اثربخشي درمان مبتني بر پذيرش و تعهد بر انعطاف‌پذيري تصوير بدني و كنترل عواطف در زنان مبتلا به اختلال پرخوري افراطي

The Effectiveness of Acceptance and Commitment Therapy on Body Image Flexibility and Affect Control in Women with Binge Eating Disorder

اﺧﺘﻼل ﭘﺮﺧﻮري اﻓﺮاﻃﯽ ﯾﮑﯽ از راﯾﺞﺗﺮﯾﻦ اﺧﺘﻼلﻫﺎي رواﻧﯽ در اﻓﺮاد داراي اﺿﺎﻓﻪ وزن و ﭼﺎق اﺳﺖ و درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﻧﻘﺶ ﻣﻮﺛﺮي در ﺑﻬﺒﻮد وﯾﮋﮔﯽﻫﺎي رواﻧﺸﻨﺎﺧﺘﯽ دارد. ﺑﻨﺎﺑﺮاﯾﻦ، ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ ﺑﺮ اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺗﺼﻮﯾﺮ ﺑﺪﻧﯽ و ﮐﻨﺘﺮل ﻋﻮاﻃﻒ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ اﺧﺘﻼل ﭘﺮﺧﻮري اﻓﺮاﻃﯽ اﻧﺠﺎم ﺷﺪ. روش ﮐﺎر: روش ﭘﮋوﻫﺶ ﻧﯿﻤﻪﺗﺠﺮﺑﯽ ﺑﺎ ﻃﺮح ﭘﯿﺶآزﻣﻮن، ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل ﺑﻮد. ﺟﺎﻣﻌﻪ ﭘﮋوﻫﺶ زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ اﺧﺘﻼل ﭘﺮﺧﻮري اﻓﺮاﻃﯽ ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﮐﻠﯿﻨﯿﮏﻫﺎي ﺗﻐﺬﯾﻪ ﺷﻬﺮ ﻗﻢ در ﺳﺎل 1397 ﺑﻮدﻧﺪ. ﻣﺠﻤﻮﻋﺎ 30 ﻧﻔﺮ ﺑﺎ روش ﻧﻤﻮﻧﻪﮔﯿﺮي در دﺳﺘﺮس اﻧﺘﺨﺎب و ﺑﺎ روش ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه ﻣﺴﺎوي ﺟﺎﯾﮕﺰﯾﻦ ﺷﺪﻧﺪ. ﮔﺮوه آزﻣﻮن ﺑﺮاي 12 ﺟﻠﺴﻪ 2 ﺳﺎﻋﺘﻪ )ﻫﻔﺘﻪاي ﯾﮏ ﺟﻠﺴﻪ( درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ درﯾﺎﻓﺖ ﮐﺮد و ﮔﺮوه ﮐﻨﺘﺮل آﻣﻮزﺷﯽ ﻧﺪﯾﺪ. اﺑﺰارﻫﺎي ﭘﮋوﻫﺶ ﺧﺮدهﻣﻘﯿﺎس اﺧﺘﻼل ﭘﺮﺧﻮري اﻓﺮاﻃﯽ در ﻣﻘﯿﺎس ﺗﺸﺨﯿﺺ اﺧﺘﻼل ﺧﻮردن و ﭘﺮﺳﺸﻨﺎﻣﻪﻫﺎي اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺗﺼﻮﯾﺮ ﺑﺪﻧﯽ و ﮐﻨﺘﺮل ﻋﻮاﻃﻒ ﺑﻮدﻧﺪ. دادهﻫﺎ ﺑﺎ روشﻫﺎي اﻧﺪازهﮔﯿﺮي ﻣﮑﺮر و آزﻣﻮن ﺗﻌﻘﯿﺒﯽ ﺑﻮﻧﻔﺮوﻧﯽ در ﻧﺮماﻓﺰار 21-SPSS ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﯾﺎﻓﺘﻪﻫﺎ ﻧﺸﺎن داد ﮐﻪ ﮔﺮوهﻫﺎي آزﻣﻮن و ﮐﻨﺘﺮل در ﻣﺮﺣﻠﻪ ﭘﯿﺶآزﻣﻮن از ﻧﻈﺮ اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺗﺼﻮﯾﺮ ﺑﺪﻧﯽ و ﮐﻨﺘﺮل ﻋﻮاﻃﻒ ﺗﻔﺎوت ﻣﻌﻨﯽداري ﻧﺪاﺷﺘﻨﺪ )0/05 < P(، اﻣﺎ ﮔﺮوهﻫﺎي آزﻣﻮن و ﮐﻨﺘﺮل در ﻣﺮاﺣﻞ ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي از ﻧﻈﺮ ﻫﺮ دو ﻣﺘﻐﯿﺮ ﺗﻔﺎوت ﻣﻌﻨﯽداري داﺷﺘﻨﺪ )0/05 < P(. ﺑﻪ ﻋﺒﺎرت دﯾﮕﺮ، درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ در ﻣﺮﺣﻠﻪ ﭘﺲآزﻣﻮن ﺑﺎﻋﺚ ﺑﻬﺒﻮد اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺗﺼﻮﯾﺮ ﺑﺪﻧﯽ و ﮐﻨﺘﺮل ﻋﻮاﻃﻒ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ اﺧﺘﻼل ﭘﺮﺧﻮري اﻓﺮاﻃﯽ ﺷﺪ و ﻧﺘﺎﯾﺞ در ﻣﺮﺣﻠﻪ ﭘﯿﮕﯿﺮي ﺣﻔﻆ ﺷﺪ )0/05 < P(. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﺑﺮ اﺳﺎس ﻧﺘﺎﯾﺞ ﺗﻮﺻﯿﻪ ﻣﯽﮔﺮدد ﮐﻪ درﻣﺎﻧﮕﺮان و رواﻧﺸﻨﺎﺳﺎن ﺑﺎﻟﯿﻨﯽ از روش درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ ﭘﺬﯾﺮش و ﺗﻌﻬﺪ در ﮐﻨﺎر ﺳﺎﯾﺮ روشﻫﺎ ﺑﺮاي ﺑﻬﺒﻮد وﯾﮋﮔﯽﻫﺎي رواﻧﺸﻨﺎﺧﺘﯽ ﺑﻪوﯾﮋه ﺑﻬﺒﻮد اﻧﻌﻄﺎفﭘﺬﯾﺮي ﺗﺼﻮﯾﺮ ﺑﺪﻧﯽ و ﮐﻨﺘﺮل ﻋﻮاﻃﻒ در زﻧﺎن ﻣﺒﺘﻼ ﺑﻪ اﺧﺘﻼل ﭘﺮﺧﻮري اﺳﺘﻔﺎده ﻧﻤﺎﯾﻨﺪ.

