مقایسه اثربخشی مداخله زوج ‌درمانی رفتاری التقاطی و تلفیقی طرحواره مبتنی بر پذیرش و تعهد بر تحمل ناکامی و رضایت زناشویی در زنان مبتلا به مولتیپل اسکلروزیس

نویسندگان
محبوبه امیربیک 1
حسین اکبری امرغان 2
الهام فریبرزی 1
حمید نجات 2
1 گروه علوم تربیتی و مشاوره، واحد مشهد، دانشگاه آزاد اسلامی، مشهد، ایران
2 گروه مشاوره و روانشناسی، واحد قوچان، دانشگاه آزاد اسلامی، قوچان، ایران
چکیده
مقدمه

مولتیپل اسکلروزیس یک بیماری نورودژنراتیو پیش­رونده است. برخورداری از رضایت زناشویی شاخصی مهم در پیش­آگهی مطلوب درمانی در اختلالات عصب روان­شناختی پیش­رونده همچون مولتیپل اسکلروزیس می­باشد. هدف از پژوهش حاضر مقایسه اثربخشی زوج ‌درمانی رفتاری التقاطی و درمان تلفیقی طرحواره مبتنی بر پذیرش و تعهد بر تحمل ناکامی ورضایت زناشویی زنان مبتلا به مولتیپل اسکلروزیس بود.

مواد و روش‌­ها

در یک کارآزمایی مقدماتی تصادفی، 42 بیمار زن مبتلا به مولتیپل اسکلروزیس به همراه همسران­شان، با استفاده از روش نمونه­گیری هدفمند انتخاب شدند و با استفاده از روش تصادفی­سازی بلوکی در قالب دو گروه درمانی و یک گروه کنترل تخصیص یافتند. دو گروه درمانی به مدت 10 جلسه هفتگی هر یک تحت یکی از درمان­های زوج‌درمانی رفتاری التقاطی و تلفیقی طرحواره مبتنی بر پذیرش و تعهد قرار گرفتند و گروه کنترل در لیست انتظار قرار گرفت. پرسشنامه تحمل ناکامی و رضایت زناشویی در سه برهه زمانی پیش­آزمون، پس­آزمون و پیگیری توسط شرکت­کنندگان تکمیل شد. داده ها با استفاده از آزمون واریانس طرح اندازه گیری های مکرر دو طرفه تحلیل شد.

یافته‌­ها

نتایج اولیه نشان داد که هر دو درمان نسبت به گروه کنترل اثربخشی معناداری بر شاخص رضایت زناشویی بیماران ایفا نمودند که تا مرحله پیگیری سه ماهه پایدار ماند (05/0>all p’s ). علاوه­براین، نتایج ثانویه نشان داد که تفاوت معناداری بین اثربخشی دو درمان وجود ندارد (05/0<p).

نتیجه­‌گیری

یافته­های این مطالعه می­تواند در طرح­ریزی چشم­انداز مداخلات درمانی در بیماران مبتلا به اختلالات نورودژنراتیو با کاربست­های بالینی همراه باشد.



کلیدواژه‌ها
زوج‌درمانی رفتاری التقاطی
درمان مبتنی بر پذیرش و تعهد
طرحواره درمانی
تحمل ناکامی
رضایت زناشویی

عنوان مقاله English

Comparison of the effectiveness of eclectic and integrated behavioral couple therapy based on acceptance and commitment schema on Tolerance of failure marital satisfaction of women with multiple

نویسندگان English

Mahbobe Amirbeik 1
Hossein Amirbeik 2
Elham Fariborzi 1
Hamid Nejat 2
1 Department of Educational Sciences and Counseling, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
2 Department of Counseling and Psychology, Quchan Branch, Islamic Azad University, Quchan, Iran
چکیده English

Introduction

Multiple sclerosis is a progressive neurodegenerative disease characterized by chronic demyelination that adversely affects various aspects of a patient’s life. Although mental health and marital satisfaction are major indicators of favorable prognosis in progressive neurological disorders such as MS, few psychological interventions have so far been performed in this respect. The aim of this study was to compare the effectiveness of two approaches of couple eclectic behavioral therapy and combined treatment of schema-based on acceptance and commitment on Tolerance of failure and marital satisfaction in women with multiple sclerosis.

Materials and Methods

This pilot randomized trial was carried out. A total of 42 female MS patients along with their husbands were selected using purposive sampling. The participants were assigned to two intervention groups and one control group using randomized block design. Those in the intervention group A and B received 10 weekly sessions of IBCT and ACST, respectively, while members of the control group were placed on a waiting list. The participants completed the Failure tolerance test and Enrich Marital Satisfaction Scale during the pre-test, post-test, and follow-up stages. Data were analyzed using repeated measures of two-way measurements.

Results

The preliminary results indicated that the two interventions significantly improved the patients’ marital satisfaction levels in both post-test and follow-up stages (all p-values < 0.05). The secondary results showed no significant difference between the effectiveness of the two treatment methods in improving Failure tolerance and marital satisfaction levels (p-value > 0.05).

