اثربخشي درمان مبتني‌ بر پذيرش و تعهد بر معناي زندگي، رضايت از زندگي، انعطاف‌ پذيري شناختي و افكار خودكشي افراد مبتلا به افسردگي

The Effects of Acceptance and Commitment Therapy on the Meaning of Life, Life Satisfaction, Cognitive Flexibility, and Suicidal Ideation in Individuals with Depression

زمينه و هدف: افسردگي از بيماري‌هاي بسيار شايع‌ در جوامع كنوني بوده و بدون شك جزو معدود بيماري‌هايي قلمداد مي‌شود كه علل پديدآورندهٔ آن، اگر نگوييم بي‌شمار اما بسيار زياد است. پژوهش حاضر با هدف اثربخشي درمان مبتني‌بر پذيرش و تعهد بر معناي زندگي، انعطاف‌پذيري شناختي، رضايت از زندگي و افكار خودكشي در افراد مبتلا به افسردگي در شهر ايلام انجام شد. روش‌بررسي: پژوهش حاضر از نوع نيمه‌آزمايشي و طرح آن از نوع پيش‌آزمون-پس‌آزمون با مرحلهٔ پيگيري بود. جامعهٔ آماري تمامي بيماران مبتلا به افسردگي مراجعه‌كننده به مراكز مشاورهٔ شهر ايلام در سال 1397 بودند. نمونهٔ آماري شامل چهل نفر از بيماران بود كه با استفاده از روش نمونه‌گيري هدف‌مند انتخاب شدند. سپس به‌صورت تصادفي در دو گروه، بيست‌ نفر گروه درمان مبتني‌بر پذيرش و تعهد و بيست نفر گروه گواه قرار گرفتند. برنامهٔ درماني طي هشت جلسه براي گروه آزمايش اجرا شد. در اين پژوهش، مقياس معناي زندگي (استيگر و همكاران، 2005)، انعطاف‌پذيري شناختي (دنيس و وندروال، 2010)، سنجش افكار خودكشي (بك، 1991) و پرسشنامهٔ رضايت از زندگي (دينر و همكاران، 1985) به‌كار رفت. جهت تحليل داده‌ها، از نرم‌افزار SPSS نسخۀ 25 و آزمون تحليل واريانس با اندازه‌گيري مكرر استفاده شد. يافته‌ها: نتايج پژوهش نشان داد كه درمان مبتني‌بر پذيرش و تعهد بر معناي زندگي، انعطاف‌پذيري شناختي، رضايت از زندگي و افكار خودكشي تأثير دارد (0٫001>p). همچنين اين نتايج در متغيرهاي معناي زندگي و انعطاف‌پذيري شناختي و افكار خودكشي در مرحلهٔ پيگيري در طي زمان پايدار بوده است؛ اما در رابطه با متغير رضايت از زندگي در طي زمان مقدار معنا‌داري از اثر مداخلهٔ آزمايشي از دست رفته است. نتيجه‌گيري: براساس نتايج پژوهش حاضر مي‌توان گفت كه درمان مبتني‌بر پذيرش و تعهد بر معناي زندگي، انعطاف‌پذيري شناختي، رضايت از زندگي و افكار خودكشي تأثير دارد و اين تأثير در طي زمان نيز پايدار بوده است.

Background & Objectives: Depression is among the most prevalent diseases; it undoubtedly has multiple etiologies. Individuals with depression often find matters irreversible and believe that neither they can help themselves nor others can assist and support them. In depression, in addition to the depressed mood, there is a decrease in the motivation to conduct activities. Accordingly, the energy level is significantly reduced and the affected person always feels tired and without doing anything. Individuals with depression are also disinterested in themselves and their lives and often attribute various shortcomings and failures to self. This group is skeptical and often generates problems with thinking, focusing, and remembering. The current study aimed to determine the effects of Acceptance and Commitment Therapy (ACT) on the meaning of life, cognitive flexibility, life satisfaction, and suicidal ideation in individuals with depression. Methods: This was a Semi-quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population f this study included all patients with depression in Ilam City, Iran, who referred to counseling centers to seek treatment. The study sample consisted of 40 patients who were recruited by purposive sampling method among those who responded to the call of the researcher. Then, the study participants were randomly divided into two groups of ACT and control (n=20/group). The treatment program was administered to the experimental group for 8 sessions. The following questionnaires were used to collect the necessary data. Meaning in Life Questionnaire, i.e., presented by Stigger et al. (2005) to assess the meaning in life and effort of finding it. The Cognitive Flexibility Questionnaire: it was developed by Dennis and Wenderval (2010) to measure cognitive flexibility. It is used in challenging situations to replace dysfunctional thoughts with more efficient ones. The Beck Scale for Suicide Ideation (1991): it is a tool for measuring the intensity of attitudes, behaviors, and planning for suicide over the past week. Moreover, the Life Satisfaction Questionnaire was designed by Diner et al. (1985). This test was designed to measure one's overall judgment of life satisfaction, i.e., theoretically predicted by comparing living conditions with predetermined standards. Additionally, descriptive and inferential statistics and repeated–measures Analysis of Variance (ANOVA) were employed for data analysis in SPSS. Results: The obtained results suggested that ACT significantly affected the meaning of life, cognitive flexibility, satisfaction with life, and suicidal ideation scores at posttest (p<0.001). The increase in the scores of the meaning of life, cognitive flexibility, and suicidal ideation sustained at the follow–up stage. However, concerning life satisfaction, a significant level of the experimental intervention effect was missed over time. Conclusion: The present study data revealed that ACT impacted the meaning of life, cognitive flexibility, life satisfaction, and suicidal ideation in the studied samples. Accordingly, the same obtained effects remained stable over time.