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پایان نامه مقایسه اثربخشی و تداوم تأثیر درمان فراشناختی و طرح¬واره درمانی به شیوه گروهی بر کاهش علائم، کیفیت زندگی و سلامت اجتماعی دانشجویان مبتلا به اختلال اضطراب اجتماعی

Code: #29996
تعداد صفحات
251
فرمت فایل
word
سال
1393
مقطع
دکترا
دسته‌بندی

خلاصه پایان نامه مقایسه اثربخشی و تداوم تأثیر درمان فراشناختی و طرح¬واره درمانی به شیوه گروهی بر کاهش علائم، کیفیت زندگی و سلامت اجتماعی دانشجویان مبتلا به اختلال اضطراب اجتماعی

برای دریافت مدرک دکتری تخصصی (ph.D.)

رشته روان­شناسی عمومی

 

چکیده

هدف: این پژوهش با هدف مقایسه اثربخشی و تداوم تأثیر طرح واره درمانی و درمان فراشناختی به شیوه گروهی بر کاهش علائم، سلامت اجتماعی و کیفیت زندگی دانشجویان مبتلا به اختلال اضطراب اجتماعی انجام شد.

روش: پژوهش حاضر  شبه تجربی بود که در آن از طرح پیش آزمون پس آزمون و پی­گیری با گروه کنترل استفاده شد. 60 نفر از دانشجویان مبتلا به اختلال اضطراب اجتماعی مراجعه کننده به مراکز مشاوره دانشگاه­های شهر کرمانشاه و اسلام آباد غرب با تشخیص روان­شناس و روان­پزشک به روش نمونه­گیری هدفمند انتخاب شدند و به صورت تصادفی در سه گروه (دو گروه آزمایشی و یک گروه کنترل) قرار گرفتند. شرکت کنندگان به مدت 10 جلسه تحت درمان گروهی با مدل طرح­واره درمانی یانگ و 10 جلسه درمان فراشناختی ولز قرار گرفتند و مرحله پی­گیری نیز سه ماه پس از پایان درمان دنبال شد. به منظور گردآوری داده­ها از پرسشنامه بالینی چند محوری میلون (MCMI)، مصاحبه بالینی ساختار یافته برای اختلال­های محور یک درIV DSM- (SCID)، پرسشنامه هراس اجتماعی (SPI)، مقیاس سلامت اجتماعی، پرسشنامه کیفیت زندگی، پرسشنامه فرم بلند طرحواره یانگ (YSQ-L 2) و پرسشنامه فراشناخت (MCQ-30) استفاده شد.

یافته­ها: نتایج نشان داد که طرح­واره درمانی و درمان فراشناختی بر متغیرهای اضطراب اجتماعی و کیفیت زندگی تأثیر متفاوت داشتند به طوری که تغییرات علائم اضطراب اجتماعی و کیفیت زندگی در اثر درمان فراشناختی افزایش بیشتری نسبت به گروه طرح­واره درمانی یافته است (p<0/05)، ولی دو روش درمانی از نظر میزان تأثیر بر سلامت اجتماعی بیماران تفاوت معناداری نداشتند (p>0/05). تداوم تأثیر درمان فراشناختی بر کاهش اضطراب اجتماعی و افزایش کیفیت زندگی به صورت معناداری از درمان طرح­واره محور بیشتر بود (p<0/05). اما تداوم اثربخشی دو نوع درمان بر سلامت اجتماعی شرکت کنندگان تفاوت معناداری نداشت (p>0/05).

نتیجه گیری: نتایج فوق حمایت مقدماتی از این برداشت کلی را ارائه کردند که باورهای فراشناختی بر روی اضطراب اجتماعی و مکانیسم­های شناختی مقصر در حفظ این اختلال تأثیر بیشتری دارند. درمان فراشناختی هم  پس از پایان دوره درمان و هم در دوره سه ماهه­ی پیگیری کارایی و اثر­بخشی بیشتری نسبت به طرح­واره درمانی در کاهش علائم اختلال اضطراب اجتماعی و افزایش کیفیت زندگی بیماران داشت.

بحث: با توجه به نتایج این پژوهش و مطالعات پیشین به نظر می­رسد رویکرد فراشناختی می­تواند نقص­ها و کاستی­های نظریه­های شناختی را جبران کند و تا حد زیادی مانع عود این بیماری پس از درمان گردد. همچنین نقش بسزایی در تمهیدات پشگیرانه داشته باشد. به نظر می­رسد رویکرد فراشناختی به لحاظ بالینی می­تواند چشم انداز نوید بخشی را در اختیار متخصصین قرار دهد.

کلید واژه ها: طرح­واره درمانی، درمان فراشناختی، اضطراب اجتماعی، سلامت اجتماعی، کیفیت زندگی، دانشجویان.

