Effectiveness of Mindfulness-Based Cognitive Therapy on Reducing Perceived Stress, Anxiety Traits and Symptoms, and Psychosomatic Symptoms in Female Patients with Obsessive-Compulsive Disorder

Document Type : Original Article

Authors

1 Associate professor, Department of Psychology, Payame Noor University, Tehran, Iran.

2 M.S of Psychology, Department of Psychology, Payame Noor University, Tehran, Iran.

Abstract

Introduction: Research suggests that obsessive-compulsive disorder (OCD) is frequently associated with elevated levels of perceived stress, anxiety, and psychosomatic symptoms, which can worsen the disorder and impede treatment progress. This study aimed to investigate the effectiveness of mindfulness-based cognitive therapy in reducing perceived stress, anxiety traits and symptoms, and psychosomatic symptoms in patients with OCD.
Method: The present study employed a quasi-experimental design that included pre-test, post-test, and follow-up stages. The study population comprised female patients who were referred to therapeutic clinics in Tehran and Tabriz during the years 2021-2022. A sample of 30 patients was selected and divided into two groups: an experimental group consisting of 15 patients and a control group also consisting of 15 patients. The experimental group underwent mindfulness-based cognitive therapy for eight sessions, while the control group received no treatment. The effectiveness of the intervention was assessed using repeated measures analysis of variance in SPSS software version 26.
Results: The analysis of perceived stress, levels of anxiety, and psychosomatic symptoms was conducted using Benferroni's alpha and a significance level of 0.0005. The results indicate that mindfulness treatment is effective in reducing perceived stress, anxiety, and psychosomatic symptoms in patients with obsessive-compulsive disorder (OCD).
Discussion and conclusion: This study demonstrated that mindfulness-based cognitive therapy is an effective intervention for reducing perceived stress in individuals with obsessive-compulsive disorder.

Keywords

References

  • Zisler, E. M., Meule, A., Koch, S., Schennach, R., Voderholzer, U. Duration of daily life activities in persons with and without obsessive – compulsive disorder. Journal of Psychiatric Research, 2024; 173: 6-13.

https://doi.org/10.1016/j.jpsychires.2024.02.052

  • Crowe, E., Staiger, P. K., Bowe, S. J., Rehm, I., Moulding, R., Herrick, C., et al. The association between trichotillomania symptoms and emotion regulation difficulties: A systematic review and meta-analysis. Journal of Affective Disorders, 2023. https://doi.org/10.1016/j.jad.2023.11.010
  • Kadivari, F., Najafi, M., Khosravani, V. Childhood emotional maltreatment, maladaptive coping and obsessive–compulsive symptoms in patients with obsessive–compulsive disorder. Clinical psychology & psychotherapy, 2023; 30(3): 620-30. https://doi.org/10.1002/cpp.2829
  • Mısırlı, M., Kaynak, G. K. Relationship obsessive compulsive disorder: A systematic review. Psikiyatride Güncel Yaklaşımlar, 2023; 15(4): 549-61.

https://doi.org/10.18863/pgy.1204303

  • Zirakbash, A., Naderi, F., Marashian, F. S., Makvandi, B. Designing unified trans-diagnostic interventions and their efficacy on the common mechanisms of the comorbid obsessive personality disorder with anxiety, depression, and obsessive-compulsive disorder: A protocol study. Journal of Education and Health Promotion, 2023; 12(1): 35.

https://doi.org/10.4103/jehp.jehp_1254_22

  • Hirschtritt, M. E., Bloch, M. H., Mathews, C. A. Obsessive-compulsive disorder: advances in diagnosis and treatment. Jama, 2017; 317(13): 1358-67. https://doi.org/1001/jama.2017.2200
  • Tonna, M., Ottoni, R., Ossola, P., De Panfilis, C., Marchesi, C. Late-onset obsessive-compulsive disorder associated with left cerebellar lesion. The Cerebellum, 2014; 13: 531-5.

https://doi.org/10.1007/s12311-014-0561-8

  • Dehghani, M., Hakimi, H., Talebi, M., Rezaee, H., Mousazadeh, N., Ahmadinia, H., et al. The relationship between fear of Covid-19 and obsessive–compulsive disorder. BMC psychology, 2023; 11(1): 133.

