اثربخشی رفتاردرمانی دیالکتیک کوتاه مدت گروهی بر کیفیت زندگی دختران نوجوان با علایم اختلال شخصیت مرزی

نویسندگان
شاهرخ مکوند حسینی
فاطمه آذرفر
پرویز صباحی
دانشگاه سمنان
10.52547/rph.13.2.100
چکیده
هدف پژوهش حاضر بررسی اثر بخشی اجرای گروهی فنون رفتار درمانی دیالکتیکی به صورت کوتاه مدت بر کیفیت زندگی نوجوانان دختر دارای علایم اختلال شخصیت مرزی بود. در یک طرح نیمه آزمایشی پس از غربالگری ، از میان افراد حائز شرایط و54 نفرحاضر به شرکت در پژوهش شدند که بر اساس سطح نمره به روش تصادفی ساده به دو گروه مساوی تقسیم شدند، گروه آزمایش رفتار درمانی دیالکتیکی را به شیوه گروهی فشرده( طی 12 جلسه دو ساعته ، هفته ای 3 بار) دریافت کردند، در حالیکه گروه کنترل درمانی دریافت نداشتند. شرکت کنندگان مقیاس کیفیت زندگی را در سه مرحله پیش آزمون، پس آزمون و پی گیری تکمیل کردند. داده های بدست با آزمون تحلیل واریانس چند متغیری تحلیل شد. نتایج تفاوت های معناداری را میان دو گروه در پس آزمون برای میانگین مولفه های: 1- عملکرد جسمی(0.003) 2- محدودیت نقش/هیجانی(0.042)3- انرژ ی/ خستگی(0.001)4- بهزیستی هیجانی(0.001)5- عملکرد اجتماعی(0.003) 6- درد(0.001) 7- سلامت عمومی(0.001) و نیز نمره کل کیفیت زندگی(0.003) نشان داد. در پیگیری 4 ماهه نیز این نتایج در مولفه های عملکرد جسمی(0.013)، عملکرد اجتماعی(0.030)، شاخص کل کیفیت(0.049) زندگی پایدار بودند.
کلیدواژه‌ها
کیفیت زندگی
رفتار درمانی دیالکتیک
اختلال شخصیت مرزی
دختران نوجوان
خانواده

عنوان مقاله English

Effectiveness of a Short-term Group Dialectic Behavior Therapy on Quality of Lif of Girl Adolescents with Borderline Personality Disorder Symptoms

نویسندگان English

Shahrokh Makvand Hosseini
Fatemeh Azarfar
Parviz Sabahi
Semnan University
چکیده English

The purpose of this study was to evaluate the effectiveness of short-term dialectical behavior therapy (DBT) techniques on quality of life in adolescent girls with symptoms of borderline personality disorder. In a semi-experimental design ,after screening, among the eligible individuals and 54 applicants were randomly divided into two equal groups according to the score level, Experimental group received dialectical behavior therapy in intensive group method (12 sessions twice a day, 3 times a week), while control group did not receive treatment. Participants completed the Quality of Life Scale (SF-36) in three stages of pre-test, post-test and follow-up. Data were analyzed using Multivariate Analysis of Variance (MANCOVA). The results showed significant differences between the two groups in the post-test for the mean components:

1- Physical Function (0.003) 2- Role / Emotional Restriction (0.042) 3- Energy / Fatigue (0.001) 4- Emotional Well-being (0.001) 5- Social Function (0.003) 6- Pain (0.0010) 7- General Health (0.001) as well as total quality of life score (0.003).At 4-month follow-up, the results were also consistent in the components of physical performance (0.013), social performance (0.030), total quality of life (0.049).

1. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub; 2013.
2. Winsper C, Lereya S, Marwaha S, Thompson A, Eyden J, Singh S. The aetiological and psychopathological validity of borderline personality disorder in childhood and adolescence: a systematic review and meta-analysis. Eur. Psychiatry. 2015;30:1188.
3. Harned MS, Valenstein HR. Treatment of borderline personality disorder and co-occurring anxiety disorders. F1000 Fac Rev. 2013;5.
4. Shen C-C, Hu L-Y, Hu Y-H. Comorbidity study of borderline personality disorder: applying association rule mining to the Taiwan national health insurance research database. BMC Med Inform Decis Mak. 2017;17(1):8.
5. Shaikh U, Qamar I, Jafry F, Hassan M, Shagufta S, Odhejo YI, et al. Patients with borderline personality disorder in emergency departments. Front psychiatry. 2017;8:136.
6. Lotfi MR, Ahi Q, Safaii I. The Role of Borderline Personality Traits and Rejection Sensitivity in Prediction of Membership in Social Networks J Health Psychol. 2018; 11(4): 28-39.
7. Gunderson JG, Hoffman PD. Understanding and treating borderline personality disorder: A guide for professionals and families. American Psychiatric Pub; 2007.
8. Boucher MÈ, Pugliese J, Allard‐Chapais C, Lecours S, Ahoundova L, Chouinard R, et al. Parent–child relationship associated with the development of borderline personality disorder: a systematic review. Personal. Ment. Health. 2017;11(4):229-55.
9. Vanwoerden S, Kalpakci A, Sharp C. The relations between inadequate parent-child boundaries and borderline personality disorder in adolescence. Psychiatr. Res. 2017;257:462-71.
10. Koster N, de Maat DA, Schreur M, van Aken MA. How borderline personality characteristics affect adolescents’ life satisfaction: The role of rejection sensitivity and social relations. Eur J Dev Psychol. 2018;15(5):594-607.
11. Imani M, Pourshahbazi M. Prediction of Borderline Personality Disorder Based On Psychological Flexibility Components: Acceptance and Action, Values and Cognitive Defusion. Research in Psychological Health. 2017.10(4): 1-9.
12. Stoffers‐Winterling JM, Völlm BA, Rücker G, Timmer A, Huband N, Lieb K. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst. Rev. 2012(8).
13. Paris J. Effectiveness of different psychotherapy approaches in the treatment of borderline personality disorder. Curr. Psychiatry Rep. 2010; 12(1), 56-60.
14. Linehan MM, Comtois KA, Murray AM, Brown MZ, Gallop RJ, Heard HL, et al. Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch. Gen. Psychiatry. 2006;63(7):757-66.
15. MacPherson HA, Cheavens JS, Fristad MA. Dialectical behavior therapy for adolescents: Theory, treatment adaptations, and empirical outcomes. Clin. Child Fam. Psychol. Rev. 2013;16(1):59-80.
16. Kaess M, Fischer-Waldschmidt G, Resch F, Koenig J. Health related quality of life and psychopathological distress in risk taking and self-harming adolescents with full-syndrome, subthreshold and without borderline personality disorder: rethinking the clinical cut-off? Borderline personality disorder and emotion dysregulation. 2017;4(1):7.
17. Zanarini MC, Frankenburg FR, Khera GS, Bleichmar J. Treatment histories of borderline inpatients. Compr Psychiatry. 2001;42(2):144-50.
18. Biskin RS. The lifetime course of borderline personality disorder. Can J Psychiatry. 2015;60(7):303-8.
19. Biskin RS. Treatment of borderline personality disorder in youth. J. Can. acad. child adolesc. psychiatry. 2013;22(3):230.
20. Hunt SM, McKenna SP. Measuring quality of life in psychiatry. Quality of life assessment: Key issues in the 1990s: Springer; 1993. p. 343-54.
21. Soeteman DI, Verheul R, Busschbach JJ. The burden of disease in personality disorders: diagnosis-specific quality of life. personality disorders. 2008;22(3):259-68.
22. Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes: Oxford university press; 2015.
