پیوندهای مفید
آمار
| تعداد نشریات | 21 |
| تعداد شماره‌ها | 642 |
| تعداد مقالات | 9,409 |
| تعداد مشاهده مقاله | 68,134,299 |
| تعداد دریافت فایل اصل مقاله | 39,789,696 |
پیش بینی عود مصرف مواد بر اساس آسیب های دوران کودکی : نقش میانجی بیگانگی روابط موضوعی، سازمان شخصیت مرزی و افسردگی | ||
| روان شناسی بالینی | ||
| مقاله 1، دوره 11، شماره 4 - شماره پیاپی 44، اسفند 1398، صفحه 1-12 اصل مقاله (935.38 K) | ||
| نوع مقاله: مقاله پژوهشی | ||
| شناسه دیجیتال (DOI): 10.22075/jcp.2020.19478.1806 | ||
| نویسندگان | ||
| حمزه ارباب1؛ حسن میرزاحسینی* 2؛ نادر منیرپور3 | ||
| 1دانشجوی دکتری مشاوره، دانشگاه آزاد اسلامی واحد قم، قم، ایران | ||
| 2استادیار، گروه روانشناسی عمومی، دانشگاه آزاد اسلامی واحد قم، قم، ایران | ||
| 3استادیار، گروه روانشناسی سلامت، دانشگاه آزاد اسلامی واحد قم، قم، ایران | ||
| تاریخ دریافت: 18 دی 1398، تاریخ بازنگری: 13 بهمن 1398، تاریخ پذیرش: 20 بهمن 1398 | ||
| چکیده | ||
| مقدمه: اثرات مخرب عود مصرف مواد همواره یکی از چالش های عمده در درمان اعتیاد بوده است. هدف این پژوهش تبیین مدل عود مصرف مواد بر اساس آسیب های دوران کودکی، با در نظر گرفتن نقش میانجی بیگانگی روابط موضوعی، سازمان شخصیت مرزی و افسردگی در گروهی از معتادان تحت درمان با متادون بود. روش: پژوهش حاضر توصیفی - همبستگی است. جامعه آماری شامل کلیه معتادان مرد تحت درمان با متادون شهرستان کاشان در بهار 1398 بودند. تعداد 170 نفربه روش نمونه گیری در دسترس و بر اساس ملاک های ورود و خروج انتخاب شدند. جمع آوری داده ها از طریق مقیاس عود مصرف، آسیب های دوران کودکی، پرسشنامه افسردگی بک، پرسشنامه روابط موضوعی بل، و سیاهه سازمان شخصیت کرنبرگ انجام شد. تحلیل داده‌ها به روش تحلیل مسیر از نوع مدل یابی معادلات ساختاری انجام شد. یافته ها: مدل یابی روابط ساختاری میان متغیرهای آسیب های کودکی، بیگانگی روابط موضوعی، سازمان شخصیت مرزی و افسردگی با عود مصرف مواد به صورت مستقیم و غیرمستقیم، برازندگی خوبی نشان داد ( RMSEA=0/0489). در میان مسیرهای غیرمستقیم، متغیرهای میانجی روابط موضوعی و افسردگی معنادار بودند. در مجموع این مدل 49/6 درصد از عود مصرف مواد در میان معتادان تحت درمان متادون را تبیین میکند. نتیجه گیری: آسیب های دوران کودکی، می‌تواند به شکل تاثیر بر سازمان شخصیت، احساس بیگانگی و بالتبع افسردگی در دوران های بعدی زندگی افراد معتاد بروز کند و عود مواد راهبردی جهت رهایی از این رنج است. از این منظر شناسایی و پرداختن به عوامل مذکور، درک عمیق تری از عود ارائه می نماید. پیشنهاد می گردد متخصصین در یک بستر درمانی مؤثر به متغیرهای مذکور در قالب پروتکل های درمانی بپردازند. | ||
| کلیدواژه‌ها | ||
| عود مصرف مواد؛ آسیب‌های دوران کودکی؛ روابط موضوعی؛ سازمان شخصیت؛ افسردگی | ||
| عنوان مقاله [English] | ||
| Predicting the Substance Use Relapse according to Childhood Trauma: Mediating Role of Object Relations Alienation, Borderline Personality Organization & Depression | ||
| نویسندگان [English] | ||
| Hamzeh Arbab1؛ Hasan Mirzahosini2؛ Nader Monirpoor3 | ||
| 1Department of Psychology, Ghom Branch, Islamic Azad University, Ghom, Iran | ||
| 2Department of Psychology, Ghom Branch, Islamic Azad University, Ghom, Iran | ||
| 3Department of Psychology, Ghom Branch, Islamic Azad University, Ghom, Iran | ||
| چکیده [English] | ||
| Introduction: Harmful effects of ubstance use relapses has been long a greate challenge in the treatment of addiction. The purpose of this study was to explain the substance use relapse model in addict individuals based on the childhood trauma, regarding the mediating roles of object relations alienation, borderline personality organization and depression in a group of Methadone-treated addicts. Method: Applying a descriptive - correlational design, among all male methadone-treated addicts of kashan city in 2019, a sample of 170 subjects were selected by available sampling method and inclusion/exclusion criteria were controlled for. Data were collected