اثربخشی شناخت درمانی مبتنی بر ذهن‌آگاهی بر کاهش استرس ادراک شده، رگه و حالت اضطراب و علایم روان‌تنی در بیماران زن مبتلا به اختلال وسواس اجباری

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار، گروه روان‌شناسی، دانشگاه پیام نور، تهران، ایران.

2 کارشناسی ارشد، گروه روان‌شناسی، دانشگاه پیام نور، تهران، ایران.

چکیده

مقدمه: پژوهش‌ها نشان‌داده‌اند که اختلال وسواس اجباری اغلب با سطوح بالایی از استرس ادراک شده، اضطراب و علائم روان‌تنی همراه است که می‌تواند این اختلال را تشدید کرده و مانع پیشرفت درمان شود. پژوهش حاضر با هدف بررسی اثربخشی شناخت درمانی مبتنی بر ذهن‌آگاهی بر کاهش استرس ادراک شده، رگه اضطراب و اضطراب حالت و علایم روان‌تنی در بیماران مبتلا به اختلال وسواس اجباری انجام شد.
روش: این پژوهش، نیمه آزمایشی با طرح پیش آزمون، پس آزمون و پیگیری است. جامعة پژوهش زنان مبتلا به اختلال وسواس اجباری بود که در سال‌های 1400-1401 به کلینیک‌های درمانی شهر تهران و تبریز مراجعه کردند.. نمونه شامل30 نفر در دوگروه آزمایش (15 نفر) و گروه گواه (15 نفر) به روش در دسترس انتخاب شدند. گروه آزمایش به مدت 8 جلسه تحن درمان شناختی مبتنی بر ذهن‌آگاهی قرار گرفت در حالی‌که گروه گواه هیج درمانی دریافت نکرد. برای بررسی اثر بخشی، از تحلیل واریانس با اندازه گیری مکرر در نرم افزار spss نسخه 26 استفاده شد.
نتایج: نتایج تحلیل استرس ادراک شده، اضطراب رگه‌، اضطراب حالت و علائم روان‌تنی  نشان داد که درمان(0005/0)  با استفاده از آلفای تعدیل شده بن فرونی و حد معنی داری ذهن‌آگاهی  مؤثر بر کاهش استرس ادراک شده، اضطراب رگه، اضطراب حالت و علایم روان‌تنی بیماران وسواس اجباری دارد.
بحث و نتیجه‌‏گیری: این پژوهش نشان داد که شناخت درمانی مبتنی بر ذهن‌آگاهی یک مداخله مؤثر برای کاهش استرس ادارک شده اضطراب و علائم روان‌تنی در بیماران مبتلا به اختلال وسواس اجباری است.

کلیدواژه‌ها

عنوان مقاله [English]

Effectiveness of Mindfulness-Based Cognitive Therapy on Reducing Perceived Stress, Anxiety Traits and Symptoms, and Psychosomatic Symptoms in Female Patients with Obsessive-Compulsive Disorder

نویسندگان [English]

  • Mahdieh Rahmanian 1
  • Mahya Asadi Khanooki 2
  • Mojgan Agahheris 1
  • Ezzatollah Kordmirza Nikoozadeh 1
1 Associate professor, Department of Psychology, Payame Noor University, Tehran, Iran.
2 M.S of Psychology, Department of Psychology, Payame Noor University, Tehran, Iran.
چکیده [English]

