Middle Eastern Journal of Disability Studies

fa مقایسهٔ اثربخشی درمان برنامۀ زمانی پارادوکس و درمان فناوری واقعیت مجازی بر حساسیت اضطرابی در بیماران مبتلا به اختلال اضطراب اجتماعی Comparing the Effectiveness of Paradoxical Timetable Therapy and Virtual Reality Technology Therapy on Anxiety Sensitivity in Patients with Social Anxiety Disorder روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article چکیده زمینه و هدف: حساسیت اضطرابی به‌عنوان متغیری شناختی نقش بسیار مهمی در بروز اختلالات روانی ازجمله اختلال اضطراب اجتماعی دارد. هدف از پژوهش حاضر، مقایسهٔ تأثیر درمان برنامهٔ زمانی پارادوکس و درمان فناوری واقعیت مجازی بر حساسیت اضطرابی در بیماران مبتلا به اختلال اضطراب اجتماعی بود. روش‌بررسی: روش پژوهش نیمه‌‌آزمایشی با طرح پیش&rlm;آزمون و پس&rlm;آزمون همراه با گروه گواه و پیگیری یک‌ماهه بود. جامعهٔ آماری پژوهش را تمامی افراد مراجعه‌کننده به مراکز مشاوره و کلینیک‌های روان‌درمانی شهر تهران در پاییز و زمستان سال ۱۴۰۱ تشکیل دادند. نمونه شامل ۴۵ نفر داوطلب واجد شرایط از افراد مبتلا به اختلال اضطراب اجتماعی بود که به مراکز مشاورهٔ شهر تهران مراجعه کردند و برمبنای مصاحبهٔ اولیه و مقیاس اضطراب اجتماعی، دارای اضطراب اجتماعی تشخیص داده شدند. افراد نمونه به‌صورت دردسترس وارد مطالعه شدند و با روش گمارش تصادفی در سه گروه پانزده‌نفری (دو گروه آزمایش و یک گروه گواه) قرار گرفتند. برای جمع‌آوری داده‌ها، از مقیاس حساسیت اضطرابی تجدیدنظرشده (تیلور و کاکس، ۱۹۹۸) استفاده شد. تحلیل داده‌ها با استفاده از آزمون تحلیل واریانس با اندازه‌گیری مکرر صورت گرفت. سطح معناداری آزمون‌ها ۰٫۰۵ در نظر گرفته شد. یافته‌ها: نتایج نشان داد، هر دو نوع درمان موجب کاهش حساسیت اضطرابی شده است (۰٫۰۰۱>p)؛ همچنین درمان برنامۀ زمانی پارادوکس درمقایسه با درمان فناوری واقعیت مجازی روش مؤثرتری برای کاهش حساسیت اضطرابی است (۰٫۰۰۱>p). نتیجه‌گیری: براساس یافته‌های پژوهش مشخص شد، درمان برنامۀ زمانی پارادوکس مؤثرتر از درمان فناوری واقعیت مجازی است؛ بنابراین درمانگران می‌توانند از درمان مذکور برای کاهش حساسیت اضطرابی در بیماران مبتلا به اختلال اضطراب اجتماعی استفاده کنند. Abstract Background & Objective: Social anxiety disorder is the most common anxiety disorder whose main feature is fear or severe anxiety. Anxiety sensitivity as a cognitive and mediating variable plays an essential role in the occurrence of mental disorders, including social anxiety disorder. A growing body of research supports the role of anxiety sensitivity in social anxiety disorder. A high prevalence of social anxiety disorder has led to the development and expansion of new treatments for this disorder. Some previous studies have shown that paradoxical timetable therapy (rooted in psychodynamic and systemic theories) and virtual reality technology therapy (in which the basic techniques of psychotherapy are simulated with the help of modern technologies) can reduce the symptoms of social anxiety disorder. Considering the research gap in comparing these two types of treatments in reducing anxiety sensitivity, the present study was conducted to compare the effectiveness of paradoxical timetable therapy and virtual reality technology on the anxiety sensitivity of patients with social anxiety disorder. Methods: This quasi–experimental research was conducted with a pretest–posttest and a one–month follow–up design with a control group. The statistical population included all people referred to counseling centers and psychotherapy clinics in Tehran City, Iran, from September 23, 2022, to March 20, 2023. The study sample consisted of 45 qualified volunteers diagnosed with social anxiety disorder based on the initial interview and social anxiety scale. They were selected by available sampling and randomly assigned to three groups of 15 people each (two experimental groups and one control group). The Anxiety Sensitive