تأثیردرمان فعال‌سازی رفتاری بر نشخوار فکری و اضطراب مرتبط با درد در زنان مبتلا به سرطان پستان

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس ارشد، گروه روان شناسی، دانشگاه آزاد اسلامی، واحد اصفهان (خوراسگان)، اصفهان، ایران.

2 استادیار، گروه روان‌شناسی بالینی، دانشکده علوم تربیتی و روانشناسی، دانشگاه آزاد اسلامی، واحد اصفهان (خوراسگان)، اصفهان، ایران.

چکیده

مقدمه: سرطان پستان از نظر روانشناختی، بیش از سایر سرطان­ها زنان را تحت تأثیر قرار می­دهد و شایع‌ترین علت مرگ ناشی از سرطان در زنان می‌باشد. این پژوهش با هدف بررسی تأثیر درمان فعال­سازی رفتاری بر نشخوار فکری و اضطراب مرتبط با درد در زنان مبتلا به سرطان پستان انجام شد.
مواد و روش ­ها: پژوهش حاضر، مطالعه­ای نیمه تجربی از نوع پیش­آزمون- پس­آزمون با گروه کنترل و پیگیری 45 روزه بود. بدین منظور از بین زنان مبتلا به سرطان پستان مراجعه­کننده به مراکز درمانی شهر اصفهان در بهار 1396، 24 نفر به صورت در ­دسترس انتخاب و به طور تصادفی در دو گروه آزمایش و کنترل جایگزین شدند (هر گروه 12 نفر). شرکت­کنندگان در پژوهش به پرسشنامه­های پاسخ نشخوارگونه نولن و همکاران و اضطراب مرتبط با درد مک کراکن و همکاران پاسخ دادند. آزمودنی­های گروه آزمایش، درمان فعال‌سازی رفتاری را در 8 جلسه 90 دقیقه‌ای، هفته­ای یک بار دریافت نمودند. داده­ها با استفاده از تحلیل واریانس اندازه­های تکرار شده تحلیل شدند.
یافته ­ها: نتایج نشان داد که تعامل اثر زمان و عضویت گروهی در نشخوار فکری و ابعاد اضطراب مرتبط با درد معنی­دار بوده است (05/0>p). همچنین، بین نمرات درمان فعال‌سازی رفتاری و گروه کنترل در متغیرهای پژوهش در هر دو مرحله پس‌آزمون (به جز پس‌آزمون علائم فیزیولوژیک) و پیگیری تفاوت معنی‌داری وجود داشت (05/0>p).
نتیجه ­گیری: بنا بر نتایج این پژوهش برای بهبود متغیرهای روانشناختی مرتبط با درد در افراد مبتلا به سرطان پستان می­توان از درمان فعال­سازی رفتاری استفاده نمود.
واژه ­های کلیدی: درمان فعال­سازی رفتاری، نشخوار فکری، اضطراب مرتبط با درد، سرطان پستان

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of Behavioral Activation Therapy on Rumination and Pain–related Anxiety in Women with Breast Cancer

نویسندگان [English]

  • S Ebrahimi 1
  • I Sajjadian 2
1 M Sc, Dept of Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
2 Assistant prof, Dept of Clinical Psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
چکیده [English]

Introduction: Breast cancer psychologically affects women more than other cancers. Further, it is the most common cause of cancer deaths in women. The present study aims to determine the effect of behavioral therapy on rumination and pain-related anxiety in women with breast cancer.
Materials and method: This research was a semi-experimental posttest-pretest control group design with a 45-days follow-up. For this purpose, among women with breast cancer referred to cancer clinics of Isfahan in the spring of 2018, 24 people were selected by the convenience sampling method and randomly assigned to two experimental and control groups (12 in each). The participants responded to the questionnaires of the rumination (Nullen et al.) and the pain-associated anxiety (McCraken et al.). Subjects in the experimental group received behavioral activation therapy in 8 sessions of 90 minutes once a week.
Results: Results of variance analysis for repeated measures showed that the interaction of time effect and group membership in rumination and anxiety dimensions related to pain was significant (p < 0.05(. The results also showed a significant difference between behavioral activation therapy and control group in research variables in both posttest (except for posttest of physiological symptoms) and follow-up (p < 0.05(.
Conclusion: According to this research results, behavioral activation therapy can be used to improve pain-related psychological variables in people with breast cancer.

