اثربخشی روان‌درمانی پویشی کوتاه مدت فشرده بر شناخت اجتماعی و تکانشگری در سربازان وظیفه مبتلا به اختلال افسردگی اساسی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار مدیریت، پژوهشگاه علوم انتظامی و مطالعات اجتماعی ناجا، تهران، ایران.

2 گروه روان شناسی، دانشکده علوم تربیتی و روان شناسی، دانشگاه شهید بهشتی، تهران، ایران.

3 دانش آموخته دکتری روان شناسی بالینی، مرکز تحقیقات علوم شناختی و رفتاری در پلیس، معاونت بهداشت، امداد و درمان فرماندهی انتظامی،

چکیده

هدف پژوهش حاضر، تعیین اثربخشی روان‌درمانی پویشی کوتاه مدت فشرده(ISTDP) بر شناخت اجتماعی و تکانشگری در سربازان وظیفه مبتلا به اختلال افسردگی اساسی بود. طرح پژوهش، نیمه آزمایشی از نوع پیش‌آزمون-پس‌آزمون-پیگیری 1 ماهه و با گروه گواه بود. جامعه آماری شامل تمامی سربازان وظیفه مرد فراجا مبتلا به اختلال افسردگی اساسی ستاد استان اصفهان و شهرستان‌های اصفهان و خمینی شهر در زمستان سال 1402 و بهار سال 1403 بود. 50 سرباز مبتلا به اختلال افسردگی اساسی با نمونه‌گیری هدفمند انتخاب و به صورت تصادفی در گروه آزمایش (25 نفر) و گروه گواه (25 نفر) گمارده شدند. پروتکل ISTDP دوانلو، برای گروه آزمایش طی 8 جلسه 90 دقیقه‌ای انجام شد و گروه گواه در لیست انتظار قرار گرفتند. آزمودنی‌ها در 3 مرحله با نسخه دوم پرسشنامه‌ افسردگی بک(1996)، مقیاس تکانشگری بارت(1995) و آزمون ذهن‌خوانی از طریق تصاویر چشم(2001) ارزیابی شدند. داده ها با با نرم افزار SPSS-28، تحلیل شد و نتایج آزمون تحلیل کوواریانس چند متغیره نشان داد که ISTDP بر شناخت اجتماعی، نشانه‌های افسردگی و تکانش‌گری (و تمامی مولفه‌های آن شامل تکانش‌گری های حرکتی، شناختی و عدم برنامه‌ریزی). در سربازان وظیفه فراجا تاثیر دارد و ماندگاری تاثیرات روان‌درمانی تا 1 ماه پس از مداخله تایید شد (05/0>p). بنابراین ISTDP یک مداخله اثربخش برای اختلال افسردگی اساسی است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The Effectiveness of Intensive Short-Term Dynamic Psychotherapy on Social Cognition and Impulsivity in conscripts with major depressive disorder

نویسندگان [English]

  • mohamadali ameri 1
  • Abolfazl Sarlaki 2
  • Sajjad Khanjani 3
1 Associate Professor of Management, Naja Police Science and Social Studies Research Institute, Tehran, Iran.
2 Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran.
3 PhD in clinical psychology, Cognitive and Behavioral Sciences Research Center in Police, Deputy Health, Aid and Treatment of Police Command, Tehran, Iran.
چکیده [English]

The present study aims to determine the effectiveness of The Effectiveness of Intensive Short-Term Dynamic Psychotherapy on Social Cognition and Impulsivity in conscripts with major depressive disorder. method research was a semi-experimental type of pre-test-post-test-1 month follow-up with a control group. The statistical population included all Faraja male conscripts suffering from major depressive disorder in the headquarters of Isfahan province, Isfahan city, and Khomeini Shahr city in the winter of 1402 and spring of 1403. 50 soldiers suffering from major depressive disorder were selected by purposive sampling and randomly assigned to the experimental group (25 people) and the control group (25 people). Dovanlo's ISTDP protocol was performed only for the experimental group during 8 sessions of 90 minutes, and the control group was placed on the waiting list. Subjects in 3 stages with the Beck Depression Inventory-II (1996), Barratt Impulsiveness Scale (1995), and Baron Cohen et al.'s (2001) Reading the Mind in the Eyes Test were evaluated. The data was analyzed with SPSS-28 software and the results of Multivariate analysis of covariance (MANCOVA) showed that ISTDP affects social cognition, symptoms of depression, and impulsivity (and all its components, including unplanned impulsivity, motor impulsivity, and cognitive impulsivity) in active-duty soldiers, and the lasting effect of psychotherapy up to 1 month after the intervention was confirmed (p<0.05). Therefore, ISTDP is an effective intervention for major depressive disorder.