 

فهرست پایان نامه مقایسه اثربخشی و تداوم تأثیر درمان فراشناختی و طرح¬واره درمانی به شیوه گروهی بر کاهش علائم، کیفیت زندگی و سلامت اجتماعی دانشجویان مبتلا به اختلال اضطراب اجتماعی

فهرست:

 

 

فهرست مطالب

 

عنوان

صفحه

 

 

 

 

فصل اول: کلیات تحقیق

1

1-1-

مقدمه

1

1-2-

بیان مسأله

2

1-3-

اهمیت و ضرورت پژوهش

7

1-4-

اهداف پژوهش

7

1-5-

سؤال های پژوهش

8

1-6-

فرضیه ها

8

1-7-

متغیرهای پژوهش

9

1-8-

تعریف مفهومی و عملیاتی متغیرها

10

 

 

 

 

فصل دوم: مبانی نظری و پیشینه تحقیق

11

2-1-

اضطراب اجتماعی

11

2-1-1-

مفهوم اضطراب اجتماعی

11

2-1-2-

ملاک های تشخیص اضطراب اجتماعی

12

2-1-3-

زیرگروه های اختلال اضطراب اجتماعی

16

2-1-4-

همه گیرشناسی، شروع، همبودی بیماری و عوامل دموگرافیک

19

2-1-5-

پیش بینی های دوره رشد

25

2-1-6-

طبیعت در برابر تربیت و نوروبیولوژی: سبب شناسی اختلال اضطراب اجتماعی

26

2-1-7-

عوامل عصب  - روانشناختی

34

2-1-8-

دوره اضطراب اجتماعی، تأثیر آن بر کیفیت زندگی و هزینه مالی آن

36

2-1-9-

پایداری اضطراب اجتماعی: رویکردها و نظریه ها

39

2-1-10

درمان های روانشناختی در اختلال اضطراب اجتماعی

58

2-1-11-

ارزیابی روش های درمان

79

2-2-

سلامت اجتماعی

84

2-2-1-

مفهوم سلامت اجتماعی فردی

84

2-2-2-

ابعاد سلامت اجتماعی فردی

87

2-2-3-

شاخص های سلامت اجتماعی جامعه

90

2-2-4-

بررسی مطالعات مرتبط با سلامت اجتماعی در ایران

99

2-2-5-

راهکارها و پیشنهاداتی برای بررسی و بهبود سلامت اجتماعی

109

2-2-6-

مدل پیشنهادی سنجش سلامت اجتماعی در ایران

113

2-3-

کیفیت زندگی

118

2-3-1-

تاریخچه کیفیت زندگی

119

2-3-2-

تعاریف مربوط به کیفیت زندگی

121

2-3-3-

رویکردهای کیفیت زندگی

126

2-3-4-

نظریه های کیفیت زندگی

129

2-3-5-

عوامل مؤثر بر کیفیت زندگی

137

2-3-6-

ویژگی های کیفیت زندگی

139

2-4-

پیشینه پژوهش

140

 

 

 

 

فصل سوم: روش تحقیق

150

3-1-

مقدمه

150

3-2-

طرح پژوهش

150

3-3-

جامعه آماری، نمونه و روش نمونه گیری

150

3-4-

ابزار پژوهش

152

3-5-

روند اجرای پژوهش

156

3-6-

شیوه تجزیه و تحلیل اطلاعات

160

 

 

 

 

فصل چهارم: یافته های تحقیق

161

4-1-

مقدمه

161

4-2-

پایایی پرسشنامه ها

161

4-3-

توصیف داده ها

162

4-4-

تحلیل داده ها

168

 

 

 

 

 

فصل پنجم: بحث و نتیجه گیری

197

5-1-

مقدمه

197

5-2-

مروری کلی بر فرضیه های پژوهش

198

5-3-

مروری بر نتایج و نوآوری یافته ها

214

5-4-

محدودیت ها

215

5-5-

پیشنهادها

217

 

 

 

 

فهرست منابع

219

 

چکیده انگلیسی

239

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

فهرست جداول

 

 

 

 

شماره

عنوان

صفحه

 

 

 

2-1

ساختارهای سلامت اجتماعی با توجه به سطوح تحلیل و پیوستار اندازه گیری

87

2-2

روند طولی شاخص کیفیت زندگی ایران طی سال­های 2005-2010

99

2-3

مقدار و رتبه ی سلامت اجتماعی در هر یک از استان های کشور بر اساس شاخص ترکیبی سلامت اجتماعی

