مقايسة باورهاي شناختي در اختلال هاي وسواس فكري-عملي، اضطراب فراگير و افسردگي اساسي

Comparation cognitive beliefs in obsessive –compulsive disorder, generalized anxiety disorder, major depression disorder

زﻣﯿﻨﻪ و ﻫﺪف زﻣﯿﻨﮥ ﭘﮋوﻫﺶ ﺑﺮ ﻃﺒﻖ ﺗﺄﮐﯿﺪ دﯾﺪﮔﺎه ﺷــﻨﺎﺧﺘﯽ ﺑﺮ ﻧﻘﺶ ﺑﺎورﻫﺎي ﺷــﻨﺎﺧﺘﯽ در آﺳــﯿﺐﺷــﻨﺎﺳــﯽ اﺧﺘﻼلﻫﺎي رواﻧﯽ ا ﺳﺖ. ﻫﺪف ﭘﮋوﻫﺶ ﺣﺎ ﺿﺮ ﻣﻘﺎﯾ ﺴﮥ ﺑﺎورﻫﺎي ﺷﻨﺎﺧﺘﯽ ﺷﺎﻣﻞ آﻣﯿﺨﺘﮕﯽ ﻓﮑﺮ-ﻋﻤﻞ، ﻣ ﺴﺌﻮﻟﯿﺖ/ ﺑﯿﺶارزﯾﺎﺑﯽ ﺗﻬﺪﯾﺪ، اﻫﻤﯿﺖ و ﮐﻨﺘﺮل اﻓﮑﺎر و ﮐﻤﺎلﻃﻠﺒﯽ/ ﻗﻄﻌﯿﺖ، در اﺧﺘﻼلﻫﺎي وﺳـــﻮاس، اﺿـــﻄﺮاب ﻓﺮاﮔﯿﺮ واﻓﺴﺮدﮔﯽ و ﮔﺮوه ﺑﻪﻫﻨﺠﺎر اﺳﺖ. ﻣﻮاد و روشﻫﺎ ﭘﮋوﻫﺶ ﺣﺎﺿﺮ از ﻧﻮع ﭘﮋوﻫﺶﻫﺎي ﻋﻠﯽ- ﻣﻘﺎﯾﺴﻪاي اﺳﺖ. ﺟﺎﻣﻌﮥ آﻣﺎري ﺑﺮاي ﻧﻤﻮﻧﮥ ﺑﺎﻟﯿﻨﯽ ﻋﺒﺎرت اﺳﺖ از ﻫﻤﮥ ﺑﯿﻤﺎران داراي اﺧﺘﻼلﻫﺎي وﺳﻮاس ﻓﮑﺮي ﻋﻤﻠﯽ، اﺿﻄﺮاب ﻓﺮاﮔﯿﺮ واﻓﺴﺮدﮔﯽ ﮐﻪ در ﻧﯿﻤﮥ دوم ﺳﺎل ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن ﺷﻬﯿﺪ زارع ﺳﺎري 1394 ﻣﺮاﺟﻌﻪ ﮐﺮدهاﻧﺪ. از ﻫﺮ ﯾﮏ از ﮔﺮوهﻫﺎي ﺑﺎﻟﯿﻨﯽ و ﺳﺎﻟﻢ 30 ﻧﻔﺮ ﺑﺎ اﺳﺘﻔﺎده از روشﻫﺎي ﻧﻤﻮﻧﻪﮔﯿﺮي در دﺳﺘﺮس اﻧﺘﺨﺎب ﺷﺪﻧﺪ و ﭘﺮﺳﺶﻧﺎﻣﻪﻫﺎي ﺑﺎورﻫﺎي وﺳﻮاﺳﯽ و آﻣﯿﺨﺘﮕﯽ ﻓﮑﺮ و ﻋﻤﻞ را ﺗﮑﻤﯿﻞ ﮐﺮدﻧﺪ. دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﺗﺤﻠﯿﻞ وارﯾﺎﻧﺲ ﭼﻨﺪ ﻣﺘﻐﯿﺮه ﺑﺮرﺳﯽ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ ﻧﺘﺎﯾﺞ ﺗﺤﻠﯿﻞ وارﯾﺎﻧﺲ ﻧﺸﺎن داد ﮔﺮوه ﻣﺒﺘﻼ ﺑﻪ اﺧﺘﻼل وﺳﻮاس در ﻣﻘﺎﯾﺴﻪ ﺑﺎ دﯾﮕﺮ ﮔﺮوهﻫﺎ ﻧﻤﺮة ﺑﯿﺸﺘﺮ درآﻣﯿﺨﺘﮕﯽ ﻓﮑﺮ-ﻋﻤﻞ، ﻣﺴﺌﻮﻟﯿﺖ/ ﺑﯿﺶارزﯾﺎﺑﯽ ﺗﻬﺪﯾﺪ، اﻫﻤﯿﺖ و ﮐﻨﺘﺮل اﻓﮑﺎر را ﮐﺴﺐ ﮐﺮد)p<0/001(؛ اﻣﺎ در ﮐﻤﺎل-ﻃﻠﺒﯽ/ ﻗﻄﻌﯿﺖ، ﺗﻔﺎوت ﻣﻌﻨﺎداري ﺑﯿﻦ ﮔﺮوه وﺳﻮاﺳﯽ و اﺿﻄﺮاب ﻓﺮاﮔﯿﺮ وﺟﻮد ﻧﺪاﺷﺖ)p<0/086(. ﮔﺮوه وﺳﻮاﺳﯽ و اﺿﻄﺮاب ﻓﺮاﮔﯿﺮ در ﺗﻤﺎم ﻋﻮاﻣﻞ ﺷﻨﺎﺧﺘﯽ ﻣﺬﮐﻮر ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه اﻓﺴﺮده و ﺑﻪﻫﻨﺠﺎر ﻧﻤﺮهﻫﺎي ﺑﻬﺘﺮي ﮐﺴﺐ ﮐﺮدﻧﺪ)p<0/001(. ﻧﺘﯿﺠﻪﮔﯿﺮي ﻧﺘﺎﯾﺞ ﺣﺎﺻﻞ ﺣﺎﮐﯽ از آن اﺳﺖ ﮐﻪ آﻣﯿﺨﺘﮕﯽ ﻓﮑﺮ-ﻋﻤﻞ، ﻣﺴﺌﻮﻟﯿﺖ/ ﺑﯿﺶارزﯾﺎﺑﯽ ﺗﻬﺪﯾﺪ، اﻫﻤﯿﺖ و ﮐﻨﺘﺮل اﻓﮑﺎر ﺑﯿﺸﺘﺮ اﺧﺘﺼﺎﺻﯽ اﺧﺘﻼل وﺳﻮاساﻧﺪ اﻣﺎ ﮐﻤﺎلﻃﻠﺒﯽ/ ﻗﻄﻌﯿﺖ ﭼﻨﺪان اﺧﺘﺼﺎﺻﯽ اﺧﺘﻼل وﺳﻮاس ﻧﯿﺴﺖ و ﻋﺎﻣﻞ آﺳﯿﺐﭘﺬﯾﺮي ﻣﺸﺘﺮك اﺧﺘﻼل وﺳﻮاس و اﺿﻄﺮاب ﻓﺮاﮔﯿﺮ اﺳﺖ. ﺑﻨﺎﺑﺮاﯾﻦ ﺗﻮﺟﻪ ﺑﻪ اﯾﻦ ﻧﺘﯿﺠﻪ در ﻃﺮحرﯾﺰي اﻗﺪاﻣﺎت رواندرﻣﺎﻧﯽ و اﺧﺘﺼﺎﺻﯽﺗﺮ ﻣﯽﺗﻮاﻧﺪ ﻣﺆﺛﺮ ﺑﺎﺷﺪ.

