Comparison of the effectiveness of cognitive therapy based on mindfulness and schema therapy on emotion regulation and distress intolerance of women with obsessive-compulsive symptoms

Authors
maryam zareii
abdolmajid bahreinian
Qasem ahi
ahmad mansouri
Islamic Azad university
Abstract
The present study aimed to comparison the effectiveness of cognitive therapy based on mindfulness and schema therapy on emotional regulation and distress tolerance of women with obsessive-compulsive symptoms. The present research method was semi-experimental with pretest, posttest and follow-up. The statistical population of the study included all women with obsessive-compulsive disorder who referred to the counseling centers of Mashhad in 2023-2024. Based on the inclusion and exclusion criteria, 48 people were selected by convenience sampling and randomly assigned to two experimental groups and one control group. The participants were evaluated using the emotion regulation questionnaire (Gross & John, 2003) and distress tolerance scale in the pretest, posttest and follow-up. Data were analyzed using SPSS 26 software and using descriptive and inferential statistics. The results of and analysis of variance with repeated measures showed that there is a significant difference between the experimental and control groups in emotion regulation and distress tolerance (P<0.05). Cognitive therapy based on mindfulness and schema therapy has led to improved emotion regulation and increased distress tolerance. Cognitive therapy based on mindfulness is more effective than schema therapy in improving emotion regulation.
Keywords
cognitive therapy based on mindfulness
distress tolerance
emotion regulation
Obsessive-compulsive disorder
Schema therapy
American Psychiatric Association: DSM -V Development. (2022). Retrieved on Aguest 22, from: http:// www.dsm5.org/pages/default.aspx .
Arnsten, AFT., & Rubia, K. (2012). Neurobiological circuits regulating attention, cognitive control, motivation, and emotion: disruptions in neurodevelopmental psychiatric disorders. J Am Acad Child Adolesc Psychiatry, 51(4),356–67.
Asani, S., Panahali, A., Abdi, R., & Gargari, R. B. (2024). Effectiveness of Reality Therapy and Mindfulness-Based Cognitive Therapy in Academic Meaning and Academic Emotions of Procrastinating Students. Modern Care Journal, 21(2).
Bayır, B., & Aylaz, R. (2021). The effect of mindfulness -based education given to individuals with substance -use disorder according to self-efficacy theory on self-efficacy perception. Applied nursing research, 57, 1 -9.
Berman, NC., Shaw, AM., & Wilhelm, S.(2018). Emotion regulation in patients with obsessive compulsive disorder: unique effects for those with "taboo thoughts." Cogn Ther Res, 42(5), 674–85.
Borelli, JL., Ruiz, SK., Crowley, MJ., Mayes, LC., Reyes, AD Los., Lewin, AB.(2015). Children's obsessive compulsive symptoms and fear-potentiated startle responses. J Obsessive Compuls Relat Disord, 6,101–7.
Brock, H., & Hany, M. (2021). Obsessive-Compulsive Disorder.
Calvocoressi, L., Lewis, B., Harris, M., & Trufan, SJ. (2020). Family accommodation in obsessive-compulsive disorder. Am J Psychiat, 152, 441-3.
Christenson, G., Faber, R., de Zwaan, M., & Raymond, N. Specker, S., & Mitchell, J. (1994). Compulsive buying Descriptive characteristics and psychiatric comorbidity. Journal of Clinical Psychiatry, 55, 5-11.
Colton, K. C., Godleski, S. A., & Crane, C. A. (2023). Applying a bifactor model to the functions of relational aggression: Associations with hostile attribution biases and difficulties with emotion regulation. Aggressive Behavior. [Doi:10.1002/ab.22053].
Dams, G. M., Calamari, J. E., Rector, N. A., & Riemann, B.C. (2020). Identification of beliefbased subtypes in obsessive-compulsive disorder using latent profile analysis. Journal of Obsessive -Compulsive and Related Disorders, 26, 100555.
Du J, Huang J, An Y, Xu W. The Relationship between stress and negative emotion: The Mediating role of rumination. Clinical Research and Trials. 2018;4(1)
Emanuel, A. S., Updegraff, J. A., Kalmbach, D. A., & Ciesla, J. A. (2010). The role of mindfulness facets in affective forecasting. Personality and Individual differences, 49(7), 815-818
Fassbinder, E., Schweiger, U., Martius, D., & Brand-de Wilde, O. (2016). Emotion regulation in schema therapy and dialectical behavior therapy. Frontiers in psychology, 7, 206865.
Francesconi, M., Flouri, E., & Harrison, A. (2022). Decision -making difficulties mediate the association between poor emotion regulation and eating disorder symptoms in adolescence. Psychological Medicine, 1-10.
Hovrud, L., Simons, R., & Simons, J. (2020). Cognitive schemas and eating disorder risk: The role of distress tolerance. International journal of cognitive therapy, 13, 54-66.
Kalil, A., Ryan, R., & Chor, E. (2014). Time investments in children across family structures. The ANNALS of the American Academy of Political and Social Science, 654(1),150-168.
Keough, ME., Riccardi, CJ., Timpano, KR., Mitchell, MA., & Schmidt, NB. (2010). Anxiety symptomatology: The as- sociation with distress tolerance and anxiety sensitivity. Behavior Therapy, 41(4), 567-74.
Krauss, S., Orth, U., & Robins, RW. (2020). Family environment and self-esteem development: a longitudinal study from age 10 to 16. Journal of personality and social psychology, 119(2), 457-478.
