اثربخشی مداخله ذهن‌آگاهی بر افکار خودکشی و هم‌جوشی فکر_عمل در مبتلایان به اختلال دوقطبی

محمدزمانی, زهرا; طباطبایی, سید موسی; طاهر, محبوبه; نیکان, عبدالصمد

doi:10.22075/jcp.2025.35675.3025

اثربخشی مداخله ذهن‌آگاهی بر افکار خودکشی و هم‌جوشی فکر_عمل در مبتلایان به اختلال دوقطبی

نوع مقاله : مقاله پژوهشی

نویسندگان

¹ دانشجوی دکتری تخصصی روانشناسی، واحد شاهرود، دانشگاه آزاد اسلامی، شاهرود، ایران. ران.

² استادیار گروه علوم شناختی، دانشکده روانشناسی و علوم تربیتی، دانشگاه سمنان، دانشگاه سمنان

³ گروه روانشناسی، واحد شاهرود، دانشگاه آزاد اسلامی، شاهرود، ایران.

⁴ گروه روان‌شناسی، واحد بندر گز، دانشگاه آزاد اسلامی، بندر گز، ایران.

10.22075/jcp.2025.35675.3025

چکیده

زمینه: اختلال دوقطبی، نوعی اختلال‌خلقی مزمن و عودکننده است که بر عملکرد اجتماعی و شغلی فرد تأثیرگذار است. هدف از انجام این پژوهش تعیین اثربخشی مداخله ذهن‌آگاهی بر افکار خودکشی و هم‌جوشی فکر-عمل در مبتلایان به اختلال دوقطبی بود.
روش: روش پژوهش نیمه‌آزمایشی و به شیوه پیش‌آزمون-پس‌آزمون با گروه کنترل و آزمایش بوده است. جامعه‌آماری پژوهش، کلیه بیماران مبتلا به اختلال دوقطبی مراجعه‌کننده به مراکز مشاوره روانشناختی شهر گرگان در سال 1401 بودند. تعداد 34 نفر با روش نمونه‌گیری در دسترس انتخاب و سپس به دو گروه آزمایش و کنترل (هر گروه 17 نفر)، به صورت تصادفی قرار گرفتند. گروه‌ آزمایش تحت 8 جلسه 90 دقیقه‌ای درمان ذهن‌آگاهی قرار گرفت و گروه کنترل تا پایان پژوهش، درمان روانشناختی دریافت نکرد. ابزارهای پژوهش پرسشنامه‌های افکار خودکشی بک (1979) و هم‌جوشی فکر_عمل راچمن و شافران (1988) بود. از آزمون پارامتریک تحلیل کواریانس با استفاده از نرم‌افزار SPSS برای تحلیل آماری استفاده شد.
یافته‌ها: نتایج نشان داد مداخله ذهن‌آگاهی اثر معناداری بر افکار خودکشی (61/0 =η²، 001/0 P<،
73/47 =₍₁₎F) و مؤلفه‌های هم‌جوشی فکر و عمل شامل مؤلفههای هم‌جوشی اخلاقی (72/0 =η²، 001/0 P<، 38/81 =₍₁₎F)، هم‌جوشی برای دیگران (36/0 =η²، 001/0 P<، 83/17 =₍₁₎F) و هم‌جوشی برای خود
(56/0 =η²، 001/0P<، 12/40 =₍₁₎F) داشت.
نتیجه‌گیری: بر این ‌اساس می‌توان نتیجه گرفت که مداخله ذهن‌آگاهی منجر به کاهش افکار خودکشی و هم‌جوشی فکر-عمل در مبتلایان به اختلال دوقطبی شد.

کلیدواژه‌ها

موضوعات

عمومى

عنوان مقاله [English]

Effectiveness of Mindfulness Intervention on Suicidal Thoughts and Thought-Action Fusion in Bipolar Disorder Patients

نویسندگان [English]

Zahra Mohamad Zamani ¹
Seyed Mosa Tabatabaee ²
Mahboobe Taher ³
Abdolsamad Nikan ⁴

¹ Ph.D Candidate in Psychology, Sha.C., Islamic Azad University, Shahrood, Iran.

