The Effectiveness of Cognitive Acceptance and Commitment Therapy on Improving Family Functioning, Marital Life Satisfaction, and Rumination in Women with Obsessive-Compulsive Disorder

Document Type : Original Article

Authors

1 Associate Professor, Department of psychology, Payame Noor University, Tehran, Iran

2 Master of Psychology, Department of psychology, Payame Noor University, Tehran, Iran

Abstract

Background and Objectives: This research aimed to investigate the effectiveness of Cognitive Acceptance and Commitment Therapy on family functioning, marital life satisfaction, and rumination in married women with obsessive-compulsive disorder.
 
Methods: The research method was semi-experimental with pretest-posttest and group control. The statistical population includes all married women with obsessive-compulsive disorder referred to Bojnoord Counseling Centers in 2023. A sample of 40 people was selected through the purposeful sampling method. The Hodgson and Rachman Obsessive-Compulsive Questionnaire (1977), McMaster Family Functioning Questionnaire (1950), Olson Marital Life Satisfaction Questionnaire (1998), and Nolen Hoeksema rumination scale (1991) were used to collect data. The experimental group underwent 8 sessions of 90-minute cognitive acceptance and commitment therapy, while the control group received no intervention throughout the study. Data were analyzed using analysis of covariance with repeated measures in SPSS23 software.
 
Results: The results show that cognitive acceptance and commitment therapy was effective in improving family functioning, marital life satisfaction, and rumination in married women with obsessive-compulsive disorder.
 
Conclusion: Cognitive acceptance and commitment therapy led to the improvement of family functioning, satisfaction with married life, and rumination by reducing emotional, cognitive, and behavioral symptoms.

Keywords

Acknowledgments: I hereby express my appreciation and thanks to the participants in this research who cooperated in this study.

 

Availability of data and materials: No restrictions.

 

Conflicts of interests: The authors declare no conflict of interest in this study.

 

Consent for publication: The signed consent to publish is sent to the publisher to permission of the authors to publish the work.

Ethics approval and consent to participate: This study was approved by the ethics committee of Payame noor University (IR-pnu-rec-1399-58). The study was conducted in accordance with the principles of the Helsinki Declaration.

 

Financial disclosure: No financial support was received for this study.

 

Author contributions: Dr. Mahdieh Rahmanian: Contributed to the conception of the work, revising the draft, approving the final version of the manuscript, and agreeing on all aspects of the work; Dr. Amin Rafieeipoor: Contributed to the data analysis and interpretation, critical revision, and approval of the final version of the manuscript; R. Gh.: Contributed to acquiring data, drafting the manuscript, and approving the final version; Zahra Nameni: Contributed to the conception and design of the study, data interpretation, drafting of the manuscript and critical revision, and approval of final version.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

References

1. Coelho DRA, Salvi JD, Vieira WF, Cassano P. Inflammation in obsessive-compulsive disorder: A literature review and hypothesis‐based potential of transcranial photobiomodulation. Journal of Neuroscience Research. 2024;102(3):e25317.
https://doi.org/10.1002/jnr.25317
PMid:38459770
 
2. Tonna M, Ottoni R, Borrelli DF, Gambolò L, Dell'Uva L, Di Donna A, et al. The association between childhood trauma and motor structure in obsessive-compulsive rituals: An ethological and evolutionary approach. Psychological trauma: theory, research, practice, and policy. 2023;10.1037/tra0001525. https://doi.org/10.1037/tra0001525
PMid:37199984  
 
3. Tudder A, Lemay Jr EP, Peters BJ. "Let's go over it again": Examining the intra-and interpersonal processes that perpetuate co-rumination in close relationships. Emotion. 2023;10.1037/emo0001297.
https://doi.org/10.1037/emo0001297
PMid:37768571  
 
4. Ralston AL, Holt NR, Andrews III AR, Huit TZ, Puckett JA, Woodruff N, et al. Mental health and marginalization stress in transgender and gender diverse adults: Differences between urban and non-urban experiences. Psychology of Sexual Orientation and Gender Diversity. 2022;10.1037/sgd0000595.
https://doi.org/10.1037/sgd0000595
PMid:38577413  
 
