فهرست مطالب

Practice in Clinical Psychology - Volume:3 Issue: 3, Summer 2015

Iranian Journal of Practice in Clinical Psychology
Volume:3 Issue: 3, Summer 2015

  • تاریخ انتشار: 1394/08/13
  • تعداد عناوین: 8
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  • ابراهیم سلطانی عظمت، بهروز دولتشاهی*، مرتضی نوری خواجوی صفحات 151-156
    زمینه
    پژوهش های اخیر بر روی نظریه ذهن نشان می دهند که بیماران با اختلال دوقطبی در طی دوره های مختلف اختلال، دچار نقص در توانایی نظریه دهن هستند.
    هدف
    هدف این مطالعه بررسی نقص ابعاد شناختی و عاطفی نظریه ذهن در بیماران دوقطبی نوع یک با دوره فروکش می باشد.
    روش
    تعداد 30 بیمار دوقطبی و 30 نفر هنجار به شکل هدفمند انتخواب شدند. و از نظر سن و تحصیلات همتاسازی گروهی شدند.و سپس آزمونهای شناختی و عاطفی نطریه ذهن روی انها اجرا شد. و در پایان نتایج با استفاده از آزمون تی مستقل و نرم افزار SPSS16 تجزیه تحلیل شد.
    یافته ها
    نتایج نشان داد که بین دو گروه تفاوت معناداری در نمره های نظریه ذهن شناختی و عاطفی و زمان واکنش وجود دارد.
    نتیجه
    این یافته ها نشان داد که بیماران دوقطبی در دوره فروکش هم در بعد شناختی و هم عاطفی نظریه ذهن از همتایان سالم خود ضعیف تر عمل می کنند. همچنین در سرعت واکنش بیماران به سرعت کمتری در بعد شناختی عمل کردند اما در بعد عاطفی سرعت واکنش بیشتر از گروه هنجار بود.
    کلیدواژگان: نظریه ذهن شناختی، نظریه ذهن عاطفی، اختلال دوقطبی
  • هانیه الستی*، بهروز دولتشاهی، حامد اختیاری صفحات 157-166
    مقدمه چاقی یکی از مهم ترین معضلات، سلامتی است، امروزه تقریبا یک سوم افراد جهان از چاقی و اضافه وزن رنج می برند. چاقی با مشکلات پزشکی شدید و مشکلات عاطفی زیادی همراه است. در کل سه رویکرد عمده ی مبتنی بر شواهد برای درمان چاقی وجود دارد: درمان جراحی، دارو درمانی و رفتاردرمانی اما با توجه به عوارض ناشی از سه درمان ذکر شده دانشمندان درمان شناختی رفتاری را هم، برای درمان چاقی مطرح کردند. هدف اصلی پژوهش تعیین اثربخشی مداخلات شناختی-رفتاری (آی پام) در کاهش وزن افراد با شاخص توده بدنی 30 و بالاتر است. روش با بهره گیری از روش نمونه برداری هدفمند، سه زن با شاخص توده بدنی 30 یا بالاتر انتخاب شدند، برای تعیین اثربخشی درمان شناختی- رفتاری چاقی از کارآزمایی آزمایشی تک آزمودنی، طرح A-B همراه با دوره ی پیگیری استفاده شد. بیماران به پرسشنامه های: سنجش روابط چند بعدی بدن- خود (MBSRQ-AS)، پرسشنامه ی عزت نفس روزنبرگ (RSES) و مقیاس پرخوری (BES) در سه مرحله دوره ی خط پایه و در جلسات درمانی دوم، چهارم، ششم، هشتم، دهم و دوازدهم پاسخ دادند، به علاوه وزن بیماران هر هفته به مدت شش ماه به صورت منظم اندازه گیری شد. برای تحلیل پژوهش از تحلیل چشمی توسط نمودارها و جداول استفاده شد، همچنین با محاسبه ی درصد بهبودی و اندازه اثر میزان اثر بخشی مداخلات شناختی رفتاری به دست آمد. یافته ها نتایج نشان داد که درمان روی کاهش وزن و ابقای وزن کاهش یافته و کاهش میزان پرخوری موثر بوده است همچنین درمان منجر به افزایش رضایت از تصویر بدن شده است اما این درمان در افزایش عزت نفس خیلی موثر نبوده است. نتیجه گیری درمان شناختی- رفتاری در کاهش وزن، زنان مبتلا به چاقی موثر بوده است و اطلاعات بدست آمده با پژوهش های مشابه مانند درمان شناختی – رفتاری کوپر و فیربرن شبیه بود.
