The Effectiveness of Mindfulness-Based Cognitive Therapy on Women's Sexual Satisfaction and Body Image with Drug Abuse

Document Type : Original Article

Authors

1 Master in Family Counseling, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran

2 Associate Professor in Health and Clinical Psychology, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran.

3 Associate Professor in Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.

4 Assistant Professor, Department of Counseling, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran

Abstract

Aim: The aim of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) on sexual satisfaction and body image in women with drug abuse.
 
Method: The research method was quasi-experimental, including a pre-test, post-test design with a control group, and a two-month follow-up. The statistical population comprised all individuals with opioid abuse who referred to addiction treatment centers for women in Tehran in 2014. Using the available sampling method, 28 women at Behbud Gostarane Hamgam were selected and randomly assigned to the experimental and control groups. The research tools were the Female Sexual Function Inventory (FSFI) by Rosen & Heiman (2000) and the Body Image Concern Inventory (BICI) by Littleton, Axom & Pury (2005). The experimental group received 8 sessions of 90 minutes (twice a week) of mindfulness-based cognitive therapy for one month. The data were analyzed using repeated measures analysis of variance.
 
Results: The results showed that mindfulness-based cognitive therapy was effective in improving sexual satisfaction and body image in women with drug abuse, and this effect was sustained in the follow-up examination (p > 0.05).
 
Conclusion: Results provide preliminary support for the use of mindfulness-based cognitive therapy to address concerns about body image and increase sexual satisfaction in women with substance abuse.

