ARTICLE INFO

Article Type

Original Research

Authors

Ghazanfari   F. (1)
Shafiei   M. (* )






(* ) Psychology Department, Literature and Humanities Faculty, Lorestan University, Khorramabad, Iran
(1) Psychology Department , Literature and Humanities Faculty, Lorestan University, Khorramabad, Iran

Correspondence

Address: Central Organization of Lorestan University, Kilometer 5 of Tehran Road, Khorramabad, Iran. Postal Code: 68151-44316
Phone: +98 (66) 33234533
Fax: +98 (66) 33120627
masumeh.shafiei62@gmail.com

Article History

Received:  October  31, 2016
Accepted:  December 11, 2016
ePublished:  March 10, 2017

BRIEF TEXT


Many of the survivors of the war show certain clinical responses after exposure to stressful event (such as loss of loved ones, breakdown of social structures, and losing social supports) [1].

… [2-10]. The results of a study indicates that aspects of self-compassion act as flexible protective factors for psychopathological consequences of traumatic events [11]. … [12-25].

This study aimed to investigate the effectiveness of self-compassion training on the on dysfunctional attitudes and life quality in people exposed to mine leading to organ failure.

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

The study was conducted in 2016 among all men who encountered amputation due to explosion of landmine and were sponsored by the Foundation of Martyr in the city of Gilan Gharb.

40 patients were selected by simple random sampling method and randomly were assigned to two 20-person groups of control and experimental. Inclusion criteria were lack of psychiatric or medical disease, non-use of psychiatric medications, minimum literacy for reading the questions and writing the answer, and the exclusion criteria were being absent in more than one-third of sessions, lack of cooperation and not doing the assignment.

To collect data, demographic information, dysfunctional attitude and life quality questionnaire were used. Dysfunctional Attitude Scale: this scale has 40 items and the scoring is done on seven-point Likert scale. This scale is the most important test of cognitive style in preceding studies in different centers of the United States in the field of cognitive therapy [26]. Research in the validity and reliability of the Dysfunctional Attitude Scale in clinical and normal population showed Cronbach’s alpha 0.85 and its construct validity through correlation with Beck Depression Inventory and Automatic Thought Questionnaire was 0.47 and 0.47 respectively [26]. In Iran, its reliability coefficient after 6 weeks was 0.9 and its construct validity through correlation with Beck Depression Questionnaire was 0.65 and its Cronbach’s alpha was 0.75 [28]. Quality of Life Questionnaire: This questionnaire has been efficient for application in clinical practice, health policy evaluation as well as for research and studies of the general population. 36-item form has been designed by Var and Sharboone by a Likert scale of five points from one to five grading and investigates the life quality of people with the components of physical performance, restrictions on activities due to physical injuries, restrictions on activities due to mental health impairments, low energy and fatigue, social performance or interaction, bodily pain, and general health [29]. Its reliability and validity have been studied in the different groups of patients. The reliability of the Persian version of this questionnaire in Iran has been 0.90. To study the validity of the tool, convergent validity and comparison of the known groups have been used. The correlation range in the convergent validity has been varied from 0.57 to 0.95 and in the comparison of known groups, the results were obtained in the differentiation of quality of life between men and women [29]. For the experimental group, the training focused on self-compassion was held during 8 one-hour sessions (Table 1). No intervention was presented for the control group. Pretest before the intervention and posttest after the intervention i.e. after the eight session were administrated in both groups. The collected data were analyzed using multivariate analysis of covariance. Before performing the analysis of covariance, its presumptions namely homogeneity of variance covariance matrix was investigated by Box test and the equality of variance in the two groups was studied by Levene Test.

The mean age was 49.8±7.94 years in the experimental group and 45.43±8.53 years in the control group. In terms of education, 9, 7, and 4 people had the educational level of primary school, bachelor degree and MA/Ms. Degree respectively, and in the control group, 7, 8, and 5 persons had educational level of junior high school, senior high school and MA/Ms. Degree respectively. In pretest stage, the mean scores of dysfunctional attitudes and life quality and its components did not have any significant difference in the control and experimental groups (p>0.05). In the posttest stage after controlling the effect of pretest, the mean score of dysfunctional attitude in the experimental group was significantly less than control group (p<0.01) and the mean scores of life quality and its components were significantly higher in the control group (p<0.05; Table 2).

