پیش بینى ناگویی هیجانی بر اساس طرحواره هاى ناسازگار اولیه و ابرازگرى هیجانى با نقش میانجیگری انعطاف پذیری شناختی در بیماران مبتلا به درد مزمن

الموضوعات :

لیلی وکیلیان ¹ (دانشجوی دکتری، دانشگاه آزاد اسلامی، واحدتنکابن، ایران)
مرتضی ترخان ² (دانشیار روان‌شناسی دانشگاه پیام نور، تهران، ایران.)
جواد خلعتبری ³ (دانشگاه آزاد اسلامی واحد تنکابن)

تاريخ الإرسال : 22 الأربعاء , شعبان, 1441 تاريخ التأكيد : 12 الأحد , جمادى الأولى, 1442 تاريخ الإصدار : 17 الإثنين , ربيع الثاني, 1443

الکلمات المفتاحية: ابرازگرى هیجانى, ناگویی هیجانی, طرحواره هاى ناسازگار اولیه, درد مزمن, انعطاف پذیری شناختی,

ملخص المقالة :

هدف پژوهش، پیش بینى ناگویی هیجانی بر اساس طرحواره‌هاى ناسازگار اولیه و ابرازگرى هیجانى با نقش میانجیگری انعطاف‌پذیری شناختی در بیماران مبتلا به درد مزمن است. روش پژوهش حاضر، همبستگی و از نوع مطالعات تحلیل مسیر بود. برای انجام پژوهش 300 نفر از بیماران دچار درد مزمن مراجعه کننده به بیمارستان های شهر تهران در سال 1397 با شیوۀ نمونه گیری پژوهش خوشه ای چندمرحله ای انتخاب شدند. شرکت کنندگان پرسشنامه های طرحواره های ناسازگار اولیه (Young, 1998)، ابرازگرى هیجان (King & Emmons, 1990)، ناگویی هیجانی تورنتو (Babgy, Parker & Taylor, 1994) انعطاف‌پذیری شناختی (Taghizadeh & Nikhah, 2015) را تکمیل نمودند. برای تحلیل داده ها از نرم‌افزارهای Amos و SPSS استفاده گردید. نتایج تحلیل مسیر نشان داد فقط حوزه های محدودیت های مختل به میزان 18/0 و دیگر جهت مندی به میزان 14/0 در تبیین واریانس ناگویی هیجانی تأثیر مثبتی دارد (05/0 >p). ابرازگرى هیجانى در تبیین واریانس ناگویی هیجانی 27/0-؛ بر متغیر میانجی (انعطاف‌پذیری شناختی) 44/0- تأثیر دارد (01/0 >p). در نهایت، ابرازگرى هیجانى با ضریب تأثیر 31/0- بر ناگویی هیجانی از طریق انعطاف پذیری شناختی تأثیر غیرمستقیم دارد (01/0 >p). از نتایج این پژوهش می توان در راستای کاهش سطح ناگویی هیجانی با استفاده از اصلاح طرحواره هاى ناسازگار اولیه، ابرازگرى هیجانى و انعطاف پذیری شناختی در بیماران مبتلا به درد مزمن استفاده کرد..

المصادر:

Aghapour, S., & Mojtabaei, M. (2018). Comparison of Cognitive Flexibility and Emotional Inhabitation among Eczema Patients and Normal Individuals. Salamat Ijtimai (Community Health), 6(1), 26-34

Ahee, Q., Mohammadifar, M. A., & Besharat, M. A. (2007). Narrative and reliability of short form Yang schema questionnaire. Journal of Psychology and Educational Sciences, 37 (3), 5-25

Babgy, R. M., Parker, J.D., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale: 1 item selection and cross-validation of the factor structure. Journal of Psychosomatic Researcher, (38), 23-32.                                

Basharpoor, S., Almardani, S., & Shahmohammadzadeh Y. (2015). The role of alexithymia and emotional expressivity in predicting somatization symptoms among students of Mohaghegh Ardabili University during 2014-2015. J Rafsanjan Univ Med Sci; 13 (10), 961-972.