Keywords


Abbasi, F., Badami, R., & Jalali, D. (2017). The Effect of Mindfulness and Acceptance Training on Body Image Concerns, Mental Skills and Free Throw Shooting Performance in Male Basketball Players with Wheelchairs.  Positive psychology Research, 4 (2): 25-40. [link]
Adams, C.E., Benitez, L., Kinsaul, J., McVay, M.A., Barbry, A., Barbry, A, Thibodeaux, A., & Copeland, A.L. (2013). Effects of Brief Mindfulness Instructions on Reactions to Body Image Stimuli among Female Smokers: An Experimental Study. Nicotine Tob Res, 15(2): 376–384. [link]
Adam, F., De Sutter, P., Day, J., & Grimm, E. (2020). A Randomized Study Comparing Video-Based Mindfulness-Based Cognitive Therapy With Video-Based Traditional Cognitive Behavioral Therapy in a Sample of Women Struggling to Achieve Orgasm. J Sex Med, 17(2):312-324. [link]
Aggarwal, N., Kherada, S., Gocher, S., & Sohu, M. (2016). A study of assessment of sexual dysfunction in male subjects with opioid dependence. Asian Journal of Psychiatry, 23:17-23. [link]
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders. Fifth Edition. [Link]
Arora, N., & Brotto, L.A. (2017). How does paying attention improve sexual functioning in women? A review of mechanisms. Sexual Medicine Reviews, 5(3): 266-274. [link]
Auteri, S. (2014). What you need to know female sexual response?  American Association of Sexuality Educators, Counselors and Therapists (AASECT). [link]
Aydin, Y., Evrensel, A., & Ceylan, M.E. (2018). Body image, self-esteem and social anxiety levels in individuals with alcohol and substance abuse. Medicine Science International Medical Journal, 7(2):260-264. [link]
Barrington, J. (2017). Mindfulness as a Protective Factor against Body Dissatisfaction: Mechanism of Action. Electronic Theses and Dissertations. 7237. [link]
Basson, R. (2000). The female sexual response: A different model. Journal of Sex &Marital Therapy, 26 (1): 51-56. [link]
Behzad, S., Khodabakhshi Koolaee, A., &Taghvaee, D. (2016). The Comparison of Body Image, Quality of Sleep and Marital Satisfaction among Substance Abuser and Non-substance Abuser Women. Community Health; 3(1): 31-40. [link]
Brotto, L., Chivers, M., Millman, R, & Albert, A. (2016). Mindfulness-based sex therapy improves genital-subjective arousal concordance in women with sexual desire/arousal difficulties. Archives of Sexual Behavior, 45:1907-1921. [link]
Brotto, L., Basson, R., Smith, K., Driscoll, M., & Sadownik, L. (2014). Mindfulness based group therapy for women with provoked vestibulodynia. Mindfulness, 6: 417-432. [link]
 Brotto, L.A., Yong, P., Smith, K.B., & Sadownik, L.A. (2015). Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. Journal of Sexual Medicine, 12(1): 238-247. [link]
Brotto, L., Bergeron, S., Zdaniuk, B., Driscoll, M., Grabovac, A., Sadownik, L.A., Smith, K.B., & Basson, R. (2019). A Comparison of Mindfulness-Based Cognitive Therapy Vs Cognitive Behavioral Therapy for the Treatment of Provoked Vestibulodynia in a Hospital Clinic Setting. Journal of Sexual Medicine, 16,909-923. [link]
Brotto, L.A., Erskine, Y., Carey, M., Ehlen, T., Finlayson, S., Heywood, M., Kwon, J., McAlpine, J., Stuart, G., Thomson, S., & Miller, S. (2012). A brief mindfulness based cognitive behavioral intervention improves sexual functioning versus wait-list control in women treated for gynecologic cancer. Gynecol Oncol, 125 (2):320-325. [link]
Bowns, C.N., & Marlatt, G.A. (2011). Mindfulness-based relapse prevention for addictive behaviors: a clinician’s guide. New York: Guilford press. [link]
Carvalheira, A., Godinho, L., & Costa, P. (2017). The impact of body dissatisfaction on distressing sexual difculties among men and women: the mediator role of cognitive distraction. Journal of Sexual Medicine, 54(3): 331–340. [link]
Cook-Cottone, C.P. (2015). Incorporating positive body image into the treatment of eating disorders: A model for attunement and mindful self-care. Body Image, 14,158-167. [link]
Dove, L., & Wiederman, N.M. (2000). Cognitive distraction and women’s sexual functioning. Journal of Sex & Marital Therapy, 26(1): 67-78. [link]
El-Sheikh, A., Mesallam, D.I., Abedelsalam, N.M., Allam, R., & Saad, A. (2018). Sex hormones genes expression and sexual dysfunction association among male heroin addicts at Zagazig University Hospitals, Egypt. Zagazig Journal of Forensic Medicine, 16(2):1-16. [link]
Esteve-Ríos, A., Garcia-Sanjuan, S., Oliver-Roig, A., & Cabañero-Martínez, M.J. (2020). Effectiveness of interventions aimed at improving the sexuality of women with multiple sclerosis: a systematic review. Clinical Rehabilitation, 34(4):438-449. [link]
Fani Sobhani, F. Khalatbari, J., & Rahmati, S. (2018). Effectiveness of Cognitive Behavioral Therapy based on body image on sexual satisfaction and marital adjustment of married infertile women. Journal of Applied Psychology, 12(1): 25-46. [link]
