Comparison of the Effectiveness of Cognitive Behavioral Therapy and Schema Therapy on Emotional Regulation and Resilience of Mothers with Children with Attention Deficit/Hyperactivity Disorder
DOI:
https://doi.org/10.61838/kman.pdmd.3.1.2Keywords:
Obsessive, compulsive symptoms, Schema therapy, Mindfulness, Cognitive behavioral therapy, compulsive disorderAbstract
Background and Objective: The present study aimed to compare the effectiveness of Cognitive Behavioral Therapy (CBT) and Schema Therapy (ST) on emotional regulation and resilience of mothers with children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD).
Methods and Materials: The research method was semi-experimental with a pre-test, post-test control group design, and follow-up. The statistical population consisted of all mothers with children aged 3 to 7 years with ADHD in Tehran in 2023. From this population, 45 participants were selected through convenience sampling and randomly assigned to two experimental groups (each with 15 participants) and one control group (15 participants). The CBT group received 10 sessions of 60 minutes each, while the ST group received 12 sessions of 60 minutes each, and the control group was placed on a waiting list. The instruments used in the present study included the Emotion Regulation Questionnaire (ERQ; Garnefski & Kraaij, 2006) and the Connor-Davidson Resilience Scale (CD-RISC; Connor & Davidson, 2003). Data analysis was conducted in two sections: descriptive and inferential (repeated measures analysis of variance).
Findings: Results indicated a significant difference between the ST and CBT groups at the 0.05 level for the components of positive refocusing and positive reappraisal. Thus, considering the post-test means, the ST method had a more significant effect on changing the components of positive refocusing and positive reappraisal compared to the CBT group. Additionally, results showed a significant difference between ST and CBT at the 0.05 level for resilience, indicating that ST had a more significant effect on changing resilience compared to the CBT group. Furthermore, the present study demonstrated that CBT and ST could improve the study variables in mothers with children with ADHD during the follow-up stage.
Conclusion: This study highlights the significant impact of Schema Therapy over Cognitive Behavioral Therapy in enhancing emotional regulation and resilience among mothers with children diagnosed with ADHD. The findings suggest that both therapeutic approaches are beneficial, but Schema Therapy offers a more substantial improvement in the measured variables, which sustains over time.
Downloads
References
Abdolmohamadi, K., & Ghadiri, F. (2023). Executive Functions and Sluggish Cognitive Tempo in People with Depressive
Disorder and Normal. Psychology of Exceptional Individuals, 13(49), 208-232.
https://doi.org/10.22054/jpe.2023.70975.2512
Alizadeh Asli, A., & Jafar Nezhad Langroudi, Z. (2018). The Effectiveness of Schema Therapy Based on Acceptance and
Mindfulness in Intimacy, Adaptation and Resiliency in Persons with Marital Conflicts in Couples of City Karaj [case
report]. Alborz University Medical Journal, 7(3), 248-256. https://doi.org/10.29252/aums.7.3.248
Álvarez, N., Lázaro, M. H., Gordo, L., Elejalde, L. I., & Pampliega, A. M. (2022). Maternal mentalization and child emotion
regulation: A comparison of different phases of early childhood. Infant Behavior and Development, 66, 101681.
https://doi.org/10.1016/j.infbeh.2021.101681
Anker, E., Haavik, J., & Heir, T. (2020). Alcohol and drug use disorders in adult attention-deficit/hyperactivity disorder:
prevalence and associations with attention-deficit/hyperactivity disorder symptom severity and emotional dysregulation.
World journal of psychiatry, 10(9), 202. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7515748/
Arch, J. J., Ayers, C. R., Baker, A., Almklov, E., Dean, D. J., & Craske, M. G. (2013). Randomized clinical trial of adapted
mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders.
Behaviour Research and Therapy, 51(4), 185-196.
https://www.sciencedirect.com/science/article/pii/S0005796713000144
Asarnow, R. F., Newman, N., Weiss, R. E., & Su, E. (2021). Association of Attention-Deficit/Hyperactivity Disorder Diagnoses
With Pediatric Traumatic Brain Injury: A Meta-analysis. JAMA Pediatrics, 175(10), 1009-1016.
https://doi.org/10.1001/jamapediatrics.2021.2033
Assari, S., Caldwell, C. H., & Bazargan, M. (2019). Association Between Parental Educational Attainment and Youth
Outcomes and Role of Race/Ethnicity. JAMA Network Open, 2(11), e1916018-e1916018.
