Effectiveness of Mindfulness-Based Cognitive Therapy on decrease of symptoms of depression, rumination and emotion regulation in pregnant women

Document Type : Original Article

Authors

1 Assistant Professor, Department of Clinical Psychology

2 University of Kurdistan

Abstract

Aim: The purpose of the present study was to determine the effectiveness of
Mindedness-Based Cognitive Therapy (MBCT) on reducing the symptoms of
depression, rumination, and emotion regulation in pregnant women. Method:
A quasi-experimental design with pre-test, post-test and a one month followup with control group was used. The statistical population included 500
pregnant women referred to health centers in the town of Ghorveh in Sanandaj
province in Iran who were one to six months pregnant. Through available
sampling method, 263 women who met the inclusion criteria were selected
and out if these, 30 participants were randomly assigned to two groups of
MBCT or control. Research tools were Beck’s (1996) Depression InventoryII, Rumination Response Scale (Nolen-Hoeksema & Morrow, 1991),
Emotion Regulation Questionnaire (Gross & John, 2003) and the MBCT
program which was adapted from Segal, Williams, & Teasdale (2018) and
Dimidjian, Goodman, Felder, Gallop, Brown, & Beck (2016). This was
administered to the experimental group during eight weekly, 90-minute
sessions and collected data was analyzed using mixed model repeated
measures analysis of variance. Results: Findings showed that MBCT had a
significant effect on improving depression symptoms (F= 55.06, P= 0.001),
rumination (F= 25.88, P= 0.001), and emotion regulation subscales including
cognitive reappraisal (F= 9.27, P= 0.02), and suppression (F= 4.69, P= 0.036),
and treatment gains were maintained at follow-up. Conclusion: This method
can be used as a low-cost and effective treatment for the treatment of
emotional disorders and improving the psychological status of pregnant
women. 

