Nourisaeed Azam, Ghorban-Shiroudi Shohreh, Salari Arsalan
Department of Psychology, Rasht Branch, Islamic Azad University, Rasht, Iran.
Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
ARYA Atheroscler. 2021 Mar;17(2):1-9. doi: 10.22122/arya.v17i0.2188.
Among the cardiovascular diseases (CVDs), myocardial infraction (MI) is one of the main causes of mortality around the world. A diagnosis of MI may be followed by psychological problems, such as depression, anxiety, and stress. Therefore, psychological interventions can be beneficial in routine treatment. The purpose of this study was to compare the effect of cognitive-behavioral therapy (CBT) and dialectical behavioral therapy (DBT) on perceived stress and coping skills in patients after MI.
This study was a randomized clinical trial with a pretest-posttest design and control group. The statistical population consisted of 45 patients after MI who referred to Noor Heart Clinic in Rasht, Iran, between 2018 and 2019. They were randomly divided into 3 groups of 15 individuals (2 interventions including CBT and DBT, and 1 control group). In the intervention groups, participants underwent 8 weekly 90-minute sessions. Data were collected using a 3 part self-report questionnaire including a demographic information form, the Ways of Coping Questionnaire (WCQ), and the Perceived Stress Scaleý-14 (PSS-14). The statistical methods used for data analysis included chi-square test, one-way ANOVA, repeated-measures ANOVA, and post hoc Bonferroni test.
We found significant main effects of group (F(2,42)=6.11; P=0.005) and time (F(2,84)=28.48; P<0.001), and a significant group-by-time interaction (F(4,84)=8.97; P<0.001) on perceived stress scores. For problem-focused coping scores, findings indicated significant main effects of group (F(2,42)=7.33; P=0.002) and time (F(2,84)=30.71; P<0.001), and a significant group-by-time interaction (F(4,84)=12.86; P<0.001). For emotion-focused coping scores, the results also indicated significant main effects of group (F(2,42) = 17.41; P < 0.001) and time (F(2,84)=31.74; P<0.001), and a significant group-by-time interaction (F(4,84)=14.90; P<0.001).
The current study revealed that DBT was more effective in improving emotion-focused coping than CBT.
在心血管疾病（CVDs）中，心肌梗死（MI）是全球主要的死亡原因之一。心肌梗死的诊断之后可能会出现心理问题，如抑郁、焦虑和压力。因此，心理干预在常规治疗中可能有益。本研究的目的是比较认知行为疗法（CBT）和辩证行为疗法（DBT）对心肌梗死后患者感知压力和应对技巧的影响。
本研究是一项采用前测-后测设计和对照组的随机临床试验。统计总体包括2018年至2019年间转诊至伊朗拉什特努尔心脏诊所的45例心肌梗死后患者。他们被随机分为3组，每组15人（2个干预组，包括CBT和DBT，以及1个对照组）。在干预组中，参与者每周接受8次，每次90分钟的治疗。使用一份由三部分组成的自我报告问卷收集数据，该问卷包括人口统计学信息表、应对方式问卷（WCQ）和感知压力量表-14（PSS-14）。用于数据分析的统计方法包括卡方检验、单因素方差分析、重复测量方差分析和事后邦费罗尼检验。
我们发现，在感知压力得分上，组间（F(2,42)=6.11；P=0.005）、时间（F(2,84)=28.48；P<0.001）存在显著的主效应，组与时间的交互作用也显著（F(4,84)=8.97；P<0.001）。对于以问题为中心的应对得分，结果表明组间（F(2,42)=7.33；P=0.002）、时间（F(2,84)=30.71；P<0.001）存在显著的主效应，组与时间的交互作用也显著（F(4,84)=12.86；P<0.001）。对于以情绪为中心的应对得分，结果同样表明组间（F(2,42)=17.41；P<0.001）、时间（F(2,84)=31.74；P<0.001）存在显著的主效应，组与时间的交互作用也显著（F(4,84)=14.90；P<0.001）。
当前研究表明，在改善以情绪为中心的应对方面，辩证行为疗法比认知行为疗法更有效。
