مقایسهٔ اثربخشی درمان ذهن‌آگاهی گروهی با فراشناخت‌درمانی‌ گروهی بر بهبود تنظیم هیجانی در بیماران بهبودیافته از اختلال سوءمصرف مواد

زمینه و هدف: اعتیاد امروزه به یکی از جدی‌ترین معضلات جامعهٔ بشری تبدیل شده است و مشکلات تنظیم هیجان در افراد معتاد وجود دارد؛ بنابراین پژوهش حاضر با هدف مقایسهٔ اثربخشی درمان ذهن‏آگاهی گروهی با فراشناخت‌درمانی گروهی بر تنظیم هیجانی در بیماران بهبودیافته از اختلال سوءمصرف مواد، صورت گرفت.روش‌بررسی: این پژوهش به‌روش نیمه‏آزمایشی با طرح پیش‏آزمون، پس‏آزمون با دورهٔ پیگیری و گروه گواه انجام شد. جامعهٔ آماری پژوهش تمامی بیماران بهبودیافته از اختلال سوءمصرف، مراجعه‏کننده به مراکز ترک اعتیاد شهر ورامین در سال 1398 بودند. به‌روش نمونه‏گیری هدف‌مند، تعداد 39 نفر انتخاب شدند و در سه گروه درمان ذهن‏آگاهی، فراشناخت‌درمانی و گواه جایگزین شدند. ابزار پژوهش پرسشنامهٔ‏ تنظیم شناختی هیجانی (گارنفسکی و همکاران، 2001) بود. روش‌های درمانی ذهن‏آگاهی (ویلیامز و کرفت، 2012) و فراشناختی (ولز، 2009) به‌صورت گروهی هرکدام در هشت جلسۀ 90دقیقه‌ای برای گروه‌های آزمایش ارائه شد. داده‌ها با استفاده از روش تحلیل واریانس مکرر و آزمون تعقیبی بونفرونی در نرم‌افزار spss نسخۀ 22 در سطح معناداری 0٫05 تحلیل شدند.یافته‏‌ها: نتایج نشان داد، درمان ذهن‌آگاهی و فراشناخت‌درمانی موجب افزایش میانگین راهبردهای مثبت و کاهش میانگین راهبردهای منفی تنظیم هیجان در پس‌آزمون و پیگیری در مقایسه با پیش‌آزمون شدند (0٫001>p). همچنین بین میانگین‌های گروه‌ فراشناخت‌درمانی و گروه درمان ذهن‌آگاهی برای متغیر راهبردهای مثبت تنظیم هیجان (0٫246=p) و برای متغیر راهبردهای منفی تنظیم هیجان (0٫858=p) تفاوت معنادار وجود نداشت.نتیجه‏‌گیری: براساس یافته‌های پژوهش، درمان ذهن‏آگاهی و فراشناخت‌درمانی بر بهبود راهبردهای تنظیم هیجان بیماران بهبودیافته از سوءمصرف مواد موثر هستند.

Comparing the Effects of Mindfulness-Based Group Therapy and Group Metacognitive Therapy on Emotion Regulation in Patients Recovered From Drug Use Disorders

Background & Objectives: Substance dependence is among the most serious problems in societies. The current therapies provide a comprehensive working model wherein substance use is viewed as a means of coping with emotion dysregulation. The primary goal of mindfulness is to help patients tolerate uncomfortable states, like craving, and to experience difficult emotions without automatically reacting. An approach to the etiology and treatment of numerous recently–considered mental disorders is the Wells metacognitive model or the self–regulatory executive function theory model. This approach has paid special attention to metacognition in understanding and treating mental health disorders. Studies examining metacognitions in substance abusers suggested the main reason for substance abuse to be the regulation of various cognitions and emotions. The present study aimed to compare the effects of Group Metacognitive Therapy (GMCT) and Mindfulness–based Group Therapy (MGT) on Emotion Regulation (ER) in recovered patients from Drug Use Disorders (DUDs).Methods: This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population was all patients recovered from DUDs referring to DUDs treatment centers in Varamin City, Iran, in 2019. The total number of individuals was unknown for reasons, like patient confidentiality; however, using targeted and voluntary sampling, 54 individuals who met the inclusion criteria were selected by Wilson Van Voorhis and Morgan (2007) as the minimum sample size for experimental and quasi–experimental research considering the odds of sample loss. Then, they were randomly divided into three groups by homogenization. Due to absence from the sessions and sample dropout, the total number of samples reached 39 (n=13/group). The inclusion criteria of the study were the age of >18 years; the diagnosis of DUDs based on The Diagnostic and Statistical Manual of Mental Disorders–5 (DSM–5); more than a week past detoxification, and not receiving pharmacotherapy for other biopsychological illnesses. The exclusion criteria included presenting the symptoms of psychosis and serious suicidal ideation. The research instrument was the Cognitive Emotion Regulation Questionnaire (Garnefski et al., 2001). GMCT and MGT were presented in eight 90–minute sessions in 2 months. GMCT and MGT sessions were based on Wells’s metacognitive therapy package (2009) and Williams and Kraft’s mindfulness package (2012), respectively. The obtained data were analyzed by repeated–measures Analysis of Variance (ANOVA) and Bonferroni posthoc test in SPSS at the significance level of 0.05.Results: MGT increased the mean±SD scores of positive ER strategies at posttest (3.10±0.10) and follow–up (3.17±0.21), compared to the pretest stage (2.73±0.22). GMCT improved the mean±SD scores of positive ER strategies at posttest (2.97±0.11) and follow–up (2.99±0.24), compared to the pretest stage (2.77±0.010) (p<0.001). MGT reduced the mean±SD scores of negative ER strategies at posttest (3.07±0.14) and follow–up (3.12±0.24), in comparison to the pretest stage (3.36±0.16). GMCT reduced the mean±SD scores of positive ER strategies at posttest (3.05±0.21) and follow–up (3.01±0.25), compared to the pretest stage (3.28±0.29) (p<0.001). The mean±SD scores of positive ER strategies increased at posttest (2.97±0.023) and follow–up (2.96±0.041) stages, in comparison to the pretest stage (2.75±0.028) (p<0.001). The mean±SD scores of negative ER strategies decreased at posttest (3.16±0.034) and follow–up (3.19±0.048) stages, compared to the pretest stage (3.33±0.053) (p=0.029). The Bonferroni posthoc test data revealed no significant difference between the mean values of the GMCT and the MGT groups (p=0.246); there were significant differences between the mean scores of the GMCT and the control groups (p=0.042), and the MGT and the control groups (p<0.001) concerning positive ER strategies, indicating the positive effect of GMCT and MGT on positive ER strategies. However, there was no significant difference between the mean scores of the GMCT and MGT groups (p=0.858); there were significant differences between the mean values of the GMCT and the control groups (p<0.001) as well as the MGT and the control groups (p=0.028) respecting negative ER strategies, reflecting the positive effects of GMCT and MGT on negative ER strategies.Conclusion: Based on these findings, GMCT and MGT were effective in improving ER strategies in recovered patients from DUDs.