The Comparison Effectiveness of acceptance and commitment therapy with exposure and response prevention and schema therapy with exposure and response prevention on experiential Avoidance & perfectionism in patients with obsession and compulsion disorder
Subject Areas : Psychology
Mahnaz Ghatreh Samani
1
,
Mahmoud Najafi
2
1 - Department of clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
2 - Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
Keywords: obsession, perfectionism, experiential avoidance, acceptance and commitment therapy, schema therapy,
Abstract :
Obsessive Compulsive Disorder is one of the disorders that affects all aspect of life and leaves destructive effects in patients' lives in the long term. The aim of this study was to compare the effectiveness of acceptance and commitment therapy along with exposure and response prevention with schema therapy along with exposure and response prevention on perfectionism and experiential avoidance of patients with obsessive-compulsive disorder. It was semi-experimental research that had pre-test and post-test with a control group. The statistical population of the present study included all patients with obsessive-compulsive disorder in 2023 in Isfahan city. After the clinical interview, 60 people were selected by available sampling method and randomly assigned in two experimental groups and one control group (20 people in each group). The experimental groups received eight 60-minute sessions of acceptance and commitment therapy with exposure and response prevention and schema therapy with exposure and response prevention. Frost's perfectionism questionnaire and acceptance and action questionnaire second version were used in this research. The results were evaluated through the statistical method of multivariate analysis of covariance. The findings data showed that the effectiveness of both treatments on perfectionism and experiential avoidance were statistically significant. Schema therapy with exposure and response prevention is more effective on experiential avoidance and the effectiveness of both treatments on perfectionism was the same. It is suggested to use schema therapy or acceptance and commitment therapy along with exposure and response prevention.
باقری شیخانگفشه، فرزین؛ کیانی، آرینا؛ صوابی نیری، وحید؛ نخستین آصف، زهرا و بوربور، زینب. (1402). اثربخشی درمان شناختی- رفتاری بر دشواری در تنظیم هیجان و انعطاف‌‌پذیری شناختی بیماران مبتلابه اختلال وسواسی- اجباری. مجله روانشناسی، 1(27)، 28-37.
بی‌طرف، شبنم؛ شعیری، محمدرضا و حکیم جوادی، منصور. (1389). هراس اجتماعی، سبک‌های والد گری و کمال‌گرایی. روانشناسی تحولی (روانشناسان ایرانی).7 (25): 75-83.
پاک، راضیه؛ عبدی، رضا و چلیبانلو، غلامرضا. (1396). اثربخشی درمان مبتنی بر پذیرش و تعهد بر اجتناب تجربه‌ای و پذیرش بیماری در افراد مبتلابه مولتیپل اسکلروزیس، مجله روانشناسی معاصر. 12 (1):63-72.
حسن‌پور، پگاه؛ آقا یوسفی، علیرضا؛ ضمیر، محسن و علی پور، احمد. (1398). مقایسه اثربخشی درمان فراتشخیصی و مواجهه سازی-بازداری پاسخ بر اجتناب تجربه‌ای و تنظیم شناختی هیجان در مبتلایان به وسواس فکری-عملی، مجله روانشناسی بالینی. 11 (43): 25-37.
حکمتیان فرد، صادق و گلستانه، سید موسی. (1402). رابطه طرح‌واره‌های ناسازگار اولیه با تعلل ورزی تحصیلی با نقش میانجی ویژگی‌های شخصیتی و کمال‌گرایی، مجله روانشناسی. 1 (27)، 38-50.
سهرابی، فرامرز؛ برجعلی، احمد و مؤمنی، محمدمهدی. (1399). اثربخشی تکنیک‌های شناختی طرح‌واره درمانی بر کاهش کمال‌گرایی افراطی، مجله رویش روانشناسی. 9 (4)، 75-82.
عباسی، ایمانه؛ فتی، لادن؛ مولودی، رضا و ضرابی، حمید. (1391). کفایت روان‌سنجی نسخه فارسی پرسشنامه پذیرش و عمل– نسخه دوم. فصلنامه علمی روش‌ها و مدل‌های روان‌شناختی، 3 (10)، 65-80.
وکیلی هریس، شهرام؛ لیوارجانی، شعله و محب، نعیمه. (1399). مدل ساختاري اختلال وسواس جبري بر اساس کمال‌گرایی ناسازگار و کنترل روان‌شناختی والدين. مجله روانشناسی، 2 (24)، 231-247.
