Comparing the Effectiveness of Schema Therapy and Acceptance and Commitment Therapy on Personality Type D and Adherence to Treatment in Patients with Coronary Artery Disease

Document Type : Original Article

Authors

1 Department of Psychology, Gorgan Branch, Islamic Azad University, Gorgan, Iran

2 Department of Psychology, School of Educational Sciences and Psychology, Ferdowsi University, Mashhad, Iran

Abstract

Abstract
Introduction: The purpose of this study was to compare the effectiveness of schema therapy with acceptance and commitment therapy on type D personality and adherence to treatment in coronary heart disease patients.
Method: A  single-subject design with multiple baseline control and 6-week follow-up was applied. Ten men with heart disease were selected by convenience sampling method among patients of Razavi Hospital in Mashhad. The efficacy of treatment protocol in three stages (baseline, 10-session treatment and 6-weeks follow-up) was examined using Type D Personality Questionnaire and  Morisky Medication Adherence Scale (MMAS-8). Data were analyzed using visual charting, Reliable Change Index (RCI), Percentage Recovery Formula and Clinical Significance.
Results: In the post-test phase, schema therapy significantly reduced type D personality and increased adherence to treatment for cardiac patients compared to acceptance and commitment therapy (p < 0.05), but at follow-up, Schema therapy was more effective in reducing type D personality and increasing adherence to treatment.
Conclusion: The results showed that schema therapy significantly improved target behaviors. No clinically important difference evident between schema therapy and acceptance and commitment therapy in term of target behaviors.

