مقایسه اثربخشی درمان دلبستگی با درمان انگیزشی در کاهش لغزش، عود، ولع و تداوم پرهیز مصرف مواد در بیماران اختلال شخصیت مرزی وابسته به مواد

دانش و پژوهش در روان شناسی کاربردی

مقاله 9، دوره 23، شماره 2 - شماره پیاپی 88، شهریور 1401، صفحه 106-122   

نوع مقاله: مقاله پژوهشی

شناسه دیجیتال (DOI): 10.30486/jsrp.2020.1882322.2134

نویسندگان

حجت اله طهماسبیان¹؛ وحید احمدی^{* 2}؛ شهرام مامی³

¹دانشجوی دکتری روانشناسی عمومی، واحد ایلام، دانشگاه آزاد اسلامی، ایلام، ایران

²استادیار، دکتری تخصصی روانشناسی سلامت، واحد ایلام، دانشگاه آزاد اسلامی، ایلام، ایران.

³استادیار، دکتری تخصصی روانشناسی عمومی، واحد ایلام، دانشگاه آزاد اسلامی، ایلام، ایران

چکیده

هدف از انجام این پژوهش مقایسه اثربخشی درمان دلبستگی با درمان انگیزشی در کاهش لغزش، عود، ولع و تداوم پرهیز مصرف مواد در بیماران اختلال شخصیت مرزی وابسته به مواد بوده است. این پژوهش مداخله‌ای با روش نیمه‌آزمایشی طرح پیش‌آزمون- پس‌آزمون با گروه گواه و پیگیری سه ماهه انجام شد. جامعه آماری کلیه افراد وابسته به مواد دارای اختلال شخصیت مرزی مراجعه کننده به مراکز ترک اعتیاد شهر کرمانشاه که 60 نفر ازآنها به روش نمونه‌گیری در دسترس به عنوان نمونه انتخاب شدند. از پرسشنامه‌های دلبستگی بزرگسالان راس (RASS Adult Attachment, 1996)، اختلال شخصیت مرزی گشتاسبی اصل و همکاران (Gashtasbi asl et al., 2017)، مراحل آمادگی تغییر رفتار و انگیزش برای درمان پروین (Parvin, 2015)، افکار اعتیاد مک مولین (McMullen Addiction Thoughts,1990)، پرسشنامه محقق ساخته عود، ولع، لغزش و پرهیز، پروتکل درمانی مداخله انگیزش مدل فرانظری تغییر (Motivational intervention of trans-theoretical model of change) (Procheska and Clemente, 1990) و پروتکل درمان دلبستگی (Jahanbakhsh et al., 2011) استفاده شد. داده‌ها توسط آزمون تحلیل کوواریانس چندمتغیره تحلیل شد. نتایج نشان داد درمان دلبستگی و درمان انگیزشی، میزان لغزش، عود و ولع بیماران را به طور معنی داری کاهش و تداوم پرهیز را افزایش می‌دهند (05/0P<). درمان دلبستگی و درمان انگیزشی بر میزان لغزش، عود، ولع و تداوم پرهیز بیماران در آزمون پیگیری ماندگاری داشته است (05/0P<). میزان تغییرات نمرات ‌لغزش، عود، ولع و پرهیز افرادی که درمان دلبستگی را دریافت کرده‌اند بیشتر از افرادی که تحت درمان انگیزشی قرار گرفته‌اند، بوده است (05/0P<). درمان دلبستگی در مقایسه با درمان انگیزشی بر کاهش لغزش، عود، ولع و تداوم پرهیز مصرف مواد در بیماران تاثیر بیشتری دارد (05/0P<). نتایج نشان داد هر دو روش مداخله در بهبود مصرف افراد دارای اختلال شخصیت مرزی تأثیرگذار بودند.  با این حال تأثیر درمان مبتنی بر درمان اعتیاد در افراد دارای اختلال شخصیت مرزی به شیوه درمان مبتنی بر دلبستگی موثرتر از درمان انگیزشی می‌باشد.

کلیدواژه‌ها

درمان دلبستگی؛ درمان انگیزشی؛ لغزش و عود؛ و ولع وتداوم پرهیز؛ اختلال شخصیت مرزی؛ افراد وابسته به مواد

مراجع

Akbari, Z. (2019). The effectiveness of cognitive-behavioral group therapy on self-control of drug abusers referred to addiction treatment centers (camps) in Tehran. Cognitive Psychology and Psychiatry, 6, 2, 74-85. (In Persian)

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM 5). Translation: Farzin Rezaei; Ali Fakhraei; Atosa Farmand; Ali Niloufari; Janet Hashemi Azar, F. (2014), Tehran: Arjmand Publications.