through the Relapse Prediction Scale, Childhood Trauma Questionnaire, Beck Depression Inventory, Bell's Object Relations Inventory, and the Kernberg’s Inventory of Personality. Data analysed by a path analysis of structural equation modeling. Results: The structural equation modelling of childhood trauma, alienation, personality organization and depression with substance use relapse directly and indirectly demonstrated significant fitness (RMSEA: 0.0489). Among indirect paths, mediator variables including object relations and depression were significant. Overall, this models explained %49/6 of the variances of substance use relapse among Methadone-treated male addicts. Conclusion: Childhood trauma impact personality organization, feelings of alienation, and depression in later life periods, and relapse is a style to get rid of these suffering. From this perspective, identifying and addressing these factors provides a deeper understanding of relapse. It is suggested that in an effective treatment context address the variables expressed in the form of treatment protocols. | ||
| کلیدواژه‌ها [English] | ||
| Substance use relapse, Childhood trauma, Object relation, Personality organization, Depression | ||
| مراجع | ||
|
. Kelly SM, O’Grady KE, Mitchell SG, Brown BS, Schwartz RP. Predictors of methadone treatment retention from a multi-site study: A survival analysis. Drug and alcohol dependence. 2011; 117(2-3): 170-5.
2. Villafranca SW, McKellar JD, Trafton JA, Humphreys K. Predictors of retention in methadone programs: A signal detection analysis. Drug and alcohol dependence. 2006; 83(3): 218–24.
3. Joseph H, Stancliff S, Langrod J. Methadone maintenance treatment (MMT): a review of historical and clinical issues. The Mount Sinai Journal of Medicine. 2000; 67(5-6): 347–64.
4. Teoh J, Yee, A, & Danaee M. Predictors of retention and mortality among patients on methadone maintenance therapy. Heroin Addiction and Related Clinical Problems. 2018; 20(4), 19-28.
5. Wallace J. Theory of 12-step oriented treatment. In F. J. Rotgers, & S. W. Morgenstern (Eds.), Treating substance abuse: Theory and technique New York: The Guilford Press. 2003.
6. Ahmadpanah M, Mirzaei Alavijeh M, Allahver-Dipour H, Jalilian F, Haghighi M, Afsar A, Gha- Ribnavaz H. Effectiveness of coping skills education program to reduce craving beliefs among addicts referred to addiction centers in Hamadan: a randomized controlled trial. Iranian J Publ Health. 2013; 42(10): 1139-44. [In Persian].
7. Liu J, Dilixiati Y, Li F, Zhang F, Mo L, Jiao L, etal. Cox regression analysis on maintenance duration and affecting factors of methadone maintenance treatment. Chin J AIDS STD. 2007; 13(2): 160-1.
8. Magura S, Nwakeze PC, Demsky SY. Pre-and in-treatment predictors of retention in methadone treatment using survival analysis. Addiction. 1998; 93(1): 51-60.
9. Esteban J, Gimeno C, Barril J, Aragonés A, Climent JM, de la Cruz Pellín M. Survival study of opioid addicts in relation to its adherence to methadone maintenance treatment. Drug and alcohol dependence. 2003; 70(2): 193-200.
10. Davison, G.C., and Neale, G. M. Abnormal Psychology. 2001; 8 th Ed. New York: John Wiley & Sons Inc.
11. Farnam A, Mahmoudzehi Sh, The Relationship between negative emotions with temptation and the likelihood of returning substance abusers: The mediating role of social support. Social Psychology Research. 2018; 18-33. [In Persian].
12. Afsar A, Bashirian S, Poorolaja, J, Hazavehei S M. M, Vatan Nawaz E, & Zinat Motlagh F. Predictors of Factors Affecting Recurrence of Drug Use among Patients With Maintenance Treatment. Journal of Health System Research. 2011; 2034-45. [In Persian].