کلیدواژه‌ها [English]

  • Intensive Short-Term Dynamic Psychotherapy
  • Social Cognition
  • Impulsivity
  • Major depressive disorder

مراجع

Abbass, A., Town, J., Holmes, H., Luyten, P., Cooper, A., Russell, L., ... & Kisely, S. (2020). Short-term psychodynamic psychotherapy for functional somatic disorders: A meta-analysis of randomized controlled trials. Psychotherapy and Psychosomatics, 89(6), 363-370. https://doi.org/10.1159/000507738
Ahmadi Tahor-Soltani, M. (2020). The Effectiveness of Dialectical Behavioral Therapy (DBT) on Emotion Regulation and Impulse Control of Soldiers with a Self-Reporting Experience. Nurse and Physician Within War, 8(28), 12-23. https://doi.org/10.52547/npwjm.8.28.12
Ajilchi, B., Kisely, S., Nejati, V., & Frederickson, J. (2020). Effects of intensive short-term dynamic psychotherapy on social cognition in major depression. Journal of Mental Health, 29(1), 40-44. https://doi.org/10.1080/09638237.2018.1466035
Ajilchi, B., Nejati, V., Town, J. M., Wilson, R., & Abbass, A. (2016). Effects of intensive short-term dynamic psychotherapy on depressive symptoms and executive functioning in major depression. The Journal of nervous and mental disease, 204(7), 500-505. https://doi.org/10.1097/NMD.0000000000000518
Alexander, F. (1980). Psychoanalytic therapy: Principles and application (Vol. 1946). U of Nebraska Press. https://doi.org/10.1017/S0033291700053836
American Psychiatric Association. (2015). Depressive disorders: DSM-5® selections. American Psychiatric Pub.
Asadirahmani, S., Moosavipour, S., Dehghan, M. H., & Azizi, M. (2024). Prediction of sleep quality based on religious orientation with a mediating role of resilience and positive thinking in soldiers. Military Psychology, 15(1), 115-137. https://dor.isc.ac/dor/20.1001.1.25885162.1403.15.1.6.8
Bakhshipour, A., Aliloo, M. M., Khanjani, Z., Ranjbar, F., & Gharamaleki, H. B. (2012). Theory of Mind Deficit in Schizophrenic Patients with Positive and Negative Symptoms: State or Trait. Medical Journal of Tabriz University of Medical Sciences, 33(6), 32-38. https://mj.tbzmed.ac.ir/Article/7615
Bakopoulou, I., & Dockrell, J. E. (2016). The role of social cognition and prosocial behaviour in relation to the socio-emotional functioning of primary aged children with specific language impairment. Research in developmental disabilities, 49, 354-370. https://doi.org/10.1016/j.ridd.2015.12.013
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “Reading the Mind in the Eyes” Test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 42(2), 241-251. https://doi.org/10.1017/S0021963001006643
Beck, A. T., Steer, R. A., & Brown, G. (1996). Beck depression inventory–II. Psychological assessment. https://doi.org/10.1037/t00742-000
Bressi, C., Fronza, S., Minacapelli, E., Nocito, E. P., Dipasquale, E., Magri, L., ... & Barone, L. (2017). Short‐term psychodynamic psychotherapy with mentalization‐based techniques in major depressive disorder patients: Relationship among alexithymia, reflective functioning, and outcome variables–A pilot study. Psychology and Psychotherapy: theory, research and practice, 90(3), 299-313. https://doi.org/10.1111/papt.12110
Bromand, N., & Hosseini Ravarizadeh, N. (2023). Comparison of effectiveness of short-term dynamic psychotherapy and object relationships on interpersonal sensitivity and aggressive behaviors in individuals with borderline personality disorder. Rooyesh-e-Ravanshenasi Journal (RRJ), 12(1), 207-216. http://dorl.net/dor/20.1001.1.2383353.1402.12.1.19.3
Busch, F. N. (2009). Anger and depression. Advances in psychiatric treatment, 15(4), 271-278. https://doi.org/10.1192/apt.bp.107.004937
Caselli, I., Ielmini, M., Bellini, A., Zizolfi, D., & Callegari, C. (2023). Efficacy of short-term psychodynamic psychotherapy (STPP) in depressive disorders: A systematic review and meta-analysis. Journal of affective disorders, 325, 169-176. https://doi.org/10.1016/j.jad.2022.12.161