کلیدواژه‌ها [English]

  • Behavioral activation therapy
  • Rumination
  • Pain-related anxiety
  • Breast cancer

مراجع

  1. Beiki O, Hall P, Ekbom A, Moradi T. Breast cancer incidence and case fatality among 4.7 million women in relation to social and ethnic background: a population based cohort study. Breast Cancer Research 2012; 14 (1): R5.
  2. GHaribi Asl1 A, Sodani M, Atari Y. The Effectiveness of Cognitive-Behavioral Group Counseling on Self-Concept and Depression in Women with Breast Cancer. JSMJ 2016; 15(3):333-45. [Persian]
  3. Banegas MP, Bird Y, Moraros J, King S, Prapsiri S, Thompson B. Breast cancer knowledge, attitudes, and early detection practices in United States-Mexico border Latinas. Journal Womens Health (Larchmt) 2012; 21 (1): 101-7.
  4. Perez A, Lee A, Law SCK, Chua T, Williams W, Chong V. Breast tumors: In Halperin EC, Perez CA, Brady LW. Principle and Practice of Radiation Oncology .5th ed, Philadelphia: Lippincott Williams and Wilkins 2008; 11: 1162-75.
  5. Safari N, Kavosi A, Jouybari L, Sanagoo A, Mohammadi GH. The Relationship between Catastrophizing, Pain-related Anxiety and Coping Strategies in Cancer Patients. IJPN 2015; 3 (2) :31-42[Persian]
  6. Turk DC, Okifuji A. Psychological factors in chronic pain: evolation and revolution. JCCP 2002; 70 (3): 678-90.
  7. Sodughi M. Pain: Psychological Social Approach. 1st ed. Kashan: University of Kashan; 2011: 425. [Persian]
  8. Curtis AJ. Health Psychology. 1st ed. London: Routledge 2000: 208.
  9. Lo C S, Ho SM, Hollon SD. The effects of rumination and negative cognitive styles on depression: A mediation analysis. Behaviour Research and Therapy 2008; 46(4): 487–95.
  10. Abela JRZ, Hankin BL. Cognitive vulnerability to depression in children and adolescents: A developmental psychopathology perspective. Handbook ofdepression in children and adolescents. New York: Guilford press 2007; 35-75.
  11. Sadock BJ, Sadock VA, Ruiz P. Comprehensive textbook of psychiatry. 9th ed. Philadelphia: Lippincot Williams & Wilkins 2009:4520.
  12. Keunyoung Y, Keun HK, Shin YS, Kang SL. Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. Journal of Anxiety Disorders 2010; 24(6): 623–28.
  13. Junwen C, Ronald M, Rapeeb, Maree J. Abbottc, Mediators of the relationship between social anxiety and post-event rumination. Journal of Anxiety Disorders 2013; 27(5): 480–86.
  14. Keisuke T, Yoshihiko T. Self-rumination, self-reflection, and depression: Self-rumination counteracts the adaptive effect of self-reflection. BRAT 2009; 47(3): 260–64.
  15. Asmundson GJ, Collimore KC, Bernstein A, Zvolensky MJ, Hadjistavropoulos HD. Is the latent structure of fear of pain continuous or discontinuous among pain patients? Taxometric analysis of the pain anxiety symptoms scale. The Journal of Pain 2007; 5: 387-95.
  16. Knaster P, Estlander AM, Karlsson H, Kaprio J, Kalso E. Temperament traits and chronic pain: the association of harm avoidance and pain-related anxiety. PLOS ONE 2012; 7 (10): 645-72.
  17. Boerma K, Linton SJ. Psychological processes underlying the development of a chronic pain problem: A prospective study of the relationship between profiles of Psychological variable in fear avoidance model in disability. Clinical Journal of pain 2006; 22(2): 160-66.
  18. Dimidjian S, Hollon SD, Dobson KS, Schmaling KB, Kohlenberg RJ, Addis ME, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. JCCP 2006; 74(4): 658-70.
