طراحی پروتکل نوروفیدبک و اثربخشی آن بر تکانشگری، بی ثباتی هیجانی و رفتار جرح خویشتن در بیماران مبتلا به اختلال شخصیت مرزی

نویسندگان
فرشته بخشیان 1
کامران یزدانبخش 1
جهانگیر کرمی 1
سیدحمزه حسینی 2
1 دانشگاه رازی
2 دانشگاه علوم پزشکی مازندران
چکیده
اختلال شخصیت مرزی اختلالی با یک الگوی فراگیر بی ثباتی در روابط بین فردی، خودانگاره و عواطف به همراه تکانشگری بارز است. این اختلال با نقص مدارهای فعالیت فرونتالی مشخص شده است که نقش مهمی را در بازداری و تنظیم پرخاشگری بازی می کنند. پژوهش حاضر با هدف طراحی پروتکل نوروفیدبک و بررسی اثربخشی آن بر تکانشگری، بی ثباتی هیجانی و رفتار جرح خویشتن در بیماران مبتلا به اختلال شخصیت مرزی انجام شد. پژوهش نیمه آزمایشی بوده که با طرح پیش آزمون – پس آزمون و دوره پیگیری با گروه گواه اجرا شد. نمونه پژوهش شامل 30 بیمار مبتلا به اختلال شخصیت مرزی بودند که با توجه به تشخیص روانپزشک و با استفاده از مصاحبه بالینی ساختارمند بر اساس DSM5 ، تشخیص اختلال شخصیت مرزی را دریافت کردند. آنها با نمونه گیری در دسترس انتخاب و به به صورت تصادفی به دو گروه تجربی (آموزش نوروفیدبک) و کنترل تقسیم شدند .گروه آزمایش تحت 30 جلسه آموزش نوروفیدبک قرار گرفتند و گروه گواه در لیست انتظار قرار گرفتند. پس از آخرین جلسه درمانی، هردو گروه مجددا ارزیابی شدند. از مقیاس اختلال شخصیت مرزی(STB، پرسشنامه تکانشگری بارات(1957)، پرسشنامه بدتنظیمی هیجانی گراتز و رومر( 2004)، مقیاس خودآسیبی(سوانسون و همکاران، 1998) برای ارزیابی استفاده شد. سه ماه بعد از اجرای پژوهش آزمودنی ها مجددا مورد پیگیری قرار گرفتند . داده ها یا تحلیل کواریانس، تحلیل کوواریانس چندمتغیر( مانکووا) و تحلیل واریانس با اندازه گیری تکراری تحلیل شدند. یافته ها نشان داد که پس از کنترل اثر پیش آزمون، آموزش نوروفیدبک تاثیر معنی داری در کاهش علایم تکانشگری، بی ثباتی هیجانی و مولفه های آن و همچنین رفتار جرح خویشتن در گروه آزمایشی به نسبت گروه کنترل داشت(000/0=p). با توجه به یافته ها می توان گفت روش آموزش نوروفیدبک به عنوان یک روش موثر در کاهش تکانشگری، بی ثباتی هیجانی و رفتار جرح خویشتن قابلیت کاربرد اجرایی در مراکز درمانی را دارد.
کلیدواژه‌ها
نوروفیدبک
تکانشگری
بی ثباتی هیجانی
رفتار جرح خویشتن
اختلال شخصیت مرزی

عنوان مقاله English

The Design of neurofeedback protocol and it’s effect on impulsivity, emotional instability, self-mutilation behavior in patient with borderline personality disorder (BPD)

نویسندگان English

Fereshte Bakhshian 1
Kamran Yazdanbakhsh 1
Jahangir Karami 1
Seyed Hamze Hoseini 2
1 Razi University
2 Mazandaran University of Medical Sciences
چکیده English

Borderline personality disorder is a disorder with a pervasive pattern of instability in interpersonal relationships, self-image, and emotions with impulsivity. This disorder is characterized by defects in the frontal activity circuits that play an important role in inhibiting and aggression regulation. The aim of this study is to design a neurofeedback protocol and investigate its effect on impulsivity, emotional instability and self-mutilation behavior in patients with borderline personality disorder. This study is a quasi-experimental study with a pre-test, post-test, follow up and control group design. The research sample consisted of 30 patients with borderline personality disorder that received a diagnosis of borderline personality disorder according to the diagnosis of a psychiatrist and a structured clinical interview based on DSM5. They were selected by available sampling and divided into experimental (neurofeedback training) and control groups randomly. The experimental group underwent 30 sessions of neurofeedback training and the control group was placed on a waiting list.

After the last treatment session, both groups were re-evaluated. To collect the data, The Borderline Personality Disorder Scale (STB), Barat Impulsivity Questionnaire (1957 Difficulties in Emotion Regulation Scale (Gratz and Roemer ,2004), and the Self-injury Scale (Swanson et al., 1998) were used. Three months after the study, the subjects were followed up again . The results showed that after controlling the effect of pretest, neurofeedback training had a significant effect on reducing the impulsivity, emotional instability and its components, as well as self-mutilation behavior in the experimental group compared to the control group(p<0/001(. With regard these results, we can say that the neurofeedback training method is an effective way to reduce the impulsivity, emotion dysregulation, and self-mutilation behavior in the treatment centers.

کلیدواژه‌ها English

Neurofeedback
impulsivity
emotional instability
self-mutilation behavior
borderline
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