اثر بخشی درمان شناختی - رفتاری بر همجوشی فکری و شدت نشانه های وسواس در بیماران مبتلا به وسواس فکری – عملی

نویسندگان
هدی جعفریان
مریم نخکوب
10.22034/rph.2025.9809
چکیده
پژوهش حاضر با هدف بررسی اثربخشی درمان شناختی رفتاری بر همجوشی فکری و شدت نشانه‌های وسواس فکری عملی در بیماران مبتلا به اختلال وسواس فکری عملی انجام شد. روش پژوهش نیمه‌آزمایشی با طرح پیش‌آزمون، پس‌آزمون و پیگیری با گروه کنترل بود. جامعه آماری پژوهش شامل بیماران مبتلا به اختلال وسواس فکری عملی مراجعه‌کننده به مراکز مشاوره و کلینیک‌های روان‌شناختی شهر تهران در بازه زمانی مهر تا آذرماه ۱۴۰۴ بود. تعداد ۴۰ بیمار پس از تشخیص اختلال بر اساس مصاحبه بالینی ساختاریافته و مقیاس ییل براون، به روش نمونه‌گیری در دسترس انتخاب و به‌صورت تصادفی در دو گروه آزمایش و کنترل جایگزین شدند. گروه آزمایش تحت درمان شناختی رفتاری قرار گرفت و داده‌ها با استفاده از پرسشنامه همجوشی فکری (TAFQ) و مقیاس شدت وسواس ییل براون (Y-BOCS) در مراحل پیش‌آزمون، پس‌آزمون و پیگیری جمع‌آوری شد. تحلیل داده‌ها با استفاده از تحلیل واریانس با اندازه‌گیری مکرر انجام گرفت. نتایج نشان داد درمان شناختی رفتاری موجب کاهش معنادار همجوشی فکری و شدت نشانه‌های وسواس در گروه آزمایش نسبت به گروه کنترل شد و این اثر در مرحله پیگیری نیز حفظ گردید. بر اساس یافته‌های پژوهش، درمان شناختی رفتاری با اصلاح باورهای ناکارآمد شناختی، به‌ویژه همجوشی فکری عملی، می‌تواند به عنوان مداخله‌ای مؤثر در کاهش نشانه‌های اختلال وسواس فکری عملی مورد استفاده قرار گیرد.
کلیدواژه‌ها
درمان شناختی رفتاری
همجوشی فکری عملی
اختلال وسواس فکری عملی
شدت نشانه‌های وسواس

عنوان مقاله English

The effectiveness of cognitive-behavioral therapy on thought fusion and severity of obsessive-compulsive symptoms in patients with obsessive-compulsive disorder

نویسندگان English

hoda jafarian
maryam nakhkoob
چکیده English

The present study aimed to investigate the effectiveness of cognitive-behavioral therapy on thought fusion and the severity of obsessive-compulsive symptoms in patients with obsessive-compulsive disorder. The research method was a quasi-experimental design with a pre-test, post-test, and follow-up with a control group. The statistical population of the study included patients with obsessive-compulsive disorder referring to counseling centers and psychological clinics in Tehran between October and December 2025. After the diagnosis of the disorder based on the Structured Clinical Interview (SCID) and the Yale-Brown Scale, 40 patients were selected using a convenience sampling method and randomly assigned to two experimental groups (20 people) and control groups (20 people). The experimental group underwent cognitive-behavioral therapy, and data were collected using the Thought Fusion Questionnaire (TAFQ) and the Yale-Brown Obsessive Compulsivity Scale (Y-BOCS) at the pre-test, post-test, and follow-up stages. Data analysis was performed using repeated measures analysis of variance. The results showed that cognitive-behavioral therapy significantly reduced thought fusion and the severity of obsessive-compulsive symptoms in the experimental group compared to the control group, and this effect was maintained at the follow-up stage. Based on the findings of the study, cognitive-behavioral therapy can be used as an effective intervention in reducing the symptoms of obsessive-compulsive disorder by modifying dysfunctional cognitive beliefs, especially thought-action fusion.