https://doi.org/10.1186/s40359-023-01112-7

  • Morgado, P., Freitas, D., Bessa, J. M., Sousa, N., Cerqueira, J. J. Perceived stress in obsessive–compulsive disorder is related with obsessive but not compulsive symptoms. Frontiers in psychiatry, 2013; 4: 21.

https://doi.org/10.3389/fpsyt.2013.00021

  • O'Brien, K. J., Ered, A., Korenic, S. A., Olino, T. M., Schiffman, J., Mittal, V. A., et al. Childhood trauma, perceived stress and anhedonia in individuals at clinical high risk for psychosis: multigroup mediation analysis. The British Journal of Psychiatry, 2023; 223(1): 273-9.

https://doi.org/10.1192/bjp.2022.185

  • Colombo, D., Baños, M., Desdentado, L., Kleiboer, A., Pavani, J. B., Wrzesien, M., et al. Daily stress encounters: Positive emotion upregulation and depressive symptoms. Emotion, 2024. https://doi.org/10.1037/emo0001362
  • Zhang, X., Zhou, Y., Zhang, K. Social capital, perceived stress, and mental health of men who have sex with men in China: A cross-sectional study. Frontiers in Psychology, 2023; 14: 1134198. https://doi.org/10.3389/fpsyg.2023.1134198
  • Cortese, S., Besag, F. M., Clark, B., Hollis, C., Kilgariff, J., Moreno, C., et al. Common pitfalls, and how to avoid them, in child and adolescent psychopharmacology: Part I. Journal of Psychopharmacology, 2024; 38(4): 311-7.

https://doi.org/10.1177/02698811241239582

  • Salek Ebrahimi, L., Mousavi, S. E., Gharraee, B., Mohammadi Bytamar, J., Saberi Isfeedvajani, M. Cognitive errors and psychological resilience in patients with social anxiety and obsessive-compulsive disorder: A cross-sectional study. Hospital Practices and Research, 2019; 4(1): 25-30. https://doi.org/10.15171/hpr.2019.04
  • Kato, D., Yoshie, M., Ishihara, M. The Eating Attitudes and Mental Health in Japanese Female University Students. Weight Loss: IntechOpen; 2018. https://doi.org/10.5772/intechopen.74627
  • Chin, P. W., Augustine, G. J. The cerebellum and anxiety. Frontiers in Cellular Neuroscience, 2023; 17: 1130505.

https://doi.org/10.3389/fncel.2023.1130505

  • Wang, X. H., Wang, T., Ao, M., He, J., Duan, J., Cui, L. B., et al. Prevalence and characteristics of anxiety in patients with unconfirmed pulmonary nodules. The Clinical Respiratory Journal. 2023; 17(3): 157-64. https://doi.org/1111/crj.13576
  • Safitri, A., Tresya, E. Five finger hypnosis to reduce anxiety levels during the covid-19 pandemic. Journal of Complementary Nursing, 2023; 2(1): 122-6.

https://doi.org/10.53801/jcn.v2i1.81

  • Sinai, Y. M., Ma, Y., Daleski, M. A., Gannot, S., Bartsch, R., Gordon, I. Indices of The Autonomic Nervous System Predict Affect and Emotional Contagion, But Not Anxiety: A Two-Dimensional Autonomic Space Approach. Authorea Preprints. 2023.

a56a220261df0089f4646411f6329b4f.pdf

  • Koly, K. N., Islam, M. S., Potenza, M. N., Mahumud, R. A., Islam, M. S., Uddin, M. S., et al. Psychosocial health of school-going adolescents during the COVID-19 pandemic: Findings from a nationwide survey in Bangladesh. PLoS One, 2023; 18(3): e0283374. https://doi.org/10.1371/journal.pone.0283374
  • Yao, Y., Chen, J., Xuan, Y. The relationship between anxiety and cognitive emotion regulation strategies: A meta- Applied Cognitive Psychology, 2023; 37(6): 1366-83.

https://doi.org/10.1002/acp.4129

  • Tian, T., Liu, D., Zhang‌, G., Wang, J., Wan, C., Fang, J., et al. Dynamic effective connectivity among large-scale brain networks mediates risk of anxiety. Human Brain Mapping, 2023; 44(9): 3730-43. https://doi.org/1002/hbm.26308
  • Psychogios, A., Gruda, D., Ojo, A. Tweet you right back: Follower anxiety predicts leader anxiety in social media interactions during the SARS-CoV-2 pandemic. Plos one, 2023; 18(2): e0279164. https://doi.org/10.1371/journal.pone.0279164
  • Singh, A., Anjankar, V. P., Sapkale, B. Obsessive-compulsive disorder (OCD): a comprehensive review of diagnosis, comorbidities, and treatment approaches. Cureus, 2023; 15(11).

