تأثير درمان گروهي فعالسازي رفتار بر علائم افسردگي و نگرشهاي ناکارآمد
محورهای موضوعی : روان شناسی
1 - دانشگاه شهید بهشتی، تهران، ایران
کلید واژه: افسردگی, فعالسازی رفتار, نگرشهای ناکارآمد ,
چکیده مقاله :
هدف اين پژوهش بررسی تأثير درمان گروهی فعالسازیِ رفتار بر کاهش علائم افسردگی و همچنين تعيين اثر اين درمان بر سازهای شناختی که در افسردگی مهم تلقی میشود، يعنی نگرشهای ناکارآمد، بود. 24 دانشجو که دچار علائم افسردگی بودند بهطور تصادفی در دو گروه آزمايشی (10 نفر) و کنترل (14 نفر) گمارده شدند. سپس گروه آزمايشی تحت 5 جلسه درمان گروهی فعالسازی رفتار قرار گرفت. علائم افسردگی و نگرشهای ناکارآمد هر دو گروه قبل و بعد از درمان مورد ارزيابی قرار گرفتند. نتایج نشان دادند که ميزان بهبود علائم افسردگی و نگرشهای ناکارآمد در گروه آزمايش بهطور معناداری بيشتر از گروه کنترل بود. تأثير یک درمان رفتاریِ خالص گروهی و مختصر، در کاهش علائم افسردگی و نگرشهای ناکارآمد دانشجويان، حائز نتایج نظری و عملی مهمی است که مورد بحث قرار گرفتهاند.
this study was designed to examine the effectiveness of group behavioral activation treatment on depressive symptoms, and its effects on dysfunctional attitudes, a cognitive construct regarded to play an important role in depression. Twenty four university students suffering from depressive symptoms, were randomly assigned to two groups: experimental group (n=10) and control group (n=14). The experimental group was treated through 5 sessions of group behavioral activation treatment. Depressive symptoms and dysfunctional attitudes in both groups were assessed before and after treatment sessions. Improvement of depresssive symptoms and dysfunctional attitudes in experimental group were significantly more than control group. Effectiveness of a brief and purely behavioral group therapy in reducing depresssive symptoms and dysfunctional attitudes has important theoretical and practical implications.
اميني، فريبا و فرهادي، علي (1380). بررسي ميزان شيوع اضطراب و افسردگي و تأثير آنها بر عملکرد تحصيلي دانشجويان دانشگاه علوم پزشکي لرستان. مجموعه خلاصه مقالات سمينار بهداشت روان دانشجويان. تهران: دانشگاه تهران.
غرائي، بنفشه (1382). تعيين وضعيت¬هاي هويتي و ارتباط آن با سبک¬هاي هويتي و افسردگي در نوجوانان تهراني. رسالة دکتري، دانشگاه علوم پزشکي ايران.
فتي، لادن (1382). ساختارهاي معناگذاري حالت¬هاي هيجاني و پردازش شناختي اطلاعات هيجاني: مقايسه دو چارچوب مفهومي. رسالة دکتري، دانشگاه علوم پزشکي ايران.
فرگوسن، ج. ا. و تاکانه، اي. (1377). تحليل آماري در روان¬شناسي و علوم تربيتي (ترجمة علي دلاور و سيامک نقشبندي). تهران: ارسباران. (تاريخ انتشار به زبان اصلي 1989).
هومن، حيدرعلي (1383). شناخت روش علمي در علوم رفتاري: پايه¬هاي پژوهش. تهران: پارسا.
يکه¬يزدان¬دوست، رخساره، رضوان¬طلب، هادي، و پيروي، اميرحسين (1380). بررسي نگرش¬هاي ناسالم، افسردگي، و شدت بيماري کرونر قلب در بيماران بستري در CCU. فصلنامة انديشه و رفتار، 4، 44-38.
يعقوبخاني غياثوند، مرضيه و احمدي، عبدالجواد (1380). بررسي وضعیت رواني دانشجويان ورودي 1375 دانشگاه بين¬المللي امام خميني (ره) و مقايسة آن با زمان فراغت از تحصيل. مجموعه خلاصه مقالات سمينار بهداشت روان دانشجويان. تهران: دانشگاه تهران.
Abela, J. R. Z., & D’Allessandro, D. U. (2002). Beck’s cognitive theory of depression: A test of the diathesis-stress and mediation components. British Journal of Clinical Psychology، 41, 111-129.
Adams, E. K., & Johnson, V. (2000). An Elementary school-based health clinic: Can it reduce medicaid Costs? Pediatrics, 105, 780-788.
Arntz, A. (2002). Cognitive therapy versus interoceptive exposure as treatment of panic disorder without agoraphobia. Behaviour Research and Therapy, 40, 325-341.
Barkham, M., Shapiro, D. A., Hardly, G. E., & Rees, A. (1999). Psychotherapy in two-plus-one sessions: Outcomes of a randomized controlled trial of cognitive-behavioral and psychodynamic-interpersonal therapy for subsyndromal depression. Journal of Consulting and clinical psychology, 67, 201-211.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996) "Manual for the Beck
Depression Inventory-II". San Antonio, TX: Psychological Corporation. http://www.answers.com. Accessed September 15, 2006.