² Assistant Professor, Department of Cognitive Sciences, Faculty of Psychology and Educational Sciences, Semnan University, Semnan University

³ Department of Psychology, Sha.C., Islamic Azad University, Shahrood, Iran

⁴ Department of Psychology, BG.C., Islamic Azad University, Bandar Gaz, Iran.

چکیده [English]

Background: Bipolar disorder is a chronic and recurrent mood disorder that affects the individual's social and occupational functioning. The aim of this study was to determine the effectiveness of mindfulness intervention on suicidal thoughts and thought-action fusion in people with bipolar disorder.
Method: The research method was quasi-experimental and pre-test-post-test with a control and experimental group. The statistical population of the study was all patients with bipolar disorder referring to psychological counseling centers in Gorgan in 2022. 34 people were selected using the convenience sampling method and then randomly assigned to two experimental and control groups (17 people in each group). The experimental group underwent 8 90-minute sessions of mindfulness therapy, and the control group did not receive psychological treatment until the end of the study. The research instruments were Beck's Suicidal Thoughts Questionnaire (1979) and Rachman and Shafran's Thought-Action Fusion Questionnaire (1988). Parametric analysis of covariance (ANCOVA & MANCOVA) was used for statistical analysis using SPSS software.
Results: The results showed that mindfulness intervention had a significant effect on suicidal thoughts (η²= 0.61, P< 0.001, F₍₁₎= 47.73) and components of thought-action fusion including moral fusion (η²= 0.72, P< 0.001, F₍₁₎= 81.38), fusion for others (η²= 0.36, P< 0.001, F₍₁₎= 17.83), and fusion for self (η²= 0.56, P< 0.001, F₍₁₎= 40.12).
Conclusion: Based on this, it can be concluded that mindfulness intervention led to a reduction in suicidal thoughts and thought-action fusion in patients with bipolar disorder

کلیدواژه‌ها [English]

