اثربخشی روان‌پویشی کوتاه مدت بر سازمان شخصیت در افراد مبتلا به اختلال شخصیت مرزی

زمینه و هدف: پژوهش حاضر با هدف تعیین اثربخشی درمان پویشی فشرده و کوتاه‌مدت بر سازمان شخصیت در افراد مبتلا به اختلال شخصیت مرزی انجام شد. روش کار: این مطالعه به روش نیمه تجربی با طرح پیش‌آزمون، پس‌آزمون و پیگیری دو‌ماهه با گروه کنترل بود. جامعه مورد نظر تمامی بیماران مبتلا به شخصیت مرزی مراجعه کننده به کلینیک تخصصی روان شناختی شهر تهران در سال 1402 بود. حجم نمونه مورد بررسی با مراجعه به جدول cohen تعیین شد. به این طریق که در سطح اطمینان 95 درصد، اندازه اثر 0.30 و توان آماری 0.83، برای هر گروه 12 نفر تعیین شد. اما از آن جایی که احتمال ریزش برخی نمونه ها وجود داشت و هم چنین در جهت تعمیم‌پذیری بیشتر نتایج، حجم نمونه در هر گروه 15 نفر تعیین شد. در مرحله اول به شیوه نمونه گیری در دسترس 30 نفر انتخاب و این 30 نفر در گام دوم به صورت تصادفی ساده (به شیوه قرعه کشی) در یک گروه آزمایش (15 نفر) و یک گروه کنترل (15 نفر) جایگزین شدند. یافته‌ها: میانگین و انحراف معیار سنی گروه آزمایش و کنترل به ترتیب 3.92 ± 43.40 و 4.49 ± 44.07 سال بود. نتایج آزمون t دو نمونه مستقل در مورد سن و آزمون دقیق فیشر در خصوص جنسیت، سطح تحصیلات و وضعیت تاهل نشان داد که بین گروه آزمایش و کنترل تفاوت آماری معنی داری وجود ندارد. میانگین نمره سازمان شخصیت قبل از مداخله به ترتیب در گروه درمان 72.25 و در گروه کنترل 72.12 ، اما پس از مداخله، میانگین نمره سازمان شخصیت در گروه درمان به صورت معنی داری نسبت به گروه کنترل افزایش نشان داد. نتیجه‌گیری: نتایج مطالعه حاضر بیانگر آن بود که استفاده از درمان پویشی فشرده و کوتاه‌مدت بر روان پویشی فشرده و کوتاه مدت بر بیماران مبتلا به شخصیت مرزی موثر است. بر این اساس توصیه می شود از درمان روان پویشی فشرده و کوتاه مدت بر بهبود سازمان در افراد مبتلا به شخصیت مرزی استفاده شود.

the effectiveness of short-term psychodynamics on personality organization in people with borderline personality disorder

background & aims: personality traits are an organized and composed set of almost fixed and stable characteristics that distinguish one person from another. a dimensional model of personality that examines deep and fundamental mechanisms within the psyche. borderline personality is one of the complex problems related to mental health. it is of particular importance compared to other personality disorders and the diagnosis of this disorder is one of the most challenging personality disorders. this disorder is known as a pervasive pattern of interpersonal relationships, self-image, emotions, and marked impulsivity, which begins in early adulthood and manifests itself in many fields, and intensive and short-term dynamic therapy can play an effective role in improving mental symptoms. therefore, the present study was conducted with the aim of determining the effectiveness of intensive and short-term behavioral therapy on personality organization in people with borderline personality disorder.methods: this study was a semi-experimental method with a pre-test, post-test and two-month follow-up plan with a control group. the target population was all patients with borderline personality who referred to the specialized psychological clinic in tehran in 1402. the sample size was determined by referring to cohen's table. in this way, at the confidence level of 95%, the effect size was 0.30 and the statistical power was 0.83 for each group of 12 people. however, since there was a possibility of some samples falling and also in order to generalize the results more, the sample size was determined to be 15 people in each group. in the first step, 30 people were selected by available sampling method, and in the second step, these 30 people were replaced by simple random (by lottery) in an experimental group (15 people) and a control group (15 people). the criteria for entering the study include: full consent to participate in treatment sessions, not having any other disease other than borderline personality (by asking the people participating in the research), education at least at the middle school level and above (in order to understand dynamic therapy), not using neuropsychiatric drugs (such as fluoxetine and sertraline), lack of receiving psychological services (such as treatment for depression or anxiety) in the past three months, and lack of history of receiving short-term and intensive dynamic therapy training. the exclusion criteria included absence of more than two sessions, suffering from mental illnesses including depression, simultaneous participation in other psychological training workshops, and refusal to continue cooperation. informed consent, justification of the participants regarding the method and purpose of the research, compliance with the principle of secrecy and confidentiality of the obtained information, the freedom of the participants to leave the study were among the ethical principles observed in this study. to collect data in addition to the demographic information form (including: age, gender, education level and marital status) from the self-report questionnaires of the personality organization in 3 stages: pre-test (before training), post-test (after training) and follow-up (2 months after completing the training) was used. sampling was done in february 1400 and the intervention started from farrudin 1401 and continued until the end of june and the follow-up period was also done until the end of september. the interventions were carried out individually by a trained clinical psychologist on sundays and tuesdays at 17:00-20:00 in the co-creating change psychological clinic (researchers' work clinic). the participants in the research did not drop out and the trainings were provided free of charge. it should be noted that these people were informed that they can withdraw from this study and receive psychological services at any time. after the end of the study, the subjects of the control group received free psychological services by a clinical psychologist.results: the mean and standard deviation of the age of the experimental and control groups were 43.40 ± 3.92 and 44.07 ± 4.49 years, respectively (p=0.669). two-way analysis of variance with repeated measurements was used to analyze the data and examine the hypotheses of personality organization. before conducting two-way analysis of variance with repeated measurements, its assumptions were examined. the results of the kolmogorov-smirnov test showed that the data distribution values are normal at the 95% confidence level (p<0.05). the results of levene's test were more than 0.05 and the assumption of homogeneity of the variances of the two groups was fulfilled. mauchly's assumption of sphericity showed that the assumption of sphericity was valid in the data for personality organization (p=0.358, χ=3.56). therefore, the assumed sphericity test was used. to evaluate the equality of covariance matrices, box's m test was used, according to the results, it was valid for personality organization variable (box's m=4.179, f=3.260, p=0.508).the results of the t-test of two independent samples regarding age and fisher's exact test regarding gender, education level and marital status showed that there is no statistically significant difference between the experimental and control groups (p<0.05). the average score of personality organization before the intervention, respectively, in the treatment group 25.72 and in the control group 12.72 (p<0.05), but after the intervention, the average score of personality organization in the treatment group increased significantly compared to the control group (p < 0.01).conclusion: the results of the present study indicated that the use of intensive and short-term dynamic therapy is more effective than intensive and short-term psychodynamic therapy on patients with borderline personality. based on this, it is recommended to use intensive and short-term psychodynamic therapy to improve organization in people with borderline personality.