorders. Cognitive and
Behavioral Practice, 14(1), 36-45. https://doi.org/10.1016/j.cbpra.2006.08.001
Leahy, R. L. (2007b). Emotional Schemas and Self-Help: Homework Compliance and Obsessive-Compulsive
Disorder. Cognitive and Behavioral Practice, 14(3), 297-302. https://doi.org/10.1016/j.cbpra.2006.08.002
Leahy, R. L. (2011). Emotional Schema Therapy: A Bridge Over Troubled Waters. In Acceptance and Mindfulness
in Cognitive Behavior Therapy (pp. 109-131).
https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118001851.ch5
Leahy, R. L. (2016). Emotional schema therapy. И ПСИХОТЕРАПИЯ, 46.
https://psyjournals.ru/journals/cpp/archive/cpp_2021_n3.pdf#page=47
Leahy, R. L. (2016). Emotional Schema Therapy: A Meta‐experiential Model. Australian Psychologist, 51(2), 82-
88. https://doi.org/10.1111/ap.12142
Leahy, R. L., Tirch, D. D., & Melwani, P. S. (2012). Processes Underlying Depression: Risk Aversion, Emotional
Schemas, and Psychological Flexibility. International Journal of Cognitive Therapy, 5(4), 362-379.
https://doi.org/10.1521/ijct.2012.5.4.362
Linehan, M. M. (1992). Behavior therapy, dialectics, and the treatment of borderline personality disorder. In
Handbook of borderline disorders. (pp. 415-434). International Universities Press, Inc.
Linehan, M. M., & Dexter-Mazza, E. T. (2008). Dialectical behavior therapy for borderline personality disorder. In
Clinical handbook of psychological disorders: A step-by-step treatment manual, 4th ed. (pp. 365-420). The
Guilford Press. https://awspntest.apa.org/record/2008-00599-009
Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., McDavid, J., Comtois,
K. A., & Murray-Gregory, A. M. (2015). Dialectical Behavior Therapy for High Suicide Risk in Individuals
With Borderline Personality Disorder: A Randomized Clinical Trial and Component Analysis. JAMA
Psychiatry, 72(5), 475-482. https://doi.org/10.1001/jamapsychiatry.2014.3039
Majdi, M. R., Mobarhan, M. G., Salek, M., Taghi, M., & Mokhber, N. (2011). Prevalence of depression in an elderly
population: A population-based study in Iran. Iranian journal of psychiatry and behavioral sciences, 5(1), 25-
32. https://brieflands.com/articles/ppbs-2928.html
Milgrom, J., Danaher, B. G., Seeley, J. R., Holt, C. J., Holt, C., Ericksen, J., Tyler, M. S., Gau, J. M., & Gemmill,
A. W. (2021). Internet and Face-to-face Cognitive Behavioral Therapy for Postnatal Depression Compared
With Treatment as Usual: Randomized Controlled Trial of MumMoodBooster [Original Paper]. J Med Internet
Res, 23(12), e17185. https://doi.org/10.2196/17185
Mitchell, R., Roberts, R., Bartsch, D., & Sullivan, T. (2019). Changes in mindfulness facets in a dialectical
behaviour therapy skills training group program for borderline personality disorder. Journal of Clinical
Psychology, 75(6), 958-969. https://doi.org/10.1002/jclp.22744
Moretta, T., Kaess, M., & Koenig, J. (2023). A comparative evaluation of resting state proxies of sympathetic and
parasympathetic nervous system activity in adolescent major depression. Journal of Neural Transmission,
130(2), 135-144. https://doi.org/10.1007/s00702-022-02577-3
Noorbala, A. A., Yazdi, S. A. B., Yasamy, M. T., & Mohammad, K. (2004). Mental health survey of the adult
population in Iran. British Journal of Psychiatry, 184(1), 70-73. https://doi.org/10.1192/bjp.184.1.70
Ofem, U. J. (2023). Adjustment Tendencies Among Transiting Students: A Mediation Analysis Using
Psychological Wellbeing Indices. International Journal of Education and Cognitive Sciences, 4(3), 1-19.
https://doi.org/10.61838/kman.ijecs.4.3.1
Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2013). Meta-Analysis and Systematic Review Assessing the
Efficacy of Dialectical Behavior Therapy (DBT). Research on Social Work Practice, 24(2), 213-223.
https://doi.org/10.1177/1049731513503047
Patten, S. B., Williams, J. V. A., Lavorato, D. H., Bulloch, A. G. M., Wiens, K., & Wang, J. (2016). Why is major
depression prevalence not changing? Journal of affective disorders, 190, 93-97.
https://doi.org/10.1016/j.jad.2015.09.002
Perepletchikova, F., Axelrod, S. R., Kaufman, J., Rounsaville, B. J., Douglas-Palumberi, H., & Miller, A. L. (2011).
Adapting Dialectical Behaviour Therapy for Children: Towards a New Research Agenda for Paediatric Suicidal
and Non-Suicidal Self-Injurious Behaviours. Child and Adolescent Mental Health, 16(2), 116-121.
https://doi.org/10.1111/j.1475-3588.2010.00583.x
Rabiee, N., Nazari, A. M., Keramat, A., Khosravi, A., & Bolbol-Haghighi, N. (2020). Effect of Dialectical
Behavioral Therapy on the Postpartum Depression, Perceived Stress and Mental Coping Strategies in Traumatic
Childbirth: A Randomized Controlled Trial: test. International Journal of Health Studies.
