بررسی اثربخشی طرحواره درمانی بر کاهش استرس، اضطراب، افسردگی و افزایش خودکارآمدی در بیماران مبتلا به مولتیپل اسکلروزیس

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی بالینی دانشگاه ازاد اسلامی رودهن

2 استادیار گروه روانشناسی دانشگاه پیام نور

3 دانشیار گروه روانشناسی دانشگاه ازاد اسلامی رودهن

چکیده

مقدمه: هدف این پژوهش بررسی اثربخشی طرحواره درمانی بر کاهش اضطراب، افسردگی، استرس و افزایش خودکارآمدی بیماران مبتلا به بیماری مولتیپل اسکلروزیس بوده است.
روش: پژوهش حاضر یک مطالعه نیمه آزمایشی با طرح پیش‌آزمون–پس‌آزمون با گروه کنترل است. جامعه آماری این پژوهش شامل کلیه افراد مبتلا به بیماری MS و عضو انجمن حمایت از بیماران مبتلا به مولتیپل اسکلروزیس شهر تهران بود. نمونه پژوهشی شامل 30 نفر بودند که به روش نمونه‌گیری هدفمند انتخاب شدند و به طور تصادفی در دو گروه آزمایش و کنترل جایگزین شدند. ابزار مورد استفاده در این پژوهش، پرسشنامه استرس، اضطراب و افسردگی (21DASS-) و پرسشنامه خودکارآمدی عمومی (GSE-10)بودند. گروه آزمایش جلسات طرحواره درمانی طی 12 جلسه دوساعته دریافت نمود و گروه کنترل هیچگونه مداخله درمانی دریافت نکردند،سپس هر دو گروه تحت پس آزمون قرار گرفتند.  داده‌ها با استفاده از تحلیل واریانس چند متغیری و تک متغیری و تی مستقل مورد تجزیه و تحلیل قرار گرفتند.
نتایج : نتایج تحلیل واریانس نشان داد که طرحواره درمانی بر استرس(0/001>f =110/90  P) ، اضطراب(0/001>f =88/92  P) و افسردگی (0/001 > f =32/29  P) اثربخش بوده است و همچنین طرحواره درمانی بر افزایش خودکارآمدی  در بیماران مبتلا به مولتیپل اسکلروزیس مو ثر بوده است (07 /12= t).
بحث و نتیجه‌گیری: با توجه به یافته مطالعه حاضر ، درمانگران می توانند از طرحواره درمانی برای کاهش اضطراب،  افسردگی، استرس و افزایش خودکار آمدی در بیماران مبتلا به مولتیپل اسکلروزیس استفاده نمایند.

کلیدواژه‌ها

عنوان مقاله [English]

Evaluation of the effectiveness of schema therapy on reducing stress, anxiety, depression and increasing self-efficacy in patients with multiple sclerosis

نویسندگان [English]

  • Maryam ّّFarhadi 1
  • Mohmmad Mehdi Pasandideh 2
  • Shahram Vaziri 3
1 Ph.D. Student of Clinical Psychology, Islamic Azad University of Roudehen
2 Assistant professor of psychology, Payam Noor University
3 Associate professor of psychology, Islamic Azad University of Roudehen
چکیده [English]

Introductoin: This study aimed to evaluate the effectiveness of schema therapy on reducing stress, anxiety, and depression in patients with multiple sclerosis.
Method: The present study was a quasi-experimental study with pre-test, post-test design with a control group. The study population consisted of all members of the MS Society of Iran located in Tehran, and the research sample consisted of 30 members of the Association who were selected using the targeted sampling method and were randomly assigned to two experiment and control groups (15 people for each group). All 2groups were tested by (DASS-21) and (GSE-10) scale, and then the experimental group received schema therapy in 12 Two-hour sessions for 12 weeks, but the control group did not receive some training, then both groups were post-test. The research data were analyzed using multivariate and univariate analysis of variance and independent t-test.
Results: The results of analysis of variance of difference scores showed that schema therapy on stress (f=110.90, P<0,001), anxiety (f= 88.92, P<0,001), and depression: (f= 32.29, P<0,001) in patients with multiple sclerosis has been effective. Schema therapy has been effective in increasing the self-efficacy of patients with multiple sclerosis (t = 12.07).
Discussion and Conclusion: The findings of this study confirm the effectiveness of schema therapy in reducing stress, anxiety, and depression and increasing self-efficacy in patients with multiple sclerosis.