13. Mohammadkhani S, Sadeghi N, Farzad V. The Causal Model of Relationships of Negative Emotions, Core Beliefs, Substance-related Beliefs, Craving and Emotion Regulation with Substance Abuse Relapse. Journal of Modern Psychological Researches. 2011; 6(23): 155-81. [In Persian].
14. Mørkved N, Winje D, Dovran A, Arefjord K, Johnsen E, Kroken RA, Rettenbacher M. Childhood trauma in schizophrenia spectrum disorders as compared to substance abuse disorders. Psychiatry research. 2018; 261, 481-487.
15. Farley M, Jacqueline M, Golding B, Young G, Mulligan M, Minkoff J. Trauma history and relapse probability among patients seeking substance abuse treatment. Journal of Substance Abuse Treatment. 2004; 27(2): 161–7.
16. Kernberg OF. Borderline conditions and pathologicalNarcism. New York. 1975. (JasonAronson).
17. Kernberg OF, Yeomans FB. Borderline personality disorder, bipolar disorder, depression, attention deficit/ hyperactivity disorder, and narcissistic personality disorder: practical differential diagnosis. Bulletin of the Menninger clinic. 2013; 77(1): 21-2.
18. Hanif R, Kliewer W, Riaz R. Personality traits differentiate Pakistani males in recovery versus relapse from substance use disorders. Personality and Individual Differences. 2019; 141, 226-228.
19. Millon T, Grossman S, Millon C, Meagher S, Ramnath R. Personality disorder in modern life. John Wiley & Sons. 2012.
20. Eurelings-Bontekoe EH, Luyten P, Jssennagger M, Veeswijk MV, Koelen J. Relationship between personality organization and Yongs cognitive model of personality pathology. Personality and Individual Differences. 2010; 49(3): 198-203.
21. Hebert E, Diguer L, Descoteaux J, Daoust JP, Rousseau JP, Normandian L, Scullion M. The personality Organization Diagnostic Form (Podf): A preliminary report on its validity and inter rater reliability. Psychotherapy Research. 2003; 13(2): 243-254.
22. Preti E, Rottoli C, Dainese S. Personality Structure Features Associated with Early Dropout in Patients with Substance-Related Disorders and Comorbid Personality Disorders. Int J Ment Health Addiction. 2015; 13(4): 536–547.
23. Asgari A,Pourshahbaz A,Farhoodian A. Personality Dimensions Influencing the Relapse of Substance Abuse in Drug Dependents under Methadone Maintenance Treatment. Journal of research on addiction. 2011; 5(19):7-20.
24. Gaber OH, Abelfatah ME. Relationship between Personality Disorders and Relapses among Sample of Substance Abuse Patients. J Psychol Clin Psychiatry. 2016; 6(6): 00381.
25. Fisher LA, Elias JW, Ritz K. Predicting relapse to substance abuse as a function of personality dimensions. Alcohol-Clin Exp Res. 1998; 22(5): 1041-7.
26. Mohseni Tabrizi A. Active Alienation And Passive Alienation: A Case Study of Iranian Students. Journal of Social Sciences. 2003; Vol. 22: 131-146. [In Persian].
27. Chalana H, Kundal T, Malhari AS. Depression as a Risk Factor for Relapse After Inpatient Opioid Detoxification: 1-Year Follow-Up Study. International Journal of High Risk Behaviors and Addiction. 2017; 6(3): e59543.
28. Heiwel S,Lönnquistl L,Källménl H. Potential risk factors associated with risk for drop‐out and relapse during and following withdrawal of opioid prescription medication. European Journal of Pain. 2011; 15(9): 966-970.
29. Hasin D, Liu X, Nunes E, McCloud S, Samet S, Endicott J. Effects of Major Depression on Remission and Relapse of Substance Dependence. Arch Gen Psychiatry. 2002;59(4):375–380.
30. Leslie K. Youth substance use and abuse: challenges and strategies for identification and intervention. Cmaj. 2008; 178(2), 145-148.
31. Fuchshuber J, Hiebler-Ragger M, Kresse A, Kapfhammer HP, Human F. Depressive Symptoms and Addictive Behaviors in Young Adults After Childhood Trauma: The Mediating Role of Personality Organization and Despair.Front Psychiatry. 2018; 9: 318.
32. Kline RB. Principles and practice of structural equation modeling: Guilford publications. 2015; New York: Guilford Press.
33. Wright FD, Beck AT, Newman CF, Liese BS. Cognitive therapy of substance abuse 2001;IN: Ali Goudarzi, Shiraz: Publishers of Rahgosha.
