Volume 12 - Articles-1401                   MEJDS (2022) 12: 233 | Back to browse issues page

XML Persian Abstract Print


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

Azad M, Bagherzadeh Golmakani Z, Mansouri A, Doustkam M. Comparing the Effectiveness of Behavioral Activation and Metacognitive Therapies on Body Image Concern, Anxiety, and Depression in Patients with Psoriasis. MEJDS 2022; 12 :233-233
URL: http://jdisabilstud.org/article-1-2708-en.html
1- PhD Student in Psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran
2- Assistant Professor in Psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran
3- Assistant Professor, Attar Institute of Higher Education, Mashhad, Iran
Abstract:   (1100 Views)

Abstract
Background & Objectives: Psoriasis has a wide range of mental health effects due to its clinical features and physical presentations. Psoriasis is associated with depression, anxiety, suicidal ideation, and negative body image. Body image includes a person's feelings about the characteristics and structure of the body. A negative body image is formed when a person experiences a negative evaluation or is ridiculed by others. High anxiety scores are always seen in patients with psoriasis. Depression is the most common mental disorder worldwide and is one of the major causes of disability. Psoriasis and depression reinforce each other. Many researchers have suggested a broader role for psychiatric and psychotherapeutic interventions to reduce the symptoms and severity of skin diseases. Therefore, this study aimed to evaluate the effectiveness of behavioral activation therapy and metacognitive therapy on body image concern, anxiety, and depression in psoriasis patients.
Methods: This research was quasi–experimental with a pretest–posttest design and a control group. The study's statistical population include all psoriasis patient referring to dermatology clinics in Razavi and Emam Reza (PBUH) hospitals in Mashhad City, Iran, in 2019. Of whom, 45 patients who obtained a higher score than the cut–off point in Body Image Concern Inventory (BICI) (Littleton et al., 2005), Hamilton Anxiety Rating Scale (HAM–A) (Hamilton, 1959), and Beck Depression Inventory–II (BDI–II) (Beck et al., 1996) were selected with available sampling method and randomly assigned to two experimental groups (15 in behavioral activation therapy, 15 in metacognitive therapy) and one control group. The inclusion criteria were as follows: providing informed consent to receive psychological treatment, having psoriasis, being between 15 and 45 years old, and obtaining a score higher than the cut–off point in the mentioned measurement scales. The exclusion criteria were the patient's lack of consent to receive psychological treatment, absence of more than two sessions, and not answering the questionnaires completely. The experimental groups underwent behavioral activation and metacognitive therapy in 8 sessions during 2 months, while the control group received no intervention. The participants completed Body Image Concern Inventory (BICI) (Littleton et al., 2005), Hamilton Anxiety Rating Scale (HAM–A) (Hamilton, 1959), and Beck Depression Inventory–II (BDI–II) (Beck et al., 1996). Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (univariate analysis of covariance and Bonferroni post hoc test) were used to analyze the research data. Data were analyzed in SPSS software version 26 at a significance level of less than 0.05.
Results: After controlling the effect of the pretest, findings showed significant differences between the experimental groups and control group in body image concern (p<0.001), anxiety (p<0.001), and depression (p<0.001). There were no significant differences between the behavioral activation and metacognitive therapy groups in depression (p=0.821) and anxiety (p=0.192). Still, there was a significant difference between behavioral activation and metacognitive therapy in body image concern (p=0.047). Behavioral activation was more effective in body image concern.
Conclusion: According to the result, behavioral activation therapy and metacognitive therapy have a significant effect on reducing body image concern, anxiety, and depression in psoriasis patients. The use of these therapies by therapists seems essential. Also, the effectiveness of behavioral activation therapy in reducing body image concerns is more than metacognitive therapy.

 

Full-Text [PDF 523 kb]   (360 Downloads)    
Type of Study: Original Research Article | Subject: Psychology