Introduction: With attention to considered various cognitive beliefs in psychopathology of disorders, the purpose of this study was comparison of cognitive beliefs include; thought action fusion (TAF), responsibility and the overestimation of threat (RT), and overimportance and control thoughts (ICT), perfectionism and the intolerance of uncertainty (PC) in obsessive –compulsive disorder (OCD), generalized anxiety disorder (GAD), major depression disorder (MDD) and normal group for more clarification psychopathology of these disorders. Materials and Methods: This study is causal-comparative research. The clinical samples include patients with OCD, GAD and MDD that referred to Sari Shahid Zareh hospital in 2015. From each of these clinical groups and normal people, 30 persons were selected available sampling method and accomplish obsessive beliefs questionnaire and thought action fusion scale. Data were analyzed by MANOVA. Results: The result of MANOVA and Tukey posthoc test showed that OCD group were significantly higher than other groups in TAF, RT and ICT (p<0/001), but in PC didn’t show the significant difference between OCD and GAD groups (p<0/086). Also, the result was shown that in all of these cognitive beliefs OCD and GAD groups were significantly higher than depression and normal groups (p<0/001). Conclusion: According to this result it seems that TAF, RT, and ICT are more specific for OCD but about PC there isn’t this specialty and it is a common cognitive vulnerability in OCD and GAD. Thus considering this result can be effective in designing more specific psychotherapeutic interventions.