اثربخشی رفتاردرمانی دیالکتیکی بر خودکنترلی و تحمل پریشانی نوجوانان دارای اختلال بی نظمی خلق اخلالگر

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دکتری روانشناسی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران

2 دانشجوی کارشناسی ارشد روانشناسی عمومی، واحد شیراز، دانشگاه ازاد اسلامی، شیراز، ایران

چکیده

اهداف: این پژوهش با هدف مقایسه اثربخشی رفتاردرمانی دیالکتیکی بر خودکنترلی و تحمل پریشانی نوجوانان اختلال بی نظمی خلق اخلالگر انجام شد.
مواد و روش­ها: روش پژوهش نیمه آزمایشی از نوع پیش‌آزمون- پس‌آزمون با گروه کنترل بود. جامعه­ی آماری این پژوهش کلیه دانش­آموزان پسر 10 تا 17 ساله شهر کازرون در سال تحصیلی 1400-1399 بود. نمونه­ی پژوهش 30 نفر از دانش­آموز پسر دارای اختلال بی نظمی خلق اخلالگر بود که از میان دانش­آموزان پسری که نمره­ی بالا در پرسشنامه غربالگری لاپورته و همکاران (2019) بود به روش نمونه­گیری تصادفی خوشه­ای چند مرحله­ای انتخاب و در دو گروه­ آزمایشی و کنترل (15 نفر در هر گروه) گمارده شدند. ابزارهای پژوهش، مصاحبه بالینی ساختاریافته، مقیاس خود کنترلی (تانجی و همکاران، 2004) و پرسشنامه تحمل پریشانی سیمونز و گاهر (2005) بود. داده­های جمع آوری شده با استفاده از تحلیل کواریانس چندمتغیری مورد تجزیه و تحلیل آماری قرار گرفتند.
یافته­ ها: نتایج نشان داد که هر رفتاردرمانی دیالکتیکی بر افزایش خودکنترلی و تحمل پریشانی کودکان اختلال بی نظمی خلق اخلالگر تأثیر معناداری دارند (001/0≥P).
نتیجه­ گیری: بنابراین می­توان نتیجه گرفت که از رفتاردرمانی دیالکتیکی می­توان به عنوان روش­های مداخله­ای مناسب در کنار درمان دارویی سود جست.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The effectiveness of dialectical behavior therapy on self-control and anxiety tolerance in adolescents with disordered mood disorders

نویسندگان [English]

  • Shahla Salimi 1
  • Shamila Gheirati 2
1 PhD in Psychology,, Sciences and Research Branch, Islamic Azad University, Tehran, Iran.
2 Master's student in general psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
چکیده [English]

Objective: The aim of this study was to compare the effectiveness of dialectical behavior therapy on self-control and adolescent distress tolerance of disordered mood disorders.
Methods: The research method was quasi-experimental pretest-posttest with a control group. The statistical population of this study was all male students aged 10 to 17 years in Kazerun in the academic year 1399-1400. The study sample consisted of 30 male students with disruptive mood disorder. Selection stages were assigned to experimental and control groups (15 people in each group). The research instruments were structured clinical interview, self-control scale (Tanji et al., 2004) and Simmons and Gaher (2005) Distress Tolerance Questionnaire. The collected data were statistically analyzed using multivariate analysis of covariance.
Results: The results showed that any dialectical behavior therapy had a significant effect on increasing self-control and distress tolerance in children with disruptive mood disorders (P≥0.001).
Conclusion: Therefore, it can be concluded that dialectical behavior therapy can be used as an appropriate intervention method along with drug therapy.

کلیدواژه‌ها [English]

