بررسی اثربخشی درمان گروهی طرحواره های هیجانی بر میزان درد و افسردگی در بیماران مبتلا به آرتریت روماتویید

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه روانشناسی سلامت، واحد بین المللی کیش، دانشگاه آزاد اسلامی، جزیره کیش، ایران

2 استاد و مدیر گروه روانشناسی سلامت دانشگاه آزاد اسلامی کرج، البرز، ایران

3 استادیار، گروه روان شناسی، دانشکده روان شناسی و علوم تربیتی، دانشگاه علامه طباطبایی، تهران، ایران

4 استادیار گروه روانشناسی دانشگاه آزاد اسلامی کرج، البرز، ایران

5 متخصص اعصاب و روان، بیمارستان معتمدی، تهران،‌ایران

چکیده

هدف این مطالعه بررسی اثربخشی درمان گروهی طرحواره­های هیجانی بر میزان درد و افسردگی در بیماران مبتلا به آرتریت روماتویید بوده است. جامعه آماری شامل تمامی بیماران مبتلا به آرتریت روماتویید مراجعه­کننده به درمانگاه­های روماتولوژی و بخش­های روماتولوژی بیمارستان­های شهر شیراز بود. 45 بیمار مبتلا به بیماری آرتریت روماتویید که مبتلا به افسردگی هم بودند،    به­صورت تصادفی در 3 گروه آزمایشی، پلاسیبو و کنترل قرار گرفتند. پرسشنامه­های  مورد استفاده در این مطالعه، پرسشنامه­های درد مک گیلو  افسردگی بک بودند. برای تجزیه و تحلیل داده­ها از روش­های تحلیل کوواریانس و واریانس با اندازه­گیری مکرر استفاده گردید. نتایج نشان داد که درمان گروهی طرحواره­های هیجانی برمیزان درد(مولفه­های حسی، عاطفی، شناختی و نمره کل) و افسردگی در بیماران مبتلا به آرتریت روماتویید اثر معناداری داشت و موجب کاهش آنها گردید و این اثر پس از پیگیری 3 ماهه ماندگاری داشت(p<0/05). با استناد به یافته­ها میتوان نتیجه گرفت که درمان گروهی طرحواره­های هیجانی میتواند یک مداخله روانشناختی اثربخش جهت کاهش درد و افسردگی در بیماران مبتلا به آرتریت روماتویید باشد.

کلیدواژه‌ها


عنوان مقاله [English]

The Effectiveness of Emotional Schemas Group Therapy on Pain and Depression in Patients with Rheumatoid Arthritis

نویسندگان [English]

  • Marieh Hosseini 1
  • Hassan Ahadi 2
  • Farhad Jomehri 3
  • Adid Kraskian-Mujembari 4
  • Morvarid Ahadi 5
1 Department of Health Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
2 Full Professor, Faculty member of Science and Research University of Tehran
3 Assistant professor, Department of Psychology, School of Psychology and Educational Sciences, Allameh Tabatabai University, Tehran, Iran
4 Assistant Professor, Department of Psychology, School of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
5 Psychiatrist, , Department of Psychiatric, Moatamedi Hospital, Tehran, Iran
چکیده [English]

Abstract
The aim of this study was to determine the effectiveness of emotional schemas group therapy on pain and depression in patients with rheumatoid arthritis. The statistical population included all patients with rheumatoid arthritis referring to rheumatology clinics and rheumatology departments of Shiraz hospitals. 45 patients with rheumatoid arthritis who were also afflicted with depression were randomly assigned into 3 experimental, placebo and control groups. The questionnaires were used in this study included McGill Pain Questionnaire and Beck Depression Inventory. Emotional schemas group therapy was conducted for 16 sessions of 2 hours and a half for experimental group only. For data analysis, covariance analysis and variance analysis with repeated measurements were used. The results showed that emotional schemas group therapy) had a significant effect on pain (sensory, emotional, cognitive, and general components), and depression in patients with rheumatoid arthritis and reduced them, and their effects remained after 3 months follow up (p Keywords: Rheumatoid arthritis, Emotional schemas therapy, Pain, depression.

