اثربخشی درمان پذیرش و تعهد بر ناگویی هیجانی بیماران مبتلا به مالتیپل‌اسکلروزیس

زمینه و هدف: مالتیپل‌اسکلروزیس، بیماری خودایمنی و از بیماری‌های شایع‌تر نورولوژیک انسان است که ازجمله عوامل آسیب‌شناسی آن می‌توان به ناگویی هیجانی اشاره کرد. پژوهش حاضر با هدف بررسی اثربخشی درمان پذیرش و تعهد بر ناگویی هیجانی در مبتلایان به مالتیپل‌اسکلروزیس انجام شد.روش‌بررسی: این پژوهش به‌شیوهٔ نیمه‌آزمایشی از نوع پیش‌آزمون-پس‌آزمون با گروه گواه و دورهٔ پیگیری دوماهه بود. جامعهٔ آماری پژوهش تمامی زنان انجمن ام‌اس استان البرز مراجعه‌کننده طی بهار سال 1396 بودند. در این پژوهش بیست بیمار مبتلا به مالتیپل‌اسکلروزیس باتوجه به ملاک‌های پژوهش به‌صورت دردسترس انتخاب شده و سپس به‌صورت تصادفی در دو گروه آزمایش و گواه گمارده شدند. جهت ارزیابی متغیر ناگویی هیجانی، آزمون ناگویی هیجانی تورنتو-20 (1994) به‌کار رفت. ده جلسه درمان پذیرش و تعهد به‌مدت دو ساعت برای گروه آزمایش اجرا شد. در نهایت داده‌ها با روش آزمون آماری تحلیل واریانس با اندازه‌گیری مکرر و آزمون تعقیبی بنفرونی با استفاده از نرم‌افزار آماری spss نسخهٔ 16 و در سطح معناداری 0٫05 تجزیه‌وتحلیل شد.یافته‌ها: نتایج نشان داد که اثر زمان (0٫001>p) و اثر گروه (0٫001=p) و اثر متقابل زمان و گروه (0٫001>p) درمان پذیرش و تعهد بر کاهش ناگویی هیجانی معنادار بوده و در دورهٔ پیگیری نیز پایدار باقی مانده است.نتیجه‌گیری: باتوجه به یافته‌های این پژوهش، با استفاده از درمان پذیرش و تعهد می‌توان به کاهش ناگویی هیجانی و نیز بهبود شناسایی هیجانات و توصیف هیجانات و توجه به فرایندهای درونی به‌جای سبک تفکر برون‌مدار، کمک کرد.

Effects of Acceptance and Commitment Therapy on Alexithymia in Patients with Multiple Sclerosis

Background & Objectives: Multiple Sclerosis (MS), as an autoimmune condition, is among the most prevalent neurological diseases in human. From the monolithic perspective of body, the abnormal immune responses in patients with MS might be accompanied by abnormal responses in the psychological level; in other words, they might have a personality trait at the psychological level involved with this condition. In this regard, a factor which might affect the deficits of immune system is alexithymia. The current study aimed to investigate the effects of Acceptance and Commitment Therapy (ACT) on alexithymia in patients with MS.Methods: This was a quasi-experimental study with a pretest-posttest and two-month follow-up as well as a control group design. All patients with MS who attended to Alborz MS Society in April and May 2017 comprised the statistical population of this research. In total, 20 patients with MS were selected according to the study inclusion criteria via convenience sampling method. Then, they were randomly assigned into the experimental and control groups. Torento-20 (1994) Inventory was used for assessing alexithymia in the study participants. After determining the appointments, 10 two-hour sessions of ACT were performed for the experimental group. After the completion of the sessions, the questionnaire was completed again by both study groups. Finally, after two months, the follow-up phase was conducted in which the experimental and control groups re-completed the questionnaire. All obtained data were analyzed in SPSS by descriptive statistics of mean and standard deviation, as well as inferential statistics using Kolmogorov-Smirnov test to examine the assumption of normality of data; Levene’s test to examine the assumption of equality of variances; repeated-measures Analysis of Variance (ANOVA), and Bonferroni follow-up test. The significance level was set at 0.05.Results: The current study findings suggested that ACT significantly decreased alexithymia; this impact sustained until follow-up phase. Moreover, the effect of time was significant (η=0.510, p<0.001, F=18.75); accordingly, alexithymia significantly differed in three measurement stages. Additionally, the effect of group was significant which indicates that alexithymia influence was different between the test and control groups (η=0.440, p=0.001, F=14.52(. In addition to the two main effects of time and group, the interaction effect between time and group was also significant (η=0.531, p<0.001, F=20.36). Significant interaction between time and group highlights that the time variable interacted with the groups effect (test and control) and varied at different levels. Besides, following the significant difference between the values of pretest, posttest, and follow-up stages, Bonferroni post-hoc test was conducted to compare the mean values of the two stages to determine which difference between the two stages was statistically significant. There was also a significant difference between the mean scores of alexithymia in the pretest and posttest and follow-up stages.Conclusion: The obtained data revealed that ACT effectively decreased alexithymia in the investigated patients with MS. As a result, this method could be implemented as an effective measure in healthcare centers. Clinical advisers, therapists, and psychologists could implement ACT to improve cognitive-emotional management and reduce alexithymia in patients with MS.