Volume 11 - Articles-1400                   MEJDS (2021) 11: 14 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Harivandi A, Sanagouye Moharer G, Shirazi M. Effects of Exposure and Response Prevention Therapy on Stress and Sense of Coherence in Patients With Obsessive-Compulsive Disorder. MEJDS 2021; 11 :14-14
URL: http://jdisabilstud.org/article-1-1924-en.html
1- Islamic Azad University, Zahedan Branch
2- University of Sistan and Baluchestan
Abstract:   (1726 Views)
Background & Objectives: In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), Obsessive–Compulsive Disorder (OCD) is classified as a separate anxiety disorder class; in the OCD category and related disorders. Chronic OCD and the unpredictable nature of aggravating symptoms and inability to control self during illness generate stress among patients with OCD. Furthermore, OCD can reduce biopsychological health and overall quality of life in the affected individuals. The high prevalence of this disorder and the need of the community to intervene and challenge therapists with these patients have led researchers to constantly seek novel therapy approaches with the best efficacy and least adverse effects to offering to psychotherapists. Effective treatment for OCD is Exposure and Response Prevention (ERP). Thus, the current study aimed to determine the effects of ERP therapy on stress and Sense of Coherence (SOC) in patients with OCD.
Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The study population consisted of all men and women with OCD referring to clinics and counseling centers in Birjand City, Iran, in the second half of 2018. In total, 40 volunteers were selected and randomly assigned into the study groups (experimental & control). The inclusion criteria of the study participants were as follows: OCD (confirmation by a psychiatrist or clinical psychologist with a diagnostic interview based on DSM–5 and receiving a score of >10 in the Maudsley Obsessive–Compulsive Inventory (Goodman et al., 1989); having a minimum level of ninth–grade education; not receiving pharmacotherapy; volunteering to receive OCD treatment; over 18 years of age, and having the desire and ability to collaborate until the end of the research. The exclusion criteria included presenting physical or viral illnesses, the presence of neurological disorders, like epilepsy, a history of any type of concussion, and reluctance to attend the treatment sessions. ERP intervention was performed based on Stekette’s treatment plan (2007) in eight 90–minute sessions. The required data were collected by the stress subscale of Depression Anxiety Stress Scale (DASS)–42 (Lovibond & Lovibond, 1995) and the Sense of Coherence Scale (Antonovsky, 1993) before and after the intervention in the study groups. The obtained data were analyzed in SPSS using Chi–squared test and one–way Analysis of Covariance (ANCOVA). The level of significance was set at 0.05.
Results: After the intervention, the stress scores in the experimental group were significantly decreased, compared to the controls (p<0.001). Besides, the SOC scores were increased in them (p<0.001). Eta coefficient values for stress and SOC were measured as 0.222 and 0.228, indicating the effects of ERP therapy on reducing stress and increasing SOC in patients with OCD.
Conclusion: The present research results revealed that ERP therapy is effective in reducing stress and increasing SOC in patients with OCD. Therefore, it is recommended that this treatment be used as a complementary approach to other psychosomatic disorders.
Full-Text [PDF 564 kb]   (456 Downloads)    
Type of Study: Original Research Article | Subject: Psychology

References
1. 1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). Washington DC: American Psychiatric Pub; 2013.
2. 2. Izadi R, Abedi MR. Alleviation of obsessive symptoms in treatment-resistant obsessive-compulsive disorder using acceptance and commitment-based therapy. Journal of Kashan University of Medical Sciences. 2013;17(3):275–86. [Persian] [Article]
3. 3. Shameli L, Mehrabizadeh Honarmand M, Naa'mi A, Davodi I. The effectiveness of emotion-focused therapy on emotion regulation styles and severity of obsessive-compulsive symptoms in women with obsessive-compulsive disorder. Iranian Journal of Psychiatry & Clinical Psychology. 2019;24(4):356–69. [Persian] [DOI]
4. 4. Olatunji BO, Davis ML, Powers MB, Smits JAJ. Cognitive-behavioral therapy for obsessive-compulsive disorder: a meta-analysis of treatment outcome and moderators. Journal of Psychiatric Research. 2013;47(1):33–41. [DOI]
