اثربخشی روان درمانی مثبت گرا بر ابعاد جسمانی و هیجانی دختران مبتلا به افسردگی مداوم (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
هدف این پژوهش، مقایسه اثربخشی مداخله مثبت نگر گروهی و فردی بر ابعاد جسمانی و هیجانی دختران نوجوان بی سرپرست/بد سرپرست مبتلا به افسردگی مداوم بود. جامعه آماری شامل دختران نوجوان بی سرپرست/بدسرپرست شهرستان بناب بود. با روش نمونه گیری دردسترس، 45 نفر با تعداد مساویدر گروه کنترل (15 نفر)، گروه آزمایش انفرادی (15 نفر انفرادی) و گروه آزمایشی گروهی (15 نفر) انتخاب و به شکل تصادفی جایگزین شدند. گروه های آزمایشی مداخله مثبت نگر فردی و گروهی را دریافت کردند؛ اما گروه کنترل مداخله ای دریافت نکرد. داده ها با استفاده از پرسشنامه افسردگی بک گردآوری شدند. نتایج تحلیل واریانس مکرر نشان دهنده اثربخشی مداخله مثبت نگر فردی در مقایسه با مداخله مثبت نگر گروهی در بهبود علایم هیجانی افسردگی مداوم بود. در گروه مداخله مثبت نگر فردی، میانگین نمرات علایم هیجانی افسردگی مداوم در پس آزمون (میانگین= 67/0) و پیگیری (میانگین= 93/0)، بسیار پایین تر از گروه مداخله مثبت نگر گروهی (میانگین پس آزمون=20/2؛ پیگیری=33/2) و گروه کنترل (میانگین پس آزمون= 93/2؛ پیگیری=57/2) بود. با وجود اینکه میانگین نمرات علایم جسمانی افسردگی مداوم در گروه مداخله مثبت نگر فردی در پس آزمون (میانگین= 07/1) و پیگیری (میانگین= 47/1) نیز همچنان پایین تر از گروه مداخله مثبت نگر گروهی (میانگین پس آزمون= 13/2؛ پیگیری=33/2) و گروه کنترل (میانگین پس آزمون= 70/3؛ پیگیری=43/3) بود؛ ولی مداخله مثبت نگر فردی و گروهی تأثیر معنی دار یکسانی بر علایم جسمانی افسردگی مداوم داشتند؛ بنابراین، میزان اثربخشی مداخله مثبت نگر گروهی و فردی بر علایم هیجانی بیشتر از علایم جسمانی افسردگی مداوم دختران بود.The Effectiveness of Positive Psychotherapy on Physical and Emotional Dimensions of Girls with Persistent Depression
This study aimed to compare the effectiveness of group and individual positive psychotherapy on the physical and emotional dimensions of orphaned and abused teenage girls. A sample of 45 girls were selected through convenience sampling and were assigned to three groups (two experimental groups and one control group) with equal numbers of participants. The experimental groups received positive interventions, while the control group did not receive any intervention. Data were gathered using the Beck Depression Inventory. The analysis of variance with repeated measures revealed that individual positive intervention was more effective than group positive intervention in alleviating the emotional symptoms of persistent depression. In the individual positive intervention group, the mean scores for emotional symptoms of persistent depression at post-test (mean = 0.67) and follow-up (mean = 0.93) were significantly lower than those in the group positive intervention group (post-test mean = 2.20; follow-up mean = 2.33) and the control group (post-test mean = 2.93; follow-up mean = 2.57). Although the mean scores for physical symptoms of persistent depression in the individual positive intervention group at post-test (mean = 1.07) and follow-up (mean = 1.47) were also lower than those in the group positive intervention group (post-test mean = 2.13; follow-up mean = 2.33) and the control group (post-test mean = 3.70; follow-up mean = 3.43), the findings indicated that both individual and group positive interventions had the same significant effect on the physical symptoms of persistent depression. Therefore, the effectiveness of positive psychotherapy is more pronounced for emotional symptoms than for physical symptoms of persistent depression among the girls.IntroductionOrphanhood and abuse are significant risk factors for adolescents, which can lead to poor physical and mental health, academic difficulties, and social challenges. Previous research indicates higher rates of cognitive, emotional, and developmental disorders, including depression, which adversely affect their psychological well-being. In 1998, Martin Seligman introduced positive psychology, shifting the clinical focus toward enhancing happiness and well-being rather than solely addressing negative symptoms. This study examined the effectiveness of group and individual positive interventions in reducing emotional and physical symptoms of persistent depression among orphaned and abused adolescent girls, leading to two proposed hypotheses: 1. There is a difference in the effectiveness of individual and group positive psychotherapy on the emotional dimensions of girls with persistent depression. 2. There is a difference in the effectiveness of individual and group positive psychotherapy on the physical dimensions of girls with persistent depression.MethodTo meet the research objectives, 45 orphaned or abused teenage girls in Bonab, Iran, under the supervision of the Welfare Department and the Relief Committee, were selected using purposive sampling. They were divided into three groups: a control group (15 participants), an individual experimental group (15 participants), and a group experimental group (15 participants). The participants were selected based on a psychiatrist's diagnosis obtained through a structured clinical interview. Inclusion criteria for the study included: providing informed consent to participate in the intervention program, not having a concurrent psychiatric disorder as diagnosed by a psychiatrist, having no criminal record, not receiving other medical services in the past six months, and being literate. Exclusion criteria included failing to attend at least two treatment sessions and engaging in other interventions or psychological programs concurrently with the treatment. The Beck Depression Inventory was used as the measurement tool. After explaining the research objectives and obtaining consent from the participants, a pre-test was administered, and the necessary measures were taken to plan the intervention sessions. Following the application of the independent variable, the dependent variable was assessed using a questionnaire, and the data were analyzed using repeated measures analysis of variance. To implement the positive psychotherapy sessions, the Parks-Shiner (2009) treatment programs, developed under the supervision of Seligman at the University of Pennsylvania, were utilized. The program consisted