The effectiveness of short-term and intensive psychodynamic therapy on the difficulty in regulating emotions and attachment styles in psychosomatic patients
Subject Areas : Attachment StylesErfan Abdollahi Chirani 1 , Farnaz Klidari 2 , Seyyed Masoomeh Moosavi 3 , Ghazal Kian Fard 4 , Fatemeh Emami 5
1 - Master's degree, Department of Psychology, Boali Sina University, Hamadan, Iran. (Corresponding author), arashmahdavi927@gmail.com Tell: 09921088635
2 - Master's degree, Department of Psychology, Semnan Branch, Islamic Azad University, Semnan, Iran.
3 - Master's degree, Department of Psychology, Garmsar Branch, Islamic Azad University, Semnan, Iran.
4 - PhD student, Department of Psychology, North Tehran Branch, Islamic Azad University, Tehran, Iran.
5 - Master's student, Department of Psychology, Bojnord University, North Khorasan, Iran.
Keywords: intensive and short-term dynamic therapy, emotion regulation, attachment styles, psycho-physical patients,
Abstract :
Abstract Introduction: Psychosomatic diseases are physical diseases that psychological factors are effective in starting or aggravating them, and intensive and short-term dynamic treatment can play an effective role in improving psychological symptoms; Therefore, the present study was conducted with the aim of determining the effectiveness of intensive and short-term dynamic therapy on the difficulty in regulating emotions and attachment styles in psycho-physical patients. Materials and methods: The research method was semi-experimental with a pre-test-post-test design and follow-up with a control group. The research population was all psychosomatic patients referred to psychosomatic clinics in Tehran in 1402. Among them, 30 people were selected by available sampling and randomly assigned to two experimental and control groups (15 people). The experimental group received dynamic therapy 15 sessions of 90 minutes, while the control group did not receive any intervention. Two groups with difficulty in emotion regulation and attachment styles were evaluated in three stages. Two-way analysis of variance with repeated measurements was used to analyze the data. Findings: The average scores of difficulty in emotion regulation and attachment styles before the intervention were 72.25, 58.36, 24.08 in the treatment group and 72.12, 59.16, 23.52 in the control group respectively. (p<0.05), but after the intervention, the average scores of attachment styles in the treatment group increased significantly compared to the control group and showed a decrease in difficulty in emotion regulation (p<0.01). Conclusion: The results of the study indicated the effect of intensive and short-term dynamic therapy intervention on the improvement of psychological symptoms in the experimental group. With caution, it is recommended to use this intervention as a complementary treatment in psycho-physical patients.
References
[1] Cho YK, Choi MG, Cheo GJ, Jang JY, Park JJ, Shin JE, et al. Randomized clinical trial: A double-blind, randomized, active-controlled, phase 3 study to evaluate the safety and efficacy of tegoprazan in patients with Gastric Ulcer.GutLiver 2019;13(1):25-46. doi:10.100 2/ejp.2164
[2] Hyphantis T, Guthrie E, Tomenson B, Creed F. Psychodynamic interpersonal therapy and improvement in interpersonal difficulties in people with severe irritable bowel syndrome. Pain 2009;145(1-2):196-203. PMID: 19643544 [DOI:10.1016/j.pain .2009.07.005].
[3] Preece DA, Mehta A, Petrova K, Sikka P, Bjureberg J, Becerra R, Gross JJ. Alexithymia and emotion regulation. J Affect Disord. 2023 Mar 1;324:232-238. doi: 10.1016/j.jad.2022.12.065. Epub 2022 Dec 23. PMID: 36566943.
[4] Habibi Asgarabad M, Salehi Yegaei P, Jafari F, Azami-Aghdash S, Lumley MA. The relationship of alexithymia to pain and other symptoms in fibromyalgia: A systematic review and meta-analysis. Eur J Pain 2023;27(3):321-337. doi:10.100 2/ejp.2064
[5] Dehghan Manshadi, Z., Neshat Doost, H.T., Talebi, H. et al. Coping strategies among Iranian children with experience of Sarpol-e-Zahab earthquake: factor structure of children’s Coping Strategies Checklist-revision1 (CCSC-R1). BMC Psychol 2020; 8, 92. https://doi.org/10.1186/s40359-020-00456-8
[6] Perry JC, Presniak MD, Olson TR. Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders. Psychiatry 2013;76(1):32-52. DOI: 10.1521/psyc.2013.76.1.32 PMID: 23458114.