https://doi.org/10.7759/cureus.48960

  • Fridgeirsson, E. A., Bais, M. N., Eijsker, N., Thomas, R. M., Smit, D. J., Bergfeld, I. O., et al. Patient specific intracranial neural signatures of obsessions and compulsions in the ventral striatum. Journal of neural engineering, 2023; 20(2): 026008. https://doi.org/ 1088/1741-2552/acbee1
  • Morais, J., Roque, M., Martins, F. S., Fonseca, S., Moreira, R. Suicide risk in obsessive-compulsive disorder: a case report. Cureus, 2023; 15(3). https://doi.org/7759/cureus.36863
  • Wang, X., Zhang, X., Tang, Y., Ge, Y., Qian, S., Ding, Y., et al. The prolonged COVID-19 pandemic caused significant psychosomatic symptoms in frontline healthcare workers. Psychiatry Research, 2023; 321: 115060. https://doi.org/1016/j.psychres.2023.115060
  • Cammisuli, D. M., Castelnuovo G. Neuroscience-based psychotherapy: A position paper. Frontiers in Psychology, 2023; 14: 1101044.

https://doi.org/10.3389/fpsyg.2023.1101044

  • Dieterle, M. P., Husari, A., Prozmann, S. N., Wiethoff, H., Stenzinger, A., Röhrich, M., et al. Diffuse, adult-onset nesidioblastosis/non-insulinoma pancreatogenous hypoglycemia syndrome (NIPHS): review of the literature of a rare cause of hyperinsulinemic hypoglycemia. Biomedicines, 2023; 11(6): 1732.

https://doi.org/10.3390/biomedicines11061732

  • Icht, M., Zukerman, G., Zigdon, A., Korn, L. There is more to cluttering than meets the eye: The prevalence of cluttering and association with psychological well-being indices in an undergraduate sample. International Journal of Language & Communication Disorders, 2023; 58(6): 2022-32. https://doi.org/1111/1460-6984.12917
  • Melchior, K., Franken, I., Deen, M., van der Heiden, C. Metacognitive therapy versus exposure and response prevention for obsessive-compulsive disorder: study protocol for a randomized controlled trial. Trials, 2019; 20: 1-11. https://doi.org/10.1186/s13063-019-3381-9
  • Mao, L., Hu, M., Luo, L., Wu, Y., Lu, Z., Zou, J. The effectiveness of exposure and response prevention combined with pharmacotherapy for obsessive-compulsive disorder: A systematic review and meta-analysis. Frontiers in psychiatry, 2022; 13: 973838.

https://doi.org/10.3389/fpsyt.2022.973838

  • Law, C., Boisseau, C. L. Exposure and response prevention in the treatment of obsessive-compulsive disorder: current perspectives. Psychology research and behavior management, 2019: 1167-74.

https://doi.org/10.2147/PRBM.S211117

  • Su, W., Zhao, D., Zhao, H., Zheng, W., Zhang, W. A 28-Year-Old Man with Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder, and Dissociative Identity Disorder Responding to Aripiprazole Augmentation of Clomipramine Combined with Psychoeducation and Exposure and Response Prevention. The American Journal of Case Reports, 2023; 24:e941534-1. https://doi.org/12659/AJCR.941534
  • Pseftogianni, F., Panagioti, M., Birtwell, K., Angelakis, I. Mindfulness interventions for obsessive–compulsive and related disorders: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology: Science and Practice, 2023.

https://doi.org/10.1037/cps0000132

  • Kruse, J. A., Seng, E. K. Changes in cognitive appraisal in a randomized controlled trial of mindfulness-based cognitive therapy for patients with migraine. Headache: The Journal of Head and Face Pain, 2023; 63(10): 1403-11.