Conclusion

The findings confirmed the research background on the positive effects of psychological interventions on MS patients’ lives. Using these findings, researchers can design effective clinical interventions for patients with neurodegenerative disorders.

کلیدواژه‌ها English

Eclectic Behavioral Couple Therapy
Acceptance and Commitment Based Therapy
Schema therapy
Failure Tolerance
Marital Satisfaction
1. Gold SM, Willing A, Leypoldt F, Paul F, Friese MA. Sex differences in autoimmune disorders of the central nervous system. Seminars in Immunopathology [Internet]. Springer Science and Business Media LLC. 2018; 41(2):177–88.
2. Chalah MA, Ayache SS. A Scope of the Social Brain in Multiple Sclerosis: Insights from Neuroimaging Studies. Cognitive and Behavioral Neurology [Internet]. Ovid Technologies (Wolters Kluwer Health). 2020; 33(2):90–102.
3. Mares J, Hartung H-P. Multiple sclerosis and COVID-19. Biomedical Papers [Internet]. Palacky University Olomouc. 2020; 164(3):217–25.
4. Koutsogeorgou E, Chiesi AM, Leonardi M. Social capital components and social support of persons with multiple sclerosis: a systematic review of the literature from 2000 to 2018. Disability and Rehabilitation [Internet]. Informa UK Limited. 2019; 42(24):3437–49.
5. Battalio SL, Glette M, Alschuler KN, Jensen MP. Anxiety, depression, and function in individuals with chronic physical conditions: A longitudinal analysis. Rehabilitation Psychology [Internet]. American Psychological Association (APA). 2018; 63(4):532–41.
6. Calabrò RS, Russo M, Dattola V, De Luca R, Leo A, Grisolaghi J, et al. Sexual Function in Young Individuals with Multiple Sclerosis. Journal of Neuroscience Nursing [Internet]. Ovid Technologies (Wolters Kluwer Health). 2018; 50(3):161–6.
7. Otero MC, Wells JL, Chen K-H, Brown CL, Connelly DE, Levenson RW, et al. Behavioral indices of positivity resonance associated with long-term marital satisfaction. Emotion [Internet]. American Psychological Association (APA). 2020; 20(7):1225–33.
8. Pakenham KI. & Samios CH. A Dyadic and Longitudinal Investigation of Adjustment in Couples Coping with Multiple Sclerosis. Journal of Behavioral Medicine. 2017; 49: 74-83.
9. Aalami M, Taimory S, & Ahi G. The Effectiveness of an Integrated Approach of Schema Therapy based Acceptance and Commitment Therapy on Marital Conflicts and Divorce Tendency in Divorce Applicant Couples. Journal of Research in Behavioural Sciences. 2020; 18(1), 132-141
10. Chand L. A study of frustration tolerance in relation to achievement motivation and sports achievements. International Journal of Applied Research. 2017; 1(6): 92-94
11. Mousavi R. Fatemi F. Shanazi Y. The relationship between failure tolerance and approval motivation with emotional adjustment of female students, Counseling Research. 2020; 19(73): 172-188
12. Mota N, Kraskian-Mujembari A, Pirnia B. Role of Sexual Function in Prediction of Anxiety, Stress and Depression in Patients with Multiple Sclerosis. Int J Appl Behav Sci [Internet]. 2019; 5(3):27-3.
13. Georgia Salivar EJ, Rothman K, Roddy MK, Doss BD. Relative cost effectiveness of in‐person and internet interventions for relationship distress. Family Process.2020; 59(1): 66-80.‌
14. Roddy MK, Nowlan KM, Doss BD, Christensen A. Integrative behavioral couple therapy: Theoretical background, empirical research, and dissemination. Family Process. 2016; 55(3): 408-422.‌
15. Blanchard VL, Hawkins AJ, Baldwin SA, Fawcett EB. Investigating the effects of marriage and relationship education on couples' communication skills: a meta-analytic study. J of Family Psychology. 2013; 23(2): 203-215.
16. Blumer MLC, Murphy MJ. Alaskan gay males’ couple experiences of societal non-support: Coping through families of choice and therapeutic means. Contemporary Family Therapy. 2015; 33(1): 273–290.
17. Peterson BD, Eifert GH, Feingold T, Davidson S. Using Acceptance and Commitment Therapy to Treat Distressed Couples: A Case Study with TwoCouples. Cognitive and Behavioral Practice. 2013; 16(4):430-42.
18. Perissutti C, Barraca J. Integrative Behavioral Couple Therapy vs. Traditional Behavioral Couple Therapy: A theoretical review of the differential effectiveness. Clínica y Salud. 2014; 24(1): 11-18.
19. McKay M, Lev A, Skeen M. (2012). Acceptance and commitment therapy for interpersonal problems: Using mindfulness, acceptance, and schema awareness to change interpersonal behaviors. New Harbinger Publications.‌
