ARTICLE INFO

Article Type

Original Research

Authors

Heidaryan   M. (*)
Rabii   M. (1)
Shahidi   E. (2)
Dowran   B. (1)
Ahmadi Tahhur Soltani   M. (1)






(*) Department of Clinical Psychology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
(1) Department of Clinical Psychology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
(2) Department of Psychotherapy, Faculty of Specialization in Cognitive-Behavioral Psychotherapy, Tolman Institute, Palermo, Italy

Correspondence

Address: Department of Clinical Psychology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Molla Sadra Street, Vanak Square, Tehran, Iran
Phone: +98 (83) 38211920
Fax: +98 (83) 38305014
heidaryan.maryam@yahoo.com

Article History

Received:  May  21, 2017
Accepted:  May 30, 2018
ePublished:  June 29, 2018

BRIEF TEXT


… [1]. Up to now different medical and psychological treatment methods have been provided to help quit smoking. … [2-13]. Factors related to quit smoking can be classified into personal, social and environmental dimensions [14]. People who are under heavy stress are more prone to start smoking again [15-16].

Feeling self-efficacy to quit smoking is one of the important psychological variables that is related to smoking and is one predictor factor of successful smoking and recurrence in smokers [17-18]. … [19-26]. The most of the clinical therapists now agree that hypnosis can help to people in treatment of a extensive spectrum of disorders and to quit habits like smoking [27]. … [28]. Hypnotherapy is used by four models psychoanalysis, Ericsson, transformational-cognitive and cognitive-behavioral [29]. Investigations show that there is a positive significant relation between negative emotions like anxiety, depression and smoking and also recurrence after quit [13]. A study with a month of follow-up indicated that self-efficacy is the first predictor factor of smoking cessation [19]. … [30]. Kirch et al. in a meta-analysis have found that improvement in the clients who have received cognitive-behavioral treatment with hypnosis is 70% more than clients who have just received CBT [31]. As studies show as well, results of intervention by two concurrent methods of treatment are more effective than one treatment method [32].

Helping to smokers particularly police forces who, as protectors of national benefits and security of the country, are in the direct contact with different classes of society is very important. The study aims to investigate the effectiveness level of a cognitive-behavioral treatment based on hypnosis on smoking cessation, anxiety and self-efficacy indicator.

This study is of semi-experimental type with a pre-test, post-test and control group plan.

This study was conducted on the all police forces of Kermanshah province in 2015.

Using a purposeful non-probabilistic sampling method from 58 smokers who desired to quit, and announced their readiness based on entry and exit criteria, finally 54 persons were selected.

… [33-34]. In order to gather data the standard-made questionnaire related to demographic data of samples, depression scale, anxiety, stress, self-efficacy scale, avoiding cigarettes, Pipher’s hypnotizability talent questionnaire and checklist of mental disorders symptoms. Cronbach alpha of depression scale, anxiety, stress were reported 0.81, 0.74 and 0.78, respectively [35]. The coefficient of Cronbach alpha and validity of self-efficacy scale of avoiding smoking were reported .96 and .88, respectively [36]. The validity of checklist of mental disorders symptoms also by Cronbach alpha and Person correlation method was obtained .98 and .82, respectively [37]. This treatment plan was held in eight 90 sessions. Before start of the sessions, from all participants a written consent was obtained regarding treatment methods including hypnosis. In the pre-test stage, participants completed the self-efficacy scale for smoking cessation. Before fifth session also this test was repeated until the changes of smoking cessation self-efficacy is evaluated after 4 sessions. In the end of treatment sessions, the number of individuals who succeeded to quit smoking and also the level of participants’ anxiety was evaluated. After one month and three months the number of individuals who kept the cessation and also the level of anxiety also were evaluated. The Chi-square test was used to examine smoking cessation in the control group and the group under cognitive-behavioral intervention, and repeated measurement test was used to examine the effectiveness of cognitive-behavioral intervention to reduce participants’ anxiety. Univariate covariance analysis test also was used to examine the difference between experiment and control groups in terms of self-efficacy scale. Data was analyzed using SPSS21 software.

