The Effectiveness of Mindfulness-Based Exposure Therapy on Preventing Generalized Anxiety Disorder, Metacognitive Beliefs, Emotional Self-Regulation, and Cognitive Distortions in Men with OCD
Subject Areas :
1 - Assistant Professor, Department of Psychology, Abhar Branch, Islamic Azad University, Abhar, Iran
Keywords: Mindfulness-Based Therapy, Generalized Anxiety Disorder, Metacognitive Beliefs, Emotional Self-Regulation, Cognitive Distortions, Obsessive-Compulsive Disorder.,
Abstract :
Obsessive-Compulsive Disorder (OCD) is one of the most common and debilitating mental disorders. Numerous factors contribute to the onset and exacerbation of this disorder, among which generalized anxiety disorder, metacognitive beliefs, emotional self-regulation, and cognitive distortions are significant. The present study aimed to determine the effectiveness of mindfulness-based exposure therapy on preventing generalized anxiety disorder, improving metacognitive beliefs, emotional self-regulation, and reducing cognitive distortions in men with OCD. This research was a quasi-experimental study with a pretest-posttest design and a control group. The statistical population included all men with OCD in the city of Sanandaj. The sample consisted of 40 men with OCD, selected through purposive sampling, and divided into experimental and control groups. Data were collected using the Generalized Anxiety Disorder Questionnaire (GAD-7), the Metacognitive Beliefs Questionnaire (MCQ), the Emotional Self-Regulation Questionnaire by Hofmann and Kashdan, and the Cognitive Distortions Questionnaire by Albert Ellis. After conducting the pretest, the experimental group underwent ten 90-minute intervention sessions, while the control group was placed on a waiting list for treatment. The posttest was conducted at the end of the intervention. Multivariate covariance analysis (MANCOVA) was used to analyze the data. The results showed that mindfulness-based exposure therapy was effective in preventing generalized anxiety disorder, improving metacognitive beliefs, enhancing emotional self-regulation, and reducing cognitive distortions in men with OCD. Covariance analysis, controlling for pretest effects, revealed a significant difference between the experimental and control groups in the posttest on the mentioned variables. Compared to the control group, the experimental group demonstrated a significant reduction in generalized anxiety disorder, metacognitive beliefs, and cognitive distortions, along with a significant increase in emotional self-regulation. Based on the findings, given that men with OCD exhibit symptoms of generalized anxiety disorder, metacognitive beliefs, emotional self-regulation issues, and cognitive distortions, mindfulness-based therapy is recommended as an effective treatment for individuals with OCD.
احمدی کانی گلزار، ارسلان.، قلی‌زاده، زلیخا.، سهرابی، احمد.، کیانی، محمد علی.، علیزاده، نرگس.، و اصغرنژاد، سحر. (1392). اثربخشی درمان شناختی رفتاری بر درمان افسردگی پس از زایمان و سه عامل پویشی تعارضات وابستگی، خشم و مادری در مادران افسرده پس از زایمان، مجله زنان، مامائی و نازائی ایران، 16(52)، 17-8.
سیاوش آبکنار، م. (1400). بررسی ارتباط اضطراب کرونا با نگرانی و شدت علائم وسواسی در بیماران مبتلا به اختلال وسواس فکری- عملی. مجله دستاور‌های نوین در مطالعات علوم انسانی، 4(39)، 184-176.
شاه کرمی، محمد.، زهراکار، کیانوش.، و محسن‌زاده، فرشاد. (1393). بررسی نقش واسطه‌ای سبک‌های حل تعارض در رابطه‌ی بین تحریف‌های شناختی بین فردی و رضایت جنسی با تعهد زناشویی. فصلنامه پژوهش در سلامت روان شناختی، 8(2)، 60-54.
موسوی، س ا.، غزایی، ب.، رمضانی فرانی، ع.، و طارمیان، ف. (1396). مقایسه خطا‌های شناختی و نشخوار‌های فکری در بیماران مبتلا به اختلال وسواس فکری عملی و فوبی اجتماعی. مجله روان پزشکی و روان‌شناسی بالینی ایران، 23(1)، 21-10.
ندری، م.، صادقی، م.، و رضایی، ف. (1402). تدوین مدل معادلات ساختاری اختلال اضطراب اجتماعی بر اساس مؤلفه‌های آسیب‌های دوران کودکی و سبک دلبستگی ناایمن با میانجی‌گری باور‌های فراشناخت. فصلنامه پژوهش‌های نوین روانشناختی، 18)70)، 250-239.
هارون رشیدی، ه.، و زکی‌زاده، ح. (1401). اثربخشی شناخت‌درمانی مبتنی بر ذهن‌آگاهی بر سازگاری اجتماعی و تحریف‌های روانشناختی مردان سالمند. روان‌شناسی پیری، 8(2)، 117-105.