mindfulness
suicidal thoughts
thought-action fusion
bipolar disorder

مراجع

Sources and references
1. Anbari Meybodi N, Basharpour S, Narimani M. Recovery from bipolar disorder type 1 based on sleep disturbance and mania-related memory bias: The mediating role of working memory. Clinical Psychology. 2023;15(1):107-117. [Persian] Doi:10.22075/JCP.2023.25781.2366
2. Davis JA, Gamble KL. Synchronized time keeping is key to healthy mood regulation. Eur J Neurosci. 2018;43(10):286-93. Doi:10.1111/ejn.13147
3. Highland D, Zhou G. A review of detection techniques for depression and bipolar disorder. Smart Health. 2022;9(4):28-31. Doi:10.1016/j.smhl.2022.100282
4. Ganji H, Ganji M. DSM-5 Psychopathology - Volume 1. Ardabil: Savalan Publications; 2016. [Persian]
5. Carvalho A, Firth J, Vieta E. Bipolar disorder. N Engl J Med. 2020;383(1):58-66. Doi:10.1056/NEJMra1906193
6. Laidi C, Godin O, Etain B, Bellivier F. Direct medical cost of bipolar disorder: Insights from the FACE-BD longitudinal cohort. J Affect Disord. 2022;306(1):223-31. Doi:10.1016/j.jad.2022.02.071
7. Zhao L, Wang Y, Jia Y, Zhong S, Sun Y, Zhou Z, et al. Cerebellar microstructural abnormalities in bipolar depression and unipolar depression: A diffusion kurtosis and perfusion imaging study. J Affect Disord. 2020;195:21-31. Doi:10.1016/j.jad.2016.01.042
8. Reich R, Gilbert A, Clari R, Burdick K. A preliminary investigation of impulsivity, aggression and white matter in patients with bipolar disorder and a suicide attempt history. J Affect Disord. 2019;247(15):88-96. Doi:10.1016/j.jad.2019.01.001
9. Teismann T, Forkmann T, Brailovskaia J, Siegmann P, Glaesmer H, Margraf J. Positive mental health moderates the association between depression and suicide ideation: A longitudinal study. Int J Clin Health Psychol. 2018;18(1):1-7. https://doi.org/10.1016/j.ijchp.2017.08.001
10. Dumith SC, Demenech LM, Carpena MX, Nomiyama S, Neiva-Silva L, Loret de Mola C. Suicidal thought in southern Brazil: Who are the most susceptible? J Affect Disord. 2020;260:610-6. Doi:10.1016/j.jad.2019.09.046
11. Shapiro L, Kennedy K, Dimick M, Benjamin I. Elevated atherogenic lipid profile in youth with bipolar disorder during euthymia and hypomanic/mixed but not depressive states. J Psychosom Res. 2022;156(5):76-84. Doi:10.1016/j.jpsychores.2022.110763
12. Falcone T, Timmons-Mitchell J. Mood Disorders and Suicide. In: Suicide Prevention: A Practical Guide for the Practitioner. Berlin: Springer; 2018. DOI: 10.1007/978-3-319-74391-2
13. Miller J, Black D. Bipolar disorder and suicide: a review. Curr Psychiatry. 2020;22(2):1-10. Doi:10.1007/s11920-020-1130-0
14. Tondo L, Baldessarini RJ, Barbuti M, Colombini P, Angst J, Azorin JM, Perugi G. Factors associated with single versus multiple suicide attempts in depressive disorders. J Affect Disord. 2020;277:306-312. Doi:10.1016/j.jad.2020.08.021
15. Hallgren J, Osby U, Westman J, Gissler M. Mortality trends in external causes of death in people with mental health disorders in Sweden, 1987–2010. Scand J Public Health. 2019;47(2):121-126. Doi:10.1177/1403494818758912
16. Leboyer M, Godin O, Llorca P, Aubin V. Key findings on bipolar disorders from the longitudinal FondaMental Advanced Center of Expertise-Bipolar Disorder (FACE-BD) cohort. J Affect Disord. 2022;307(15):149-156. Doi:10.1016/j.jad.2022.03.053
17. Yousefi K, Zargham-Hajbi M, Saravani S. Predicting Suicidal Tendency Based on Psychological Hardiness and Perceived Body Image in Patients with Multiple Sclerosis (MS). Q Sci-Res J Health Psychol. 2021;10(39):157-70. [Persian] https://doi.org/10.30473/hpj.2021.55611.4980
18. Jamali S, Najafi M, Quraishi FS, Rahimian BE. Effectiveness of Acceptance and Commitment Therapy on Suicidal Thoughts and Psychological Resilience in Patients with Bipolar Disorder. Psychol Stud. 2021;17(1):7-22. [Persian] Doi:10.22051/PSY.2021.34436.2376
19. Homayoun F, Boqoli H. Comparison of Thought-Action Fusion, Attribution Styles, and Attention Control in Patients with Obsessive-Compulsive Disorders and Depression. Psychol Methods Models. 2019;10(35):175-92. [Persian] Doi:20.1001.1.22285516.1398.10.35.10.5
20. Jelinek L, Balzar A, Moritz S, Reininger K, Miegel F. Therapists' Thought-Action Fusion Beliefs Predict Utilization of Exposure in Obsessive-Compulsive Disorder. Behav Ther. 2020;53(1):23-33. Doi:10.1016/j.beth.2021.05.004