Introduction: Research suggests that obsessive-compulsive disorder (OCD) is frequently associated with elevated levels of perceived stress, anxiety, and psychosomatic symptoms, which can worsen the disorder and impede treatment progress. This study aimed to investigate the effectiveness of mindfulness-based cognitive therapy in reducing perceived stress, anxiety traits and symptoms, and psychosomatic symptoms in patients with OCD.
Method: The present study employed a quasi-experimental design that included pre-test, post-test, and follow-up stages. The study population comprised female patients who were referred to therapeutic clinics in Tehran and Tabriz during the years 2021-2022. A sample of 30 patients was selected and divided into two groups: an experimental group consisting of 15 patients and a control group also consisting of 15 patients. The experimental group underwent mindfulness-based cognitive therapy for eight sessions, while the control group received no treatment. The effectiveness of the intervention was assessed using repeated measures analysis of variance in SPSS software version 26.
Results: The analysis of perceived stress, levels of anxiety, and psychosomatic symptoms was conducted using Benferroni's alpha and a significance level of 0.0005. The results indicate that mindfulness treatment is effective in reducing perceived stress, anxiety, and psychosomatic symptoms in patients with obsessive-compulsive disorder (OCD).
Discussion and conclusion: This study demonstrated that mindfulness-based cognitive therapy is an effective intervention for reducing perceived stress in individuals with obsessive-compulsive disorder.
Extended Abstract
Introduction
Obsessive-Compulsive Disorder (OCD) is a common psychiatric disorder that affects approximately 2% of the population. It is characterized by intrusive thoughts, known as obsessions, and repetitive behaviors or mental acts, referred to as compulsions. These symptoms significantly affect individuals' functioning and quality of life, often co-occurring with other conditions such as anxiety and depression. While conventional treatments, including medication and Cognitive-Behavioral Therapy (CBT), are effective for some, a substantial proportion (40-60%) of patients do not achieve complete symptom relief. This, along with medication side effects and relapse rates, underscores the need to explore alternative interventions. Emerging evidence suggests that Mindfulness-Based Cognitive Therapy (MBCT), which integrates mindfulness meditation with cognitive therapy, may be a promising approach. This study aims to address this gap by investigating the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in reducing perceived stress, as well as both trait and state anxiety, and psychosomatic symptoms in patients with Obsessive-Compulsive Disorder (OCD). By fostering a more adaptive relationship with thoughts and feelings, MBCT may provide a complementary treatment option for this complex disorder that is associated with fewer side effects. This research will assess the impact of this novel intervention on the multidimensional reduction of symptoms in patients with obsessive-compulsive disorder (OCD), potentially providing a more holistic and effective approach to managing this debilitating condition. The present study will utilize a [mention study design, e.g., pre-post design with a control group] to evaluate the effectiveness of an 8-week Mindfulness-Based Cognitive Therapy (MBCT) program.
Method
This study employed a quasi-experimental design featuring pre-test, post-test, and follow-up assessments to evaluate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on female patients diagnosed with Obsessive-Compulsive Disorder (OCD). The statistical population consisted of women diagnosed with OCD who sought treatment at therapy clinics in Tehran, Iran, between 2021 and 2022. A convenience sample of 30 participants was recruited and randomly assigned to either an experimental group (n=15) or a control group (n=15). Inclusion criteria included scoring above the mean on the Yale-Brown Obsessive Compulsive Scale, the absence of other mental disorders, literacy, an age range of 25 to 50 years, and not participating in any concurrent therapies. The experimental group participated in eight 45-minute sessions of Mindfulness-Based Cognitive Therapy (MBCT), following a protocol adapted from Bowen and Marlatt (2011). These sessions included exercises such as the raisin exercise, body scan meditation, and mindful breathing. The control group received no treatment. Data were collected using the Perceived Stress Questionnaire, the State-Trait Anxiety Inventory, the Psychosomatic Symptoms Questionnaire, and the Obsessive-Compulsive Inventory. These instruments have demonstrated strong reliability and validity in previous research, with Cronbach's alpha values ranging from 0.72 to 0.92. Data analysis was conducted using repeated measures ANOVA in SPSS version 26 to evaluate the effectiveness of the Mindfulness-Based Cognitive Therapy (MBCT) intervention on perceived stress, state and trait anxiety, and psychosomatic symptoms across three assessment points: pre-test, post-test, and 6-month follow-up.
