Comparing Effectiveness of Mentalization-Based Therapy and Dialectical Therapy on Distress Tolerance in Nurses with Mental Fatigue Problems

Document Type : Original Article

Authors

1 PhD Student, Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran.

2 Assistant Professor, Department of Psychology, Na.c , Islamic Azad University ،Najafabad , Iran.

3 Assistant Professor, Department of Psychology، Safahan Non-Profit Higher Education Institute, Isfahan, Iran

4 . Assistant Professor, Department of Psychology, , Najafabad Branch، Islamic Azad University ،Najafabad, , Iran.

5 Professor, Department of Psychiatric Nursing, University of Medical Sciences, Isfahan, Iran

Abstract

Aim: Distress tolerance in nurses is considered a fundamental psychological protective factor for nursing profession. Therefore, present study was conducted with aim of comparing effectiveness of mentalization-based therapy and dialectical therapy on distress tolerance in nurses with mental fatigue problems.
 
Method: This study was a quasi-experimental study with a pre-test and post-test design and a control group. 44 nurses working at Imam Khomeini Hospital in Falavarjan were selected through purposive sampling and randomly assigned to two experimental groups and a control group. The research instrument was the Distress Tolerance Scale (Simons & Gaher, 2005). The two experimental groups received treatment for 8 sessions, and control group did not receive any treatment. The data were analyzed through analysis of variance with repeated measures.
 
Results: The research results showed that the difference between the mean scores in the post-test and follow-up for the control group was statistically significant compared to the mentalization therapy and dialectical therapy groups (p < 0.05). However, the difference between the mean scores of the mentalization therapy and dialectical therapy groups was not statistically significant (p > 0.05).
 
Conclusion: Therefore, it can be said that both treatment methods are effective and have increased distress tolerance in nurses with mental fatigue problems. In addition, there is no difference between effectiveness of two methods of mentalization therapy and dialectical therapy on distress tolerance in nurses with mental fatigue problems.