21. Berle D, Starcevic V. Thought–action fusion: Review of the literature and future directions. Clin Psychol Rev. 2016;25(3):263–84. Doi:10.1016/j.cpr.2004.12.001
22. Lee S, Lee S. Korean Version of the Thought-Action Fusion Scale: The Evidence for Its Psychometric Properties. Psychiatry Investig. 2021;18(4):348-56. https://doi.org/10.30773/pi.2020.0396
23. Farokhi H, Sohrabi F. Investigating the factor structure, reliability, and validity of the Thought Fusion Questionnaire (TFI) in students. Clin Psychol Pers. 2020;17(1):249-55. [Persian] Doi:10.22070/CPAP.2020.2901
24. Lee EB, Barney JL, Twohig MP, Lensegrav Benson T, Quakenbush B. Obsessive compulsive disorder and thought action fusion: Relationships with eating disorder outcomes. Eat Behav. 2020;37:101386. Doi:10.1016/j.eatbeh.2020.101386
25. McNicol K, Wells A. Metacognition and Obsessive-Compulsive Symptoms: The Contribution of Thought-Fusion Beliefs and Beliefs about Rituals. Int J Cogn Ther. 2017;5:330-40. Doi:10.1521/ijct.2012.5.3.330
26. Mirzamohammadi S, Heshmati R. The effectiveness of mindfulness training on thought fusion in individuals with obsessive-compulsive symptoms. New Psychol Res. 2021;16(64):1-24. [Persian] Doi:20.1001.1.27173852.1400.16.64.5.4
27. Malemir B, Keyvanloo S, Rafiei-Rad Z, Mozazeh R, Sadri M, Zavarei Z. Comparison of physical health and thought-action fusion in patients with obsessive-compulsive, bipolar, and normal obsessive-compulsive disorder. J Cogn Psychol Psychiatry. 2021;8(1):147-59. [Persian] Doi:10.22098/jhrs.2022.10209.1042
28. Cairncross M, Miller C. The effectiveness of mindfulness-based therapies for ADHD: a metaanalystic review. Atten Disord. 2020;24(5):627-643. Doi:10.1177/1087054715625301
29. Ahmadi Katayuncheh F, Khoshakhlaq H. The effectiveness of emotion-focused therapy on metaemotion, mindfulness, and emotional capital of women with multiple sclerosis in Isfahan. Clinical Psychology. 2023;15(4):15-27. [Persian] http://journal.rums.ac.ir/article-1-7262-en.html
30. Chesin MS, Sonmez CC, Benjamin-Philips CA, Beeler B, Brodsky BS, Stanley B. Preliminary effectiveness of adjunct mindfulness based cognitive therapy to prevent suicidal behavior in outpatients who are at elevated suicide risk. Mindfulness. 2020;6(6):1345-1355. Doi:10.1007/s12671-015-0405-8
31. Raj S, Sachdeva SA, Jha R, Sharad S, Singh T, Arya YK, Verma SK. Effectiveness of mindfulness based cognitive behavior therapy on life satisfaction, and life orientation of adolescents with depression and suicidal ideation. Asian J Psychiatry. 2019;39:58-62. Doi:10.1016/j.ajp.2018.12.001
32. Khadem S, Fakhri MK, Emadian SO. The effectiveness of mindfulness-based cognitive therapy on rumination, perfectionism, and thought-action fusion in women with obsessive-compulsive disorder. Stud Adolesc Young People. 2022;4(10):147-63. [Persian] https://doi.org/10.61838/kman.jayps.4.4.11
33. Hanstede M, Gidron Y, Nyklícek I. The effects of a mindfulness intervention on obsessive-compulsive symptoms in a non-clinical student population. J Nerv Ment Dis. 2018;196(10):776-779. Doi:10.1097/NMD.0b013e31818786b8
34. Scott J, Paykel E, Morriss R, Bentall R, Kinderman P, Johnson T, Hayhurst H. Cognitive-behavioral therapy for severe and recurrent bipolar disorders: Randomised controlled trial. Br J Psychiatry. 2017;188:313-320. Doi: 10.1192/bjp.188.4.313
35. Wendt A, Stamper G, Howland M, Cerimele J, Bhat A. Indirect psychiatric consultation for perinatal bipolar disorder: A scoping review. Gen Hosp Psychiatry. 2021;68:19-24. Doi:10.1016/j.genhosppsych.2020.11.011
36. Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clin Psychol. 1979;47(2):343-352. Doi:10.1037//0022-006x.47.2.343
37. Sueki H. Re-examination of reliability and validity of suicide ideation scale. Jpn J Ment Health. 2018;32:48–54. https://core.ac.uk/reader/295360480
38. Leghaei M, Mehrabizadeh Honarmand M, Arshadi N. Structural equation modeling of students' suicidal ideation based on resilience and coping strategies with the mediating role of depression. Clin Psychol Stud. 2020;10(40):27-46. [Persian] https://doi.org/10.22054/jcps.2021.56410.2458
39. Rachman S, Shafran R. Cognitive distortions: Thought–action fusion. Clin Psychol Psychother. 1998;6(2):80-5. https://doi.org/10.1177/1073191112436670
Kabat-Zinn J. Mindfulness‐based interventions in context: past, present, and future. Clin Psychol Sci Pract. 2010;10(2):144-156. Doi:10.1093/clipsy.bpg016