Keywords

References

  1. اسدی نوقابی، احمدعلی.، و ذوالفقاری، میترا. (1390). پرستاری بهداشت مادران و نوزادان. تهران: نشر و تبلیغ بشری.
  2. بختیاری، آزاده.، و عابدی، احمد. (1391). اثربخشی درمان گروهی مبتنی بر الگوی فراشناختی ذهن آگاهی انفصالی بر افسردگی پس از زایمان. فصلنامه روان‌شناسی کاربردی، 6(2 پیاپی 22): 24-9.
  3. بشارت، محمدعلی. (1383). بررسی مشخصه‌های روان‌سنجی مقیاس افسردگی بک. گزارش پژوهشی: دانشگاه تهران.
  4. بهشتی، نگار.، زمستانی، مهدی.، و رضاعی، فرزین. (1397). مقایسه اثربخشی درمان شناختی رفتاری معطوف بر عدم تحمل ابهام و درمان دارویی بر مؤلفه‌های نگرانی، عدم تحمل ابهام و اجتناب شناختی در مبتلایان به اختلال اضطراب فراگیر. مجله روان‌پزشکی و روان‌شناسی بالینی ایران، ۲۴(۳): 255-240.
  5. زمستانی، مهدی.، یوسفی، ناصر.، و کشاورزی، سارا. (1394). اثربخشی درمان شناختی رفتاری گروهی همراه با آموزش خانواده بر مؤلفه‌های مرتبط با خودکشی در دختران اقدام کننده به خودکشی. فصلنامه مشاوره و رواندرمانی خانواده، 5(3): 120-107.
  6. فتی، لادن.، بیرشک، بهروز.، عاطف وحید، محمد کاظم.، و دابسون، کیت استفان. (1384). ساختارهای معنا گذاری/ طرحواره‌ها و پردازش شناختی اطلاعات هیجانی: مقایسه دو چارچوب مفهومی. مجله روان‌پزشکی و روان‌شناسی بالینی ایران، 11(3): 326-312.
  7. قاسم پور، عبدالله.، ایل بیگی، رضا.، و حسن زاده، شهناز. (1391). خصوصیات روان‌سنجی پرسشنامه تنظیم هیجانی گراس و جان در یک نمونه ایرانی. ششمین همایش بهداشت روانی دانشجویان، دانشگاه گیلان، گیلان، ایران.
  8. قضایی، مریم.، داودی، ایران.، نیسی، عبدالکاظم.، مهرابی زاده هنرمند، مهناز.، و بساک نژاد، سودابه. (1397). اثربخشی درمان شناختی رفتاری و آموزش روانی بر ترس از زایمان طبیعی و متغیرهای مرتبط با آن. فصلنامه روان‌شناسی کاربردی، 12(1 پیاپی 45): 125-103.
  9. کاویانی، حسین.، و موسوی، اشرف السادات. (1387). ویژگی‌های روان‌سنجی مقیاس اضطراب بک در طبقات سنی و جنسی جمعیت ایرانی. مجله دانشکده پزشکی، دانشگاه علوم پزشکی تهران، 66(2): 140-136.
  10. لطفی نیا، علی. (1386). مقایسه روش حل مساله در دانشجویان افسرده همراه با نشخوار فکری و حواس‌پرتی. رساله دکترای تخصصی. رشته روان‌شناسی بالینی، دانشگاه علوم پزشکی ایران. انستیتو روان‌پزشکی تهران.
  11. محمدپور، سمانه.، تاجیک زاده، فخری.، و محمدی، نورالله. (1395). اثربخشی شناخت درمانی مبتنی بر ذهن آگاهی بر کاهش علائم افسردگی، نشخوار ذهنی و نگرش‌های ناکارامد زنان باردار مبتلا به افسردگی. مجله روان‌شناسی بالینی و شخصیت، 16(1): 198-187.
  12. محمدی شیر محله، فاطمه.، جمهری، فرهاد.، کراسکیان، آدیس.، و ملیحی الذاکرینی، سعید. (1395). اثربخشی ذهن آگاهی بر کاهش اضطراب و قندخون بیماران دیابتی با نوع شخصیت بازدارنده. فصلنامه روان‌شناسی کاربردی، 10 (2 پیاپی 38): 156-139.
  13. هومن، حیدرعلی. (1395). شناخت روش علمی در علوم رفتاری. تهران: سازمان مطالعه و تدوین کتب علوم انسانی دانشگاه‌ها (سمت)، مرکز تحقیق و توسعه علوم انسانی.
  14. References
  15. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2): 217-237.
  16. Arch, J. J., Dimidjian, S., & Chessick, C. (2012). Are exposure-based cognitive behavioral therapies safeduring pregnancy? Archives of Women's Mental Health, 15(6): 445-457.
  17. Balzarotti, S., John, O. P., & Gross, J. J. (2010). An Italian adaptation of the emotion regulation questionnaire. European Journal of Psychological Assessment. 26(1): 61–67.
  18. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio, 78(2): 490-498.
  19. Biebel, K., & Alikhan, S. (2016). Paternal postpartum depression. Journal of Parent and Family Mental Health, 1(1): 1-5.
  20. Britton, W. B., Shahar, B., Szepsenwol, O., & Jacobs, W. J. (2012). Mindfulness-based cognitive therapy improves emotional reactivity to social stress: results from a randomized controlled trial. Behavior Therapy, 43(2): 365-380.
  21. Cisler, J. M., & Olatunji, B. O. (2012). Emotion regulation and anxiety disorders. Current Psychiatry Reports, 14(3): 182-187.
  22. Creswell, J. D. (2017). Mindfulness interventions. Annual Review of Psychology, 68(1): 491-516.
  23. Davies, H., Swan, N., Schmidt, U., & Tchanturia, K. (2012). An experimental investigation of verbal expression of emotion in anorexia and bulimia nervosa. European Eating Disorders Review, 20(6): 476-483.
  24. Dhillon, A., Sparkes, E., & Duarte, R. V. (2017). Mindfulness-based interventions during pregnancy: A systematic review and meta-analysis. Mindfulness, 3(1): 1-17.
  25. Dimidjian, S., Goodman, S. H., Felder, J. N., Gallop, R., Brown, A. P., & Beck, A. (2016). Staying well during pregnancy and the postpartum: A pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse/recurrence. Journal of Consulting and Clinical Psychology, 84(2): 134-145.
  26. Dunn, C., Hanieh, E., Roberts, R., & Powrie, R. (2012). Mindful pregnancy and childbirth: Effects of a mindfulness-based intervention on women’s psychological distress and well-being in the perinatal period. Archives of Women's Mental Health, 15(2): 139-143.
  27. Ehring, T., Tuschen-Caffier, B., Schnülle, J., Fischer, S., & Gross, J. J. (2010). Emotion regulation and vulnerability to depression: Spontaneous versus instructed use of emotion suppression and reappraisal. Emotion, 10(4): 563-571.