Bahadori, K. J., Hashemi, N. T., & Beyrami, M. (2010). The relationship between attachment styles and resilience with substance use tendencies. Journal of Addiction Research, 9 (47), 33-25. (In Persian)

Ball, S. A. (2004). Personality traits, disorders, and substanceabuse. In R. M. Stelmack (ED.) On the psychobiology ofpersonality: Essays in honor of Marvin Zuckerman. New York: pergamon.

Bernard, K., Meade, E.B., & Dozier M. (2013). Parental synchrony and nurturance as targets in an attachment based intervention: building upon Mary Ainsworth’s insights about mother–infant interaction. Attachment & Human Development,15(5–6):507–523.

Brisch, K. H. (2002). Treating attachment disorders: From theory to therapy. translator, Guildford Publications. Can Child Adolesc Psychiatr Rev, 58- 117.

Collins & Read (1990). Adult Attachment Scale, retrieved from: www.gse.uci.edu/childcare.

Daniel, F. (2007). The psychometric properties of a French version of the Socrates in different groups of patients presenting different substance- abusers. Addiction Research and Theory, 15(2), 153-160.

Davidson, S., & Ireland, C. A. (2009). Substance misuse: the relationship between attachment styles, personality traits and coping in drug and non-drug users. Drugs and Alcohol Today, 9(3), 22-27.

Doran, N., McChargue, D., & Cohen, L. (2007). Impulsivity and the reinforcing value of cigarette smoking. Faculty Publications, Department of Psychology, 283.

Ebrahimi, A. A., & Yarmohammadian, A. (2013). Motivational interview: Principles and strategies for changing addictive behaviors. First Edition, Isfahan: Kankash Publications. (In Persian)

Ewing, E.S., Diamond, G., & Levy, S. (2015). Attachment-based family therapy for depressed and suicidal adolescents; theory, clinical model and empirical support. Attachment & Human Development, 17(2): 136-156.

Esalati, P., Arab, A., & MehdiNejad, V. (2019). The effectiveness of Frankel semantic therapy on health (reducing addiction readiness and increasing bio-psychological) of female students with depression. Health Education and Health Promotion of Iran, 7 (1): 84-92. (In Persian)

Gashtasbi, A. S., Fatehi, M., & Mozarminia, R. (2017). Construction and evaluation of psychometric properties of borderline personality disorder questionnaire. The Fourth World Conference and the First National Conference on Modern Research in Iran and the World in Psychology and Educational Sciences. Law and Social Sciences, Shiraz University. (In Persian)

Geraham, P. L., & Avadis, J. H. (2001). Diagnosis and treatment of adult psychiatric disorders in clinical psychology. Translation: Mohammad Reza Nikkho. Publications: Speech.

Ghorbani, M. (2002). Investigating the application of motivational interviewing in the treatment of Iranian addicts. Journal of Drug Abuse, 1, 1. (In Persian)

Guttman, S., & Crowell, J. (2006). Attachment and Externalizing disorders: A developmental psychopathology perspective. Journal of the American Academy of Child & Adolescent Psychiatry, 45(4): 440-451.

Haghshenas, M., Gholamali, L. M., & Fathabadi, J. (2017). Comparison of Behavioral Activation / Inhibition System and Nature Characteristics in Substance Dependents and Non-Dependents. Journal of Addiction Research Quarterly, 11(41): 154- 155. (In Persian)

HajiHassani, M., & Hashemi, F (2017). Addiction tendency: The role of attachment styles. Chaharmahal and Bakhtiari Disciplinary Encyclopedia, 20, 38-25. (In Persian)

Hamidi, F. (2008). The Relationship between attachment styles and marital satisfaction in married students of dabiri. Family Research Quarterly, 9. (In Persian)

Hashemi, T., Ranjbar, A., & Machinchi, A. N. (2015). Symptoms of borderline personality and tendency to substance abuse. Congress of the Iranian Psychological Association, 566. (In Persian)

Hatami, V. A. (2010). The mediating role of attachment style in the relationship between parenting style and marital commitment in married students of Allameh Tabatabaei University. Master Thesis in Family Counseling, Allameh Tabatabaei University. (In Persian)

Heidari, A., Mohammadi, R., & Bahmani, M. (2018). The effectiveness of motivational interview on reducing cravings and relapse in patients using methadone-treated substances. Journal of Addiction Research, 11, 43, 89-104. (In Persian)

Jahanbakhsh, M., Amiri, F., Bahadori, M., Rumi, H., & Jamshidi, A. (2011). The effectiveness of attachment-based therapy on depressive symptoms in girls with attachment problems. Behavioral Science Research, 9 (4): 250- 259. (In Persian)

Jazayeri, A., & Dehghani, M. (2004). Investigating the relationship between attachment styles, addiction and psychological profile of addicted people in comparison with non-addicted people (in self-reported centers of Bushehr province). Journal of Addiction Research, 2(6): 55-66. (In Persian)

Kassel, J.D., Wardle, M., & Roberts, J.E. (2007). Adult attachment security and college student substance use. Addictive Behaviors, 32(6): 1164-76.