of six 90-minute sessions conducted in both group settings and individually. ResultsTo examine the assumptions of the analysis of variance (ANOVA) test for the pre-test, post-test, and follow-up scores of persistent depression and its subcomponents across all three groups, the normality of score distributions were calculated using the Kolmogorov-Smirnov test. The results indicated that the components followed a normal distribution (p < 0.05). The homogeneity of variances was evaluated using Levene's test, which confirmed that this assumption was valid for the aforementioned components (p < 0.05). The sphericity assumption was tested using Mauchly's test; results for the pre-test scores of persistent depression and its subcomponents showed that this assumption was not valid for any of the variables (p > 0.05), except for the subcomponent of physical symptoms of persistent depression (p < 0.05). Since the epsilon values were less than 0.75, the Greenhouse-Geisser correction was applied. Finally, Box's M test results indicated that the assumption of homogeneity of variance-covariance matrices was met for all subcomponents of persistent depressive symptoms (p < 0.001). The mean scores for emotional symptoms of persistent depression in the individual positive intervention group (mean = 2.93) and the group positive intervention group (mean = 3.13) during the pre-test were nearly equal to the mean score in the control group (mean = 2.87). However, in the post-test, the mean score for emotional symptoms in the individual positive intervention group (mean = 0.67) was significantly lower than that of the group positive intervention group (mean = 2.20) and the control group (mean = 2.93). In the follow-up test, the mean scores for emotional symptoms in the individual positive intervention group (mean = 0.93) remained substantially lower than those in the group positive intervention group (mean = 2.33) and the control group (mean = 2.87).For persistent depressive physical symptoms, the mean scores in the individual positive intervention group (mean = 3.53) and the group positive intervention group (mean = 4.07) during the pre-test were somewhat comparable to the mean score in the control group (mean = 3.93). However, in the post-test, the mean scores for physical symptoms in the individual positive intervention group (mean = 1.07) were significantly lower than those in the group level positive intervention (mean = 2.13) and the control groups (mean = 3.93). In the follow-up test, the mean scores for physical symptoms in the individual positive intervention group (mean = 1.47) remained lower than those in the group positive intervention group (mean = 2.33) and the control group (mean = 3.93). The results indicated that individual positive psychotherapy effectively reduced emotional symptoms of persistent depression in orphaned and abused adolescent girls who received the intervention. However, no significant difference was observed in the effects of this intervention on physical symptoms between the groups that received individual versus group interventions; both formats had similar effects on the physical dimensions of the participants. ConclusionConsidering the findings and the greater effectiveness of individual therapy compared to group therapy, it can be argued that persistent depression affects various dimensions of an individual's life, including physical, cognitive, emotional, and motivational aspects. A lack of awareness of positive human assets and capabilities, combined with a focus on depressive symptoms, can hinder improvement and prolong the duration of the disorder. Experts suggest that awareness, focus, and the strengthening of positive emotions and capabilities can effectively address various symptoms of depression and help overcome negative emotions. Enhancing and focusing on these capabilities can be particularly effective in identifying the root causes of an individual's problems. In cases of persistent depression, where individuals experience low mood for extended periods, engaging in purposeful and structured relationships within a positive psychology framework can significantly transform their worldview and attitudes toward life events. Conversely, experiences from researchers indicate that group counseling may have limitations, such as participants’ inability to disclose personal issues. Therefore, positive interventions, due to their short-term nature, comprehensibility of techniques, and cost-effectiveness compared to other treatment approaches, can be suitable for individuals with persistent depression. This study focused on orphaned and abused teenage girls under the care of the Welfare and Relief Committee of East Azerbaijan Province, Bonab. Consequently, caution should be exercised when generalizing the results to other unaccompanied teenagers. Future research should compare the effectiveness of this method with other therapeutic approaches. Other limitations of this study include its single-sex sample, reliance on a questionnaire, and use of a non-random sampling method.Ethical Considerations Compliance with Ethical Guidelines: We adhered to all ethical standards throughout the research process, which involved maintaining the confidentiality of participants’ identities and securing informed consent from each participant.Author Contributions: All authors contributed to the study. The first author provided the treatments to the participants and wrote the initial draft of the manuscript. The second author supervised the whole process of the research. The third author conducted the data analysis and provided critical insights for the interpretation of results. The fourth author assisted with the literature review and contributed to the development of the research methodology.Conflict of Interest: The authors declare that there are no conflicts of interest related to this study.Funding: The authors did not receive any financial support for this research.Acknowledgments: The authors wish to express their gratitude to all participants for their time and involvement in this study.
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