اثربخشی آموزش گروهی شناختی- رفتاری مهارت های مراقبت از خود بر علائم مثبت، منفی و آسیب شناسی روانی کلی در بیماران مبتلا به اسکیزوفرنی در بیماران مبتلا به اسکیزوفرنی

الموضوعات :

مسعود کاشانی لطف آبادی ¹ (دانشجوي دکتراي روانشناسي عمومي، گروه روانشناسي، واحد تربت جام، دانشگاه آزاد اسلامي، تربت جام، ايران)
محمد حسین بیاضی ² (دانشيار، گروه روانشناسي، واحدتربت جام ، دانشگاه آزاد اسلامی، تربت جام ، ایران.)
علی رضا رجایی ³ (دانشیار، گروه روانشناسي، واحد تربت جام، دانشگاه آزاد اسلامی، تربت جام، ایران.)

تاريخ الإرسال : 17 السبت , جمادى الثانية, 1442 تاريخ التأكيد : 23 الإثنين , شعبان, 1445 تاريخ الإصدار : 01 الإثنين , رمضان, 1445

الکلمات المفتاحية: درمان شناختی- رفتاری, اسکیزوفرنی, خود- مراقبتی, آموزش,

ملخص المقالة :

این پژوهش با هدف تعیین اثربخشی آموزش گروهی شناختی – رفتاری مهارت های مراقبت از خود بر علائم مثبت، منفی و آسیب شناسی روانی کلی بیماران مبتلا به اسکیزوفرنی انجام گردید. در این پژوهش نیمه تجربی از بین بیماران بستری در بیمارستان روانپزشکی ابن سینا در مشهد که واجد ملاک های ورود به مطالعه بودند، 50 نفر به طور تصادفی انتخاب و به دو گروه مداخله (26 نفر) و کنترل (24 نفر) تقسیم شدند.گروه مداخله تحت آموزش گروهی شناختی – رفتاری مهارت های مراقبت از خود براساس پروتکل Kashani-Lotfabadi & et al (2020) و گروه کنترل در لیست انتظار قرار گرفتند. پژوهش با استفاده از روش نمونه گیری در دسترس به صورت پیش آزمون – پس آزمون و پیگیری با گروه کنترل انجام گرفت. داده ها توسط مقیاس درجه بندی نشانگان بالینی مثبت و منفی (Kay, Fiszbein, Opler. 1987) در طی سه مرحله جمع آوری و مورد ارزیابی قرار گرفتند. برای تحلیل داده ها از آزمون تحلیل کواریانس استفاده گردید. یافته ها نشان داد که آموزش گروهی شناختی – رفتاری مهارت های مراقبت از خود می تواند بر کاهش علائم منفی بیماران مبتلا به اسکیزوفرنی مؤثر باشد (05/0 >p). ولی بین دو گروه از نظر میانگین نمرات علائم مثبت و آسیب شناسی روانی کلی تفاوت معناداری وجود نداشت (05/0 <P).

المصادر:

