Middle Eastern Journal of Disability Studies

Background & Objectives: Obsessive–Compulsive Disorder (OCD) is a chronic and debilitating neurotic disorder. It includes disorders related to the sixth category of disorders in mental disorders' diagnostic and statistical guide. Psychological flexibility was proposed to understand mental pathology and mental health; its role was confirmed in OCD. Evidence suggests the negative effect of OCD on marital satisfaction. Moreover, failure to treat OCD can lead to additional trauma and other psychological and emotional disorders, like depression. Therefore, psychological interventions, like Acceptance and Commitment Therapy (ACT), are necessary in this regard. The goal of this treatment is to reduce empirical avoidance along with increasing psychological flexibility. Thus, the present study aimed to determine the effects of ACT on cognitive flexibility and marital satisfaction among women with OCD.
Methods: This was a quasi–experimental study with pretest–posttest and a control group design. The statistical population included all married women with OCD referring to Hamyar psychological and counseling clinic of Tehran City, Iran, in 2020. The study sample included 30 individuals selected by the convenience and voluntary sampling method and randomly assigned to the experimental and control (n=15/group) groups. The inclusion criteria of the study included married women with OCD established by a psychiatrist or clinical psychologist based on the criteria of the American Psychiatric Association; not using the medicine; no history of hospitalization; obtaining scores above 15 based on the Yale–Brown Obsessive–Compulsive Scale (Goodman et al., 1989); the age range of 20–50 years; at least one year after their formal marriage; have a minimum literacy, and willingness to collaborate in research. The exclusion criteria included non–cooperation, illiteracy, and absence from more than two training sessions. The study participants completed Yale–Brown Obsessive Compulsive Scale (Goodman et al., 1989), Cognitive Flexibility Scale (Dennis & Vander Aall, 2010), and ENRICH Marital Satisfaction Scale–Short Form (Olson & Olson, 2000). The experimental group received eight 60–minute ACT sessions in two months; however, the controls received no training. The obtained data were analyzed in SPSS using descriptive statistics, such as mean and standard deviation, and inferential statistics, including Independent Samples t–test and Multivariate Analysis of Covariance (MANCOVA) at a significance level of α=0.01.
Results: The obtained results indicated that after adjusting the pretest effect, there was a significant difference in the posttest results between the study groups in cognitive inflexibility aspects, including controllable perception (p=0.049), the perception of different perspectives (p=0.003), and the perception of behavior justification (p<0.001) and in marital satisfaction components, including ideal distortion (p=0.003), marital satisfaction (p=0.047), and communication (p=0.002); however, it was not significant in conflict resolution component (p=0.050). The effect size of cognitive flexibility components was for the perception of controllability (0.211), the perception of different perspectives (0.307), and the perception of behavior justification (0.357), and effect size of marital satisfaction components were for ideal distortion (0.312), marital satisfaction (0.222) and communication (0.344).
Conclusion: Based on the research findings, ACT effectively increases cognitive flexibility and marital satisfaction in married women with OCD.