34. Kafi SM, Mollazade Esfenaji R, Norikhajavi M, Salehi E. The Effectiveness of Group Behavioral Therapy on Interaction Behavior Analysis on Marital Adjustment and Prevention of Detoxification. Modern Psychological Research. (Tabriz University Psychology) 2010; 6(23): 111-132. [In Persian].
35. Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K. Initial reliability and validity of a new retrospective measure of child abuse and neglect. The American journal of psychiatry. 1994;151(8):1132.
36. Shanni Yeilagh M, Milaili N, Shokrkon H. Prevalence of child abuse and prediction of this through general health of parents, adaptability, variable self-esteem and student's academic performance and demographic variables in harried and normal girl students in guidance school of Ahvaz. J Educ Sci Psychol. 2007; 14(1): 167-94. [In Persian].
37. Beck A, Ward C. H, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychology. 1961; 4, 561–571.
38. Fata L, Bireshk B, Atef V, Mohammad K, Dobson D. Schema semantic structures, emotional states, and cognitive processing of emotional information. Journal of Thought and Behavior. 2010;11(2): 25-32. [In Persian].
39. Kernberg OF, Clarkin OF. "The Inventory personality organization". 1995; The New York Hospital-Cornell Medical Center.
40. Lenzenweger MF, Clarkin J, Kernberg OF, Foelsch PA. "The Inventory of Personality Organization: Psychometrice properties, factorial composition, and criterion relations with affect, aggressive dyscontrol, psychosis proneness, and self-domains in a nonclinical sample". Psychological Assessment. 2001; Vol. 13(4): 577-591.
41. Al Behbahani M, Mohammadi N. Investigating the Psychometric Properties of the Kernberg Personality Inventory. Iranian Journal of Psychology. 2007; vol 42: 185-195. [In Persian].
42. Bell M, Billington R, Becker B. A scale for the assessment of object relations: Reliability, validity, and factorial invariance. Journal of Clinical Psychology. 1986; 42(5): 733-41.
43. Derefinko KJ, Salgado García FI, Talley KM, Bursac Z, Johnson KC,Murphy JG,McDevitt-Murphy ME, Andrasik F, Sumrok DD. Adverse childhood experiences predict opioid relapse during treatment among rural adults. Addict Behav. 2019; 96:171-174.
44.Banducci AN,Hoffman E, Lejuez CW, Koenen KC. The relationship between child abuse and negative outcomes among substance users: psychopathology, health, and comorbidities. Addict Behav. 2014; 39(10):1522-7.
45. Fernández-Montalvo J, López-Goñi JJ, Arteaga A. Psychological, physical, and sexual abuse in addicted patients who undergo treatment. Journal of interpersonal violence. 2015;30(8):1279-98.
46. Gil-Rivas V, Prause J, Grella CE. Substance use after residential treatment among individuals with co-occurring disorders: The role of anxiety/depressive symptoms and trauma exposure. Psychology of Addictive Behaviors. 2009; 23(2): 303–314.
47. Blizard RA. Bluhn AM. Attachment to the abuser: Integrating object-relations and trauma theories in treatment of abuse survivors. Psychotherapy. 1994; 3(1):383-390.
48. Atkinson R, Atkinson RS, Heilgard E. Psychology. Translated by: Barahani M, Karimi Y, Shahrarai M, Birshak B, Beik M, Gahan N, Zamani Z, Mohammaduddin Bana M.Tehran 2011; Vol. I, Roshd Publications. [In Persian].
49. Leahy RL, Tirch D, Napolitano LA. Emotion regulation in psychotherapy: A practitioner's guide 2011: Guilford Press.
50. Sihvola E, Rose RJ, Dick DM, Pulkkinen L, Marttunen M, Kaprio J. Earlyonset depressive disorders predict the use of addictive substances in adolescence: A prospective study of adolescent Finnish twins. Addiction 2008; 103(12), 2053−45.
51. Kohut H. The restoration of the self: CT: University of Chicago Press; 2009.
52.Yousefzadeh Ch, Yasrabi k, Yasrabi M. The Relationship between Object Relationships and Interpersonal Guilt in Drug and Drug Abuse Problems. First International Comprehensive Congress of Iranian Psychology. 2015; Tehran, Iran Development Conferences Center.
53. Bellak L, Hurvich M, Gediman HK. Ego Functions in Schizophrenics, Neurotics, and Normals 1973; New York: John Wiley.
54. Summers F. Object relations theories and psychopathology: A comprehensive text: Routledge; | ||
|
آمار تعداد مشاهده مقاله: 3,219 تعداد دریافت فایل اصل مقاله: 2,146 |
||