پیوندهای مفید
اخبار و اعلانات
آمار
| تعداد نشریات | 25 |
| تعداد شماره‌ها | 959 |
| تعداد مقالات | 7,899 |
| تعداد مشاهده مقاله | 13,352,575 |
| تعداد دریافت فایل اصل مقاله | 9,478,422 |
رابطه مکانیسم‌های دفاعی رشد نایافته و افسردگی پس از زایمان با نقش میانجی تنهایی اجتماعی | ||
| مطالعات اجتماعی روان شناختی زنان | ||
| مقاله 4، دوره 20، شماره 4 - شماره پیاپی 73، بهمن 1401، صفحه 110-133 اصل مقاله (1.02 M) | ||
| نوع مقاله: مقاله پژوهشی | ||
| شناسه دیجیتال (DOI): 10.22051/jwsps.2022.37901.2514 | ||
| نویسندگان | ||
| رعنا شکیب حاجی آقا1؛ محسن کچویی* 2؛ زینب هدایتی3؛ فاطمه جلالیان گبلو4 | ||
| 11. دانشجوی کارشناسی ارشد روانشناسی بالینی خانواده، گروه روانشناسی، دانشکده علوم انسانی، دانشگاه علم و فرهنگ، تهران، ایران. Ranashakib76@gmail.com | ||
| 22. استادیار روانشناسی سلامت، گروه روانشناسی، دانشکده علوم انسانی، دانشگاه علم و فرهنگ، تهران، ایران (نویسنده مسئول). kachooei.m@gmail.com | ||
| 33. کارشناسی مامایی، دانشکده مامایی و پرستاری، دانشگاه بابل، بابل، ایران. Zeynabhedayati02@gmail.com | ||
| 44. کارشناسی مامایی، دانشکده مامایی و پرستاری، دانشگاه شهید بهشتی، تهران، ایران. Fatemehe.jalalian55@gmail.com | ||
| چکیده | ||
| افسردگی پس از زایمان به‌عنوان یکی از اختلال‌های شایع پس از زایمان، با ایجاد دگرگونی‌های منفی و مخرب در خلق‌وخوی مادر و فضای خانواده، سازگاری مادر با کودک تازه متولدشده و پرورش کودک در ارتباطی سالم با مادر را بسیار مختل می-کند. لذا پژوهش حاضر باهدف بررسی نقش میانجی‌گری تنهایی اجتماعی بر رابطه مکانیسم‌های دفاعی رشد نایافته و افسردگی پس از زایمان انجام شد. در یک بررسی از نوع همبستگی از میان کلیه‌ی زنان تازه زایمان کرده شهر تهران 227 زن مراجعه‌کننده به مراکز بهداشت شهر تهران به‌صورت نمونه‌گیری در دسترس انتخاب شدند و مقیاس افسردگی پس از زایمان ادینبورگ، پرسش‌نامه سبک‌های دفاعی اندروز و همکاران و مقیاس تنهایی اجتماعی را تکمیل کردند. برای تجزیه‌وتحلیل داده‌ها از الگو یابی معادلات ساختاری، آزمون همبستگی پیرسون و نرم‌افزارهای AMOS و SPSS استفاده شد. یافته‌ها نشان داد که در سطح اطمینان 95% الگوی ساختاری تحقیق، برازش مناسبی دارد به این صورت که مکانیسم‌های دفاعی رشد نایافته اثر غیرمستقیم مثبت به‌واسطه تنهایی اجتماعی بر افسردگی پس از زایمان دارند و می‌توانند احتمال ابتلا به این اختلال را افزایش دهند. | ||
| کلیدواژه‌ها | ||
| افسردگی پس از زایمان؛ مکانیسم دفاعی رشد نایافته؛ تنهایی اجتماعی؛ زنان تازه زایمان کرده | ||
| عنوان مقاله [English] | ||
| The Relationship between Immature Defense Mechanisms and Postpartum Depression: The Mediating Role of Social Loneliness among Women in Postpartum Period | ||
| نویسندگان [English] | ||
| Rana Shakib Haji agha1؛ Mohsen Kachooei2؛ Zeynab Hedayati3؛ Fatemehe Jalalian Gabloo4 | ||
| 1MSc student in clinical family psychology, Department of Psychology, Humanities Faculty, University of Science and Culture, Tehran, Iran. Ranashakib76@gmail.com | ||
| 2*Corresponding Author, Assistant Professor of Health Psychology, Department of Psychology, Humanities Faculty, University of Science and Culture, Tehran, Iran. kachooei.m@gmail.com. (Corresponding author) | ||
| 3Bachelor of Midwifery, Department of Nursing and Midwifery, University of Babol, Babol, Iran. Zeynabhedayati02@gmail.com | ||
| 4Bachelor of Midwifery, Department of Nursing and Midwifery, Shahid Beheshti University, Tehran, Iran. Fatemehe.jalalian55@gmail.com | ||
| چکیده [English] | ||
| Postpartum depression, one of the most common postpartum disorders, disrupts the mother's adjustment to the newborn and raising the child in a healthy relationship with the mother by causing harmful and destructive changes in the mother's mood and family environment. Therefore, the present study aimed to investigate the mediating role of social loneliness on the relationship between immature defence mechanisms and postpartum depression. In a correlational study, we selected 227 women visiting Tehran health centres by convenience sampling among all postpartum women in Tehran. They were asked to answer the Edinburgh Postpartum Depression Scale, Andrews and colleagues' Defense