  • Dialectical Behavior Therapy
  • Self-Control
  • Distress Tolerance
  • Disruptive Mood Disorder
  • Adolescents
بگیان کوله مرزی، محمدجواد، کرمی، جهانگیر، مومنی، خدامراد و مومنی، خدامراد (1398). اثربخشی یکپارچه­سازی رفتاردرمانی دیالکتیکی و درمان شناختی مبتنی بر ذهن شفقت­ورز بر کاهش واکنش­پذیری شناختی و انگیزه­های اقدام به خودکشی در افراد اقدام کننده. مجله دست­آوردهای روان‌شناختی، 26 (2 پیاپی 22)، 1-26. [Doi:10.22055/psy.2019.26161.2105]
بگیان کوله مرزی، محمدجواد، کرمی، جهانگیر، مومنی، خدامراد و مومنی، خدامراد (1398). مقایسه اثربخشی سیستم روان‌درمانی تحلیل شناختی- رفتاری (CBASP) و یکپارچه‌سازی رفتاردرمانی دیالکتیکی با درمان شناختی مبتنی بر ذهن شفقت ورز بر کاهش درد ذهنی و دشواری‌های تنظیم هیجانی افراد اقدام‌کننده به خودکشی. مطالعات روان‌شناسی بالینی، 9 (34)، 35-63. [Doi:10.22054/jcps.2019.34758.1937]
بشرپور، سجاد و عینی، ساناز. (1401). تدوین مدل علی سازگاری تحصیلی دانش‌آموزان با ناتوانی یادگیری براساس خودکارآمدی تحصیلی و اشتیاق تحصیلی: نقش میانجی تاب‌آوری تحصیلی. مجله ناتوانی‌های یادگیری، 12(2)، 18-33. https://doi.org/10.22098/jld.2022.7608.1814
سلطانی، متین؛ نریمانی، محمد و موسی‌زاده، توکل. (1401). بررسی آموزش راهبردهای خودتنظیمی بر سازگاری اجتماعی و هماهنگی دیداری حرکتی دانش آموزان دارای ناتوانی های یادگیری. مجله ناتوانی‌های یادگیری، 12(2)، 34-45. https://doi.org/10.22098/jld.2023.12017.2055
فرامرزی، سالار و عنایتی، الهه. (1400). مقایسه‌ی هیجانات تحصیلی دانش‌آموزان با انواع اختلال یادگیری خاص. مجله ناتوانی‌های یادگیری، 10(4)، 87-103. 10.22098/JLD.2021.6897.1736
مارا، توماس (2005). راهنمای جامع و کاربردی رفتاردرمانی دیالکتیکی فردی: ترجمه شیرین ایزدی و مهناز غیاثی، انتشارات ارجمند (1395). تهران: انتشارات ارجمند
نریمانی، محمد؛ تقی‌زاده، سارا و نریمانی، آذین. (1401). اثربخشی برنامه توانبخشی شناختی آرام بر بهبود حافظه کاری و توجه کودکان مبتلا به اختلالات یادگیری. مجله ناتوانی‌های یادگیری، 12(1)، 85-97. https://doi.org/10.22098/jld.2022.11688.2046
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Pub. [Doi:10.1176/appi.books.9780890425596]
Basharpoor, S., & Eyni, S. (2023). Developing a causal model of academic adjustment of Students with learning disabilities based on academic self-efficacy and academic eagerness: The mediating role of the academic resilience. Journal of Learning Disabilities, 12(2),18-33. (In Persian) https://doi.org/10.22098/jld.2022.7608.1814
Bass, C., van Nevel, J., Swart, J. (2014). "A comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment of adolescents". International Journal of Behavioral Consultation and Therapy. 9 (2): 4–8. [Doi:10.1037/h0100991]
Begian Koleh Marzi, Mohammad Javad, Karami, Jahangir, Momeni, Khodamrad and Momeni, Khodamrad (1398). The effectiveness of integrating dialectical behavior therapy and compassionate mind-based cognitive therapy on reducing cognitive reactivity and suicidal ideation in perpetrators. Journal of Psychological Achievements, 26 (2 consecutive 22), 1-26.[Persion].  [Doi:10.22055/psy.2019.26161.2105]
Begian Koleh Marzi, Mohammad Javad, Karami, Jahangir, Momeni, Khodamrad and Momeni, Khodamrad (1398). Comparison of the effectiveness of the Cognitive-Behavioral Analysis (CBASP) psychotherapy system and the integration of dialectical behavior therapy with compassionate mind-based cognitive therapy to reduce mental pain and emotional regulation difficulties in suicidal individuals. Clinical Psychology Studies, 9 (34), 35-63. [Persion]. [Doi:10.22054/jcps.2019.34758.1937]
Bernstein, A., Zvolensky, M. J., Vujanovic, A. A., & Moos, R. (2009). Integrating anxiety sensitivity, distress tolerance, and discomfort intolerance: A hierarchical model of affect sensitivity and tolerance. Behavior Therapy, 40 (3), 291-301. [Doi:10.1016/j.beth.2008.08.001]