وکیلی هریس، شهرام؛ لیوارجانی، شعله و محب، نعیمه. (1398). مدل فراتشخیصی اضطراب و افسردگی در جمعیت غیر بالینی: نقش میانجی بیش کنترل گری. فصلنامه پژوهش در سلامت روان‌شناختی، ۱۳ (۱)، ۸۱-۹۸.
Basile, B., Tenore, K., & Mancini, F. (2018). Investigating schema therapy constructs in individuals with depression. Psychology & Clinical Psychiatry, 9(2), 214-221.
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior therapy, 42(4), 676-688 .
Chaabi, I., Mehrabizade Honarmand, M., & Amini, N. (2022). The Effectiveness of Schema Therapy in Experiential Avoidance and Anxiety Sensitivity of Students with Academic Procrastination. Psychological Achievements, 29(English Special Issue), 1-14. (text in Persian).
Fassbinder, E., & Arntz, A. (2018). Schema Therapy with Emotionally Inhibited and Fearful Patients. Journal of Contemporary Psychotherapy, 49(1), 7–14.
Haaland, A. T., Vogel, P. A., Launes, G., Haaland, V. O., Hansen, B., Solem, S., & Himle, J. A. (2011). The role of early maladaptive schemas in predicting exposure and response prevention outcome for obsessive-compulsive disorder. Behaviour Research and Therapy, 49(11), 781–788.
Handley, A. K., Egan, S. J., Kane, R. T., & Rees, C. S. (2015). A randomised controlled trial of group cognitive behavioural therapy for perfectionism. Behaviour Research and Therapy, 68, 37–47.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25.
Hershenberg, R., Mavandadi, S., Wright, E., & Thase, M. E. (2017). Anhedonia in the daily lives of depressed Veterans: A pilot report on experiential avoidance as a moderator of emotional reactivity. Journal of Affective Disorders, 208, 414–417.
Hewitt, P. L., Flett, G. L., & Mikail, S. F. (2017). Perfectionism: A relational approach to conceptualization, assessment, and treatment. Guilford Publications.
Kirk, A., Meyer, J. M., Whisman, M. A., Deacon, B. J., & Arch, J. J. (2019). Safety behaviors, experiential avoidance, and anxiety: A path analysis approach. Anxiety Disorders, 64, 9–15.
Lee, E. B., Ong, C. W., An, W., & Twohig, M. P. (2018). Acceptance and commitment therapy for a case of scrupulosity-related obsessive-compulsive disorder. Bulletin of the Menninger Clinic, 82(4), 407-423.
Limburg, K., Watson, H. J., Hagger, M. S., & Egan, S. J. (2017a). The Relationship Between Perfectionism and Psychopathology: A Meta-Analysis. Clinical Psychology, 73(10), 1301–1326.
Malivoire, B. L., Kuo, J. R., & Antony, M. M. (2019). An examination of emotion dysregulation in maladaptive perfectionism. Clinical Psychology Review, 71, 39–50.
Mobarakeh, K., Neshatdoost, H. T., & Abedi, M. (2012). The Effect of acceptance and commitment therapy on the frequency and severity of symptoms of obsessive compulsive disorder. Research in Medical Sciences, 14(10). (text in Persian).
Moroz, M., & Dunkley, D. M. (2019). Self-critical perfectionism, experiential avoidance, and depressive and anxious symptoms over two years: A three-wave longitudinal study. Behavior Research and Therapy, 112, 18-27.
McKay, D. (2018). Obsessive-compulsive disorder research: Growing in scope, advances unclear. Anxiety Disorders, 56, 5–7.
Miegel, F., Jelinek, L., & Moritz, S. (2019). Dysfunctional beliefs in patients with obsessive-compulsive disorder and depression as assessed with the Beliefs Questionnaire (BQ). Psychiatry Research, 272, 265-274.
Nordahl, H. M., & Nysæter, T. E. (2005). Schema therapy for patients with borderline personality disorder: a single case series. Behavior Therapy and Experimental Psychiatry, 36(3), 254–264.
Ong, C. W., Lee, E. B., Krafft, J., Terry, C. L., Barrett, T. S., Levin, M. E., & Twohig, M. P. (2019). A randomized controlled trial of acceptance and commitment therapy for clinical perfectionism. Obsessive-Compulsive and Related Disorders, 22, 100-444.
