ARTICLE INFO

Article Type

Original Research

Authors

Ghadampour   E. (1 )
Radmehr   P. (*)
Yousefvand   L. (2)






(*) Psychology Department, Literature & Humanities Faculty, Lorestan University, Lorestan, Iran
(1 ) Psychology Department, Literature & Humanities Faculty, Lorestan University, Lorestan, Iran
(2) Educational Management Department, Literature & Humanities Faculty, Lorestan University, Lorestan, Iran

Correspondence

Address: Khorramabad, Kamalvand, Kiloumetr5 Khorramabad-Tehran, Lorestan University, Literature & Humanities Faculty, Psychology Department
Phone: +98 (83) 48224904
Fax: -
radmehr.p12@gmail.com

Article History

Received:  May  20, 2016
Accepted:  November 8, 2016
ePublished:  March 25, 2017

BRIEF TEXT


... [1-8]. Depression with a lifetime prevalence of 16.6% is one of the most common psychiatric disorders that has high association with social anxiety disorder among adolescents [9, 10]. … [11-15]. Accordingly, consistent with the cognitive perspective, social anxiety disorder and its association with depression can be due to common cognitive factors such as cognitive-behavioral avoidance and mental rumination. Mental rumination is another common structure among social anxiety disorder and depression [16].

… [17-42]. Smiths et al. in their research concluded that cognitive therapy was appropriate for symptoms of depression with a social anxiety comorbidity [43]. Hazlet-Stevens concluded in his study that reduction of mindfulness-based stress has an effective effect on reducing the symptoms of comorbidity of anxiety and depression [44]. The results of Ariana-Kia et al. `s research indicate the effectiveness of mindfulness-based cognitive therapy in reducing rumination in patients with major depressive disorder [45]. In their study, Dimidjian et al. concluded that mindfulness-based cognitive therapy reduces rumination [46].

The purpose of this study was to determine the effectiveness of mindfulness-based cognitive therapy on cognitive-behavioral avoidance and rumination in patients with social anxiety disorder and depression.

The present study is quasi-excremental with pretest-posttest design with the control group.

This study was conducted in Khorramabad city in the academic year 2014-2015 among all female high school students aged between 14 and 17 years old who were afflicted with social anxiety disorder and depression.

30 adolescent girls with comorbidity of social anxiety and depression patients were selected through convenience sampling method.

… [47-50]. Screening was carried out to implement the plan. Five schools were selected randomly-clustered, and among the 5 schools, 437 social anxiety and depression questionnaire were completed. Individuals who received high social anxiety and depression scores (a standard deviation higher than the mean of the group (30 persons) were subjected to structured interviews (into two groups of 15) based on DSM-IV-TR. The tools used in the research were: 1. Structured Clinical Interview for Axis 1 Disorders (SCID): This interview is a flexible tool developed by First et al. [50]. The diagnostic agreement for most of the general and specific diagnoses was moderate or good (kappa higher than 60%). The overall reached agreement (total kappa 52% for current diagnoses and 55% for the total diagnosis of life span) is also satisfactory. 2-Social Anxiety Questionnaire for the Adolescents (SAS-A): This scale has 18 items and three sub-scales: FNE (Fear of Negative Experience), Social Avoidance and Depression in new situation (SAD-New) and Social Avoidance and General Depression (SAD-General). Reliability of the questionnaire in the present study was 0.81 using Cronbach`s alpha coefficient. 3- Beck Depression Inventory- Second Edition (BDI-II): This questionnaire is a revised Beck Depression Inventory that is designed to measure the severity of depression. Beck et al. results showed that this questionnaire has a high internal consistency. Also, another study reported that the internal correlation of this scale with the Cronbach`s alpha coefficient was 0.93 and its test-retest reliability was 0.93 [50]. … [51, 52]. 4-Cognitive-Behavioral Avoidance Scale (CBAS): CBAS has four subscales of cognitive-social avoidance, cognitive-non-social avoidance, social-behavioral avoidance, and non-social behavioral avoidance. There is a moderate internal correlation between 0.39 and 0.57 among the CBAS subscales [19]. In Moldez et al. research, total internal consistency and cognitive-non-social, behavioral non-social, socio-behavioral and cognitive-social subscales were reported 0.91, 0.80, 0.75, 0.86 and 0.78 respectively [53]. The internal consistency of the Persian version of the social and nonsocial avoidance measures in a sample of 698 subjects in Iran were 0.84 and 0.89 respectively and the test-retest reliability were 0.64 and 0.65 respectively [54]. 5-Ruminative Responses Scale (PRS): The PRS is a 22-item scale that measures people`s tendency to mental rumination in response to depressed mood. This scale, based on empirical evidence, has a high internal consistency. Cronbach`s alpha coefficient ranges from 0.88 to 0.92 and its test-retest correlation is 0.67 [45]. The experimental group received mindfulness-based cognitive therapy in 8 sessions of 2 hours (one week`s session), and the control group received no intervention during this period. Finally, posttest was performed in both groups, and again, two months later, follow-up was carried out. Statistical analysis: Collected data was analyzed using SPSS 19 software in two descriptive and inferential levels.

The mean age in the experimental group and control group was 15.46±1.18 and 15.60±1.12 years respectively. In the experimental group, the mean score of cognitive-behavioral avoidance and mental rumination variables in the post-test and follow-up stages were significantly lower than the control group (p<0.01). Therefore, mindfulness-based cognitive therapy could significantly be effective in reducing the variables of cognitive-behavioral avoidance and mental rumination in the experimental group compared to the control group in both posttest and follow-up stages. This training was effective on posttest stage 33.2% for cognitive-behavioral avoidance and 46.9% for mental rumination and it was effective in the follow up stage 39.8% for behavioral-cognitive avoidance and 51.7% for mental rumination (Table 2).

… [55]. The reason for the effectiveness of MBC in these studies is that teaching mindfulness leads to change in defective thinking patterns and the teaching of control skills, and increases the preventive aspect of treatment. Regarding the effectiveness of MBCT on mental rumination, researchers in their study have shown that meditation exercises for mind, play a significant role in reducing rumination and this decrease in turn reduces the inconsistent cognitive content and emotional symptoms, especially anxiety symptoms, depression and inefficient attitudes. One aspects of MBTC is that individuals learn to deal with emotions and negative thoughts and experience mental events positively [56]. Today, the use of variety methods of yoga and meditation especially with a moderate and higher socioeconomic status is prevalent.

In future studies, it is recommended that MBCT intervention be conducted on both sexes, girls and boys, and other age group, and more broadly in other geographical areas.

The main limitation of this research was to do this on adolescent aged 14-17 years in Khoramabad City that makes it difficult to generalize results to other age levels and other geographical regions.

Mindfulness-based cognitive therapy is effective in reducing cognitive-behavioral avoidance and rumination in patients with social anxiety disorder and depression.

Finally, we sincerely thank all the factors, especially the respectful management of education and schools in the City of Khorramabad and all the student who helped us in the process of this research.

Non-declared

All participants in the study announced their informed consent. Also, in order to observe ethical principles, after the follow-up phase, the control group was also trained in mindfulness-based cognitive therapy.

This article has not been sponsored by any organization.

TABLES and CHARTS

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