@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2017;9(3):111-117
ISSN: 2008-2630 Iranian Journal of War & Public Health 2017;9(3):111-117
Effectiveness of Emotion-Focused Therapy on Emotional Dysregulation, Hopelessness and Suicidal Ideation in Post-Traumatic Stress Disorder Veterans
ARTICLE INFO
Article Type
Original ResearchAuthors
Mikaeili N. (1)Molavi P. (2)
Einy S. (*)
Tagavy R. (3)
(*) Psychology, Educational Sciences & Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
(1) Psychology, Educational Sciences & Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
(2) Psychiatry, Medical, Ardabil University of Medical Sciences, Ardabil, Iran
(3) Psychology, Psychology, Ardabil Branch, Islamic Azad University, Ardabil, Iran
Correspondence
Address: Psychology and Educational Sciences Faculty, End of Daneshgah Street, University of Mohaghegh Ardabili, Ardabil, IranPhone: +98 (45) 33262678
Fax: +98 (45) 33511508
sanaz.einy@yahoo.com
Article History
Received: January 29, 2017Accepted: March 11, 2017
ePublished: July 27, 2017
ABSTRACT
Aims
Post-Traumatic Stress Disorder (PTSD) is one of the prominent psychological
consequences of war that is seen in veterans. Emotion-focused therapy is a short-term
intervention that can target a range of disruptions to the disorder. The purpose of this study
was to investigate the efficacy of emotion-focused therapy on emotional distress, suicidal
ideation and disappointment of veterans with PTSD.
Materials & Methods In this semi-experimental design with pretest-posttest design with control group in year 2016, 50 veterans with PTSD who were referred to Isfahan Ardabil psychiatric hospital were selected through convenient sampling and randomly assigned to two groups of experimental and control groups. The data were collected using a post-traumatic stress disorder checklist-military version, Desperate Beck Questionnaire, Beck Suicidal Thinking Scale, and Threat Settlement Scale. Then, the sessions focused on excitement were performed for 8 sessions of 1.5 hours for the experimental group. Data were analyzed by SPSS 23 software using multivariate covariance analysis test.
Findings After controlling the effects of pretest, there was a significant difference between the mean posttest scores of the two groups in each of the emotional maladaptive, suicidal ideation and disappointment variables (p<0.05).
Conclusion Emotion-focused therapy can reduce emotional distress, suicidal thoughts and frustration of veterans with PTSD.
Materials & Methods In this semi-experimental design with pretest-posttest design with control group in year 2016, 50 veterans with PTSD who were referred to Isfahan Ardabil psychiatric hospital were selected through convenient sampling and randomly assigned to two groups of experimental and control groups. The data were collected using a post-traumatic stress disorder checklist-military version, Desperate Beck Questionnaire, Beck Suicidal Thinking Scale, and Threat Settlement Scale. Then, the sessions focused on excitement were performed for 8 sessions of 1.5 hours for the experimental group. Data were analyzed by SPSS 23 software using multivariate covariance analysis test.
Findings After controlling the effects of pretest, there was a significant difference between the mean posttest scores of the two groups in each of the emotional maladaptive, suicidal ideation and disappointment variables (p<0.05).
Conclusion Emotion-focused therapy can reduce emotional distress, suicidal thoughts and frustration of veterans with PTSD.
CITATION LINKS
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[28]Prochaska JO, Norcross JC. Systems of psychotherapy. Seyyed Mohammadi Y, translator. Pacific Grove: Brooks Cole; 2009.
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[30]Greenberg LS, Paivio SC. Working with the emotions in psychotherapy. New York City: Guilford Press; 1997. pp. 14-290.
[31]Church D. The treatment of combat trauma in veterans using EFT (Emotional Freedom Techniques): A pilot protocol. J Traumatology. 2010:16(1):55-65.
[32]Church D, Hawk C, Brooks AJ, Toukolehto O, Wren M, Dinter I, et al. Psychological trauma symptom improvement in veterans using emotional freedom techniques: A randomized controlled trial. J Nerv Ment Dis.. 2013;201(2):153-60.
