اثربخشی درمان فراشناختی بر ذهن خوانی، حافظه سرگذشتی و تنظیم شناختی هیجان در دانش آموزان مبتلا به اختلال اضطراب اجتماعی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس ارشد روانشناسی، گروه روانشناسی، دانشکده علوم اجتماعی، دانشگاه رازی، کرمانشاه، ایران

2 استادیار گروه مشاوره، دانشکده علوم انسانی و اجتماعی، دانشگاه کردستان، ایران

3 استادیار گروه روانشناسی، دانشکده علوم انسانی و اجتماعی، دانشگاه کردستان، سنندج، ایران

10.48308/apsy.2024.236968.1707

چکیده

هدف: پژوهش حاضر با هدف اثربخشی درمان فراشناختی بر ذهن‌خوانی، حافظه سرگذشتی و تنظیم شناختی هیجان در دانش‌آموزان مبتلا به اختلال اضطراب اجتماعی انجام شد.
 
روش: طرح پژوهش حاضر نیمه آزمایشی از نوع پیش‌آزمون، پس‌آزمون و پیگیری همراه با گروه گواه بود. جامعه آماری این پژوهش، دانش‌آموزان دختر مقطع متوسطه دوم مبتلا به اختلال اضطراب اجتماعی مراجعه‌کننده به مراکز مشاوره آموزش و پرورش سنندج در سال تحصیلی 1402-1401 بودند که 30 نفر از آن‌ها به‌صورت هدفمند انتخاب و به‌صورت تصادفی در دو گروه گواه و آزمایش قرار داده شدند. گروه آزمایش 8 جلسه 90 دقیقه‌ای درمان فراشناختی دریافت کرد، اما گروه گواه هیچ درمانی دریافت نکرد. تمامی شرکت‌کنندگان در سه مرحله پیش‌آزمون، پس‌آزمون و پیگیری (چهار ماه بعد از پس‌آزمون) به پرسشنامه‌های اضطراب اجتماعی، آزمون حافظه سرگذشتی، پرسشنامه تنظیم شناختی هیجان و آزمون ذهن‌خوانی از طریق چشم پاسخ دادند. جهت تجزیه‌وتحلیل داده‌ها از آزمون آماری تحلیل واریانس با اندازه‌گیری مکرر استفاده شد.
 
یافته‌ها: نتایج تحلیل داده‌ها نشان داد که درمان فراشناختی تأثیر معناداری در کاهش میزان اضطراب اجتماعی گروه آزمایش داشته است (01/0> p) و موجب افزایش معنادار حافظه سرگذشتی، ذهن‌خوانی و تنظیم شناختی هیجان در دانش‌آموزان مبتلا به اضطراب اجتماعی شده است (01/0> p)، همچنین این اثر با گذشت زمان نیز حفظ شده است.
 
نتیجه‌گیری: بر اساس این یافته‌ها، پیشنهاد می‌شود که درمان فراشناختی به‌عنوان یک روش کارآمد در مدارس و مراکز مشاوره برای دانش‌آموزان مبتلا به اضطراب اجتماعی به‌کار گرفته شود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Effectiveness of Metacognitive Therapy on Mind Reading, Autobiographical Memory, and Cognitive Emotion Regulation in Students with Social Anxiety Disorder

نویسندگان [English]

  • Barzan Soleimani 1
  • Anvar Dastbaz 2
  • Hassan Gharibi 3
1 Master of Psychology, Department of Psychology, Faculty of Social Sciences, Razi University, Kermanshah, Iran
2 Assistant Professor, Department of Counseling, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Iran
3 Assistant Professor, Department of Psychology, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Iran
چکیده [English]

Aim:The present study aimed to investigate the effectiveness of metacognitive therapy on mind reading, autobiographical memory, and cognitive emotion regulation in students with social anxiety disorder.
Method: The present research design was a pre-test, post-test, and follow-up with a Comparison group. The statistical population included female high school students with social anxiety disorder who had been referred to educational counseling centers in Sanandaj during the 2022-2023 academic year. A total of 30 students were selected using purposive sampling and randomly assigned to experimental and Comparison groups. The experimental group received eight 90-minute sessions of metacognitive therapy, while the Comparison group received no treatment. All participants completed social anxiety questionnaires, autobiographical memory tests, cognitive emotion regulation questionnaires, and the Reading the Mind in the Eyes Test at three stages: pre-test, post-test, and follow-up (four months after the post-test). Repeated measures ANOVA was used to analyze the data.
Results: The findings indicated that metacognitive therapy significantly reduced social anxiety in the experimental group (p < 0.01) and led to a significant increase in autobiographical memory, mind reading, and cognitive emotion regulation (p < 0.01). These effects were maintained over time.
Conclusion: Based on these findings, it is recommended that metacognitive therapy be implemented as an effective intervention in schools and counseling centers for students with social anxiety disorder.