20. Roddy MK, Nowlan KM, Doss BD, Christensen A. Integrative behavioral couple therapy: Theoretical background, empirical research, and dissemination. Family Process 2016 ;55(3), 408-422.
21. Blanchard, V.L., Hawkins, A.J., Baldwin, S.A., & Fawcett, E.B. Investigating the effects of marriage and relationship education on couples' communication skills: a meta-analytic study. J of Family Psychology. 2013; 23(2): 203-215
22. Blumer MLC, Murphy MJ. Alaskan gay males’ couple experiences of societal non-support: Coping through families of choice and therapeutic means. Contemporary Family Therapy. 2015; 33(1): 273–290
23. Peterson BD, Eifert GH, Feingold T, Davidson S. Using Acceptance and Commitment Therapy to Treat Distressed Couples: A Case Study with TwoCouples. Cognitive and Behavioral Practice. 2013; 30; 16(4):430-42.
24. Perissutti C, Barraca J. Integrative behavioral couple therapy vs. traditional behavioral couple therapy: A theoretical review of the differential effectiveness. Clinical y Saluda.2013; 24(1): 11-18.
25. McKay M, Lev A, Skeen M. Acceptance and commitment therapy for interpersonal problems: Using mindfulness, acceptance, and schema awareness to change interpersonal behaviors. New Harbinger Publications. 2012; 22(2).
26. Lev A, Mckey M. Acceptance and Commitment Therapy for Couples: Using Mindfulness, Values, and Schema Awareness to Rebuild relationships. Translated by: Nejat H, Forutan M. Mashhad: Fara angizesh Publication. 2017; 10-12. [Link].
27. Aalami M, Taimory S, Ahi G. The Effectiveness of an Integrated Approach of Schema Therapy based Acceptance and Commitment Therapy on Marital Conflicts and Divorce Tendency in Divorce Applicant Couples. 2020. [Persian]
28. Veisi S, Mohaghegh H, Yaghoobi A, Shams SS, Pirnia B. Comparison of the effectiveness of two mindfulness and logotherapy methods on anxiety index in chronic daily headache of women with marital conflict: A clinical trial study. Chronic Diseases Journal. 2020; 8(2): 78-84.‌
29. Pirnia B, Pirnia K. Effectiveness of Oxytocin on Reducing Alcohol Consumption and Depression Syndrome in a Patient with Oropharyngeal Carcinoma. International Journal of Cancer Management [Internet]. Kowsar Medical Institute. 2018; In Press (In Press).
30. Pirnia B, Homayounfar N, Hosseini N, Ebrahimi F, Haj Sadeghi Z, Malekanmehr P. The Predictive Role of Body Image and Sexual Function in Quality of Life After Modified Radical Mastectomy Regarding the Mediating Role of Emotion; A Cross Sectional Study. International Journal of Cancer Management [Internet]. Kowsar Medical Institute. 2020; 13(11).
31. Pirnia B, Khosravani V, Maleki F, Kalbasi R, Pirnia K, Malekanmehr P, et al. The role of childhood maltreatment in cortisol in the hypothalamic–pituitary–adrenal (HPA) axis in methamphetamine-dependent individuals with and without depression comorbidity and suicide attempts. Journal of Affective Disorders [Internet]. Elsevier BV. 2020; 263:274–81.
32. Pirnia B, Hamdieh M, Kazemi Ashtiani M, Malekanmehr P, Pirnia K, Zahiroddin A, Sadeghi P. The Effectiveness of Intranasal Oxytocin on Addiction Severity Index and Anhedonia Symptoms in an Alcoholic Case with Oropharyngeal Cancer, a Protocol for a Single-case Experimental Design Pilot Study. Iranian Journal of Pharmaceutical Research. 2020; 19(3): 18-23.‌
33. Harrington, N. Frustration intolerance beliefs: Their relationship with depression, anxiety, and anger, in a clinical population. Cognitive Therapy and Research. 2006; 30(6): 699-709.
34. Baba Raissi M, Ali Mehdi M. Accreditation Failed Tolerance Questionnaire. Azamoniar Pouya Institute, Tehran. 2014.
35. Fawers, l. Elson J. Designing a tool to measure marital satisfaction in couples. Journal Of psychological Information. 1998; 21(8): 415-391.
36. Arefi M, Nawabinejad SH, Shafiabadi A, Kiamanesh A. Attachment styles, gender and marital satisfaction. Educational Research Journal of Islamic Azad University, Bojnourd Branch. 2012; 7(31): 132-117. [Persian]
37. Benson LA, Nguyen TP. Integrative Behavioral Couple Therapy. Encyclopedia of Couple and Family Therapy [Internet]. Springer International Publishing. 2019; 1506–13.
38. Christensen A, Atkins DC, Baucom B, Yi J. Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy. Journal of Consulting and Clinical Psychology [Internet]. American Psychological Association (APA). 2010; 78(2): 225–35.