ARTICLE INFO

Article Type

Original Research

Authors

P   Molavi (1)
Salvat Ghojehbeiglou   H (1)
Nadr Mohammadi   M (*1)
Ghalaei   S.M (2)






(*1) Psychiatry Department, Medicine Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
(1) Psychiatry Department, Medicine Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
(1) Psychiatry Department, Medicine Faculty, Ardabil University of Medical Sciences, Ardabil, Iran
(2) Psychology Department, Psychology Faculty, Ardabil Branch, Islamic Azad University, Ardabil, Iran

Correspondence

Article History

Received:  August  11, 2018
Accepted:  December 25, 2018
ePublished:  May 15, 2019

BRIEF TEXT


In Iran, a significant group of warriors and veterans suffer from post-traumatic stress disorder (PTSD). Efforts have been made to evaluate a variety of psychological treatments.

... [1-8]. It has been shown that cognitive-behavioral stress management interventions are effective in self-efficacy beliefs and increase it (self-efficacy plays an effective role in stress control and management) [9]. Ramezani et al. [10] showed that cognitive-behavioral therapy is effective in increasing the emotion control and reducing symptoms of suicidal thoughts in veterans with posttraumatic stress disorder (PTSD). Studies by Hojjat et al. [11] showed that training stress coping strategies to veterans with PTSD wives is effective in reducing marital conflicts. Schweizer et al. [12] studied cognitive interventions in teenagers with PTSD. They selected 30 teenagers who were exposed to PTSD and were under treatment and were provided with cognitive therapy for 20 days. The results showed a relative improvement in PTSD symptoms and an increase in using comparative strategies in the studied patients. ... [13, 14].

This study aimed at determining the effectiveness of stress management training on reducing perceived stress in veterans with PTSD.

This research is a semi-experimental study with pre-test and post-test design with control group.

This research was conducted on 22 veterans with PTSD, who were hospitalized in Issar Psychiatric Hospital of Ardabil in 2017-18

Using a convenience sampling method, 22 veteran who were similar in age, education and socioeconomic status were selected and randomly divided into two experimental and control groups (for each group: n=11). Inclusion criteria included suffering from PTSD diagnosed by a psychiatrist, no other psychiatric disorders and no participation in any stress management training before intervention. Exclusion criteria included unwillingness to continue the research and being absent for more than one session

The following tools were used to collect data: 1- The Perceived Stress Scale (PSS): It was developed by Cohen et al. in 1983 and has 14, 10, and 4-item versions, which is used to measure the general stress experienced during the past month. PSS evaluates thoughts and feelings about stressful events, control, overcome, coping with stress, and the experienced stresses. Its concurrent validity has been proven by significant positive correlations with the scores of the Effects of Life Events Inventory, Depression syndrome questionnaire and social anxiety questionnaire [15]. ... [16, 17]. Also, in the Bastani et al. research, its content validity approved and its reliability have been calculated 0.82 by Cronbach's alpha coefficient [18]. ... [19]. 2- The Mississippi Scale for Combat-Related PTSD: It is a self-report scale developed by Keane et al. in 1988 to assess the severity of post-traumatic stress disorder symptoms. This scale has been validated by Goodarzi [20] in Iran, with the Cronbach's alpha coefficient of 0.92. To determine the concurrent validity of this scale, three scales, including the Effects of Life Events Inventory, the PTSD list and Padua Inventory were used. The correlation coefficient of the Mississippi scale was reported for each obtained 0.23, 0.82 and 0.75, respectively (21). The subjects were randomly assigned into the experimental and control groups (for each group: n=12) and were informed about the research design and stages. The demographic information questionnaire, PSS and PTSD questionnaire were given to both groups before the intervention. The cognitive-behavioral stress management was performed for the experimental group. The training sessions were held in ten 45-min group sessions twice a week by a researcher (clinical psychology specialist) at Isar Hospital. The Cognitive-Behavioral Stress Management Method was designed in 1980 by the behavioral therapists group at the University of Miami. This program combines various types of relaxation, illustration and other anxiety reduction techniques with conventional cognitive-behavioral approaches such as cognitive reconstruction, effective coping training, expressionism training and anger management (Table 1). After the intervention, the questionnaires were returned to the both groups. At first, Kolmogorov-Smirnov and Shapiro-Wilk tests were used to examine the normal distribution of data and the Levene's test was used to assess homogeneity of variances. Data analysis was done by SPSS 21 software using univariate and multivariate analysis of variance methods.

Most veterans with PTSD participated in the study were in the age group of 51-55 years and married, and they had below diploma degree and unemployed (Table 1). The mean scores of the experimental group in the post-test were lower than that of the control group for the dependent variables (PTSD symptoms and perceived stress), whereas there was no significant difference in the control group. Moreover, the difference between PTSD symptoms and perceived stress was significant between the experimental and control groups in the post-test and those who were in the experimental group showed fewer symptoms of PTSD and perceived stress (Table 2).The two groups were significantly different in terms of perceived stress and the reduced PTSD symptoms (p=0.001) and stress management training was effective in reducing perceived stress (F=51.116, P=0.001) and PTSD symptoms (F=6.733; P=0.017).

The findings of this study are consistent with the findings of Abniki et al. [9], Ramezani et al. [10], Hojjat et al. [11], Ahmadzadeh Aghdam et al. [13], Akbari et al. [22], Rosier et al. [23], Öst et al. [24] and Gloster et al. [25]. The results of studies by Akbari et al. [22] show that stress management training includes assignments and principles that through cognitive methods is intended to change the attitude of a person and re-evaluate the stressful situation. It seeks to strengthen the desired behavior, control the behavior in a stressful event and reduce the hidden inappropriate behavior through behavioral-based assignments, or it employs a combination of cognitive and behavioral strategies simultaneously. ... [26, 27].

Similar studies are suggested to compare the results.

Stress management training was carried out only on veterans who were at Isar Hospital in Ardebil and that it is difficult to generalize the result for veterans of other cities.

Stress management training is effective in reducing perceived stress and PTSD symptoms in veterans with PTSD.

We are grateful to all veterans and hospital staff of Isar Hospital who helped us in this research.

None declared.

Prior research, the coordination was made with the Ardabil University of Medical Sciences and Isar Hospital and the consent of the research samples was obtained.

This research was supported by the Ardabil University of Medical Sciences.

TABLES and CHARTS

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