Pinto, A., Dargani, N., Wheaton, M. G., Cervoni, C., Rees, C. S., & Egan, S. J. (2017). Perfectionism in obsessive-compulsive disorder and related disorders: What should treating clinicians know?. Obsessive-Compulsive and Related Disorders, 12, 102–108.
Pittman, C. M., & Youngs, W. H. (2021). Rewire Your OCD Brain: Powerful Neuroscience-Based Skills to Break Free from Obsessive Thoughts and Fears. New Harbinger Publications..
Reuman, L., Buchholz, J., & Abramowitz, J. S. (2018). Obsessive beliefs, experiential avoidance, and cognitive fusion as predictors of obsessive-compulsive disorder symptom dimensions. contextual behavioral science, 9, 15-20.
Shafran, R., Wade, T. D., Egan, S. J., Kothari, R., Allcott-Watson, H., Carlbring, P., Andersson, G. (2017). Is the devil in the detail? A randomised controlled trial of guided internet-based CBT for perfectionism. Behaviour Research and Therapy, 95, 99–106.
Sharifi, T., & Ghazanfari, A. (2022). Comparison of the effectiveness of schema therapy and acceptance and commitment therapy on perfectionism in patients with obsessive-compulsive personality disorder. Psychiatric Nursing, 10(3), 117-131. (text in Persian).
Spencer, S. D., Meyer, M. S., & Masuda, A. (2023). A case-series study examining acceptance and commitment therapy for experiential avoidance-related mixed anxiety and depression in a telehealth platform. Clinical Case Studies, 22(1), 78-96.
Spinhoven, P., van Hemert, A. M., & Penninx, B. W. J. H. (2017). Experiential Avoidance and Bordering Psychological Constructs as Predictors of the Onset, Relapse and Maintenance of Anxiety Disorders: One or Many? Cognitive Therapy and Research, 41(6), 867–880.
Sohrabi, M., Bakhtiarpour, S., Sohrabi, F., Saadi, Z. E., & Asgari, P. (2023). Effectiveness of Contextual Schema Therapy for Extreme Perfectionism and Emotion Regulation in Individuals with Perfectionism Disorder. Clinical Research in Paramedical Sciences, 12(2). (text in Persian).
Taghavizade Ardakani, M., Akbari, B., Hossein Khanzade, A. A., & Moshkbide Haghighi, M. (2019). Comparing the effects of cognitive-behavioral therapy and acceptance and commitment therapy on the perfectionism of patients with obsessive-compulsive disorder. Internal Medicine Today, 26(1), 24-37. (text in Persian).
Tenore, K., Basile, B., Mancini, F., & Luppino, O. I. (2018). A theoretical integration of Schema Therapy and Cognitive Therapy in OCD treatment: Conceptualization and rationale. Psychology, 9(09), 22-78.
Thiel, N., Jacob, G. A., Tuschen-Caffier, B., Herbst, N., Külz, A. K., Hertenstein, E., Voderholzer, U. (2016). Schema therapy augmented exposure and response prevention in patients with obsessive–compulsive disorder: Feasibility and efficacy of a pilot study. Behavior Therapy and Experimental Psychiatry, 52, 59–67.
Twohig, M. P., Abramowitz, J. S., Bluett, E. J., Fabricant, L. E., Jacoby, R. J., Morrison, K. L., … Smith, B. M. (2015). Exposure therapy for OCD from an acceptance and commitment therapy (ACT) framework. Obsessive-Compulsive and Related Disorders, 6, 167–173.
Twohig, M. P., Hayes, S. C., & Masuda, A. (2006). Increasing willingness to experience obsessions: Acceptance and commitment therapy as a treatment for obsessive-compulsive disorder. Behavior therapy, 37(1), 3-13.
Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder. Consulting and Clinical Psychology, 78(5), 705–716.
Williams, J. L., Hardt, M. M., Henschel, A. V., & Eddinger, J. R. (2019). Experiential avoidance moderates the association between motivational sensitivity and prolonged grief but not posttraumatic stress symptoms. Psychiatry Research, 273, 336–342.
Zakiei, A., Khazaie, H., Rostampour, M., Lemola, S., Esmaeili, M., Dürsteler, K., ... & Brand, S. (2021). Acceptance and commitment therapy (ACT) improves sleep quality, experiential avoidance, and emotion regulation in individuals with insomnia—results from a randomized interventional study. Life, 11(2), 133-152.