Coren, A. (2020). Short-term psychotherapy: A psychodynamic approach. Bloomsbury Publishing.
Corruble, E., Hatem, N., Damy, C., Falissard, B., Guelfi, J. D., Reynaud, M., & Hardy, P. (2003). Defense styles, impulsivity and suicide attempts in major depression. Psychopathology, 36(6), 279-284. https://doi.org/10.1159/000075185
Cramer, P. (2006). Protecting the self: Defense mechanisms in action. Guilford Press. ISBN-1-59385-298-3. ISBN-978-1-5938-5298-6
Davanloo, H. (1995). Intensive short-term dynamic psychotherapy: major unlocking of the unconscious-part II. The course of the trial therapy after partial unlocking. International Journal of Short-Term Psychotherapy, 10, 183-230.
Ecker, B., Ticic, R., & Hulley, L. (2024). Intensive Short-Term Dynamic Psychotherapy (ISTDP). In Unlocking the Emotional Brain (pp. 212-225). Routledge. ISBN: 9781003231431 https://doi.org/10.1002/9781118625392.wbecp351
Ekhtiari, H., Safaei, H., Esmaeeli Djavid, G., Atefvahid, M. K., Edalati, H., & Mokri, A. (2008). Reliability and validity of Persian versions of Eysenck, Barratt, Dickman and Zuckerman Questionnaires in assessing risky and impulsive behaviors. Iranian journal of psychiatry and clinical psychology, 14(3), 326-336. https://psycnet.apa.org/record/2009-08650-003
Evenden, J. L. (1999). Varieties of impulsivity. Psychopharmacology, 146(4), 348-361. https://link.springer.com/article/10.1007/pl00005481
Ferenczi, S., & Rank, O. (1924). Entwicklungsziele der Psychoanalyse: Zur Wechselbeziehung von Theorie und Praxis (No. 1). Internationaler Psychoanalytischer Verlag. https://cir.nii.ac.jp/crid/1130000795695363456
First, M. (2014). Structured Clinical Interview for the DSM (SCID). The Encyclopedia of Clinical Psychology John Wiley & Sons. Inc [Google Scholar]. https://doi.org/10.1002/9781118625392.wbecp351
Gagnon, J., & Daelman, S. (2011). An empirical study of the psychodynamics of borderline impulsivity: A preliminary report. Psychoanalytic Psychology, 28(3), 341. https://psycnet.apa.org/buy/2011-12014-001
Hashemi, S. S., & Ahmadi, H. (2021). The effect of commanders' leadership abilities on reducing desertion, aggression and depression among IRI police soldiers. Journal of Research Police Science, 22(4), 115-44. https://www.magiran.com/p2253417
Heidarinasab, L., Khorianian, M., & Tayyebi, Z. (2014). Effectiveness of intensive short-term dynamic psychotherapy in reducing symptoms and changing defense styles in patients with depression. Clinical Psychology Studies, 4(14), 143-168. https://jcps.atu.ac.ir/article_517_en.html
Heshmati, A., Khakpoor, S., Kosari, Z., Mohammadi, M., & Zenoozian, S. (2019). Prevalence of Suicide Ideation among Students of Zanjan University of Medical Sciences. Journal of Research in Behavioural Sciences, 17(1), 35-43. http://rbs.mui.ac.ir/article-1-642-en.html
Javid, M., Mohammadi, N., & Rahimi, C. H. (2012). Psychometric properties of an Iranian version of the Barratt Impulsiveness Scale-11 (BIS-11). Psychological Models and Methods, 2(8), 23-34. https://dorl.net/dor/20.1001.1.22285516.1391.2.8.2.1
Jennissen, S., Connolly Gibbons, M. B., Crits-Christoph, P., Schauenburg, H., & Dinger, U. (2021). Insight as a mechanism of change in dynamic therapy for major depressive disorder. Journal of counseling psychology, 68(4), 435. https://doi.org/10.1037/cou0000554
Kashanaki, H., & Aslani, S. (2018). Review of intensive short-term dynamic psychotherapy: theory to practice. Rooyesh-e-Ravanshenasi Journal (RRJ), 7(8), 225-260. https://dorl.net/dor/20.1001.1.2383353.1397.7.8.1.4
Lane, R. D. (2018). From reconstruction to construction: The power of corrective emotional experiences in memory reconsolidation and enduring change. Journal of the American Psychoanalytic Association, 66(3), 507-516. https://doi.org/10.1177/0003065118782198
Lazar, S. G. (2014). The cost-effectiveness of psychotherapy for the major psychiatric diagnoses. Psychodynamic Psychiatry, 42(3), 423-457. https://doi.org/10.1521/pdps.2014.42.3.423