کلیدواژه‌ها [English]

  • Multiple sclerosis
  • schema therapy
  • stress
  • anxiety
  • depression
  • self-efficacy

مراجع

  1. Reich DS, Lucchinetti CF, Calabresi PA. Multiple Sclerosis. New Engl J Medicine. 2018; 378:169–180. 
  2. Filippi M, Rocca MA, Barkhof F, Brück W, Chen JT, Comi G, et al. Association between pathological and MRI findings in multiple sclerosis. Lancet Neurol. 2012; 11:349–360. doi:10.1016/S1474-4422(12)70003-0
  3. Inojosa H, Schriefer D, Ziemssen T. Clinical Outcome Measures in Multiple Sclerosis: A review. Autoimmun Rev. 2020.
  4. Kaunzner UW, Al-Kawaz M, Gauthier SA. Defining Disease Activity and Response to Therapy in MS. Curr Treat Option Ne. 2017; 19:20. doi: 10.1007/s11940-017-0454-5
  5. Leocani L, Rocca MA, Comi G. MRI and neurophysiological measures to predict course, disability and treatment response in multiple sclerosis. Curr Opin Neurol. 2016; 29:243. doi: 10.1097/WCO.0000000000000333
  6. Azami M, Khorshidi A. Epidemiology of Multiple Sclerosis in Iran: A Systematic Review and Meta-analysis. 2019; 2 (1):4-14. URL: http://newresearch.medilam.ac.ir/article-1-430-fa.html
  7. solaro C, Cella M, Signori A, Martinelli V, Radaelli M, Centonze D, et al. Neuropathic Pain Special Interest Group of the Italian Neurological Society. Identifying neuropathic pain in patients with multiple sclerosis: a cross-sectional multicenter study using highly specific criteria. Journal of Neurology.2018; 265: 828–835.
  8. Fiest K, Fisk J, Patten S, Tremlett H, Wolfson C, Warren S, McKay K, Berrigan L, Marrie RA. Fatigue and comorbidities in multiple sclerosis. IJMSC 2016; 18(2): 96-104
  9. Cortez VR, Duriez-Sotelo E, Carrillo-Mora P, Pérez-Zuno JA.Correlación entre las lesions desmielinizantes y el deterioro de las funciones ejecutivas en una muestra de pacientes mexicanos con esclerosis múltiple. Neurología. 2012 .28:394-399.
  10. Mc Cabe, M.P. Mood and self-esteem of persons with multiple sclerosis following an exacerbation. Journal of Psychosomatic Research, 2005. 59: 161-166.
  11. Bashi Abdolabadi H, Pilevar s, Saremi A A. "The effect of cognitive rehabilitation on cognitive functions, memory, depression and anxiety in patients with multiple sclerosis. Journal of Shefaye Khatam, 2016; 4( 3):28-40
  12. Weersing, V R, Shamseddeen W, Garber J, Hollon S D, Clarke G N, Beardslee W R, et al. Prevention of depression in at-risk adolescents: Predictors and moderators of acute effects. Journal of the American Academy of Child & Adolescent Psychiatry.2016; 55: 219-226.
  13. Osborne TL, Jensen MP, Ehde DM, Hanley pain intensity, pain-related interference, and psychological functioning in persons with multiple sclerosis and pain. Pain; 2007;127(1-2):52-62.
  14. Denison L, Moss-Morris R, &Chalder T. A review of psychological correlates of adjustment in patients with multiple sclerosis. Journal of Clinical Psychology Review, 2009; 29(2):141-153.
  15. Hughes AJ,  Beier M,  Hartoonian N, ,  Turner Ap,  Amtmann  D, and  Ehde Self-Efficacy as a Longitudinal Predictor of Perceived Cognitive Impairment in Individuals with Multiple Sclerosis. Arch Phys Med Rehabil.2015; 96(5):913-919.
  16. Kalantarei Hormozi A, Bijani J and Hosseini Nejad N. The effectiveness of cognitive-behavioral group therapy on self-efficacy and self-esteem of married men with substance abuse. Journal of Consulting Research, 2014; (52): 92-107.
