Volume 11, Issue 1 (2019)
Iran J War Public Health 2019, 11(1): 1-6 |
Back to browse issues page
Article Type:
Subject:
History
Received: 2018/04/11 | Accepted: 2018/07/17 | Published: 2019/03/12
Received: 2018/04/11 | Accepted: 2018/07/17 | Published: 2019/03/12
Rights and permissions
Authors
R. Taghavi1, R. Kazemi *2
1- Clinical Psychology Department, Humanities Faculty, Ardabil Branch, Islamic Azad University, Ardabil, Iran
2- Psychiaty Department, Medical Faculty, Ardabil Branch, Islamic Azad University, Ardabil, Iran , Dr_reza.kazemi@yahoo.com
2- Psychiaty Department, Medical Faculty, Ardabil Branch, Islamic Azad University, Ardabil, Iran , Dr_reza.kazemi@yahoo.com
Abstract (3961 Views)
Aims: Post-traumatic stress disorder (PTSD) is one of the prominent psychological consequences of war that is seen in veterans. Behavioral activation treatment is a short-term intervention that can target a range of disruptions to the disorder. The purpose of the present study was to investigate effectiveness of short-term behavioral activation therapy on the rumination and experimental avoidance of veterans with PTSD.
Material & Methods: In this semi-experimental study with pretest-posttest design with control group, 40 veterans with PTSD who referred to Isar Ardabil psychiatric hospital in 2017 were selected through purposive sampling and randomaly assigned to two groups of experimental and control. The data were collected using a posttrumatic stress disorder checklist (military version), ruminal responses scale and acceptance and action questionnaire-II. Then, behavioral activation therapy were performed for 10 sessions (one hour in per session) for the experimental group. Data were analyzed by SPSS 23 using multiple covariance analysis.
Finding: After controlling the effects of pretest, the mean scores of rumination (F=4.843; p= 0.035) and experiential avoidance (F=5.123; p= 0.030) were significantly higher in the experimental group than the control group.
Conclusion: Training behavioral activation therapy reduces rumination and experiential avoidance of veterans with PTSD.
Material & Methods: In this semi-experimental study with pretest-posttest design with control group, 40 veterans with PTSD who referred to Isar Ardabil psychiatric hospital in 2017 were selected through purposive sampling and randomaly assigned to two groups of experimental and control. The data were collected using a posttrumatic stress disorder checklist (military version), ruminal responses scale and acceptance and action questionnaire-II. Then, behavioral activation therapy were performed for 10 sessions (one hour in per session) for the experimental group. Data were analyzed by SPSS 23 using multiple covariance analysis.
Finding: After controlling the effects of pretest, the mean scores of rumination (F=4.843; p= 0.035) and experiential avoidance (F=5.123; p= 0.030) were significantly higher in the experimental group than the control group.
Conclusion: Training behavioral activation therapy reduces rumination and experiential avoidance of veterans with PTSD.
References
1. Kamalmanesh A, Maredpour A. Evaluation of post-traumatic stress disorder among war survivors. Health Res J. 2017;2(2):87-98. [Persian] [DOI:10.18869/acadpub.hrjbaq.2.2.87]
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-5. Rezaei F, Fakhraee A, Charismatic A, Lotus A, Hashemi Azar J, Shamloo F, translators. 5th Edition. Tehran: Arjmand Press; 2013. pp. 102-9. [Persian]
3. Sadock BJ, Sagock VA, Ruiz P. Kaplan Sadock's synopsis of psychiatry: behavioral sciences. Volume 1. Rezaei F, translator. 11th Edition. Tehran: Arjmand Press; 2014. pp. 203-6. [Persian]