References
1. Parisi R, Webb RT, Kleyn CE, Carr MJ, Kapur N, Griffiths CEM, et al. Psychiatric morbidity and suicidal behaviour in psoriasis: a primary care cohort study. Br J Dermatol. 2019;180(1):108–15. [DOI]
2. Ali FM, Cueva AC, Vyas J, Atwan AA, Salek MS, Finlay AY, et al. A systematic review of the use of quality-of-life instruments in randomized controlled trials for psoriasis. Br J Dermatol. 2017;176(3):577–93. [DOI]
3. Gündüz A, Topçuoğlu V, Usta Gündüz EB, Ergun T, Gencosmanoglu DS, Sungur MZ. Significant effects of body image on sexual functions and satisfaction in psoriasis patients. J Sex Marital Ther. 2020;46(2):160–9. [DOI]
4. Founta O, Adamzik K, Tobin AM, Kirby B, Hevey D. Psychological distress, alexithymia and alcohol misuse in patients with psoriasis: a cross-sectional study. J Clin Psychol Med Settings. 2019;26(2):200–19. [DOI]
5. Deveci E, Kocacenk T, Şahan E, Yılmaz O, Öztürk A, Kırpınar İ. Oxidative stress and inflammatory response in patients with psoriasis; is there any relationship with psychiatric comorbidity and cognitive functions? Psychiatry and Clinical Psychopharmacology. 2019;29(4):682–95. [DOI]
6. Korman AM, Hill D, Alikhan A, Feldman SR. Impact and management of depression in psoriasis patients. Expert Opin Pharmacother. 2016;17(2):147–52. [DOI]
7. Egeberg A, Thyssen JP, Wu JJ, Skov L. Risk of first‐time and recurrent depression in patients with psoriasis: a population‐based cohort study. Br J Dermatol. 2019;180(1):116–21. [DOI]
8. Erdogan H, Altinoz A, Acer E, Saracoglu Z, Bilgin M. Evaluation of anxiety sensitivity in patients with psoriasis. Dermatol Sin. 2019;37(1):28. [DOI]
9. Chen A, Beck KM, Tan E, Koo J. Stigmatization in psoriasis. J Psoriasis Psoriatic Arthritis. 2018;3(3):100–6. [DOI]
10. Ghorbanibirgani A, Fallahi-Khoshknab M, Zarea K, Abedi H. The lived experience of psoriasis patients from social stigma and rejection: a qualitative study. Iran Red Crescent Med J. 2016;18(7):e27893. [DOI]
11. Obradors M, Blanch C, Comellas M, Figueras M, Lizan L. Health-related quality of life in patients with psoriasis: a systematic review of the European literature. Qual Life Res. 2016;25(11):2739–54. [DOI]
12. Rosińska M, Rzepa T, Szramka-Pawlak B, Żaba R. Body image and depressive symptoms in person suffering from psoriasis. Psychiatr Pol. 2017;51(6):1145–52. [DOI]
13. Annunziata MA, Giovannini L, Muzzatti B. Assessing the body image: relevance, application and instruments for oncological settings. Support Care Cancer. 2012;20(5):901–7. [DOI]
14. Wynne C, Comiskey C, McGilloway S. The role of body mass index, weight change desires and depressive symptoms in the health-related quality of life of children living in urban disadvantage: testing mediation models. Psychology & Health. 2016;31(2):147–65. [DOI]
15. Teo I, Reece GP, Christie IC, Guindani M, Markey MK, Heinberg LJ, et al. Body image and quality of life of breast cancer patients: influence of timing and stage of breast reconstruction: Body image and breast reconstruction. Psycho-Oncology. 2016;25(9):1106–12. [DOI]
16. American Psychiatric Association. DSM-5. Seyed Mohammadi Y. (Persian translator). Tehran: Ravan Publication; 2019.
17. Słomian A, Łakuta P, Bergler-Czop B, Brzezińska-Wcisło L. Self-esteem is related to anxiety in psoriasis patients: a case control study. J Psychosom Res. 2018;114:45–9. [DOI]
18. Ferreira BI, Abreu JL, Dos Reis JP, Figueiredo AM. Psoriasis and associated psychiatric disorders: a systematic review on etiopathogenesis and clinical correlation. J Clin Aesthet Dermatol. 2016;9(6):36–43.
19. Cvitanovic H, Jancic E. Influence of stressful life events on coping in psoriasis. Coll Antropol. 2014;38(4):1237–40.
20. Lamb RC, Matcham F, Turner MA, Rayner L, Simpson A, Hotopf M, et al. Screening for anxiety and depression in people with psoriasis: a cross-sectional study in a tertiary referral setting. Br J Dermatol. 2017;176(4):1028–34. [DOI]
21. Pujol RM, Puig L, Daudén E, Sánchez-Carazo JL, Toribio J, Vanaclocha F, et al. Mental health self-assessment in patients with moderate to severe psoriasis: an observational, multicenter study of 1164 patients in Spain (the VACAP study). Actas Dermosifiliográficas. 2013;104(10):897–903. [DOI]
22. Innamorati M, Quinto RM, Lester D, Iani L, Graceffa D, Bonifati C. Cognitive impairment in patients with psoriasis: a matched case-control study. J Psychosom Res. 2018;105:99–105. [DOI]
23. World Health Organization. Depression and other common mental disorders: global health estimates. World Health Organization; 2017.
24. Wojtyna E, Łakuta P, Marcinkiewicz K, Bergler-Czop B, Brzezińska-Wcisło L. Gender, body image and social support: biopsychosocial determinants of depression among patients with psoriasis. Acta Derm Venerol. 2017;97(1):91–7. [DOI]
