The Effects of Schema Therapy on Emotional Self-Awareness, Vulnerability, and Obsessive Symptoms Among Patients with Obsessive-Compulsive Disorder

Abstract

Background and Objectives: Mental disorders, including obsessive-compulsive disorder, are multidimensional phenomena. Most patients with mental disorders reject or resist receiving treatments and hence, effective strategies are needed for their treatment.As an extension of cognitive behavioral therapy, schema therapy incorporates different views and presents a multi-component approach for the management of not only cognitions and behaviors, but also emotions. This study aimed to assess the effects of schema therapy on emotional self-awareness, vulnerability, and obsessive symptoms among patients with obsessive-compulsive disorder. Methods: This was an experimental clinical trial. Study population consisted of all patients with obsessive-compulsive disorder who, in a six-month period in 2016, referred to psychology clinics located in Birjand, Iran. A total of 32 eligible patients were recruited and randomly assigned to control and intervention (i.e. schema therapy) groups. Data collection instruments were a researchermade demographic questionnaire, Young schema questionnaire, and Yale-Brown obsessive-compulsive scale. The data were entered into the SPSS software (v. 22.0) and analyzed using the multivariate analysis of covariance at a significance level of less than 0.05. Results: One patient from the intervention group voluntarily withdrew from the study. The posttest mean score of emotional selfawareness in the intervention group was significantly greater than the pretest mean score, while the posttest mean scores of the vulnerability schema and obsessive symptoms were significantly lower than the pretest scores (P < 0.001). Moreover, the control and the intervention groups differed significantly from each other respecting the posttest mean scores of emotional self-awareness, vulnerability, and obsessive symptoms (P < 0.001). Conclusions: Schema therapy alleviates obsessive symptoms through positively affecting emotional self-awareness and the two schemas of vulnerability. These findings suggest that these variables play significant roles in the development of obsessive symptoms. Therefore, schema therapy is recommended as an effective treatment for outpatients suffering from obsessive-compulsive disorder.

Schema Therapy’s Efficacy on Obsessive Symptoms among Patients with Obsessive-Compulsive Disorder

“…The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was developed by Goodman et al, (1989). The scale is regarded as the gold standard in the measurement of obsessive-compulsive disorder symptoms severity and treatment response.…”

“…Five items measure time occupied by obsessive thoughts, interference distress associated with obsessive thoughts, resistance against obsession and degree of control over obsessive thoughts, and the other 5 items measuring compulsions. The items are rated on a 5-point Likert scale ranging from 0 (no symptoms) to 4 (severe symptoms) and yield a global severity score ranging between 0 to 40, with 2 items (5 th item in obsessions subscale and 5 th item in compulsions subscale) having negative scores (Goodman et al, 1989). The total score between 0 and 7 is subclinical.…”

“…The total score between 0 and 7 is subclinical. A score from 8 to 15=mild OCD; 16-23=moderate; 24-31=severe; and 32-40=extreme OCD (Goodman et al, 1989)…”

Effects of Emotional Schema Therapy and Dialectical Behavior Therapy on Cognitive Emotion Regulation in Patients with Bipolar II Disorder

“…Emotion regulation is a key component of the coping process, playing an important role in normal and abnormal cognitive and emotional processes and making people respond more flexibly to environmental events, challenges, and stresses (12). Emotional self-regulation contributes to triggering, creating, increasing, maintaining, and decreasing positive and negative emotions in response to events (12,13). In general, emotional self-regulation comprises two parts: Positive/adaptive and negative/maladaptive strategies.…”