5. Kam JW, Wong AY, Thiemann RF, Hasan F, Andrews-Hanna JR, Mills C. On the relationship between unprompted thought and affective well-being: A systematic review and meta-analysis. Psychological Bulletin. 2024;10.1037/bul0000428.
https://doi.org/10.1037/bul0000428
PMid:38619477  
 
6. Tapias E, Vila‐Badia R, Cárdenas M, Ardévol I, Lacasa F, Ribalta T, et al. KidsTime: A multifamily prevention approach for parents with a mental illness and their children and relatives. Journal of Family Therapy. 2024;10.1111/1467-6427.12451.
https://doi.org/10.1111/1467-6427.12451  
 
7. Chen P, Rao S-Y, Zhang W, Jiang Y-Y, Xiang Y, Xiang NX, et al. Mental health status among children and adolescents in one-child and multichild families: a meta-analysis of comparative studies. Current Opinion in Psychiatry. 2024;10.1097/yco.0000000000000935:10.1097. https://doi.org/10.1097/YCO.0000000000000935
PMid:38415684  
 
8. Wiley JD, Reynolds J, Strate L, Porter A, Seymour P, Beach R, Patel R. Medicare inclusion of licensed mental health counselors and marriage and family therapists. 2024;10.1037/rmh0000262. https://doi.org/10.1037/rmh0000262  
 
9. Taylor ZE, Carrizales A, Carlo G, Herrera F, Reyes O, Escobedo J, et al. The impact of COVID‐19 on mental health and well‐being of Latine youth from rural and agricultural families in the Midwest. Journal of Community & Applied Social Psychology. 2024;34(2):e2788. d
https://doi.org/10.1002/casp.2788  
 
10. Pan T, Chen D, Yu Z, Liu Q, Chen Y, Zhang A, Kong F. Analysis of current situation and influencing factors of marital adjustment in patients with Crohn's disease and their spouses. Medicine. 2024;103(11):e37527.
https://doi.org/10.1097/MD.0000000000037527
PMid:38489689 PMCid:PMC10939668  
 
11. Vivek K, Kamal R, Perera E, Gupte CM. Vitamin D Deficiency Leads to Poorer Health Outcomes and Greater Length of Stay After Total Knee Arthroplasty and Supplementation Improves Outcomes: A Systematic Review and Meta-Analysis. JBJS reviews. 2024;12(4):e23.
https://doi.org/10.2106/JBJS.RVW.23.00150
PMid:38574186 PMCid:PMC10990007  
 
12. Kerney MA, Hargons CN, Peterson R, Cannon B, Stevens-Watkins D, Burnett C, Higgins-Hord L. "The State of Your Psyche": Black Conceptualizations of Mental Health. The Counseling Psychologist. 2024;10.1177/00110000241230556:00110000241230556. https://doi.org/10.1177/00110000241230556  
 
13. Ashkinazi M, Wagner SA, Cunningham K, Mattson RE. Body image satisfaction and body-related partner commentary link to marital quality through sexual frequency and satisfaction: A path model. Couple and Family Psychology: Research and Practice. 2022;10.1037/cfp0000216.
https://doi.org/10.1037/cfp0000216  
 
14. Wang Z, Chen X, Zhou J, Lin C, Zhao J, Li Q. The effect of a couple‐based posttraumatic growth intervention in supporting couples coping with colorectal cancer: A randomized controlled study. Psycho‐Oncology. 2024;33(3):e6326. https://doi.org/10.1002/pon.6326
PMid:38498049  
 
15. Hosseinpoor M, Masoumi SZ, Kazemi F, Soltani F, Ahmadpanah M. Investigating the effect of couple-centered counseling by Gottman method on the intimacy of infertile couples referring to the infertility Ward of Fatemieh hospital, Hamadan, Iran in 2020: a quasi-experimental study. BMC psychiatry. 2022;22(1):581.
https://doi.org/10.1186/s12888-022-04228-z
PMid:36050679 PMCid:PMC9434942  
 