http://ijhs.shmu.ac.ir/index.php/ijhs/article/view/760
Rahmani Moghaddam, F., Bagherzadehgolmakani, Z., Touzandehjani, H., & Nejat, H. (2023). Exploring the Impact
of Dialectical Behavior Therapy on Emotional Regulation and Rumination among the Physically Disabled
People using the Services of the Welfare Organization of Mashhad. Research in Clinical Psychology and
Counseling, 13(1), 123-138. https://doi.org/10.22067/tpccp.2023.75967.1269
Rancans, E., Vrublevska, J., Snikere, S., Koroleva, I., & Trapencieris, M. (2014). The point prevalence of depression
and associated sociodemographic correlates in the general population of Latvia. Journal of affective disorders,
156, 104-110. https://www.sciencedirect.com/science/article/pii/S0165032713008355
Safari, A., & Aftab, R. (2021). The Effectiveness of Online Dialectical Behavior Therapy on the Emotion
Regulation Difficulties, Guilt Feeling and Dissociative Symptoms in Depressed People. Applied Psychology,
15(4), 206-179. https://doi.org/10.52547/apsy.2021.223466.1132
Sedighi Arfaee, F., Rashidi, A., & Tabesh, R. (2021). The Distress Tolerance in the Elderly: The Role of
Experiential Avoidance, Rumination and Mindfulness. Aging Psychology, 7(1), 12-11.
https://doi.org/10.22126/jap.2021.6108.1498
Shahsavari Googhari, Z., Hafezi, F., Asgari, P., & Heidari, A. (2022). The effectiveness of mindfulness-based
cognitive therapy and acceptance and commitment therapy on medical science students’ subjective well-being,
psychological distress, and emotion regulation. J Shahrekord Univ Med Sci, 24(1), 35-41.
https://doi.org/10.34172/jsums.2022.07
Shakibayi, F., & Esmaeeli, M. (2014). Study of MDD epidemiology in students of middle school (11-16 yrs. old)
Of Esfahan city in 2007-8 [Research]. Journal of Research in Behavioural Sciences, 12(2), 274-284.
http://rbs.mui.ac.ir/article-1-379-en.html
Sheikh, S., Alzackerini, S. M., Shirmahaleh, F. M., Zam, F., & Baseri, A. (2021). Investigating the effect of two
methods of dialectic behavioral therapies and metacognitive therapy on the body mass index and emotional
eating behavior in patients with type 2 diabetes. International Journal of Health Studies, 36-42.
http://ijhs.shmu.ac.ir/index.php/ijhs/article/view/855
Simon, G. E., Shortreed, S. M., Rossom, R. C., Beck, A., Clarke, G. N., Whiteside, U., Richards, J. E., Penfold, R.
B., Boggs, J. M., & Smith, J. (2022). Effect of Offering Care Management or Online Dialectical Behavior
Therapy Skills Training vs Usual Care on Self-harm Among Adult Outpatients With Suicidal Ideation: A
Randomized Clinical Trial. JAMA, 327(7), 630-638. https://doi.org/10.1001/jama.2022.0423
Tabatabayi, A. S., Yosofi, Z., Motamedi, M., & Taheri, S. (2021). The Effectiveness of Dialectical Behavior
Therapy on Self-Forgiveness and Depression in Teenager Girls with Self-injury History in Isfahan. Journal of
Clinical Psychology, 13(1), 13-22. https://doi.org/10.22075/jcp.2021.18167.1699
Taheri Daghiyan, A., Qasemi Motlagh, M., & Mehdian, H. (2019). The effectiveness of dialectical behavior therapy
on anxiety and rumination in depressed patients. medical journal of mashhad university of medical sciences,
62(December), 264-274. https://doi.org/10.22038/mjms.2019.14535
Telch, C. F., Agras, W. S., & Linehan, M. M. (2001). Dialectical behavior therapy for binge eating disorder. Journal
of consulting and clinical psychology, 69(6), 1061-1065. https://doi.org/10.1037/0022-006X.69.6.1061
Vahabi, M., Pui-Hing Wong, J., Moosapoor, M., Akbarian, A., & Fung, K. (2022). Effects of Acceptance and
Commitment Therapy (ACT) on Mental Health and Resiliency of Migrant Live-in Caregivers in Canada: Pilot
Randomized Wait List Controlled Trial [Original Paper]. JMIR Form Res, 6(1), e32136.
Vanderlind, W. M., Everaert, J., & Joormann, J. (2022). Positive emotion in daily life: Emotion regulation and
depression. Emotion, 22(7), 1614-1624. https://doi.org/10.1037/emo0000944
Visted, E., Vøllestad, J., Nielsen, M. B., & Schanche, E. (2018). Emotion Regulation in Current and Remitted
Depression: A Systematic Review and Meta-Analysis [Systematic Review]. Frontiers in psychology, 9.
https://doi.org/10.3389/fpsyg.2018.00756
Yavuz, K. F., Türkçapar, M. H., Demirel, B., & Karadere, E. (2011). Adaptation, validity and reliability of the
Leahy Emotional Schema Scale Turkish version based on Turkish university students and workers. Dusunen
Adam Journal of Psychiatry and Neurological Sciences, 24(4), 273. https://dusunenadamdergisi.org/article/622
Yousefi, T., Fallah, M. H., Vaziri, S., & Afshani, A. R. (2021). Explaining Parent-Adolescent Conflict Consequence
from a Parent's Viewpoint: A Qualitative Study [Original Research Article]. Middle Eastern Journal of
Disability Studies---, 11(0), 95-95. https://doi.org/10.29252/mejds.0.0.170
Zhang, B., Fu, W., Guo, Y., Chen, Y., Jiang, C., Li, X., & He, K. (2022). Effectiveness of mindfulness-based
cognitive therapy against suicidal ideation in patients with depression: A systematic review and meta-analysis.
Journal of affective disorders, 319, 655-662. https://doi.org/10.1016/j.jad.2022.09.091
