نقش واسطه‌ای دشواری‌های تنظیم هیجانی و اجتناب تجربی در رابطه بین سازوکارهای دفاعی و افکار خودکشی در نوجوانان

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناسی ارشد روان شناسی بالینی، گروه روان شناسی، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران.

2 کارشناسی ارشد روان شناسی عمومی، گروه روان شناسی، واحد تهران جنوب، دانشگاه آزاد اسلامی، تهران، ایران

چکیده

هدف: هدف پژوهش حاضر تعیین نقش واسطه‌­ای اجتناب تجربی و دشواری‌­های تنظیم هیجان در رابطه بین سازوکارهای دفاعی با افکار خودکشی نوجوانان بود. روش: پژوهش از نوع توصیفی- همبستگی و جامعه آماری این پژوهش شامل تمام نوجوانان شهر کرج در پاییز سال 1398 بود که از میان آن­ها به روش نمونه گیری در دسترس از مناطق آموزشی 3 و 7، 270 نوجوان 15 تا 18 سال (125 پسر و 143 دختر) انتخاب شدند. ابزار پژوهش شامل پرسشنامه سازوکارهای دفاعی-40 آندروز و همکاران (۱۹93) (DSQ-40)؛ پرسشنامه دشواری در تنظیم هیجان گراتز و روئمر (2004) (ERDS)؛ پرسشنامه اجتناب تجربی چندبعدی گراتز و همکاران (2011) (MEAQ) و مقیاس شناخت‌های خودکشی رود و همکاران (2010) (SCS) بود. برای تحلیل داده‌­ها از روش مدل‌یابی معادلات ساختاری استفاده شد. یافته­‌ها: در پژوهش حاضر رابطه مستقیم رابطه مستقیم سازوکارهای پخته (348/0-=β، 001/0=P) و ناپخته (440/0-=β، 001/0=P) با افکار خودکشی معنادار بود. رابطه مستقیم اجتناب تجربی با افکار خودکشی معنادار بود (224/0-=β، 001/0=P). رابطه مستقیم دشواری تنظیم هیجان با افکار خودکشی معنادار بود (439/0=β، 001/0=P). رابطه غیرمستقیم سازوکارهای دفاعی پخته با افکار خودکشی معنادار بود (295/0-=β، 001/0=P). رابطه غیرمستقیم سازوکارهای دفاعی ناپخته با افکار خودکشی معنادار بود (314/0=β، 001/0=P). نتیجه‌­گیری: براساس نتایج حاصل از پژوهش حاضر پیشنهاد می­‌شود در درمان نوجوانان خودکشی‌­گرا سازوکارهای دفاعی، اجتناب تجربی و راهبردهای تنظیم هیجان در آنها مدنظر قرار گیرد.

کلیدواژه‌ها


عنوان مقاله [English]

The mediating role of emotion regulation difficulties and experiential avoidance in the relationship between defense mechanisms and suicidal ideation in adolescents

نویسندگان [English]

  • Raziyeh Nikfallah 1
  • Arsalan Barekat 2
1 Master of Clinical Psychology, Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
2 Master of General Psychology, Department of Psychology, South Tehran Branch, Islamic Azad University, Tehran, Iran.
چکیده [English]

Aim: This study aimed to determine the mediating role of experiential avoidance and emotion regulation difficulties in the relationship between defense mechanisms and adolescent suicidal ideation. Method: The study was descriptive-correlational and the statistical population of this study included all adolescents in Karaj in the fall of 2019, of which 270 adolescents aged 15 to 18 years (125 boys and 143 girls) were selected by available sampling method from educational areas 3 and 7. The study tools were included Defense Style Questionnaire-40 by Andrews et al., (1993) (DSQ-40); Emotion Regulation Difficulty Scale by Gratz & Roemer (2004) (ERDS); Multidimensional Experiential Avoidance Questionnaire by Gámez et al., (2011) (MEAQ) and Suicide Cognitions Scale by Rudd et al. (2010) (SCS). Structural equation modeling was used to analyze the data. Results: In the present study, the direct relationship between mature (β=-0.348, P=0.001) and immature (β=-0.440, P=0.001) mechanisms with suicidal ideation was significant. The direct relationship between experimental avoidance with suicidal ideation was significant (β=-0.224, P=0.001). The direct relationship between emotion regulation difficulty and suicidal ideation was significant (β=0.439, P=0.001). The indirect relationship between mature defense mechanisms and suicidal ideation was significant (β=-0.295, P=0.001). The indirect relationship between immature defense mechanisms and suicidal ideation was significant (β=0.314, P=0.001). Conclusion: Based on the results of the present study, it is suggested that in the treatment of suicidal adolescents, defense mechanisms, experiential avoidance, and emotion regulation strategies be considered.