Styles questionnaire, and the Social Loneliness Scale. Data were analyzed using the Pearson correlation test and structural equation modelling by AMOS software and SPSS. The results showed that at the 95% confidence level of the structural model of the research, it has a good fit; Thus, immature defence mechanisms have a positive indirect effect due to social loneliness on postpartum depression, and they can increase the risk of the disorder. Postpartum Depression, Immature Defense Mechanism, Social Loneliness, Women in Postpartum Period. Introduction Entering the stage of motherhood leads to significant changes in the individual and social identity of the mother and other family members. Also, it increases the risk of postpartum depression due to substantial changes in physiological and psychological dimensions ( Dennis & Vigod, 2020), which begins with symptoms of depressed mood, excessive anxiety, insomnia, and weight change within four weeks after childbirth. Such a situation can negatively affect the degree of attachment between mother and baby and other family relationships and pose a threat to the safety and health of the baby and other children (Norouzi & Mohammadi, 2015). Among the psychological factors that can affect postpartum depression are defence mechanisms, which are subconscious psychological processes that protect “the ego” from anxiety, painful thoughts, and feelings away from the realm of consciousness (Freud, 1923). Moreover, it can be said that neurosis is due to the continuous use of immature defences. Given this relationship, it is crucial to identify the mediating structures between them, one of which is social loneliness. If newly delivered women do not receive the social support they need or do not consider existing sources of support as social support, they will feel lonely, predicting postpartum depression (Pourkhaleghi, Askarizadeh, & Fazilat-Pour, 2017). Considering the effect of immature defence mechanisms and social loneliness on postpartum depression, it is vital to discover the mechanism of these relationships. Therefore, this study investigates the relationship between immature defence mechanisms and postpartum depression concerning the mediating role of social loneliness. Methodology The research method of the present study is descriptive, and the statistical population consists of all newly delivered women in Tehran in 1400. To determine the sample size in multivariate regression studies, between 5 and 15 observations per measured (observed) variable are considered (Hooman, 2005). Considering that the number of variables measured in the present study is equal to 12 subscales, the minimum sample size was estimated to be 60, and the ideal volume was estimated to be 180. According to the probability of falling subjects, 230 people were considered. Participants were selected based on inclusion and exclusion criteria through the available sampling method. After deleting the distorted data, the information of 227 participants was statistically analyzed using SPSS and AMOS software. The instruments used in this study included the Edinburgh Postpartum Depression Scale, the Defense Styles Questionnaire, and the Social Loneliness Scale, which was completed by newly delivered women referring to health centres after obtaining informed consent. Firstly, the correlations between the variables were calculated using the Pearson correlation coefficient. Then, path analysis was used to investigate the mediating role of social loneliness in the relationship between immature defence mechanisms and postpartum depression. Findings The mean age of newly delivered women was 28.44, and its standard deviation was 4.55 (age range: 20-45). The highest frequency in terms of age group is related to the class of 20 to 29 years. Also, 127 of them (55.9%) had a cesarean delivery, and 100 (44.1%) had a normal delivery. In addition, in terms of