Comparing The Efficacy Of Mindfulness-Based Cognitive Therapy And Acceptance And Commitment-Based Therapy On Adolescent Rumination And Cognitive Avoidance In Kermanshah City
Main Article Content
Abstract
Objective: Adolescence is a period marked by changes in social structures and physical growth, which may lead to emotional and behavioral disturbances. This study aimed to determine the effectiveness of mindfulness-based cognitive therapy and acceptance and commitment-based therapy on adolescent rumination and cognitive avoidance in Kermanshah city with a two-month follow-up.
Method: This study was conducted in 1401 on 45 adolescents in Kermanshah city. A cluster sampling method was used to select and randomly assign participants to three intervention groups: Group 1 (15 participants received mindfulness-based cognitive therapy), Group 2 (15 participants received acceptance and commitment-based therapy), and a control group (15 participants). The Response Style Questionnaire (RRS) and Cognitive Avoidance Questionnaire were used, and the data were analyzed using SPSS version 26.
Findings: Acceptance and commitment-based therapy was significantly more effective in reducing cognitive avoidance (p<0.05) than mindfulness-based cognitive therapy, and its effects persisted during the follow-up period (p<0.05). In healthcare settings, both mindfulness-based cognitive therapy and acceptance and commitment-based therapy can be utilized as sustainable interventions to reduce rumination and cognitive avoidance in adolescents.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Abbasi, M., Baghian Koleh Merz, M. J., Ghasemi Jobneh, R., & Dargahi, S. (2014). Comparison of self-morbidity, social anxiety and cognitive avoidance in mothers of students with and without special learning difficulties. Exceptional Education, 6(134), 5-14.
Alfoneh, A., Imani, M., & Sarafraz, M. R. (2019). A Comparison of the effectiveness of group therapy based on acceptance and commitment therapy and cognitive behavioral therapy on experiential avoidance and cognitive fusion in patients with migraine headache. Armaghane Danesh, 25(2), 69-83.
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical psychology: Science and practice, 10(2), 125.
Bagherinejad, M., Salehi Federdi, J., & Tabatabai, S. M. (2011). The relationship between rumination and depression in a sample of Iranian students. Journal of educational studies and psychology, 11(1), 21-38.
Basak Nejad, S., Moini, N., & Mehrabizadeh, M. (2011). The relationship between post event processing and cognitive avoidance with social anxiety among students. Quarterly Journal of Behavioral Sciences, 4(4), 335-340.
Bergmadi, M., Asadi, J., & Aghili Kardamahle, S. M. (2013). The effect of mindfulness on rumination, distraction and mental health in abused and neglected adolescents in Gorgan city. Paper presented at the The first national conference of educational sciences and psychology of spirituality and health.
Bögels, S. M., & Mansell, W. (2004). Attention processes in the maintenance and treatment of social phobia: hypervigilance, avoidance and self-focused attention. Clinical psychology review, 24(7), 827-856.
Brinkborg, H., Michanek, J., Hesser, H., & Berglund, G. (2011). Acceptance and commitment therapy for the treatment of stress among social workers: A randomized controlled trial. Behaviour research and therapy, 49(6-7), 389-398.
Carroll, K. M., & Onken, L. S. (2009). Behavioral therapies for drug abuse. The American Journal of Psychiatry, 162, 1451-1461.
Cheung, M. S. P., Gilbert, P., & Irons, C. (2014). An exploration of shame, Social rank and rumination in relation to depression. Personality and Individual Differences, 36(5), 1143-1153.
Conner, C. M., & White, S. W. (2014). Stress in mothers of children with autism: Trait mindfulness as a protective factor. Research in Autism Spectrum Disorders, 8(6), 617-624.
Delcea, C., Bululoi, A. S., Gyorgy, M., & Rad, D. (2023). PSYCHOLOGICAL DISTRESS PREDICTION BASED ON MALADAPTIVE COGNITIVE SCHEMAS AND ANXIETY WITH RANDOM FOREST REGRESSION ALGORITHM. Pharmacophore, 14(5), 62-9.
Delcea, C., Bululoi, A. S., Gyorgy, M., & Siserman, C. V. (2023). Medico-Legal Approach to Incestuous Sexual Orientation in Men. Archives of Pharmacy Practice, 14(4), 69-74.
Delcea, C., Rad, D., Gyorgy, M., Runcan, R., Breaz, A., Gavrilă-Ardelean, M., & Bululoi, A. S. (2023). A Network Analysis Approach to Romanian Resilience-Coping Mechanisms in the Covid-19 Era. Pharmacophore, 14(4), 57-63.