https://doi.org/10.1001/jamanetworkopen.2019.16018
Azadeh Seyf Hosseini, A. S. H., Asadi, J., Sanagoo, A., & Khajvandkhoshly, A. (2019). Comparison of Schema Therapy Based
on Group Therapy and Mindfulness – Based Stress Reduction on resiliency in mothers of children with cancer. medical
journal of mashhad university of medical sciences, 62(December), 411-420. https://doi.org/10.22038/mjms.2019.14914
Baniadam, l., Makvand Hoseini, S., & Sedaghat, M. (2017). The efficacy of schema therapy on obsessive compulsive disorder
and Marital Satisfaction on Married Women. Journal of Applied Psychological Research, 8(2), 131-143.
https://doi.org/10.22059/japr.2017.68337
Baucom, D. H., Epstein, N. B., Kirby, J. S., & LaTaillade, J. J. (2010). Cognitive-behavioral couple therapy. In Handbook of
cognitive-behavioral therapies, 3rd ed. (pp. 411-444). Guilford Press. https://psycnet.apa.org/record/2010-10108-013
Beheshti, A., Chavanon, M.-L., & Christiansen, H. (2020). Emotion dysregulation in adults with attention deficit hyperactivity
disorder: a meta-analysis. BMC psychiatry, 20(1), 120. https://doi.org/10.1186/s12888-020-2442-7
Blair, L. A. (2021). Marital Coping and Resilience in Couples with One Partner with a Common Variable Immune Deficiency
Diagnosis Northcentral University]. https://search.proquest.com/openview/dd3db16e1fc23cfaf792ce8f56bdecde/1?pq-
origsite=gscholar&cbl=18750&diss=y
Borjali, P. D., M., Madbeigi, Z., & Gholshani, P. D., F. (2017). The Relationship between Early Maladaptive Schemas,
Maternal Attachment Styles, and Anxiety Disorders in Children [Research]. Quarterly Journal Of Family and Research,
14(2), 31-48. http://qjfr.ir/article-1-301-en.html
Bulut, S., & Subasi, M. (2020). Group therapy in adults with obsessive-compulsive disorder: A review. Open Journal of
Medical Psychology, 9(04), 150. https://www.scirp.org/html/2-2250250_103144.htm
Champ, R. E., Adamou, M., & Tolchard, B. (2023). Seeking connection, autonomy, and emotional feedback: A self-
determination theory of self-regulation in attention-deficit hyperactivity disorder. Psychological review, 130(3), 569-603.
https://doi.org/10.1037/rev0000398
Chen, M. A., & Fagundes, C. P. (2022). Childhood maltreatment, emotion regulation strategies and depressive symptoms
during spousal bereavement. Child abuse & neglect, 128, 105618.
https://www.sciencedirect.com/science/article/pii/S0145213422001387
Choi-Kain, L. W., & Gunderson, J. G. (2008). Mentalization: Ontogeny, Assessment, and Application in the Treatment of
Borderline Personality Disorder. American Journal of Psychiatry, 165(9), 1127-1135.
https://doi.org/10.1176/appi.ajp.2008.07081360
Cortese, S. (2020). Pharmacologic treatment of attention deficit–hyperactivity disorder. New England Journal of Medicine,
383(11), 1050-1056. https://www.nejm.org/doi/full/10.1056/NEJMra1917069
Cristea, I. A., Huibers, M. J. H., David, D., Hollon, S. D., Andersson, G., & Cuijpers, P. (2015). The effects of cognitive
behavior therapy for adult depression on dysfunctional thinking: A meta-analysis. Clinical psychology review, 42, 62-71.
https://www.sciencedirect.com/science/article/pii/S0272735815001166
Danaei Sij, Z., Manshaee, G., & Nadi, M. (2018). The Effectiveness of schema group therapy on attachment styles (secure,
insecure anxiety & insecure avoidance) and symptoms in patients with obsessive-compulsive disorder [Original Article].
Journal of Birjand University of Medical Sciences, 25(3), 181-192. http://journal.bums.ac.ir/article-1-2414-en.html
Dear, B. F., Fogliati, V. J., Fogliati, R., Gandy, M., McDonald, S., Talley, N., Holtmann, G., Titov, N., & Jones, M. (2018).
