نقش میانجی توجه متمرکز بر خود و دیگری در رابطه بین سامانه‌های بازداری‌فعال‌سازی رفتاری و نشانه‌های افسردگی در بیماران افسرده

مقدمه: توجه به عوامل شناختی موثر و تدوام‌ بخش افسردگی، از اولویت ‌های پژوهشی و درمانی است. هدف از پژوهش حاضر آزمون مدل میانجی توجه متمرکز بر خود و دیگری در رابطه بین سامانه‌های بازداری_فعال ‌سازی رفتاری و نشانه‌های افسردگی در بیماران افسرده بود. روش کار: پژوهش حاضر توصیفی_مقطعی در قالب یک طرح همبستگی از نوع مدل ‌سازی معادلات ساختاری از بین افراد افسرده مراجعه ‌کننده به مراکز مشاوره قم در نیمه اول سال 1400 انجام شد که به روش نمونه ‌گیری در دسترس 200 نفر انتخاب شدند. برای جمع ‌آوری داده ‌ها از مقیاس سامانه ‌های بازداری و فعال ‌سازی رفتاری (bis/bas)، پرسشنامه افسردگی beck و پرسشنامه کانون توجه (faq) استفاده شد. داده‌ ها در محیط نرم‌افزارهای  spss-26و amos-24 از طریق ضریب همبستگی پیرسون و مدل‏‌سازی معادلات ساختاری تحلیل شدند. به منظور آزمون معنا داری مسیرهای غیرمستقیم از تحلیل بوت استراپ استفاده شد.یافته ‌ها: الگوی نهایی پس از اصلاح، از طریق حذف مسیر سامانه بازداری رفتاری به نشانه‌های افسردگی و توجه متمرکز بر دیگری، با آزاد کردن تعدادی از خطاهای کوواریانس برازش خوبی با داده‌ها داشت (0.968=cfi=،0.090،rmsea). سایر مسیرهای مستقیم، معنا‌دار بودند (0.05>p). تحلیل بوت‌استراپ آشکار ساخت توجه متمرکز بر خود در رابطه بین سامانه فعال ‌سازی رفتاری و نیز سامانه بازداری رفتاری با نشانه‌های افسردگی نقش میانجی‌گرانه دارد (0.0001>p).نتیجه‌ گیری: توجه متمرکز برخود به عنوان یک میانجی‌گر کلیدی می‌تواند اثرات محافظتی فعالیت سامانه فعال ‌ساز رفتاری را بر نشانه‌های افسردگی بکاهد و از سوی دیگر اثرات مخرب فعالیت سامانه بازداری رفتاری را بر نشانه‌های افسردگی تشدید نماید.

the mediating role of self and external-focused attention in the relationship between behavioral inhibition/activation systems and depression symptoms among depressed patients

