Effectiveness of a Hybride Dialectical Behavior Therapy and Lithum Carbonate compared to Sole Medication Treatment on Emotion-regulation, Self-control and Cognitive-flexibility of Bipolar Disordered Patients

Document Type : Original Article

Authors

1 Master of Clinical Psychology.Department of Psychology. Islamic Azad University. Birjand Branch. Birjand .Iran

2 Assistant Professor, Department of Psychology, Islamic Azad University.Birjand Branch. Birjand. Iran

Abstract

Abstract

Introduction: The aim of this study was to compare the impacts of hybriding dialectical behavior therapy(DBT) and Lithium Carbonate medication treatment compared to sole medication treatment on emotion-regulation, self-control, and cognitive-flexibility in a group of bipolar-disordered patients.
Method: In a randomized controlled trial design statistical population of bipolar disordered patients, referred to Ibn Sina Hospital in Mashhad in 2019 was targeted. A sample of 30 patients was chosen by the available sampling method and considering inclusion/exclusion criterias. Selected participants were randomly divided into two equal groups of A and B. The instruments included Garnfsky’s Emotional Cognitive Regulation Questionnaire, Tanji’s Self-Control Questionnaire, and Dennis's Cognitive Flexibility. Over an 8 weeks period group A underwent the weekly 60 minutes session of DBT and received Lithium Carbonate medication treatment, while group B received  only Lithium Carbonate. A statistical analysis of MANCOVA was performed.
Results: The results indicated significant differences between hybrid therapy and sole Lithium Carbonate treatment regarding emotion-regulation, self-control, and cognitive-flexibility in bipolar patients. The hybrid treatment was more effective than sole medication(P<0.001)
Conclusion: It could be concluded that the combination of DBT with medication could be more effective in emotion-regulation, self-control, and cognitive-flexibility in bipolar patients.

Keywords


  1. Novick DM, Swartz HA, Frank E. Suicide attempts in bipolar I and bipolar II disorder: a review and meta‐analysis of the evidence. Bipolar disorders. 2010 Feb;12(1):1-9.
  2. Akhavan Sh, Sajjadian I. The effectiveness of dialectical behavior therapy on emotional instability and impulsivity in people with bipolar disorder. Journal of Clinical Psychology. 2016 Sep 22;8(3):11-24.
  3. Sadock J, Sadock VA, Ruiz P. Summary of non-medical practice.Kaplan and Zadok; Behavioral Sciences / Clinical Practice. Volume One, Eleventh Edition. Tehran: Arjmand. 2015.
  4. Goodman M, Carpenter D, Tang CY, Goldstein KE, Avedon J, Fernandez N, Mascitelli KA, Blair NJ, New AS, Triebwasser J, Siever LJ. Dialectical behavior therapy alters emotion regulation and amygdala activity in patients with borderline personality disorder. Journal of psychiatric research. 2014 Oct 1;57:108-16.
  5. McCauley E, Berk MS, Asarnow JR, Adrian M, Cohen J, Korslund K, Avina C, Hughes J, Harned M, Gallop R, Linehan MM. Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: a randomized clinical trial. JAMA psychiatry. 2018 Aug 1;75(8):777-85.
  6. Öngen DE. Cognitive emotion regulation in the prediction of depression and submissive behavior: Gender and grade level differences in Turkish adolescents. Procedia-Social and Behavioral Sciences. 2010 Jan 1;9:1516-23.
  7. Poursalehi Navideh M, Piyvastehghar, M, Khosravi Z, Golshani F. Comparison of the effectiveness of dialectical behavior therapy and neurofeedback on reducing the prognostic symptoms of bipolar disorder. Journal of Applied Psychological Research. 2015;7 (4): 101-116.
  8. Wetterborg D, Dehlbom P, Långström N, Andersson G, Fruzzetti AE, Enebrink P. Dialectical behavior therapy for men with borderline personality disorder and antisocial behavior: A clinical trial. Journal of personality disorders. 2020 Feb;34(1):22-39.
  9. Tebbett-Mock AA, Saito E, McGee M, Woloszyn P, Venuti M. Efficacy of dialectical behavior therapy versus treatment as usual for acute-care inpatient adolescents. Journal of the American Academy of Child & Adolescent Psychiatry. 2020 Jan 1;59(1):149-56.
  10. Mousavi Moghadam SR. Investigating the relationship between spiritual intelligence and self-control and defense mechanisms in third year female high school students. Journal of Islamic Azad University. 2015; 25 (1): 59-64.
  11. Abbasi, M. The effectiveness of dialectical behavior therapy on reducing anxiety and increasing stubbornness and self-control of depressed students. Master Thesis, Islamic Azad University, Bojnourd Branch. 2014.
  12. DiRocco A, Liu L, Burrets M. Enhancing dialectical behavior therapy for the treatment of bipolar disorder. Psychiatric Quarterly. 2020 Sep;91(3):629-54.
  13. Afshari B, Omidi A, Sehat M. The effect of dialectical behavior therapy on executive function in patients with a bipolar disorder. Feyz Journal of Kashan University of Medical Sciences. 2018;22(4):404-10.
  14. Soltani E, Shareh H, Bahrainian SA, Farmani A. The mediating role of cognitive flexibility in correlation of coping styles and resilience with depression. Pajoohandeh Journal. 2013 Jun 10;18(2):88-96.
  15. Salehi M, Hamid N, Beshlideh K, Arshadi N. Comparison of the Effectiveness of Holographic Reprocessing and Dialectical Behavioral Therapy on Cognitive Flexibility and Impulsivity among Depressed Patients with a Suicide Attempt in Ilam, Iran. scientific journal of ilam university of medical sciences. 2019 Dec 10;27(5):1-4.
  16. Linehan MM. DBT® Skills Training Manual, Second Edition. Guilford Publications. 2014.
  17. Eskandari H, Ghaderi K. The effectiveness of group dialectical behavior therapy on increasing resilience of the physically disabled. Journal of Disability Studies. 2017; 1 (7): 1-18.
  18. Hoseini Omam SS, Najafi M, Makvand Hosseini S, Salavati M, Rezaei AM. Comparison of the effectiveness of emotion regulation skills training based on Gross Model and Linehan Model on suicidal thoughts in adolescents with borderline personality disoerder. Journal of Psychological Studies. 2019 Apr 21;15(1):131-46.
  19. Samani S, Sadeghi L. Adequacy of Psychometric Indicators of Cognitive Emotion Regulation Questionnaire. Psychological Methods and Models. 2010; 1 (1): 51-62.