Beck, A. T. (1974). The development of depression: A cognitive model. In R. J. Friedman & M. M. Katz (Eds.), The psychology of depression: Contemporary theory and research. John Wiley & Sons.

Beck, A. T., & Epstein, N. (1993). An inventory for measuring clinical anxiety: Psychometric Properties. Journal of Consulting and Clinical Psychology, 56 (3), 893-897.                                                            

Besharat, M. A. (2007). Construction and validation of multidimensional perfectionism scale in Tehran. Psychological Research, 1 (2), 67-46.

Ciuluvica, C., & Fulcheri, M. (2014). Emotion regulation strategies and quality of life in dermatologic patients. Procedia Soc Behav Sci, (127), 661–665

Cox, B.J., Swinson, R.P., Shulman, I.D & Bourdeau, D. (1995). Alexithymia in panic disorder and social phobia. Comprehensive Psychiatry, (36), 195–198.

 

Dadomo, H., Grecucci, A., Giardini, I., Ugolini, E., Carmelita, A., & Panzeri, M. (2016). Schema therapy for emotional dysregulation: Theoretical implication and clinical applications. Frontiers in Psychology, (7), 1987.

Di Tella, M., & Castelli, L. (2016). Alexithymia in chronic pain disorders. Curr Rheumatol Rep, 18 (7), 41.

Dickstein, D. P., Nelson, E., MCclure, E. B., Grimly, M. E., Knoph, L., Brotman, M. A., Rich, B. A., Pine, D. S., & Leibenluf, E. (2007). Cognitive flexibility in phenotype of pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry, (46), 341-355.

Flinka, N., Lehto, S., Koivumaa-Honkanen, H., Viinamäki, H., Ruusunen, A., & Valkonen-Korhonen, M. (2017). Early maladaptive schemas and suicidal ideation in depressed patients. European Journal of Psychiatry, 31(3), 87-92.

Gan, Y., Liu, Y., & Zhang, Y. (2004). Flexible coping responses to severe acute respiratory syndrome-related and daily life stressful events. Asian Journal of Social Psychology, 7, 55–66

Ghiyasi, Gh., Molavi, H., Neshat Doost, H., & Salavati, M. (2011). Investigating the factor structure of the Young Schemas Questionnaire (third version of the short form) in Tehran. Journal of Psychological Achievements, 3 (1), 93- 118.

Gholizadeh, Z., & Sorani, H. (2016). The effectiveness of neurofeedback on cognitive flexibility. Quarterly Journal of Modern Psychological Research, 12 (48), 1-15.

Goerlich, K.S. (2018). The Multifaceted Nature of Alexithymia a Neuro-scientific Perspective. Frontiers in Psychology, 9(16), 1641.

Herdiana, I., Suryanto, A., & Handoyo, S. (2018). Family Resilience: A Conceptual Review. Advances in Social Science, Education and Humanities Research, (133), 42- 48.

Izadi, F., Ashrafi, E., & Fathi Ashtiani, A. (2017). Structural Pattern of the Relationship between Negative Emotional Schemas and Physical Symptoms with the Mediation of Emotional Disappointment and Emotional Expression, Behavioral Sciences Research Journal, 6 (3), 323-3

Karatzias, T., Jowett, S., Begley, A., & Deas, S. (2016). Early maladaptive schemas in adult survivors of interpersonal trauma: foundations for a cognitive theory of psychopathology. European Journal of Psychotraumatology, (7), 307-313

Keltner, D., Sauter, D., Tracy, J., & Cowen, A. (2019).  Emotional Expression: Advances in Basic Emotion Theory. J Nonverbal Behav, (43), 133–160

King, L.A, & Emmons, R.A. (1990). Conflict over emotional expression: Psychological and physical Correlates. Journal of Personality and Social Psychology, 58 (5), 864- 877.

Leahy, R.L. (2015). Emotional schema therapy. Translated by Jahangiri S. Tehran: Ibn Sina. [In Persian].

Linton, S. J., Flink, I. K & Vlaeyen, J. W. S. (2018a). Understanding the Etiology of Chronic Pain From a Psychological Perspective. Physical Therapy, 98(5), 315-324.

