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
چکیده
این پژوهش با هدف تعیین اثربخشی درمان شناختی - رفتاری بر همجوشی فکری و شدت نشانه‌های وسواس در بیماران مبتلا به اختلال وسواس فکری‌عملی در شهر تهران انجام شد. روش پژوهش حاضر نیمه‌آزمایشی با طرح پیش‌آزمون-پس‌آزمون با گروه کنترل بود. جامعه آماری شامل کلیه زنان مبتلا به وسواس فکری‌عملی بود که در بازه زمانی فروردین تا خرداد ماه 1404 به کلینیک های شهر تهران که از میان آن‌ها نمونه‌ای به روش نمونه‌گیری در دسترس انتخاب و به‌صورت تصادفی در دو گروه آزمایش و کنترل جایگزین شدند. ابزارهای اندازه‌گیری شامل پرسشنامه همجوشی فکری و مقیاس وسواس فکری‌عملی ییل-بران بود. گروه آزمایش تحت جلسات درمان شناختی - رفتاری قرار گرفت، در حالی که گروه کنترل هیچ مداخله‌ای دریافت نکرد. داده‌ها با استفاده از تحلیل کوواریانس تجزیه و تحلیل شدند.نتایج نشان داد که پس از اعمال مداخله، تفاوت معناداری بین گروه‌های آزمایش و کنترل در متغیرهای همجوشی فکری و شدت نشانه‌های وسواس وجود دارد. درمان شناختی - رفتاری به‌طور معناداری منجر به کاهش میزان همجوشی فکری و کاهش شدت علایم وسواس در بیماران گروه آزمایش در مقایسه با گروه کنترل شد. بر اساس یافته‌های پژوهش، درمان شناختی - رفتاری با اصلاح تحریف‌های شناختی و کاهش آمیختگی فکر و عمل، رویکردی کارآمد در بهبود نشانه‌های بالینی بیماران مبتلا به وسواس فکری‌عملی محسوب می‌شود و استفاده از این پروتکل درمانی در مراکز بازتوانی و کلینیک‌های روان‌شناختی توصیه می‌گردد.
کلیدواژه‌ها
درمان شناختی - رفتاری
همجوشی فکری
شدت نشانه‌های وسواس
اختلال وسواس فکری‌عملی

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

This study aimed to determine the effectiveness of cognitive-behavioral therapy on thought fusion and the severity of obsessive-compulsive symptoms in patients with obsessive-compulsive disorder in Tehran. The present study method was a quasi-experimental design with a pre-test-post-test design with a control group. The statistical population included all women with obsessive-compulsive disorder who visited clinics in Tehran between April and June 1404, from which a sample was selected using convenience sampling and randomly assigned to two experimental and control groups. The measurement tools included the Thought Fusion Questionnaire and the Yale-Brown Obsessive-Compulsive Scale. The experimental group underwent cognitive-behavioral therapy sessions, while the control group did not receive any intervention. The data were analyzed using analysis of covariance. The results showed that after the intervention, there was a significant difference between the experimental and control groups in the variables of thought fusion and the severity of obsessive symptoms. Cognitive-behavioral therapy significantly reduced the rate of thought fusion and the severity of obsessive-compulsive symptoms in patients in the experimental group compared to the control group. Based on the research findings, cognitive-behavioral therapy, by correcting cognitive distortions and reducing thought-action fusion, is an effective approach in improving the clinical symptoms of patients with obsessive-compulsive disorder, and the use of this treatment protocol is recommended in rehabilitation centers and psychological clinics.

کلیدواژه‌ها English

cognitive-behavioral therapy
thought fusion
severity of obsessive-compulsive symptoms
Obsessive-compulsive disorder
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.