اثربخشي ماتريكس درمان پذيرش و تعهد با شفقت بر رفتارهاي خودآسيب رسان و كيفيت زندگي دانش آموزان داراي علائم اختلال شخصيت مرزي

The Effectiveness of ACT Matrix with compassion on self-injury behaviors and quality of life of Students with symptoms of Borderline Personality Disorders

پژوهش حاضر جهت تعيين اثربخشي ماتريكس درمان پذيرش و تعهد با شفقت بر رفتارهاي خودآسيب‌رسان و كيفيت زندگي دانش‌آموزان داراي علائم اختلال شخصيت مرزي انجام گرديد. اين مطالعه از نوع آزمايشي با طرح پيش‌آزمون و پس‌آزمون با گروه كنترل بود. در اين پژوهش با استفاده از روش تصادفي چندمرحله‌اي 30 نفر از دانش‌آموزان دختر 17-15 سال (مقطع متوسطه دوم) شهر اهواز انتخاب و به‌طور تصادفي در گروه آزمايشي و گروه كنترل (15 نفر در هر گروه) قرار گرفتند. دانش‌آموزان عضو گروه آزمايشي يك دوره مداخله 16 جلسه‌اي (هر هفته يك جلسه، به مدت 1 ساعت) دريافت كردند و اعضاي گروه كنترل نيز در انتظار مداخله قرار گرفتند. آزمودني‌هاي هر دو گروه قبل از شروع مداخله، در پايان دوره، و دو ماه پس از پايان دوره (در مرحله‌ي پيگيري)، به پرسشنامه‌ رفتار خودآسيب‌رسان كلونسكي و گلن و شاخص كيفيت زندگي كامينز پاسخ دادند. داده‌ها با استفاده از تحليل كوواريانس چندمتغيري مورد بررسي قرار گرفت. نتايج حاصل از تحليل داده‌ها نشان داد كه ماتريكس درمان پذيرش و تعهد با شفقت باعث كاهش علائم رفتارهاي خودآسيب رسان (05/64= F و 001/0p<) و ارتقاي كيفيت زندگي (76/41 = Fو 001/0p<) دانش‌آموزان گروه آزمايشي در مقايسه با گروه كنترل‌شده است و نتايج درماني 2 ماه پس از پايان دوره در گروه آزمايشي حفظ ‌شده است (01/0p<). اين مداخله مي‌تواند در كاهش رفتارهاي خودآسيب رسان و ارتقاي كيفيت زندگي دانش‌آموزان داراي علائم اختلال شخصيت مرزي مورد استفاده قرار گيرد.

ntoduction Researches has recently provided convincing evidence about diagnosing borderline personality disorder in youth. Therefore National Institute for Clinical Excellence (NICE) acknowledged the diagnosis of borderline personality in individuals under 18 years old and if necessary supports treatment and early intervention in this age group. ACT matrix is an approach based on route selection and upgrading the ability of individuals to approach valuable goals, despite the problems in life. Therefore, in the matrix model getting viewpoints of clients considered as the basis of treatment and by examining actions of getting away and getting close to values and compassion in commitment and change strategies helps them achieve a live, purposeful and meaningful life. In fact mindfulness due to taking viewpoints provides context for getting compassion and mindfulness. Mindfulness and compassion are two wings of a bird that both play effective role in inspiring for man, their transition and also individual evolution to fly. Overall, on the one hand according to evidence-based researches about effectiveness of ACT with compassion treatment on a wide range of borderline personality disorder symptoms and on the other hand lack of this kind of researches in Iran, this question arises that whether ACT with compassion is effective on self-injury behaviors and quality of life of female students with symptoms of borderline personality disorder. Method Present study is an experimental design by using pre and posttest with a control group. Therapeutic intervention in experimental group implemented 16 sixty minute sessions weekly for female students between 15-17 years old who have Borderline personality symptoms. During this time participants in experimental and control group responded to Self-Injury behavior Scale of Klonsky and Glenn (2009) and Quality of Life Index of Cummins (2002), before and after intervention and in follow-up (8 weeks after the end of intervention). Results The findings of covariance analysis showed that ACT matrix with Compassion has significantly reduced symptoms of self-injury and improved quality of life. Eta coefficient shows that ACT with Compassion therapy explain 47% of self-injury behaviors and 46% of life quality and these results has been maintained in follow-up stage. Discussion The results of this study showed that despite the cultural and social differences between the present research group and the groups studied in other societies and cultures, ACT matrix with Compassion therapy has significantly reduced symptoms of self- injury and improved quality of life in teenagers with symptoms of borderline personality disorder. This approach seeks to teach teens how to break up from thought content by taking viewpoints, instead of stuck the past and conceptualizing on future live sort their life story, recognizing values and important individuals of their lives and ultimately taking step to achieve these goals and values without getting stuck in trap of their attention and with compassion for themselves and others.