[7] Heshmati R, Lo C, Khooy MP, Naseri E. Pathway linking Emotional Suppression to Depression and Anxiety in Cancer Patients undergoing Chemotherapy: The Mediating Role of Ego-strength [published online ahead of print, 2022 Aug 4]. Curr Aging Sci 2022;10.2174/1874609815666220804123152. doi:10.2174/187460981 5666220804123152
[8] Messina I, Scottà F, Marchi A, Benelli E, Grecucci A, Sambin M. Case Report: Individualization of Intensive Transactional Analysis Psychotherapy on the Basis of Ego Strength. Front Psychol 2021;12:618762. Published 2021 Jun 9. doi:10.3389/fpsyg.2021.618762
[9] Abbass, A., Kisely, S., Kroenke, K .Short- Term Psychodynamic Psychodynamic Psychotherapy for somatic Disorders. Psychotherapy and psychosomatic 2009 78: 265-274.
[10] Abbass, A., Campbell, S., Magee, K., & Tarzwell, R. Intensive short-term dynamic psychotherapy to reduce rates of emergency department return visits for patients with medically unexplained symptoms: preliminary evidence from a pre-post intervention study. Cjem 2009; 11(6), 529-534. https://doi.org/10.1017/s1481803 500011799
[11] Russell L, Abbass A, Allder S. A review of the treatment of functional neurological disorder with intensive short-term dynamic psychotherapy. Epilepsy Behav 2022;130:108657. doi:10.1016/j.yebeh.2022.108657.
[12] Farzdi H, Heidarei A, Moradimanesh F, Naderi F. The Effectiveness of Short-Term Dynamic Psychotherapy on Symptoms Severity and Disease Perception among Patients with Irritable Bowel Syndrome: A Pilot study”. SALĀMAT-I IJTIMĀĪ (Community Health. 2021 8 (2), 221-31. https://doi.org/10.22037/ch.v8i2.31425. [Farsi]
[13] Bagby R, Parker JDA, Taylor GJ. The twenty-item Toronto Alexithymia scale: I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research 1994; 38(1):23 32.[DOI:10.1016/0022-3999(94)90005-1].
[14] Besharat MA. Reliability and factorial validity of a Farsi version of the 20-item Toronto Alexithymia Scale with a sample of Iranian students. Psychological Reports 2007; 101(1):209-20. [DOI:10.2466/pr0.101.1.209-220] [PMID]. [Farsi]
[15] Andrews, G., Singh, M., and Bond, M. .The defense style questionnaire. Journal of Nervous and mental Disease 1993 181(4):pp.246-56.
[16] Heidarinasab, L., Shaeiri, M. Factorial Structure of the Defense Style Questionnaire (DSQ-40). Journal of Modern Psychological Researches 2011; 6(21): 77-97. [Farsi]
[17] Markstrom, C. A., Sabino, V. M., Turner, B. J., & Berman, R. C. The psychosocial inventory of ego strengths: Development and validation of a new Eriksonian measure. Journal of youth and adolescence 1997; 26(6), 705-732.
[18] Altafi Sh. Examining and comparing self-efficacy and personality traits of drug addicts and non-addicts. Master's thesis in clinical psychology. Shahed University of Tehran;2009. [Farsi]
[19] Davanloo, H. Management of tactical defenses in intensive short‐term dynamic psychotherapy, Part I: Overview, tactical defenses of cover words and indirect speech. Int J Intensive Short Term Dyn Psychother 1996. 11(3), 129-152 doi: 10.22051/psy.2018.21331.1790
[20] Ahmadi, F. The effectiveness of intensive and short-term psychodynamic therapy on mental health, quality of life and disability caused by headache in patients with chronic tension headache, master's thesis, Allameh Tabatabai University, Faculty of Psychology and Educational Sciences, 2016 [Farsi].
[21] Nabizadeh A, farhadi M, rashid K, kordnoghabi R. The Effectiveness of Tactical Defenses Neutralization in Intensive Short-Term Dynamic Psychotherapy on Defensive Styles, Anxiety, and Fear of Intimacy in Non-Clinical Sample. rph 2019; 13 (1) :24-39. [Farsi] ]
[22] Mami, S., Safarnia, A., Tardast, L., Abbasi, B. Effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) to Reducing Alexithymia in Women Applicant for Divorce. Journal of Psychological Studies, 2021; 16(4): 127-142. doi: 10.22051/psy.2018.21331.1690
[23] Shams S, Ghelichkhan N, yousefi N, alijani S. Comparison of the effectiveness of short-term intensive dynamic psychotherapy and mentalization-based therapy on emotional dysregulation, defense mechanisms and insecure attachment styles in women who have experienced the trauma of marital infidelity. IJPN 2022; 10 (1) :106-121. [Farsi]