Didonna, F. (2009). Clinical handbook of mindfulness (Vol. 18): Springer.
Fang, S., & Ding, D. (2020). A meta-analysis of the efficacy of acceptance and commitment therapy for children. Journal of Contextual Behavioral Science, 15, 225-234.
Flaxman, P. E., & Bond, F. W. (2010). A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training. Behaviour research and therapy, 48(8), 816-820.
Fledderus, M., Bohlmeijer, E. T., Fox, J.-P., Schreurs, K. M., & Spinhoven, P. (2013). The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial. Behaviour research and therapy, 51(3), 142-151.
Forkmann, T., Brakemeier, E.-L., Teismann, T., Schramm, E., & Michalak, J. (2016). The effects of mindfulness‐based cognitive therapy and cognitive behavioral analysis system of psychotherapy added to treatment as usual on suicidal ideation in chronic depression: Results of a randomized-clinical trial. Journal of affective disorders, 200, 51-57.
Grunberg, V. A., Mace, R. A., Bannon, S. M., Greenberg, J., Bakhshaie, J., & Vranceanu, A. M. (2021). Mechanisms of change in depression and anxiety within a mind-body activity intervention for chronic pain. Journal of affective disorders, 292, 534-541.
Haji Eqharari, L., Asadi, F., Jaosi, S., & T., V. (2017). Effectiveness of acceptance and commitment (ACT) therapy on behavioral inhibition and cognitive-behavioral avoidance of women with generalized anxiety disorder Nursing Research, 13(6), 31-38.
Hallis, L., Cameli, L., Dionne, F., & Knäuper, B. (2016). Combining Cognitive Therapy with Acceptance and Commitment Therapy for depression: A manualized group therapy. Journal of Psychotherapy Integration, 26(2), 186.
Han, J., Liu, J.-E., Su, Y.-L., & Qiu, H. (2019). Effect of a group-based acceptance and commitment therapy (ACT) intervention on illness cognition in breast cancer patients. Journal of Contextual Behavioral Science, 14, 73-81.
Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35(4), 639-665.
Helmes, E., & Ward, B. G. (2017). Mindfulness-based cognitive therapy for anxiety symptoms in older adults in residential care. Aging & mental health, 21(3), 272-278.
Hor, M., Aghaei, A., Abedi, A., & Attari, A. (2012). The effectiveness of acceptance and commitment therapy on depression in patients with type 2 diabetes. Journal of Behavioral Sciences Research, 11(2), 121-128.
Karimi, S., Aghamir Mohammad Ali, Z., Abu Bakri Makoui, S., Vahidifard, M., Habbi, M., & Amoo Khalili, M. (2019). Effectiveness of treatment based on acceptance and commitment on emotional impairment and cognitive avoidance in students with generalized anxiety disorder. Scientific Quarterly Journal of Psychological Studies, 16(61), 109-126.
Kerami, R., Sharifi, T., Nikkhah, M., & Ghazanfari, A. (2018). Effectiveness of emotion regulation training based on grass model on reducing rumination and social anxiety in female students with 60-day follow-up. Health Education and Health Promotion of Iran, 7(1), 1-9.
Levin, M. E., Hildebrandt, M. J., Lillis, J., & Hayes, S. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior Therapy, 43(4), 741-756.
Li, S., Chen, X., Ran, G., Zhang, Q., & Li, R. (2021). Shyness and internalizing problems among Chinese adolescents: The roles of independent interpersonal stress and rumination. Children and Youth Services Review, 128, 106151.
Liu, S., Yang, L., Zhang, C., Xiang, Y.-T., Liu, Z., Hu, S., & Zhang, B. (2020). Online mental health services in China during the COVID-19 outbreak. The Lancet Psychiatry, 7(4), e17-e18.
LoriHilt, M., & Swords, C. M. (2021). Acceptability and preliminary effects of a mindfulness mobile application for ruminative adolescents. Behavior Therapy, 52(6), 1339-1350.
Maher, E. L., & Cordova, J. V. (2019). Evaluating equanimity: Mindfulness, intimate safety, and relationship satisfaction among meditators. Couple Family Psychol Res Pract, 8(2), 77-89.
Mahmoudzadeh, R., & Mohammadkhani, S. (2015). The mediating role of cognitive avoidance and anxiety in the relationship between negative perfectionism and procrastination. Journal of Psychological Achievements, Shahid Chamran University, Ahvaz, 4(23), 94-73.