    کلیدواژگان: درمان شناختی، رفتاری، چاقی، رضایت از تصویر بدن، عزت نفس، پرخوری
  • شیرین فرازمند، پروانه محمدخانی، عباس پورشهباز، بهروز دولتشاهی صفحات 209-217
    این پژوهش با هدف بررسی نقش میانجی طرحواره های ناسازگار اولیه در رابطه ی بین بدرفتاری های عاطفی دوران کودکی و آشفتگی های روانی بعدی در میان دانشجویان انجام گرفته است. نمونه مورد مطالعه 315 نفر از دانشجویان دانشگاه های تهران بوده است که به شیوه نمونه گیری در دسترس انتخاب شدند. برای سنجش متغیرهای مورد پژوهش از پرسشنامه تجارب زندگی (LEQ)، پرسشنامه کوتاه طرحواره یانگ نسخه 90 آیتمی (YSQ-SF-3)، چک لیست نشانگان آشفتگی (TSC-40) استفاده شد. یافته های پژوهش با استفاده از روش تحلیل مسیر از طریق SPSS مورد تجزیه و تحلیل قرار گرفت. نتایج تحلیل مسیر نشان داد که رابطه ی بین تجربه مورد بدرفتاری عاطفی قرار گرفتن در دوران کودکی با آشفتگی های روانی بزرگسالی در جمعیت دانشجویان به وسیله ی طرحواره های نقص/ شرم، آسیب پذیری به ضرر و بیماری، ایثار و استحقاق تعدیل می شود. یافته های بدست آمده از پژوهش حاضر موید آن است که تجربه بدرفتاری عاطفی در دوران کودکی از طریق ایجاد آسیب پذیری شناختی در کودکان مانند شکل گیری طرحواره های ناسازگار اولیه که ساختارهای شناختی انعطاف ناپذیر و افراطی هستند و باعث سوگیری منفی در تفسیر اطلاعات شناختی و هیجانی می شوند، می توانند آشفتگی های روانی در بزرگسالی را پیش بینی کنند.
    کلیدواژگان: بدرفتاری های عاطفی، آشفتگی های روانی، طرحواره های ناسازگار اولیه
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  • Ebrahim Soltani Azemat, Behrooz Dolatshahi *, Morteza Nori Khajavi Pages 151-156
    Objective
    This study aimed to assess deficits of cognitive and emotional aspects of theory of mind in patients with bipolar disorder type 1 within a remission period.
    Methods
    In this case- control study, 30 bipolar patients and 30 normal individuals were selected through Purposive sampling method for the purpose of the study. Then, they were matched based on their educational background and age. Finally, all participants were asked to complete the Kessler Psychological Distress Scale (K10), eyes test, Theory of Mind Picture Stories Tasks. Data were analyzed using the independent t-test.
    Results
    Results show that there is a significant difference between two groups regarding their scores of cognitive theory of mind (t=4.85, P<0.01). and emotional theory of mind(t=4.54, P<0.01). and their reaction time for cognitive test(t=10.34, P<0.01) and emotional test(t=4.61, P<0.01).
    Conclusion
    The results show that bipolar patients type I with remission period have deficit regarding cognitive and emotional theory of mind. And because of this, they are weak in understanding others ’cognitive mind states like opinions and ambitions, and others’ emotional mind states like feelings and emotions. In fact, it can be concluded that the deficit in Theory of cognitive and emotional mind in bipolar patients with remission period can be the result of the malfunction of brain regions and cognitive infrastructures like executive performances.
    Keywords: Theory of mind, Bipolar disorder, Cognition, Affect
  • Hanieh Alasty *, Behrouz Dolatshahi, Hamed Ekhtiari Pages 157-166
    Objective
    Obesity is a major health problem. Nowadays approximately one-third of the world population suffer from obesity which is frequently accompanied with serious medical and emotional problems. Three main evidence-based options exist for the treatment of obese individuals: lifestyle modification, pharmacotherapy, and bariatric surgery. The purpose of this study was to determine the effectiveness of cognitive-behavioral treatment in treating of patients with obesity.
    Methods
    Three women with body mass index of 30 kg/m2 or more were selected by purposive sampling method to take a part in an A-B single subject design with follow up. Patients responded to the multidimensional body-self relations questionnaire-appearance scales (MBSRQ-AS), Binge eating scale (BES) and Rosenberg self-esteem scale (RSES) at 3 stages of baseline (pre-treatment), treatment (2nd, 4th, 6th, 8th, 10th, and 12th sessions), and follow up. In addition, weighing of patients was carried out at beginning of each session. Data were analyzed by graphs and improvement rates.