https://doi.org/10.1111/head.14627

  • Huynh, T., Torquati, J. C. Examining connection to nature and mindfulness at promoting psychological well-being. Journal of Environmental Psychology, 2019; 66: 101370. https://doi.org/1016/j.jenvp.2019.101370
  • Torres, L. C., Pereira, T., Pinheiro, P,. Lima, V., de Luna, G. Mindfulness as Adjuvant Treatment for Obsessive-Compulsive Disorder: An Integrative Review. Revista Portuguesa de Psiquiatria e Saúde Mental. 2023; 9(2): 58-65. https://doi.org/10.51338/rppsm.290
  • Weintraub, M. J., Denenny, D., Ichinose, M. C., Zinberg, J., Morgan-Fleming, G., Done, M., et al. A randomized trial of telehealth mindfulness-based cognitive therapy and cognitive behavioral therapy groups for adolescents with mood or attenuated psychosis symptoms. Journal of consulting and clinical psychology, 2023; 91(4): 234. https://doi.org/1037/ccp0000782
  • Hanssen, I., Huijbers, M., Regeer, E., Van Bennekom, M. L., Stevens, A., Van Dijk, P., et al. Mindfulness-based cognitive therapy v. treatment as usual in people with bipolar disorder: A multicentre, randomised controlled trial. Psychological Medicine, 2023; 53(14): 6678-90. https://doi.org/1017/S0033291723000090
  • Nikdoost, F., Tahmouresi, N., Abaspoor Azar, Z. The Predicting Perceived Stress Based on Cognitive Emotion Regulation and Difficulties in Emotion Regulation in Patients with Obesity. Alborz University Medical Journal, 2019; 8(1): 17-26. http://aums.abzums.ac.ir/article-1-882-en.html [in Persian].
  • Naeemi, M. Predicting life satisfaction of bodybuilders based on anxiety trait and cognitive emotional regulation mediated by happiness. journal of motor and behavioral sciences, 2021; 4(3): 231-8.

https://www.jmbs.ir/article_146443.html?lang=en [In Persian].

  • Powell T, Enright S. Controlling Anxiety and Psychological Stress(1991), translated by Pejman A, (2008); Ghazal Publications, First Edition.
  • Asli Azad, M., Manshaee, G. R., Ghamarani, A. Effectiveness of acceptance and commitment therapy on cognitive emotion regulation and intolerance of uncertainty of the students with obsessive-compulsive disorder. Psychology of Exceptional Individuals, 2020; 9(36): 33-53. https://doi.org/10.22054/jpe.2019.44480.2027. [In Persian].
  • Amani, E., Ghaffari Nouran, A., Hashemi, T., Narimani, M., Beyrami, M. Comparison of the effectiveness of mindfulness-based stress reduction and self-regulated learning on the mental vitality of female students. Journal of School Psychology, 2022; 11(1): 6-16. https://doi.org/22098/jsp.2022.1570 [In Persian].
  • Aw, M. Y., Henderson, S., Chan, Y. H., Doshi‌, K., Htay, H., Agus, N., et al. Effectiveness of mindfulness-based interventions delivered via technology versus therapist among patients on peritoneal dialysis at an outpatient clinic in Singapore. International Journal of Nursing Practice, 2024:e13233.

https://doi.org/10.1111/ijn.13233

  • Zeinabeh, M. Z., Atefeh, A., Masumeh, G. H. P., Tania, D., Mojgan, S., Katayoun, A. The Effect of Mindfulness-Based Stress Reduction Counseling on Blood Glucose and Perceived Stress in Women with Gestational Diabetes. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics, 2023; 45(09): e517-e23.

https://doi.org/10.1055/s-0043-1775810

  • Ye, Q., Huang, Y., Ge, X., Song, X. Validation of online mindfulness-enhanced course for stress reduction in teachers. Frontiers in Psychiatry, 2023; 14: 1086142.

https://doi.org/10.3389/fpsyt.2023.1086142

  • Sauvain-Sabé, M., Congard, A., Kop, J-L., Weismann-Arcache, C., Villieux, A. The mediating roles of affect and coping strategy in the relationship between trait mindfulness and burnout among French healthcare professionals. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 2023; 55(1): 34. https://doi.org/1037/cbs0000312
  • Gragnani, A., Zaccari‌,V. , Femia, G., Pellegrini, V., Tenore, K., Fadda, S., et al. Cognitive–behavioral treatment of obsessive–compulsive disorder: The results of a naturalistic outcomes study. Journal of Clinical Medicine, 2022; 11(10): 2762.

