The effectiveness of metacognitive therapy and emotion-focused therapy in improving thought fusions and stop signals in people with obsessive-compulsive disorder

Document Type : Original Article

Authors

1 Ph.D. in Clinical Psychology, Department of Clinical Psychology, International Campus, Shiraz University, Shiraz, Iran

2 Assistant professor, faculty member, clinical psychology department, faculty of educational sciences and psychology, Shiraz University, Iran

3 Professor, Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, Shiraz University, Iran

Abstract

It has been shown that metacognition therapy (MCT) is effective on thought fusions and stop signals, but there has been no research on emotion-focused therapy (EFT) on these variables, so this research aims to compare the effectiveness of metacognitive therapy and emotion-focused therapy in improving the symptoms of stop signals and thought fusion in people with obsessive-compulsive disorder (OCD(. This study utilized a quasi-experimental design with pre-and post-tests and a two-month follow-up period. The participants were evaluated using the Structured Clinical Interview for DSM-5 (SCID-5), Yale-Brown, and a psychiatrist or clinical psychologist's diagnosis. They were randomly assigned to groups. Each group began with 16 individuals. Moreover, Wells' thought fusion Instrument and Myers' stop signals questionnaire were employed in this research. The results indicated that in terms of thought fusion, the mean difference between the MCT group and the control group (-17.440) was greater than the mean difference between the EFT group and the control group (-15.059), and the mean difference between the MCT group and the control group (-9.29) was greater than the mean difference between the EFT group and the control group (-7.071) in stop signals. The mean difference between the two treatments and the control group demonstrated that MCT is more effective than EFT at reducing the specified components.