  28. Fortinash, K. M., & Worret, P. A. H. (2014). Psychiatric mental health nursing. E-Book: Elsevier Health Sciences.
  29. Fowler, J. C., Madan, A., Allen, J. G., Oldham, J. M., & Frueh, B. C. (2019). Differentiating bipolar disorder from borderline personality disorder: Diagnostic accuracy of the difficulty in emotion regulation scale and personality inventory for DSM-5. Journal of Affective Disorders, 62(1): 856-860.
  30. Goodman, J. H., Guarino, A., Chenausky, K., Klein, L., Prager, J., Petersen, R., Freeman, M. (2014). CALM Pregnancy: results of a pilot study of mindfulness-based cognitivetherapy for perinatal anxiety. Archives of women's mental health, 17(5), 373-387.
  31. Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological Inquiry, 26(1), 1-26.
  32. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of personality and social psychology, 85(2), 348-362.
  33. Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psychology, 78(2), 169-183.
  34. Kendall-Tackett, K. (2010). Four research findings that will change what we think about perinatal depression. The Journal of perinatal education, 19(4), 7-19.
  35. Kring, A. M., & Sloan, D. M. (2009). Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment: Guilford Press.
  36. Kuyken, W., Hayes, R., Barrett, B., Byng, R., Dalgleish, T., Kessler, D., & Cardy, J. (2015). Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. The Lancet, 386(9988), 63-73.
  37. Ladan F, B. B., Atefvahid K, Dabson S,. (2003). Mnagzary structures schemas, emotional states and cognitive processing of emotional information: Comparison of the conceptual framework. Thought and Behavior in Clinical Psychology, 11(3), 312-326.
  38. Luminet, O. (2004). Assessment and measurement of rumination. In C. Papageorgiou and A. Wells (Eds.), Rumination: Nature, theory, and treatment of negative thinking in depression. (pp. 187-215). Chichester: Wiley.
  39. Marchand, W. (2012). Depression and Bipolar Disorder: YourGuide to Recovery: Bull Publishing Company.
  40. Martin-Asuero, A., & Garcia-Banda, G. (2010). The mindfulness-based stress reduction program (MBSR) reduces stress-related psychological distress in healthcare professionals. The Spanish Journal of Psychology, (2)13, 897-905.
  41. Metcalf, C. A., Gold, A. K., Davis, B. J., Sylvia, L. G., & Battle, C. L. (2019). Mindfulness as an Intervention for Depression. Psychiatric Annals, 49(1), 16-20.
  42. Miklowitz, D. J., Semple, R. J., Hauser, M., Elkun, D., Weintraub, M. J., & Dimidjian, S. (2015). Mindfulness-based cognitive therapy for perinatal women with depression or bipolar spectrum disorder. Cognitive Therapy and Research, 39(5), 590-600.
  43. Munk‐Olsen, T., Gasse, C., & Laursen, T. (2012). Prevalence of antidepressant use and contacts with psychiatrists and psychologists in pregnant and postpartum women. Acta Psychiatrica Scandinavica, 125(4): 318-324.
  44. Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta Earthquake. Journal of Personality and Social Psychology, 61(1): 115-123.
  45. Papageorgiou, C., & Wells, A. (2004). Depressive rumination: Nature, theory and treatment. Chichester: Wiley.
  46. Piet, J., & Hougaard, E. (2011). The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysis. Clinical Psychology Review, 31(6): 1032-1040.
  47. Saxena, P., Dubey, A., & Pandey, R. (2011). Role of emotion regulation difficulties in predicting mental health and well-being. SIS Journal of Projective Psychology & Mental Health, 18(2): 23-31.
  48. Segal, Z., Williams, M., & Teasdale, J. (2018). Mindfulness-based cognitive therapy for depression. Guilford Publications.
  49. Teasdale, J., Segal, Z., Williams, J., Ridgeway, V., & Soulsby, J. M., & Lau, MA (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4): 615-623.
  50. Varcarolis, E. M. (2016). Essentials of psychiatric mental health nursing. E-Book: A communication approach to evidence-based care: Elsevier health sciences.
  51. Vieten, C., & Astin, J. (2008). Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: Results of a pilot study. Archives of Women's Mental Health, 11(1): 67-74.
  52. Vliegen, N., Casalin, S., & Luyten, P. (2014). The course of postpartum depression: a review of longitudinal studies. Harvard Review of Psychiatry, 22(1): 1-22.
  53. Wardrop, A. A., & Popadiuk, N. E. (2013). Women's experiences with postpartum anxiety: Expectations, relationships, and sociocultural influences. The Qualitative Report, 18(3): 1-24.
  54. Zemestani, M., & Ottaviani, C. (2016). Effectiveness of mindfulness-based relapse prevention for co-occurring substance use and depression disorders. Mindfulness, 7(6): 1347-1355.
  55. Zemestani, M., Davoodi, I., Mehrabizadeh Honarmand, M., Zargar, Y., & Ottaviani, C. (2015). Comparative effects of group metacognitive therapy versus behavioral activation in moderately depressed students. Journal of Mental Health, 12(1):1-7.

Files

Share

How to cite

Statistics