  17. Newman MG, Lera SL, Erickson TM, Przeworski A, Castonguay LG. Worry and generalized anxiety disorder: a review and theoretical synthesis of evidence on nature, etiology,mechanisms, and treatment. Annu Rev Clin Psychol. 2013; 9: 275-297.
  18. Văcăraș,V. Văcăraș, V. Nistor , C. Văcăraș, D. Nicolae Opre,A. Blaga,P and. Mureșanu, D. F. The Influence of Depression and Anxiety on Neurological Disability in Multiple Sclerosis Patients. Hindawi Behavioural Neurology Volume 2020; Article ID 6738645, 8 pages https://doi.org/10.1155/2020/6738645
  19. Martinsen K  D ., Kendall  P  C , Stark  K , &Neumer  S  Prevention of anxiety and depression in children: Acceptability and feasibility of the Trans diagnostic EMOTION program. Cognitive and Behavioral Practice, 2016; 23: 1-13
  20. Jones K H, Ford D V, Jones F A, John A, Middleton R M, Jones H L, et al. A Large-Scale Study of Anxiety and Depression in People with Multiple Sclerosis: A Survey via the Web Portal of the UK MS Register. Article in PLoS ONE · 2012; 7 (7): e41910.1-10
  21. Abdul Razzak H, Harbi A, and Ahli S. Depression: Prevalence and Associated Risk Factors in the United Arab Emirates, Oman Medical Journal, 2019; 34(4): 274–282.
  22. Boeschoten R E, Braamse A M J, Beekman ATF,Oppen P v, Dekker J, Uitdehaag B MJ, et al, Prevalence of depression and anxiety in Multiple Sclerosis: A systematic review and meta-analysis,” Journal of the Neurological Sciences. 2017; 372: 331–341.
  23. Jiang X, Olsson T, Hillert J, Kockum I, and Alfredsson L. Stressful life events are associated with the risk of multiple sclerosis. Eur J Neurol. 2020; 27(12): 2539–2548.Published online 2020 Aug 23. doi: 10.1111/ene.14458
  24. Asadi Haghighat M, ZahraKar K, farzad V. Cognitive-Behavioral Stress Management Training (CBSM) on Reducing Stress Symptoms of Women with Multiple Sclerosis (MS) . Journal of Disability Studies 2019; (9):77.Published online 2019 Nov
  25. Karimi S, Andayeshgar B, and Khatony A. Prevalence of anxiety, depression, and stress in patients with multiple sclerosis in Kermanshah-Iran: a cross-sectional study. BMC Psychiatry, 2020; 20:166
  26. Hejazizadeh N. Pazokian M. Nasiri M. Self-efficacy in Patients with Multiple Sclerosis: A Model Test Study. Evidence Based Care Journal 2020; 09:30 originally published online 01 January 2020.DOI: 10.22038/ebcj.2020.45326.2230 Online ISSN: 2008-370X
  27. Galhardo A, Cunha M, Gouveia J P.Measuring Self-Efficacy to Deal with Infertility: psychometric Properties and Confirmatory Factor Analysis of the Portuguese Version of the Infertility Self-Efficacy Scale.Journal of Research in Nursing & Health; 2013; 36: 65-74.
  28. . Wilski M, Kocur P, Górny M, Koper M, Nadolska A, Chmielewski B, et al. Perception of multiple sclerosis impact and treatment efficacy beliefs: mediating effect of patient’s illness and selfappraisals. J Pain Symptom Manage. 2019; 58(3):437-44.
  29. Ifantopoulou P N, Artemiadis A K, Triantafyllou N, Chrousos G, Papanastasiou I, Darviri C. Selfesteem is associated with perceived stress in multiple sclerosis patients. Neurol Res. 2015; 37(7):588-92. doi: 10.1179/1743132815Y.0000000016. Epub 2015 Mar 3.
  30. Motl RW, McAuley E, Wynn D, Sandroff B, Suh Y. Physical activity, self-efficacy, and health-related quality of life in persons with multiple sclerosis: analysis of associations between individual-level changes over one year Quality of Life Research , 2013 ; 22: 253–261
  31. Jongen PJ, Wesnes K, Geel B V,Pop P, Schrijver H, Visser LH, et al.  Does self-efficacy affect cognitive performance in persons with clinically isolated syndrome and early relapsing remitting multiple sclerosis? Journal of   Multiple, Sclerosis International, 2015; 960 282: 1-8. doi: 10.1155/2015/960282. Epub 2015 Apr 29.
