اثربخشی طرحواره درمانی بر طرحواره‌های ناسازگار اولیه، تنظیم هیجانی و دوز مصرف در معتادان با درمان نگهدارنده با متادون

پژوهش های روان شناسی بالینی و مشاوره

مقاله 5، دوره 12، شماره 1 - شماره پیاپی 23، شهریور 1401، صفحه 79-99   

نوع مقاله: مقاله پژوهشی

شناسه دیجیتال (DOI): 10.22067/tpccp.2022.73062.1185

نویسندگان

بیتا ثلاثی¹؛ بهزاد شوقی^{* 2}

¹دانشجوی دکتری، گروه روانشناسی ، واحد سمنان ،دانشگاه آزاد اسلامی،سمنان، ایران

²دانشیار، گروه روانشناسی بالینی، واحد آشتیان، دانشگاه آزاد اسلامی، آشتیان، ایران

چکیده

هدف: مدل طرحواره‌ درمانی بر نقش طرحواره­های ناسازگار اولیه، راهبردهای تنظیم هیجان و دوز مصرف تأکید زیادی دارد. این مطالعه با هدف بررسی اثربخشی طرحواره درمانی بر طرحواره­های ناسازگار اولیه، تنظیم هیجانی و دوز مصرف در بیماران با درمان نگهدارنده با متادون بود.
روش: طرح پژوهش حاضر از نوع طرح‌های نیمه آزمایشی و با پیش‌آزمون- پس­آزمون بود. جامعه مورد مطالعه شامل 44 نفر از بیماران تحت درمان با متادون که در سال‌های 99-1398 به کلینک­های ترک اعتیاد منطقه 10 تهران مراجعه کرده بودند، شامل می­شود. تعیین نمونه به روش نمونه­گیری در دسترس انجام شد و در نهایت 22 نفر برای گروه آزمایش و 22 نفر برای گروه کنترل گمارش تصادفی شدند. جلسات درمانی شامل 12 جلسه 90 دقیقه‌ای به مدت دو هفته بود. از پرسشنامه‌های مقیاس طرحواره‌های ناسازگار اولیه  و مقیاس دشواری تنظیم هیجان برای جمع­آوری اطلاعات استفاده شد. تحلیل داده­های به‌دست‌آمده با تحلیل کوواریانس چند متغیری مورد تحلیل قرار گرفت.
یافته‌ها: نتایج نشان داد که تفاوت معنی­داری بین سه متغیر طرحواره‌های ناسازگار اولیه، تنظیم هیجانی و دوز مصرف متادون در گروه تحت درمان با پروتکل طرحواره درمانی با گروه کنترل وجود دارد.
نتیجه‌: طرحواره درمانی به دلیل تأکید بر باورها و راهبردهای فرد در ارتباط با هیجان­های شخصی خود می‌تواند به‌عنوان یک  روش مداخله‌ای تأثیرگذار برای طرحواره­های ناسازگار اولیه، تنظیم هیجان و دوز مصرفی متادون مورد استفاده قرار گیرد. پیشنهاد می­گردد که مشاوران و روان‌درمانگران، کارگاه­های طرحواره درمانی که منجر به بهبود مسائل روان‌شناختی مرتبط با آن می­شود، برگزار نمایند.

کلیدواژه‌ها

طرحواره‌های ناسازگار اولیه؛ تنظیم هیجانی؛ طرحواره درمانی؛ متادون

مراجع

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review, 30(2), 217-237.

Amodeo, M., Chassler, D., Oettinger, C., Labiosa, W., & Lundgren, L. M. (2008). Client retention in residential drug treatment for Latinos. Evaluation and Program Planning, 31(1), 102-112.

Azizi, A., Mirzaei, A., & Shams, J. (2010). Correlation between distress tolerance and emotional regulation with students smoking dependence (In Persian). Hakim Research Journal, 13(1), 11-18.