5. 5. Esfahani M, Safari S, Kajbaf MB. Effectiveness of group therapy based on exposure and response prevention on severity of obsessive-compulsive symptoms. Journal of Clinical Psychology. 2013;5(2):35–44. [Persian] [DOI]
6. 6. Angst J, Gamma A, Endrass J, Goodwin R, Ajdacic V, Eich D, et al. Obsessive-compulsive severity spectrum in the community: prevalence, comorbidity, and course. Eur Arch Psychiatry Clin Neurosci. 2004;254(3):156–64. [DOI]
7. 7. Coluccia A, Fagiolini A, Ferretti F, Pozza A, Goracci A. Obsessive-compulsive disorder and quality of life outcomes: protocol for a systematic review and meta-analysis of cross-sectional case-control studies. Epidemiology, Biostatistics and Public Health. 2015;12(2):1030–7. [DOI]
8. 8. Mohammadi MR, Rahgozar M, Bagheri Yazdi A, Naghavi HR, Pour Etemad HR, Amini H, et al. Epidemiological study of psychiatric disorders in Tehran province. Iranian Journal of Psychiatry and Clinical Psychology. 2003;9(2):4–13. [Persian] [Article]
9. 9. Geffken GR, Storch EA, Duke DC, Monaco L, Lewin AB, Goodman WK. Hope and coping in family members of patients with obsessive-compulsive disorder. Journal of Anxiety Disorders. 2006;20(5):614–29. [DOI]
10. 10. Goldstein DS. Adrenal responses to stress. Cellular and Molecular Neurobiology. 2010;30(8):1433–40. [DOI]
11. 11. Steketee G, Frost RO, Wincze J, Greene KAI, Douglass H. Group and individual treatment of compulsive hoarding: a pilot study. Behav Cogn Psychother. 2000;28(3):259–68. [DOI]
12. 12. Hassanvand Amouzadeh M, Aghili M. The cognitive predictors of obsessive- compulsive symptoms in students. Journal of Health and Care. 2015;17(4):281–90. [Persian] [Article]
13. 13. Shafiee S, Rasooli A, Shahgholian M, Dehghan M. The role of worry, emotional schemas and brain-behavioral systems (BIS-BAS) in prediction of obsessive beliefs. Journal of Psychological Studies. 2017;13(3):7–24. [Persian] [Article]
14. 14. Anholt GE, Aderka IM, van Balkom AJLM, Smit JH, Hermesh H, de Haan E, et al. The impact of depression on the treatment of obsessive–compulsive disorder: results from a 5-year follow-up. Journal of Affective Disorders. 2011;135(1–3):201–7. [DOI]
15. 15. Vastamäki J. Sense of coherence and unemployment [Academic dissertation]. [Nuremberg]: Faculty of Social Sciences of the University of Kuopio, Erlangen-Nuremberg Univ; 2009.
16. 16. Flensborg-Madsen T, Ventegodt S, Merrick J. Sense of coherence and physical health. A cross-sectional study using a new scale (SOC II). The Scientific World Journal. 2006;6(175091):2200–11. [DOI]
17. 17. Asnaani A, Kaczkurkin AN, Alpert E, McLean CP, Simpson HB, Foa EB. The effect of treatment on quality of life and functioning in OCD. Comprehensive Psychiatry. 2017;73:7–14. [DOI]
18. 18. Olatunji BO, Berg H, Cox RC, Billingsley A. The effects of cognitive reappraisal on conditioned disgust in contamination-based OCD: an analogue study. Journal of Anxiety Disorders. 2017;51:86–93. [DOI]
19. 19. Pakniya N, Mirzaei A, Jahan J, Ranjbarsudejani Y, Sayyah SS. To compare the effectiveness of confrontation/encontur and response prevention model with the dangerous ideation reduction method on reducing alexithymia and cognitive avoidance amonge obsessive disorder patients. Quarterly Journal of Psychological Studies. 2018;14(1):109–26. [Persian]
20. 20. Narimani M, Maleki-Pirbazari M, Mikaeili N, Abolghasemi A. Appraisal of effectiveness and comparison of exposure and response prevention therapy and acceptance and commitment therapy (ACT)-based training on improving of obsessive and compulsive disorder patients' components of life quality. Journal of Clinical Psychology. 2016;8(1):25–36. [Persian] [Article]
21. 21. Akbari M, Hosayni ZS. Meta-analysis comparing the efficacy of exposure and response prevention, cognitive-behavior therapy and third wave of behavior therapies on obsessive-compulsive disorder. Quarterly of Applied Psychology. 2019;12(4):473–90. [Persian]
22. 22. Shivarani M, Azadfalah P, Moradi AR, Eskandari H. The effectiveness of narrative exposure therapy in posttraumatic stress disorder and autobiographical memory. Journal of Clinical Psychology. 2017;9(2(34)):1–14. [Persian] [DOI]
23. 23. Hosseini SM, Javidi H, Mehryar AH, Hosseini SE. Compare the efficacy of metacognitive therapy (MCT), exposure, and response prevention (ERP) for the treatment of obsessive beliefs and depression symptoms in women with obsessive-compulsive disorder (OCD). Middle Eastern Journal of Disability Studies. 2019;9(0):94–94. [Persian] [Article]