  32. Arnett PA, Barwick FH, Beeney JE. Depression in multiple sclerosis. Review and theoretical proposal.2008; 14: 691-724.
  33. Young, J E. Cognitive Therapy for Personality Disorders: A Schema-Focused Approach. Sarasota, Fl: Professional Resource Press.1990
  34. Thase ME, Nierenberg AA, Vrijland P, van Oers HJ, Schutte A-J, and Simmons JH. Remission with mirtazapine and selective serotonin reuptake inhibitors: a meta-analysis of individual patient data from 15 controlled trials of acute phase treatment of major depression. International clinical psychopharmacology, 2010; 25(4):189-98.
  35. Zakerzadeh Z. Golparvar M, Aghaei As .The effectiveness of integrated therapist-centered therapy and Young's schema therapy on the perception of exclusion of people with borderline personality traits. Journal of Clinical Psychology & Personality 2020; 18(1) Serial 34:125-136.
  36. MarySue, V. Heilemanna, Huibrie, C. Pieters, Priscilla, Kehoe, Qing, Y. Schema therapy, motivational interviewing, and collaborative-mapping as treatment for depression among low income, second generation Latinas. Journal of Behavior Therapy and Experimental Psychiatry, 2011; 42, 473- 480.
  37. Ghorban Alipour M, Moghaddamzadeh A, Jafari I. The effectiveness of schema therapy and logo therapy on death anxiety in people with self-morbidity. Journal of Clinical Psychology and Counseling.2017; 7 (1): 52-66. DOI: 10.22067/ijap.v7i1.51952
  38. Titov N, Dear BF, Ali S, Zou JB, Lorian CN, Johnston L, et al. Clinical and cost-effectiveness of therapistguided internet-delivered cognitive behavior therapy for older adults with symptoms of depression: a randomized controlled trial. Behavior Therapy, 2015; 46(2):193-205.
  39. Tusi Rad S R, Razavi Nematollahi V S .Comparison of the effect of two methods of schema therapy and emotional disclosure in reducing students' depression. Journal of Women and Family Studies.2016; 8 (33), 91-112.
  40. Khoshnood G H, Shirkavand N, Ashoori J, Arab Salari Z. Effects of Schema Therapyon the Happiness and Mental Health of Patients with Type II Diabetes. Diabetes Nursing. 2015;   3 (1): 8 - 18.
  41. Ahmadi M, Karaminia R, Watankhah H R, Hemmati Sabet A, Ahangarani Z, Hemmati M. The Comparison of Eye Movement Desensitization Reprocessing (EMDR) intervention and group cognitive therapy Efficacy on reducing depression symptoms in depressed war veterans. Journal of Military Psychology.2011; 2 (7):1-9.
  42. Shahamat, F. Prediction of general health symptoms (physicalization, anxiety and depression) based on early maladaptive schemas. Journal of Psychology, University of Tabriz. 2010; 5(20):107-128.
  43. Dickhaut V, Arntz A. Combined group and individual schema therapy for borderline personality disorder: A pilot study, Journal of Behavior Therapy andExperimental Psychiatry, 2014; 45(2): 242-251. Doi: 10.1016/j.jbtep. 2013.11.004.
  44. Malogiannis I A, Arntz A, Spiropoulou A, Tsartsara E, Aggeli A, Karveli S, Vlavianou M. Schema Therapy for patients with chronic depression: a single case series study. Journal of Behavior Therapy and Experimental Psychiatry.2014; 45(3): 319-329. doi: 10.1016/j.jbtep.2014.02.003
  45. Renner F, Lobbestael J, Peeters F, Arntz A, Huibers M. Early maladaptive schemas in depressed patients stability and relation with depressive symptoms over the course of treatment. Journal of Affective Disorders, 2012; 136(3), 581-90. Doi: 10.1016/j.jad.2011.10.027. Epub 2011 Nov 25.