introductiondepression is a globally common disease. unfortunately, its prevalence is increasing. behavioral changes are a significant aspect of depression diagnosis. two separate systems shaping human behavior: 1. the behavioral approach system (bas) and 2. the behavioral inhibition system (bis), which are effective factors in depression.the level of sensitivity in bas and bis is closely related to psychological damage. at the same time, the direct relationship between them can only be explained relatively. therefore, understanding the intervention mechanism and mediator roles in explaining the causes of depression is important. self-focused attention is a vital structure that can mediate the effect of brain-behavioral systems on depression. in beck’s cognitive model, a depressed person suffers from a negative attitude about himself, his experiences, and the future. the consequence of this pervasive negativity is the person becoming depressed. in well’s metacognitive model of depression, it is assumed that the control of attention becomes inflexible in psychological disorders in such a way that attention is focused on the self with a continuous and repetitive pattern, and processing is based on concern and threat detection. despite significant progress in the diagnosis and treatment of depression, searching for the vulnerability factors of this disorder and how these factors interact with each other remains a fundamental issue in mental health. due to the significant prevalence of depression in outpatients of medical and counseling centers, it is of high priority to understand the factors involved in the occurrence and persistence of this disorder.methodsthe present research design is descriptive and cross-sectional, and in terms of its purpose, it is fundamental research. the current study population consisted of depressed men and women-based on clinical interviews and the results of the beck’s depression inventory-13 (bdi-13) -referring to counseling centers in qom in the first half of 1400. two hundred people were selected by purposive sampling method based on the inclusion criteria (18 to 45 years old and admitted to a counseling center in the last month), exclusion criteria (beginning psychotherapy sessions for depression, taking neuropsychiatric drugs for depression, incomplete tests/leaving more than 20% of items unanswered, more than six months passed since the last diagnostic session), and the minimum proportional sample size to perform the structural equation model. they answered the bis/bas scale, beck depression inventory-13 (bdi-13), and the focus of attention questionnaire (faq) voluntarily. all ethical principles of the research were observed. therefore, permission was obtained from the university’s ethics committee under the code ir.guilan.rec.1400.023. the subjects’information was coded anonymously. besides, they had the right to participate knowingly and voluntarily and to withdraw from the research at any stages.this study used descriptive statistics (mean, standard deviation, skewness, kurtosis, and correlation matrix) and inferential statistics (pearson’s correlation coefficient and structural equation modeling technique) for data analysis. spss-26 and amos-24 software were used for statistical analysis. bootstrap analysis was used in the macro program from preacher and hayes to test the significance of indirect paths.resultsone hundred thirty-six women (68%) and 64 men (32%) participated in the study, with an average age of 34.94±8.42 years (women 35.70±8.05 and men 33.32±9.01 years) (n=200). sixty-nine people were single (34.5%), 84 were married (42%), and 47 were widowed or divorced (23.5%). one hundred seven people were childless (53.5%), and 93 subjects had one to three children (46.5%). six women (4.4%) had given birth in the last six months, and the rest had no history of giving birth in the previous six months. thirty-nine people had an undergraduate degree (19.5%), 73 had a bachelor’s degree (36.5%), and 88 had a master’s degree (44%). none of the sample subjects was taking neuropsychiatric drugs before entering the study. the mardia coefficient for the research variables was 4.521, and the critical ratio was 2.682, less than 5. therefore, the multivariate normality assumption was valid for the model test.the structural equation modeling method was used to test the proposed mediating model of self and external-focused attention in the relationship between bas/bis and depression symptoms among counseling center clients. the results of the fit indices showed that the pcfi and pnfi indices in the proposed model were greater than 0.5, and they were acceptable. however, the other fit indices of the proposed model are not acceptable. in the first step, the two non-significant paths of the model (bis to the symptoms of depression and external-focused attention) were removed to improve the model. in the second step, the final model of the research was designed by drawing the correlation between the covariance errors. the results in the table 1 show that after the modifications, the final model of the research mode has desirable fit indices.1. the fit indices of the proposed and modified model of the current research*fit indicesx2dfp-valuecmin/dfrmsea (cl90%)pnficfipcfiifigfisrmrproposed model101.318<0.00112.6620.242 (0.20-0.28)0.5980.7910.6010.7960.7820.112first modified model101.38100.00210.1390.214 (0.17-0.25)0.6730.7950.6790.8000.8810.112final model23.3890.0052.5980.090 (0.04-0.11)0.7070.9680.7150.9690.9680.061the acceptable level of indices: pnfi, pcfi (>0.5), ifi, gfi, cfi (>0.9), rmsea (<0.08), cmin/df (<3 good, <5 acceptable)*abbreviations; cmin/df: chi-square/degree-of-freedom ratio; rmsea: root mean square error of approximation; pcfi: parsimonious comparative fit index; gfi: goodness of fit index; pnfi: parsimonious normed fit index; ifi: incremental fit index; cfi: comparative fit index. srmr: standardized root mean squared residual.the coefficient of depression variable determination is 0.632, indicating that all exogenous and mediating variables, i.e., bas, bis, self-focused attention, and external-focused attention, can predict 63% of the changes in depression symptoms, which is very strong. indicatively, the coefficients of determining the variables of external-focused and self-focused attention are 26% and 7%, respectively, which is weak. the results of mediating relationships were analyzed using the