Transdiagnostic internet-delivered cognitive-behaviour therapy (CBT) for adults with functional gastrointestinal disorders
(FGID): A feasibility open trial. Journal of psychosomatic research, 108, 61-69.
https://doi.org/10.1016/j.jpsychores.2018.02.015
Dickhaut, V., & Arntz, A. (2014). Combined group and individual schema therapy for borderline personality disorder: A pilot
study. Journal of Behavior Therapy and Experimental Psychiatry, 45(2), 242-251.
https://doi.org/10.1016/j.jbtep.2013.11.004
Doomen, L. (2018). The effectiveness of schema focused drama therapy for cluster C personality disorders: An exploratory
study. The Arts in Psychotherapy, 61, 66-76. https://doi.org/10.1016/j.aip.2017.12.002
Duarte, J., & Pinto-Gouveia, J. (2016). Effectiveness of a mindfulness-based intervention on oncology nurses’ burnout and
compassion fatigue symptoms: A non-randomized study. International journal of nursing studies, 64, 98-107.
https://doi.org/10.1016/j.ijnurstu.2016.10.002
Epstein, N. B., & Baucom, D. H. (2002). Enhanced cognitive-behavioral therapy for couples: A contextual approach. American
Psychological Association. https://psycnet.apa.org/record/2003-04003-000
Esmailian, N., Tahmasian, K., Dehghani, M., & Mvtaby, F. (2015). Effectiveness of Mindfulness-Based Cognitive Therapy
(MBCT) on Emotion Regulation, Mindful Attention and Acceptance in Children with Divorced Parents. Clinical
Psychology Achievements, 1(2), 45-66. https://doi.org/10.22055/jacp.2015.12003
Faghfouriazar, M. (2023). The Effectiveness of Selected Perceptual-Motor Exercises on Working Memory and Quality of Life
of Elderly Women. Aging Psychology, 9(3), 310-293. https://doi.org/10.22126/jap.2023.9426.1719
Faraone, S. V., & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24(4), 562-
575. https://doi.org/10.1038/s41380-018-0070-0
Farrokhi, H., Aghamohammadian Sharbaaf, H., Seyedzadeh Dalooyi, S. I., & Zolfaghari, H. (2023). Examining the
Effectiveness of Human-Robotic Interaction on the Executive Functions of Children with Autism Spectrum Disorders
[Original Research Article]. Middle Eastern Journal of Disability Studies---, 13(0), 71-71. http://jdisabilstud.org/article-
1-3018-en.html
http://jdisabilstud.org/article-1-3018-en.pdf
Fırat, M., Gökmen, B. D., Kanbay, Y., & Utkan, M. (2022). Burnout and psychological resilience in nurses: A structural
equality modeling. Journal of Education and Research in Nursing, 19(4), 396-402.
https://jag.journalagent.com/jern/pdfs/JERN_19_4_396_402.pdf
Freedland, K. E., Carney, R. M., Rich, M. W., Steinmeyer, B. C., & Rubin, E. H. (2015). Cognitive Behavior Therapy for
Depression and Self-Care in Heart Failure Patients: A Randomized Clinical Trial. JAMA internal medicine, 175(11), 1773-
1782. https://doi.org/10.1001/jamainternmed.2015.5220
Garmezy, N. (1991). Resiliency and Vulnerability to Adverse Developmental Outcomes Associated With Poverty. American
behavioral scientist, 34(4), 416-430. https://doi.org/10.1177/0002764291034004003
Ghandiyani, K., Hasanzadeh, S., Gholamali Lavasani, M., & Azizi, M. (2022). Positive Features in Children with Attention
Deficit Hyperactivity Disorder: Systematic Review of Research [Applicable]. Journal of Exceptional Children, 22(2), 7-
18. http://joec.ir/article-1-1417-en.html
Ghorbanalipoor, M., Moghadamzadeh, a., & Jafary, E. (2017). The Effectiveness of Schema Therapy and Logo Therapy on
Death Anxiety in Patients with Hypochondriasis. Research in Clinical Psychology and Counseling, 7(1), 52-66.
https://doi.org/10.22067/ijap.v7i1.51952
Hai, T., Duffy, H. A., Lemay, J. A., & Lemay, J. F. (2022). Impact of stimulant medication on behaviour and executive functions
in children with attention-deficit/hyperactivity disorder. World Journal of Clinical Pediatrics, 11(1), 48.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771318/
Hasani, F., Rezazadeh, M., Ganbari Panah, A., & Khoshkabar, A. (2022). Effectiveness of Schema Therapy on Sexual
Satisfaction, Emotional Regulation, and Resilience in Nurses with Marital Boredom Symptoms. Community Health
Journal, 16(2), 71-81. https://doi.org/10.22123/chj.2022.237680.1530
Hayes, A. M., & Feldman, G. (2004). Clarifying the construct of mindfulness in the context of emotion regulation and the
process of change in therapy. Clinical Psychology: Science and Practice, 11(3), 255-262.