Fernandes, D.V., Gouveia, M.J., Canavarro, M.C., & Moreira. H. (2018). Mindfulness and psychological adjustment in paediatric obesity: The mediating role of body image Psychology. Community & Health, 7(1):122–137. [link]
Fuller-Tyszkiewicz, M., Richardson, B., Lewis, V., Linardon, J., Mills, J., Juknaitis, K., Lewis, C., Coulson, K., O'Donnell, R., Arulkadacham, L., Ware, M., & Krug, I. (2019). A randomized trial exploring mindfulness and gratitude exercises as eHealth-based micro-interventions for improving body satisfaction. Computers in Human Behavior,95:58-65. [link]
Gottman, J., & Silver, N. (1999). The Seven Principles for Making Marriage Work. Crown Publishers imprint. [link]
Griffith, C., & France, B.L. (2019). Difference between Men and Women in Drug Use Disorders. Archives of Clinical and Medical Case Reports, 3(1): 27-32. [link]
Hajiha, Z., Bahrami Ehsan, H., & Rostami, R. (2018). Addict Women’s Lived Experience in Tehran: Development of an Explanatory Model. Etiadpajohi, 12 (47):111-134. [link]
Holzel, B.K., Lazar, S.W., Gard, T., Schuman-Olivier, Z., Vago, D.R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6): 537-559. [link]
Hocaloski, S., Elliott, S., Brotto, L., Breckon, E., & McBride, K. (2016). A mindfulness psych educational group intervention targeting sexual adjustment for women with multiple sclerosis and spinal cord injury: A pilot study. Sexual Disabil, 34:183-198. [link]
Holzhauer, C.G., Zenner, A., &Wulfert, E. (2016). Poor body image and alcohol use in women. Psychol Addict Behav, 30(1):122-127. [link]
Hoveizeh, Z., & DashtBozorgi, Z. (2018). Effectiveness of Mindfulness-based Cognitive Therapy on Physical Self-Description and Repetitive Negative Thinking of Female Adolescent with Eating Disorder. Community Health journal, 11(3, 4): 65-75. [link]
Hucker, A., & McCabe, M. (2015). Incorporating mindfulness and chat groups into an online cognitive behavioral therapy for mixed female sexual problems. J Sex Res, 52: 627-639. [link]
Jaderek, I., & Lew-Starowicz, M. A Systematic Review on Mindfulness Meditation-Based Interventions for Sexual Dysfunctions. J Sex Med, 16(10):1581-1596. [link]
Jones, A., Winter, V.R., Pekarek, E., & Walters, J. (2018). Binge drinking and cigarette smoking among teens: Does body image play a role? Child Youth Serv Rev, 91: 232-236. [link]
Karremans, J.C., Schellekens, M.P.J., & Kappen, G. (2017). Bridging the sciences of mindfulness and romantic relationships: A theoretical model and research agenda. Personality and Social Psychology Review, 21(1): 29–49. [link]
Kabat-Zinn, J.(2015). Mindfulness. Mindfulness. 6:1481–1483. [link]
Khaddouma, A., Gordon, K.C., & Bolden, J. (2015). Zen and the art of dating: Mindfulness, differentiation of self, and satisfaction in dating relationships. Journal Sexual and Relationship Therapy, 30(2): 268-285. [link]
Khoshkerdar, P., & Raeisi, Z. (2020). The effect of mindfulness‐based stress reduction on body image concerns of adolescent girls with dysfunctional eating attitudes. Australian Journal of Psychology, 72(1): 11-19. [link]
Khodabakhshi-Koolaee, A., Sarvestani, A., Mansour, L., Habibi, H., & Rahmatizadeh, M. (2015). Impact of Methamphetamine and Opium Use in Sexual Satisfaction and Body Image in Married Substance and Non-substance User Men. Social Determinants of Health, 1(2): 71-80. [link]
Khodabakhshi  Koolae,  A.,  Eslamei,  M.,  & Mohamadi,  F. (2017). The  Effectiveness  of  Hope  Group  Therapy  on  Body  Image and Sexual Satisfaction in Addicted Men: A Randomized Controlled Randomized Clinical Trial Study. Community  Health, 4(1):24-33. [link]
Kvalem, I.L., Træen, B., Markovic, A., & Von Soest, T. (2019). Body image development and sexual satisfaction: A prospective study from adolescence to young adulthood. J Sex Res, 56(6): 791–801. [link]
Lavell, C.H., Webb, H.J., Zimmer-Gembeck, M.J., & Farrell, L.J. (2018). A prospective study of adolescents’ body dysmorphic symptoms: Peer victimization and the direct and protective roles of emotion regulation and mindfulness. Body Image, 24:17-25. [link]
Lazaridou, A., & Kalogianni, C. (2013). Mindfulness and sexuality. Sexual and Relationship Therapy, 28: 29-38. [link]
Leshner, A.I. (1998). Drug addiction research and the health of women. Edited by: Wetherington, C. L., Roman. US National Institute of Health: DIANE publishing Co. [link]
Littleton, H.L., Axom, D.S., & Pury, C.L. (2005). Development of the Body Image Concern Inventory. Behavior Research and Therapy, 43: 229- 241. [link]
Lin, H.C., & Lin Y.C. (2018). The Study of Body Image, Self-esteem and Sexual Satisfaction of College Students in Southern Taiwan. Universal Journal of Educational Research, 6(4): 647-652. [link]
Lin, C.Y., Potenza, M.N., Broström, A., Blycker, G.R., & Pakpour, A.H. (2019). Mindfulness-based cognitive therapy for sexuality (MBCT-S) improves sexual functioning and intimacy among older women with epilepsy: A multicenter randomized controlled trial. Seizure: European Journal of Epilepsy, 73: 64-74. [link]
