مقایسۀ اثربخشی درمان ذهن‌آگاهی، معنادرمانی و درمان فعال‌سازی رفتاری بر کیفیت خواب دانشجویان دختر افسرده

زمینه و هدف: یکی از نشانه‌های رایج اختلال‌های روانی و هیجانی که به‌ویژه برای افسردگی و خودکشی ذکر شده‌ است، اختلال در خواب است. هدف پژوهش حاضر تعیین تفاوت اثربخشی ذهن‌آگاهی، معنادرمانی و درمان فعال‌سازی رفتاری بر کیفیت خواب دانشجویان دختر افسرده بود.روش‌بررسی: روش پژوهش از نوع نیمه‌آزمایشی با طرح پیش‌آزمون، پس‌آزمون و پیگیری با گروه گواه بود. جامعهٔ آماری پژوهش حاضر را مراجعان دانشجوی دختر مقطع کارشناسی تشکیل دادند که براساس فراخوان به مرکز مشاورهٔ امید مهر در سال 1398 مراجعه کردند. از میان آن‌ها 60 نفر به‌روش نمونه‌گیری دردسترس انتخاب شدند و با همگن‌سازی سن در چهار گروه درمان ذهن‌آگاهی، معنادرمانی، درمان فعال‌سازی رفتاری و گواه قرار گرفتند. شرکت‌کننده‌ها در مراحل پیش‌آزمون، پس‌آزمون و پیگیری به شاخص کیفیت خواب پیتزبورگ (بویسی و همکاران، 1989) و سیاهۀ افسردگی بک (بک، 1961) پاسخ دادند. گروه‌های آزمایش هشت جلسه درمان ذهن‌آگاهی، ده جلسه معنادرمانی و ده جلسه فعال‌سازی رفتاری دریافت کردند. برای تحلیل داده‌ها از روش تحلیل واریانس با اندازه‌گیری‌های مکرر و آزمون تعقیبی بونفرونی به کمک نرم‌افزار spss نسخۀ 25در سطح معناداری 0٫05 استفاده شد.یافته‌ها: نتایج نشان داد که تفاوت معنادار بین گروه‌های درمان‌ ذهن‌آگاهی، معنادرمانی و فعال‌سازی رفتاری با گروه گواه در متغیر کیفیت خواب وجود دارد (0٫001>p) و بین سه گروه درمانی تفاوت معنادار وجود ندارد. همچنین نتایج حاکی‌از تفاوت میانگین‌ها در مراحل پیش‌آزمون با پس‌آزمون (0٫001>p) و پیش‌آزمون با پیگیری (0٫001>p) برای متغیر کیفیت خواب است و نشان‌‌دهندۀ تداوم تاثیر مداخلات در مرحلۀ پیگیری است (0٫001=p).نتیجه‌گیری: براساس نتایج پژوهش، هر سه رویکرد درمان ذهن‌آگاهی، معنادرمانی و درمان فعال‌سازی رفتاری هریک با هدف قراردادن یک ‌بُعد از افسردگی بر کیفیت خواب دختران افسرده اثربخش هستند و اثر کاهنده دارند.

Comparing the Effects of Mindfulness-Based Therapy, Logo therapy, and Behavioral Activation Therapy on Sleep Quality in Depressed Female Students

Background & Objectives: Depressive disorders are chronic and debilitating conditions that affect numerous individuals worldwide. Sleep disorders are among the most frequent symptoms of mood and emotional conditions, especially depression and suicidal ideation and attempts; sleep problems have been identified as a risk factor for suicide. Depressed patients present decreased mindfulness than others; therefore, Mindfulness–Based Therapies (MBTs) can facilitate treating depressed patients and improving their symptoms. Logotherapy is used to treat depressed patients and offers the acceptance of life and the search for its meaning in the most tragic circumstances. Behavioral Activation Therapy (BAT) is a novel psychotherapy approach used by psychotherapists to treat depressive disorders. This study aimed to compare the effects of MBT, Logotherapy, and BAT on sleep quality in depressed female students.Methods: This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The statistical population of the present study included female undergraduate students who were referred to Omidmehr Counseling Center in Tehran City, Iran, in 2019. The study participants were recruited by a call. In total, 60 subjects were selected by convenience sampling method and divided into 4 age–matched groups; MBT, Logotherapy, BAT, and control (n=15/group). The inclusion criteria of the study were obtaining a score higher than the cut–off line (>5) on the Pittsburgh Sleep Quality Index (PSQI; Buysse et al., 1989) and a score of >17 on the Beck Depression Inventory (BDI; Beck et al., 1961); no chronic bio psychological illnesses, not abusing drugs and alcohol (clinical tests were conducted on very suspicious cases); not using antidepressants (medical records were reviewed), and not receiving concurrent psychological interventions (the records of suspicious cases were reviewed). The exclusion criteria of the study included absence from one–third of intervention sessions, as well as encountering a particular crisis or failure to meet the inclusion criteria of the research during th received 8 sessions of MBT per Wolf and Serpa’s intervention protocol (2015); 10 sessions of Logotherapy based on Hutzell’s intervention protocol (2002), and 10 sessions of BAT per the intervention protocol of Lejuez and associates (2011). However, the control group received no e intervention sessions. The study participants completed the PSQI and BDI at pretest, posttest, and follow–up stages. The experimental groups intervention. The obtained data were analyzed using repeated–measures Analysis of Variance (ANOVA) and Bonferroni posthoc test in SPSS at the significance level of 0.05.Results: The present study data suggested the significant effect of an intervention in the experimental group on sleep quality (p<0.001). Accordingly, at least one of the provided interventions affected the sleep quality of the explored depressed students. The effect of time was also significant on sleep quality (p<0.001). Thus, the presented intervention altered the posttest and follow–up scores of the study subjects, compared to the pretest phase. The interaction of time and group was significant for sleep quality (p<0.001). Additionally, repeated–measures ANOVA data concerning the effect of the group demonstrated a significant difference between the mean scores of the experimental and control groups (p<0.001). Bonferroni posthoc test data indicated a significant difference between MBT, Logo therapy, and BAT groups and the controls (p<0.001). There existed no significant difference between the three treatment groups in this respect (p=1.000). Bonferroni test data indicated a difference between the pretest and posttest mean scores (p<0.001) as well as pretest and follow–up values (p<0.001) for sleep quality; such findings highlighted the positive effects of the provided interventions and the continuation of such impacts until the follow–up stage (p=1.000).Conclusion: The present study results revealed that all presented approaches, including MBT, Logotherapy, and BAT, each targeting a dimension of depression, were effective on the sleep quality of depressed females and improved the relevant symptoms in them.