  46. Morad Hasili M, Shams Esfandabad H, Kakavand A R. A Comparison of the effectiveness of schema therapy and cognitive-behavioral therapy on the self-efficacy and lifestyle related to weight loss. Journal of Mental Health Research: 2015; 9 (4) 50-61.
  47. Mitchell A J, Benito-León J, José- González M M, Rivera-Navarro J.Quality of life and its assessment in multiple sclerosis: integrating physical and psychological components of wellbeing. Journal of Lancet Neurology, 2005; 4(9): 556 – 660. doi: 10.1016/S1474-4422(05)70166-6
  48. Lovibond SH, Lovibond PF. Manual for the depression anxiety stress scales. Psychology foundation. Sydney; 1995.
  49. Antony MM, Brlow DH..Handbook of Assessment and Treatment Planning for Psychological Disorder. New York, Guilford press. 2002.
  50. Sahebi A, Asghari M J, Salari R S. Validation of Depression Anxiety and Stress Scale (DASS-21) for an Iranian Population. Journal of Iranian Psychologists 2005;1( 4) :36-54
  51. Rezaei Adriani M, Azadi A, Ahmadi F, Vahdiyan Azimi, A. Comparison of depression, anxiety, stress and quality of life of male and female students living in dormitories.Journal of Nursing. 2007; 2 (5): 31-38.
  52. Schwarzer R, Jerusalem M. Generalized Self-Efficacy Scale. In S. Wright, & M. Johnston, & J. Weinman (Eds.), Measures in Health Psychology: A User’s Portfolio. Causal and Control Beliefs .Windsor, UK: Nfer Nelson. 1995; 35–37.
  53. Rajabi Gholamreza .Reliability and validity of the general self-efficacy scale in psychology students of the Faculty of Educational Sciences and Psychology of Shahid Chamran University of Ahvaz and Marvdasht Azad University. New educational ideas. Spring and summer 2006; 2( 1 -2) : 111 - 122
  54. Payamani F. Miri M. Jahani U. Assessment of different methods to cope with stress amongst patients suffer from MS in MS Association in Tehran. Mendish Nursing Quarterly. 2010; 1(1):45-54.
  55. Shahab A, Ahadi H, Jamhari H, Mojambari Kraskian A. The effectiveness of group emotional schema therapy on subjective, well-being, fatigue of patients with multiple sclerosis in Shiraz.Methods and psychological models / Tenth year / Number 4 / Winter 2020 ;10(4):77-96
  56. Nenadić L, Lamberth S, Reiss N. Group schema therapy for personality disorders: a pilot study for implementation in acute psychiatric in-patient settings .Journal of Psychiatry Research, 2017; 253: 9 -12.
  57. Hazlett-S H. Mindfulness -based stress reduction for comorbid anxiety and depression case report and clinical considerations. Journal of Nerv Ment Dise; 2012; 200(11): 999-1003.:
  58. Karami J, Azami Y, Jalalvand M, Darabi A, RastgooN. The Effectiveness of Cognitive Group Therapy based on Schema in Reducing Job Stress among Nurses.Sadra medical journal. 2016; 4 (4): 221 – 230
  59. Farhadi1, M, Pasandideh, MF. The Effectiveness of Mindfulness ((MBSR) on stress, anxiety and depression and increasing the self-efficacy in patients with multiple( 2018) Journal of Clinical Psychology & Personalit Vol. 15, No. 2, Serial 29Autumn & Winter 2017- 2018 pp.: 7-15
  60. Nusratabadi M , Grouh A, Effectiveness of Schema Therapy on Reducing Anxiety and Depression and Improving Sexual Function in Women with Vaginismus(2020) Journal of Clinical Psychology & Personality Vol. 18, No. 2, Serial 35, Autumn & Winter 2020-2021, pp.: 11-19. DOI: https://dx.doi.org/ 10.22070/ cpap. 2020.293



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