    Results
    Results showed that therapy was effective in weight loss, reduction of binge eating,and maintaining of weight loss. It also increased body image satisfaction but failed in selfesteem improvement.
    Conclusion
    The cognitive-behavioral treatment was effective in treating of obese patients. This treatment outcome data are consistent with cognitive-behavioral treatment of obesity proposed by other scientists.
    Keywords: Cognitive, behavioral therapy, Obesity, Self, esteem, Body image, Binge eating
  • Seyed Reza Alvani *, Norzarina Mohd Zaharim, Laurel Wynne Kimura Pages 167-176
    Objective
    Type 2 diabetes mellitus is a chronic and progressive disease that has reached the epidemic level around the world. In Malaysia, according to the third National Health and Morbidity Survey (2006), the prevalence of diabetes has increased to 14.9% from 8.3% in 1996. Co-morbid psychological factors such as depression, anxiety, and stress have been shown to be high among type 2 diabetic patients in Malaysia and they were also associated with the level of glycemia. The present study sought to examine the relationships of diabetes distress and psychological well-being to glycemic control among adults with type 2 diabetes.
    Methods
    A total of 60 adults with type 2 diabetes participated in the study and were given the diabetes distress scale (DDS-17) and well-being questionnaire (W-BQ 22) to measure their level of distress and psychological well-being using Pearson correlation test. The most recent data on glycemic control (or blood glucose level, HbA1c) were obtained from the participants’medical records, (with poor glycemic control defined by HbA1c>7.5%). Statistical Package for the Social Sciences (SPSS 19) used to analyze the data obtained from questionnaires.
    Results
    Pearson correlation results indicated significant positive relationship between blood glucose level and variables of diabetes distress (r=0.27, P=0.03) and psychological well-being (r=0.53, P=0.00). There were no significant relationships between blood glucose level and diabetes distress dimensions (emotional burden, physician-related distress, regimen-related distress, and internal distress). However, there were significant relationships between blood glucose level and variables of depression (r=-0.27, P=0.03) and anxiety (r=-0.41, P=0.00), both of which are dimensions of psychological well-being.
    Conclusion
    The study results have shown that diabetes distress and psychological wellbeing are associated with glycemic control and while it is not always possible to avoid stress, learning to recognize and cope with stressors may help individuals with diabetes maintain good glycemic control and improve general well-being. These results are consistent with the results of past studies in Malaysia.abuse.
    Keywords: Anxiety, Blood glucose level, Depression, Psychology, Stress
  • Parvaneh Mohammadkhani, Elham Eskandari, Ali Mehrabi, Mahdi Bagheri* Pages 177-184
    Objective
    The present study aimed to investigate the selective attention hypothesis in a group of Iranian outpatients with depressive disorder.
    Methods
    Causal-comparative and correlation methods were used to analyze the data. A total of 60 subjects participated in this study. Of them, 31 patients diagnosed with depression were assigned in the depressive group and 29 nondepressed individuals were observed as control (normal) group. Participation in this study was completely voluntary. Participants were screened by the structured clinical interview for the DSM-IV (SCID), answered to Beck depression inventory–II (BDI-II), and took part in the Visual Dot-Probe (VDP) task. The data were analyzed by correlation analysis and t test.
    Results
    The results showed that the depressed group got higher score in BDI compared to the control group and this difference was statistically significant. But the differences between two groups regarding attention biases were not large enough to be significant.
    Conclusion
    The following results could be because of the different reasons such as culture. Furthermore, there were several limitations to the current study which are discussed.
    Keywords: Depression, Attention, Culture
  • Mehrnaz Yekta *, Reza Rostami, Elham Fayyaz Pages 185-194
    Objective
    Recent studies on treating obsessive compulsive disorder (OCD) have investigated noninvasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) to improve patients’ impaired emotion and cognition. However, such experiments have yielded mixed results, especially with respect to cognition. This study aimed to investigate whether anodal and cathodal tDCS applied over the dorsolateral prefrontal cortex (DLPFC) would improve decision making and reduce obsession symptoms in patients with OCD.
    Methods
    the current study is analysis of variance. In this regard, 20 patients with obsessive compulsive disorder (n=20) were randomly assigned to receive either experimental (active) or control (sham) tDCS. To measure cognitive functions, the participants underwent a series of decision making neuropsychological tasks; to measure obsession symptoms, the Yale-brownobsessive compulsive and Beck anxiety scale (BAI) were used. The parameters of active tDCS included administration of 2 mA for 20 minutes per day for 15 consecutive days, anode electrode over the right DLPFC (F4), and cathode electrode over the left DLPFC (F3) region.