This type of treatment is effective in reducing dysfunctional attitudes in people exposed to landmine explosion leading to organ failure. These results are consistent with the results of studies conducted by Yoshida et al. [18], Besser and Neira [19], and Jain et al. [20] that expressed in their study that with increasing dysfunctional attitudes, mental disorders are significantly increased and positive attitude is associated with moderate symptoms of post-traumatic symptoms [21-36].

It is recommended that in future studies be done with controlling this confounding variables. Also, effectiveness of used approach in this study can be examined in the clinical samples with different psychological problems.

In this study, only amputees who were exposed to landmine and all of whom were male were studied. The effect of pretest on posttest scores, non-implementation of the follow-up to study the effectiveness of using methods in amputee people who exposed to landmine, and lack of comparison of this method with other treatment methods were the limitations of this study.

Self-compassion training is effective for improving dysfunctional attitudes and life quality in people faced with landmine explosion leading to the amputation.

We sincerely appreciate the Foundation of Martyr in the city of Gilan Gharb and the participating veterans in this study.

Non-declared

Confidentiality of the information and psychologically and mentally making people ready to participate in this study were the ethical issues observed in this study.

This study was funded by the authors.

TABLES and CHARTS

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CITIATION LINKS

[1]Başoğlu M, Livanou M, Salcioğlu E, Kalender D. A brief behavioral treatment of chronic post traumatic stress disorder in earthquake survivors: Results from an open clinical trial. Psychol Med. 2003;33(4):647-54.
[2]Abhari-Ahmadi SA. Long-term effects of war on psychosocial status of patients with post-traumatic stress disorder. Proceedings of The Third Symposium of Neurological Complications Psychol War. Tehran: Golban Press; 2000. pp. 83-7. [Persian]
[3]Yavari A, Esfandiari E, Masoumi M, Saeedi H, Allami M. Consideration of chronic pain and current prosthetic satisfaction. in above knee amputees. Iran J War Public Health. 2011;3(10):53-8. [Persian]
[4]Seyed Hosseini Davarani SH, Moosavi B, Karbalaei Esmaeili S, Soroosh MR, Masoumi M. Service satisfaction among war related bilateral lower limb amputation Iran J War Public Health. 2010;3(1):49-54. [Persian]
[5]Azarmi S, Farsi Z, Sajadi S.A. Development of adaptation questionnaire using roy’s adaptation model and its psychometrics on veterans with lower limb amputation. Hayat. 2013;19(4):26-37. [Persian]
[6]American Psychiatric Association. Diagnosis and statistical manual disorder. 4th edition. Washington DC: American Psychiatric Association; 2000. pp. 165-73.
[7]Raes F. Rumination and worry as mediators of the relationship between self-compassion and depression and anx iety. Personal Individ Differ. 2010;48(6):757-61.
[8]Terry LM, Leary RM. Self-compassion, self-regulation and health. J Self Identit. 2011;10(3):352-62.
[9]Seligowski VA, Miron RL, Orcutt KH. Relations among self-compassion, PTSD symptoms, and psychological health in a trauma-exposed sample. Mindfulness; 2015;6(5):1033-41.
[10]Ehreta MA, Joormannb J, Berkingc M. Examining risk and resilience factors for depression: The role of self-criticism and self-compassion. Cogn Emot. 2015;29(8):1496-504.
[11]Zeller M1, Yuval K, Nitzan-Assayag Y, Bernstein A. Self-compassion in recovery following potentially traumatic stress: Longitudinal study of at-risk youth. J Abnorm Child Psychol. 2015;43(4):645-53.
[12]Miron RL, Sherrill AM, Orcutt KH. Fear of self- compassion and psychological inflexbility interact to predict PTSD symptom severity. J Contextual Behav Sci. 2015;4(1):37-41.
[13]Woodruff CS, Glass RC, Arnkoff BD, Crowley JK, Hindman KB, Hirschhorn WE. Comparing self-compassion, mindfulness, and psychological inflexibility as predictors of psychological health. Mindfulness. 2014;5(4):410-21.