کلیدواژه‌ها [English]

  • Meta-Cognitive Therapy
  • Autobiographical Memory
  • Mind Reading
  • Emotional Cognitive Regulation
  • Social Anxiety Disorder

Alves, F., Figueiredo, D. V., & Vagos, P. (2022). The prevalence of adolescent social fears and social anxiety disorder in school contexts. International journal of environmental research and public health, 19(19), 12458. https://doi.org/10.3390/ijerph191912458

Arehart-Treichel, J. (2007). Social anxiety in teenagers raises substance-Abuse Risk. Psychiatric News. https://doi.org/10.1176/pn.42.11.0015

Asher, M., Asnaani, A., & Aderka, I. M. (2017). Gender differences in social anxiety disorder: A review. Clinical psychology review, 56, 1-12. https://doi.org/10.1016/j.cpr.2017.05.004

Aloi, M., Rania, M., Carbone, E. A., Caroleo, M., Calabrò, G., Zaffino, P., ... & Segura-Garcia, C. (2021). Metacognition and emotion regulation as treatment targets in binge eating disorder: a network analysis study. Journal of eating disorders, 9, 1-9. https://doi.org/10.1186/s40337-021-00376-x

Baron-Cohen, S. (1991). Precursors to a theory of mind: Understanding attention in others. Natural theories of mind: Evolution, development and simulation of everyday mindreading, 1, 233-251. https://psycnet.apa.org/record/1991-97348-015

Bartholomay, E. M., Stone, B. M., & Lyons, G. A. (2023). Depression and social anxiety symptoms explain substance use problems beyond amount/frequency of substance use. Current Psychology, 42(8), 6249-6256. https://doi.org/10.1007/s12144-021-01984-1

Besharat, M. A., & Bazzazian, S. (2014). Psychometri properties of the Cognitive Emotion Regulation Questionnaire in a sample of Iranian population. Advances in Nursing & Midwifery, 24(84), 61-79.  https://journals.sbmu.ac.ir/en-jnm/article/view/7360

Boytos, A. S., & Costabile, K. A. (2022). Social Influence and Autobiographical Recall: Shared Reality and Epistemic Trust Shape Perceptions of Autobiographical Events. Social Cognition, 40(5), 411-437. https://doi.org/10.1521/soco.2022.40.5.411

Brown, E. J., Heimberg, R. G., Horner, K. J., Juster, H. R., Liebowitz, M. R., Safren, S. A., & Schneier, F. R. (1999). Psychometric properties of the Liebowitz Social Anxiety Scale. Psychological medicine, 29(1), 199-212. https://doi.org/10.1017/s0033291798007879

Bruffaerts, R., Harris, M. G., Kazdin, A. E., Vigo, D. V., Sampson, N. A., Chiu, W. T., . . . The, W. H. O. W. M. H. S. C. (2022). Perceived helpfulness of treatment for social anxiety disorder: findings from the WHO World Mental Health Surveys. Social Psychiatry and Psychiatric Epidemiology, 57(10), 2079-2095. https://doi.org/10.1007/s00127-022-02249-3

Colombo, D., Serino, S., Suso-Ribera, C., Fernández-Álvarez, J., Cipresso, P., García-Palacios, A., . . . Botella, C. (2021). The Moderating Role of Emotion Regulation in the Recall of Negative Autobiographical Memories. International journal of environmental research and public health, 18(13), 7122. https://doi.org/10.3390/ijerph18137122

Conway, M. A., & Pleydell-Pearce, C. W. (2000). The construction of autobiographical memories in the self-memory system. Psychological review, 107(2), 261. https://psycnet.apa.org/doi/10.1037/0033-295X.107.2.261