    Results
    After 10 sessions of anodal and cathodal tDCS, patients showed significant improvement in decision making tasks. The same results were observed for obsession symptoms.
    Conclusion
    The data were analyzed by SPSS 18.0.0 software, using analysis of variance methods.This study demonstrated that anodal tDCS over left DLPFC, concurrent with cathodal tDCS over right DLPFC, improved cognitive impairment and reduced obsession symptoms in patients with OCD.
    Keywords: Obsessive compulsive disorder, Decision making, Transcranial direct current stimulation (tDCS)
  • Shaahin Mahmoudzadeh, Parvaneh Mohammadkhani *, Behrouz Dolatshahi, Soofi Moradi Pages 195-202
    Objective
    The purpose of this study was to investigate the relationship of psychological wellbeing with variables of mindfulness and emotion regulation strategies, and then to identify which one predicts better psychological well-being.
    Methods
    We used a descriptive-analytical design for this study. A total of 243 students from 3 Tehran universities were selected using the convenience sampling method. Three measurement instruments were used in this study: mindful attention awareness scale (MAAS), cognitive emotion regulation questionnaire (CERQ), and psychological well-being scale (PWS). The statistical analysis included the Pearson correlation coefficient and stepwise regression analysis. Study variables were calculated with SPSS ver. 19.
    Results
    The results indicated that mindfulness and psychological well-being are positively correlated to most of the more adaptive cognitive emotion regulation strategies and negatively correlated to most of the less adaptive ones. In the fifth model of regression analysis, positive reappraisal (Beta=0.27), catastrophizing (Beta=-0.24), refocus on planning (Beta=0.24), mindfulness (Beta=0.22), and acceptance (Beta=-0.10) were the best predictors of psychological well-being, consecutively, and together accounted for 46% of the variance.
    Conclusion
    Higher mindfulness and using more adaptive cognitive emotion regulation strategies are associated with higher psychological well-being. Regression analysis also suggests that higher levels of positive reappraisal, refocusing on planning, mindfulness, lower levels of catastrophizing, and acceptance predict higher levels of psychological well-being.
    Keywords: Mindfulness, Cognitive emotion regulation, Psychological well, being
  • Fahimeh Ghahvechi, Hosseini *, Ali Fathi Ashtiani, Mojtaba Satkin Pages 203-208
    Objective
    The purpose of the present study was to compare the efficacy of metacognitive therapy with cognitive therapy on reducing test anxiety and meta-worry among students.
    Methods
    The present study is a quasi-experimental research with pre- and post-test design with a control group. Study population comprised all female students of Tarbiat-ModaresUniversity of Tehran and sample included 15 students who selected by available sampling method and then randomly assigned in 3 groups. Test Anxiety Inventory and the Anxious Thoughts Inventory were given to 3 groups. For analyzing the data, analysis of covariance (ANCOVA) and repeated measure method were used. Students in 3 groups were matched with regard to age and marital status.
    Results
    The results of co-variance test showed that there are differences between 3 groups in test anxiety. Metacognitive and cognitive therapy had same efficacy in reducing test anxiety, while the metacognitive therapy had more efficacy than cognitive therapy in reducing metaworry.
    Conclusion
    Considering the effectiveness of two treatments on test anxiety, results of the present study can be useful for specialists. Also, results of metacognitive therapy can be helpful in reduction of meta-worry.
    Keywords: Test anxiety, Metacognitive therapy, Cognitive therapy, Meta, worry
  • Shirin Farazmand, Parveneh Mohammadkhani *, Abbas Pourshahbaz, Behrooz Dolatshahi Pages 209-217
    Objective
    This study aimed to investigate the mediating role of maladaptive schemas between childhood emotional maltreatment and psychological distress among college students.
    Methods
    This was a descriptive-correlative and after the fact study. A total of 315 students were selected with multistage cluster sampling from students of Tehran universities. The participants completed the lifetime of experiences questionnaire (LEQ), Young’s schema questionnaire short form with 90-item (YSQ-SF-3), and the trauma symptom checklist-40 (TSC-40). Data were analyzed by path analysis using SPSS 16.
    Results
    The results indicated that perception of childhood emotional maltreatment was associated with later psychological distress and mediated through schema of defectiveness/ shame, vulnerability to harm, self-sacrifice, and entitlement.
    Conclusion
    In this study, our findings suggested that childhood emotional maltreatment is contributed to later psychological distress by developing cognitive vulnerability of children through maladaptive schemas. These schemas are rigid and extreme cognitive structures that negatively filter and bias cognitive and emotional information.
    Keywords: Childhood emotional maltreatment, Psychological distress, Early maladaptive schemas, College students