ARTICLE INFO

Article Type

Original Research

Authors

Makvand Hosseini   Sh. (* )
Kasiri   M. (1 )
Najafi   M. (2 )
Shahi   M. (2 )






(* ) Clinical Psychology Department, Psychology & Educational Sciences Faculty, Semnan University, Semnan, Iran
(1 ) Clinical Psychology Department, Human Sciences Faculty, Islamic Azad University, Semnan, Iran
(2 ) Clinical Psychology Department, Psychology & Educational Sciences Faculty, Semnan University, Semnan, Iran

Correspondence

Address: Faculty of Psychology & Educational Sciences, Semnan University, Darband, Mehdishahr, Semnan, Iran
Phone: +982333624250
Fax: +982333626888
shmakvand@yahoo.com

Article History

Received:  January  15, 2015
Accepted:  April 6, 2015
ePublished:  April 20, 2015

BRIEF TEXT


… [1, 2] Trauma and stress are associated with many psychiatric problems [3]. Many of the survivors of the war, after exposure to stressing event (such as absence of the people they like, disorder in social structure and loss of social protections) show specific clinical responses [4]. ... [5-11]. Mental health is probably one of the factors which are damaged in people with this disorder.

Studies on the correlation between mental health and traumatic attack showed that people who were exposed to such events are not in good mental health [12]. There is a significant relationship between veteran family function and general health of veterans [13]. Traumatic stress disorder is a psychiatric disorder and has adverse effects on well-being, cognitive ability, interpersonal relationships and general function in the society [14]. ... [15-19]

The main objective of this study was to evaluate the efficacy of cognitive-behavioral therapy to improve mental health of veterans with post-traumatic stress disorder under medical treatment.

This is a quasi-experimental study with pretest and posttest and control group

The study was implemented in 2014.The study population included all veterans with post-traumatic stress disorder in Sadr Hospital in Tehran (Iran).

The sample consisted of 20 patients who were selected using convenience sampling and randomly divided into two groups of 10 people in experimental and control groups.

These patients received post-traumatic stress disorder using structured clinical interview for clinical disorders and diagnosing of mental Disorders, and they had received psychiatric medical therapy. Inclusion criteria included patients who consent to participate in the research, long-term use of psychiatric drugs and the diagnosis of post-traumatic stress disorder. Exclusion criteria included having other psychiatric diseases and having drug addiction. The instrument used in this research was 28-item questionnaire of mental health developed by Goldberg. This is a self-reporting instrument for assessing mental health of the individuals. The questionnaire is composed of 4 subscales including: somatization, anxiety, depression and inadequate social productivity actions [20]. Each question is scored on a four Likert scale. The overall reliability of the questionnaire was 0.95. The internal reliability through Cronbach's alpha was 0.73 for physical health, 0.77 for anxiety, 0.85 for inadequate social productivity action and 0.86 for depression [21]. In this study, cognitive-behavioral tasks were used [22]. The treatment consisted of 8 sessions which were: 1) introduction of therapist and participants and setting goals, 2) explanation of the cognitive model, determination of the beliefs and their effects, and relaxation training, 3) learning to recognize irrational thinking and its effect on emotions, 4) description of the relationship between beliefs and behaviors and behavioral outcomes of beliefs, 5) training of ABC model, 6) the logical analysis of behaviors and beliefs objectively, 7) evaluation and assessment of changes in behavior, such as self-punishment, self-rewarding, etc. and 8) summarization, conclusion and comments. After selecting subjects and obtaining informed consent of subjects to participate in the study, all subjects in both groups completed Goldberg Mental Health Questionnaire and data was obtained and recorded from the questionnaire as a pre-test. Then, 8 cognitive behavioral group therapy sessions were implemented during 2 months for the experimental group by a skilled and experienced therapist. Control group received no treatment intervention or non-treatment intervention, but like experimental group they received a long-term appropriate psychiatric treatment for post-traumatic stress. Immediately after completion of the sessions, all 20 subjects completed questionnaires of mental health again and data was extracted and recorded for final analysis. The obtained data were introduced into advanced statistical software. To assess the efficacy of cognitive-behavioral intervention on the mental health, Multivariate Analysis of Covariance (MANCOVA) was used to remove the effect of pre-test.

There was a significant difference in the linear combination of components of mental health in both experimental and control groups. Through pre-test control, there was a significant difference in all subscales of mental health in the post-test stage. Therefore, cognitive-behavioral therapy results in a significant difference in the sub-scales between the experimental and control groups (Table 1).

Cognitive-behavioral therapy is effective on reducing the symptoms of post-traumatic stress disorder. Therapies based on the cognitive-behavioral approaches are more appropriate and effective, compared to many other methods, to improve post-traumatic stress disorder symptoms [23-26]. Methods of cognitive-behavioral therapy are effective on alleviating the symptoms of post-traumatic stress disorder and depression of patients by which they are affected [27, 28]. ... [29-37].

More comprehensive sample should be used to reach a more reliable explanation of the results. Follow-up tests should be administered in longer intervals to investigate the stability of the health effects.

One of the limitations of this study is that the present research has been conducted on veterans with post-traumatic stress disorder treated with drugs. In addition, the limitation in the number of samples and the sole investigation on males were of the limitations for this study. Follow-up the experimental group was not possible at different intervals.

Cognitive-behavioral therapy is an effective intervention to treat post-traumatic stress disorder. This treatment can reduce the symptoms of post-traumatic stress disorder, such as avoidance and stress, resulting in mental health and quality of life improvement in the patients.

All veterans with post-traumatic stress disorder, the Sadr Hospital officials are appreciated.

There was no conflict of interest.

Non-declared

The study was funded by the authors.

TABLES and CHARTS

Show attach file


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