اثربخشی رفتار درمانی دیالکتیکی بر تنظیم هیجان و نشخوار فکری در معلولین جسمی-حرکتی تحت پوشش بهزیستی شهرستان مشهد (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
هدف: این مطالعه با هدف بررسی اثربخشی رفتاردرمانی دیالکتیکی بر تنظیم هیجان و نشخوار فکری در معلولین جسمی حرکتی بهزیستی شهرستان مشهد انجام شد. روش: پژوهش حاضر نیمه آزمایشی با طرح پیش آزمون، پس آزمون و پیگیری همراه با گروه گواه بود. جامعه آماری کلیه ی معلولین جسمی حرکتی 20 تا 50 ساله بودند که در سال 1398 تحت پوشش بهزیستی مشهد قرار داشتند. 30 نفر از این افراد، که دارای نمرات پایین در راهبردهای سازی یافته و نمرات بالا در راهبردهای سازش نایافته و نشخوار فکری بودند، به روش نمونه گیری در دسترس انتخاب شدند و به صورت تصادفی در گروه آزمایش(15 نفر) و گروه گواه(15 نفر) جای داده شدند. شرکت کنندگان پژوهش در مراحل پیش آزمون، پس آزمون و پیگیری به مقیاس تنظیم شناختی هیجان گارنفسکی (2001) و نشخوار فکری نولن هوکسما و مارو (1991) پاسخ دادند. درمان برای گروه آزمایش در یازده جلسه ی شصت دقیقه ای اجرا شد. داده ها با استفاده از تحلیل واریانس چندمتغیری با اندازه گیری مکرر در نرم افزار SPSS-25 مورد تحلیل قرار گرفتند. یافته ها: نتایج پژوهش نشان داد که بین تنظیم هیجان (راهبردهای سازش یافته) و نشخوار فکری در پیش آزمون، پس آزمون و پیگیری تفاوت معنا داری وجود دارد (05/0> p ) و نتایج مربوط به اثر تعاملی بین زمان و گروه نشان می دهد این اثر در متغیرهای تنظیم هیجان (راهبردهای سازش یافته و راهبردهای سازش نایافته) و نشخوار فکری معنادار بوده است؛ بنابراین، بین سطوح مختلف گروه ها تعامل وجود دارد و بر اساس یافته های پژوهش، آموزش رفتاردرمانی دیالکتیک بر تنظیم هیجانی و نشخوار فکری در معلولین جسمی حرکتی اثربخش است.Exploring the Impact of Dialectical Behavior Therapy on Emotional Regulation and Rumination among the Physically Disabled People using the Services of the Welfare Organization of Mashhad
Introduction Physical disabilities make people disable to use their body parts effectively for at least six months, disrupting the efficiency of body and challenging the physical abilities (Lucas-Carrasco et al., 2011). One of the variables affecting the mental well-being of physically disabled people is emotion. Emotion regulation involves managing emotions arising from a wide range of stressful and non-stressful situations, positively or negatively (Miranda et al., 2012). Another issue that can affect the life of physically disabled people is rumination, defined as a response to a negative mood (Calvete et al., 2021). Emotion dysregulation is common in many mental disorders and emotion regulation forms the basis of dialectical behavior therapy (Asarnow et al., 2021). Some of the issues used in this kind of treatment are behavior change, emotion regulation, mindfulness, and acceptance (Rizvi & Thomas, 2016). The statistics show that physically disabled people constitute a significant part of Iran’s population. These people are facing many problems in various areas, therefore; research is needed to improve their mental health and quality of life. This study aimed to investigate the impacts of dialectical behavior therapy on emotion regulation and rumination in physically disabled people in the Welfare Organization of Mashhad, Iran. Method This quasi-experimental study used a pre-test, post-test, and follow-up with a control group design. The statistical population consisted of all physically disabled people in the Welfare Organization of Mashhad in 2019, from which 30 were selected through convenience sampling. The participants were then randomly assigned to experimental and control groups. For this study cognitive emotion regulation questionnaire and Nolen-Hoeksema and Morrow’s rumination scale were used as to measure the study variables. The cognitive emotion regulation questionnaire has been designed by Garnefski et al. (2002) to measure cognitive emotion regulation. It includes 36 items, evaluating nine different emotion regulation strategies. Nolen-Hoeksema and Morrow’s Rumination Scale developed by Nolen-Hoeksema and Morrow (1991), consists of two subscales of ruminative responses and distracting responses. It should be noted that only the subscale of ruminative responses was used in the present study. The ruminative responses subscale has 22 items. Dialectical behavior therapy method was performed on the experimental group for eleven weekly sessions. Results The data were analyzed using SPSS-25. The results showed that Mauchly’s Test of Sphericity is significant for adaptive and non-adaptive strategies and rumination ( p <0.05). Thus, the greenhouse-geyser epsilon index was used for correction. Moreover, the results of Pillai's trace test for adaptive and non-adaptive strategies and rumination are significant ( p <0.05). The results showed that there is a significant difference between the scores of emotion regulation variables (adaptive strategies) and rumination in the pre-test, post-test and follow-up ( p <0.05). The results related to the interaction impact between time and group show that this impact was significant for the emotion regulation variables (adaptive and non-adaptive strategies) and rumination. Therefore, there is an interaction between different levels of the groups, which indicates that 47%, 15%, and 32% of the intra-group variations can be explained by the interaction between time and group, respectively. Furthermore, the results related to intergroup impacts show that there is no significant difference between the scores of emotional regulation variables (adaptive strategies and non-adaptive strategies) and rumination in the experimental and control groups ( p >0.05). Discussion and conclusion This study aimed to explore the impact of dialectical behavior therapy on emotion regulation and rumination in physically disabled people in the Welfare Organization of Mashhad. The results showed that dialectical behavior therapy led to the improvement of adaptive strategies and the reduction of non-adaptive behaviors. It is clear that physically disabled people experience all kinds of negative emotions due to their physical and motor difficulties and their resulting limitations. Moreover, dialectical behavioral therapy techniques focus on emotional dysregulation. Dialectical behavior therapy presupposes that improving skills and using them result from better emotion regulation. The goal of dialectical behavior therapy is modifying emotions towards emotional efficiency in a way that negative emotions are driven towards adaptation. Hence, the participants learned to use such dialectical behavioral therapy techniques as mindfulness and disturbance tolerance in dealing with suffering and stress. They learned not to be oversensitive to their emotions and not to use resistance and avoidance instead of positive emotion regulation strategies. In explaining the impact of dialectical behavior therapy on rumination, it can be said that in this therapy, the participants were taught not to be afraid of change and not to resist changing their negative thoughts. They were taught to pay attention to learning new skills like mindfulness to deal with their negative thoughts. Acceptance and non-judgment in dialectical behavior therapy sessions make people stop excessive conflict with their negative emotions and rumination and experience their emotions in a real way. Finally, due to the limited research sample and the selection based on the severity of the disability, intervening variables such as family and economic status were not under the control of the therapist. Looking forward, it will be important that counselors and therapists use the dialectical behavior therapy to improve emotion regulation and rumination in other societies.
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