educational level, the highest frequency is related to undergraduate education, and in terms of employment status, the highest frequency is allocated to the housewife class. Social loneliness showed a significant positive correlation with immature defence mechanisms (r = 0.37, p <0.01) and postpartum depression (r = 0.46, p <0.01). The path analysis method was used to test the mediation pattern of social loneliness with immature defence mechanisms and postpartum depression. In this model, the direct pathway from immature defence mechanisms to postpartum depression was statistically significant (p = 0.040). The values of good fit indices obtained for the final model showed that the assumed model perfectly fits the data. The bootstrap procedure's indirect effect study results that immature defence mechanisms could significantly predict postpartum depression through social mediation alone. The indirect effect of immature defence mechanisms on postpartum depression was 0.15 and statistically significant (p <0.001). In the final model, 0.14% of the variance of social loneliness was explained by immature defence mechanisms, and 0.23% of the variance of postpartum depression was explained by defence mechanisms mediated by social loneliness. Result The results showed that immature defence mechanisms and postpartum depression were significantly correlated. Due to the use of immature defence mechanisms, they feel more social loneliness, which in turn causes depressive symptoms. It can be said that with the birth of a child, the mother becomes a new and unique psychological organization that is closely related to representations, unconscious processes, feelings, and experiences that are often overlooked in other moments of life (Stern, 1995). Thus, childbirth and the need to reorganize the conscious and subconscious aspects of representing oneself and others may reactivate unprocessed experiences, such as loss and grief. Also, based on the interaction hypothesis, it can be said that the emotion of depression activates the compensatory mechanism, and the compensatory mechanism, in turn, intensifies the feeling of depression. If "the ego" can not find another way out in the face of these emotions and fails to regulate and manage emotions, a mood disorder such as depression will form or persist. As a result, finding immature defence mechanisms in newborn women therapists and informing mothers about the function of these mechanisms in different life situations can change their perception of social loneliness. In this case, by reducing the feeling of social loneliness, the occurrence and persistence of postpartum depression can be prevented. | ||
| کلیدواژه‌ها [English] | ||
| Postpartum Depression, Immature Defense Mechanism, Social Loneliness, Postpartum Women | ||
| مراجع | ||
|
بشارت، محمدعلی. (1397). مقیاس تنهایی اجتماعی: پرسش‌نامه، روش اجرا و نمره‌گذاری. روانشناسی تحولی: روان‌شناسان ایرانی، 14(56)، 476-475. بشارت، محمدعلی.، حاجی‌آقازاده، ماریا و قربانی، نیما. (1386). تحلیل رابطه هوش هیجانی، مکانیسم‌های دفاعی و هوش عمومی. روانشناسی معاصر، 2(1)، 56-25. پور خالقی، نجمه.، عسکری زاده، قاسم و فضیلت پور، مسعود. (۱۳۹۶). پیش‌بینی افسردگی پس از زایمان در زنان نخست‌زا: نقش حمایت اجتماعی و نوع زایمان. مجله سلامت و مراقبت، 19(1)، 29-۱۸. جناآبادی، حسین.، ناستی‌زایی، ناصر و مرزیه، افسانه. (1396). نقش حمایت اجتماعی ادراک‌شده و احساس تنهایی اجتماعی-عاطفی در عود اعتیاد (مطالعه موردی: معتادان خود معرف به مراکز ترک اعتیاد زاهدان). اعتیاد پژوهی، 11(44)، 106-91. رنجبری، توحید.، بشارت، محمدعلی و پور حسین، رضا. (۱۳۹۶). نقش واسطه‌ای مکانیسم‌های دفاعی در رابطه بین آسیب‌های دلبستگی و نشانه‌های اضطراب و افسردگی. روانشناسی تحولی: روان‌شناسان ایرانی، 14(53)، 27-15. شفیعی، محمد.، داودی‌زاده جلگه، حمیده.، دبیری فرد، سارا و شفیعی، میلاد. (۱۳۹۷). بررسی ارتباط حمایت اجتماعی با افسردگی پس از زایمان در مادران نوزادان نارس. نشریه طلوع بهداشت یزد، 17(4)، 93-81. قربانی، نیما. (1382). روان درمانگری پویشی فشرده و کوتاه‌مدت: مبادی و فنون. تهران: انتشارات سازمان مطالعه و تدوین کتب دانشگاهی در علوم اسلامی و انسانی (سمت). مریمی، فرزانه.