Abstract:
مقدمه: چاقی از جمله مشکلاتی است که شیوع آن طی دهه های گذشته، روند رو به شتابی داشته است. مطالعه حاضر با هدف مقایسه اثربخشی گروه‏درمانی درمان مبتنی بر تعهد و پذیرش و تنظیم هیجانی بر همجوشی شناختی، ذهن‏آگاهی، تنظیم هیجانی در زنان مبتلا به چاقیانجام گرفت. روش کار: پژوهش حاضر از نوع نیمه آزمایشی با طرح پیشآزمون_پسآزمون سه گروهی بود. نمونهای به حجم 45 نفر از افراد مبتلا به چاقی به روش نمونهگیری هدفمند انتخاب و در دو گروه آزمایشی (آموزش تنظیم هیجان و درمان مبتنی بر پذیرش و تعهد) و یک گروه کنترل قرار گرفتند (15 نفر در هر گروه). سپس 12 جلسه 120 دقیقهای آموزش تنظیم هیجان و درمان مبتنی بر پذیرش و تعهد در گروههای آزمایشی انجام شد. دادهها با استفاده از پرسش نامه همجوشی شناختی ، پرسشنامه ذهن آگاهی و مقیاس دشواری در تنظیم هیجان جمعآوری شد. تجزیه و تحلیل دادهها با استفاده از آزمون آماری تحلیل کوواریانس با نرمافزار SPSS-21 انجام گرفت. یافتهها: نتایج پژوهش نشان داد که آموزش تنظیم هیجان و درمان مبتنی بر پذیرش و تعهد بر کاهش همجوشی شناختی و بهبود تنظیم هیجان و ذهن آگاهی افراد مبتلا به چاقی موثر است (05/0>P). اما بین این دو درمان تفاوت معناداری وجود نداشت (05/0P). نتیجهگیری: با توجه به تایید اثربخشی آموزش تنظیم هیجان و درمان مبتنی بر پذیرش و تعهد بر درمان چاقی پیشنهاد میشود که درمانگران، این دو درمان را در کاهش همجوشی شناختی و بهبود تنظیم هیجان و ذهن آگاهی افراد دارای اضافه وزن مد نظر قرار دهند.
Introduction: Obesity is one of the diseases whose prevalence has been accelerating over the past decades. It is estimated that about 1.2 billion people in the world are obese or overweight. In Iran, 5.5% of children and adolescents under 18 years of age and 21.5% of people over 18 years of age are obese. According to the World Health Organization (WHO), obesity is the accumulation of fat in the body. Recently, mindfulness has attracted a lot of attention in the field of obesity and overweight. The intervention, along with mindfulness meditation, with the aim of increasing overall psychological and physiological self-regulation, is perfectly commensurate with the cognitive, emotional, physiological, and behavioral dysregulations observed in eating disorders, especially in the case of impulsive overeating. Considering the effect of negative thoughts and beliefs on overeating behaviors and subsequent overweight and on the other hand the role of cognitive fusion as an important and determining factor in the negative evaluation of disturbing thoughts, the role of cognitive fusion can be added Checked the weight. Recently, in line with the efforts of health professionals, one of the effective ways to prevent and treat obesity and reduce its psychological, social and economic consequences is to consider psychological treatment programs along with other medical and sports treatments. In recent years, there has been a great deal of discussion about mindfulness-based therapeutic interventions. These treatments are known as the third wave of behavioral therapy. Acceptance and Commitment Therapy is one of the most common third-wave therapies for behavioral therapy and aims to help clients achieve a rich, valuable, and satisfying life through psychological resilience. Emotion regulation training is one of the emotion-based therapies that can affect the psychological symptoms of people with obesity and has been less considered by researchers so far. The aim of this study was to compare the effectiveness of group therapy based on commitment and acceptance therapy and emotional regulation on cognitive fusion, mindfulness, and emotional regulation in obese women.
Methods: The present study was an interventional study with a pre-test / post-test design that was performed in 1398 on obese patients referred to psychiatric and psychology clinics in the west of Tehran. The selection of the intervention group was as follows: The subjects were invited to participate in the study in coordination and consultation with the clinic officials and according to the inclusion criteria. Then, 45 patients were selected by purposive sampling method and divided into three groups of 15 (acceptance and commitment based experimental group, emotion regulation training experimental group and control group). First, the necessary information about the objectives of the study was provided to the patients and they entered the study of their own free will. Finally, informed consent obtained from all subjects. Criteria for entering this study include: Age over 16 years, being overweight, not having a psychological disorder, not receiving any other psychological treatment. Exclusion criteria were unwillingness to continue cooperation and a maximum of two sessions of absence for the patient. Then, 12 120-minute sessions of emotion regulation training and acceptance and commitment therapy were performed in the experimental groups. Data were collected using Cognitive Fusion Questionnaire, Mindfulness Questionnaire and Emotion Regulation Difficulty Scale. Data were analyzed using analysis of covariance with SPSS-21 software. First, the normality of data distribution was checked by Kolmogorov-Smirnov test. Then, analysis of covariance was used to examine the differences between the two groups in terms of research variables. Before applying the analysis of variance test, its hypotheses were tested by Leven test and regression slope.
Results: The results of analysis of covariance showed that the difficulty in regulating emotion, mindfulness and cognitive fusion after therapeutic interventions was significantly different between the three groups (P = 0.0001). Then, the Fisher post hoc test was used to examine which of the two groups are different. The results of this test showed that the difference between each of the groups of emotion regulation training and treatment based on acceptance and commitment with the control group is significant, but between the results of the two types of treatment are not significantly different.
Conclusion: The research results showed that emotion regulation training and acceptance and commitment-based therapy is effective in reducing cognitive fusion and improving emotion regulation and mindfulness in obese people. Therefore, considering the confirmation of the effect of emotion regulation training based on acceptance and commitment in the treatment of obesity, it is suggested that therapists consider these two therapies in reducing cognitive fusion and improving emotion regulation and mindfulness of overweight people.