Keywords

References

Abdi, R., Naseri, M., & Mirmohamadi, F. (2023). The relationship between alexithymia, cognitive avoidance, and distress tolerance with the dimensions of obsessive-compulsive disorder symptoms. Journal of Research in Psychopathology, 4(11), 1-9.doi 10.22098/ jrp.2022.10442.1073
Abramowitz, J. S. (2006). The Psychological Treatment of Obsessive—Compulsive Disorder. The Canadian Journal of Psychiatry, 51(7), 407-416. doi:10.1177/070674370605100702
Ahangar, A.,& Asadi, F., Health, S. (2020). The effectiveness of metacognitive therapy on intolerance of ambiguity in students with obsessive compulsive symptoms. Women and Family Studies, 13(47), 71-91. doi: 10.30495/jwsf.2020.1899637.1453
Allen, L. B., & Barlow, D. H. (2009). Relationship of exposure to clinically irrelevant emotion cues and obsessive-compulsive symptoms. Behavior Modification, 33(6), 743-762. doi:10.1177/0145445509344180
Asl Alavi oaydar, S. S., Khodabakhsh, R., & Mehrinjad, S. A. (2020). Comparing the effectiveness of cognitive-behavioral and meta-cognitive therapy on the confusion of thoughts of patients suffering from obsessive-compulsive disorder. Clinical Psychology and Personality, 16(2), 41-51. doi:10.22070/cpap.2020.2856
Ayatmehr, F., & Sadeghpour, S. (2018). Comparative Efficacy of Metacognitive therapy versus Cognitive-Behavioral therapy on reducing the metacognitive beliefs, fusion beliefs, stop signals and control/threat beliefs in patient with washing obsession. doi. 10.29252/shenakht.5.1.1
Brennan, M. A., Emmerling, M. E., & Whelton, W. J. (2014). Emotion-focused group therapy: Addressing self-criticism in the treatment of eating disorders. Counselling and Psychotherapy Research, 1-9.
Dolhanty, J., & Greenberg, L. S. (2009). Emotion-focused therapy in a case of anorexia nervosa. Clin Psychol Psychother, 16(4), 366-382. doi:10.1002/cpp.624
Elliot R, L. G. (2022). Emotion-focused Counselling in Action (Ramezani,M, Ramezani,ARostmi M, Trans.). Ravan pablicashion.
Ferrando, C., & Selai, C. (2021). A systematic review and meta-analysis on the effectiveness of exposure and response prevention therapy in the treatment of Obsessive-Compulsive Disorder. Journal of Obsessive-Compulsive and Related Disorders, 31, 100684. doi:10.1016/j.jocrd.2021.100684
First, M. B., Williams, J. B. W., Karg, R. S., & Spitzer, R. L. (2016). User's guide for the SCID-5-CV Structured Clinical Interview for DSM-5® disorders: Clinical version. American Psychiatric Publishing, Inc.
Fisher, P. L., & Wells, A. (2008). Metacognitive therapy for obsessive-compulsive disorder: a case series. J Behav Ther Exp Psychiatry, 39(2), 117-132. doi:10.1016/j.jbtep.2006.12.001
Fouladi, A., Khademi, A., & Shaker Dioulagh, A. (2023). The effectiveness of compassion therapy and meta-cognitive therapy on the level of nurses' meta-emotion. Journal of Research in Psychopathology, 4(11), 23-32. doi:10.22098/jrp.2022.11300.1131
Golmohammadi, M., Ahadi, B., & Farahbijari, A. (2022). The relation between early maladaptive schemas and suicidal ideation in girls: The mediating role of emotion regulation strategies. Journal of Research in Psychopathology, 3(10), 18-26.doi 10.22098/jrp.2022.11528.1135
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R., & Charney, D. S. (1989). The yale-brown obsessive compulsive scale: II. Validity. Archives of general psychiatry, 46(11), 1012-1016. doi: 10.1001/archpsyc.1989.01810110054008.
Greenberg, L. S. (2004). Emotion–focused therapy. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 11(1), 3-16. doi:10.1002/cpp.388
Greenberg, L. S. (2010). Emotion-focused therapy: A clinical synthesis. Focus, 8(1), 32-42. doi:10.1176/foc.8.1.foc32
Gwilliam, P., Wells, A., & Cartwright-Hatton, S. (2004). Does Meta-cognition or Responsibility Predict Obsessive-Compulsive Symptoms: A Test of the Metacognitive Model. Clinical Psychology & Psychotherapy, 11(2), 137-144. doi:10.1002/cpp.402
Jani, S., Hajloo, N., & Narimani, M. (2023). Comparing the Effectiveness of Internet-Based Cognitive-Behavioral Therapy and Emotion-Focused Therapy on Ambiguity Tolerance and Threat Sensitivity in Married Women with Obsessive-Compulsive Disorder. Clinical Psychology and Personality, 20(2), 77-89. doi 10.22070/cpap.2022.16385.1241
Jani, S., Hajloo, N., & Narimani, M. (2023). Comparison of the effectiveness of Internet-based cognitive-behavioral therapy and emotion-focused therapy on cognitive fusion and sexual intimacy in married women with obsessive-compulsive disorder. Journal of Modern Psychological Researches, 18(69). doi: 10.22034/JMPR.2023.16240
Kang, J. I., Namkoong, K., Yoo, S. W., Jhung, K., & Kim, S. J. (2012). Abnormalities of emotional awareness and perception in patients with obsessive–compulsive disorder. Journal of affective disorders, 141(2-3), 286-293. doi:10.1016/j.jad.2012.04.001
MacKinnon, R. A., Michels, R., & Buckley, P. J. (2015). The psychiatric interview in clinical practice: American Psychiatric Pub.