، مریمی، زهره.، بیگدلی، ایمان‌الله.، نجفی، محمود و کیانی، مهدیه. (۱۳۹۹). نقش حمایت اجتماعی و صفات شخصیتی در بروز افسردگی پس از زایمان. مجله علمی دانشگاه علوم پزشکی گرگان، 22(1)، 94-88. مسگریان، فاطمه.، آزاد فلاح، پرویز.، فراهانی، حجت‌الله و قربانی، نیما. (۱۳۹۶). روابط موضوعی و مکانیسم‌های دفاعی در اضطراب اجتماعی. روانشناسی تحولی: روان‌شناسان ایرانی، 14(53)، 14-3. منتظر صومعه‌سرایی، فروغ و اسدی مجره، سامره. (۱۳۹۸). مقایسه حمایت اجتماعی ادراک‌شده، رضایت زناشویی و همدلی در زنان مبتلا به افسردگی پس از زایمان و عادی. مجله دانشگاه علوم پزشکی سبزوار، 26(4)، 430-421. نوروزی، زیبا و محمدی، مسعود. (۱۳۹۳). پیش‌بینی افسردگی پس از زایمان بر اساس سابقه اضطراب، افسردگی و پیوند والدینی در زنان زایمان کرده مراجعه‌کننده به مراکز بهداشتی-درمانی شیراز. مجله علوم پزشکی رازی، 21(127)، 30-24. هومن، حیدر علی. (1385). الگویابی معادلات ساختاری با استفاده از نرم‌افزار لیزرل. تهران: انتشارات سازمان مطالعه و تدوین کتب دانشگاهی در علوم اسلامی و انسانی (سمت).
Andrews, G., Singh, M. & Bond, M. (1993). The defense style questionnaire. Journal of Nervous and Mental Disease, 181(4), 246-256. Behbodi, M. (2001). The prevalence of postpartum depression and the effective factors of referred women to Beheshti Health center. Thesis of Master, Psychology, Tehran: Beheshti University. (In Persian) Benute, G. R. G., Nozzella, D. C. R., Prohaska, C., Liao, A., De Lucia, M. C. & Zugaib, M. (2013). Twin pregnancies: Evaluation of major depression, stress, and social support. Twin Research and Human Genetics, 16(2), 629-633. Besharat, M. A. (2018). Social loneliness scale: Questionnaire, instruction and scoring (Farsi Version). Journal of Developmental Psychology: Iranian Psychologists, 14(56), 475-476. (In Persian) Besharat, M. A., Hajiaqazadeh, M. & Ghorbani, N. (2007). Analysis of the relationship between emotional intelliggence. Biannual Journal of the Iranian Psychological Association, 2(1), 25-56. (In Persian) Brooks-Gunn, J. & Chase-Lansdale, P. L. (1995). Adolescent parenthood. Paper presented at the Portions were presented at a conference entitled" Outcomes of Early Childbearing: An Appraisal of Recent Evidence," Bethesda, MD, May 1992. Caligor, E., Kernberg, O. F. & Clarkin, J. F. (2007). Handbook of dynamic psychotherapy for higher level personality pathology: American Psychiatric Pub. Crane, R. M. (2005). Social distance and loneliness as they relate to headphones used with portable audio technology. Humboldt State University, Dennis, C. L. & Vigod, S. (2020). Preventing postpartum depression: Fatigue management is a place to start. Evidence-Based Nursing, 23(1), 25-25. DiTommaso, E. & Spinner, B. (1993). The development and initial validation of the social and emotional loneliness scale for adults (SELSA). Personality and Individual Differences, 14(1), 127-134. Freud, A. (1946). The Ego and the Mechanisms of Defense. NewYork: Publisher, International Universities Press. Freud, S. (1923). The Ego and the Id. In J. Strachey et al. (Trans.), The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XIX. London: Hogarth Press. Gan, Y., Xiong, R., Song, J., Xiong, X., Yu, F., Gao, W., Hu, H., Zhang, J., Tian,Y., Gu, X., Zhang, J. & Chen, D. (2019). The effect of perceived social support during early pregnancy on depressive symptoms at 6 weeks postpartum: a prospective study. BMC Psychiatry, 19(1), 1-8. Ghorbani, N. (2003). Intensive short-term dynamic psychotherapy: Basics and techniques. Tehran: Publications of SAMT. (In Persian) Hays, R. D. & DiMatteo, M. R. (1987). A short-form measure of loneliness. Journal of Personality Assessment, 51(1), 69-81. Hooman, H. A. (2005). Modeling structural equations using Lisrel software. Tehran: Publications of SAMT. (In Persian) Hu, L. T. & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55. Jenaabadi, H., Nastiezaie, N. & Marziyeh, A. (2018). The