4. Panagioti M, Gooding PA, Tarrier N. A meta-analysis of the association between posttraumatic stress disorder and suicidality: The role of comorbid depression. Compr Psychiatry. 2012;53(7):915-30. [DOI:10.1016/j.comppsych.2012.02.009]
5. Roley ME, Claycomb MA, Contractor AA, Dranger P, Armour CH, Elhai JD. The relationship between rumination, PTSD, and depression symptoms. J Affect Disord. 2015;180(15):116-21. [DOI:10.1016/j.jad.2015.04.006]
6. Raines AM, Vidaurri DN, Portero AK, Schmidt NB. Associations between rumination and obsessive-compulsive symptom dimensions. Personal Individ Differ. 2017;113(15):63-7. [DOI:10.1016/j.paid.2017.03.001]
7. Borders A, Rothman DJ, McAndrew LM. Sleep problems may mediate associations between rumination and PTSD and depressive symptoms among OIF/OEF veterans. Psychol Trauma. 2015;7(1):76-84. [DOI:10.1037/a0036937]
8. Spinhoven PH, Penninx BW, Krempeniou A, Van Hemert AM, Elzinga B. Trait rumination predicts onset of post-traumatic stress disorder through trauma-related cognitive appraisals: A 4-year longitudinal study. Behav Res Ther. 2015;71:101-9. [DOI:10.1016/j.brat.2015.06.004]
9. Meiser-Stedman R, Shepperd A, Glucksman ED, Dalgleish T, Yule W, Smith P. Thought control strategies and rumination in youth with acute stress disorder and post‐traumatic stress disorder following single‐event trauma. J Child Adolesc Psychopharmacol. 2014;24(1):47-51. [DOI:10.1089/cap.2013.0052]
10. Basharpoor S, Shafiei M, Daneshvar S. The comparison of experiential avoidance, mindfulness and rumination in trauma-exposed individuals with and without posttraumatic stress disorder (PTSD) in an Iranian sample. Arch Psychiatr Nurs. 2015;29(5):279-83. [DOI:10.1016/j.apnu.2015.05.004]
11. Heidarirad H, Shafiei M, Basharpoor S. The role of suicide ideation and rumination in predicting posttraumatic stress disorder (PTSD) in trauma-exposed individuals. Personal Individ Differ. 2016;5(13):65-85. [Persian]
12. Blackburn L, Owens GP. Rumination, resilience and posttraumatic stress disorder symptom severity among veterans of Iraq and Afghanistan. J Aggress Maltreat Trauma. 2016;25(2):197-209. [DOI:10.1080/10926771.2015.1107174]
13. Morina N. The role of experiential avoidance in psychological functioning after war-related stress in Kosovar civilians. J Nerv Ment Dis. 2007;195(8):697-700. [DOI:10.1097/NMD.0b013e31811f44a6]
14. Hershenberg R, Mavandadi S, Wright E, Thase ME. Anhedonia in the daily lives of depressed veterans: A pilot report on experiential avoidance as a moderator of emotional reactivity. J Affect Disord. 2017;208(1):414-7. [DOI:10.1016/j.jad.2016.10.011]
15. Eifert GH, Forsyth JP, Arch J, Espejo E, Keller M, Langer D. Acceptance and commitment therapy for anxiety disorders: Three case studies exemplifying a unified treatment protocol. Cogn Behav Pract. 2009;16(4):368-85. [DOI:10.1016/j.cbpra.2009.06.001]
16. Karekla M, Panayiotou G. Coping and experiential avoidance: Unique or overlapping constructs? J Behav Ther Exp Psychiatry. 2011;42(2):163-70. [DOI:10.1016/j.jbtep.2010.10.002]
17. Sloan DM. Emotion regulation in action: Emotional reactivity in experiential avoidance. Behav Res Ther. 2004;42(11):1257-70. [DOI:10.1016/j.brat.2003.08.006]
18. Kashdan TB, Kane JQ. Posttraumatic distress and the presence of posttraumatic and meaning in life experiential avoidance as a moderator. Personal Individ Differ. 2011;50(1):84-9. [DOI:10.1016/j.paid.2010.08.028]
19. Shenk CE, Putnam FW, Noll JG. Experiential avoigance and the relationship between child maltreatment and PTSD symptoms: Preliminary evidence. Child Abuse Negl. 2012;36(2):118-26. [DOI:10.1016/j.chiabu.2011.09.012]