Keywords

References

منابع
1. Braunwald, E., D. Zipes, and P. Libby. "Heart disease 6th ed." Philladelphia WB Saunders company (2001): 1180-1182. ‏
2. Cepeda-Valery, Beatriz, et al. "Measuring health related quality of life in coronary heart disease: the importance of feeling well." International journal of cardiology 149.1 (2011): 4-9. ‏
3. Riso, Lawrence P., Ronald K. Miyatake, and Michael E. Thase. "The search for determinants of chronic depression: a review of six factors." Journal of affective disorders 70.2 (2002): 103-115. ‏
4. Birami, Mansour, Mahmoud Ali, Majid, Nemati Sogoli Tapeh, Fatemeh (2010). The Relationship between Active-Behavioral Inhibition Activation Systems and Personality Dimensions with Coronary Heart Disease, Medical Journal of Tabriz University of Medical Sciences, 2010; 32(4): 85-80
5. Oginska-Bulik, N. (2006). Occupational stress and its consequences in healthcare professionals: the role of type D personality. Int J Occup Med Environ Health, Vol.19, pp.113-122.
6. Mols F, Denollet J (2010). Type D personality among noncardiovascular patient populations: a systematic review. General Hospital Psychiatry. 32(1):66-72.
7. Svansdottir E, Hrobjartur D, Thorarinn G, Daniel T, Thorgilsson H, Sigtryggsdottir U. (2012). Validity of Type D personality in Iceland: association with disease severity and risk markers in cardiac patients. J Behav Med, 35: 155-166.
8. Ogińska-Bulik N. (2014). Type D personality and quality of life in subjects after myocardial infarction. Kardiol Pol. 72(7):624-730.
9. Fakhari, AS, Noroozi, Q, 2, Validity and reliability of the Persian version of the Personality Type Questionnaire (DS14) D in coronary heart disease patients, Medical Journal of Tabriz University of Medical Sciences and Sixth, No. 2, Successive 112, 87-78. Denollet, Johan. "Personality and coronary heart disease: TheType-D scale-16 (DS16)." Annals of Behavioral Medicine 20.3 (1998): 209-215. ‏
10. Eslick, Guy D. "Health care seeking behaviors, psychological factors, and quality of life of noncardiac chest pain." Disease-a-month 9.54 (2008): 604-612. ‏
11. van der Wal, Martje HL, Tiny Jaarsma, and Dirk J. van Veldhuisen. "Non‐compliance in patients with heart failure; how can we manage it?" European journal of heart failure 7.1 (2005): 5-17. ‏
12. Jia-Rong, Wu, Debra, K., Moser, Missok, L., Chung, Terry, A. Lennie (2008). Objectively Measured, but Not Self-reported, Medication Adherence Independently Predicts EventFree Survival in Patients with Heart Failure.
13. Denhaerinck, K., Manhaeve, D., Dobbels, F., Garzoni, D., Nolt, C., and Geest, S. D. (2007). Prevalence and consequences of non-adherence to hemodialysis regimens. American journal of critical care. 16, 3, 222-235
14. Wu, Jia-Rong, et al. "Objectively measured, but not self-reported, medication adherence independently predicts event-free survival in patients with heart failure." Journal of cardiac failure 14.3 (2008): 203-210. ‏
15. Young, Jeffrey E., Janet S. Klosko, and Marjorie E. Weishaar. Schema therapy: A practitioner's guide. Guilford Press, 2003. ‏
16. Ahmadi, Farzaneh, Fareed, Ali, Berjali, Mahmood. Comparison of early maladaptive schemas and cognitive emotion regulation strategies in patients with coronary artery obstruction and healthy controls. Journal of Behavioral Sciences. 2014; 8(1): 55-63.
17. Hayes SC, Pistorello J & Levin ME. Acceptance and commitment therapy as a unified model ofbehavior change. The Counseling Psychologist, 2012; 40(7):976-1002.
18. Millon, Theodore, Seth Grossman, and Robert Tringone. "The Millon Personality Spectrometer: A tool for personality spectrum analyses, diagnoses, and treatments." (2010). ‏
19. Ahmadpour Mobarkae, Alireza, Ahadi, Hassan, Mazaheri, Mohammad Mehdi, Nafisi, Gholamreza. Construction and validation of a scale for assessing type D personality and its relationship with coronary heart disease. Knowledge and Research in Applied Psychology, 2009. 9(60): 32–37.
20. Bergvik, Svein, et al. "Psychometric properties of the Type D scale (DS14) in Norwegian cardiac patients." Scandinavian Journal of Psychology 51.4 (2010): 334-340. ‏
21. Howard, Siobhán, and Brian M. Hughes. "Construct, concurrent and discriminant validity of Type D personality in the general population: associations with anxiety, depression, stress and cardiac output." Psychology & health 27.2 (2012): 242-258. ‏
22. Weng, Chia-Ying, et al. "The validity of the Type D construct and its assessment in Taiwan." BMC psychiatry 13.1 (2013): 46. ‏
23. Riso, Lawrence P., Rachel E. Maddux, and Noelle Turini Santorelli. "Early Maladaptive Schemas in Chronic Depression." (2007). ‏
24. Yu, Xiao-nan, Jianxin Zhang, and Xiaohui Liu. "Application of the Type D Scale (DS14) in Chinese coronary heart disease patients and healthy controls." Journal of psychosomatic research 65.6 (2008): 595-601. ‏
25. Zoology, Donation, Agilar Vafaie, Maryam. The Relationship between Type D Personality with Behavioral Inhibition Systems and Behavioral Activator Systems. Tabriz University Psychology Quarterly, 2006; 1 (2-3): 123-144.
26. Morisky DE, Ang A, Krousel-Wood M, Ward H. Predictive Validity of a Medication Adherence Measure in an Outpatient Setting. J. Clin. Hypertens. 2008: 10(5): 348-354
27. Bakaiian, Mahdieh. Evaluation of wounds, bases, and wounds as outgroups of patients undergoing treatment in M.P. Faculty of Psychology, Shiraz University. 2013
28. Young JE (2007) Early Maladaptive Schemas in Chronic Depression. In: Riso(ed.) Chronic Depression Guilford press, New York, USA.
29. Spatola, Chiara AM, et al. "The ACTonHEART study: rationale and design of a randomized controlled clinical trial comparing a brief intervention based on Acceptance and Commitment Therapy to usual secondary prevention care of coronary heart disease." Health and quality of life outcomes 12.1 (2014): 22. ‏
30. Soltani Shal, Reza, Aqa Mohammadian Sharabaf, Mohammad. The Role of Psychological Variables and the Importance of Psychotherapy in the Psychopathology of Cardiac Patients. Journal of Zanjan University of Medical Sciences. 2015: 23 (96): 109-121
31. Bayazi M H, Gohari Z, Hojjat S K, Behrad A. Relationship between emotional schemas and anxiety, depression and coping stress styles in patients with coronary artery disease. JNKUMS. 2014; 5 (5):1091-1098
32. Khoshnoud, Ghasemali, Gharib Khairi, Zahra, Khawouri, Jamal, Farvand, Nasser. Each treatment session on Hadiam and mental health of my patients with type 2 diabetes. Diabetic Publications Student of Diabetes Nursing and Midwives. 2015; 3 (1): 8-18.
33. Sohrabi, S. The effect of Schema-focused cognitive therapy on stress reduction in coronary heart disease patients in Mashhad. Master's thesis and Ferdowsi University of Mashhad. 2010
34. Rahimiyan, S., Gaffari, TM. SCHEMA THERAPY AS A TREATMENT FOR CHRONIC DISORDERS. Indian J.Sci.Res.2014; 4 (3): 437-446.
35. Brouwers, C., Mommersteeg, P. M., Nyklíček, I., Pelle, A. J., Westerhuis, B. L., Szabó, B. M., & Denollet, J. Positive affect dimensions and their
 
