تغییرات در انعطاف پذیری روانی در طول درمان مبتنی بر پذیرش و تعهد برای اختلال وسواسی جبری
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|36645||2015||7 صفحه PDF||سفارش دهید||6600 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Journal of Contextual Behavioral Science, Available online 9 July 2015
Acceptance and commitment therapy (ACT) has a small research base as a treatment for obsessive compulsive disorder (OCD) and related disorders. It is presumed that the process of change in ACT is an increase in psychological flexibility. This study focuses on session by session changes in psychological flexibility in 41 adults diagnosed with OCD who were treated with ACT compared with 38 individuals who received progressive relaxation training. In a randomized controlled design, participants received 8, one-hour weekly sessions with posttreatment assessment one week after treatment and follow up three months later. Results showed that treatment effects were gradual with significantly better outcomes for ACT occurring in the final two sessions. Multiple levels of analyses show that changes in psychological flexibility predict changes in OCD better than changes in OCD severity predicting changes in psychological flexibility. Similarly, multiple levels of mediational analyses showed that posttreatment levels of psychological flexibility mediate pretreatment to follow up reductions in OCD severity.
Obsessive compulsive disorder (OCD) is characterized by obsessive thoughts, images, or impulses and related compulsive actions that are aimed at neutralizing or regulating obsessions (American Psychiatric Association, 2013). OCD affects about 1% of the population (Kessler, Chiu, Demler, & Walters, 2005) and is associated with deficits in many areas of functioning and low quality of life scores (Kugler et al., 2013). The most supported psychosocial treatment for OCD is exposure with ritual prevention (ERP) or ERP with cognitive therapy procedures (generally labeled CBT for OCD); but while effective for many, these treatments are not effective for everyone (Olatunji, Davis, Powers, & Smits, 2013). Thus, additional treatment options and conceptualizations of OCD are needed. One treatment approach with growing empirical support for the treatment of OCD is acceptance and commitment therapy (ACT; Bluett, Homan, Morrison, Levin, & Twohig, 2014; Twohig, Morrison, & Bluett, 2014). Cognitive theorists have long held that thoughts with obsessive content are common across most people, but that there is something unique about the way individuals diagnosed with OCD experience and react to these thoughts (e.g., Rachman & de Silva, 1978). The ACT theory of OCD is consistent with this basic notion. The theory of cognition that undergirds ACT, Relational Frame Theory (RFT; Hayes, Barnes-Holmes, & Roche, 2001), suggests that the meaning and function of cognitive events are regulated by separate contexts and that these contexts can be independently addressed. Specifically, ACT primarily focuses on putative functional contexts under which obsessions and associated anxiety are argued to occur including those that promote literal meaning, reason giving, and escape and avoidance of particular internal experiences. ACT attempts to change these contexts through such methods as cognitive defusion (experiencing cognition as an ongoing process rather than allowing the results of this process to overly structure the situation and overly regulate behavior), experiential acceptance (willingness to contact inner experiences without needless defense), and values-based action (choosing desired consequences of ongoing patterns of behavior so as to establish reinforcers in the present). Thus, ACT focuses much more on the function of obsessions rather than the accuracy or frequency of their content.