Binge eating disorder is one of the most common mental disorders in overweight, and acceptance and commitment therapy play an active role in improving psychological characteristics. Therefore, the present study aimed to determine the effectiveness of acceptance and commitment therapy on body image flexibility and affect control in women with binge eating disorder. Methods: The research method was quasi-experimental with pretest, posttest, and follow-up design with the control group. The research population consisted of women with binge eating disorder referred to nutrition clinics of Qom city in the 2018 year. Totally 30 people were selected by the available sampling method and randomly replaced into two equal groups. The experimental group received acceptance and commitment therapy for 12 sessions of 2 hours (one session per week), and the control group didn’t receive training. The research instruments were binge eating disorder subscale in eating disorder diagnostic scale and questionnaires of body image flexibility and affect control. Data were analyzed with methods of repeated measures and Bonferroni post hoc test in SPSS-21 software. Results: The results showed that the experimental and control groups in the pretest phase there was no significant difference between in terms of body image flexibility and affect control (P > 0.05), but the experimental and control groups in the posttest and follow-up phases there was a significant difference in terms of both variables (P < 0.05). In other words, training of rehabilitation based on acceptance and commitment in the posttest phase led to improved body image flexibility. It affected control in women with binge eating disorder, and the results were maintained in the follow-up phase (P < 0.05). Conclusions: Based on the results, it is recommended that therapists and clinical psychologists use from acceptance and commitment therapy method along with other ways to improve psychological characteristics, particularly improving body image flexibility and affect control in women with binge eating disorder.