Middle Eastern Journal of Disability Studies

fa بررسی اثربخشی برنامهٔ فراتشخیصی مبتنی‌بر پذیرش و تعهد بر میزان افکار منفی تکراری و اختلالات افسردگی، اضطراب و وسواس فکری-عملی Determining the Effectiveness of Transdiagnostic Protocol Based on Acceptance and Commitment on Repetitive Negative Thinking, Depression, Anxiety, and Obsessive-Compulsive Symptoms روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article <div style="text-align: justify;">زمینه و هدف: برمبنای دیدگاه فراتشخیصی، انواع تفکر منفی تکراری به‌واسطهٔ فرایندهای مشابهی مشخص می‌شود که قابلیت کاربست در انواع محتواهای وابسته به اختلالات خاص را دارد. هدف مطالعهٔ حاضر، بررسی اثربخشی برنامهٔ فراتشخیصی مبتنی‌بر پذیرش و تعهد بر میزان افکار منفی تکراری و اختلالات افسردگی، اضطراب و وسواس فکری-عملی بود. روش‌بررسی: این پژوهش با روش مطالعهٔ تک‌موردی و طرح خط پایهٔ چندگانه انجام شد. جامعهٔ آماری پژوهش را مراجعه‌کنندگان بخش روان‌پزشکی بیمارستان امام‌حسین(ع) طی اسفند۱۳۹۹ تا خرداد۱۴۰۰ تشکیل دادند. با روش نمونه‌گیری هدفمند شش بیمار مبتلا به اختلالات افسردگی اساسی، اضطراب تعمیم‌یافته و وسواس فکری-عملی، انتخاب شدند. به‌منظور جمع‌آوری داده‌ها، پرسش‌نامهٔ افسردگی بک-نسخۀ دوم (بک و همکاران، ۱۹۹۶)، پرسش‌نامهٔ اضطراب بک (بک و همکاران، ۱۹۸۸)، مقیاس وسواس فکری‌-عملی ییل-براون (گودمن و همکاران، ۱۹۸۹) و پرسش‌نامهٔ افکار تکرارشوندهٔ ده‌سؤالی (مک‌ایوی و همکاران، ۲۰۱۰) به‌کار رفت. برنامهٔ مداخلهٔ فراتشخیصی مبتنی‌بر پذیرش و تعهد طی چهار جلسه به‌صورت انفرادی اجرا شد. تحلیل داده‌ها برپایهٔ روش‌های تحلیل ترسیمی، شاخص تغییر پایا و درصد بهبودی صورت گرفت‌.  یافته‌ها: نتایج نشان داد، برنامهٔ فراتشخیصی مبتنی‌بر پذیرش و تعهد سبب کاهش تفکر منفی تکراری و علائم افسردگی و اضطراب شد؛ اما نشانگان وسواس فکری-عملی به‌طور معناداری کاهش نیافت.  نتیجه‌گیری: براساس نتایج پژوهش، می‌توان تفکر منفی تکراری را سازه‌ای فراتشخیصی در نظر گرفت که با مؤلفه‌های پذیرش و تعهد تعدیل‌پذیر است؛ هرچند نقش عوامل اختصاصی نیازمند بررسی بیشتر است. </div> Abstract Background & Objectives: Thinking and its interaction with emotions and behavior are the most challenging areas of psychology. The scientific study of thinking has been done to discover its general mechanisms and explain the processes involved in its anomalies. One of the most important forms of abnormal thinking is repetitive negative thinking. The transdiagnostic view of repetitive negative thinking argues that types of repetitive negative thinking are identified by similar processes that can be applied to a variety of disorders-related content. The present study investigated the effectiveness of transdiagnostic protocol based on acceptance and commitment repetitive negative thinking, depression, anxiety, and obsessive-compulsive symptoms. Methods: To conduct the study, we used the single-subject method of multiple baseline design. The statistical population of the research comprised the patients of the Psychiatry Department of Imam Hossein Hospital from February 2021 to May 2021. A single case study method was used during the initial baseline period and multiple separate assessment courses. In this way, we can examine the changes in the desired behaviors and symptoms in the subject. Then, the effectiveness of this treatment program based on acceptance and commitment focused on repetitive negative thinking individually and in 4 sessions was evaluated on reducing the rate of repetitive negative thinking and disorders of depression, anxiety, and obsessive-compulsive disorder. Thirty-seven patients were evaluated, of whom, due to not completing the baseline steps, unwillingness to continue the process and request drug treatment, and explicit expression of suicidal ideation, during the evaluation and sample selection period, 6 people were finally stabilized and asynchronously entered the intervention program and completed the intervention steps. Beck Depression Inventory-II (Beck et al., 1996), Beck Anxiety Inventory (Beck et al., 1988), Yale-Brown Obsessive-Compulsive Scale (Goodman