Keywords

Main Subjects

References

Allen, J. G. (2006). Handbook of mentalization-based treatment. [link]
Asarnow, J. R., Berk, M. S., Bedics, J., Adrian, M., Gallop, R., Cohen, J.,... & McCauley, E. (2021). Dialectical behavior therapy for suicidal self-harming youth: Emotion regulation, mechanisms, and mediators. Journal of the American Academy of Child & Adolescent Psychiatry, 60(9), 1105-1115. [link]
Balideh, D., Nejati, F., & Torkaman, M. (2025). Emotional regulation training for nursing students: effects on emotional adjustment and psychological distress. BMC nursing, 24(1), 1379.‏ [link]
Barker, L. M., & Nussbaum, M. A. (2011). Fatigue, performance and the work environment: a survey of registered nurses. Journal of advanced nursing, 67(6), 1370-1382. [link]
Beanlands, H., McCay, E., Wang, A., Aiello, A., Schwind, J., Martin, L. S.,... & Newman, K. (2021). Exploring undergraduate nursing students’ experiences of engaging with a dialectical behavior therapy-skills group intervention: findings of a thematic analysis. Canadian Journal of Nursing Research, 53(1), 39-46. [link]
Conway, C. C., Naragon-Gainey, K., & Harris, M. T. (2021). The structure of distress tolerance and neighboring emotion regulation abilities. A essment, 28(4ss), 1050-1064. [link]
El-Ashry, A. M., Hussein Ramadan Atta, M., Alsenany, S. A., Farghaly Abdelaliem, S. M., & Abdelwahab Khedr, M. (2023). The effect of distress tolerance training on problematic internet use and psychological wellbeing among faculty nursing students: A randomized control trial. Psychology Research and Behavior Management, 4015-4032. [link]
Fonagy, P., & Campbell, C. (2016). Attachment theory and mentalization. In The Routledge handbook of psychoanalysis in the social sciences and humanities (pp. 115-131). Routledge. [link]
Haft, S. L., O'Grady, S. M., Shaller, E. A., & Liu, N. H. (2022). Cultural adaptations of dialectical behavior therapy: A systematic review. Journal of consulting and clinical psychology, 90(10), 787.‏ [link]
Hayden, M. C., Müllauer, P. K., Beyer, K. J., Gaugeler, R., Senft, B., Dehoust, M. C., & Andreas, S. (2021). Increasing mentalization to reduce maladaptive defense in patients with mental disorders. Frontiers in psychiatry, 12, 637915. [link]
Jang, H. J., Kim, O., Kim, S., Kim, M. S., Choi, J. A., Kim, B.,... & Jung, H. (2021). Factors affecting physical and mental fatigue among female hospital nurses: The Korea Nurses’ Health Study. In Healthcare (Vol. 9, No. 2, p. 201). MDPI. [link]
Jarden, R. J., Jarden, A., Weiland, T. J., Taylor, G., Bujalka, H., Brockenshire, N., & Gerdtz, M. F. (2021). New graduate nurse wellbeing, work wellbeing and mental health: A quantitative systematic review. International journal of nursing studies, 121, 103997. [link]
Kumpasoğlu, G. B., Saunders, R., Campbell, C., Nolte, T., Montague, R., Pilling, S., ... & Fonagy, P. (2025). Mentalizing, epistemic trust and interpersonal problems in emotion regulation: A sequential path analysis across common mental health disorders and community control samples. Journal of affective disorders, 372, 502-511.‏ [link]
Lass, A. N., Veilleux, J. C., DeShong, H. L., & Winer, E. S. (2023). What is distress tolerance? Presenting a need for conceptual clarification based on qualitative findings. Journal of Contextual Behavioral Science, 29, 23-32. [link]
Linehan, M. M. (1987). Dialectical behavior therapy for borderline personality disorder: Theory and method. Bulletin of the Menninger Clinic, 51(3), 261. [link]
Linehan, M. M., & Wilks, C. R. (2015). The course and evolution of dialectical behavior therapy. American journal of psychotherapy, 69(2), 97-110. [link]
Mahmoudpour A, Shariatmadar A, Borjali A, Shafiabadi A. (2022). Psychometric Properties of the Distress Tolerance Scale (DTS) in the Elderly. Quarterly of Educational Measurment. 12 (46), 49-64. (In Persian) [link]
Markowitz, J. C., Milrod, B., Luyten, P., & Holmqvist, R. (2019). Mentalizing in interpersonal psychotherapy. American journal of psychotherapy, 72(4), 95-100. [link]
Mohseni, M., Kalantari, M., Namdari, K., & Abedi, A. (2023). Comparison of the effectiveness of transdiagnostic-integrated, mindfulness, and dialectical behavior therapy with CBT on psychological inflexibility in individuals with chronic pain. Quarterly Journal of Applied Psychology, 17(4), 169–193. [link]
Morken, K. T. E., Binder, P. E., Arefjord, N. M., & Karterud, S. W. (2019). Mentalization-based treatment from the patients’ perspective–what ingredients do they emphasize?. Frontiers in Psychology, 10, 1327. [link]
Narimani, M., Salehi, M., & Kazemi, N. (2015). The effectiveness of dialectical behavior therapy on stress reduction and increasing self-efficacy among nurses. Journal of Health and Care (JHC), 17(4), 270–280.
 [link]
Nikbagha S M, Tabesh Mofrad N, Naseri Manesh M, Karami S. (2023).The effect of Mindfulness-based cognitive therapy in Anxiety sensitivity, Deficits in emotional processing and Distress tolerance of Nurses with Symptoms of Generalized Anxiety Disorder. Iranian Journal of Psychiatric Nursing.11 (1), 52-64. (In Persian) [link]
Norman-Nott, N., Briggs, N. E., Hesam-Shariati, N., Wilks, C. R., Schroeder, J., Diwan, A. D., ... & Gustin, S. M. (2025). Online Dialectical Behavioral Therapy for Emotion Dysregulation in People With Chronic Pain: A Randomized Clinical Trial. JAMA Network Open, 8(5), e256908-e256908.‏ [link]
Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2014). Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT). Research on social work practice, 24(2), 213-223. [link]
Ramachandran, H. J., Bin Mahmud, M. S., Rajendran, P., Jiang, Y., Cheng, L., & Wang, W. (2023). Effectiveness of mindfulness‐based interventions on psychological well‐being, burnout and post‐traumatic stress disorder among nurses: A systematic review and meta‐analysis. Journal of Clinical Nursing, 32(11-12), 2323-2338. [link]
Rizvi, S. L., Bitran, A. M., Oshin, L. A., Yin, Q., & Ruork, A. K. (2024). The State of the Science: Dialectical Behavior Therapy. Behavior Therapy. [link]
Safary, A., & Aftab, R. (2021). The effectiveness of online dialectical behavior therapy on emotion regulation difficulties, guilt, and dissociative symptoms in depressed individuals. Journal of Applied Psychology, 15(4), 179–206. [link]
Salmanian S, Jabalameli S, Moghimian M, Arjmandi F. (2022). Comparison of the effectiveness of metallization-based therapy and emotion-regulated therapy based on the Gross process model on self-compassion and resilience in Critical Care Unit Nurses. NPWJM.10 (36) 7. [link]
Simons, J. S., & Gaher, R. M. (2005). The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and emotion, 29(2), 83-102. [link]
Soudabeh Gharibi 1  HasanPasha Sharifi 2  HamidReza khankeh 3  Susan Emamipour. (2022). Comparison of distress tolerance and resilience of nurses working in the accident department with nurses working in the hospital. Medical Journal of Mashad University of Medical Sciences. 65 (2), 569-577. (In Persian) [link]
Tofangchi M, Raeisi Z, Ghamarani A, Rezaei H. (2022). The Psychometric Properties of Distress Tolerance Scale (DTS) inWomen with Tension-Type Headaches. Journal of Anesth Pain.12(4), 34-43. (In Persian) [link]
Traynor, J. M., Ruocco, A. C., McMain, S. F., Hermanto, N., Blumberger, D. M., Cardish, R., & Daskalakis, Z. (2023). A feasibility trial of conjoint magnetic seizure therapy and dialectical behavior therapy for suicidal patients with borderline personality disorder and treatment-resistant depression. Nature mental health, 1(1), 45-54. [link]
Van Berkel, A. S. (2023). Change is the Only Constant: How Dialectical Behavior Therapy (DBT) Can Be Made More Culturally Responsive Across Treatment Settings. [link]
Van Cutsem, J., Marcora, S., De Pauw, K., Bailey, S., Meeusen, R., & Roelands, B. (2017). The effects of mental fatigue on physical performance: a systematic review. Sports medicine, 47, 1569-1588.‏ [link]
Wang, Q., Wang, F., Zhang, S., Liu, C., Feng, Y., & Chen, J. (2023). Effects of a mindfulness-based interventions on stress, burnout in nurses: a systematic review and meta-analysis. Frontiers in Psychiatry, 14, 1218340. [link]

Files

Share

How to cite

Statistics