Capobianco, L., & Nordahl, H. (2023). A brief history of metacognitive therapy: From cognitive science to clinical practice. Cognitive and Behavioral Practice, 30(1), 45-54. https://psycnet.apa.org/doi/10.1016/j.cbpra.2021.11.002

Dryman, M. T., & Heimberg, R. G. (2018). Emotion regulation in social anxiety and depression: a systematic review of expressive suppression and cognitive reappraisal. Clinical psychology review, 65, 17-42.  https://doi.org/10.1016/j.cpr.2018.07.004

Drigas, A., Mitsea, E., & Skianis, C. (2022). Metamemory: Metacognitive strategies for improved memory operations and the role of VR and mobiles. Behavioral Sciences, 12(11), 450. https://doi.org/10.3390/bs12110450

Fombouchet, Y., Pineau, S., Perchec, C., Lucenet, J., & Lannegrand, L. (2023). The development of emotion regulation in adolescence: What do we know and where to go next?. Social Development, 32(4), 1227-1242. https://psycnet.apa.org/doi/10.1111/sode.12684

Garnefski, N., & Kraaij, V. (2007). The cognitive emotion regulation questionnaire. European journal of psychological assessment, 23(3), 141-149. https://psycnet.apa.org/doi/10.1027/1015-5759.23.3.141

Gkika, S., Wittkowski, A., & Wells, A. (2018). Social cognition and metacognition in social anxiety: A systematic review. Clinical Psychology & Psychotherapy, 25(1), 10-30. https://doi.org/10.1002/cpp.2127

Hammersmark, A. T., Hjemdal, O., Hannisdal, M., Lending, H. D., Reme, S. E., Hodne, K., ... & Johnson, S. U. (2024). Metacognitive therapy for generalized anxiety disorders in group: A case study. Journal of Clinical Psychology, 80(4), 884-899. https://doi.org/10.1002/jclp.23615

Hassani, J., Fiazi, M., & Akbari, E. (2016). Validity, reliability, and confirmatory factor structure of the Persian version of the Liebowitz Social Anxiety Scale. Social Psychology Research, 6(24), 35-52.  https://www.socialpsychology.ir/article_62993.html?lang=fa

Heeren, A., Jones, P. J., & McNally, R. J. (2018). Mapping network connectivity among symptoms of social anxiety and comorbid depression in people with social anxiety disorder. Journal of Affective Disorders, 228, 75-82. https://doi.org/10.1016/j.jad.2017.12.003

Jefferies, P., & Ungar, M. (2020). Social anxiety in young people: A prevalence study in seven countries. PloS one, 15(9), e0239133.  https://doi.org/10.1371/journal.pone.0239133

Kaviani, H., Rahimi, P., & Naghavi, H. R. (1999). Investigation of deficits in autobiographical memory retrieval in suicide attempters. Advances in Cognitive Sciences, 1(2-3), 16-23. http://icssjournal.ir/article-1-585-fa.html

Lombardi, E., Valle, A., Bianco, F., Castelli, I., Massaro, D., & Marchetti, A. (2022). Supporting mentalizing in primary school children: the effects of thoughts in mind project for children (TiM-C) on metacognition, emotion regulation and theory of mind. Cognition and Emotion, 36(5), 975-986. https://doi.org/10.1080/02699931.2022.2067521

Lynch, H., McDonagh, C., & Hennessy, E. (2021). Social anxiety and depression stigma among adolescents. Journal of Affective Disorders, 281, 744-750. https://doi.org/10.1016/j.jad.2020.11.073

Levinson, C. A., Brosof, L. C., Vanzhula, I., Christian, C., Jones, P., Rodebaugh, T. L., . . . Weeks, J. W. (2018). Social anxiety and eating disorder comorbidity and underlying vulnerabilities: Using network analysis to conceptualize comorbidity. International Journal of Eating Disorders, 51(7), 693-709. https://doi.org/10.1002/eat.22890

Liebowitz, M. R. (1987). Social phobia. Modern problems of pharmacopsychiatry, 22(141), e173. https://doi.org/10.1159/000414022