24. 24. Radmehr M, Ashktorab T, Neisi L. Effect of the educational program based on Pender’s theory on the health promotion in patients with obsessive -compulsive disorder. Journal of Nursing Education. 2013;2(2):56–63. [Persian] [Article]
25. 25. Yosefi A, Rahimian-Boogar I, Rezaei AM. The effectiveness of cognitive analytic therapy on mental health of patients with obsessive-compulsive disorder. Journal of Clinical Psychology. 2013;5(3):1–12. [Persian] [DOI]
26. 26. Kameli S, Hosseinpour Moghaddam S, Zandipour T, Ghasemzadeh AR. Mental health improvement of women with obsessive-compulsive disorder through cognitive- behavioral group therapy. Journl of Medical Council of Iran. 2014;31(4):329–38. [Persian] [Article]
27. 27. Moritz S, Külz A, Voderholzer U, Hillebrand T, McKay D, Jelinek L. “Phobie à deux” and other reasons why clinicians do not apply exposure with response prevention in patients with obsessive–compulsive disorder. Cognitive Behaviour Therapy. 2019;48(2):162–76. [DOI]
28. 28. Foa EB, McLean CP. The efficacy of exposure therapy for anxiety-related disorders and its underlying mechanisms: the case of OCD and PTSD. Annu Rev Clin Psychol. 2016;12(1):1–28. [DOI]
29. 29. Hedman E, Ljótsson B, Axelsson E, Andersson G, Rück C, Andersson E. Health anxiety in obsessive compulsive disorder and obsessive-compulsive symptoms in severe health anxiety: an investigation of symptom profiles. Journal of Anxiety Disorders. 2017;45:80–6. [DOI]
30. 30. Motivala SJ, Arellano M, Greco RL, Aitken D, Hutcheson N, Tadayonnejad R, et al. Relationships between obsessive-compulsive disorder, depression and functioning before and after exposure and response prevention therapy. International Journal of Psychiatry in Clinical Practice. 2018;22(1):40–6. [DOI]
31. 31. Bahrammasir A, Kiyan-Ersi F. The effectiveness of mindfulness training on reduction of obsessive-compulsive disorder symptoms and increase marital satisfaction of married women. Journal of Arak University of Medical Sciences. 2019;21(7):18–27. [Persian] [Article]
32. 32. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. The yale-brown obsessive-compulsive scale: I. development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006–11. [DOI]
33. 33. Delavar A. Educational and psychological research. Tehran: Virayesh; 2015. [Persian]
34. 34. Dadfar M, Bolhari J, Dadfar K, Bayanzadeh SA. Prevalence of the obsessive-compulsive disorder symptoms. Iranian Journal of Psychiatry & Clinical Psychology. 2001;7(1):27–33. [Persian] [Article]
35. 35. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy. 1995;33(3):335–43. [DOI]
36. 36. Sahebi A, Asghari MJ, Salari RS. Validation of depression anxiety and stress scale (DASS-21) for an Iranian population. Journal of Developemental Psychology: Iranian Psychologists. 2005;1(4):36–54. [Persian]
37. 37. Antonovsky A. The structure and properties of the sense of coherence scale. Social Science & Medicine. 1993;36(6):725–33. [DOI]
38. 38. Sabri Nazarzadeh R, Abdkhodaei MS, Tabibi Z. Study of causal relationship between sense of coherence, psychological hardiness, coping strategies and mental health. Journal of Research in Psychological Health. 2012;6(1):26–35. [Persian] [Article]
39. 39. Alipour A, Sharif N. Validity and reliability of the sense of coherence (SOC) ‎questionnaire in university ‎students. Pejouhandeh. 2012;17(1):50–6. [Persian] [Article]
40. 40. Stekette GS. Treatment of obsessive compulsive disorder. Bakhshipoor Roodsari A, Mahmood Aliloo M. (Persian translator). Tabriz: Ravan Pooya; 2007.
41. 41. Robinson LJ, Freeston MH. Emotion and internal experience in obsessive compulsive disorder: reviewing the role of alexithymia, anxiety sensitivity and distress tolerance. Clinical Psychology Review. 2014;34(3):256–71. [DOI]
42. 42. Kampmann IL, Emmelkamp PMG, Hartanto D, Brinkman W-P, Zijlstra BJH, Morina N. Exposure to virtual social interactions in the treatment of social anxiety disorder: a randomized controlled trial. Behaviour Research and Therapy. 2016;77:147–56. [DOI]
43. 43. Moin Al-Ghorabaiee F, Karamloo S, Noferesti A. Metacognitive components in patients with generalized anxiety disorder, obsessive-compulsive disorder and depressed mood disorder. Iranian Journal of Psychiatry & Clinical Psychology. 2017;23(2):164–77. [Persian] [DOI]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Middle Eastern Journal of Disability Studies

Designed & Developed by : Yektaweb