association with inflammatory biomarkers in patients with chronic heart failure. Biological psychology. 2013; 92(2), 220-226.
36. Van den Broek KC, Versteeg H, Erdman RA, Pedersen SS. The distressed (Type D) personality in both patients and partners enhances the risk of emotional distress in patients with an implantable cardioverter defibrillator. Journal of affective disorders. 2011; 130(3).447-453
37. Denollet, J., Schiffer, A. A., & Spek, V. A general propensity to psychological distress affects cardiovascular outcomes evidence from research on the Type D (distressed) personality profile. Circulation: cardiovascular quality and outcomes. 2011; 3(5), 546-557.
38. Graham CD, Gillanders D, Stuart S & Gouick J. An acceptance and commitment therapy (ACT) based intervention for an adult experiencing post-stroke anxiety and medically unexplained symptoms. Clinical Case Studies, 2014; 13(3):230-48
39. Burrows CJ. Acceptance and commitment therapy with survivors of adult sexual assault: A case study. Clinical Case Studies, 2013; 12(3):246-59.
40. Goodwin CL, Forman EM, Herbert JD, Butryn ML & Ledley GS. A pilot study examining the initial effectiveness of a brief acceptance-based behavior therapy for modifying diet and physical activity among cardiac patients. Behav Modif, 2012; 36(2):199-217.
41. Bundek N. Maybe memory isn't the problem. J Aprexis Health Solutions 2009; 10(3): 110-16.
42. Lerman I. Adherence to treatment. The key for avoiding long term complications type 2 diabetes. Arche Med Res 2005; 10(2): 300-6.
43. Insel KC, Cole L. Individualizing memory stategies to improve medician adherence. Appl Nurs Res. 2005; 18(4): 199-204
44. Stilly, C. S., Sereika, S., Muldoon, M. F., Ryan, C. M. and Dunbar-jacub, J. Psychological and cognitive function: Predictors of adherence with cholesterol lowering treatment. Annual of Behavioral Medication. 2004; 27, 117-124
45. Nazarband, N, Azad Fallah, P, Fathi Ashtiani, AS, Ashari, H, Khodadadi, M. Relationship between Anxiety Personality Trail with Effective Functioning and Working Memory Processing Adequacy. Journal of Psychology.2012; (16) 1. 51-69
46. Zahednezhad, E, Poursharifi, H, Babapour, J. The Relationship between Health Control Center, Memory and Physician-Patient Relationship with Satisfaction with Treatment in Type II Diabetic Patients. Urmia Nursing and Midwifery Journal. 2011; 9 (2). 75-67.
47. Hekmatpour, D, Mohammadi, AS, Ahmadi, F, Arefi, H. Submitted; Journal of Critical Care Nursing. 2009; (2) 3. 91-97.

Files

History

  • Receive Date: 11 September 2017
  • Revise Date: 17 April 2020
  • Accept Date: 16 June 2020

Share

How to cite

Statistics