https://doi.org/10.1093/clipsy.bph080
Hemmati, M., & Ebrahim Maddahi, M. (2018). Compare the effectiveness of couples therapy based on schema therapy with
couples therapy based on acceptance and commitment therapy on family resiliency of couples. Woman and family studies,
6(2), 145-163. https://www.magiran.com/paper/2018324
Hyman, I., Guruge, S., & Mason, R. (2008). The impact of migration on marital relationships: A study of Ethiopian immigrants
in Toronto. Journal of Comparative Family Studies, 39(2), 149-163.
https://www.utpjournals.press/doi/abs/10.3138/jcfs.39.2.149
Kumpfer, K. L. (2002). Factors and Processes Contributing to Resilience. In M. D. Glantz & J. L. Johnson (Eds.), Resilience
and Development: Positive Life Adaptations (pp. 179-224). Springer US. https://doi.org/10.1007/0-306-47167-1_9
Lalouni, M., Ljótsson, B., Bonnert, M., Ssegonja, R., Benninga, M., Bjureberg, J., Högström, J., Sahlin, H., Simrén, M.,
Feldman, I., Hedman-Lagerlöf, E., Serlachius, E., & Olén, O. (2019). Clinical and Cost Effectiveness of Online Cognitive
Behavioral Therapy in Children With Functional Abdominal Pain Disorders. Clinical Gastroenterology and Hepatology,
17(11), 2236-2244.e2211. https://doi.org/10.1016/j.cgh.2018.11.043
Li, X., Ye, L., Tian, L., Huo, Y., & Zhou, M. (2020). Infertility-Related Stress and Life Satisfaction among Chinese Infertile
Women: A Moderated Mediation Model of Marital Satisfaction and Resilience. Sex Roles, 82(1), 44-52.
https://doi.org/10.1007/s11199-019-01032-0
Masruroh, N. L. (2022). Strengthening Resilience of Family Caregiving for the Elderly through Religious Coping Approach:
From Philosophy to Gerontological Family Nursing Practice. https://www.preprints.org/manuscript/202204.0143
Miu, A. C., Szentágotai-Tătar, A., Balázsi, R., Nechita, D., Bunea, I., & Pollak, S. D. (2022). Emotion regulation as mediator
between childhood adversity and psychopathology: A meta-analysis. Clinical psychology review, 93, 102141.
https://doi.org/10.1016/j.cpr.2022.102141
Mohammadi, F., Taleb, N., Rezaei Shojaei, S., & Emami roudi, T. (2019). The Effectiveness of Schema Therapy on Cognitive
Flexibility and Resiliency in Patients with Generalized Anxiety. medical journal of mashhad university of medical
sciences, 62(2), 34-42. https://doi.org/10.22038/mjms.2020.16176
Nikan, A., Torabi, a., mohseninasab, z., bahadori, a., javanmard, z., & hosinirad, m. (2023). Comparing the effectiveness of
schema therapy and cognitive therapy based on mindfulness on stress, resilience, emotion regulation and psychological
well-being of cardiovascular patients. rph, 19(1), 46-60. http://rph.khu.ac.ir/article-1-4370-en.html
Parandin, S. (2020). The effectiveness of mindfulness training on emotional self-regulation, enduring anxiety disorder and
moral resilience, resolving marital conflicts in couples with compatibility problems in Kermanshah. Scientific Journal of
Social Psychology, 8(56), 57-72. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8249950/
Poole, J. C., Dobson, K. S., & Pusch, D. (2017). Anxiety among adults with a history of childhood adversity: Psychological
resilience moderates the indirect effect of emotion dysregulation. Journal of affective disorders, 217, 144-152.
https://www.sciencedirect.com/science/article/pii/S0165032717300083
Pugh, M. (2015). A narrative review of schemas and schema therapy outcomes in the eating disorders. Clinical psychology
review, 39, 30-41. https://www.sciencedirect.com/science/article/pii/S0272735815000586
Qiu, C., & Shum, K. K.-m. (2022). Relations between caregivers’ emotion regulation strategies, parenting styles, and
preschoolers’ emotional competence in Chinese parenting and grandparenting. Early Childhood Research Quarterly, 59,
121-133. https://doi.org/10.1016/j.ecresq.2021.11.012
Rahbar Karbasdehi, F., Abolghasemi, A., & Rahbar Karbasdehi, E. (2020). The Effectiveness of Schema Therapy on
Psychological Resilience and Social Empowerment in Students with Depression Symptoms. Journal of Psychological
Studies, 15(4), 73-90. https://doi.org/10.22051/psy.2019.23724.1808
Rahbar, T. M., Keshavarz, P., Abolghasemi, A., & Rahbar, K. F. (2019). The effectiveness of group schema therapy on
behavioral activation/inhibition systems and cognitive emotion regulation in female students with anxiety symptoms.