Ball, S. A. (2004). Treatment of personality disorders with co-occurring substance dependence: Dual focus schema therapy. Handbook of personality disorders: Theory and practice, 398-425.

Ball, S. A., Cobb-Richardson, P., Connolly, A. J., Bujosa, C. T., & O'neall, T. W. (2005). Substance abuse and personality disorders in homeless drop-in center clients: symptom severity and psychotherapy retention in a randomized clinical trial. Comprehensive psychiatry, 46(5), 371-379.

Brummett, B. R. (2007). Attachment style, early maladaptive schemas, coping self-efficacy, therapy alliance and their influence on addiction severity in methadone-maintenance treatment.

Caner, N., & Evgin, D. (2021). Digital risks and adolescents: The relationships between digital game addiction, emotional eating, and aggression. International journal of mental health nursing, 30(6), 1599-1609.

Chou, R., Cruciani, R. A., Fiellin, D. A., Compton, P., Farrar, J. T., Haigney, M. C., . . . Marcus, S. M. (2014). Methadone safety: a clinical practice guideline from the American Pain Society and College on Problems of Drug Dependence, in collaboration with the Heart Rhythm Society. The Journal of Pain, 15(4), 321-337.

Control, C. f. D., & Prevention. (2012). Vital signs: risk for overdose from methadone used for pain relief-United States, 1999-2010. MMWR. Morbidity and mortality weekly report, 61(26), 493-497.

Dellinger, R. P., Levy, M. M., Carlet, J. M., Bion, J., Parker, M. M., Jaeschke, R., . . . Beale, R. (2008). Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive care medicine, 34(1), 17-60.

Dir, A. L., Banks, D. E., Zapolski, T. C., McIntyre, E., & Hulvershorn, L. A. (2016). Negative urgency and emotion regulation predict positive smoking expectancies in non-smoking youth. Addictive behaviors, 58, 47-52.

Duckworth, A., & Gross, J. J. (2014). Self-control and grit: Related but separable determinants of success. Current directions in psychological science, 23(5), 319-325.

Erfan, A., Noorbala, A. A., Amel, S. K., Mohammadi, A., & Adibi, P. (2018). The effectiveness of emotional schema therapy on the emotional schemas and emotional regulation in irritable bowel syndrome: single subject design. Advanced biomedical research, 7.

Ersche, K. D., Turton, A. J., Chamberlain, S. R., Müller, U., Bullmore, E. T., & Robbins, T. W. (2012). Cognitive dysfunction and anxious-impulsive personality traits are endophenotypes for drug dependence. American Journal of Psychiatry, 169(9), 926-936.

Fareed, A., Vayalapalli, S., Scheinberg, K., Gale, R., Casarella, J., & Drexler, K. (2013). QTc interval prolongation for patients in methadone maintenance treatment: a five years follow-up study. The American journal of drug and alcohol abuse, 39(4), 235-240.

Farrell, J. M., & Shaw, I. A. (2019). Experiencing schema therapy from the inside out. New York, GuilfordPress, 33-35.

Fassbinder, E., Schweiger, U., Martius, D., Brand-de Wilde, O., & Arntz, A. (2016). Emotion regulation in schema therapy and dialectical behavior therapy. Frontiers in psychology, 7, 1373.

Fulcher, G., Singer, J., Castañeda, R., Fraige Filho, F., Maffei, L., Snyman, J., & Brod, M. (2014). The psychosocial and financial impact of non-severe hypoglycemic events on people with diabetes: two international surveys. Journal of Medical Economics, 17(10), 751-761.

Gaznick, N., Tranel, D., McNutt, A., & Bechara, A. (2014). Basal ganglia plus insula damage yields stronger disruption of smoking addiction than basal ganglia damage alone. nicotine & tobacco research, 16(4), 445-453.