[33]Akbari E, Poursharifi H, Fahimi S, Azimi Z, Alilou MM, Amiri Pichakolaei A, et al. Effectiveness of emotion focused therapy on sexual victims of romantic relationships: A single case study. J Fundam Ment Health. 2016;18(1):10-21. [Persian]
[34]Khojasteh Mehr R, Shiralinia KH, Rajabi GH, Beshlideh K. The effects of emotion-focused couple therapy on depression symptoms reduction and enhancing emotional regulation in distressed couples. Appl Couns. 2012;3(1):1-18. [Persian]
[35]Sobhi-Gharamaleki N, Porzoor P, Aghajani S, Narimani M. Effectiveness of emotion regulation training on reduction of anxiety, stress and depression symptoms among university students. Health Educ Health Promot. 2015;3(1):5-13. [Persian]
[36]Golpour R, Abolghasemi A, Ahadi B, Narimani M. The effectiveness of cognitive self-compassion training and emotion-focused therapy on quality of life with depression disorder. J Clin Psychol. 2014;1(21):53-64. [Persian]
[37]Weathers FW, Keane TM, Davidson JR. Clinician-administered PTSD scale: A review of the first ten years of research. Depress Anxiety. 2001;13(3):132-56.
[38]Mirzaee J, Karami GR, Ameli J, Hemmati MA. Investigation of clinical diagnosis by psychological tests in PTSD outpatients and inpatients. J Mil Med. 2004;6(3):201-8. [Persian]
[39]Goodarzi MA. Reliability and validity of post- traum atic stress disorder Mississippi scale. J Psychol. 2003;7(2):135-78. [Persian]
[40]Beck AT, Weissman A, Lester D. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol. 1974;42(6):861-5.
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[42]Yousefi N, Shirbigy N. The relationship between acceptation in ma exam with hopelessness and self–handicapping. Iran High Educ. 2012;4(4):159-81. [Persian]
[43]Kaviani H. Interview and psychological inventories. 1st edition. Tehran: Besat Press; 2002. pp. 171-8. [Persian]
[44]Gratz KL, Roemer L. Multidimensional assessment of emotion regulation a dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2008;30(4):315-9.
[45]Asgari P, Pasha G, Aminian M. The relationship emotional regulation, life events and body image with eating disorder in women. Andisheh va Raftar. 2009;4(13):65-78. [Persian]
[46]Greenberg LS. Emotion-Focused The rapy: A Clinical Synthesis. J Lifelong Learn Psychiatry. 2010;8(1):32-42.
[47]Sabury M. The effectiveness of cognitive therapy in reducing suicidal thoughts and emotion-focused cognitive triangle patients with major depression [Dissertation]. Mashhad: Mashhad University; 2013. [Persian]
[48]Schotte DE, Clum GA. Problem- solving skills in suicidal psychiatric patients. J Consult Clin Psychol. 1987;55(1):49-54.
[49]Narimani M, Alisari Nasirlou K, Effat Parvar S. The effectiveness of emotion-focused training for cognitive emotional regulation strategies of emotionally abused students. Appl Couns. 2013;3(2):37-50. [Persian]
[2]Tull MT, Barrett HM, McMillan ES, Roemer L. A preliminary investigation of relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behav Ther. 2007;38(3):303-13.
[3]Leahy R, Napolitano LA, Tirch D. Emotion regulation in psychotherapy: A practitioners guide. New York: Guilford Press; 2011.
[4]Foa EB, Kozak MJ. Emotional processing of fear: Exposure to corrective information. Psychol Bull. 2008;99(1):20-35.
[5]Mazloom M, Yaghubi H, Mohammadkhani S. The relationship of metacognitive beliefs and emotion regulation difficulties with posttraumatic stress disorder. J Behav Sci. 2014;8(2):105-13. [Persian]
[6]Bardeen JR, Kumpula MJ, Orcutt HK. Emotion regulation difficulties as a prospective predictor of posttraumatic stress symptoms following as mass shooting. J Anxiety Dis. 2013;27(2):188-96.
[7]Ozdamir O, Boysan M, Ozdamir PG, Yilmaz E. Relationships between posttraumatic stress disorder (PTSD), dissociation, quality of life, hopelessness, and suicidal ideation among earthquake survivors. Psychiatry Res. 2015;228(2):598-605.