Addington, J., Epstein, I., Liu, L., French, P., Boydell, K. M., & Zipursky, R. B. (2011). A randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis. Schizophrenia Research, 125(1), 54-61.
Arnaiz, A., Zumárraga, M., Díez-Altuna, I., Uriarte, J. J., Moro, J., & Pérez-Ansorena, M. A. (2011). Oral health and the symptoms of schizophrenia. Psychiatry Research, 188(1), 24-28.
Bible, L. J., Casper, K. A., Seifert, J. L., & Porter, K. A. (2017). Assessment of self-care and medication adherence in individuals with mental health conditions. Journal of the American Pharmaceutical Association(2003),57(3s),s203-s210.doi: 10.1016/j.japh.2017.02.023.
Bighelli, I., Salanti, G., Reitmeir, C., Wallis, S., Barbui, C., Furukawa, T. A., & Leucht, S. (2018). Psychological interventions for positive symptoms in schizophrenia: protocol for a network meta-analysis of randomised controlled trials. BMJ Open, 8(3), e019280. doi: 10.1136/bmjopen-2017-019280
Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., Meier, MH., Ramrakha, S., Shalev, I., Poulton, R., Moffitt, TE. (2014). The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science, 2(2), 119-137.
Donato, K. (2017). Self-Care as a Burdened Virtue. Episteme, 28(1), 3-6.
Enomoto, T., Tatara, A., Goda, M., Nishizato, Y., Nishigori, K., Kitamura, A.,Kamada, M., Taga, S,. Hashimoto, T., Ikeda, K., Fujii, Y. (2019). A Novel Phosphodiesterase 1 Inhibitor DSR-141562 Exhibits Efficacies in Animal Models for Positive, Negative, and Cognitive Symptoms Associated with Schizophrenia. Journal of Pharmacology and Experimental Therapeutics, 371(3), 692-702.
Favrod, J., Nguyen, A., Tronche, A.-M., Blanc, O., Dubreucq, J., Chereau-Boudet, I., Capdevielle, D., Llorca, P. M. (2019). Impact of positive emotion regulation training on negative symptoms and social functioning in schizophrenia: a field test. Frontiers in Psychiatry, 10(1), 532-542.
Gluschkoff, K., Jokela, M., & Rosenström, T. (2019). The general psychopathology factor: structural stability and generalizability to within-individual changes. Frontiers in Psychiatry, 10(1), 594-604. DOI: 10.3389/fpsyt.2019.00594.
Granholm, E., Holden, J., Link, P. C., & McQuaid, J. R. (2014). Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: Improvement in functioning and experiential negative symptoms. Journal of Consulting and Clinical Psychology, 82(6), 1173-85. doi: 10.1037/a0037098.