Abramowitz, J. S. (2018). Getting over OCD: a 10-step workbook for taking back your life. Guilford Publications.
American Psychiatric Association. (2022). iagnostic and statistical manual of mental disorders (5th ed. , text rev. ). doi: 10.1176/appi. books. 9780890425787.
Arch, J. J. , & Abramowitz, J. S. (2015). Exposure therapy for obsessive–compulsive disorder: An optimizing inhibitory learning approach. Journal of Obsessive-Compulsive and Related Disorders, 6, 174-182.
Bellia, F. , Girella, A. , Annunzi, E. , Benatti, B. , Vismara, M. , Priori, A. , ... & D’Addario, C. (2024). Selective alterations of endocannabinoid system genes expression in obsessive compulsive disorder. Translational Psychiatry, 14(1), 118.
Bischof, C. , Hohensee, N. , Dietel, F. A. , Doebler, P. , Klein, N. , & Buhlmann, U. (2024). Emotion Regulation in Obsessive-Compulsive Disorder: An Ecological Momentary Assessment Study. Behavior Therapy. https://doi.org/10.1016/j. beth. 2024.01.011.
Calun-Nadulska, P. , & Sikora, JM. (2019). Therapy of an obsessive-compulsive disorder in a cognitive-behavioural approach. psychiatry psychologies kliniczna-journal of psychiatry and clinical psychology. 19(2), 210-215.
Citkowska-Kisielewska, A. , Rutkowski, K. , MIELIMAKA, M. , Sobanski, J. A. , & Dembinska, E. (2020). Obsessive-compulsive symptoms in obsessive-compulsive disorder and in generalized anxiety disorder: occurrence and correlations. Journal of Psychiatric Practice®, 26(2), 101-119.
Citkowska-Kisielewska, A. , Rutkowski, K. , Sobański, J. A. , Dembińska, E. , & Mielimąka, M. (2019). Anxiety symptoms in obsessive-compulsive disorder and generalized anxiety disorder. Psychiatr. Pol, 53(4), 845-864.
De Prisco, M. , Tapoi, C. , Oliva, V. , Possidente, C. , Strumila, R. , Lageborn, C. T. , & Fico, G. (2024). Clinical features in co-occuring obsessive-compulsive disorder and bipolar disorder: A systematic review and meta-analysis. European Neuropsychopharmacology, 80, 14-24.
Doron, G. , Derby, D. , Szepsenwol, O. , Nahaloni, E. , & Moulding, R. (2016). Relationship obsessive–compulsive disorder: interference, symptoms, and maladaptive beliefs. Frontiers in Psychiatry, 7, 58.
Grøtte, T. , Solem, S. , Vogel, P. A. , Güzey, I. C. , Hansen, B. , & Myers, S. G. (2015). Metacognition, responsibility, and perfectionism in obsessive–compulsive disorder. Cognitive Therapy and Research, 39(1), 41-50.
Hanley, A. W. , Abell, N. , Osborn, D. S. , Roehrig, A. D. , & Canto, A. I. (2016). Mind the gaps: are conclusions about mindfulness entirely conclusive?. Journal of Counseling & Development, 94(1), 103-113.
Hosseini, K. , & Soleimani, E. (2021). The Relationship between Child Abuse and Cognitive Distortions with Clinical Symptoms of Obsessive-Compulsive Disorder: The Mediating Role of Emotion Dysregulation. International Journal of Behavioral Sciences, 15(2), 88-95.
İnaltekin, A. , & Yağcı, İ. (2024). Difficulty in Emotion Regulation, Metacognition, Psychiatric Symptoms, and Suicide Probability in Obsessive-Compulsive Disorder, Psychiatry Clin Psychopharmacol. 1-7.
Izhar, L. I. , Babiker, A. , Rizki, E. E. , Lu, C. K. , & Abdul Rahman, M. (2022). Emotion Self-Regulation in Neurotic Students: A Pilot Mindfulness-Based Intervention to Assess Its Effectiveness through Brain Signals and Behavioral Data. Sensors, 22(7), 2703.
Jacobson, N. C. , Newman, M. G. , & Goldfried, M. R. (2016). Clinical feedback about empirically supported treatments for obsessive‐compulsive disorder. Behavior therapy, 47(1), 75-90.
Jiang, S. S. , Liu, X. H. , Han, N. , Zhang, H. J. , Xie, W. X. , Xie, Z. J. , ... & Huang, X. B. (2022). Effects of group mindfulness-based cognitive therapy and group cognitive behavioural therapy on symptomatic generalized anxiety disorder: a randomized controlled noninferiority trial. BMC psychiatry, 22(1), 1-11.
Klenfeldt, I. F. , Skoog, G. , Skoog, J. , & Skoog, I. (2024). The natural history of lifetime psychiatric disorders in patients with obsessive‐compulsive disorder followed over half a century. Acta Psychiatrica Scandinavica.