Ghandehari, A. (2018). Effectiveness of group schema therapy in metacognitive beliefs and methadone dose reduction in men under methadone treatment. Scientific Quarterly Research on Addiction, 11(44), 169-186.

Giesen-Bloo, J., Van Dyck, R., Spinhoven, P., Van Tilburg, W., Dirksen, C., Van Asselt, T., . . . Arntz, A. (2006). Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy. Archives of general psychiatry, 63(6), 649-658.

Gladden, R. M., O’Donnell, J., Mattson, C. L., & Seth, P. (2019). Changes in opioid-involved overdose deaths by opioid type and presence of benzodiazepines, cocaine, and methamphetamine—25 states, July–December 2017 to January–June 2018. Morbidity and Mortality Weekly Report, 68(34), 737.

Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment, 26(1), 41-54.

Gratz, K. L., Rosenthal, M. Z., Tull, M. T., Lejuez, C., & Gunderson, J. G. (2006). An experimental investigation of emotion dysregulation in borderline personality disorder. Journal of abnormal psychology, 115(4), 850.

Gratz, K. L., & Tull, M. T. (2010). The relationship between emotion dysregulation and deliberate self-harm among inpatients with substance use disorders. Cognitive therapy and research, 34(6), 544-553.

Grüsser, S. M., Thalemann, C. N., Platz, W., Gölz, J., & Partecke, G. (2006). A new approach to preventing relapse in opiate addicts: a psychometric evaluation. Biological psychology, 71(3), 231-235.

Hahn, T., Dresler, T., Ehlis, A.-C., Plichta, M. M., Heinzel, S., Polak, T., . . . Fallgatter, A. J. (2009). Neural response to reward anticipation is modulated by Gray's impulsivity. Neuroimage, 46(4), 1148-1153.

Hopwood, C. J., Pincus, A. L., & Wright, A. G. (2019). The interpersonal situation: Integrating personality assessment, case formulation, and intervention. Using basic personality research to inform personality pathology, 94-121.

Jacob, G. A., & Arntz, A. (2013). Schema therapy for personality disorders—A review. International Journal of Cognitive Therapy, 6(2), 171-185.

Kellogg, S. H., & Tatarsky, A. (2012). Re-envisioning addiction treatment: A six-point plan. Alcoholism Treatment Quarterly, 30(1), 109-128.

Kelly, T. H., & Bardo, M. T. (2016). Emotion regulation and drug abuse: Implications for prevention and treatment (Vol. 163, pp. S1-S2).

Keulen-de Vos, M. (2013). Emotional states, crime and violence: A schema therapy approach to the understanding and treatment of forensic patients with personality disorders.

Kharasch, E. D., & Greenblatt, D. J. (2019). Methadone disposition: implementing lessons learned. Journal of clinical pharmacology, 59(8), 1044.

Kun, B., & Demetrovics, Z. (2010). Emotional intelligence and addictions: A systematic review. Substance Use & Misuse, 45(7-8), 1131-1160.

Louis, J. P., Wood, A. M., Lockwood, G., Ho, M.-H. R., & Ferguson, E. (2018). Positive clinical psychology and Schema Therapy (ST): The development of the Young Positive Schema Questionnaire (YPSQ) to complement the Young Schema Questionnaire 3 Short Form (YSQ-S3). Psychological Assessment, 30(9), 1199.

Martin, P., Weinberg, B. A., & Bealer, B. K. (2007). Healing addiction: An integrated pharmacopsychosocial approach to treatment: John Wiley & Sons.

Nalaskowska, M., & Cierpiałkowska, L. (2014). Social and psychological functioning of opiate dependent patients in methadone maintenance treatment–longitudinal research report. Alcoholism and Drug Addiction, 27(3), 237-254.

Noori, R., Narenjiha, H., Aghabakhshi, H., Habibi, G., & Khoshkrood Mansoori, B. (2012). Methadone maintenance therapy outcomes in Iran. Substance Use & Misuse, 47(7), 767-773.