20. Basharpoor S, Shafiei M, Atadokht A, Narimani M. The Role of experiential avoidance and mindfulness in predicting the symptoms of stress disorder after exposure to trauma in traumatized people supported by Emdad Committee and Bonyade Shahid organization of Gilan Gharb in the first half of 2014. J Rafsanjan Univ Med Sci. 2015;14(5):405-16. [Persian]
21. Bakhshaie J, Zvolensky MJ, Allan N, Vujanovic AA, Schmidt NB. Differential effects of anxiety sensitivity components in the relation between emotional nonacceptance and post-traumatic stress symptoms among trauma-exposed treatment-seeking smokers. Cogn Behav Ther. 2015;44(3):175-89. [DOI:10.1080/16506073.2015.1004191]
22. Cobb AR, Lancaster CL, Meyer EC, Lee HJ, Telch MJ. Pre-deployment trait anxiety, anxiety sensitivity and experiential avoidance predict war-zone stress-evoked psychopathology. J Contextual Behav Sci. 2017;6(3):276-87. [DOI:10.1016/j.jcbs.2017.05.002]
23. Dimidjian S, Hollon SD, Dobson KS, Schmaling KB, Kohlenberg RJ, Addis ME, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. J Consult Clin Psychol. 2006;74(4):658-70. [DOI:10.1037/0022-006X.74.4.658]
24. Lejuez CW, Hopko DR, Acierno R, Daughters SB, Pagoto SL. Ten year revision of the brief behavioral activation treatment for depression: Revised treatment manual. Behav Modif. 2011;35(2):111-61. [DOI:10.1177/0145445510390929]
25. Ritschel LA, Ramirez CL, Jones M, Craighead WE. Behavioral activation for depressed teens: A pilot study. Cogn Behav Pract. 2011;18(2):281-99. [DOI:10.1016/j.cbpra.2010.07.002]
26. Myers CE, Vanmeenen KM, Servatius RJ. Behavioral inhibition and PTSD symptoms in veterans. Psychiatry Res. 2012;196(2-3):271-6. [DOI:10.1016/j.psychres.2011.11.015]
27. Mulick PC, Naugle AE. Behavioral activation for comorbid PTSD and major depression: A case study. Cogn Behav Pract. 2004;11(4):378-87. [DOI:10.1016/S1077-7229(04)80054-3]
28. Wagner AW, Zatzick DF, Ghesquiere A, Jurkovick GJ. Behavioral activation as an early intervention for posttraumatic stress disorder and depression among physically injured trauma survivors. Cogn Behav Pract. 2007;14(4):341-9 [DOI:10.1016/j.cbpra.2006.05.002]
29. Moshier SJ, Otto MW. Behavioral activation treatment for major depression: A randomized trial of the efficacy of augmentation with cognitive control training. J Affect Disord. 2017;210:265-8. [DOI:10.1016/j.jad.2017.01.003]
30. Muris P, Roelofs J, Rassin E, Franken I, Mayer B. Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Personal Individ Differ. 2005;39(6):1105-11. [DOI:10.1016/j.paid.2005.04.005]
31. Conway M, Csank PA, Holm SL, Blake CK. On assessing individual differences in rumination on sadness. J Pers Assess. 2000;75(3):404-25. [DOI:10.1207/S15327752JPA7503_04]
32. Mansouri A, Bakhshipour Rodsari A, Mahmood Aliloo M, Farnam AR, Fakhari A. The comparison of worry, obsession and rumination in individual with Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Major Depression Disorder and normal individual. Psychol Stud. 2012;7(4):55-74. [Persian]
33. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011;42(4):676-88. [DOI:10.1016/j.beth.2011.03.007]
34. Abbasi E, Fati L, Moludi R, Zarrabi H. Psychometric properties of persian version of Acceptance and Action Questionnaire-II. J Manag Syst. 2013;2(10):65-80. [Persian]
35. Zemestani M, Davoodi I, Mehrabizadeh Honarmand M, Zargar Y. Effectiveness of group behavioral activation on depression, anxiety and rumination in patients with depression and anxiety. J Clin Psychol. 2014;5(4):73-84. [Persian]
36. Contractor AA, Elhai JD, Ractliffe KC, Forbes D. PTSD's underlying symptom dimensions and relations with behavioral inhibition and activation. J Anx Disord. 2013;27(7):645-51. [DOI:10.1016/j.janxdis.2013.07.007]