Marvi, N., Golmakani, N., Esmailee, H., & Shareh, H. (2018). The Relationship between Sexual Satisfaction and Genital Selfimage in Infertile Women. Journal of Midwifery and Reproductive Health, 6(4):1468-1475. [link]
Marques, J. (2017). A mindful moral compass for twenty-first century leadership: the noble eightfold path. Journal of Values-Based Leadership, 10(1):1-20. [link]
McCabe, M., Althof, S.E., Assalian, P., Chevret-Measson, M., Leiblum, S.R., Simonelli, C., & Wylie, K. (2010). Psychological and interpersonal dimensions of sexual function and dysfunction. The Journal of Sexual Medicine, 7(2): 327-336. [link]
Mohammadi, Kh., Heydari, M., & Faghihzadeh, S. (2008). The Female Sexual Function Index (FSFI): validation of the Iranian version. Payesh, 7 (3): 269-278. [link]
Moradi, M., & Samari, A.A. (2017). Effectiveness of mindfulness-based cognitive therapy on clinical syndrome and body image in women with bulimia nervosa. Journal of Fundamentals of Mental Health, 19(5): 549-556. [link]
Mousavi Asl, S.S. (2015). Investigating the relationship between ego development and concerns about body image. Third National Conference on Mental Health and Wellness papers. Quchan, Iran. [link
Mousavi, S.A., Pourhosein, R., Zare Moghaddam, A., Rahmatnejad, A., & Gomnam, A. (2016). Effectiveness of mindfulness-based cognitive therapy (MBCT) on the body image in the male body-building athletes. Applied Psychological Research Quarterly, 7 (2): 127-140. [link]
National Institute of Drug Abuse Advancing addiction science (2018). Heroin. Government Office. Washington DC. [link]
Neumark-Sztainer, D., Watts, A.W., & Rydell, S. (2018). Yoga and body image: How do young adults practicing yoga describe its impact on their body image? Body Image, 27(13):156-168. [link]
Paterson, L., Handy, A., & Brotto, L.A. (2016). Pilot study of eight-session mindfulness-based cognitive therapy adapted for women's sexual interest/arousal disorder. J Sex Res, 54: 859-861. [link]
Quinn-Nilas, C., Benson, L., Milhausen, R.R., Buchholz, A.C., & Goncalves, M. (2016). The Relationship between Body Image and Domains of Sexual Functioning Among Heterosexual, Emerging Adult Women. Send to Sex Med, 4(3): e182-9. [link]
Rosen, R., Brown, C., & Heiman, J. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26(2):191-208. [link]
Rao, T.S.S., Maheshwari, S., George, M., Chandran, S., Manohar, S., & Rao, S.S. (2018). Psychosocial interventions for sexual dysfunction in addictive disorders. Indian J Psychiatry, 60(8): 506-509. [link]
Sadri Damirchi, E., asadi shishegaran, S., & Esmaili Ghazivalooi, F. (2017). Effectiveness of Mindfulness-Based Cognitive Therapy in Craving, Dependency, and Cognitive Emotion Regulation in Drug-Dependent Women. Etiadpajohi, 11 (43):51-69. [link]
Salmani, K., Amini, H., Bayatpor, M., Fazell Kalkhoran, J., Salehi, M. (2017). The relationship between body image and body mass index with mental health in the course of development. Quarterly Journal of Child Mental Health, 4(3): 3-15. [link]
Shabani, J., & Abdi, H. (2020). The Effectiveness of Mindfulness-Based Cognitive Therapy on Sexual Disorders and Sexual Satisfaction in Women with spouses’ extra-marital relationships. RBS, 18 (1):60-69. [link]
Shiukhy Soqanloo, R., Vaziri, S., & Lotfi Kashani, F. (2015). Effectiveness of sex mindfulness training on sexual satisfaction of married women. Journal of Novel Applied Sciences, 4(9), 1007-1011. [link]
Stephenson, K.R., & Kerth, J. (2017). Effects of mindfulness-based therapies for female sexual dysfunction: A meta-analytic review. J Sex Res, 54: 832-849. [link]
Tsai, A., Hughes, E.K., Fuller-Tyszkiewicz, M., Buck, K., Krug, I. (2017). The Differential Effects of Mindfulness and Distraction on Affect and Body Satisfaction Following Food Consumption. Front Psychol, 8:1696. [link]
Velten, J., Margraf, J., Chivers, M., & Brotto, L. (2018). Effects of a Mindfulness Task on Women’s Sexual Response. The Journal of Sex Research, 55(6): 747-757. [link]
Zamzami, A., Agahheriss, M., & Alipor, A. (2015). The efficacy of Behavioral-mindfulness Intervention on Self-concept Promotion and Life Quality Improvement of Female Students with Negative Body Image. Clinical Psychology and Personality, 2 (23): 71-84. [link]
Zhang, M., Zhang, H., Shi, C.X., McGoogan, J., Zhang, B., Zhao, L., Zhang, M., Rou, K., & Wu, Z. (2014).  Sexual dysfunction improved in heroin-dependent men after methadone maintenance treatment in Tianjin, China. PLoS One, 9(2): e88289. [link]
Woertman, L., & Van Den Brink, F. (2012). Body image and female sexual functioning and behavior: a review. The Journal of Sex Research, 49(3):184-211. [link]
Webb, J.B., Rogers, C.B., Etzel, L., & Padro, M.P. (2018). Mom, quit fat talking—I'm trying to eat (mindfully) here!: Evaluating a sociocultural model of family fat talk, positive body image, and mindful eating in college women. Appetite, 26,169-175. [link]