مقایسه تاثیر درمان‌های شناختی-رفتاری و فراتشخیصیِ یکپارچه بر خودپنداره جنسی، صمیمیت جنسی و عملکرد جنسی در زنان با اختلال ملال پیش از قاعدگی

هدف: هدف پژوهش حاضر، مقایسه اثربخشی درمان شناختی رفتاری با فراتشخیصی یکپارچه بر سه متغیر خودپنداره جنسی، صمیمیت جنسی و عملکرد جنسی در زنان با اختلال ملال پیش از قاعدگی است.روش: روش پژوهش بر مبنای هدف، کاربردی و از نظر روش، کمی و از نوع نیمه‏آزمایشی، با طرح پیش‏آزمون، پس‏آزمون با گروه کنترل همراه با پیگیری 2 ماهه بود. جامعه آماری پژوهش شامل تمامی زنان متاهل با دامنه سنی 25 تا 45 سال مبتلا به اختلال ملال پیش از قاعدگی مراجعه کننده به مراکز درمانی وابسته به دانشگاه علوم‏پزشکی و بهزیستی شهرستان لار در سال 401-1400 بود که حداقل شش ماه الی یک سال از زمان مشکلات قاعدگی آن ها میگذشت و بیماری جسمی خاصی نداشتند که با روش نمونه‏گیری هدفمند از بین آن‏ها تعداد 60 نفر انتخاب و به شیوه انتصاب تصادفی در سه گروه مساوی 20 نفری جایگزین شدندیافته‌ها: گروه‏های آزمایش و کنترل پرسشنامه چندوجهی خودپنداره جنسی (msscq)، پرسشنامه عملکرد جنسی زنان (fsfi) و پرسشنامه صمیمیت جنسی (siq) را در مراحل مختلف سنجش تکمیل کردند. هر دو درمان فراتشخیصی و شناختی-رفتاری طی 9 جلسه برای آزمودنی‏های گروه‏های آزمایش ( نه افراد گروه کنترل) اجرا شد. داده‏ها با استفاده از آمار توصیفی، آزمون پیش فرض‏های آماری، آنالیز واریانس آمیخته و آزمون تعقیبی بن‏فرونی تحلیل شد. نتایج نشان داد هر دو درمان بر بهبود میانگین نمره خودپنداره جنسی، صمیمیت جنسی و عملکرد جنسی تاثیر معناداری داشته‏اند. اثربخشی درمان شناختی-رفتاری بر خودپنداره جنسی و عملکرد جنسی نسبت به درمان فراتشخیصی یکپارچه بیشتر بوده است اما تاثیر درمان فراتشخیصی یکپارچه بر صمیمیت جنسی بالاتر بوده است. یافته‏های پژوهش حاضر حمایتی تجربی برای دو روش درمانی در جهت بهبود شاخص‏های جنسی در زنان متاهل بود. آگاهی روان درمانگران حوزه سلامت و بهداشت خانواده از این رویکردها می‏تواند کمک کننده باشد.

comparison of the effect of cognitive behavioral therapy and integrated transdiagnostic treatment on sexual self concept, sexual intimacy, and sexual function in women with premenstrual dysphoric disorder

introduction: menstruation is a natural cycle in every woman's body. today, informing everyone about the challenges of menstruation and understanding the needs of women during this period is more important than ever. menstruation creates special conditions before or during this period. this may lead to annoying symptoms and disrupt some of daily activities. one of the most common menstrual mental disorders is pre-menstrual dysphoric disorder (pmdd), which is associated with behavioral, physical, and emotional symptoms. one of the basic points in the assessment of pmdd is sexual issues (nowosielski et al., 2010). in each phase of sexual activity, sexual dysfunction is experienced depending on the psychological-physiological changes.sexual self-concept significantly influences sexual performance at both intrapersonal and interpersonal levels (guyon et al., 2020). another significant issue is sexual intimacy, including the expression of feelings, thoughts, fantasies, and making romantic experiences with the partener (masoumi et al., 2017). most women with pmdd do not embark on treating the disorder, the result of which might be destructive impacts on personal and marital relationships. so far, only pharmacotherapy has been prescribed for pmdd, though no medication can alleviate all symptoms of the disoroder. therefore, over the immediate past, one of the most significant issues for investigating the disorder has been psychological treatments for alleviating the symptoms through actively managing of the individuals.considering the necessity of seeking the most effective method in this regard, this study tried to compare the effectiveness of cognitive-behavioral therapy (cbt) with integrated transdiagnostic therapy (itt) on sexual self-concept, sexual intimacy, and sexual function among women with pmdd.method: this semi-experimental study applied a quantitative design, including a pre-test, post-test, and a two-month follow-up assessment. the statistical population included all married women aged 25 to 45 years who experienced menstrual issues. these women had visited one of the psychiatry or psychology clinics, specialized gynecology and obstetrics clinics, or midwifery clinics of larestan in 2021-2022. applying a purposive sampling, 60 participants were selected and randomly categorized into three groups of 20 people (two experimental groups and one control group). research tools for collecting data consisted of the multidimensional sexual self-concept questionnaire (msscq) (snell, 1992), the female sexual function index (fsfi) (rosen and et al., 2000) and the sexual intimacy questionnaire (siq) (bagarozzi, 2013). before implementing the intervention, a pre-test was run for all three groups. the first and second experimental groups underwent the unified transdiagnostic intervention and cognitive-behavioral therapy, respectively, in nine 90-minute sessions, while the control group received no intervention. at the end of the treatment period, all participants were given a post-test, and finally, two months later, the participants were re-evaluated in the follow-up stage. for analyzing the data, descriptive statistics, statistical assumptions test, mixed analysis of variance, and bonferroni test were applied, using spss-24.results: the results indicated that the integrated transdiagnostic therapy and cognitive-behavioral therapy significantly enhanced the average scores on sexual self-concept, sexual intimacy, and sexual function and the impacts remained to the follow-up stage. cognitive-behavioral therapy significantly outperformed integrated transdiagnostic therapy in its effects on sexual self-concept, but the latter had a greater impact on sexual intimacy. the results indicated an average difference of 10.933 (p<0.001) in sexual self-concept between the cognitive behavioral therapy group and the control group, a difference of -6.05 (p<0.001) in sexual performance, and an average difference of 8.133 (p<0.001) in sexual intimacy between the integrated metadiagnostic treatment group and the control group. this research confirms the effectiveness of cognitive behavioral therapy on sexual intimacy, aligning with the findings of braga et al. (2022) and rodriguez-moreno et al. (2022). as sexual self-concept, and sexual intimacy are considered the cognitive-emotional variables, one can conclude that both therapies can play an effective role in improving the scores of all of the three variables. however, in regard with the greater impact of cognitive-behavioral therapy compared to integrated transdiagnostic therapy on the sexual self-concept and sexual funsction, one can say that in cognitive-behavioral therapy, emotions are influenced by cognitive factors; that is, the inability of experiencing, identifying, and controlling the improper emotions is the result of negative thoughts and beliefs as well as the application of ineffective methods. thus resorting to cognitive-behavioral therapy can be effective through modifying biases and ineffective cognitions and through decreasing cognitive errors and challenging them. the therapy focuses on the impacts of beliefs, thoughts, and attitudes on the way of interpreting information, triggers effective coping responses, and controls negative emotions. in general speaking, one can say that sexual self-concept and sexual function, as the factors characterized by more cognitive elements, are influenced and improved.