@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2018;10(1):1-7

Background
The main feature of the post-traumatic stress disorder (PTSD) is that the person experiences an injurious or stressful event followed by a disturbance that lasts for more than a month, and some of its symptoms are: re-experience such as disturbing memories, painful dreams, degenerative reactions, flashbacks, intense distress and physiological responses to accident-inducing stimuli [1]. These symptoms disrupts the occupational, social and educational performance of people with signs of post-traumatic stress disorder and disrupts their lives [2].
Previous Studies
… [3-6]. Patients with PTSD are likely to reveal symptoms of diagnosis for at least one other psychiatric disorder such as depression, bipolarity, anxiety, and medicine consumption 80% more than those who do not have the PTSD symptoms. This disorder is associated with high levels of social, occupational, and physical disabilities and high cost of the economy and medicine facilities [1]. PTSD is associated with depression [7], long-term disorder in psychosocial function [8], alcohol consumption [9], substance abuse disorders [10], and behavioral and inhibition problems [11]. This disorder is also associated with falling sleep quality [12], and suicidal ideation [13]. One of the risk factors for PTSD after facing with trauma is the reduction of emotional control. … [14-16]. In a study that compared the setting of excitement and negative mood in PTSD veterans and veterans without PTSD, Demarvey et al. found that PTSD veterans had more mood fluctuations and excitement problems [17]. … [18-20]. Also, Watkins et al. in a research study have shown that PTSD symptoms are stimuli for suicidal tendencies in veterans [21]. … [22-39].
Aim(s)
Empirical evidence suggest the effectiveness of cognitive-behavioral therapy in a wide range of disorders and psychological variables such as depression, anxiety, obsession, PTSD and other disorders. Exposure to harmful events has been affected by its wide-ranging and devastating effects on psychological and behavioral functions, including the regulation of excitement and suicidal thoughts in veterans with PTSD which is one of the main health problems of veterans. Therefore, considering the importance of this issue, the purpose of this study was to investigate the effect of cognitive-behavioral therapy on the control of excitement and suicidal thoughts in veterans with posttraumatic stress disorder.
Research type
The present applied research is a semi-experimental design with pretest and posttest design with control group.
Research society, place and time
This study was conducted in 2016-17 in the injured veterans with posttraumatic stress disorder admitted to Ghods Hospital in Sanandaj.
Sampling method and number
Using convenience sampling method, 40 subjects were selected and through random assignment, 20 subjects were placed in each control and experimental groups. Inclusion criteria included the diagnosis of posttraumatic stress disorder by the hospital's psychiatrist, the absence of physical and psychiatric disorders, non-addiction, the least literacy of reading and writing, and the lack of use of medication or other mental intervention simultaneously, and the absence of more than one-third of treatment sessions, lack of cooperation and doing homework were the criteria for exiting subjects. Used devices & materials
Used devices&materials
The data collection tool included Beck's suicidal thoughts scale [40, 41] and emotional inhibition inventory [42, 43]. After receiving written and verbal consent from veterans for not receiving other psychotherapy and not taking self-administrated medication for three months, mentioning the confidentiality of all information and speeches, with the emphasis on voluntary and free-of-charge meetings of the treatment group and the continuous company, treatment session based on cognitive behavioral therapy (CBT) by Houghton et al. [38] was performed (Table 1). Patients in the experimental group were treated by a therapist for 9 90-minute sessions with CBT group therapy. However, patients in the control group received the only daily routine of the hospital. Before the first session, the questionnaire of emotional inhibition and Beck's suicidal thoughts scale were completed by the participants as pretest and after the completion of therapeutic sessions of the questionnaires as a posttest. Statistical analysis was performed using SPSS 16 software. The Kolmogorov-Smirnov test was used to check the normal distribution of data. To examine the consistency of variances among dependent variables, Levene test was used and to examine the homogeneity of covariance assumption, box test was used. First, the univariate covariance analysis was used to compare the differences between the dependent variables in both the experimental and control groups. Then, using multivariate covariance analysis, the difference between the two experimental and control groups in terms of the difference between the pretest and posttest scores in the dependent variables was examined. Cognitive-behavioral therapy as independent variable and emotional control and suicidal thoughts were considered as dependent variables.
Findings by Text
The mean age in the experimental and control groups was 52.74±3.11 and 54.73±2.97 years respectively. The percentage of injury of veterans was 16.83±3.98% and 12.24±3.17% respectively and duration of attendance in war was 46.50±2.92 and 47.30±3.09 months respectively. The mean posttest of the experimental group was lower than the control group in the subscales of emotional control and lower suicidial thought (Table 2). After modifying the pretest scores, the difference between the experimental and control groups was significant and cognitive-behavioral therapy increased the control of excitement (F=25.40) and its subscales and decreased suicidal ideation (F=38.19) and its subscales in the veterans with PTSD (p=0.001).
Main comparison to the similar studies
The results of this study showed that cognitive-behavioral therapy has been effective in improving the performance of work and experimental avoidance in post-test phase. The results of this study were consistent with the findings of other studies in this field [26-31, 37]. … [44].
Suggestions
It is suggested that, given the effectiveness of CBT group therapy for PTSD symptoms and improved emotional control and suicidal thoughts, these services should be used in existing medical centers such as psychiatric hospitals. It is also recommended that this treatment be used to treat other psychiatric disorders associated with PTSD.
Limitations
One of the limitations of this study was the impossibility of conducing the follow-up phase. Also, due to the single gender of the subjects of this study, it should be cautious to generalize its findings to women and other cultures and other disorders. The selection of the research samples based on convenience sampling method also made some difficulties in performing the study.
Conclusions
Cognitive-behavioral therapy is effective in increasing the control of excitement and reducing symptoms of suicidal ideation in veterans with posttraumatic stress disorder.
Acknowledgments
We are grateful to all the veterans who helped us with this research.
Conflict of interest
Non-declared
Ethical Permissions
The satisfaction of all veterans participated in the study was obtained. Also, in order to observe the ethics of research, the names of all veterans were coded.
Funding Sources
All sources of funding have been provided by the research authors.

TABLES and CHARTS

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