Miers, A. C., & Warner, C. M. (2023). Adolescent social anxiety: Bridging cognitive and social behavioral perspectives through a developmental lens. In C. R. Martin, V. B. Patel, & V. R. Preedy (Eds.), Handbook of Lifespan Cognitive Behavioral Therapy (pp. 89-100): Academic Press. https://doi.org/10.1016/B978-0-323-85757-4.00042-0 

Moscovitch, D. A., Vidovic, V., Lenton-Brym, A. P., Dupasquier, J. R., Barber, K. C., Hudd, T., . . . Romano, M. (2018). Autobiographical memory retrieval and appraisal in social anxiety disorder. Behaviour research and therapy, 107, 106-116. https://doi.org/10.1016/j.brat.2018.06.008

Mediavilla, R., López-Arroyo, M., Gómez-Arnau, J., Wiesepape, C., Lysaker, P. H., & Lahera, G. (2021). Autobiographical memory in schizophrenia: The role of metacognition. Comprehensive Psychiatry, 109, 152254. https://doi.org/10.1016/j.comppsych.2021.152254

Norton, A. R., & Abbott, M. J. (2016). Self-focused cognition in social anxiety: A review of the theoretical and empirical literature. Behaviour Change, 33(1), 44-64. https://psycnet.apa.org/doi/10.1017/bec.2016.2

Nejati, V., Zabihzadeh, A., Maleki, Q., & Mohseni, M. (2012). Social cognition disorder in patients with major depression: Evidence from the eye reading mind test. Applied Psychology, 6(1), 23-10.  https://apsy.sbu.ac.ir/article_95795.html

Nordahl, H., Anyan, F., Hjemdal, O., & Wells, A. (2022). Metacognition, cognition and social anxiety: A test of temporal and reciprocal relationships. Journal of Anxiety Disorders, 86, 102516. https://doi.org/10.1016/j.janxdis.2021.102516

Normann, N., & Morina, N. (2018). The efficacy of metacognitive therapy: a systematic review and meta-analysis. Frontiers in psychology, 9, 2211. https://psycnet.apa.org/doi/10.3389/fpsyg.2018.02211

Nordahl, H., & Wells, A. (2018). Metacognitive therapy for social anxiety disorder: An A–B replication series across social anxiety subtypes. Frontiers in psychology, 9, 540. https://doi.org/10.3389/fpsyg.2018.00540

Orlovsky, I., Ready, R. E., Gutchess, A., Heideman, K., & Martins-Klein, B. (2024). The role of autobiographical resilience memories in emotion regulation: an account of age differences in mnemonic and positive reappraisal. Experimental aging research, 50(5), 652-677. https://doi.org/10.1080/0361073X.2023.2254659

Quesque, F., & Rossetti, Y. (2020). What do theory-of-mind tasks actually measure? Theory and practice. Perspectives on Psychological Science, 15(2), 384-396. https://doi.org/10.1177/1745691619896607

Ranta, K., Laakkonen, E., & Niemi, P. M. (2016). Patterns of Metaperception in Adolescents with Social Anxiety: Mind Reading in the Classroom. Journal of Child and Family Studies, 25(12), 3497-3510. https://psycnet.apa.org/doi/10.1007/s10826-016-0519-1

Ronchi, L., Banerjee, R., & Lecce, S. (2020). Theory of mind and peer relationships: The role of social anxiety. Social Development, 29(2), 478-493. https://psycnet.apa.org/doi/10.1111/sode.12417

Rozen, N., & Aderka, I. M. (2023). Emotions in social anxiety disorder: a review. Journal of anxiety disorders, 95, 102696. https://doi.org/10.1016/j.janxdis.2023.102696

Szuhany, K. L., & Simon, N. M. (2022). Anxiety disorders: a review. Jama, 328(24), 2431-2445. https://doi.org/10.1001/jama.2022.22744

Soleimani, B., Yazdanbakhsh, K., & Momeni, K. (2021). Modeling the relationship between overgeneral autobiographical memory and problem solving in people with borderline personality disorder: The mediating role of metacognitive awareness. Jornal of Cognitive Psychology, 9 (3), 1-15. http://jcp.khu.ac.ir/article-1-3420-en.html

Steinmair, D., Horn, R., Richter, F., Wong, G., & Löffler-Stastka, H. (2021). Mind reading improvements in mentalization-based therapy training. Bulletin of the Menninger Clinic, 85(1), 59-82. https://doi.org/10.1521/bumc.2021.85.1.59