16. Hwang W, Cakirsoy‐Aslan AD, Brown MT, Silverstein M. Husband-wife religious denomination homogamy and marital satisfaction over time: The moderating role of religious intensity. Family Relations. 2021;70(5):1498-513.
https://doi.org/10.1111/fare.12521  
 
17. Lee YG, Kelley HH. Financial perceptions and financial behaviors across marital status and gender. Family and Consumer Sciences Research Journal. 2023;52(2):86-101.
https://doi.org/10.1111/fcsr.12493  
 
18. Hodge AS, Norton J, Karwoski LT, Yoon J, Hook JN, Kansiewicz K, et al. The experience of, and beliefs about, divine grace in mainline protestant Christianity: A consensual qualitative approach. Archive for the Psychology of Religion. 2023;45(3):285-307. https://doi.org/10.1177/00846724231197241  
 
19. Ferreira S, Pêgo JM, Morgado P. A systematic review of behavioral, physiological, and neurobiological cognitive regulation alterations in obsessive-compulsive disorder. Brain sciences. 2020;10(11):797.
https://doi.org/10.3390/brainsci10110797
PMid:33138023 PMCid:PMC7692269  
 
20. Davies R, Price Tate R, Taverner NV. What next for "counseling" in genetic counseling training: A reflection on how CBT and ACT approaches can contribute to the genetic counseling toolkit. Journal of Genetic Counseling. 2024;
https://doi.org/10.1002/jgc4.1873
PMid:38342751  
 
21. Morais J, Roque M, Martins FS, Fonseca S, Moreira R. Suicide risk in obsessive-compulsive disorder: a case report. Cureus. 2023;15(3).
https://doi.org/10.7759/cureus.36863  
 
22. Evey KJ, Steinman SA. A Systematic Review of the Use of Acceptance and Commitment Therapy (ACT) to Treat Adult Obsessive-Compulsive Disorder (OCD). Behavior Therapy. 2023; https://doi.org/10.1016/j.beth.2022.02.009
PMid:37863582  
 
23. van Reekum EA, Woo JJ, Petropoulos JA, Samaan Z, Mbuagbaw L. Association between the COVID‐19 pandemic and psychiatric symptoms in people with preexisting obsessive‐compulsive, eating, anxiety, and mood disorders: a systematic review and meta‐analysis of before‐after studies. Psychiatry and Clinical Neurosciences. 2023;77(11):583-91.
https://doi.org/10.1111/pcn.13582
PMid:37565691 PMCid:PMC11488625  
 
24. Matsumoto K, Nonaka M, Arai K, Nakamura M. Cognitive behavioral therapy for a Japanese woman with olfactory reference disorder (ORD) comorbid with schizophrenia: A case study. Psychiatry and Clinical Neurosciences Reports. 2024;3(1):e179.
https://doi.org/10.1002/pcn5.179
PMid:38868464 PMCid:PMC11114287  
 
25. Peteet JR. The Moral Dimension of Mental Health Treatment. Journal of Psychiatric Practice®. 2024;30(2):157-61.
https://doi.org/10.1097/PRA.0000000000000775
PMid:38526404  
 
26. Rahmani F, Gowhari H, Jolfai Fotouhi M, Saedi S. The Effectiveness of Acceptance and Commitment Therapy on Empathy and Interpersonal Relationships in Obsessive-Compulsive Patients. Iranian Evolutionary Educational Psychology Journal. 2024;6(1):94-105. doi:10.22034/6.1.94  
 
27. Balsom AA, Klest B, Sander B, Gordon JL. Acceptance and commitment therapy adapted for women with infertility: a pilot study of the Infertility ACTion program. Reproductive Health. 2024;21(1):43.
https://doi.org/10.1186/s12978-024-01766-5
PMid:38576027 PMCid:PMC10996141  
 
28. Mousavi Haghighi SE, Rishehri P, Mousavi SA. Effectiveness of acceptance and commitment therapy and integrated behavioral couples therapy on intimacy and family functioning in divorce-seeking couples. Journal of research and health. 2022;12(3):167-76.
https://doi.org/10.32598/JRH.12.3.1972.1  
 