https://www.sid.ir/paper/401730/en
Renner, F., Arntz, A., Peeters, F. P. M. L., Lobbestael, J., & Huibers, M. J. H. (2016). Schema therapy for chronic depression:
Results of a multiple single case series. Journal of Behavior Therapy and Experimental Psychiatry, 51, 66-73.
https://doi.org/10.1016/j.jbtep.2015.12.001
Shafietabar, M., Akbari Chermahini, S., & Molaei Yasavoli, M. (2020). Factorial Structure and Psychometric Properties of the
Emotion Regulation Checklist – Parent Form [Research]. Quarterly Journal of Child Mental Health, 7(3), 80-95.
https://doi.org/10.52547/jcmh.7.3.8
Sheykhangafshe, F. B., Saeedi, M., Niri, V. S., Nakhostin, Z., & Bourbour, Z. (2023). The effectiveness of cognitive-behavioral
therapy on difficulties in emotional regulation and cognitive flexibility in patients with obsessive-compulsive disorder.
Journal of Psychology, 27(1), 28-37. https://psycnet.apa.org/record/2024-37952-004
Son, D.-M., & Ham, O.-K. (2020). Influence of group resilience on job satisfaction among Korean nurses: A cross-sectional
study. Journal of clinical nursing, 29(17-18), 3473-3481. https://doi.org/10.1111/jocn.15385
Takahashi, A. M. (2016). Job stress in Japanese academia: The role of relative income, time allocation by task, and children.
Journal of Asian Economics, 43, 12-17. https://doi.org/10.1016/j.asieco.2016.01.004
Van den Broek, E., Keulen-de Vos, M., & Bernstein, D. P. (2011). Arts therapies and Schema Focused therapy: A pilot study.
The Arts in Psychotherapy, 38(5), 325-332. https://doi.org/10.1016/j.aip.2011.09.005
Van Donzel, L., Ouwens, M. A., & Van Alphen, S. P. J., Bouwmeester, S, Videler, A. C. (2021). The effectiveness of adapted
schema therapy for cluster C personality disorders in older adults – integrating positive schemas. Contemporary Clinical
Trials Communications, 21, 100715. https://doi.org/10.1016/j.conctc.2021.100715
Wang, X. (2022). Intergenerational effects of childhood maltreatment: The roles of parents’ emotion regulation and
mentalization. Child abuse & neglect, 128, 104940. https://doi.org/10.1016/j.chiabu.2021.104940
Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and
Therapy, 34(11), 881-888. https://doi.org/10.1016/S0005-7967(96)00050-2
Wong, T.-Y., Chang, Y.-T., Wang, M.-Y., & Chang, Y.-H. (2022). The effectiveness of child-centered play therapy for
executive functions in children with attention-deficit/hyperactivity disorder. Clinical Child Psychology and Psychiatry,
28(3), 877-894. https://doi.org/10.1177/13591045221128399
Xu, G., Strathearn, L., Liu, B., Yang, B., & Bao, W. (2018). Twenty-Year Trends in Diagnosed Attention-Deficit/Hyperactivity
Disorder Among US Children and Adolescents, 1997-2016. JAMA Network Open, 1(4), e181471-e181471.
https://doi.org/10.1001/jamanetworkopen.2018.1471
Yao, A., Shimada, K., Kasaba, R., & Tomoda, A. (2022). Beneficial Effects of Behavioral Parent Training on Inhibitory Control
in Children With Attention-Deficit/Hyperactivity Disorder: A Small-Scale Randomized Controlled Trial [Original
Research]. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.859249
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2006). Schema therapy: A practitioner's guide. guilford press.
https://books.google.com/books?hl=en&lr=&id=1x7TDwAAQBAJ&oi=fnd&pg=PP1&dq=41.+Young,+J.+E.,+Klosko,
+J.+S.,+%26+Weishaar,+M.+E.+(2003).+Schema+therapy:+A+practitioner%27s+guide.+Guilford+Press.%E2%80%8F
&ots=P0qSfQBMFR&sig=3yDLJRPaL8D4snKEw2M-obnndtE
Downloads
Publication Timeline
- Submitted
- Revised
- Accepted
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