et al., 1989), and Repetitive Thinking Questionnaire-10 (McEvoy et al., 2010) were used to collect data. The data were analyzed based on analytic drawing, stable change index, and recovery rate methods. Results: Results show that with the training considered, the change in the magnitude of repetitive negative thinking in the depression group was decreasing and this decreasing trend was significant by taking into account the stable change index and the percentage of the recovery obtained. The greatest reduction in the size of negative thinking has occurred in depressed people. The percentage of improvement in the recurring thoughts of anxiety patients in this study in the treatment phase did not reach more than 50%. It should be noted that the final evaluation of the treatment phase is related to the implementation of the evaluation after the third session of treatment. But in the follow-up phase, which took place after the fourth session of treatment, two weeks apart, the recovery rate increased significantly. This percentage is ultimately above the recovery standard in the recovery percentage index. In addition, the stable change coefficient confirms the significance of this decreasing change. The effect of the intervention program in reducing repetitive negative thoughts of patients with obsessive-compulsive disorder after the third treatment session and the last evaluation of the treatment phase was weak. Neither of the two clinical specimens reached the standard of recovery. One person from the obsessive-compulsive disorder group has grown to more than 50% in the rate of repetitive thoughts in the follow-up phase. The lowest mean decrease in the rate of repetitive thoughts among groups is related to obsessive-compulsive disorder. Although the stable change index for the obsessive-compulsive group indicates the significance of the changes, that is, these changes are not the result of measurement error or mere accident, the effect size of the intervention variable is not optimal. The average recovery rate in the group with obsessive-compulsive disorder is not significant and acceptable. Conclusion: According to the results, repetitive negative thinking is a transdignostic construct that is correctable with acceptance and commitment components. However, the role of specific factors is needed to be investigated. تفکر منفی تکراری, درمان مبتنی‌بر پذیرش و تعهد, افسردگی, اضطراب, وسواس فکری-عملی Repetitive negative thinking, Acceptance and commitment therapy, Depression, Anxiety, Obsessive-compulsive 204 204 http://jdisabilstud.org/browse.php?a_code=A-12-2995-1&slc_lang=fa&sid=1 Faramarz Sohrabi فرامرز سهرابی sohrabi@atu.ac.ir 100319475328460062093 100319475328460062093 No PhD in Psychology, Professor at Allameh Tabataba’i University, Tehran, Iran دکترای روان‌شناسی بالینی، استاد دانشگاه علامه طباطبائی، تهران، ایران Ahmad Borjali احمد برجعلی borjali@atu.ac.ir 100319475328460062094 100319475328460062094 No PhD in Psychology, Professor at Allameh Tabataba’i University, Tehran, Iran دکترای روان‌شناسی، استاد دانشگاه علامه طباطبائی، تهران، ایران Mohammad Reza Falsafi Nejd محمدرضا فلسفی نژاد falsafinejad@yahoo.co.uk 100319475328460062095 100319475328460062095 No PhD in Educational Psychology-Assessment & Measurement, Associate Professor at Allameh Tabataba’i University, Tehran, Iran دکترای روان‌شناسی تربیتی-سنجش و اندازه‌گیری، دانشیار دانشگاه علامه طباطبائی، تهران، ایران Hosein Eskandari حسین اسکندری sknd@atu.ac.ir 100319475328460062096 100319475328460062096 No PhD in Psychology, Professor at Allameh Tabataba’i University, Tehran, Iran دکترای روان‌شناسی، استاد دانشگاه علامه طباطبائی، تهران، ایران Ali Reza Zinati Afkham علی رضا زینتی افخم alirezazinati61@gmail.com 100319475328460062097 100319475328460062097 Yes PhD Candidate in Psychology, Allameh Tabataba’i University, Tehran, Iran دانشجوی دکترای روان‌شناسی، دانشگاه علامه طباطبائی، تهران، ایران