[8]Azad Marzabadi E, Moqtadaee K, Aria Pooran S. The effectiveness of mindfulness training on psychological symptoms in veterans with post- traumatic stress disorder. J Behav Sci. 2013;7(1):67-74. [Persian]
[9]Sheykhan R, Ghazanfari F, Jadidi F, Adineh M, Sadrmohamadi R. Attachment styles and cognitive emotion regulation strategies as predictor of post-traumatic stress disorder in veterans. J Mazand Univ Med Sci. 2016;26(137):95-104. [Persian]
[10]krysinska k, Lester D. Post-traumatic stress disorder and suicide risk: A systematic review. Arch Suicide Res. 2010;14(1):1-23.
[11]Panagioti M, Gooding PA, Tarrier N. A meta-analysis of the association between posttraumatic stress disorder and suicidality: The role of comorbid depression. Compr Psychiatry. 2012;53(7):915-30.
[12]Coohey C, Dirks- Bihun A, M.Renner L, Baller R. Strain, depressed mood and suicidal thoughts among maltreated adolescents in the United States. Child Abuse Negl. 2014;38(7):1171-9.
[13]Leiner AS, Compton MT, Houry D, Nadine J, Kaslow J. Intimate partner violence, psychological distress, and suicidality: A path model using data from African American women seeking care in an urban emergency department. J Fam Violence. 2008;23(6):473-81.
[14]Pompili M, Sher L, Serafini G, Forte A, Innamorati M, Dominici G, et al. Posttraumatic stress disorder and suicide risk among veterans: A literature review. J Nerv Ment Dis. 2013;201(9):802-12.
[15]Ghamari-Givi H, Hosseini Kiasari ST. The effectiveness of cognitive- existential group therapy on hopelessness in patients with multiple sclerosis. Daneshvar. 2014;21(112):1-11. [Persian]
[16]Snyder CR. Hope theory: rainbows in the mind. Psychol Inq. 2002;13(4):249-75.
[17]Hasson-Ohayon I, Kravetz S, Meir T, Rozencwaig S. Insight into severe mental illness, hope, and quality of life on persons with schizophrenia and schizoaffective disorders. Psychiatry Res. 2009;167(3):231-8.
[18]Johnson KL. The relationship of hope and quality of life in combat veterans seeking treatment for posttraumatic stress disorder. Kansas: University of Kansas, Psychology and Research in Education Publisher; 2001. pp. 29-58.
[19]Leahy RL. Cognitive therapy techniques: A practitioner s guide. 2rd edition. Fata L, Shakiba Sh, Tahmasbi Moradi Sh, Naseri H, Ziaei K, translators. New York City: Guilford Press; 2001. [Persian]
[20]Paunović N. Exposure inhibition therapy as a treatment for chronic posttraumatic stress disorder: A controlled pilot study. Psychology. 2011;2(6):605-14.
[21]Talbot NL, Gamble SA. IPT for women with trauma histories in community mental health care. J Contemp Psychother. 2008;38(1):35-44.
[22]McCarthy KS, Connolly-Gibbons MB, Barber JP. The relation of rigidity across relationship with symptoms and functioning: An investigation with the revised central relationship questionnaire. J Couns Psychol 2008;55(3):346-58.
[23]Fridja NH. The emotions. Cambridge, MA: Cambridge University Press; 1986. pp. 9-41.
[24]Greenberg LJ, Warwar SH, Malcolm WM. differential effects of emotion-focused therapy and psychoeducation in facilitating forgiveness and letting go of emotional injuries. J Counsel Psychol. 2008;55(2):185-96.
[25]Pos AE, Greenberg LS. Emotion-focused therapy: The trans- forming power of affect. J Contemp Psychother. 2007;37(1):25-31.
[26]Greenberg LS, Angus L. The contribution of emotion processes to narrative change: A dialectical-constructivist approach. In: Angus L, McLeod J, editors. Handbook of narrative and psychotherapy: Practice, theory, and research. Thousand Oaks, CA, US: Sage Publications; 2004. pp. 331-50.
[27]Greenberg LS. Emotion focused therapy for depression. Pers Exp Psychother. 2017;16(2):106-17.