29. Maleki Pirbazari M, Narimani M, Mikaeili N, Abolghasemi A. Effectiveness of Acceptance and Commitment Therapy on Improving Symptoms and Increasing Quality of Life in Patients with Obsessive-compulsive Disorder in Interacting with OCD Family History. Journal of Modern Psychology. 2021;1(1):37-50. doi:10.22034/jmp.2021.126768  
 
30. Safari S, Kalantari M, Yazdkhasti F, Abedi MR, Oreyzi HR. The effectiveness of Acceptance and Commitment Therapy on severity of symptoms and Function of children with obsessive-compulsive disorder. Journal of Research in Behavioural Sciences. 2021;18(4):587-604.
https://doi.org/10.52547/rbs.18.4.587  
 
31. Esmaili H, Sotoudehasl N, Ghorbani R, Maheri M. Comparison of the effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) and Drug Therapy on Obsessive-Compulsive Disorder (OCD). Iranian Journal of Practice in Clinical Psychology. 2024;12(1):43-51.
https://doi.org/10.32598/jpcp.12.1.899.1  
 
32. Naderi Moghaddam N, Panah Ali A, Aghdasi AN, Hejazi M. The Effectiveness of Acceptance and Commitment Therapy on Marital Conflict and Emotional Divorce of Women Facing Divorce. Women's Health Bulletin. 2023;10(2):122-32. doi:10.30476/whb.2023.97237.1204  
 
33. Brysbaert M. How many participants do we have to include in properly powered experiments? A tutorial of power analysis with reference tables. Journal of cognition. 2019;2(1).
https://doi.org/10.5334/joc.72
PMid:31517234 PMCid:PMC6640316  
 
34. Riley RD, Ensor J, Snell KI, Harrell FE, Martin GP, Reitsma JB, et al. Calculating the sample size required for developing a clinical prediction model. Bmj. 2020;368.
https://doi.org/10.1136/bmj.m441
PMid:32188600  
 
35. Rahmanian M, Asl MM. The Effectiveness of acceptance and commitment-Based Therapy (ACT) on Rumination and Perceived Stress of Women with Obsessive-Compulsive Disorder (OCD) in corona pandemic conditions. Rooyesh-e-Ravanshenasi Journal (RRJ). 2023;12(2):163-72.  
 
36. Pseftogianni F, Panagioti M, Birtwell K, Angelakis I. Mindfulness interventions for obsessive-compulsive and related disorders: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology: Science and Practice. 2023;10.1037/cps0000132.
https://doi.org/10.1037/cps0000132  
 
37. Grove L, Roche AI, Doyle R, Stowe ZN, Thomas EB. ACT-informed treatment of co-morbid psychiatric disorders in the postpartum period: A case report. Clinical case studies. 2023;22(1):38-59.
https://doi.org/10.1177/15346501221091273  
 
38. Bürkle JJ, Fendel JC, Schmidt S. Mindfulness-based and acceptance-based programmes in the treatment of obsessive-compulsive disorder: a study protocol for a systematic review and meta-analysis. BMJ open. 2021;11(6):e050329.
https://doi.org/10.1136/bmjopen-2021-050329
PMid:34172553 PMCid:PMC8237723  
 
39. Martin JL, Carlson GC, Kelly MR, Song Y, Mitchell MN, Josephson KR, et al. Novel treatment based on acceptance and commitment therapy versus cognitive behavioral therapy for insomnia: A randomized comparative effectiveness trial in women veterans. Journal of Consulting and Clinical Psychology. 2023;10.1037/ccp0000836. https://doi.org/10.1037/ccp0000836
PMid:37535521 PMCid:PMC10592426  
 
40. Zamani E, Moatamed A, Bakhtiar M. The effectiveness of acceptance and commitment therapy on depression in multiple sclerosis. New Trends Issues Proc Humanit Soc Sci. 2017;3(2):53-8.
https://doi.org/10.18844/prosoc.v3i2.1599  
 