Bowlin, S. L., Baer, R. A. (2021). Relationship between mindfulness, self-control, and psychological functioning. Personality and Individual Differences, 52:411-415. [Doi:10.1016/j.paid.2011.10.050]
Cameron, A., Reed, K. P., & Ninnemann, A. (2013). Reactivity to negative affect in smokers: The role of implicit associations and distress tolerance in smoking cessation. Addictive behaviors, 38 (12), 2905-2912. [Doi:10.1016/j.addbeh.2013.08.012]
Cook, N. E., & Gorraiz, M. (2016). Dialectical behavior therapy for nonsuicidal self-injury and depression among adolescents: preliminary meta-analytic evidence. Child and adolescent mental health21(2), 81–89. [Doi:10.1111/camh.12112]
Daly M, Baumeister RF, Delaney L, MacLachlan M. Self-control and its relation to emotions and psychobiology: evidence from a Day Reconstruction Method study. J Behav Med. 2014; 37(1):81- 93. [Doi:10.1007/s10865-012-9470-9]
Elhai, J. D., Levine, J. C., O’Brien, K. D., & Armour, C. (2018). Distress tolerance and mindfulness mediate relations between depression and anxiety sensitivity with problematic smartphone use. Computers in Human Behavior, 84, 477-484. [Doi:10.1016/j.chb.2018.03.026]
Farris, S. G., Metrik, J., Bonn-Miller, M. O., Kahler, C. W., & Zvolensky, M. J. (2016). Anxiety sensitivity and distress intolerance as predictors of cannabis dependence symptoms, problems, and craving: the mediating role of coping motives. Journal of studies on alcohol and drugs, 77 (6), 889-897. [Doi:10.15288/jsad.2016.77.889]
Faramarzi, S., & Enayati, E. (2021). Comparison of students' academic emotions with types of specific learning disabilities. Journal of Learning Disabilities,  10(4), 87-103. (In Persian) 10.22098/JLD.2021.6897.1736
Holliday, S. B., Pedersen, E. R., & Leventhal, A. M. (2016). Depression, posttraumatic stress, and alcohol misuse in young adult veterans: The trans diagnostic role of distress tolerance. Drug and alcohol dependence, 161, 348-355. [Doi:10.1016%2Fj.drugalcdep.2016.02.030]
Juarascio, A. S., Felton, J. W., Borges, A. M., Manasse, S. M., Murray, H. B., & Lejuez, C. W. (2016). An investigation of negative affect, reactivity, and distress tolerance as predictors of disordered eating attitudes across adolescence. Journal of Aolescence, 49, 91-98. [Doi:10.1016%2Fj.adolescence.2016.02.005]
Kaufman, J., Birmaher, B., Axelson, D. A., Perepletchikova, F., Brent, D., Ryan, N. (2016). K-SADS-PL DSM 5. Child and Adolescent Research and Education, Program Yale University. [Doi:10.1097/00004583-199707000-00021]
Kring, A. M., Sheri, L., Johnson, C., & John, M. (2012). Abnormal psychology, 12th Edition. Zamani, N., Ahmadi, V., Ataie Moghanloo, V., & Mirshekar, S. (2014). Comparing the Effectiveness of two Therapeutic Methods of Dialectical Behavior Therapy and Cognitive Behavior Therapy on the Improvement of Impulsive Behavior in the Patients Suffering from Major Depressive Disorder (MDD) Showing a Ten. https://www.amazon.com/Abnormal-Psychology-12th-Ann-Kring/dp/1118018494
Laporte, P. P., Matijasevich, A., Munhoz, T. N., Santos, I. S., Barros, A. J. D., Pine, D. S., Rohde, L. A., Leibenluft, E., Salum, G. A. (2021).  Disruptive Mood Dysregulation Disorder: Symptomatic and Syndromic Thresholds and Diagnostic Operationalization. Journal of Child Psychology and Psychiatry, 60(2), 286-295. [Doi:10.1016/j.jaac.2019.12.008]
Laporte, P.P., Matijasevich, A., Munhoz, T.N., Santos, I.S., Barros, A.J., Pine, D.S., Rohde, L.A., Leibenluft, E., & Abrahão Salum, G. (2019). Disruptive Mood Dysregulation Disorder: symptomatic and syndromic thresholds and diagnostic operationalization. medRxiv, 19002436. [Doi:10.1101/19002436]
Leyro, T. M., Bernstein, A., Vujanovic, A.A. et al. (2011). Distress Tolerance Scale: A Confirmatory Factor Analysis Among Daily Cigarette Smokers. Journal of Psychopathology and Behavioral Assessment, 33, 47–57 (2011). [Doi:10.1007/s10862-010-9197-2]
Leyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010). Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults. Psychological Bulletin, 136 (4), 576-600. [Doi:10.1037%2Fa0019712]
Liang, L., Feng, L., Zheng, X., Wu, Y., Zhang, C., Li, J. (2021). Effect of dialectical behavior group therapy on the anxiety and depression of medical students under the normalization of epidemic prevention and control for the COVID-19 epidemic: a randomized study. Annals of Palliative Medicine, 10(10), 10591-10599. [Doi:10.21037/apm-21-2466]
Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). New York, NY: Guilford Press.
Linke, J. O., Adleman, N. E., Sarlls, J., Ross, A., Perlstein, S., Frank, H. R., Towbin, K. E., Pine, D. S., Leibenluft, E., Brotman, M. A. (2020). White Matter Microstructure in Pediatric Bipolar Disorder and Disruptive Mood Dysregulation Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1135-1145. [Doi:10.1016/j.jaac.2019.05.035]
 Little, H., Tickle, A., das Nair, R. (2017). "Process and impact of dialectical behaviour therapy: A systematic review of perceptions of clients with a diagnosis of borderline personality disorder" (PDF). Psychology and Psychotherapy: Theory, Research and Practice. 91 (3): 278–301. [Doi:10.1111/papt.12156PMID 29034599]
Macatee, R. J., Capron, D. W., Guthrie, W., Schmidt, N. B., & Cougle, J. R. (2015). Distress tolerance and pathological worry: Tests of incremental and prospective relationships. Behavior Terapy, 46 (4), 449-462. [Doi:10.1016/j.beth.2015.03.003]
MacKillop, J., & De Wit, H. (Eds). (2013). The Wiley-Blackwell Handbook of Addiction Psychopharmacology. John Wiley & Sons.
Mara, Thomas (2005). A Comprehensive and Practical Guide to Individual Dialectical Behavior Therapy: Translated by Shirin Izadi and Mahnaz Ghiasi, Arjmand Publications (2016). Tehran: Arjmand Publications.[Persion].
Mayer, J. D., Salovey, P., Caruso, D. R., Sitarenios, G. (2003).  Measuring emotional intelligence with the MSCEIT V.2.0. Emotion. 3, 97-105. [Doi:10.1037/1528-3542.3.1.97]
McKay, M., Wood, J.C. and Brantley, J. (2007). The Dialectical Behavior Therapy Skills Workbook. New Harbinger, Oakland. Mental Health, 21(2), 81–89. https://cursosdepsicologia.com.ar/wp-content/uploads/2021/05/THEDIA1.pdf
Michel, N. M., Rowa, K., Young, L., & McCabe, R. E. (2016). Emotional distress tolerance across anxiety disorders. Journal of anxiety disorders, 40, 94-103. [Doi:10.1016/j.janxdis.2016.04.009]
Mulraney, M., Silk, T. J., Gulenc, A., Efron, D., Hazell, P., Sciberras, E. (2021). Persistence of disruptive mood dysregulation disorder in children with attention-deficit/hyperactivity disorder. J Affect Disord, 278, 502-505. [Doi:10.1016/j.jad.2020.09.109]
Narimani, M., Taghizadeh, S., & Narimani, A. (2022). Effectiveness of ARAM Cognitive Rehabilitation Package on Improvement of Working Memory and Attention in Children with Learning Disabilities. Journal of Learning Disabilities,  12(1),85-97. (In Persian) https://doi.org/10.22098/jld.2022.11688.2046
Nilsen, F. A., Bang, H., Boe, O., Martinsen, Ø. L., Lang-Ree, O. C., Røysamb, E. (2021). The Multidimensional Self-Control Scale (MSCS): Development and validation. Psychological Assessment, 32(11), 1057-1074. [Doi:10.1037/pas0000950]
Pederson, L. (2012). "Interpersonal Effectiveness". The expanded dialectical behavior therapy skills training manual : practical DBT for self-help, and individual and group treatment settings. Eau Claire, WI: Premier Pub. & Media.
Pederson, L. (2015). "19 Skills Training". Dialectical behavior therapy: a contemporary guide for practitioners. Chichester, West Sussex: Wiley. [Doi:ISBN 9781118957882]
