Recent Innovations in Psychology

Recent Innovations in Psychology

Comparing the Effectiveness of the Group Therapy and Training Based on the Combined Approach of Acceptance and Commitment and Schema Therapy on Impulsiveness and Schema Modes of People with Borderline Personality Disorder

Document Type : Original Article

Authors
1 MSc. in clinical psychology, Hamedan Branch, Islamic Azad University, Hamedan, Iran.
2 Assistant Professor, Department Of psychology, South Tehran Branch, Islamic Azad University, Tehran, Iran.
3 Ph.D. in Clinical Psychology, Hamedan Branch, Islamic Azad University, Hamedan, Iran.
Abstract
The aim of this study was to compare the effectiveness of the group therapy and training based on the combined approach of acceptance and commitment and schema therapy on impulsive behaviors and schema modes of people with borderline personality disorder. This was a semi-experimental study with a pretest-posttest design. The statistical population was all the clients of a psychological center in the fall and winter 2023 that 45 people with the diagnosis of BPD were screened through a clinical interview. Due to the withdrawal of some volunteers, the data of 36 people were analyzed in 3 groups of 12 people. The experimental groups underwent 10 intervention sessions. Research instruments included the Barratt Impulsivity Scale (BIS-11) and the Schema Modes Questionnaire (SMQ). In order to analyze the data, multivariate covariance analysis was used. The findings showed that group therapy was effective in the demanding parent mode (P<0.05), but training was not effective (P>0.05). In the angry child mode, detached protector mode, healthy adult mode and impulsive behaviors, both ways were effective (P<0.05) and there was no significant difference (P>0.05). Both ways were effective in the vulnerable child mode, impulsive child mode, happy child mode and punitive parent mode (P<0.05), but group therapy had more effect than training. Based on these findings, it can be concluded that the combined approach of acceptance and commitment with schema therapy, using both group therapy and training methods, is effective for people diagnosed with borderline personality disorder, but that group therapy has more advantages for these people.
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Amaro, H., Magno-Gatmaytan, C., Meléndez, M., Cortés, D. E., Arevalo, S., & Margolin, A. (2010). Addiction treatment intervention: An uncontrolled prospective pilot study of spiritual self-schema therapy with Latina women. Substance Abuse31(2), 117-125. https://doi.org/10.1080/08897071003641602
American Psychiatric Association. (2022). DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM 5-TR), American Psychiatric Association: Washington. URL: https://www.psychiatry.org/psychiatrists/practice/dsm
Arntz, A., Gitta A. Lee, C. W., Manon Brand-de Wilde, O., Fassbinder, E., Harper, P., Lavender, A. Lockwood, G., Malogiannis, I. A. Ruths, F. A., Schweiger, U., Shaw, I. A., Zarbock, G., & Farrell, J. M. (2022). Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder A Randomized Clinical Trial. JAMA Psychiatry. 79(4), 287-299. https://doi.org/10.1001/jamapsychiatry.2022.0010
Bach, B., & Farrell, J. M. (2018). Schemas and modes in borderline personality disorder: The mistrustful, shameful, angry, impulsive, and unhappy child. Psychiatry research, 259, 323–329. https://doi.org/10.1016/j.psychres.2017.10.039
Barratt, E., Stanford, M. S., Kent, T. A., & Felthous, A. (1997). Neuropsychological and cognitive psycho-physiology substrates of impulsive aggression. Biological Psychiatry, 41, 1045-1061. https://doi.org/10.1016/s0006-3223(96)00175-8  
Brenning, K.M., De Clercq, B., Wille, B.,Vergauwe, J. (2020). Towards a fine-grained analysis of the link between borderline personality pathology and job burnout: Investigating the association with work-family conflict. Personality and IndividualComputers & Education, 103922.Differences, 162, 110030. https://psycnet.apa.org/doi/10.1016/j.paid.2020.110030
Cousineau, P., Thanh-Lan, N. (2013). Schema therapy - ACT – mindfulness.  Sante Ment Que, 38(2), 195-213. https://doi.org/10.7202/1023996ar
Dong, H., Wang, M., Zheng, H., Zhang, J., & Dong, GH. (2021). The functional connectivity between the prefrontal cortex and supplementary motor area moderates the relationship between internet gaming disorder and loneliness. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 108, 110154. https://doi.org/10.1016/j.pnpbp.2020.110154
Dousti, P., Dousti, P., & Yavari, A. (2024). The effectiveness of the integrated model of acceptance and commitment and schema therapy on the feeling of loneliness and social problem solving of people with Prolong Grief Disorder. Rooyesh-e-Ravanshenasi Journal (RRJ)12(11), 161-170 (In Persian). URL: https://frooyesh.ir/article-1-4861-fa.html