کلیدواژه‌ها [English]

  • Experimental avoidance
  • suicidal ideation
  • emotion regulation
  • defense mechanisms and adolescents
Andrews, G., Singh, M., & Bond, M. (1993). The Defense Style Questionnaire. Journal of Nervous and Mental Disease, 181(4), 246-56. [Link]
Anestis, M. D., Khazem, L. R., & Law, K. C. (2015). How many times and how many ways: the impact of number of non-suicidal self-injury methods on the relationship between non-suicidal self-injury frequency and suicidal behavior. Suicide and Life-Threatening Behavior, 45(2), 164-177. [Link]
Brereton, A., & McGlinchey, E. (2019). Self-harm, emotion regulation, and experiential avoidance: A systematic review. Archives of Suicide Research, 1-24. [Link]
Caligor, E., Kernberg, O. F., & Clarkin, J. F. (2007). Handbook of dynamic psychotherapy for higher level personality pathology (1st Ed.). Arlington, VA, US: American Psychiatric Publishing, Inc. [Link]
Carvalho, A. F., Hyphantis, T. N., Taunay, T. C., Macêdo, D. S., Floros, G. D., Ottoni, G. L., ... Lara, D. R. (2013). The relationship between affective temperaments, defensive styles and depressive symptoms in a large sample. Journal of Affective Disorders, 146(1), 58-65. [Link]
Colman, A. M. (2009). A Dictionary of Psychology (3rd Ed.). Oxford University Press. [Link]
Cramer, P., & Porcerelli, J. H. (2016). Defense Mechanisms. In H. S. Friedman (Ed.), Encyclopedia of Mental Health (2nd Ed.) (pp. 13-17). Oxford: Academic Press. [Link]
Diehl, M., Chui, H., Hay, E. L., Lumley, M. A., Grühn, D., & Labouvie-Vief, G. (2013). Change in coping and defense mechanisms across adulthood: longitudinal findings in a European American sample. Developmental psychology, 50(2), 634-48. [Link]
Dumith, S. C., Demenech, L. M., Carpena, M. X., Nomiyama, S., Neiva-Silva, L., & Loret de Mola, C. (2020). Suicidal thought in southern Brazil: Who are the most susceptible? Journal of Affective Disorders, 260, 610-616. [Link]
Dworsky, C. K. O., Pargament, K. I., Wong, S., & Exline, J. J. (2016). Suppressing spiritual struggles: The role of experiential avoidance in mental health. Journal of Contextual Behavioral Science, 5(4), 258-265. [Link]
Eifert, G. H., Forsyth, J. P., Arch, J., Espejo, E., Keller, M., & Langer, D. (2009). Acceptance and commitment therapy for anxiety disorders: Three case studies exemplifying a unified treatment protocol. Cognitive and Behavioral Practice, 16(4), 368-385. [Link]
Ellis, T. E., & Rufino, K. A. (2015). A psychometric study of the Suicide Cognitions Scale with psychiatric inpatients. Psychological Assessment, 27 (1), 82-89. [Link]
Ellis, T. E., & Rufino, K. A. (2016). Change in experiential avoidance is associated with reduced suicidal ideation over the course of psychiatric hospitalization. Archives of Suicide Research, 20(3), 426-437. [Link]
Gámez, W., Chmielewski, M., Kotov, R., Ruggero, C., & Watson, D. (2011). Development of a measure of experiential avoidance: The Multidimensional Experiential Avoidance Questionnaire. Psychological Assessment, 23(3), 692. [Link]
Granieri, A., La Marca, L., Mannino, G., Giunta, S., Guglielmucci, F., & Schimmenti, A. (2017). The relationship between defense patterns and dsm-5 maladaptive personality domains. Frontiers in Psychology, 8, 1926. [Link]
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 55-41. [Link]
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change. New York, NY: Guilford Press. [Link]
Hilt, L. M., Hanson, J. L., & Pollak, S. D. (2011). Emotion Dysregulation. In B. B. Brown & M. J. Prinstein (Eds.), Encyclopedia of Adolescence (pp. 160-169). Academic Press. [Link]
Jonbeshi, A., & Abolmaali, Alhoseini, K. (2017). Confirmatory factor analysis of the experiential avoidance questionnaire in high school students. International Journal of Behavioral Sciences, 11(1), 1-4. [Link]
Kline, R. B. (2016). Principles and practice of structural equation modeling (4th Ed). Guilford Press. [Link]
Links, P. S., Gould, B., & Ratnayake, R. (2003). Assessing suicidal youth with antisocial, borderline, or narcissistic personality disorder. Canadian Journal of Psychiatry, 48(5), 301-310. [Link]