Makri, A., Ekhtiari, H., Edalati, H., & Ganjgahi, H. (2008). The relationship between craving and diverse aspects of addiction severity among heroin injection addicts. Iranian Psychiatric and Clinical Psychological Journal, 14 (3): 298-306. (In Persian)

Mashhadi, A., Soltani Shurbakhorloo, E., & Razmjooei, R. (2010). On the relationship between emotional intelligence and symptoms of borderline personality disorder. Journal of  fundamentals of mental Heallth, 12: 390-9. (In Persian)

McMullin, R. E., & Gehlaar, M. (1990). Thinking and drinking: An expose of drinkers disorted beliefs. Wheelers Hill, Victoria, Australia: Marlin Publications.

Mikulincer, M., & Shaver, R. (2003). The attachment behavioral system in adulthood: activation, psychodynamics, and interpersonal processes. Adv Exp Soc Psychol, 35: 53-152.

Miller, W.R., & Rollnick, S. (1991).  Motivational Interviwing. The Guilford Press.

Mirkarimi, S. K., Honarvar, M. R., Aryaei, M., BardiArzani, R., & Kamran, A. (2015). The effect of motivational interviewing method on adherence to treatment in people with hypertension. Knowledge Horizon Quarterly, 21 (3): 213-220. (In Persian)

Mohammad Alizadeh Namini, A., Ismailzadeh Akhundi, M., & Safar Mohammadloo, N. (2018). Evaluation of the effectiveness of motivational interviewing and medication in Mani on substance craving in comparison with medication. Journal of Cognitive Psychology and Psychiatry. 4, 2: 1-11. (In Persian)

Namazpour, J., Radfer, M., Qavami, H., & Sheikhi, N. (2017). Evaluation of the effectiveness of the follow-up care model on slippage and cravings of patients treated with methadone maintenance. Journal of Urmia School of Nursing and Midwifery, 15:2 (91): 127-138. (In Persian)

Parvin, M. (2015). Determining the psychometric properties of the Behavior Change Scale and Motivation Scale for treatment in substance abusers referred to medical centers in Kermanshah. Master Thesis in Clinical Psychology. (In Persian)

Parvizifard, A. (2012). Impact psycho educational group intervention using C.B.T on Iranian male drug addicts a rehabilatiom center, PHD thesis. University Putramalas.

Paulk, A., & Zayac, R. (2013). Attachment style as a predictor of risky sexu al behavior in adolescents. Journal of Social Sciences, 9(2): 42-47. (In Persian)

Pirnia, B., Rezaei, M., Mansour, S., Suleimani, A. A., Pirkhaefi, A., & Suleimani, A. (2016). Addiction and psychological consequences, the relationship between anxiety and induced craving index in people treated with methadone maintenance with and without anxiety symptoms, a cross-sectional study. Cognitive Psychology and Psychiatry, 3 (2): 33-43. (In Persian)

Rastgar, F. L., & Mohammadian, A. (2018). The mediating role of attachment styles in the relationship between personality traits and remembrance. Quarterly Journal of Neuroscience (Khatam Healing), 7, 2: 44-55. (In Persian)

Roger, K., Kristyn, Z., Joanna, H., & E. Stephanie, K. E. (2016). Attachment Based Treatments for Adolescents: The Secure Cycle as a Framework for Assessment, Treatment and Evaluation. Attachment Human Development, 17(2): 220–239.

Tajeri, B., Ahadi, H., & Jamhari, F. (2013). The effect of cognitive-behavioral therapy on abstinence, temptation, recurrence and change in glass addicts' attitudes. Journal of Clinical Psychology Studies, 7, 2: 1-29. (In Persian)

Timothy, J., Trull, L. K., Freeman, T. J., Vebares, A. M., Choate, A. C. H., & Andrea, M. W.  (2018). Borderline personality disorder and substance use disorders: an updated review. Borderline Personality Disorder and Emotion Dysregulation,5: 15.

Tomko, R.L., Trull, T.J., Wood, P.K., & Sher, K.J. (2014). Characteristics of borderline personality disorder in a community sample: comorbidity, treatment utilization, and general functioning. Journal of personality Disord, 28(5):734–750.

Trinidad, D.R., & Johnson, C.A. (2002). The association between emotional intelligence and early adolescent tobacco and alcohol use. Personality and Individual Differences, 32(1):95-105.

Trull, T.J., Jahng, S., Tomko, R.L., Wood, P.K., & Sher, K.J. (2010). Revised NESARC personality disorder diagnoses: gender, prevalence, and comorbidity with substance dependence disorders. Journal of personality Disorder, 24(4):412–426.