Dousti, P., Ghodrati, G., & Ebrahimi, M. (2018). A guide to group therapy based on acceptance and commitment therapy, Amin Negar Publications: Tehran (In Persian). URL: https://elmnet.ir/doc/31546199-26502
Ellison, W. D., Rosenstein, L. K., Morgan, T. A., & Zimmerman, M. (2018). Community and clinical epidemiology of borderline personality disorder. Psychiatric Clinics41(4), 561-573. https://doi.org/10.1016/j.psc.2018.07.008
Gojani, P. J., Masjedi, M., Khaleghipour, S., & Behzadi, E. (2017). Effects of the schema therapy and mindfulness on the maladaptive schemas hold by the psoriasis patients with the psychopathology symptoms. Advanced biomedical research6(1), 4. https://doi.org/10.4103/2277-9175.190988
Gonzalez-Torres, M. A. (2018). Psychodynamic psychotherapies for borderline personality disorders. Current developments and challenges ahead. BJPsych International15(1), 12-14. https://doi.org/10.1192%2Fbji.2017.7
Grecucci, A., Messina, I., & Dadomo, H. (2018). Decoupling Internalized Dysfunctional Attachments: A Combined ACT and Schema Therapy Approach, Frontiers in Psychology, 9, 1-3. https://doi.org/10.3389/fpsyg.2018.02332
Heinz, A. J., Bui, L., Thomas, K. M., & Blonigen, D. M. (2015). Distinct facets of impulsivity exhibit differential associations with substance use disorder treatment processes: A cross-sectional and prospective investigation among military veterans. Journal of substance abuse treatment55, 21-28. https://doi.org/10.1016/j.jsat.2015.02.005
Javid, M., Mohammadi, N., & Rahimi, C. (2012). Psychometric properties of an Iranian version of the Barratt Impulsiveness Scale-11 (BIS-11). Psychological Models and Methods2(8), 23-34 (In Persian). URL:https://dorl.net/dor/20.1001.1.22285516.1391.2.8.2.1
Kaplan, B., Yazici Gulec, M., Gica, S., & Gulec, H. (2020). The association between neurocognitive functioning and clinical features of borderline personality disorder. Brazilian Journal of Psychiatry42, 503-509. https://doi.org/10.1590/1516-4446-2019-0752
Martin, K., Horn, M., & Wilensky, U. (2019). Prevalence of Direct and Emergent Schema and Change after Play. Informatics in Education, 18 (1), 183-212. https://doi.org/10.15388/infedu.2019.09
Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt impulsiveness scale. Journal of clinical psychology51(6), 768-774. https://doi.org/10.1002/1097-4679(199511)51:6%3C768::AID-JCLP2270510607%3E3.0.CO;2-1
Salavati, M., Yeke Yazdan Dost, R. (2010), Therapy Schema (special guide for clinical psychologists), Danje Publications, first edition (In Persian). https://elmnet.ir/doc/31717050-60204?elm_num=1
Schaich, A., Braakmann, D., Richter, A., Meine, C., Assmann, N., Köhne, S., ... & Fassbinder, E. (2020). Experiences of patients with borderline personality disorder with imagery rescripting in the context of schema therapy—A qualitative study. Frontiers in Psychiatry11, 550833. https://doi.org/10.3389/fpsyt.2020.550833
Setkowski, K., Palantza, C., Van Ballegooijen, W., Gilissen, R., Oud, M., Cristea, I. A., Noma, H., Furukawa, T. A. Arntz, A., Van, B., Anton, J. L. & Cuijpers, P. (2023).Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis. Psychological Medicine, 53, 3261–3280. https://doi.org/10.1017/S0033291723000685 
Stratton, N., Mendoza Alvarez, M., Labrish, C.,Barnhart, R., & McMain, S. (2020). Predictors of dropout from a 20-week dialectical behavior therapy skills group for suicidal behaviors and borderline personality disorder. Journal of personality disorders, 34(2), 216-230. https://doi.org/10.1521/pedi_2018_32_391
Strickland, J. C., & Johnson, M. W. (2021). Rejecting impulsivity as a psychological construct: A theoretical, empirical, and sociocultural argument. Psychological review, 128(2), 336–361. https://doi.org/10.1037/rev0000263
Virgil Zeigler-Hill, V., Z., Green, B.,Arnau, R.C., Sisemore, T., B., & Myers, E.M. (2011). Trouble ahead, trouble behindL Narcissism and early maladaptivr schemas. Journal of Behavior Therapy and Experimental Psychiatry, 42, 31-103. https://doi.org/10.1016/j.jbtep.2010.07.004
Young JE, Klosko JS, Weishaar ME. (2006), Schema therapy: A practitioner's guide. guilford press; Nov 1. URL: https://www.guilford.com/books/Schema-Therapy/Young-Klosko-Weishaar/9781593853723
Zurita Ona, P. (2020). Acceptance & commitment therapy for borderline personality disorder: A flexible treatment plan for clients with emotion dysregulation. Context Press/New Harbinger Publications. https://psycnet.apa.org/record/2021-08392-000

  • Receive Date 23 March 2024
  • Revise Date 12 April 2024
  • Accept Date 22 April 2024
  • First Publish Date 22 April 2024