Questionnaire (Taylor & Cox, 1998) was used to collect data. The revised anxiety sensitivity index has a four–factor ordinal structure. These factors include fear of respiratory symptoms, fear of anxiety reactions, fear of cardiovascular symptoms, and cognitive dyscontrol. The reliability of this questionnaire in the present study was 0.92. The first experimental group undertook six 90–minute paradoxical timetable program therapy (Besharat, 2019), and the second group received eight 45–minute virtual reality technology therapy sessions (North, North & Coble, 2017). The control group did not receive any intervention. The obtained data were analyzed using repeated measure analysis of variance. The significance level of the tests was considered 0.05. The inclusion criteria were as follows: suffering from social anxiety disorder based on the diagnostic interview and the social anxiety scale questionnaire (with a score of at least 50), informed consent to participate in treatment and research sessions, aged 18 to 50 years, having minimum degree of diploma, no concomitant use of psychiatric drugs, and without other clinical or chronic physical disorders (such as cardiovascular diseases). The exclusion criteria were not participating in more than two treatment sessions, the occurrence of severe stressful events in life (such as divorce or death of first–degree relatives) during the research process, and unwillingness to continue the treatment. Results: The results showed that both types of paradoxical timetable therapy and virtual reality technology reduced anxiety sensitivity in people with social anxiety disorder (p<0.001). The non–significance of the mean difference between the posttest and follow–up phase also shows the permanent effect of the two therapeutic methods of paradoxical timetable and virtual reality technology therapy on anxiety sensitivity and its components one month after the end of the implementation period. Based on this, the results of the present study showed that the two methods of treatment have reduced the average anxiety sensitivity and its components in a stable manner; however, the effectiveness of the paradoxical timetable therapy was higher. Conclusion: Based on the research findings, the treatment of paradoxical timetable was more effective in reducing anxiety sensitivity than the virtual reality technology intervention. Therefore, therapists can use the mentioned treatment to reduce anxiety sensitivity in patients with social anxiety disorder. حساسیت اضطرابی, اختلال اضطراب اجتماعی, درمان برنامۀ زمانی پارادوکس, درمان فناوری واقعیت مجازی Anxiety sensitivity, Social anxiety disorder, Paradoxical timetable therapy, Virtual reality technology 106 106 http://jdisabilstud.org/browse.php?a_code=A-12-3529-1&slc_lang=fa&sid=1 Vajihe Babaie وجیهه بابایی v.babaie@iau-tnb.ac.ir 100319475328460058039 0009-0008-5781-540X No PhD Student, Department of Psychology, North Tehran Branch, Islamic Azad University, Tehran, Iran دانشجوی دکتری روان‌شناسی، گروه روان‌شناسی، واحد تهران‌شمال، دانشگاه آزاد اسلامی، تهران، ایران Khadijeh Abolmaali Alhosseini خدیجه ابوالمعالی kh.abolmaali@iau-tnb.ac.ir 100319475328460058040 100319475328460058040 Yes Full Professor, Department of Psychology, North Tehran Branch, Islamic Azad University, Tehran, Iran استادتمام، گروه روان‌شناسی، واحد تهران‌شمال، دانشگاه آزاد اسلامی، تهران، ایران Mohammad Bagher Hobbi محمد باقر حبی Mb.hobbi@iau-tnb.ac.ir 100319475328460058041 100319475328460058041 No Assistant Professor, Department of Psychology, Faculty of Humanities, The Imam Hossein Comprehensive University, Tehran, Iran استادیار، گروه روان‌شناسی، عضو هیئت‌علمی دانشگاه جامع امام‌حسین(ع)، تهران، ایران