[28]Prochaska JO, Norcross JC. Systems of psychotherapy. Seyyed Mohammadi Y, translator. Pacific Grove: Brooks Cole; 2009.
[29]Greenberg LS, Foerster F. Task analysis exemplified: The process of resolving unfinished business. J Cons Clin Psychol. 1996;64(3):439-46.
[30]Greenberg LS, Paivio SC. Working with the emotions in psychotherapy. New York City: Guilford Press; 1997. pp. 14-290.
[31]Church D. The treatment of combat trauma in veterans using EFT (Emotional Freedom Techniques): A pilot protocol. J Traumatology. 2010:16(1):55-65.
[32]Church D, Hawk C, Brooks AJ, Toukolehto O, Wren M, Dinter I, et al. Psychological trauma symptom improvement in veterans using emotional freedom techniques: A randomized controlled trial. J Nerv Ment Dis.. 2013;201(2):153-60.
[33]Akbari E, Poursharifi H, Fahimi S, Azimi Z, Alilou MM, Amiri Pichakolaei A, et al. Effectiveness of emotion focused therapy on sexual victims of romantic relationships: A single case study. J Fundam Ment Health. 2016;18(1):10-21. [Persian]
[34]Khojasteh Mehr R, Shiralinia KH, Rajabi GH, Beshlideh K. The effects of emotion-focused couple therapy on depression symptoms reduction and enhancing emotional regulation in distressed couples. Appl Couns. 2012;3(1):1-18. [Persian]
[35]Sobhi-Gharamaleki N, Porzoor P, Aghajani S, Narimani M. Effectiveness of emotion regulation training on reduction of anxiety, stress and depression symptoms among university students. Health Educ Health Promot. 2015;3(1):5-13. [Persian]
[36]Golpour R, Abolghasemi A, Ahadi B, Narimani M. The effectiveness of cognitive self-compassion training and emotion-focused therapy on quality of life with depression disorder. J Clin Psychol. 2014;1(21):53-64. [Persian]
[37]Weathers FW, Keane TM, Davidson JR. Clinician-administered PTSD scale: A review of the first ten years of research. Depress Anxiety. 2001;13(3):132-56.
[38]Mirzaee J, Karami GR, Ameli J, Hemmati MA. Investigation of clinical diagnosis by psychological tests in PTSD outpatients and inpatients. J Mil Med. 2004;6(3):201-8. [Persian]
[39]Goodarzi MA. Reliability and validity of post- traum atic stress disorder Mississippi scale. J Psychol. 2003;7(2):135-78. [Persian]
[40]Beck AT, Weissman A, Lester D. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol. 1974;42(6):861-5.
[41]Dejhkam N, Sharifi HP, Human HA. Conformity and norm of the beck hopelessness scale among students of Tehran Islamic Azad University [Dissertation]. Tehran: Tehran University; 2003. [Persian]
[42]Yousefi N, Shirbigy N. The relationship between acceptation in ma exam with hopelessness and self–handicapping. Iran High Educ. 2012;4(4):159-81. [Persian]
[43]Kaviani H. Interview and psychological inventories. 1st edition. Tehran: Besat Press; 2002. pp. 171-8. [Persian]
[44]Gratz KL, Roemer L. Multidimensional assessment of emotion regulation a dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2008;30(4):315-9.
[45]Asgari P, Pasha G, Aminian M. The relationship emotional regulation, life events and body image with eating disorder in women. Andisheh va Raftar. 2009;4(13):65-78. [Persian]
[46]Greenberg LS. Emotion-Focused The rapy: A Clinical Synthesis. J Lifelong Learn Psychiatry. 2010;8(1):32-42.
[47]Sabury M. The effectiveness of cognitive therapy in reducing suicidal thoughts and emotion-focused cognitive triangle patients with major depression [Dissertation]. Mashhad: Mashhad University; 2013. [Persian]
[48]Schotte DE, Clum GA. Problem- solving skills in suicidal psychiatric patients. J Consult Clin Psychol. 1987;55(1):49-54.
[49]Narimani M, Alisari Nasirlou K, Effat Parvar S. The effectiveness of emotion-focused training for cognitive emotional regulation strategies of emotionally abused students. Appl Couns. 2013;3(2):37-50. [Persian]