41. George DR, Hanson R, Wilkinson D, Garcia-Romeu A. Ancient roots of today's emerging renaissance in psychedelic medicine. Culture, Medicine, and Psychiatry. 2022;46(4):890-903.
https://doi.org/10.1007/s11013-021-09749-y
PMid:34476719 PMCid:PMC8412860  
 
42. Priede A, Rodríguez‐Pérez N, Hoyuela F, Cordero‐Andrés P, Umaran‐Alfageme O, González‐Blanch C. Cognitive variables associated with depressive and anxiety symptoms in patients with cancer: A five‐year follow‐up study. Psycho‐Oncology. 2022;31(5):798-805.
https://doi.org/10.1002/pon.5864
PMid:34921574  
 
43. Ebrahimi S, Moheb N, Karimpour A. Comparison of the Effectiveness of Cognitive-behavioral Therapy and Acceptance and Commitment Therapy on Cognitive Distortions and Rumination in Adolescents With Social Anxiety Disorder. 2024;10.32598/jpcp.12.1.922.1.
https://doi.org/10.32598/jpcp.12.1.922.1  
 
44. Showani E, Asadpour E, Zahrakar K, Ahmadi S. The efficacy of acceptance and commitment therapy (ACT) on women's emotional empathy and forgiveness. Journal of Psychological Science. 2023;22(122):229-48. doi:10.52547/JPS.22.122.229  
 
45. Asadpour E. The efficacy of acceptance and commitment based therapy on marital satisfaction and self-efficiency of mothers with children with cerebral palsy. Journal of psychologicalscience. 2021;20(105):1493-512.
https://doi.org/10.52547/JPS.20.105.1493  
 
46. Rossman SM, Lerner RE, Córdova JV. Disentangling acceptance: Direct and indirect effects of partner acceptance on felt acceptance and relationship satisfaction. Journal of Family Psychology. 2022;36(3):378.
https://doi.org/10.1037/fam0000900
PMid:34197160 PMCid:PMC8720111  
 
47. Finnes A, Anderzén I, Pingel R, Dahl J, Molin L, Lytsy P. Comparing the Efficacy of Multidisciplinary Assessment and Treatment, or Acceptance and Commitment Therapy, with Treatment as Usual on Health Outcomes in Women on Long-Term Sick Leave-A Randomised Controlled Trial. International Journal of Environmental Research and Public Health. 2021;18(4):1754.
https://doi.org/10.3390/ijerph18041754
PMid:33670235 PMCid:PMC7916944  
 
48. Mohebi M, Sadeghi-Bahmani D, Zarei S, Gharayagh Zandi H, Brand S. Examining the effects of mindfulness-acceptance-commitment training on self-compassion and grit among elite female athletes. International Journal of Environmental Research and Public Health. 2021;19(1):134.
https://doi.org/10.3390/ijerph19010134
PMid:35010391 PMCid:PMC8750224  
 
49. Rauwenhoff JC, Bol Y, van Heugten CM, Batink T, Geusgens CA, van den Hout AJ, et al. Acceptance and commitment therapy for people with acquired brain injury: Rationale and description of the BrainACT treatment. Clinical rehabilitation. 2023;37(8):1011-25.
https://doi.org/10.1177/02692155231154124
PMid:36750988 PMCid:PMC10291735  
 
50. Taleshi ZU, AkbarZadeh N, Rahimi A, Razghandi S, Soraki PA. Effectiveness of Acceptance and Commitment Therapy on Family Functioning and Inefficient Attitudes of Women in Second Marriages. Psychology of Woman Journal. 2023;4(4):76-83.
https://doi.org/10.61838/kman.pwj.4.4.9  
 
51. Bragdon LB, Harvey JR, Moldow R. Cognitive-behavioral therapy for obsessive-compulsive disorder: a brief review. Psychiatric Annals. 2024;54(3):e75-e9.
https://doi.org/10.3928/00485713-20240227-01  
Razavi International Journal of Medicine
Volume 13, Issue 1
special issue; Psychology in Health
March 2025
Pages 126-140

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