کلیدواژه‌ها English

Cognitive-behavioral therapy
cognitive-action fusion
obsessive-compulsive disorder
severity of obsessive symptoms
Bowers, E. M., Levin, M. E., Ong, C. W., & Twohig, M. P. (2025). A randomized controlled trial of self-help acceptance and commitment therapy and cognitive behavioral therapy for perfectionism. Behaviour Research and Therapy, 104806.
Callaghan, T., Greene, D., Shafran, R., Lunn, J., & Egan, S. J. (2024). The relationships between perfectionism and symptoms of depression, anxiety and obsessive-compulsive disorder in adults: a systematic review and meta-analysis. Cognitive Behaviour Therapy, 53(2), 121-132.
Çetin, Ç., Eroğlu, E. Ö., Özdemir, P., & Demir, B. (2024). Are the Symptom Dimensions in Obsessive Compulsive Disorder Related to Thought-Action Fusion, Magical Thinking, and Schizotypal Personality Traits?. Archives of Neuropsychiatry, 61(3), 265.
Chen, Y., Wang, P., & Li, Z. (2025). Exploring genetic and epigenetic markers for predicting or monitoring response to cognitive-behavioral therapy in obsessive-compulsive disorder: A systematic review. Neuroscience & Biobehavioral Reviews, 106192.
Dell’Osso, L., Amatori, G., Bonelli, C., Nardi, B., Massimetti, E., Cremone, I. M., ... & Carpita, B. (2025). Autism spectrum disorder, social anxiety and obsessive–compulsive disorders: beyond the comorbidity. BMC Psychiatry, 25(1), 37.
Haddad, M., Dieckmann, L. H. J., Viola, T. W., de Araújo, M. R., da Silva, N. R., & Mari, J. D. J. (2025). The Efficacy of Fluvoxamine in Anxiety Disorders and Obsessive-Compulsive Disorder: An Overview of Systematic Reviews and Meta-Analyses. Pharmaceuticals, 18(3), 353.
Hlynsson, J. I., Bergström, J., & Carlbring, P. (2025). Seeing beyond the diagnostic and statistical manual: A function-centered review of obsessive-compulsive disorder and anxiety disorders. Journal of Obsessive-Compulsive and Related Disorders, 100967.
Hosseini, S. A., Nasri, M., & Dastgerdi, R. (2025). Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Short-Term Psychodynamic Therapy on Cognitive Fusion and Obsessive-Compulsive Symptoms in Individuals with Obsessive-Compulsive Disorder. Health, 3(1), 45-54.
Huynh, P. A., Miles, S., & Nedeljkovic, M. (2024). Perfectionism as a moderator of the relationship between orthorexia nervosa and obsessive–compulsive symptoms. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 29(1), 6.
Lee, S. W., Lee, S. J., & Choi, M. (2025). Psychological Inflexibility, Cognitive Fusion, and Thought–Action Fusion as a Transdiagnostic Construct: Direct Comparisons Among Major Depressive Disorder, Obsessive–Compulsive Disorder, and Healthy Controls. Psychiatry Investigation, 22(1), 93.
Mohammadi, G., Asgharnezhadfarid, A., Tajrishi, K. Z., Gharraee, B., & Moloodi, R. (2025). Comparative Effectiveness of Face-to-Face Cognitive-Behavioral Therapy and Combined Cognitive-Behavioral Therapy (Face-to-Face + Web-Based Application) on Maladaptive Perfectionism and Obsessive-Compulsive Symptoms. Medical Journal of the Islamic Republic of Iran, 39, 30.
Nedaei, A., Sheykholeslami, A., & Sadri, E. (2025). The Effectiveness of "Cognitive-Behavioral Therapy" on the Difficulties of Emotional Regulation, Intolerance of Uncertainty and Thought Fusion in People Suffering From Comorbid Depression and Anxiety. Journal of Health Promotion Management, 13(5), 12-29.
Schons, K. R. R., Gil, A., Fasolo, B. N. D., Barbosa, L. M., de Mattos, M. P. B., & dos Santos, V. F. L. (2025). Impact of maladaptive perfectionism on mental health and the role of cognitive behavioral therapy: a narrative review. Debates em Psiquiatria, 15, 1-13.
Shafran, R., Thordarson, D. S., & Rachman, S. (1996). Thought-action fusion in obsessive compulsive disorder. Journal of Anxiety Disorders, 10(5), 379-391.
Shemrani, S., Najafi, M., & Khosravani, V. (2025). Thought-action fusion associated with obsessive–compulsive symptomatology in OCD patients: The pathways from experiential avoidance, thought suppression, and depression. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 43(1), 19.
Sher, A., Wootton, B. M., & Paparo, J. (2024). A preliminary investigation of the mediating roles of self‐compassion and emotion dysregulation in the relationship between maladaptive perfectionism and obsessive‐compulsive behaviors. Journal of Clinical Psychology, 80(3), 591-609.
Spencer, S. D., Stiede, J. T., Wiese, A. D., Goodman, W. K., Guzick, A. G., & Storch, E. A. (2022). Cognitive-behavioral therapy for obsessive-compulsive disorder. The Psychiatric Clinics of North America, 46(1), 167.
Steele, D. W., Kanaan, G., Caputo, E. L., Freeman, J. B., Brannan, E. H., Balk, E. M., ... & Adam, G. P. (2025). Treatment of obsessive-compulsive disorder in children and youth: A meta-analysis. Pediatrics, 155(3), e2024068992.
Van Noppen, B., Sassano-Higgins, S., Appasani, R., & Sapp, F. (2021). Cognitive-behavioral therapy for obsessive-compulsive disorder: 2021 update. Focus, 19(4), 430-443.
Woolley, M. G., Schwartz, S. E., Knudsen, F. M., Lensegrav-Benson, T., Quakenbush-Roberts, B., & Twohig, M. P. (2024). Thought-shape fusion in residential eating disorder treatment: Cognitive defusion as a mediator between thought-action fusion and treatment outcome. Eating Behaviors, 54, 101909.
Wu, L., Liu, C., Huang, P., Wang, Z., Cai, M., Fang, P., & Liu, X. (2025). The component-to-trait relationship between intolerance of uncertainty and obsessive–compulsive personality traits: a network analysis. BMC Psychiatry, 25(1), 659.
Xie, L., Hu, P., Guo, Z., Chen, M., Wang, X., Du, X., & Liu, S. (2024). Immediate and long-term efficacy of transcranial direct current stimulation (tDCS) in obsessive-compulsive disorder, posttraumatic stress disorder and anxiety disorders: a systematic review and meta-analysis. Translational Psychiatry, 14(1), 343.