Marszalek, J. M. , Lasiter, S. , Jianfang, L. , Ghaffari, A. , Martsolf, G. R. , Poghosyan, L. , & Neff, D. (2023).cognitive distortions and mental disorders. Journal of Nursing Measurement. 1(5), 1-17.
Masjoodi, S. , Farrokhi, M. , Afkham, B. V. , & Koohsar, J. S. (2024). Advances in DTI Studies for Diagnoses and Treatment of Obsessive-Compulsive Disorder. Psychiatry Research: Neuroimaging, 111794.
Osland, S. , Arnold, P. D. , & Pringsheim, T. (2018). The prevalence of diagnosed obsessive compulsive disorder and associated comorbidities: A population-based Canadian study. Psychiatry research, 268, 137-142.
Öst, L. G. , Havnen, A. , Hansen, B. , & Kvale, G. (2015). Cognitive behavioral treatments of obsessive–compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014. Clinical psychology review, 40, 156-169.
Pallant, J. (2020). SPSS survival manual: A step by step guide to data analysis using IBM SPSS. McGraw-hill education (UK).
Potter, K. , & Coyle, A. (2017). Psychotherapeutic practitioners’ views of the efficacy of mindfulness for the treatment of obsessive compulsive disorder: A qualitative key informant analysis. European Journal of Psychotherapy & Counselling, 19(2), 124-140.
Restoy, D. , Oriol-Escudé, M. , Alonzo-Castillo, T. , Magán-Maganto, M. , Canal-Bedia, R. , Díez-Villoria, E. , ... & Lugo-Marín, J. (2024). Emotion regulation and emotion dysregulation in children and adolescents with Autism Spectrum Disorder: A meta-analysis of evaluation and intervention studies. Clinical Psychology Review, 102410.
Sáez-Suanes, G. P. , García-Villamisar, D. , & Del Pozo Armentia, A. (2023). The role of intellectual disability and emotional regulation in the autism–depression relationship. Autism, 27(7), 1960-1967.
Şahin, H. , Köşger, F. , EşSizoğlu, A. , & Aksaray, G. (2018). The relationship between obsessive belief level and cognitive flexibility in patients with obsessive compulsive disorder. Archives of Neuropsychiatry, 55(4), 376-383.
Sliwa, L. (2001). Review of Treatment plans and interventions for depression and anxiety disorders. s Guilford: York N.
Spada, M. M. , Georgiou, G. A. , & Wells, A. (2010). The relationship among metacognitions, attentional control, and state anxiety. Cognitive behaviour therapy, 39(1), 64-71.
Storch, E. A. , McGuire, J. F. , & McKay, D. (Eds. ). (2018). The clinician's guide to cognitive-behavioral therapy for childhood obsessive-compulsive disorder. Academic Press.
Strohmeier, C. W. , Rosenfield, B. , DiTomasso, R. A. , & Ramsay, J. R. (2016). Assessment of the relationship between self-reported cognitive distortions and adult ADHD, anxiety, depression, and hopelessness. Psychiatry research, 238, 153-158.
Tabachnick, B. G. , Fidell, L. S. , & Ullman, J. B. (2013). Using multivariate statistics (Vol. 6, pp. 497-516). Boston, MA: pearson.
Totzeck, C., Teismann, T., Hofmann, S. G., von Brachel, R., Zhang, X. C., Pflug, V., & Margraf, J. (2018). Affective styles in mood and anxiety disorders–Clinical validation of the “Affective Style Questionnaire”(ASQ). Journal of Affective Disorders, 238, 392-398.
Wu, M. S. , McGuire, J. F. , Martino, C. , Phares, V. , Selles, R. R. , & Storch, E. A. (2016). A meta-analysis of family accommodation and OCD symptom severity. Clinical Psychology Review, 45, 34-44.
Wunder, Z. I. , & Jones, L. L. (2023). Mindful Metacognition: Attention, Beliefs, and Skills in the Acceptance of Experiences. Mindfulness, 14(12), 2917-2931.
Yalım, E. , Ünsal, C. , & Gündoğmuş, İ. (2024). The Relationship Between Occupational Functionality and Metacognition in Patients with Obsessive-Compulsive Disorder. Cureus, 16(1), 1-9.
Zainal, N. H. , & Newman, M. G. (2024). Which client with generalized anxiety disorder benefits from a mindfulness ecological momentary intervention versus a self-monitoring app? Developing a multivariable machine learning predictive model. Journal of Anxiety Disorders, 102, 102825.
Zimmermann, F. F. , Burrell, B. , & Jordan, J. (2018). The acceptability and potential benefits of mindfulness-based interventions in improving psychological well-being for adults with advanced cancer: a systematic review. Complementary therapies in clinical practice, 30, 68-78.