کلیدواژه‌ها [English]

  • Rheumatoid arthritis
  • Emotional Schemas Therapy
  • Pain
  • Depression
Adineh, M, Hasani, J. (2016). The Effect of Written Emotional Disclosure in Interpersonal Problems of Children with Oppositional Defiant Disorder: A Single Subject Study, Quarterly Journal of Psychological Methods and Models, Volume 7, Issue 23, pp. 1-18.
Dworkin, R.H., Turk, D.C., Revicki, D.A., Harding, G., Coyne, K.S., Peirce-Sandner, S., Melzack, R. (2009). Development and initial validation of an expanded and revised version of the short-form Mc Gill Pain Questionnaire (SF-MPQ-2), PAIN, 144(1):35-42.
Davis, M.C., Zautra, A.J., Wolf, L.D., Tennen, H., Yeung, E.W. (2015). Mindfulness and cognitive – behavioral Interventions for chronic pain: differential effects on daily pain reactivity and stress reactivity, JConsult ClinPsychol,83 (1):24-35.
Eccleston, C., Morley, S., and Williams, A.C.D. (2013). Psychological approaches to chronic pain management: evidence and challenges, British journal of anesthesia, 111 (1): 59-63.
Erfan, A., Noorbala, A.A. Mohammadi, A., Adibi, P. (2018). The effectiveness of emotional schema therapy on psychological symptoms of patients with irritable Bowel syndrome, Int J Educ Psychol Res, 4:26-32.
Fata, L. (2003). Meaning assignment structure/schema, emotional states and cognitive processing of emotional information: comparing two conceptual frameworks, PhD thesis of clinical psychology, Tehran Psychiatric Institute.
 
Fogarty, F.A., Booth, R.J., Gamble, G.D., Delbeth, N., and Consedine, N.S. (2015). The effect of mindfulness-based stress reduction on disease activity in people with rheumatoid arthritis: a randomized controlled trial, Ann Rheum Dis ,74(2): 472-474.
Fu, x., Jun Li, z., Yang, C., Feng, L., Sun, L., Yao, Y., Ting Huang, Y. (2017). The prevalence of depression in rheumatoid arthritis in china: A systematic review, Oncotarget. V.8 (32): 53623-53630.
Groth-Marnat, Gray, (2015). Handbook of Psychology Assessment: For Clinical Psychologists, Advisers and Psychiatrists (Vol. 2), Translated by Pasha Sharifi, Hassan, Nikkhoo, Mohammad Reza, Roshd Publications, Tehran.
 
Hall, C.W., Row, K.A., Wuensch, K.I., Godley, K.R. (2013). The role of self-compassion in physical and psychological well-being. JPsychology, 147:311-23.
 
Hamzehpour Haghighi T, Dousty Y, Fakhri M K. Effectiveness of group cognitive behavioral therapy on illness and pain perception in patients with rheumatoid arthritis. SJKU. 2015; 20 (3) :45-57.
Hewlett, S., Ambler, N., Almeida, C., Blair, P.S., choy, E., Dures, E., Hammond, A., Hollingworth, W., Kirwan, J., Plummer, z., Rooke, C., Thorn, J., Tomkinson, K., Pollock, J. (2015). Protocol for a randomized Controlled trial for Reducing Arthritis Fatigue by clinical Teams (RAFT) using cognitive- behavioral approaches, DoI: 10.1136/bmjopen-009061.
Keefe, F J. Somers, TJ. Psychological approaches to understanding and treating arthritis pain. J. Nat. Rev. Rheumatoi. (2010); 6: 210-216.
 
Khosravi, M, Sedigh, S, Moradi Alamdar, Sh, Zendedel, K. (2012). McGill pain Persian Questionnaire, Translated, Conformity and Reliability in Cancer Patients: A Short Report of journal of Medical school, Tehran University of Medical Sciences 71, (1): 53-58.
 