https://doi.org/10.3390/jcm11102762

  • Ashkanasy, N. M., Kay, A. A. Mindfulness and emotion: a five-level analysis. Journal of Management & Organization, 2023; 29(3): 406-24. https://doi.org/10.1017/jmo.2023.22
  • Baumann, I., Kalmar, J., Gruber, E., Blanck, P., Vonderlin, E., Heidenreich, T., et al. Change motivation and mindfulness in individual psychotherapy: Examining a sample of adult outpatients with depression and/or anxiety. Journal of Clinical Psychology. 2024.

https://doi.org/10.1002/jclp.23645

  • Williams, M., Honan, C., Skromanis, S., Sanderson, B., Matthews, A. J. Psychological outcomes and mechanisms of mindfulness-based training for generalised anxiety disorder: A systematic review and meta-analysis. Current Psychology, 2024; 43(6): 5318-40.

https://doi.org/10.1007/s12144-023-04695-x

  • Khalili, M. D., Hosseini, S. M., Sabahi, P. Effects of Mindfulness-Based Cognitive Therapy on Anxiety Sensitivity in Patients with Multiple Sclerosis. Jundishapur Journal of Chronic Disease Care, 2023; 12(1).

https://doi.org/10.5812/jjcdc-132672

  • Gautam, A., Polizzi, C. P., Mattson, R. E. Mindfulness, procrastination, and anxiety: Assessing their interrelationships. Psychology of Consciousness: Theory, Research, and Practice. 2019. https://doi.org/1037/cns0000209
  • Saragih, I. D., Batubara, S. O., Sharma, S., Saragih, I. S., Chou, F. H. A meta‐analysis of mindfulness‐based interventions for improving mental health and burden among caregivers of persons living with dementia. Worldviews on Evidence‐Based Nursing, 2024; 21(2): 183-93. https://doi.org/1111/wvn.12690
  • Liu, H., Kong, L., Sun, Q., Ma, X. The effects of mindfulness‐based interventions on nurses' anxiety and depression: A meta‐ Nursing Open, 2023; 10(6): 3622-34.

https://doi.org/10.1002/nop2.1610

  • Maas genannt Bermpohl, F., Huelsmann, L., Martin, A. Efficacy of mindfulness-and acceptance-based cognitive-behavioral therapies for bodily distress in adults: a meta-analysis. Frontiers in Psychiatry, 2023; 14:1160908.  https://doi.org/ 3389/fpsyt.2023.1160908
  • Tam, C. C., Zhou, Y., Qiao, S., Li, X., Shen, Z. Mindfulness, psychological distress, and somatic symptoms among women engaged in sex work in China. Applied Psychology: Health and Well‐Being, 2022; 14(3): 967-86.

https://doi.org/10.1111/aphw.12362

  • Shokoohi Nejad, N., Bayat, M. R., Zanganeh Motlagh, F. Comparing the effectiveness of cognitive therapy based on mindfulness and compassion therapy on automatic negative thoughts, psychological symptoms, pain intensity, and quality of life in patients with fibromyalgia. Journal of Arak University of Medical Sciences, 2022; 25(1): 156-73.

https://doi.org/10.32598/jams.25.1.6744.1

  • Brandtner, A., Antons, S., King, D. L., Potenza, M. N., Tang, Y. Y., Blycker, G. R., et al. A preregistered, systematic review considering mindfulness-based interventions and neurofeedback for targeting affective and cognitive processes in behavioral addictions. Clinical Psychology: Science and Practice, 2022; 29 (4): 379. https://doi.org/1037/cps0000075
  • Liu, Z., Jia, Y., Li, M., Meng, X., Shang, B., Wang, C., et al. Effectiveness of online mindfulness-based interventions for improving mental health in patients with physical health conditions: Systematic review and meta-analysis. Archives of Psychiatric Nursing, 2022; 37: 52-60. https://doi.org/1016/j.apnu.2021.10.001
  • Liu, L., Tian, L., Jiang, J., Zhang, Y., Chi, X., Liu, W., et al. Effect of an Online Mindfulness-Based Stress Reduction Intervention on Postpandemic Era Nurses' Subjective Well-being, Job Burnout, and Psychological Adaptation. Holistic Nursing Practice, 2023; 37(5): 244-52. https://doi.org/1097/HNP.0000000000000603

Files

Share

How to cite

Statistics