Strand, E. R., & Nordahl, H. (2024). Do Patient's Interpersonal Problems Improve Following Metacognitive Therapy? A Systematic Review and Meta‐Analysis. Clinical Psychology & Psychotherapy, 31(2), e2973. https://doi.org/10.1002/cpp.2973

Tetik, D., Gica, S., Bestepe, E. E., Buyukavsar, A., & Gulec, H. (2022). Emotional information processing and assessment of cognitive functions in social anxiety disorder: an event-related potential study. Clinical EEG and Neuroscience, 53(2), 104-113. https://doi.org/10.1177/1550059420981506

Vannucci, M., Pelagatti, C., Hanczakowski, M., & Chiorri, C. (2019). Visual attentional load affects the frequency of involuntary autobiographical memories and their level of meta-awareness. Memory & cognition, 47, 117-129. https://doi.org/10.3758/s13421-018-0854-0

Vellante, M., Baron-Cohen, S., Melis, M., Marrone, M., Petretto, D. R., Masala, C., & Preti, A. (2013). The “Reading the Mind in the Eyes” test: Systematic review of psychometric properties and a validation study in Italy. Cognitive neuropsychiatry, 18(4), 326-354. https://doi.org/10.1080/13546805.2012.721728

Wang, S., Zhao, Y., Wang, X., Yang, X., Cheng, B., Pan, N., . . . Gong, Q. (2021). Emotional intelligence mediates the association between middle temporal gyrus gray matter volume and social anxiety in late adolescence. European Child & Adolescent Psychiatry, 30(12), 1857-1869. https://doi.org/10.1007/s00787-020-01651-z

Washburn, D., Wilson, G., Roes, M., Rnic, K., & Harkness, K. L. (2016). Theory of mind in social anxiety disorder, depression, and comorbid conditions. Journal of Anxiety Disorders, 37, 71-77. https://doi.org/10.1016/j.janxdis.2015.11.004

Wells, A. (2013). Advances in metacognitive therapy. International Journal of Cognitive Therapy, 6(2), 186-201. https://doi.org/10.1521/ijct.2013.6.2.186

Wells, A., & Nordahl, H. (2023). Metacognition and mental regulation. In D. J. A. Dozois & K. S. Dobson (Eds.), Treatment of psychosocial risk factors in depression (pp. 383–406). American Psychological Association. https://doi.org/10.1037/0000332-017

Wells, A., Reeves, D., Heal, C., Fisher, P., Doherty, P., Davies, L., ... & Capobianco, L. (2023). Metacognitive therapy home-based self-help for anxiety and depression in cardiovascular disease patients in the UK: A single-blind randomised controlled trial. PLoS medicine, 20(1), e1004161. https://doi.org/10.1371/journal.pmed.1004161

Welze, H., & Markowitsch, H. (2005). Towards a bio-psycho-social model of autobiographical memory. Memory, 13(1), 63-78. https://doi.org/10.1080/09658210344000576

Williams, J. M., & Broadbent, K. (1986). Autobiographical memory in suicide attempters. Journal of abnormal psychology, 95(2), 144. https://psycnet.apa.org/doi/10.1037/0021-843X.95.2.144

Yapici Eser, H., Kacar, A. S., Kilciksiz, C. M., Yalcinay-Inan, M., & Ongur, D. (2018). Prevalence and associated features of anxiety disorder comorbidity in bipolar disorder: a meta-analysis and meta-regression study. Frontiers in psychiatry, 9, 229. https://doi.org/10.3389/fpsyt.2018.00229

Zainal, N. H., & Newman, M. G. (2018). Worry amplifies theory-of-mind reasoning for negatively valenced social stimuli in generalized anxiety disorder. Journal of Affective Disorders, 227, 824-833. https://doi.org/10.1016/j.jad.2017.11.084

Zsido, A. N., Arato, N., Lang, A., Labadi, B., Stecina, D., & Bandi, S. A. (2021). The role of maladaptive cognitive emotion regulation strategies and social anxiety in problematic smartphone and social media use. Personality and Individual Differences, 173, 110647. https://doi.org/10.1016/j.paid.2021.110647