Middle Eastern Journal of Disability Studies

fa مقایسهٔ اثربخشی مداخلهٔ مبتنی‌بر پذیرش و تعهد و ضرباهنگ دوگوشی بر عملکردهای شناختی زنان مبتلا به اختلال وسواسی جبری Comparing the Effectiveness of Acceptance and Commitment Therapy and Binaural Beats on Cognitive Functions in Individuals With Obsessive-Compulsive Disorder روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article چکیده زمینه و هدف: اختلال وسواسی جبری با افکار مزاحم و رفتارهای تکراری مشخص می‌شود که عملکردهای شناختی افراد را تحت‌تأثیر قرار می‌دهد. پژوهش حاضر باهدف مقایسهٔ اثربخشی دو مداخلهٔ مبتنی‌بر پذیرش و تعهد و ضرباهنگ دوگوشی بر بهبود عملکردهای شناختی ازجمله توجه و حافظه و کارکردهای اجرایی، در زنان مبتلا به اختلال وسواسی جبری انجام شد. روش‌بررسی: روش پژوهش نیمه‌آزمایشی با طرح پیش‌آزمون و پس‌آزمون همراه با گروه گواه و دورۀ پیگیری یک‌ماهه بود. جامعهٔ آماری پژوهش را تمامی زنان مبتلا به اختلال وسواسی جبری مراجعه‌کننده به مراکز مشاورهٔ شهر زنجان در سال ۱۴۰۳ تشکیل دادند. با روش نمونه‌گیری دردسترس، ۴۵ داوطلب واجد شرایط وارد مطالعه شدند و به‌طور تصادفی در دو گروه آزمایش مداخلهٔ مبتنی‌بر پذیرش و تعهد و مداخلهٔ ضرباهنگ دوگوشی و یک گروه گواه (هر گروه پانزده نفر) قرار گرفتند. برای جمع آوری داده‌ها، مقیاس وسواس فکری‌عملی ییل-براون (گودمن و همکاران، ۱۹۸۹)، آزمون ان-بک (کرچنر، ۱۹۵۸)، آزمون برو/نرو (هافمن، ۱۹۸۴) و آزمون نماد ارقام (اسمیت، ۱۹۷۳) به‌کار رفت. داده‌ها بااستفاده از روش تحلیل واریانس با اندازه‌گیری مکرر و آزمون تعقیبی بونفرونی در نرم‌افزار SPSS نسخهٔ ۲۵ تحلیل شد. سطح معناداری آزمون‌های آماری ۰٫۰۵ بود. یافته‌ها: اثر زمان و اثر گروه و اثر متقابل زمان و گروه بر عملکردهای شناختی (بازداری و حافظهٔ کاری و سرعت پردازش) افراد مبتلا به اختلال وسواسی جبری معنادار بود (۰٫۰۵>p). دو مداخلهٔ مبتنی‌بر پذیرش و تعهد و ضرباهنگ دوگوشی بر عملکردهای شناختی تأثیر معنادار داشت (۰٫۰۵>p). همچنین بین دو روش مداخله در اثرگذاری بر متغیرها تفاوت معناداری مشاهده نشد (۰٫۰۵<p). نتیجه‌گیری: براساس نتایج، دو مداخلهٔ مبتنی‌بر پذیرش و تعهد و ضرباهنگ دوگوشی دارای نقش مؤثری در بهبود عملکردهای شناختی افراد مبتلا به اختلال وسواسی جبری ‌است و هیچ‌کدام بر دیگری برتری ندارد. Abstract Background & Objectives: Obsessive–Compulsive Disorder (OCD) is characterized by intrusive, irrational, and distressing thoughts (obsessions) and repetitive physical or mental acts (compulsions), often leading to reduced quality of life, increased suicide risk, and significant interference with daily activities. A key aspect of OCD is its negative impact on cognitive functions, including attention, memory, executive functions, and response inhibition. Acceptance and Commitment Therapy (ACT) emphasizes altering individuals' psychological relationship with their thoughts and emotions through acceptance, mindfulness, and value–based action. Conversely, binaural beats, a non–invasive brain stimulation method, involve presenting two different frequencies to each ear, processing the frequency difference as a new frequency, leading to brainwave synchronization (eg, alpha or gamma waves). Given OCD's detrimental effects on cognitive functions and the scarcity of comparative studies in Iran, this study aimed to compare the effectiveness of ACT and binaural beats in improving cognitive functions (inhibition, working memory, and processing speed) in women with OCD. This research not only identifies more effective approaches but also provides clinicians with diverse therapeutic options to enhance patients' quality of life. Methods: This quasi–experimental study used a pretest–posttest with a 1–month follow–up design and a control group. The statistical population comprised all women with OCD referred to counseling centers in Zanjan City, Iran, in 2024. Forty–five eligible women were selected via convenience sampling and randomly assigned to three groups: ACT (15 participants), binaural beats (15 participants), and control (15 participants). The inclusion criteria for the subjects in the study were as follows: female gender, having at least a bachelor's degree, being between the ages of 25 and 40, not participating in workshops and psychotherapy sessions at the same time as the current study, not taking