ثربخشی درمان گروهی مبتنی‌بر پذیرش و تعهد بر تجربه و ادراک رنج، تنظیم هیجان، شادکامی و اضطراب وجودی در بیماران مبتلا به میگرن

زمینه و هدف: میگرن یکی از مهم‌ترین بیماری‌های سایکوسوماتیک است که به‌علت اتساع عروق محصورکنندهٔ مغز بروز می‌کند. پژوهش حاضر با هدف اثربخشی درمان گروهی مبتنی‌بر پذیرش و تعهد بر تجربه و ادراک رنج، تنظیم هیجانی، شادکامی و اضطراب وجودی در بیماران مبتلا به میگرن انجام شد.روش‌بررسی: پژوهش حاضر از نوع نیمه‌آزمایشی با طرح پیش‌آزمون و پس‌آزمون و دورهٔ پیگیری یک‌ماهه با گروه گواه بود. تعداد چهل بیمار مبتلا به میگرن در شهرستان گناوه، به‌صورت داوطلبانه انتخاب شدند. سپس به‌طور تصادفی در گروه‌های درمان گروهی مبتنی‌بر پذیرش و تعهد (بیست نفر) و گواه (بیست نفر) قرار گرفتند. داده‌ها با استفاده از مقیاس تجربه و ادراک رنج (اسچالز و همکاران، 2010)، پرسشنامهٔ تنظیم هیجان (گارنفسکی و همکاران، 2001)، مقیاس شادکامی آکسفورد (آرجیل و لو، 1990) و مقیاس اضطراب وجودی (گود و گود، 1974) جمع‌آوری شد. از رویکرد پذیرش و تعهد براساس راهنمای درمانی هایز و همکاران (2013) استفاده شد. تجزیه‌وتحلیل داده‌ها با استفاده از آزمون آماری تحلیل واریانس با اندازه‌گیری مکرر و آزمون تعقیبی بونفرونی در سطح معنا‌داری 0٫05 صورت گرفت.یافته‌ها: نتایج نشان داد، برای متغیرهای تجربه و ادراک رنج، تنظیم هیجان، شادکامی و اضطراب وجودی، اثر زمان (0٫001>p)، اثر گروه (0٫001>p) و اثر متقابل زمان*گروه (0٫001>p) معنادار است. در مقایسۀ مراحل پیش‌آزمون و پس‌آزمون (0٫001p) در چهار متغیر ذکرشده تفاوت معنادار مشاهده شد؛ اما بین مراحل پس‌آزمون و پیگیری در این متغیرها تفاوت معنادار مشاهده نشد که نشان‌دهندۀ تداوم تاثیر مداخلات در مرحلۀ پیگیری است.نتیجه‌گیری: براساس نتایج، درمان مبتنی‌بر پذیرش و تعهد در کاهش تجربه و ادراک رنج، افزایش شادکامی، بهبود تنظیم هیجانی و کاهش اضطراب وجودی بیماران مبتلا به میگرن موثر است و می‌توان از درمان مذکور در راستای بهبود کیفیت زندگی و سلامت روان این بیماران استفاده کرد.

Effects of Group Acceptance and Commitment Therapy on the Experience and Perception of Suffering, Existential Anxiety, Emotion Regulation, and Happiness in Patients With Migraine

Background & Objectives: Migraine is among the most essential psychosomatic diseases, caused by the dilation of the occlusive brain vessels. Periodic migraine attacks can impair a patient’s functioning and reduce their ability to perform all aspects of daily living activities, such as employment, housework, and other physical and non–physical practices. Such defects include the effects imposed on the tolerance of the perception of suffering and disorder in Existential Anxiety (EA) and Emotion Regulation (ER) as well as reduced happiness and subjective wellbeing. There exists a high prevalence of migraine in societies. A cost–effective psychological approach is Acceptance and Commitment Therapy (ACT). Such treatment can significantly improve the symptoms of patients with migraine. Thus, the present study aimed to investigate the effects of group ACT on the experience and perception of suffering, ER, EA, and happiness in patients with migraine.Methods: This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population of this study consisted of all patients who were diagnosed with migraine and recorded in the apple system of health centers, hospitals, and the specialized clinic of Genaveh City, Iran, from September 2016 to April 2018. In total, 40 of these patients who were willing to participate in the study were selected voluntarily and were randomly assigned into two groups of group ACT and control (n=20/group). The inclusion criteria included patients with migraine in Genaveh, have ≥3 migraine headaches per month, age between 18 to 40 years, have at least a diploma, no history of other physical illnesses, satisfaction to participate in the study, no use of psychiatric drugs, not receiving other psychological therapies, and the absence of stressful events, such as divorce or the death of a loved one in the past 6 months. The exclusion criteria also included failure to participate in the program of group ACT sessions, absence from >2 intervention sessions, failure to complete the provided questionnaires at any stage of the research, incident effect of the study subject’s personal life where they failed to continue to participate in the psychotherapy sessions, and using drugs that affect the study results. The following tools were used for gathering the required data: the Scale of Experience and Perception of Suffering) Schulz et al., 2010), the Emotion Regulation Questionnaire (Garnefski et al., 2001), the Oxford Happiness Scale (Argyle & Lu, 1990), and the Existential Anxiety Scale (Good & Good, 1974) in the pretest, posttest, and follow–up phases. The intervention consisted of a group ACT based on Hayes et al.’s package (2013); it was delivered in eight 120–minute sessions per week. However, the control group received no intervention. The repeated–measures Analysis of Variance (ANOVA) was used at the significance level of 0.05 to analyze the findings in SPSS.Results: The results of repeated–measures ANOVA on the experience and suffering of perception, ER, happiness, and EA suggested that time effect (p<0.001), group effect (p<0.001), and time*group effect (p<0.001) were significant. Moreover, Bonferroni posthoc test data indicated a significant difference in the experience and suffering of perception, ER, happiness, and EA between pretest and posttest scores (p<0.001) as well as between pretest and follow–up values (p<0.001) in the experimental group. However, there was no significant difference between posttest and follow–up stages concerning the experience and suffering of perception (p=0.895), ER (p=0.925), happiness (p=1.000), and EA (p=1.000); thus, these data indicated the continued effectiveness of the provided intervention until the one–month follow–up phase.Conclusion: According to the present study results, it can be suggested that group ACT was effective in reducing the perception of suffering, increasing happiness, improving ER, and reducing EA in patients with migraine.