23. Ellwood C. Predictors of quality of life in the systems training for emotional predictability and problem-solving (STEPPS) programme for clients with borderline personality disorder: University of Surrey; 2017.
24. IsHak WW, Elbau I, Ismail A, Delaloye S, Ha K, Bolotaulo NI, et al. Quality of life in borderline personality disorder. Harvard rev psychiat. 2013;21(3):138-50.
25. Oostendorp J, Chakhssi F. Klinische dialectische gedragstherapie bij borderlinepersoonlijkheidsstoornis: effect op klachten, coping, hechting en kwaliteit van leven. Tijdschr Psychiatr. 2017;59(12):750-8.
26. Hagen S, Woods-Giscombe CL, Chung J, Beeber LS. Potential Benefits of Dialectical Behavioral Therapy for Adolescents Receiving Treatment for Borderline Personality Disorder Traits: Implications for Psychiatric Nurses. Nursing and Health. 2014;2(5):89-99.
27. Katsakou C, Marougka S, Barnicot K, Savill M, White H, Lockwood K, et al. Recovery in borderline personality disorder (BPD): a qualitative study of service users' perspectives. PloS one. 2012;7(5).
28. Linehan M, Dimeff L, Koerner K, Miga E. Research on dialectical behavior therapy: Summary of the data to date. Seattle, WA: Linehan Institute, http://www behavioraltech org. 2014.
29. McFetridge M, Coakes J. The longer-term clinical outcomes of a DBT-informed residential therapeutic community; An evaluation and reunion. therapeutic communities. 2010;31(4):406.
30. Montazeri A, Goshtasb A, Vhdany M. Reliability and validity of such set Farsi questionnaire SF-36. Payesh J. 2005;5(1):49-56.
31. Carter GL, Willcox CH, Lewin TJ, Conrad AM, Bendit N. Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Aust N Z J Psychiatry. 2010;44(2):162-73.
32. Sajadi SF, Riyahi H, Sahraeeyan Z, Sadeghi R, Tajikzadeh F, Mahmoudi T, et al. A Comparative Study of the Prevalence and Intensity of Borderline Personality Features in Male and Female High School Students in Fars Province. Int J School Health. 2015;2(2):e25625.
33. Sharifi V, Asadi SM, Mohammadi MR, Amini H, Kaviani H, Semnani Y, et al. Reliability and feasibility of the Persian version of the structured diagnostic interview for DSM-IV (SCID). Advances in cognitive science. 2004;6(1):10-22.
34. Swales M, Hibbs RA, Bryning L & HastingsRP. Health related quality of life for young people receiving dialectical behaviour therapy (DBT): a routine outcome-monitoring pilot. SpringerPlus. 2016; 5(1), 1137.‌
35. Comtois KA, Kerbrat AH, Atkins DC, Harned MS, Elwood L. Recovery from disability for individuals with borderline personality disorder: a feasibility trial of DBT-ACES. Psychiatr Serv. 2010;61(11):1106-11.
36. Perseius KI, Andersson E, Åsberg M, Samuelsson M. Health‐related quality of life in women patients with borderline personality disorder. Scandinavian. J. Caring Sci. 2006;20(3):302-7.
37. Miller NE, Magruder KM. Cost-effectiveness of psychotherapy: A guide for practitioners, researchers, and policymakers: Oxford University Press; 1999.
38. Adler DA, Bungay, K. M., Cynn, D. J., & Kosinski, M. Patient-based health status assessments in an outpatient psychiatry setting. Psychiatr Serv. 2000;51(3):341-8.
39. Priebe S, Bhatti, N., Barnicot, K., Bremner, S., Gaglia, A., Katsakou, C., ... & Zinkler, M. (2012). . Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: a pragmatic randomised controlled trial. Psychother Psychosom. 2012;81(6):356-65.
40. Shafran R, Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., ... & Salkovskis, P. M. Mind the gap: Improving the dissemination of CBT. Behav Cogn Psychother. 2009;47(11):902-9.
41. Cramer V, Torgersen, S., & Kringlen, E. . Personality disorders and quality of life. A population study. Compr Psychiatry. 2006;47(3):178-84.
پژوهش در سلامت روانشناختی
دوره 13، شماره 2 - شماره پیاپی 38
تابستان 1398
صفحه 100-114