اثربخشي درمان مبتني بر رويكرد فراشناختي ولز بر باورهاي فراشناختي و نشخوار فكري زنان خانه دار داراي اختلال وسواس جبري

The effectiveness of Wells metacognitive approach therapy on metacognitive beliefs and rumination in Homeowners with obsessive-compulsive disorder

ﻫﺪف ﭘﮋوﻫﺶ ﺗﻌﯿﯿﻦ اﺛﺮﺑﺨﺸﯽ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ روﯾﮑﺮد ﻓﺮاﺷﻨﺎﺧﺘﯽ وﻟﺰ ﺑﺮ ﺑﺎورﻫﺎي ﻓﺮاﺷﻨﺎﺧﺘﯽ و ﻧﺸﺨﻮار ﻓﮑﺮي اﻓﺮاد داراي اﺧﺘﻼل وﺳﻮاس ﺟﺒﺮﯾﺒﻮد. ﻣﻄﺎﻟﻌﻪ ﻧﯿﻤﻪﺗﺠﺮﺑﯽ ﺑﺎ ﻃﺮح ﭘﯿﺶآزﻣﻮن و ﭘﺲآزﻣﻮن ﺑﺎ ﮔﺮوهﻫﺎي آزﻣﺎﯾﺶ و ﮐﻨﺘﺮل ﺑﻮد.ﺟﺎﻣﻌﻪ ﭘﮋوﻫﺶ زﻧﺎن ﺧﺎﻧﻪدار داراي اﺧﺘﻼل وﺳﻮاس ﺟﺒﺮي ﺷﻬﺮﺳﺘﺎن ﺑﺮوﺟﺮد در ﺳﺎلﻫﺎي1396-97ﺑﻪ ﺗﻌﺪاد 1297 ﻧﻔﺮ ﺑﻮدﻧﺪ. ﻧﻤﻮﻧﻪ 30 ﻧﻔﺮ ﺑﻮدﻧﺪ ﮐﻪ ﺑﺎ روش ﻧﻤﻮﻧﻪﮔﯿﺮي در دﺳﺘﺮس اﻧﺘﺨﺎب و ﺑﺎ روش ﺗﺼﺎدﻓﯽ در دو ﮔﺮوه ﻣﺴﺎوي ﺟﺎﯾﮕﺰﯾﻦ ﺷﺪﻧﺪ. ﮔﺮوه آزﻣﺎﯾﺶ 8 ﺟﻠﺴﻪ 60 دﻗﯿﻘﻪاي ﺗﺤﺖ درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ روﯾﮑﺮد ﻓﺮاﺷﻨﺎﺧﺘﯽ وﻟﺰ ﻗﺮار ﮔﺮﻓﺖ و ﮔﺮوه ﮐﻨﺘﺮل آﻣﻮزﺷﯽ درﯾﺎﻓﺖ ﻧﮑﺮد. اﺑﺰار ﭘﮋوﻫﺶ ﭘﺮﺳﺸﻨﺎﻣﻪ ﺑﺎورﻫﺎي ﻓﺮاﺷﻨﺎﺧﺘﯽ )وﻟﺰ و ﮐﺎرﺗﺮاﯾﺖ-ﻫﺎﺗﻮن، 2004( و ﻧﺸﺨﻮار ﻓﮑﺮي )ﻧﻮﻟﻦ-ﻫﻮﮐﺴﻤﺎ و ﻣﺎرو، 1991( ﺑﻮدﻧﺪ. دادهﻫﺎ ﺑﺎ روش ﺗﺤﻠﯿﻞ ﮐﻮوارﯾﺎﻧﺲ ﭼﻨﺪﻣﺘﻐﯿﺮي در ﻧﺮماﻓﺰار SPSS 21 ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ ﻧﺸﺎن داد ﺑﯿﻦ ﮔﺮوهﻫﺎي آزﻣﺎﯾﺶ و ﮐﻨﺘﺮل از ﻧﻈﺮ ﺑﺎورﻫﺎي ﻓﺮاﺷﻨﺎﺧﺘﯽ و ﻧﺸﺨﻮار ﻓﮑﺮي ﺗﻔﺎوت ﻣﻌﻨﯽداري وﺟﻮد داﺷﺖ. ﺑﻪ ﻋﺒﺎرت دﯾﮕﺮ، درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ روﯾﮑﺮد ﻓﺮاﺷﻨﺎﺧﺘﯽ وﻟﺰ ﺑﺎﻋﺜﮑﺎﻫﺶ ﺑﺎورﻫﺎي ﻓﺮاﺷﻨﺎﺧﺘﯽ و ﻧﺸﺨﻮار ﻓﮑﺮي در زﻧﺎن ﺧﺎﻧﻪدار داراي اﺧﺘﻼل وﺳﻮاس ﺟﺒﺮي ﺷﺪ. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﺛﺮﺑﺨﺸﯽ ﺷﯿﻮه درﻣﺎﻧﯽ ﺑﺮ ﮐﺎﻫﺶ ﺑﺎورﻫﺎي ﻓﺮاﺷﻨﺎﺧﺘﯽ و ﻧﺸﺨﻮار ﻓﮑﺮي زﻧﺎن ﺧﺎﻧﻪدار، ﺗﻮﺻﯿﻪ ﻣﯽﮔﺮدد ﮐﻪ درﻣﺎﻧﮕﺮان ﺑﺎﻟﯿﻨﯽ از درﻣﺎن ﻣﺒﺘﻨﯽ ﺑﺮ روﯾﮑﺮد ﻓﺮاﺷﻨﺎﺧﺘﯽ وﻟﺰ در ﮐﻨﺎر ﺳﺎﯾﺮ روشﻫﺎي درﻣﺎﻧﯽ ﺑﺮاي ﺑﻬﺒﻮد ﺑﺎورﻫﺎي ﻓﺮاﺷﻨﺎﺧﺘﯽ و ﻧﺸﺨﻮار ﻓﮑﺮي اﺳﺘﻔﺎده ﻧﻤﺎﯾﻨﺪ.

The aim of this research was to determine the effectiveness of Wells metacognitive approach therapy on metacognitive beliefs and rumination of people with obsessive-compulsive disorder. This study was quasi-experimental with pre-test and post-test design with experimental and control groups. The research population was housewives with obsessive-compulsive disorder of Borujerd province in 2017-18 years with number of 1297 people. The research sample was 30 people who were selected by available sampling method and randomly assigned into two equal groups. Experimental group received 8 sessions of 60 minutes (two sessions per week) based on Wells metacognitive approach therapy and control group received no training. The research tools were the questionnaires of metacognitive beliefs (Wells & Cartwright-Hatton, 2004) and rumination (Nolen-Hoeksema & Morrow, 1991). Data were analyzed by multivariate analysis of covariance method in SPSS software version 21. The findings showed that there was a significant difference between the experimental and control groups in terms of metacognitive beliefs and rumination. In the other word, Wells metacognitive approach therapy led to decrease metacognitive beliefs and rumination in housewives with obsessive-compulsive disorder (p < 0/001). Regarding to the effectiveness of treatment method on decreasing metacognitive beliefs and rumination of housewives, it is recommended that therapists and clinical psychologists use Wells metacognitive approach therapy along with other therapies to improve metacognitive beliefs and rumination.