Klareskog, L., Catrina, A.I., Paget, S. (2009). Rheumatoid arthritis. Lancet, 373:659-672.
Koechlin, H., Coakley, R., Schechter, N.,Werner, C., Kossowsky, J. (2018). The role of emotion regulation in chronic pain: A systematic literature review, Journal of psychosomatic Research, 107: 38-45.
Kolyaie, L., Badri, R., Bahrami, M., Hosseini, S.A. (2016).  The effect of emotional schema therapy on reduction of depression in high school students. International Journal of humanities and cultural studies, pp 680-689.
Leahy, Robert L, Tirch, Dennis, Napolitano, Lisa A, Emotion regulation in psychotherapy: a practitioner’s guide, c2011. Translated by Mansouri Rad, Abdolreza, Arjmand Publications, Tehran.
Leahy, R.L., Tirch, D.D., Melwani, p.s. (2012). Processes underlying deperession: Risk aversion, emotional schemas, and psychological Flexibility. International journal of Cognitive Therapy, 5(4),362-379.
Liu, L., Xu, N., Wang, L. (2017). Moderating role of self-efficacy on the associations of social support with depressive and anxiety symptoms in Chinese patients with rheumatoid arthritis, Neuro psychiatr Dis Treat, 13: 2141-2150.
Longo, D, Kasper, D, Jameson, Fauci. Harrison's principles of internal medicine,19th ed, c2015. With introduction and under supervision of Masoumeh Akhlaghi, Translation by Farzaneh Mohammadi, Mohaddeseh Ardestani, Andisheh Rafi, Tehran.
Majeed, M.H., Ail, A.A., Sudak, D.M. (2018). Mindfulness-based interventions for chronic pain: Evidence and applications, Asian Journal of psychiatry, 32:79- 83.
. Matcham, F., Rayner, L., Steer, S., Hotopf, M. (2013). The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis, Rheumatolog,52:2136-2148.
Melzack, R. (1975). The McGill Pain Questionnaire: major properties and scoring methods, Pain, 1(3): 277-299.
Montero–Marin, J.M. et.al; (2017). efficacy of attachment-based compassion therapy in the Treatment of Fibromyalgia: A randomized controlled Trial, Front, Psychiatry, 8:307. doi: 10.3389/fpsyt.00307.
Parsamanesh, F, Kraskian, A, Hakami, M, Ahadi, H. (2018). Effectiveness of Gross emotion regulation model on emotional distress and emotional eating behavior, Quarterly Journal of Psychological Methods and Models, Volume 8, Issue29, pp. 23-52.
Prothero, L., Barley, E., Galloway, J., Georgopoulou, S., Sturt, J. (2018). The evidence base for psychological interventions for rheumatoid arthritis: A systematic review of reviews, International Journal of Nursing studies, 82: 20-29.
Rezaei, F., Taher Neshat Doost , H., Molavi, H., Abedi, M.R., Karimifar, M. (2014). Comparative study of early maladaptive schemas in rheumatoid arthritis patients and normal adults. International Journal of Basic and Applied science, 2 (3): 53-58.
Rezaei M, Ghadampur E, Rezaei M, Kaemi R. (2015). Effectiveness of Emotional Schema Therapy on Rumination and Severity of Depression in Patients with Major Depressive Disorder, JCP; 7(4): 45-58.
Sharp, L. (2016). Psychological management of chronic pain in patients with rheumatoid arthritis: challenges and solutions, Journal of pain Research, 9:137-146.
Tajeri, B, Ahadi, H, Jomehri, F. (2010). Studying Effectiveness of Cognitive- behavior Skills Training on Attitude, Depression & Mood Addicts in Methamphetamine Addicts, Quarterly Journal of Psychological Methods and Models, Volume 2, Issue 5, pp. 81-99.
Van Onna, M., Boonen, A. (2016). The challenging interplay between rheumatoid arthritis, aging and comorbidities, BMC Musculo Skeletal Disorders, 17:184.
Yalom, I.D., The Theory and Practice of Group Psychotherapy; fifth Edition, Basic Books, May, 2005, New York.