Blanco, C., Lipsitz, J., & Caligor, E. (2001). Treatment of chronic depression with a 12-week program of interpersonal psychotherapy. The American Journal of Psychiatry, 158, 371-376.
Blankstein, K. R., & Segal, Z. V. (2001). Cognitive assessment: Issues and methods. In K. S. Dobson (Ed.), Handbook of cognitive-behavioral therapies (2nd Ed.) (pp. 40-85). New York: Guilford Press.
Chambless, D. L., Baker, M. J., Baucom, D. H., Beutler, L. E., Calhoun, K. S., Crits-Christoph, P., Daiuto, A., DeRubeis, R., Detweiler, J., Haaga, D. A. F., Johnson, S. B., McCurry, S., Mueser, K. T., Pope, K. S., Sanderson, W. C., Shoham, V., Stickle, T., Williams, D. A., & Woody, S. R. (1998). Update on Empirically Validated Therapies، II. The Clinical Psychologist, 51, 3-16.
Cicchetti, D. (2006). Development and Psychopathology. In D. Cicchetti & D. J. Cohen (Eds.), Developmental Psychopathology: Theory and method (2nd Ed.) (pp. 1-23). New Jersey: John Wiley & Sons.
Clark, D. A., Beck, A. T., & Alford, B. A. (1999). Scientific foundations of cognitive theory and therapy of depression. New York: John wiley & Sons.
Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implication. Journal of Abnormal Psychology,100, 316-336.
Cottraux, J., Note, I., Yao, S. N., Lafont, S., Note, B., Mollard, E., Bouvard, M., Sauteraud, A., Bourgeois, M., & Dartigues, J. F. (2001). A randomized controlled trial of cognitive therapy versus intensive behavior therapy in obsessive compulsive disorder. Psychotherapy and Psychosomatics, 70, 288-297.
Crum, R. M., Cooper-Patrick, L., & Ford, D. E. (1994). Depressive symptoms among general medical patients: Prevalence and one-year outcome. Psychosomatic Medicine, 56,109-117.
De Mello, M. F., de Jesus Mari, J., Bacaltchuk, J., Verdeli, H., & Neuge-bauer, R. (2005). A systematic review of research findings on the efficacy of interpersonal therapy for depressive disorders. European Archives of Psychiatry and Neurological Sciences, 255, 75-82.
Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg,
R. J., Addis, M. E., Gallop، R., McGlinchey, J. B., Markley، D. K., Gollan, J. K., Atkins, D. C., Dunner, D. L., & Jacobson, N. S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658-670.
Eldridge, K. A., Lawrence, M. A., & Christensen, A. (1999). Research methods with couples. In P. C. Kendall, J. N. Butcher & G. N. Holmbeck (Eds.), Handbook of research methods in clinical psychology (pp. 681-699). New York: John Wiley & Sons.
Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., Collins, J. F., Glass, D. R., Pilkonis, P. A., Leber, W. R., Docherty, J. P., Fiester, S. J., & Parloff, M. B. (1989). National institute of mental health treatment of depression collaborative research program: General effectiveness of treatments. Archives of General Psychiatry, 46, 971-982.
Feldman, L. A. (1993). Distinguishing depression and anxiety in self-report: Evidence from confirmatory factor analysis on nonclinical and clinical samples. Journal of Consulting and Clinical Psychology, 61, 631-638.
Fisher, P. L., & Wells, A. (2005). How effective are cognitive and behavioral treatments for obsessive-cumpulsive disorder? A clinical significance analysis. Behaviour Research and Therapy, 43, 1543-1558.
Hamilton, K. E., & Dobson, K. S. (2002). Cognitive therapy of depression: Pretreatment patient predictors of outcome. Clinical Psychology Review, 22, 875-893.
Goldney, R. D., Fisher, L. J., Dal Grande, E., & Taylor, A. W. (2004). Subsyndromal depression: Prevalence، use of health services and quality of life in an Australian population. Social Psychiatry and Psychiatric Epidemiology, 39, 293-298.
Gollan, J., Atlis, M., & Marlow-O’Connor, M. (2003). Behavioral activation: Group treatment for depression (pilot version). Unpublished manual, University of Chicago.
Hollon, S. D. (2001). Behavioral activation treatment for depression: A commentary. Clinical Psychology: Science and Practice. 8, 271-278.
Hopko, D. R., Armento, M. E. A., Cantu, M. S. Chambers, L. L., & Lejuez,
C. W. (2003). The use of daily dairies to assess the relations among mood
state, overt behavior, and reward value of activities. Behaviour Research
and Therapy, 41, 1137-1148.
Hopko, D. R., Lejuez, C. W., & Hopko, S. D. (2004). Behavioral activation as an intervention for coexistent depressive and anxiety symptoms. Clinical Case Studies, 3, 37-48.