Lee, D., Lee, S. J., Park, C. S., Kim, B. J., Lee, C. S., Cha, B., ... & Choi, J. W. (2019). The mediating effect of impulsivity on resilience and depressive symptoms in Korean conscripts. Psychiatry investigation, 16(10), 773. https://doi.org/10.30773/pi.2019.04.02.3
Mohammadi M, Vaisi-Raygani A, Jalali R, Ghobadi A, Salalri N. Prevalence of depression in soldiers of Iranian military centers: A meta-analysis. Ebnesina. 2019;21(4):34- 40. https://doi.org/10.22034/21.4.34
Moradzadeh Khorasani, L., Mirzaian, B., & Hassanzadeh, R. (2020). The effectiveness of intensive short-term dynamic psychotherapy on mentalization in non-suicidal self-injurious people. Iranian Journal of Psychiatric Nursing, 8(3), 22-35. http://ijpn.ir/article-1-1561-en.html
Nejati, V., Kamari, S., & Jafari, S. (2018). Construction and examine the psychometric characteristics of Student Social Cognition Questionnaire (SHAD). Social Cognition, 7(2), 123-144. https://doi.org/10.30473/sc.2018.29262.1931
Nejati, V., Zabihzadeh, A., Maleki, G. H., & Mohseni, M. (2013). Social cognition in patients with major depression disorder: evidence from reading mind in the eyes test. https://apsy.sbu.ac.ir/article_95795.html
Nikoogoftar, M., Rajaeenia, H., & Moradi, M. (2024). The effectiveness of reality therapy on the resilience and quality of life of soldiers with a history of desertion referring to counseling centers. Military Psychology, 15(2), 119-141. https://dor.isc.ac/dor/20.1001.1.25885162.1403.15.2.5.9
Park, W., Park, S., Choi, M., & Kim, K. (2021). A Meta-Analysis of Impulsivity Related to Self-destructive Behavior in Korean Adolescents. Research in Community and Public Health Nursing, 32(3), 325-343. https://doi.org/10.12799/jkachn.2021.32.3.325
Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt impulsiveness scale. Journal of clinical psychology, 51(6), 768-774. https://doi.org/10.1002/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-1
Perry, J. C., Bond, M., & Békés, V. (2017). The rate of improvement in long-term dynamic psychotherapy for borderline personality disorder. The Journal of Nervous and Mental Disease, 205(7), 517-524. https://doi.org/ 10.1097/NMD.0000000000000697
Pinkham, A. E., Penn, D. L., Perkins, D. O., & Lieberman, J. (2003). Implications for the neural basis of social cognition for the study of schizophrenia. American Journal of Psychiatry, 160(5), 815-824. https://doi.org/10.1176/appi.ajp.160.5.815
Rahimi, C. (2014). Application of the beck depression inventory-II in Iranian University students. Clinical Psychology and Personality, 12(1), 173-188. https://dorl.net/dor/20.1001.1.23452188.1393.12.1.14.7
Rostami, H., Ahmadi, E., Noori, I., & Andalib, R. (2022). The relationship between anxiety, stress and depression with pain perception with the mediating role of resilience in patients with chronic pain in a military hospital. Military Psychology, 13(49), 39-64. https://dor.isc.ac/dor/20.1001.1.25885162.1401.13.49.3.7
Sajadinezhad, M. S., Asadirahmani, S., Dehghan, M. H., & Azizi, M. (2023). The Prediction of Addiction Tendency Among Soldiers Based on Wisdom Through the Mediating Role of Hope. Military Psychology, 14(3), 169-191. https://dor.isc.ac/dor/20.1001.1.25885162.1402.14.3.7.6
Sarlaki A. The effect of strengthening inhibitory control on the improvement of symptoms and neurological correlates of depression in adolescents: Feasibility of remote cognitive rehabilitation in the coronavirus crisis. Tehran: Shahid Beheshti University; 2022. https://ganj.irandoc.ac.ir/#/articles/b11afef46613c774e6a211e3685807b5
Sarlaki, A., Farokhzad, M., Khanzadeh, F., Younesi Sinaki, M., Razavi Mahdiian, S. Z., & Tayyar Parvin, M. (2024). Effectiveness of Intensive Short-Term Dynamic Psychotherapy on Object Relations, Anger, and Guilt in Women with Major Depressive Disorder. Psychological Achievements. https://doi.org/10.22055/psy.2024.44694.3112