  19. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Washington. DC: American Psychiatric Association 2013.
  20. Hopko DR, Armento MEA, Robertson S, Ryba MM, Carvalho JP, Colman LK, et al. Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: Randomized trial. JCCP 2011; 79(6): 834-49.
  21. Mazzuccelli GT, Da Silva M. The potential of behavioural activation for the treatment of chronic pain: An exploratory review. Clinical Psychologist 2016; 20(1): 5-16.
  22. Zemestani M, Davoodi I, Mehrabi-Zadeh Honarmand M, ZargarY. Effectiveness of group behavioral activation on depression, anxiety and rumination in patients with depression and anxiety. Clinical Psychology 2014; 5 (4): 84-73. [Persian]
  23. Ryba MM, Lejuez CW, Hopko DR. Behavioral activation for depressed breast cancer patients: The impact of therapeutic compliance and quantity of activities completed on symptom reduction. JCCP 2014; 82 (2): 325-35.
  24. Daughters SB, Braun AR, Sargeant MN, Reynolds EK, Hopko DR, Blanco C, et al. Effectiveness of a brief behavioral treatment for inner-city illicit drug users with elevated depressive symptoms: The life enhancement treatment for substance abuse. JCP 2008; 69 (1): 122-29.
  25. Fleiss JL, Tytun A & Ury HK. A simple approximation for calculating sample sizes for comparing independent proportions. Biometrics1980; 36(2): 343-46.
  26. Ghanavati A, Bahrami F, Godarzi K, Rouzbahani M. Effectiveness of compassion-based therapy on rumination and concern of women with breast cancer. Quarterly Journal of Health Psychology2018; 7(27), 152-168. (Persian)
  27. Nolen-Hoeksema S, Marrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. JPSP 1991; 61(1):115-21.
  28. Papageorgiou C, Wells A. Depressive rumination: nature, theory, and treatment.1th ed. New York: John Wiley &Sons 2004; 78(3): 687-99.
  29. Mansouri A, BakhshiPour A, Mahmoodalilou M, Farnam A, Fakhari A. The comparison of worry, obsession and rumination in individual with Generalized Anxiety Disorder, Obsessive Compulsive Disorder, Major Depression Disorder and normal individual. JPS 2011; 7(4): 55-74.[ Persian].
  30. cCracken LM, Zayfert C, Gross RT. The pain anxiety symptoms scale: development and validation of a scale to measure fear of pain. Pain 1992; 50 (1): 67-73.
  31. Strahl C, Kleinknecht RA, Dinnel DL. The role of pain anxiety, coping, and pain self-efficacy in rheumatoid arthritis patient functioning. Behaviour Research and Therapy 2000; 38 (9): 863-73.
  32. McCracken LM, Dhingra L. A short version of the Pain Anxiety Symptom Scale (PASS-20): Preliminary development and validity. Pain research and mangement 2002; 7(1): 45-50.
  33. McCracken LM. A contextual analysis of attention to chronic pain: what the patient does with their pain might be more important than their awareness or vigilance alone. The Journal of Pain 2007; 8 (3): 230-36.
  34. Davoudi A, Zargar Y, Mozaffaripoursisakht A, Nargesi, Mola k. Relationship between catastrophic pain, neuroticism, social support and coping strategies with functional disability in rheumatic patients. HPJ 2012; 1(1): 59-73. [Persian]
  35. Dimidjian S, Martell CR, Addis ME, Herman-Dunn R. Behavioral activation for depression. Barlow DH. Clinical handbook of psychological disorders. 4th ed. A step-by step treatment manual. New York: Guilford Press 2014; 353-393.

فایل ها

اشتراک گذاری

ارجاع به این مقاله

آمار