Perepletchikova, F., Nathanson, D., Axelrod, S. R., Merrill, C., Walker, A., Grossman, M., Rebeta, J., Scahill, L., Kaufman, J., Flye, B., Mauer, E., Walkup, J. (2017). Randomized Clinical Trial of Dialectical Behavior Therapy for Preadolescent Children With Disruptive Mood Dysregulation Disorder: Feasibility and Outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, 56(10), 832-840. [Doi:10.1016/j.jaac.2017.07.789]
Piquero, A. R., Jennings, W. G., Farrington, D. P., Diamond, B., Gonzalez, J. M. R. (2016). A meta-analysis update on the effectiveness of early self-control improvement programs to improve self-control and reduce delinquency. Journal of Experimental Criminology, 12(2), 229-248. [Doi:10.1007/s11292-016-9257-z]
Pou, J. S. (2019). Dialectical Behavior Therapy and Mentalization Based Treatment for Borderline Personality Disorder: Similarities, Differences, and Clinical Implications. Biola University.
Short, N. A., Babson, K. A., Schmidt, N. B., Knight, C. B., Johnson, J., & Bonn Miller, M. O. (2016). Sleep and affective functioning: Examining the association between sleep quality and distress tolerance among veterans. Personality and Individual Differences, 90, 247-253. [Doi:10.1016/j.paid.2015.10.054]
Simons, J., & Gaher, R. (2005). The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and Emotion, 29 (2), 83– 102. [Doi:10.1007/s11031-005-7955-3]
Soltani, M., Narimani, M., & Mousazadeh, T. (2023). Effectiveness of Teaching Self-regulation Strategies on Social Adaptation and Visual-Motor Coordination of Students with Learning Disabilities. Journal of Learning Disabilities, 12(2), 34-45. https://doi.org/10.22098/jld.2023.12017.2055
Steil, R., Dittmann, C., Müller-Engelmann, M., Dyer, A., Maasch, A. M., Priebe, K. (2018). "Dialectical behaviour therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study in an outpatient treatment setting". European Journal of Psychotraumatology, 9 (1), 1423832. [Doi:10.1080%2F20008198.2018.1423832]
Stoddard, J., Wiggins, J. L., Wakschlag, L. S. (2021). Editorial: Defining the Clinical Boundary of Disruptive Mood Dysregulation Disorder Symptoms in Youth. J Am Acad Child Adolesc Psychiatry. 60(2), 216-218. [Doi:10.1016/j.jaac.2020.12.019]
Tangney, J., Baumeister, R. F., & Boone, A. L. (2004). High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of Personality, 72, 271–324.
Vogel, E. N., Singh, S., & Accurso, E. C. (2021). A systematic review of cognitive behavior therapy and dialectical behavior therapy for adolescent eating disorders. Journal of eating disorders9(1), 131. [Doi:10.1186/s40337-021-00461-1]
Vujanovic, A. A., Dutcher, C. D., & Berenz, E. C. (2016). Multimodal examination of distress tolerance and posttraumatic stress disorder symptoms in acute-care psychiatric inpatients. Journal of Anxiety Disorders, 48 (3), 45-53. [Doi:10.1016/j.janxdis.2016.08.005]
Ward, M. M., Swan, G. E., & Jack, L. M. (2001). Self-reported abstinence effects in the first month after smoking cessation. Addictive Behaviors, 26 (3), 311-27. [Doi:10.1016/s0306-4603(00)00107-6]
Wisniewski, L. & Ben-Porath, D. D. (2015). Dialectical behavior therapy and eating disorders: The use of contingency management procedures to manage dialectical dilemmas. American Journal of Psychotherapy, 69(2), 129–140. [Doi:10.1176/appi.psychotherapy.2015.69.2.129]
Wong, S. F., Aardema, F., & Grisham, J. R. (2019). Inverse Reasoning Processes in Obsessive-Compulsive Disorder: Replication in a Clinical Sample. Journal of Anxiety Disorders, 63 (2), 1-8. [Doi:10.1016/j.janxdis.2019.01.005]
Zalewski, M., Lewis, J. K., Martin, C. G. (June 2018). "Identifying novel applications of dialectical behavior therapy: considering emotion regulation and parenting". Current Opinion in Psychology. 21: 122–126. [Doi:10.1016/j.copsyc.2018.02.013]