[14]de Graaf LE, Roelofs J, Huibers MJ. Measuring dysfunctional attitudes in the general population: The dysfunctional attitude scale (form A) revised. Cognit Ther Res. 2009;33(4):345-55.
[15]Weich S, Churchill R, Lewis G. Dysfunctional attitudes and the common mental disorders in primary care. J Affect Disord. 2003;75(2):269-78.
[16]Lewinshon PM, Joiner TE, Rhode P. Evaluation of cognitive diathesis stress models in predicting major depressive disorder in adolescents. J Abnorm Psychol. 2001;110(2):203-15.
[17]Ellis A. How may therapy and Practice of psychotherapy has influenced and changed other psychotherapies. J Ration Cogn Ther. 2004;22(2):79-83.
[18]Yoshida H, Kobayashi N, Honda N, Matsuoka H, Yamaguchi T, Homma H, et al. Post-traumatic growth of children affected by the Great East Japan Earthquake and their attitudes to memorial services and media coverage. Psychiatry Clin Neurosci. 2016;70(5):193-201.
[19]Besser A, Neria y. PTSD symptoms, satisfaction with life, and prejudicial attitudes toward the adversary among Israeli civilians exposed to ongoing missile attacks. J Trauma Stress. 2016;22(4):268-75.
[20]Jain S, McLean C, Adler EP, Rosen CS. Peer support and outcome for veterans with posttraumatic stress disorder (PTSD) in a residential rehabilitation program. Community Ment Health J. 2016;52(8):1089-92.
[21]Safaee A, Zeykhami B, Tabatabaee SH, Moghimi Dehkardi B. quality of life and Quality of life and its influencing factors in breast cancer patients unde rgoing chemotherapy. Epidemiol Iran. 2007;3(3-4):61-6. [Persian]
[22]Schnurr PP, Lunney CA. Symptom benchmarks of improved quality of life in PTSD. Depress Anxiety. 2016;33(3):247-55.
[23]Currier JM, Drescher KD, Hollan JM, Lisman R, Foy DW. Spirituality, forgiveness, and quality of life: Testing a mediational model with military veterans with PTSD. Int J Psychol Relig. 2016;26(2):167-79.
[24]Mandani B, Fakhri A. Study of health related quality of life in posttraumatic stress disorder war veterans. Iran J War Public Health. 2013;5(2):18-25. [Persian]
[25]Gilbert P, Procter S. Compassionate mind training for people with high sham eand selfcriticism: A pilot study of a gr oup therapy approach. Clin Psychol Psychother. 2006;13(6):352-79.
[26]Ebrahimi A, Neshatdoost HT, Kalantari M, Molavi H, Asadollahi Gh. Contributions of dysfunctional attitude scale and general health subscales to prediction and odds ratio of depression. J Shahrekord Univ Med Sci. 2008;9(4):52-8. [Persian]
[27]Beck AT, Brown G, Steer RA, Weissman AN. Factor analysis of the dysfunctional attitude scale in a clinical population. Psychol Assess. 1991;3(3):478-83.
[28]Bayanzadeh SA, Bolhary J, Dadfar M, Karimi Keisomi I. Effectiveness of cognitive-behavioral religious - cultural therapy in improvement of obsessive-compulsive patients. Razi J Med Sci. 2005;11(44):913-23. [Persian]
[29]Rostami R, Moghadasetabrizi Y, Dar veeshpour KA, Montazeri A. The effect of exercise on quality of life of opioid dependent patients under methadone maintenance therapy. Appl Psychol Res Q. 2012;3(1):1-11. [Persian]
[30]Gilbert P. Introducing comp-assion- focused therapy. Adv Psychiatri Treat. 2009;15(3):199-208.
[31]Barnard LK, Curry JF. Self-Compassion: Conceptualizations, correlates & int rventions review of general psychology. Rev Gen Psychol. 2011;15(4):289-303.
[32]Raque-Bogdan TL, Ericson SK, Jackson J, Martin HM, Bryan NA. Attachment and mental and physical health: Self-compassion and mattering as medi ators. J Couns Psychol. 2011;58(2):272-8.
[33]Germer CK, Neff KD. Self-compassion inclinicalpractice. J Clin Psychol. 2013;69(8):2-12.
[34]Neff KD, Hseih Y, Dejitthirat K. Self -compassion, achievement goals, and cop ing with academic failure. J Psychol Educ. 2005; 4(3):263-87.
[35]Allen BA, Leary MR. Self-Compassion, Stress and Coping. Soc Personal Psychol Compass. 2010;4(2):107-18.
[36]Reddy SD, Negi LT, Dodson-Lavelle B, Ozawa-de Silva B, Pace TW, Cole S P, et al. Cognitive-based compassion training: A promising prevention strategy for at-risk adolescents. J Child Fam Stud. 2013;22(2):219-30.