Liu-Ambrose, M. G. Donaldson, Y. Ahamed, Y. (2006). Otago home-based strength and balance retraining improves executive functioning in older fallers: a randomized controlled trial. Journal of the American Geriatrics Society, 56 (10), 1821–1830.

Mahdavi, A., & Manshaei, Gh. (2016). Comparison of mood swings and emotional expression in patients with coronary heart disease and healthy individuals. Feyz Scientific-Research Monthly, 20 (3), 266-260

Main, CJ., Keefe, FJ., Jensen, MP., & Vowles, KE. (2015). Fordyce’s Behavioral Methods for Chronic Pain and Illness: Republished with Invited Commentar­ies. Philadelphia, PA: Wolters Kluwer.

Martin, R., & Young, J. (2010). Schema therapy. In K. S. Dobson (Ed.), Handbook of cognitive-behavioral therapies (p. 317–346). Guilford Press.

Mardia K. V. (1971). The effect of nonnormality on some multivariate tests and robustness to nonnormality in the linear model, Biometrika, 58(1), 105–121.

Masuda, A., & Tully, E.C. (2012).The Role of Mindfulness and Psychological Flexibility in Somatization, Depression, Anxiety, and General Psychological Distress in a Nonclinical College Sample. Journal of Evidence-Based Complementary & Alternative Medicine, 17 (1), 66-71

Mirza-Huseini, H., Vahidi Monfared, Z., & Setayeshi Azhari, M. (2018). Modeling the Structural Equations of Relationships between Early Maladaptive Schemas and Positive and Negative Emotions among Disabled Veterans with the Mediating Role of Alexithymia, Journal of military Psychology, 32 (8), 43-55

Mittinty, M. M., Vanlint, S., Stocks, N., Mittinty, M. N., & Moseley, G. L.(2018). Exploring effect of pain education on chronic pain patients' expectation of recovery and pain intensity. Scandinavian journal of pain,  18(2), 211–219.

Mohammadzadeh, F. (2013). Chronic pain epidemiology in Tehran and small regional estimates of its prevalence in Tehran neighborhoods. Using Bayesian Approach (Urban HEART-2 study), Iranian Journal of Epidemiology,9 (1), 19-31.

Nikolaeva, I. (2014). A grammar of Tundra Nenets. Berlin: Mouton de Gruyter.

Nordahl, D., Høifødt, R., Bohne, A., Landsem, I., Wang, C., & Thimm, J.  (2019). Early maladaptive schemas as predictors of maternal bonding to the unborn child. BMC Psychol, 7 (23), 1-11.

Pahlevan, M., Besharat, M. A., Borjali, A & Farahani, H. (2018). [ The mediator role of meta-cognitive beliefs between alexithymia and the intensity of pain in patients with chronic pain (Persian)]. J Anesth Pain;9(1):1-13.

Parkoohi, P., Amirzadeh, K., Mohabbati, V., & Abdollahifard, Gh. (2015). Satisfaction with chronic pain treatment. Anesthesiology and pain medicine, 5 (4), 23- 528.

Peyvastegar, M., Haji, Z. S., & Taghavi, H.T. (2016). Perfectionism: Awareness - Evaluation - Treatment. Avari Noor Publications.

Popolo, R., MacBeth, A., Canfora, F., Rebecchi, D., Toselli, C., Salvatore, G & Dimaggio G. (2018). Metacognitive interpersonal therapy in group (MIT-G) for young adults personality disorders. A pilot randomized controlled trial. Psychology and Psychotherapy: Theory, Research & Practice.

Quinton, S., & Wagner, H.L. (2005). Alexithymia, ambivalence over emotional expression, and eating attitudes. Personality and Individual Differences, 38, 1163-1173.

Rafieinia, P. (2001). The relationship between emotion expression styles and general health in students. Master Thesis in Psychology, Tarbiat Modares University.

Raulin, M.L. (1984). Development of a scale to measure intense ambivalence. Journal of Consulting and Clinical Psychology, 52(1), 63–72

Ravat, S., Olivier, B., Gillion, N., PT, & Lewis, F. (2019). Laterality judgment performance between people with chronic pain and pain-free individuals. A systematic review and meta-analysis, Physiotherapy Theory and Practice, 36(12), 1279-1299.