Results
Participants in the experimental Mindfulness-Based Cognitive Therapy (MBCT) group (ages 28-40) and the control group (ages 27-42) exhibited expected demographic distributions. The experimental group showed significant reductions in perceived stress, trait anxiety, state anxiety, and psychosomatic symptoms from pre-test to post-test, with these improvements sustained at the 6-month follow-up. The control group exhibited no significant changes. Before conducting the main analysis, the assumption of normality was verified using the Shapiro-Wilk test (p > .05 for all variables). Levene's test confirmed that the assumption of homogeneity of variances was satisfied for all dependent variables: perceived stress (p = .093), trait anxiety (p = .765), state anxiety (p = .793), and psychosomatic symptoms (p = .082). Box's M test further validated the homogeneity of the covariance matrices for perceived stress (Box's M = 15.42, F = 2.625, p = .215), trait and state anxiety (Box's M = 27.58, F = 5.835, p = .136), and psychosomatic symptoms (Box's M = 47.49, F = 2.387, p = .174). However, Mauchly's test indicated a violation of sphericity (p = .001), .001); therefore, Greenhouse-Geisser correction was used. applied. Multivariate analysis of covariance (MANCOVA) revealed a significant effect of Mindfulness-Based Cognitive Therapy (MBCT) on the combined dependent variables (Pillai's Trace = .967, F(2, 28) = 34.293, p < .001, η² = .65), indicating that the intervention accounted for 65% of the variance. Univariate analyses, following Bonferroni correction (α = .017), demonstrated that MBCT significantly reduced perceived stress (F(1, 28) = 68.941, p < .0005, partial η² = .738), trait anxiety (F(1, 28) = 83.963, p < .0005, partial η² = .843), state anxiety (F(1, 28) = 94.645, p < .0005, partial η² = .764), and psychosomatic symptoms (F(1, 28) = 291.966, p < .0005, partial η² = .207). These findings demonstrate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in reducing symptoms of Obsessive-Compulsive Disorder (OCD), showing significant reductions in perceived stress, anxiety, and psychosomatic symptoms. The results align with the research objectives and suggest that MBCT can serve as a valuable treatment option for individuals with OCD. Furthermore, the study's findings have important implications for OCD treatment and underscore the significance of considering MBCT as a complementary therapeutic approach.
Conclusion
This study aimed to investigate the effectiveness of mindfulness-based cognitive therapy in reducing perceived stress, as well as trait and state anxiety, and somatic symptoms in patients with obsessive-compulsive disorder. The findings indicate that mindfulness-based cognitive therapy is effective in alleviating these symptoms. These results are consistent with previous research, underscoring the significance of mindfulness-based interventions in mitigating negative emotions and enhancing mental health.
The study's limitations include its focus on female patients and reliance on self-report measures. Future research should explore the effectiveness of mindfulness-based cognitive therapy in male patients and employ a combination of self-report and interview measures to collect more comprehensive data.
The results of this study have significant implications for the treatment of obsessive-compulsive disorder, indicating that mindfulness-based cognitive therapy can serve as a valuable complement to traditional treatments. Additionally, the findings underscore the importance of taking cultural and individual differences into account when developing mindfulness-based interventions.
Future studies should aim to replicate these findings and investigate the long-term effects of mindfulness-based cognitive therapy on symptoms of obsessive-compulsive disorder. Additionally, researchers should explore the potential applications of mindfulness-based interventions for other mental health conditions.
Ethical Considerations
Compliance with Ethical Guidelines: This study was conducted under the ethical code IR.PNU.REC.1400.134, issued by the ethics committee of Payame Noor University. All participants provided informed consent before participation, and their anonymity and the confidentiality of their data were strictly maintained throughout the study. Participants were fully informed about the study's purpose, procedures, and their right to withdraw at any time without consequence.
Funding: This study did not receive any funding for its execution.
Authors’ Contribution: This paper is based on Mahya Asadi's thesis. Mahdieh Rahmanian, Mojgan Agahheris and Ezatolah Kirdmirza served as the thesis supervisor and contributed to the conceptualization, methodology, supervision, and writing - review & editing.
Conflict of Interest: The authors declare no conflicts of interest in conducting this research.
Acknowledgments: The authors would like to thank the patients who participated in this study for their cooperation and time.

کلیدواژه‌ها [English]

  • Obsessive-Compulsive Disorder
  • Perceived Stress
  • Anxiety Traits and Symptoms
  • Mindfulness-Based Cognitive Therapy
  • Psychosomatic Symptoms

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