Difference of smoking cessation indicator between the two control group and under intervention group GBH was significant in the post-test (x2=15.52), first follow-up (x2=19.2) and second follow-up (p=0.001). In the other word, GBH treatment was significantly effective on smoking cessation (table 2). There was a significant difference between GBH group’s anxiety scores in the pre-test, post-test stages and also pre-test stage and follow-up session (p<0.01; table 3). In the CBH group there wasn’t significant difference between subjects’ anxiety in the post-test with follow-up session (p>0.05). In the control group also there was a significant difference between subjects’ average in the pre-test and post-test (p<0.01; table 3) but there wasn’t a significant difference between post-test and follow-up and also pre-test and follow-up. In the measurement stage of post-test and follow-up there was a significant difference between two groups in terms of anxiety. In the other words, intervention group in the post-test and follow-up reported less anxiety level that indicates effectiveness of the treatment intervention. Insignificance in the post-test stages and follow-up sessions implied durability of intervention. Results of Levin test to examine the homogeneity assumption of the groups’ variance indicated that the two control and experiment groups was homogenous in variance (p=0.13, F(52,1)=2.36). Average scores of self-efficacy index in the pre-test and post-test stages in the experiment group were 52.7±25.35 and 77.7±11.40 and in the control group was 84.50±62.33 and 93/5±80/36, respectively. Review of the results indicated that GBH intervention was significant statistically on self-efficacy increase (p<0.05; F(51,1)=4.56).

In a meta-analysis conducted in 24 studies on 5704 subjects, concerning effectiveness of hypnosis on smoking cessation, 30.6% of the subjects succeeded to quit [38]. In another research conducted on 186 subjects, 87% of the subjects after three months follow-up had successful cessation [39]. Also results of much research including a study with 226 subjects and two years follow-up [40] and final report of another research with 454 subjects and one year follow-up [41] and a review with 286 subjects [42], imply that cognitive-behavioral intervention based on hypnosis is effective on hypnosis. However, results of a meta-analysis consider effectiveness of hypnosis on smoking cessation insignificance [43]. Of course, critics consider the reason is due to the non-uniformity of the evaluated studies [44]. An overview of the previous studies suggests that hypnosis is effective on self-efficacy level. As results of a research aligned with this study have indicated that hypnotherapy is effective on self-efficacy level as well [44]. Also in the final report of two another studies, researchers have suggested that using hypnotherapy has a significant effect on increase of self-efficacy feeling [45]. Hypnosis effectiveness on anxiety reduction has been reported in different studies. As aligned with results of this study in an investigation conducted by the aim of comparing three behavioral, behavioral-cognitive and cognitive-behavioral hypnotherapy treatments to reduce anxiety disorder symptoms, researchers report that cognitive-behavioral hypnotherapy is more effective than the two other methods [46]. Also researchers in a meta-analysis with subject of effectiveness of hypnotherapy on reduction of anxiety and negative emotions that was conducted on 26 researches, in experimental controlled conditions with 2342 subjects, have found that treatment intervention using hypnotherapy to reduce anxiety shows significant difference with other treatment methods [47]. To explain the results of this hypothesis and successful results of the similar studies it seems that results of intervention by two concurrent treatment methods, compared to one treatment method, shows more effective improvement [48]. … [49, 50].

Considering that the interventions was conducted in group way and in view of that in the military forces hierarchy has a particular importance in the interventions among individuals, group therapy of military forces by different degrees in one group lead to limitation in self-disclosure and to express their past experiences. For the reason it is suggested that as much as possible, forces who are almost in a same military hierarchy category be in one group until better group interactions are taken place.

Among the important limitation of this research are that internal and external resources and published research are very limited. As no published research on the present study subject hasn’t been performed in the country.

Cognitive-behavioral treatment intervention based on hypnosis is effective on smoking cessation and increase of self-efficacy indicator and results into reduction of military forces anxiety.

The researchers thank and appreciate sincere cooperation of the Command of Kermanshah Province Police and also management of the province Applied Research Office, Colonel Amiri.

There is no conflict of interests.

All participants were informed sufficiently and their conscious satisfaction to perform hypnosis was taken by written.

This research has been performed by private expenses.


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