Moghtader, L. (2015). The effectiveness of mindfulness-based cognitive therapy in reducing rumination, dysfunctional attitude and negative automatic thoughts in patients with generalized anxiety disorders. Journal of Medical Sciences Studies, 27(9), 825-835.
Narimani, M., & Taheri Fard, M. (2018). The effectiveness of acceptance/commitment training to decrease experiential avoidance and psychological distress in teenagers with specific learning disorder. Journal of Learning Disabilities, 8(4), 110-133.
Nolen-Hoeksema, S., Blair, E., & Sonja, L. (2008). Rethinking Rumination. Perspectives of Psychological Science, 3, 400-424. In.
Ong, C. W., Barney, J. L., Barrett, T. S., Lee, E. B., Levin, M. E., & Twohig, M. P. (2019). The role of psychological inflexibility and self-compassion in acceptance and commitment therapy for clinical perfectionism. Journal of Contextual Behavioral Science, 13, 7-16.
Peng, Y., Zhou, H., Zhang, B., Mao, H., Hu, R., & Jiang, H. (2022). Perceived stress and mobile phone addiction among college students during the 2019 coronavirus disease: The mediating roles of rumination and the moderating role of self-control. Personality and Individual Differences, 185, 111222.
Pourabdel, S., Sobhi Qaramalki, N., & Abbasi, M. (2014). A comparison of academic procrastination and academic vitality in students with and without specific learning disorder. Learning Disabilities, 4(3), 22-38.
Rezaei, F., & Rezakhani, S. (2018). The role of cognitive emotion regulation strategies and coping styles in predicting rumination in women (who referred to Health Houses of district 14 in Tehran). Knowledge and Research in Applied Psychology, 20(2), 90-99.
Segal, Z. V., Teasdale, J. D., & Williams, J. M. (2002). Mindfulness Based cognitive therapy for depression. New York: The Guilford Press.
Shallcross, A. J., Duberstein, Z. T., Sperber, S. H., Visvanathan, P. D., Lutfeali, S., Lu, N., . . . Spruill, T. M. (2022). An Open Trial of Telephone-Delivered Mindfulness-Based Cognitive Therapy: Feasibility, Acceptability, and Preliminary Efficacy for Reducing Depressive Symptoms. Cognitive and Behavioral Practice, 29(2), 280-291.
Spek, A. A., Van Ham, N. C., & Nyklíček, I. (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial. Research in developmental disabilities, 34(1), 246-253.
Stortenbeker, I., olde Hartman, T., Kwerreveld, A., Stommel, W., van Dulmen, S., & Das, E. (2022). Unexplained versus explained symptoms: The difference is not in patients' language use. A quantitative analysis of linguistic markers. Journal of Psychosomatic Research, 152, 110667.
Talebizadeh, M., Shahmir, E., & Jafar Fard, S. (2011). Effectiveness of mindfulness-based cognitive therapy in the decrease of depression and maniac symptoms of individuals diagnosed with bipolar disorder. Thought and behavior, 7(26), 17-26.
Twohig, M. P., & Levin, M. E. (2017). Acceptance and Commitment Therapy as a Treatment for Anxiety and Depression: A Review. Psychiatric Clinics of North America, 40(4), 751-770.
Viskovich, S., Pakenham, K. I., & Fowler, J. A. (2021). A mixed-methods evaluation of experiential intervention exercises for values and committed action from an Acceptance and Commitment Therapy (ACT) mental health promotion program for university students. Journal of Contextual Behavioral Science, 22, 108-118.
Weiner, B. A., & Carton, J. S. (2012). Avoidant coping: A mediator of maladaptive perfectionism and test anxiety. Personality and Individual Differences, 52(5), 632-636.
Xingmin, B. S. Z., Ping, B. S. H., Zhengying, M. S. F., Wenxian, M. S. Z., Huijuan, M. S. W., Yang, M. S. Y., . . . Haiyan, B. S. G. (2019). Effects of Mindfulness-Based Stress Reduction on Depression, Anxiety, and Pain in Patients With Postherpetic Neuralgia. The Journal of Nervous and Mental Disease, 207(6), 482-486.
Yeraghchi, A., Jamhari, F., Seyrafi, M., Kraskian Mujembari, A., & Mohammadi Farsani, G. (2018). The effectiveness of acceptance and commitment therapy on weight loss and cognitive emotion regulation in obese individuals. Health Education and Health Promotion of Iran, 7(2), 192-201.