Granholm, E., Holden, J., & Worley, M. (2018). Improvement in negative symptoms and functioning in cognitive-behavioral social skills training for schizophrenia: Mediation by defeatist performance attitudes and asocial beliefs. Schizophrenia Bulletin, 44(3), 653-661.
Granholm, E., McQuaid, J. R., McClure, F. S., Auslander, L. A., Perivoliotis, D., Pedrelli, P., Patterson, T., Jeste, D. V. (2005). A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia. The American Journal of Psychiatry, 162(3), 520-529. doi: 10.1176/appi.ajp.162.3.520
Haddad, P. M., & Correll, C. U. (2018). The acute efficacy of antipsychotics in schizophrenia: a review of recent meta-analyses. Ther Adv Psychopharmacol, 8(11), 303-318. doi: 10.1177/2045125318781475
Jones, C., Hacker, D., Xia, J., Meaden, A., Irving, C. B., Zhao, S., Chen, J,. Shi, C. (2018). Cognitive behavioural therapy plus standard care versus standard care for people with schizophrenia. The Cochrane Database of Systematic Reviews, 12(12), Cd007964. doi: 10.1002/14651858.CD007964.pub2
Kashani-Lotfabadi, M., Talaei, A., Modares-Gharavi, M., Aboozarian, S.-S., Mohammadi, A., Hashemi, B. M., & Salarhaji, A. (2020). The Effectiveness of Cognitive-Behavioral Group Therapy on Improving Self-Care Skills among Women with Chronic Schizophrenia. International Journal of Behavioral Sciences, 13(4), 135-141.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.
Klingberg, S., Wölwer, W., Engel, C., Wittorf, A., Herrlich, J., Meisner, C., Buchkremer, G., Wiedemann, G. (2011). Negative symptoms of schizophrenia as primary target of cognitive behavioral therapy: results of the randomized clinical TONES study. Schizophrenia Bulletin, 37(suppl_2), S98-S110.
Konstantakopoulos, G., Ploumpidis, D., Oulis, P., Patrikelis, P., Soumani, A., Papadimitriou, G. N., & Politis, A. M. (2011). Apathy, cognitive deficits and functional impairment in schizophrenia. Schizophrenia Research, 133(1-3), 193-198.
Kunikata, H., Yoshinaga, N., & Nakajima, K. (2016). Effect of cognitive behavioral group therapy for recovery of self‐esteem on community‐living individuals with mental illness: Non‐randomized controlled trial. Psychiatry and Clinical Neurosciences, 70(10), 457-468.
Laws, K. R., Darlington, N., Kondel, T. K., McKenna, P. J., & Jauhar, S. (2018). Cognitive Behavioural Therapy for schizophrenia-outcomes for functioning, distress and quality of life: a meta-analysis. BMC psychology, 6(1), 32-42.
Liu, Y., Yang, X., Gillespie, A., Guo, Z., Ma, Y., Chen, R., & Li, Z. (2019). Targeting relapse prevention and positive symptom in first-episode schizophrenia using brief cognitive behavioral therapy: A pilot randomized controlled study. Psychiatry Research, 272(1), 275-283.
Lodha, P., & De Sousa, A. (2020). Cognitive Behavioural Therapy and Its Role in the Outcome and Recovery from Schizophrenia. Schizophrenia Treatment Outcomes (pp. 299-312): Springer.
Lysaker, P. H., Gagen, E., Wright, A., Vohs, J. L., Kukla, M., Yanos, P. T., & Hasson-Ohayon, I. (2019). Meta-cognitive deficits predict impaired insight in schizophrenia across symptom profiles: a latent class analysis. Schizophrenia Bulletin, 45(1), 48-56.
Malaspina, D., Walsh-Messinger, J., Gaebel, W., Smith, L. M., Gorun, A., Prudent, V,. Trémeau, F. (2014). Negative symptoms, past and present: a historical perspective and moving to DSM-5. European Neuropsychopharmacology, 24(5), 710-724.
Margariti, M., Ploumpidis, D., Economou, M., Christodoulou, G. N., & Papadimitriou, G. N. (2015). Quality of life in schizophrenia spectrum disorders: associations with insight and psychopathology. Psychiatry Research, 225(3), 695-701. doi: 10.1016/j.psychres.2014.11.016.
Moritz, S., Pfuhl, G., Lüdtke, T., Menon, M., Balzan, R. P., & Andreou, C. (2017). A two-stage cognitive theory of the positive symptoms of psychosis. Highlighting the role of lowered decision thresholds. Journal of Behavior Therapy and Experimental Psychiatry, 56(1), 12-20.
Naeem, F., Khoury, B., Munshi, T., Ayub, M., Lecomte, T., & Farooq, S. (2016). Brief Cognitive Behavioral Therapy for Psychosis (CBTp) for Schizophrenia: Literature Review and Meta-analysis. International Journal of Cognitive Therapy, 9(1), 73-86. doi: 10.1521/ijct_2016_09_04.
Park, S., Lee, H. K., & Kim, H. (2020). Effects of a Korean version of the metacognitive training program for outpatients with schizophrenia on theory of mind, positive symptoms, and interpersonal relationships. Behavioural and Cognitive Psychotherapy, 48(1), 14-24. doi: 10.1017/s1352465819000560
Peralta, V., & Cuesta, M. J. (1994). Psychometric properties of the positive and negative syndrome scale (PANSS) in schizophrenia. Psychiatry Research, 53(1), 31-40.
Putri, N. A. R., Kurnianingsih, T., & Andayani, S. (2020). Daily Living Performance in Schizophrenic Patients in Correlation with Positive and Negative Symptoms. Althea Medical Journal, 7(2), 72-78.
Rabinowitz, J., Levine, S. Z., Garibaldi, G., Bugarski-Kirola, D., Berardo, C. G., & Kapur, S. (2012). Negative symptoms have greater impact on functioning than positive symptoms in schizophrenia: analysis of CATIE data. Schizophrenia Research, 137(1-3), 147-150.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Synopsis of Psychiatry: Behavioral Sciences. New York: Wolters Kluwer.
Škodlar, B., Henriksen, M. G., Sass, L., Nelson, B., & Parnas, J. (2013). Cognitive-behavioral therapy for schizophrenia: a critical evaluation of its theoretical framework from a clinical-phenomenological perspective. Psychopathology, 46(4), 249-265.
Van Rooijen, G., Isvoranu, A.-M., Kruijt, O. H., Van Borkulo, C. D., Meijer, C. J., Wigman, J. T., Ruhe, H.G,. Cahn, W. (2018). A state-independent network of depressive, negative and positive symptoms in male patients with schizophrenia spectrum disorders. Schizophrenia Research, 193(1), 232-239.
Yoshinaga, N., Nosaki, A., Hayashi, Y., Tanoue, H., Shimizu, E., Kunikata, H., Okada, Y,. Shiraishi, Y. (2015). Cognitive behavioral therapy in psychiatric nursing in Japan. Nursing Research and Practice, 2015(4).1-9.