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الگویابی پیشایندها و پسایندهای روانشناختی بیماری ریزش موی سکهای مبتنی بر رویکرد فراتشخیصی | ||
| روانشناسی سلامت | ||
| مقالات آماده انتشار، پذیرفته شده، انتشار آنلاین از تاریخ 20 اسفند 1404 اصل مقاله (1.52 M) | ||
| نوع مقاله: علمی- پژوهشی | ||
| شناسه دیجیتال (DOI): 10.30473/hpj.2025.73428.6204 | ||
| نویسندگان | ||
| آرزو مرادی تولائی1؛ ایمان الله بیگدلی* 1؛ علی مشهدی1؛ مهدی رزم آرا2؛ محمد جفرانی3 | ||
| 1دانشگاه فردوسی مشهد، مشهد، ایران | ||
| 2دانشگاه علوم پزشکی مشهد، مشهد، ایران | ||
| 3دانشگاه مرکزی میشیگان، میشیگان،امریکا | ||
| چکیده | ||
| مقدمه: ریزش مویسکهای یک بیماری مزمن چند عاملی است که سببشناسی دقیق آن شناسایی نشده است، لیکن مطالعات مختلف نقش عوامل روانی را در بهوجود آمدن این بیماری مطرح میکنند. با توجه به نگاه عمیق رویکرد فراتشخیصی به سببشناسی اختلالات، هدف این مطالعه مدلیابی عوامل روانشناختی پیشایند و پیامد بیماری ریزش مویسکهای بر اساس رویکرد فراتشخیصی میباشد. روش: نمونهی این مطالعه را200 نفر از بیماران مبتلا به بیماری ریزش موی سکهای مراجعهکننده به کلینیکهای پوست دانشگاه علوم پزشکی مشهد تشکیل دادند که از طریق نمونهگیری در دسترس انتخاب شدند. ابزارهای پژوهش شامل پرسشنامهی چند بعدی اختلالات هیجانی، پرسشنامه حساسیت اضطرابی فلوید، پرسشنامه تنظیم هیجان گراس و جان، پرسشنامه چندبعدی اجتناب تجربی و فرم کوتاه پرسشنامه ذهنآگاهی فرایبورگ بودند که بصورت خودگزارشی توسط بیماران تکمیل گردند. یافتهها: نتایج حاکی از آن بود که روانرنجورخویی و حساسیت اضطرابی بهعنوان متغیرهای پیشبین، اختلالات هیجانی در بیماران را پیشبینی میکنند. ذهنآگاهی در این مطالعه به عنوان متغیر میانجی شناسایی شد، لیکن نقش میانجی متغیرهای بدتنظیمی هیجان و اجتناب تجربی در این مدل تایید نشد (p<0.05)، نقش تعدیلکننده سن و جنس در مطالعه حاضر، معنیدار نبود. دراین مطالعه همبستگی معنیداری بین تمام متغیرها به جز تنظیم هیجان با شدت بیماری برقرار بود. نتیجهگیری: با توجه به نتایج مطالعه حاضر، فاکتورهای زیربنایی فراتشخیصی در شکلگیری و روند ریزش موی سکهای نقش دارند و جهت درمان این بیماری می بایست برنامه های درمانی جامع بصورت ترکیبی با تاکید بر عوامل زیربنایی شکل دهنده ی بیماری درنظر گرفته شود. | ||
| کلیدواژهها | ||
| ریزش موی سکهای؛ رویکرد فراتشخیصی؛ روانرنجورخویی؛ اختلالات هیجانی | ||
| عنوان مقاله [English] | ||
| Modeling of Psychological Antecedents and Consequences of Alopecia Areata Based on the Transdiagnostic Approach | ||
| نویسندگان [English] | ||
| arezoo moradi tavalaei1؛ Imanollah Bigdeli1؛ Ali Mashhadi1؛ Mahdi Razmara2؛ mohammad Jafferany3 | ||
| 1Ferdowsy university of Mashhad, Mashhad, Iran | ||
| 2Mashhad University of Medical Science, Mashhad, Iran | ||
| 3Central Michigan University, Michigan, USA | ||
| چکیده [English] | ||
| Objective: Alopecia areata (AA) is a complex autoimmune condition with non-scarring alopecia, and it occurs in approximately 2% of the global population. Although its pathogenesis includes both genetic and immunological factors, mounting evidence supports the significance of psychological determinants in inducing as well as exacerbating the condition. The transdiagnostic approach, which is a method characterizing key psychological processes underlying greater than one disorder, offers a new paradigm to study AA's psychosocial determinants. The current research analyzes how transdiagnostic factors, particularly neuroticism, anxiety sensitivity, emotion regulation, mindfulness, and experiential avoidance, correlate with severity of AA and emotional comorbidities in an Iranian clinical sample. Our research contributes to closing relevant gaps in extant research in that: (1) the variables are compared simultaneously, not separately, and (2) a full mediation model is considered to shed light on personality-outcome pathways. Method: We performed a cross-sectional survey of 200 AA patients (123 men, 77 women; mean age=29.93±7.93 years) enrolled from clinics of dermatology of Imam Reza Hospital, Mashhad. Candidates were confirmed by board-certified dermatologists for AA diagnosis, while disease severity was measured using the Alopecia Areata Severity Index (AASI). All participants completed validated Persian versions of Multidimensional Emotional Disorder Inventory (MEDI) for emotional disorders, Anxiety Sensitivity Index-16 (ASI-16), Freiburg Mindfulness Inventory-Short Form (FMI-SF), Gross & John Emotion Regulation Questionnaire (ERQ), Multidimensional Experiential Avoidance Questionnaire (MEAQ). Structural Equation Modeling (SEM) through Smart-PLS 3.0 examined direct/indirect associations between transdiagnostic variables, with mediation testing through bootstrapping (5000 samples). The research was ethically approved in ethical commite of ferdowsi university of Mashhad (IR.UM.REC.1402.174). Results: Key findings of this study are: Neuroticism had the highest correlation with emotional disorders (β=0.819, p<0.001), explaining 67.1% variance. High neuroticism predicted lower mindfulness (β=-0.560) and higher disease severity (β=0.206). Mindfulness mediated 38.7% of neuroticism's effect on emotional disorders (β=-0.206, p<0.001) and reduced experiential avoidance (β=-0.687). Anxiety sensitivity had direct effects on emotional disorders (β=0.280) and emotion dysregulation (β=-0.393), but indirect effects through avoidance were nonsignificant (p=0.818). Counter hypotheses, emotion dysregulation, and experiential avoidance could not mediate psychological effects (p>0.05). The demographic variable of age/sex showed few effects of moderation (all p>0.10). Conclusion: This study provides the first evidence for transdiagnostic mechanisms in AA, identifying neuroticism and mindfulness as pivotal treatment targets. We suggest for: Revised AA management guidelines incorporating psychological assessments, Development of brief mindfulness interventions tailored for dermatology settings, Increased collaboration between dermatologists and psychologists. These innovations could transform AA from a purely dermatological condition to a biopsychosocial model of care, potentially improving treatment adherence and reducing relapse rates. | ||
| کلیدواژهها [English] | ||
| Alopecia Areata, Transdiagnostic, Neuroticism, Mindfulness, Psychological Comorbidity | ||
| مراجع | ||
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