Rhodes, A., Rozell, T. (2017). Cognitive flexibility and undergraduate physiology students: increasing advanced knowledge acquisition within an ill-structured domain. Adv Physiol Educ, (41): 375- 382.

Salovey, P., Rothman, A. J., Detweiler, J. B., & Steward, W. T. (2000). Emotional states and physical health. American Psychologist, 55(1), 110–121.

Saariaho, A.S., Saariaho, A. K., & Karukiri, M. M. (2015). Alexithymia and early Maladaptive Schemas in chronic pain patients. Scandinavian Journal of Psychology, 56 (4), 1-12.

Schmidt, N. B., Joiner, T. E., Young, J. E., & Telch, M. J. (1995). The schema questionnaire: Investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas. Journal of Cognitive Therapy and Research, (19), 295-321.

Sifneos, P.E. (1973). The prevalence of •galexithymic•h characteristics in psychosomatic patients. Psychother Psychosom, (22), 255-262.

Steven, J., Linton, Ida K., Flink, W.S., & Vlaeyen, S. (2018). Understanding the Etiology of Chronic Pain from a Psychological Perspective. Phys Ther, (98), 315–324

 Tahere. M., Nasiri. A., Moadab. F., Nayebi. N., & Asadi, L. (2015). Strategies to improve student's educational achievement motivation at guilan university of medical sciences. Res Dev Med Educ, 4(2), 133-139

Taghizadeh, M. E., & Nikkhah, L. (2015). The effectiveness of teaching metacognitive strategies on cognitive flexibility, decision-making style and creative problem solving in students. Master Thesis, University of South Tehran.

Taylor, CDj., Bee, P., & Haddock, G. (2017). Does schema therapy change schemas and symptoms? A systematic review across mental health disorders. Psychology and Psychotherapy, 90(3), 456-479

Taylor. G. J., & Babgy, M. (2000). An overview of the alexithymia construct. The handbook of emotional intelligence (pp.263-276). San Francisco: Jossey Bass.

Tesio, V., Goerlich, K.S., Hosoi, M., & Castelli, L. (2019) Editorial: Alexithymia: State of the Art and Controversies. Clinical and Neuroscientific Evidence. Front. Psychol, (10), 120-129.

Thimm, J.C. (2013). Early maladaptive schemas and interpersonal problems: Acircumflex analysis of YSQ-SF. International Journal of Psychology & Psychological Theapy, 13(1),113-124.

Tilki, M. (2016). The effectiveness of acceptance and commitment training on resilience, psychological flexibility and emotional numbness in women with chronic pain. Master Thesis, Clinical Psychology, Islamic Azad University, Campus Branch, Shahroud Research Sciences

Veld, D.M.J., Walraven, J.M., & Weerth, C.D. (2012). The relation between emotion regulation strategies and physiological stress responses in middle childhood. Psychoneuroendocrinology, 37(8), 1309-1319

Voderholzer, U., Schwartz, C., Thiel, N., Kuelz, A., Hartmann, A., Scheidt, C., Schlegl, S., & Zeeck, A. (2013). A Comparison of Schemas, Schema Modes and Childhood Traumas in Obsessive-Compulsive Disorder, Chronic Pain Disorder and Eating Disorders. Psychopathology, (1), 1-9.

Wachs, K., & Cordova, J. V. (2007). Mindful relating: Exploring mindfulness and emotion repertoires in intimate relationships. Journal of Marital and Family Therapy, 33(4), 464–481

Young, J. E. (1998). Cognitive Therapy for personality Disorder: A schema-Focused approach.

Young, J. E., Klosko, J. S, & Weishaar, M. E. (2003). Schema therapy: A practitioner s Guilford Press. 

Zad Hassan, Z., & Siraj Khorami, N. (2016). Concerns about body image, early maladaptive schemas and mood swings with social anxiety among female students of Islamic Azad University. Social Psychology, 3(38), 61-80.