Kyron, M. J., Hooke, G. R., Bryan, C. J., & Page, A. C. (2022). Distress tolerance as a moderator of the dynamic associations between interpersonal needs and suicidal thoughts. Suicide and Life‐Threatening Behavior, 52(1), 159- 170.
Li, Y., Ju, R., Hofmann, S. G., Chiu, W., Guan, Y., Leng, Y., & Liu, X. (2023). Distress tolerance as a mechanism of mindfulness for depression and anxiety: Cross-sectional and diary evidence. International Journal of Clinical and Health Psychology, 23(4), 100392.
Lian, A. E. Z., & Bono, S. A. (2023). Refining the Experiential Component of Schema Therapy for Traumatised Populations: a New Continuum of Experiential Techniques. European Journal of Trauma & Dissociation, 7(4), 100352.
Lopes, PN., Nezlek, JB., Extremera, N., Hertel, J., Fernández‐Berrocal, P., & Schütz, A. (2021). Emotion regulation and the quality of social interaction: Does the ability to evaluate emotional situations and identify effective responses matter? Journal of personality, 79(2), 429-467.
Magliano, L., Tosini, P., Guarneri, M., Marasco, C.(2016). Burden on the families of patients with obsessivecompulsive disorder: a pilot study. Euro Psychiatry, 11, 192-7.
Monaco, MRL., Di Stasio, E., Zuccalà, G., Petracca, M., Genovese, D., & Fusco, D.(2020). Prevalence of ObsessiveCompulsive Symptoms in Elderly Parkinson Disease Patients: A Case-Control Study, 28(2), 167-75.
Monaco, MRL., Di Stasio, E., Zuccalà, G., Petracca, M., Genovese, D., & Fusco, D.(2020). Prevalence of ObsessiveCompulsive Symptoms in Elderly Parkinson Disease Patients: A Case-Control Study, 28(2), 167-75.
Monahan, P., Black, D., & Gabel, J. (2021). Reliability and validity of a scale to measure change in persons with compulsive buying. Psychiatry Res, 64(1), 59-67.
O’Cleirigh, C., Ironson, G., & Smits, J.A.(2007). Does distress tolerance moderate the impact of major life events on psychosocial variables and behaviors important in the management of HIV? Behavior therapy, 38(3), 314-23.
Paltell, K. C., & Berenz, E. C. (2022). The Influences of Posttraumatic Stress Disorder and Distress Tolerance on Trauma and Alcohol Cue Reactivity in a Sample of Trauma-Exposed College Students. Journal of Studies on Alcohol and Drugs, 83(1), 106-114.
Ranney, R.M., Berenz, E., Rappaport, L. M., Amstadter, A., & Dick, D. (2022). Anxiety sensitivity and distress tolerance predict changes in internalizing symptoms in individuals exposed to interpersonal trauma. Cognitive Therapy and Research, 46(1), 217-231.
Renner, F., DeRubeis, R., Arntz, A., Peeters, F., Lobbestael, J., Huibers, M.J.H. (2018). Exploring mechanisms of change in schema therapy for chronic depression. Journal of Behavior Therapy and Experimental Psychiatry, 58, 97-105.
Rusadi, R. M., Sugara, G. S., & Isti’adah, F. N. (2023). Effect of mindfulness-based cognitive therapy on academic grit among university student. Current Psychology, 42(6), 4620-4629.
Sifat, M. S., Ehlke, S. J., Ogunsanya, M., Frank-Pearce, S. G., Boozary, L. K., Alexander, A. C., & Kendzor, D. E. (2023). Greater Discrimination Frequency and Lower Distress Tolerance Are Associated with Mental Health Problems Among Racially Privileged and Minoritized Adults Accessing an Urban Day Shelter. Journal of Racial and Ethnic Health Disparities, 1(1), 1-17.
Simons, J. S., & Gaher, R. M. (2005). The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and Emotion, 29, 83-102
Simons, R. M., Sistad, R. E., Simons, J. S., & Hansen, J. (2018). The role of distress tolerance in the relationship between cognitive schemas and alcohol problems among college students. Addictive behaviors, 78, 1-8.
Sulaimani, M. F., & Bagadood, N. H. (2020). Implication of coronavirus pandemic on obsessive-compulsive-disorder symptoms. Reviews on Environmental Health, 1(ahead-of-print).
Torres, AR., Prince, MJ., Bebbington, PE., Bhugra, D., Brugha, TS., & Farrell, M.(2006). Obsessive-compulsive disorder: Prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity survey of 2000. Am J Psychiat, 163, 1978-85.
Treasure, J., Bektas, S., Mutwalli, H., Dhopatkar, N., & Himmerich, H. (2022). Novel approaches to tackling emotional loss of control of eating across the weight spectrum. Proceedings of the Nutrition Society, 1 -9.
van Dijk, S. (2022). Older adults with character: ‘Towards treatment in later life’. [Thesis fully internal (DIV), University of Groningen]. University of Groningen. https://doi.org/10.33612/diss.250880874
Vujanovic, A. A., Webber, H. E., McGrew, S. J., Green, C. E., Lane, S. D., & Schmitz, J. M. (2022). Distress tolerance: prospective associations with cognitivebehavioral therapy outcomes in adults with posttraumatic stress and substance use disorders. Cognitive Behaviour Therapy, 1-17.