25. Pompili M, Innamorati M, Erbuto D, Costanzo A. Psychiatric comorbidity and suicide risk in patients with psoriasis. European Psychiatry. 2016;33(1):395–6. [DOI]
26. Gruchała A, Marski K, Zalewska-Janowska A. Psychotherapeutic methods in psoriasis. Our Dermatol Online. 2020;11(2):113–9. [DOI]
27. Bayegan K, Sotodeh Asl N, Karami A, Asadzadeh Daraei H. Comparison of the effectiveness of metacognitive therapy and behavioral activation on depression in elderly with type 2 diabetes. Avicenna J Neuro Psycho Physiology. 2020;7(1):9–14. [DOI]
28. Pour Mohammad Ghouchani K, Madhi S, Forootan Nejad K. The effectiveness of behavioral activation therapy on metacognitive beliefs and concerns of physical image of depressed girl students. Rooyesh. 2020;8(10):133–42. [Persian] [Article]
29. Fernández-Rodríguez C, González-Fernández S, Coto-Lesmes R, Pedrosa I. Behavioral activation and acceptance and commitment therapy in the treatment of anxiety and depression in cancer survivors: a randomized clinical trial. Behav Modif. 2021;45(5):822–59. [DOI]
30. Gholamrezaei S, Yousefvand M, Ghazanfari F, Farokhzadian AA. The effectiveness of meta cognitive therapy in meta cognitive beliefs change and body image concern (BICI) of depressed female high school students. Instruction and Evaluation. 2018;10(40):105–27. [Persian] [Article]
31. Callesen P, Reeves D, Heal C, Wells A. Metacognitive therapy versus cognitive behaviour therapy in adults with major depression: a parallel single-blind randomised Trial. Sci Rep. 2020;10(1):7878. [DOI]
32. Thorslund J, McEvoy PM, Anderson RA. Group metacognitive therapy for adolescents with anxiety and depressive disorders: a pilot study. J Clin Psychol. 2020;76(4):625–45. [DOI]
33. Chu BC, Crocco ST, Esseling P, Areizaga MJ, Lindner AM, Skriner LC. Transdiagnostic group behavioral activation and exposure therapy for youth anxiety and depression: initial randomized controlled trial. Behav Res Ther. 2016;76:65–75. [DOI]
34. Nagy GA, Cernasov P, Pisoni A, Walsh E, Dichter GS, Smoski MJ. Reward network modulation as a mechanism of change in behavioral activation. Behav Modif. 2020;44(2):186–213. [DOI]
35. Wells A. Metacognitive therapy for anxiety and depression. Mohammadkhani SH. (Persian translator). Tehran: Ebn-e-Sina Publication; 2016.
36. Dammen T, Papageorgiou C, Wells A. An open trial of group metacognitive therapy for depression in Norway. Nord J Psychiatry. 2015;69(2):126–31. [DOI]
37. Hoffart A, Johnson SU, Nordahl HM, Wells A. Mechanisms of change in metacognitive and cognitive behavioral therapy for treatment-resistant anxiety: the role of metacognitive beliefs and coping strategies. J Exp Psychopathol. 2018;9(3):204380871878741. [DOI]
38. Delavar A. Educational and psychological research. Tehran: Virayesh Pub; 2015. [Persian]
39. Littleton HL, Axsom D, Pury CLS. Development of The Body Image Concern Inventory. Behav Res Ther. 2005;43(2):229–41. [DOI]
40. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50–5. [DOI]
41. Beck A, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation; 1996.
42. Pooravari M, Habibi M, Abedi Parija H, Seyed Ali Tabar SH. Psychometric properties of body image concern inventory in adolescent. Pejouhandeh. 2014;19(4):189–99. [Persian] [Article]
43. Maier W, Buller R, Philipp M, Heuser I. The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord. 1988;14(1):61–8. [DOI]
44. Slater P, Bunting B, Hasson F, Al-Smadi AM, Gammouh OS, Ashour A, et al. An examination of factor structure of the hamilton anxiety rating scale in a non-clinical Persian sample. Int J Res Nurs. 2019;10(1):1–9. [DOI]
45. Taheri Tanjani P, Garmaroudi G, Azadbakht M, Fekrizadeh Z, Hamidi R, Fathizadeh S, et al. Validity and reliability Beck Depression Inventory-II among the Iranian elderly population. Journal of Sabzevar University of Medical Sciences. 2015;22(1):189–98. [Persian] [Article]
46. Kanter JW, Diéguez Hurtado G, Rusch LC, Busch AM, Santiago-Rivera A. Behavioral activation for Latinos with depression. Clinical Case Studies. 2008;7(6):491–506. [DOI]
47. Ferguson GA, Takane Y. Statistical analysis in psychology and education. Delavar A, Naghshbandi S. (Persian translator). Tehran: Arasbaran Publication; 2007.
48. Wells A, Fisher P, Myers S, Wheatley J, Patel T, Brewin CR. Metacognitive therapy in recurrent and persistent depression: a multiple-baseline study of a new treatment. Cogn Ther Res. 2009;33(3):291–300. [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.

© 2025 CC BY-NC 4.0 | Middle Eastern Journal of Disability Studies

Designed & Developed by : Yektaweb