103

2-4

رتبه ی شاخص توسعه ی انسانی سال 2011 کشورهای خاور میانه و شمال افریقا

107

3-1

ویژگی های جمعیت شناختی شرکت کنندگان

151

4-1

پایایی  پرسشنامه ها

161

4-2

خلاصه آمار توصیفی متغیر اضطراب اجتماعی در پیش آزمون و پس آزمون گروه­های مختلف

162

4-3

خلاصه آمار توصیفی متغیر سلامت اجتماعی در پیش آزمون و پس آزمون گروه­های مختلف

164

4-4

خلاصه آمار توصیفی متغیر کیفیت زندگی در پیش آزمون و پس آزمون گروه های­مختلف

166

4-5

آزمون کلموگروف- اسمیرنوف برای بررسی نرمال بودن توزیع متغیرهای وابسته

169

4-6

آزمون لوین برای برابری واریانس خطا برای متغیر اضطراب اجتماعی

170

4-7

آزمون باکس برای برابری ماتریسهای کوواریانس برای متغیر اضطراب اجتماعی

170

4-8

آزمونهای چندمتغیری طرح اندازه گیری مکرر برای اضطراب اجتماعی

171

4-9

آزمون­های درون­گروهی و بین­گروهی طرح اندازه­گیری مکرر برای متغیر اضطراب اجتماعی

171

4-10

آزمون شفه برای مقایسه زوجی متغیر اضطراب اجتماعی بین گروه­های مختلف

172

4-11

آزمون لوین برای برابری واریانس خطا برای اضطراب اجتماعی

173

4-12

آزمون باکس برای برابری ماتریسهای کوواریانس مؤلفه­های اضطراب اجتماعی

174

4-13

آزمونهای چندمتغیری طرح اندازه گیری مکرر مؤلفه­های اضطراب اجتماعی

175

4-14

آزمونهای درون­گروهی و بین­گروهی طرح اندازه­گیری مکرر مؤلفه­های اضطراب اجتماعی

176

4-15

آزمون شفه برای مقایسه زوجی اضطراب اجتماعی بین گروه های مختلف

177

4-16

آزمون لوین برای برابری واریانس خطا برای کیفیت زندگی

178

4-17

آزمون باکس برای برابری ماتریسهای کوواریانس برای متغیر کیفیت زندگی

179

4-18

آزمونهای چندمتغیری طرح اندازه­گیری مکرر برای کیفیت زندگی

179

4-19

آزمونهای درون گروهی و بین گروهی طرح اندازه گیری مکرر کیفیت زندگی

180

4-20

آزمون شفه برای مقایسه زوجی کیفیت زندگی بین گروههای مختلف

180

4-21

آزمون لوین برای برابری واریانس خطا برای مؤلفه­های کیفیت زندگی

182

4-22

آزمون باکس برای برابری ماتریسهای کوواریانس مؤلفه­های کیفیت زندگی

183

4-23

آزمون طرح اندازه گیری مکرر برای مؤلفه های کیفیت زندگی

183

4-24

آزمونهای درون­گروهی و بین­گروهی طرح اندازه گیری مکرر مؤلفه­های کیفیت زندگی

184

4-25

آزمون شفه برای مقایسه زوجی کیفیت زندگی بین گروه­های مختلف

186

4-26

آزمون لوین برای برابری واریانس خطا برای سلامت اجتماعی

188

4-27

آزمون باکس برای برابری ماتریس­های کوواریانس برای متغیر سلامت اجتماعی 

189

4-28

آزمونهای چندمتغیری طرح اندازه گیری مکرر برای سلامت اجتماعی 

189

4-29

آزمونهای درون­گروهی و بین­گروهی طرح اندازه­گیری مکرر سلامت اجتماعی 

190

4-30

آزمون شفه برای مقایسه زوجی سلامت اجتماعی  بین گروه­های مختلف

190

4-31

آزمون لوین برای برابری واریانس خطا برای مؤلفه­های سلامت اجتماعی

192

4-32

آزمون باکس برای برابری ماتریسهای کوواریانس مؤلفه­های سلامت اجتماعی

192

4-33

آزمون طرح اندازه گیری مکرر برای مؤلفه­های سلامت اجتماعی

193

4-34

آزمون­های درون­گروهی و بین­گروهی طرح اندازه­گیری مکرر مؤلفه­های سلامت اجتماعی

194

4-35

آزمون شفه برای مقایسه زوجی سلامت اجتماعی  بین گروه­های مختلف

195

منبع:

منابع فارسی

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اصغری مقدم، محمدعلی و فقیهی، سمانه (1382). اعتبار و پایایی پرسشنامه زمینه یابی سلامت (فرم کوتاه 36 سؤالی)

در دو نمونه ایرانی. دانشور رفتار، (1)10.

افضلی، محمد حسن (1388). «مقایسه سبک ها و مکانیسم های دفاعی افراد مبتلا به وسواس بی اختیاری، اختلال

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امینی، همایون و همکاران (1386). «روایی نسخه فارسی مصاحبه ساختاریافته تشخیصی برای اختلال های محور یک

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بر باورهای فراشناختی و اعتماد شناختی در بیماران مبتلا به اختلال اضطراب اجتماعی، مجله روان­شناسی بالینی، سال چهارم، شماره 1 (پیاپی 13).

بهمنی، بهمن؛ تمدنی، مجتبی و عسگری، مجید (1383)، بررسی کیفیت زندگی و رابطه آن با نگرش دینی و عملکرد

تحصیلی دانشجویان دانشگاه آزاد اسلامی واحد جنوب تهران، طب و تزکیه، شماره 25، 32-44.

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