Senna, S., Schwab, B., Melo, H. M., Diaz, A. P., & Schwarzbold, M. L. (2022). Social cognition and suicide-related behaviors in depression: a cross-sectional, exploratory study. Brazilian Journal of Psychiatry, 44(6), 639-643. https://doi.org/10.47626/1516-4446-2021-2407
Shabani, A., Masoumian, S., Zamirinejad, S., Hejri, M., Pirmorad, T., & Yaghmaeezadeh, H. (2021). Psychometric properties of structured clinical interview for DSM‐5 disorders‐clinician version (SCID‐5‐CV). Brain and behavior, 11(5), e01894. https://doi.org/10.1002/brb3.1894
Shafa'i Moqadam, E., & Niazi, M. (2021). Explanation of the Psychosocial Model of Suicidal Behavior among Soldiers Focusing on Depression and Group Cohesion. Journal of military Psychology, 11(44), 17-29. https://dor.isc.ac/dor/20.1001.1.25885162.1399.11.44.2.2
Sharifi, V., Asadi, S. M., Mohammadi, M. R., Amini, H., Kaviani, H., Semnani, Y., ... & Jalali Roudsari, M. (2004). Reliability and feasibility of the Persian version of the structured diagnostic interview for DSM-IV (SCID). Advances in cognitive science, 6(1), 10-22. http://icssjournal.ir/article-1-26-en.html
Sharifi, V., Shadloo, B., & Shahrivar, Z. (2017). Structured clinical interview for DSM‐5 disorders: SCID‐5‐CV clinician version. Tehran: Ebne Sina.
Shekari, H., Yousefi, S., & Ahmadi, M. (2018). Study of frequency and severity of depression in bandar lengeh air defense forces. Paramedical Sciences and Military Health, 13(1), 27-32. http://jps.ajaums.ac.ir/article-1-141-en.html
Shelef, L., Korem, N., Yavnai, N., Yedidya, R., Ginat, K., Shahar, G., & Yacobi, A. (2018). Depression and impulsiveness among soldiers who died by suicide: A psychological autopsy study. Journal of affective disorders, 235, 341-347. https://doi.org/10.1016/j.jad.2018.04.068
Shim, E. J., Hwang, H., Lee, K. M., Lee, J. Y., Lee, S. D., Baik, M. J., ... & Hahm, B. J. (2020). Somatic symptoms and sleep quality as indicators of depression and suicide risk among Korean military conscripts. Psychiatry research, 287, 112912. https://doi.org/10.1016/j.psychres.2020.112912
Smith, J. D. (2014). Focusing on reflections: mentalization and mirroring in brief dynamic therapy. British Journal of Psychotherapy, 30(2), 212-228. https://doi.org/10.1111/bjp.12078
Todorov, A.; Fiske, S. T. & Prentice, D. A. (2011). Social Neuroscience: toward understanding the underpinnings of the social mind. Oxford University Press.
Town, J. M., Falkenström, F., Abbass, A., & Stride, C. (2022). The anger-depression mechanism in dynamic therapy: Experiencing previously avoided anger positively predicts reduction in depression via working alliance and insight. Journal of counseling psychology, 69(3), 326. https://doi.org/10.1037/cou0000581
Wienicke, F. J., Beutel, M. E., Zwerenz, R., Brähler, E., Fonagy, P., Luyten, P., ... & Driessen, E. (2023). Efficacy and moderators of short-term psychodynamic psychotherapy for depression: A systematic review and meta-analysis of individual participant data. Clinical psychology review, 101, 102269. https://doi.org/10.1016/j.cpr.2023.102269
Wrege, J. S., Busmann, M., Meyer, A. H., Euler, S., Lang, U. E., & Walter, M. (2021). Impulsiveness in borderline personality disorder predicts the long‐term outcome of a psychodynamic treatment programme. Clinical psychology & psychotherapy, 28(3), 633-641. https://doi.org/10.1002/cpp.2526
Zabihzadeh, A., Nejati, V., Maleki, G., Darvishi, M., & Radfar, F. (2012). The Study of Relationship between mind reading ability and big five factors of personality. Adv Cogn Sci, 14(1), 19-30. https://psycnet.apa.org/record/2012-32203-006
روانشناسی نظامی
دوره 15، شماره 4 - شماره پیاپی 60
شماره پیاپی 60، فصلنامه زمستان
شهریور 1404
صفحه 129-156

فایل ها

سابقه مقاله

  • تاریخ دریافت: 20 مهر 1403
  • تاریخ بازنگری: 13 اسفند 1403
  • تاریخ پذیرش: 16 شهریور 1404

هم رسانی

ارجاع به این مقاله

آمار