Mitmansgruber, H., Beck, T. N., & Schüßler, G. (2008). “Mindful helpers”: Experiential avoidance, meta-emotions, and emotion regulation in paramedics. Journal of Research in Personality, 42(5), 1358-1363. [Link]
Najmi, S. (2013). Thought suppression. Oxford Handbooks Online: Oxford University Press. [Link]
Neacsiu, A. D., Fang, C. M., Rodriguez, M., & Rosenthal, M. Z. (2018). Suicidal behavior and problems with emotion regulation. Suicide and Life-Threatening Behavior, 48(1), 52-74. [Link]
Perry, J. C., & Metzger, J. (2014). Introduction to "defense mechanisms in psychotherapy". Journal of clinical psychology, 70(5), 405. [Link]
Plutchik, R. (1997). The circumplex as a general model of thestructure of emotions and personality. In: Plutchik, R., & Conte, H. T., editors. Circumplex models of personality and emotions. Washington, DC: American Psychological Association. [Link]
Pompili, M., Rinaldi, G., Lester, D., Girardi, P., Ruberto, A., & Tatarelli, R. (2006). Hopelessness and suicide risk emerge in psychiatric nurses suffering from burnout and using specific defense mechanisms. Archives of psychiatric nursing, 20(3), 135-143. [Link]
Puhalla, A. A., McCloskey, M. S., Brickman, L. J., Fauber, R., & Coccaro, E. F. (2016). Defense styles in Intermittent Explosive Disorder. Psychiatry Research, 238, 137-142. [Link]
Raudales, A. M., Short, N. A., & Schmidt, N. B. (2019). Emotion dysregulation as a prospective predictor of suicidal ideation in an at-risk mixed clinical sample. Archives of Suicide Research, 1-13. [Link]
Rogers, M. L., Ringer, F. B., & Joiner, T. E. (2018). The association between suicidal ideation and lifetime suicide attempts is strongest at low levels of depression. Psychiatry Research, 270, 324-328. [Link]
Roush, J. F., Brown, S. L., Mitchell, S. M., & Cukrowicz, K. C. (2017). Experiential avoidance, cognitive fusion, and suicide ideation among psychiatric inpatients: The role of thwarted interpersonal needs. Psychotherapy research, 1-10. [Link]
Rudd, M.D., Schmitz, B., McClenen, R., Joiner, T., Elkins, G., & Claassen, C. A. (2010). The Suicide Cognitions Scale: A suicide-specific measure of hopelessness. Manuscript in preparation. [Link]
Sala, M. N., Testa, S., Pons, F., & Molina, P. (2015). Emotion regulation and defense mechanisms. Journal of Individual Differences, 36(1), 19-29. [Link]
Schmalz, J., E., & Murrell, A. R. (2010). Measuring Experiential Avoidance in Adults: The Avoidance and Fusion Questionnaire. International Journal of Behavioral Consultation and Therapy, 6(3), 198-213. [Link]
Sepehreinjad, M., & Hatamian, P. (2018). Forecast of suicidal thoughts based on emotional dysregulation and experimental avoidance in nurses. Iranian Journal of Nursing Research, 13(4), 39-44. [Link]
Teismann, T., Forkmann, T., Brailovskaia, J., Siegmann, P., Glaesmer, H., & Margraf, J. (2018). Positive mental health moderates the association between depression and suicide ideation: A longitudinal study. International Journal of Clinical and Health Psychology, 18(1), 1-7. [Link]
Vaillant, G. E. (1994). Ego mechanisms of defense and personality psychopathology. Journal of abnormal psychology, 103(1), 44-50. [Link]
Vaillant, G. E. (2012). Defense Mechanisms. In V. S. Ramachandran (Ed.), Encyclopedia of Human Behavior (2nd Ed.) (pp. 659-666). San Diego: Academic Press. [Link]
Weiss, N. H., Gratz, K. L., & Lavender, J. M. (2015). Factor structure and initial validation of a multidimensional measure of difficulties in the regulation of positive emotions: The DERS-Positive. Behavior modification, 39(3), 431-453. [Link]
Whitman, C. N., & Gottdiener, W. H. (2015). Implicit Coping Styles as a Predictor of Aggression. Journal of Aggression, Maltreatment & Trauma, 24(7), 809-824. [Link]
Williams, A. D. (2012). Distress tolerance and experiential avoidance in compulsive acquisition behaviors. Australian Journal of Psychology, 64(4), 217-224. [Link]
Yates, T. M. (2004). The developmental psychopathology of self-injurious behavior: Compensatory regulation in posttraumatic adaptation. Clinical Psychology Review, 24(1), 35-74. [Link]