Melchior, K., van der Heiden, C., Deen, M., Mayer, B., & Franken, I. H. (2023). The effectiveness of metacognitive therapy in comparison to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial. Journal of Obsessive-Compulsive and Related Disorders, 36, 100780. doi:10.1016/j.jocrd.2023.100780
Mohammadkhani, S. (2013). The role of fusion beliefs and metacognitions in obsessive–compulsive symptoms in general population. Practice in Clinical Psychology, 1(2), 97-104.‏
Myers, S. G., Fisher, P. L., & Wells, A. (2009). An empirical test of the metacognitive model of obsessive-compulsive symptoms: fusion beliefs, beliefs about rituals, and stop signals. J Anxiety Disord, 23(4), 436-442. doi:10.1016/j.janxdis.2008.08.007
Nayebaghayee, A., Aleyasin, S., Heidari, H.,& Davodi, H. (2019). Effectiveness of Metacognitive Therapy on Dysfunctional Beliefs, Inflated Sense of Responsibility, and Intolerance of Uncertainty in Patients with Obsessive-Compulsive Disorder (OCD). Clinical Psychology Studies, 9(33), 1-24. doi: 10.22054/jcps.2019.35742.1969
Plate, A. J., & Aldao, A. (2017). Emotion regulation in cognitive-behavioral therapy: Bridging the gap between treatment studies and laboratory experiments. In The science of cognitive behavioral therapy (pp. 107-127): Elsevier. doi:10.1016/B978-0-12-803457-6.00005-2
Qamari Givi, H., Imani, H., Brahmand, A., & Sadeghi Movahed, F. (2012). Investigating emotional inhibition and recognition deficits in patients with obsessive-compulsive disorder. Journal of Clinical Psychology, 4(2), 9-18. doi:10.22075/jcp.2017.2084
Reid, J. E., Laws, K. R., Drummond, L., Vismara, M., Grancini, B., Mpavaenda, D., & Fineberg, N. A. (2021). Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive psychiatry, 106, 152223. doi:10.1016/j.comppsych.2021.152223
Shameli, L., Mehrabizadeh Honarmand, M., Naa'mi, A., & Davodi, I. (2019). The Effectiveness of Emotion-Focused Therapy on Emotion Regulation Styles and Severity of Obsessive-Compulsive Symptoms in Women With Obsessive-Compulsive Disorder [Original Research]. Iranian Journal of Psychiatry and Clinical Psychology, 24(4), 356-369. doi:10.32598/ijpcp.24.4.456
Singh, N. N., Wahler, R. G., Winton, A. S. W., & Adkins, A. D. (2004). A Mindfulness-Based Treatment of Obsessive-Compulsive Disorder. Clinical Case Studies, 3(4), 275-287. doi:10.1177/1534650103259646
Solem, S., Myers, S. G., Fisher, P. L., Vogel, P. A., & Wells, A. (2010). An empirical test of the metacognitive model of obsessive-compulsive symptoms: replication and extension. J Anxiety Disord, 24(1), 79-86. doi:10.1016/j.janxdis.2009.08.009
Steketee, G., & Frost, R. O. (1994). Measurement of risk-taking in obsessive-compulsive disorder. Behavioural and Cognitive Psychotherapy, 22(4), 287-298. doi:10.1017/S1352465800013175  
Storbeck, J., & Clore, G. L. (2007). On the interdependence of cognition and emotion. Cognition and Emotion, 21(6), 1212-1237. doi:10.1080/02699930701438020
Thompson, S., & Girz, L. (2020). Overcoming shame and aloneness: Emotion-focused group therapy for self-criticism. Person-Centered & Experiential Psychotherapies, 19(1), 1-11. doi:10.1080/14779757.2019.1618370
Timulak, L., & Keogh, D. (2022). Transdiagnostic emotion-focused therapy: A clinical guide for transforming emotional pain. American Psychological Association.‏
van der Heiden, C., Melchior, K., Dekker, A., Damstra, M., & Deen, M. (2016). Metacognitive therapy for obsessive–compulsive disorder: A pilot study. Journal of Obsessive-Compulsive and Related Disorders, 9, 24-29. doi:10.1016/j.jocrd.2016.02.002
Wahl, K., Salkovskis, P. M., & Cotter, I. (2008). 'I wash until it feels right' the phenomenology of stopping criteria in obsessive-compulsive washing. Journal of anxiety disorders, 22(2), 143-161. doi:10.1016/j.janxdis.2007.02.009
Watson, J. C., Goldman, R. N., & Greenberg, L. S. (2011). Contrasting Two Clients in Emotion-Focused Therapy for Depression 1: The Case of "Tom," "Trapped in the Tunnel". Pragmatic Case Studies in Psychotherapy, 7(2), 268–304. doi:10.14713/pcsp.v7i2.1091
Wells, A.(2013). A practical guide to the metacognitive treatment of anxiety and depression(Mohammad Khani sh,Trans).Tehran:publication Varai Danesh
Wells, A.(2015). Metacognition  Therapy for anxiety and depression. (Akbari.m, Mohammadi.A, Andooz,z, Trans).Tehran:publication Arjmand
Wnuk, S. M., Greenberg, L., & Dolhanty, J. (2015). Emotion-focused group therapy for women with symptoms of bulimia nervosa. Eating disorders, 23(3), 253-261. doi:10.1080/10640266.2014.964612
Woody, S. R., Steketee, G., & Chambless, D. L. (1995). Reliability and validity of the Yale-Brown obsessive-compulsive scale. Behaviour research and therapy, 33(5), 597-605. doi:10.1016/0005-7967(94)00076-V
Zwaigenbaum, L., Bryson, S., & Garon, N. (2013). Early identification of autism spectrum disorders. Behav Brain Res, 251, 133-146. doi:10.1016/j.bbr.2013.04.004
Journal of Research in Psychopathology
Volume 5, Issue 16
May 2024
Pages 36-43

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