role of perceived social support and feelings of social-emotional loneliness in addiction relapse (Case study: Self-referred addicts to drug rehab centers in Zahedan). Etiadpajohi, 11(44), 91-106. (In Persian( Khan, M. J. & Gul, S. (2016). Differences in defense mechanisms between depressive patients and non-depressive individuals. Pakistan Journal of Social and Clinical Psychology, 14(2), 47-51. Kline, R. B. (2015). Principles and Practice of Structural Equation Modeling. Publisher, The Guilford Press; Fourth edition. MacCallum, R. C., Browne, M. W. & Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1, 130-149. Maryami, F., Maryami, Z., Bigdeli, I., Najafi, M. & Kiani, M. (2020). The role of social support and personality traits in the incidence of postpartum depression. Journal of Gorgan University of Medical Sciences, 22(1), 88-94. (In Persian) McMahon, C., Barnett, B., Kowalenko, N. & Tennant, C. (2005). Psychological factors associated with persistent postnatal depression: past and current relationships, defence styles and the mediating role of insecure attachment style. Journal of Affective Disorders, 84(1), 15-24. Mesgarian, F., Azad Fallah, P., Farahani, H. & Ghorbani, N. (2017). Object Relations and defense mechanisms in social anxiety. Journal of Developmental Psychology: Iranian Psychologists, 14(53), 3-14. (In Persian) Nikpour, M., Delavar, M. A. & Abedian, Z. (2013). Type of delivery and self-reported postpartum symptoms among Iranian women. Clinical and Experimental Obstetrics & Gynecology, 40(1), 144-147. Norouzi, Z. & Mohammadi, M. (2015). Prediction of postpartum depression based on parental bonding, history of anxiety, and depression among women attended health care centers in Shiraz. Razi Journal of Medical Sciences, 21(127), 24-30. (In Persian) Peindl, K. S., Wisner, K. L. & Hanusa, B. H. J. (2004). Identifying depression in the first postpartum year: guidelines for office-based screening and referral. Journal of Affective Disorders, 80(1), 37-44. Peplau, L. A. (1985). Loneliness research: Basic concepts and findings. Social Support: Theory, Research and Applications, 269–286. Plutchik, R., Kellerman, H. & Conte, H. R. (1979). A Structural Theory of Ego Defenses and Emotions. Emotions in Personality and Psychopathology, 227–257. Pourkhaleghi, N., Askarizadeh, G. & Fazilat-Pour, M. (2017). Predicting post-partum depression of nulliparous women: Role of social support and delivery type. Journal of Health and Care,19(1), 18-29. (In Persian) Ranjbari, T., Besharat, M. A. & Pourhossein, R. (2017). The mediating role of defense mechanisms in the relationship between attachment pathologies and the symptoms of depression and anxiety. Journal of Developmental Psychology: Iranian Psychologists, 14(53), 15-27. (In Persian) Raphael-Leff, J. (2018). 'Climbing the walls': Therapeutic intervention for post-partum disturbance 1. In 'Spilt milk' (pp. 60-81): Routledge. Russell, D. W. J. (1996). UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure. Journal of Personality Assessment, 66(1), 20-40. Stern, D. (1995). The Motherhood Constellation. A Unified View of Parent-Infant Psychotherapy. NewYork (Basic Books) . Tabachnick, B. G., Fidell, L. S., & Ullman, J. B. (2007). Using Multivariate Statistics (Vol. 5). Boston, MA: Pearson.. Vaillant, G. E. J. A. (1971). Theoretical hierarchy of adaptive ego mechanisms: A 30-year follow-up of 30 men selected for psychological health. Archives of General Psychiatry, 24(2), 107-118. Watson, D. C. (2002). Predicting psychiatric symptomatology with the Defense Style Questionnaire-40. International Journal of Stress Management, 9(4), 275-287. Zaidi, F., Nigam, A., Anjum, R., Agarwalla, R. (2017). Postpartum depression in women: A risk factor analysis. Journal of Clinical and Diagnostic Research, 11(8), QC13- QC16. | ||
|
آمار تعداد مشاهده مقاله: 693 تعداد دریافت فایل اصل مقاله: 416 |
||