Jacobson, N. S., & Gortner, E. T. (2000). Can depression be de-medicalized
in the 21st century: Scientific revolution, counter revolutions and the magnetic field of normal science. Behaviour Research and Therapy, 38, 103-117.
Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychlogy: Science and Practice, 8, 255-270.
Judd, L. L., Paulus, M. P., Wells, K. B., & Rapaport, M. H. (1996). Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. American Journal of Psychiatry, 153, 1411-1417.
Kazdin, A. E. (1992). Research design in clinical psychology (2nd Ed.).
Boston, MA: Allyn & Bacon.
Lambert, K. G. (2006). Rising rates of depression in today’s society: Consideration of roles of effort-based rewards and enhanced resilience in day-to-day functioning. Neuroscience and Biobehavioral Reviews, 30, 497-510.
Kendall, P. C., Flannery-Schroeder, E. C., & Ford, J. D. (1999). Therapy outcome research methods, In P. C. Kendall, J. N. Butcher & G. N. Holmbeck (Eds.), Handbook of research methods in clinical psychology (330-363). New York: John Wiley & Sons.
Lewinsohn, P. M., & Graf, M. (1973). Pleasant activities and depression.
Journal of Consulting and Clinical Psychology, 41, 261-268.
Lewinsohn, P. M., & Libet, J. (1972). Pleasant events, activity schedules,
and depression. Journal of Abnormal Psychology, 79, 291-295.
Lewinsohn, P. M., & Shaffer, M. (1971). Use of home observations as an integral part of the treatment of depression: Preliminary report and case
studies. Journal of Consulting and Clinical Psychology, 37, 87-94.
Lavretsky, H., & Kumar, A. (2002). Clinically significant non-major depression: Old concepts، new insights. American Journal of Geriatric
Psychiatry,10, 239-255.
Libet, J., & Lewinsohn, P. M. (1973). The concepts of social skill with special reference to the behavior of depressed persons. Journal of Consulting and Clinical Psychology, 40, 304-334.
MacPhillamy, D. J., & Lewinsohn, P. M. (1974). Depression as a function of levels of desired and obtained pleasure. Journal of Abnormal psychology, 83, 651-657.
Mufson, L., Dorta, K. P., Wickramaratne, P., Nomura, Y., Olfson, M., & Weissman, M. M. (2004). A Randomized Effectiveness Trial of Interpersonal Psychotherapy for Depressed Adolescents. Archives of General Psychiatry, 61, 577-584.
Öst، L-G.، Alm، T.، Brandberg، M.، & Breitholtz، E. (2001). One vs. five sessions of exposure and five sessions of cognitive therapy in the treatment of claustrophobia. Behaviour Research and Therapy، 39، 167-183.
Öst, L-G., & Breitholtz, E. (2000). Applied relaxation vs. cognitive therapy
in the treatment of generalized anxiety disorder. Behaviour Research and
Therapy, 38, 777-790.
Öst, L-G., Thulin, U., & Ramnero, j. (2004). Cognitive behavior therapy vs exposure in vivo in the treatment of panic disorder with agoraphobia. Behaviour Research and Therapy, 42, 1105-1127.
Paunovic, N., & Öst, L-G. (2001). Cognitive-behavior therapy vs. exposure therapy in the treatment of PTSD in refugees. Behaviour Research and Therapy, 39,1183-1197.
Porter, J. f., Spates, R., & Smitham, S. (2004). Behavioral activation: Group therapy in public mental health settings: A pilot investigation. Professional Psychology: Research and Practice, 35, 297-301.
Powell, R. A., Symbaluk, D. G., & MacDonald, S. E. (2005). Introduction to learning and behavior (2nd ed.). Belmont, CA: Wadsworth/Thomson Learning.
Robbins, P. R., & Tanck, R. H. (1984). The Beck Depression Inventory and self-reports of behavior over a ten-day period. Journal of Personality Assessment, 48, 42-45.
Seligman, M. E. P., Walker, E. F., & Rosenhan, D. L. (2001). Abnormal
psychology (4th Ed.). New York: Norton.
Silverman, J. S., Silverman, J. A., & Eardley, D. A. (1984). Do maladaptive attitudes cause depression? Archives of General Psychiatry, 41, 28-30.
Simons, A. D., Garfield, S. L., & Murphy, G. E. (1984). The process of change in cognitive therapy and pharmacotherapy for depression: Changes in mood and cognition. Archives of General Psychiatry, 41, 45-51.
Weissman, M. M., & Markowitz, J. C. (1998). An overview of interpersonal
psychotherapy، In J. C. Markowitz. (Ed.), Interpersonal psychotherapy. Washington, D. C.: American Psychiatric Press.
Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2000). Comprehensive guide to interpersonal psychotherapy. New York: Basic Books.
Whittal, M. L., Thordarson, D. S., & McLean, P. D. (2005). Treatment of obsessive-compulsive disorder: Cognitive behavior therapy vs. exposure and response prevention. Behaviour Research and Therapy, 43, 1559-1576.
Whooley, M. A. & Simon, G. E. (2000). Managing depression in medical outpatients. The New England Journal of Medicine, 343, 1942-1950