psychiatric medications specific to obsessive–compulsive disorder, lacking substance abuse, and scoring more than 30 on the Yale–Brown Obsessive–Compulsive Disorder Scale. The exclusion criteria for the subjects from the study included not cooperating in completing the research instruments, missing more than two sessions in therapy sessions, not completing therapy assignments, being consistently late for more than 30 minutes during three sessions, and the occurrence of unexpected events such as severe illness or death of a loved one during the study. Written consent forms were obtained from all participants, and they were informed of their right to withdraw from the study at any time. Participant information was recorded with specific codes to maintain confidentiality. Data collection tools included the Yale–Brown Obsessive–Compulsive Scale (YBOCS) (Goodman et al., 1989), the N–Back Test (Kirchner, 1958) for working memory, the Go/No–Go Test (Hoffman, 1984) for inhibition, and the Symbol Digit Modalities Test (SDMT; Smith, 1973) for processing speed. The ACT intervention, based on Hayes and Strosahl's (2004) protocol (CVR=0.69), consisted of eight 90–minute weekly sessions covering rapport–building, creative hopelessness, acceptance, cognitive defusion, self–as–context, value identification, and committed action. The binaural beats intervention (420 and 460 Hz frequencies, 30 minutes, three times weekly for 15 days; CVR=0.73) was delivered via headphones. The control group received no intervention. For data analysis in the descriptive section, descriptive statistics, including frequency, percentage, mean, and standard deviation, were used. In the inferential analysis section, the research objective was examined using a repeated–measures ANOVA and a Bonferroni post hoc test. All analyses were performed in SPSS statistical software version 25. The significance level of statistical tests was set at 0.05. Results: Time, group, and their interaction effects on cognitive functions (inhibition, working memory, and processing speed) in women with OCD were significant (p<0.05). The two interventions based on acceptance and commitment and binaural beats had a significant effect on cognitive functions (p<0.05). Also, there was no significant difference between the two intervention methods in their effects on the variables (p>0.05).  Conclusion: This study demonstrated that both ACT and binaural beats significantly improve cognitive functions (inhibition, working memory, and processing speed) in women with OCD, with no significant difference between the two interventions. These findings suggest that clinicians can utilize both methods to enhance cognitive flexibility and reduce symptoms. درمان مبتنی‌بر پذیرش و تعهد, ضرباهنگ دوگوشی, عملکردهای شناختی, اختلال وسواسی جبری Acceptance and commitment therapy, Binaural beats, Cognitive functions, Obsessive–compulsive disorder 97 97 http://jdisabilstud.org/browse.php?a_code=A-12-4048-1&slc_lang=fa&sid=1 Mahnaz Reyhani مهناز ریحانی mahnaz.reyhani1358@gmail.com 100319475328460067918 100319475328460067918 No Department of, Psychology Ard.C., Islamic Azad University, Ardabil, Iran گروه روان‌شناسی، واحد اردبیل، دانشگاه آزاد اسلامی، اردبیل، ایران Amene Sadat Kazemi آمنه سادات کاظمی akazemi@iautmu.ac.ir 100319475328460067919 100319475328460067919 Yes Department of Psychology, TeMS.C., Islamic Azad University, Tehran, Iran گروه روان‌شناسی، واحد علوم پزشکی تهران، دانشگاه آزاد اسلامی، تهران، ایران Toran Soleimani توران سلیمانی tsoleimani@iau.ac.ir.com 100319475328460067920 100319475328460067920 No Department of Educational Studies and Curriculum Planning, Ard.C., Islamic Azad University, Ardabil, Iran گروه علمی مطالعات تربیتی و برنامه‌ریزی درسی، واحد اردبیل، دانشگاه آزاد اسلامی، اردبیل، ایران Peyman Hassani Abharian پیمان حسنی ابهریان abharian@icss.ac.ir 100319475328460067921 100319475328460067921 No Department of Cognitive Psychology And Rehabilitation, Institute for Cognitive Science Studies, Tehran, Iran گروه روان‌شناسی و توان‌بخشی شناختی، مؤسسه آموزش عالی علوم‌شناختی، تهران، ایران