Nutt, D. J., Robbins, T. W., Stimson, G. V., Ince, M., & Jackson, A. (2006). Drugs and the future: Brain science, addiction and society: Elsevier.

Pugh, M. (2015). A narrative review of schemas and schema therapy outcomes in the eating disorders. Clinical psychology review, 39, 30-41.

Raffa, R. B., Burmeister, J. J., Yuvasheva, E., & Pergolizzi Jr, J. V. (2012). QTc interval prolongation by d-propoxyphene: what about other analgesics? Expert opinion on pharmacotherapy, 13(10), 1397-1409.

Renner, F., DeRubeis, R., Arntz, A., Peeters, F., Lobbestael, J., & Huibers, M. J. (2018). Exploring mechanisms of change in schema therapy for chronic depression. Journal of behavior therapy and experimental psychiatry, 58, 97-105.

Ribas, K. H. d. S., Ribas, V. R., Barros, S. S. M., Ribas, V. R., Filizola, M. d. G. N., Ribas, R. d. M. G., . . . Martins, H. A. d. L. (2018). The participation of Early Maladaptive Schemas (EMSs) in the perception of pain in patients with migraine: A psychological profile. Dementia & Neuropsychologia, 12, 68-74.

Roper, L., Dickson, J. M., Tinwell, C., Booth, P. G., & McGuire, J. (2010). Maladaptive cognitive schemas in alcohol dependence: Changes associated with a brief residential abstinence program. Cognitive therapy and research, 34(3), 207-215.

Sahu, P., Mathur, A., Ganesh, A., Nair, S., Chand, P., & Murthy, P. (2020). Acceptance of e-consult for Substance Use Disorders during the COVID 19 pandemic: A study from India. Asian journal of psychiatry, 54, 102451.

Salemink, E., Raaijmakers, S., Meeus, W., Branje, S., Koot, H., Van Lier, P., & Wiers, R. (2014). Implicit alcohol-coping associations in heavy drinking neurotic adolescents. Paper presented at the Meeting of the Research Society on Alcoholism, Bellevue, WA.

Savage, E. H. (2016). Facilitator perceptions of mobile ACHESS for social support in addiction relapse prevention. Capella University.  

Sempértegui, G. A., Karreman, A., Arntz, A., & Bekker, M. H. (2013). Schema therapy for borderline personality disorder: A comprehensive review of its empirical foundations, effectiveness and implementation possibilities. Clinical psychology review, 33(3), 426-447.

Shorey, R. C., Stuart, G. L., & Anderson, S. (2013). Early maladaptive schemas among young adult male substance abusers: A comparison with a non-clinical group. Journal of substance abuse treatment, 44(5), 522-527.

Tang, Y.-Y., Tang, R., & Posner, M. I. (2016). Mindfulness meditation improves emotion regulation and reduces drug abuse. Drug and alcohol dependence, 163, 13-18.

Vanyukov, M. M., Kirisci, L., Moss, L., Tarter, R. E., Reynolds, M. D., Maher, B. S., . . . Clark, D. B. (2009). Measurement of the risk for substance use disorders: phenotypic and genetic analysis of an index of common liability. Behavior genetics, 39(3), 233-244.

Young, A. (1994). Lessons from the East Asian NICs: A contrarian view. European economic review, 38(3-4), 964-973.

Yousefi, F., Arasteh, M., Nazemi, A., & Bahrami, M. (2015). The Effect of the Combination Therapy, Family Therapy, Group Therapy and Methadone Therapy on Patients with Substance Abuse. Family Counseling and Psychotherapy, 5(1), 24-41.

Zeigler-Hill, V., Green, B. A., Arnau, R. C., Sisemore, T. B., & Myers, E. M. (2011). Trouble ahead, trouble behind: Narcissism and early maladaptive schemas. Journal of behavior therapy and experimental psychiatry, 42, 96-103.