Comparing the Effectiveness of Schema Therapy and Cognitive-Behavioral Therapy on Cognitive Flexibility and Negative Automatic Thoughts in Patients with Major Depressive Disorder: A Randomized Controlled Clinical Trial in Tehran City, Iran

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Barouti M.; Chinaveh M.; Saedi S.

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Journal Paper

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Journal: Journal of Disability Studies Year:2023 | Volume:13 | Issue:0 Page(s): 45-45

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Title

Comparing the Effectiveness of Schema Therapy and Cognitive-Behavioral Therapy on Cognitive Flexibility and Negative Automatic Thoughts in Patients with Major Depressive Disorder: A Randomized Controlled Clinical Trial in Tehran City, Iran

Author(s)

Barouti M. | Chinaveh M. | Saedi S. | Issue Writer Certificate

Keywords

Cognitive flexibility

Negative automatic thoughts

Major depressive disorder

Cognitive–Behavioral therapy

Schema therapy

Abstract

Abstract Background & Objectives: Major depressive disorder is a common and severe mental illness. Clinical research suggests that individuals with a Major depressive disorder are cognitively inflexible, exhibiting ruminative, rigid, and automatic thoughts within a negative schema. Because Major depressive disorder leads to disability of people and a disease burden on society, it is necessary to investigate effective treatments. Several psychological interventions have been implemented in people with Major depressive disorder, such as cognitive behavioral and Schema therapy. Cognitive behavioral therapy is one of the most evidence–based psychological interventions for treating Major depressive disorder. The foundation of cognitive behavioral therapy is to reform dysfunctional emotions, thoughts, and actions. In addition, Schema therapy is another promising approach to treating depression. Therefore, the present study aims to compare the effects of cognitive behavioral therapy and Schema therapy on Cognitive flexibility and Negative automatic thoughts in patients with Major depressive disorder. Methods: The present study was a three–group randomized clinical trial study (with a pretest, posttest, and follow–up design with a control group). The statistical population included all patients diagnosed with Major depressive disorder in the Entekhabe No and Aryaz clinics in Tehran City, Iran, during the spring and summer of 2022. A total of 45 eligible volunteer patients were included in the study by the convenience sampling method. They were randomly allocated to two intervention and one control groups (15 people in each group). Patients in the first intervention group received 10 sessions (two sessions per week, each session lasting 90 minutes) of Schema therapy. Patients in the second intervention group had 12 sessions (two sessions per week, each lasting for 60 minutes) of cognitive behavioral therapy. However, the control group did not receive any intervention. The data collection tools included the Cognitive flexibility Inventory (CFI) (Dennis and Vander Wal, 2010) and the Automatic Thoughts Questionnaire (ATQ–30) (Hollon and Kendall, 1980). Data were analyzed using descriptive statistics (frequency indices, mean, and standard deviation) and inferential statistics (the Fisher exact test, 1–way analysis of variance, analysis of variance with repeated measurements, and Tukey post hoc test) in SPSS 24 at a significance level of 0. 05. Results: The results showed that the variance analysis of Cognitive flexibility and Negative automatic thoughts were significant in terms of time effect (p<0. 001), group effect (p<0. 001), and interaction effect of time and group (p<0. 001). In the posttest and follow–up stages, there was a significant difference between the intervention groups and the control group in the variables of Cognitive flexibility (p<0. 001) and Negative automatic thoughts (p<0. 001). In the posttest, a significant difference was observed between the effectiveness of cognitive behavioral therapy and Schema therapy in reducing the scores of Negative automatic thoughts (p<0. 001) and increasing the scores of Cognitive flexibility (p=0. 013),as a result, cognitive behavioral therapy was more effective. In the follow–up, cognitive behavioral therapy, compared to Schema therapy, was more effective in reducing the scores of Negative automatic thoughts (p=0. 009). However, no significant difference was seen between the intervention groups in increasing Cognitive flexibility (p=0. 101). Conclusion: According to the findings, Schema therapy and cognitive behavioral therapy are effective in increasing Cognitive flexibility and reducing Negative automatic thoughts of patients, but cognitive behavioral therapy is more effective than Schema therapy. As a result, both approaches can be used to increase Cognitive flexibility and reduce the Negative automatic thoughts of patients with Major depressive disorder.

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