Comparison of the Effectiveness of Acceptance and Commitment Therapy and Metacognitive Therapy on Adaptive and Maladaptive Strategies of Cognitive Emotion Regulation in Patients with Substance Use Disorder undergoing Methadone Maintenance Treatment

پژوهش های روان شناسی بالینی و مشاوره

Article 4, Volume 12, Issue 1 - Serial Number 23, September 2022, Pages 60-78   

Document Type: Original Article

DOI: 10.22067/tpccp.2022.70654.1118

Authors

Ali Ahmadi Roghabadi¹; Zahra Bagherzadeh Golmakani^{* 2}; Mahdi Akbarzade²; Ahmad Mansouri²; Mohammadreza Khodabakhsh²

¹PhD Student of General Psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran

²Assistant Professor, Department of Psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran

Abstract

Purpose: Substance use disorder, as one of the chronic psychiatric diseases, has become one of the major problems in society today. The aim of this study was to compare the effectiveness of acceptance and commitment therapy and metacognitive therapy on adaptive and maladaptive strategies of emotional regulation in patients with substance use disorder who were under the Methadone Maintenance Treatment (MMT).
Method: The method of the present study was semi-experimental with a pre-test and post-test design, a three-month follow-up step and a control group. The sample consisted of 60 patients receiving methadone maintenance treatment who had visited Mashhad addiction treatment centers during the second 6 months of 2018. Subjects were selected by the convenience sampling emthod and randomly assigned to two experimental groups (acceptance and commitment therapy and metacognitive therapy) and also a control group. Data were collected using the Cognitive Emotion Regulation Questionnaire (CERQ) and were analyzed using SPSS 24 software.
Findings: The results showed that both acceptance and commitment therapy and metacognitive therapy are effective in increasing adaptive cognitive emotion regulation strategies and reducing maladaptive cognitive emotion regulation strategiesis. Moreover, the findings showed that acceptance and commitment therapy is more effective than metacognitive therapy in modifying cognitive emotion regulation strategies. In general, it can be concluded that the treatment based on acceptance and commitment is an appropriate therapeutic approach for patients with substance use disorder who are under the methadone maintenance treatment.

Keywords

Acceptance and Commitment Treatment; metacognitive therapy; Emotional Cognitive Regulation; adaptive and maladaptive strategies

References

Afzali, R., Sarami, H., & Irankhah, A. (2018). Content Analysis of Media Content in Control over and Counter against Narcotics in Iran (Ettela'at and Iran Newspapers). Research on Addiction, 12(45), 31-52. (in Persian).

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review, 30(2), 217-237.

Besharat, M. A. (2016). Cognitive Emotion Regulation Questionnaire: Instruction and Scoring. Journal of developmental Psychology, 13(50), 221-223. (in Persian)

Bloy, S., Oliver, J. E., & Morris, E. (2011). Using acceptance and commitment therapy with people with psychosis: A case study. Clinical Case Studies, 10(5), 347-359.

Cederberg, J. T., Cernvall, M., Dahl, J., von Essen, L., & Ljungman, G. (2016). Acceptance as a mediator for change in acceptance and commitment therapy for persons with chronic pain? International Journal of Behavioral Medicine, 23(1), 21-29.

Compas, B. E., Jaser, S. S., Bettis, A. H., Watson, K. H., Gruhn, M. A., Dunbar, J. P., . . . Thigpen, J. C. (2017). Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review. Psychological bulletin, 143(9), 939-991.

Decker, K. P., Peglow, S. L., Samples, C. R., & Cunningham, T. D. (2017). Long-term outcomes after residential substance use treatment: Relapse, morbidity, and mortality. Military medicine, 182(1-2), e1589-e1595.

Dimaggio, G., D'Urzo, M., Pasinetti, M., Salvatore, G., Lysaker, P. H., Catania, D., & Popolo, R. (2015). Metacognitive interpersonal therapy for co‐occurrent avoidant personality disorder and substance abuse. Journal of clinical psychology, 71(2), 157-166.

Estévez, A., Jáuregui, P., Sánchez-Marcos, I., López-González, H., & Griffiths, M. D. (2017). Attachment and emotion regulation in substance addictions and behavioral addictions. Journal of behavioral addictions, 6(4), 534-544.

Fadardi, J., & Barerfan, Z. (2011). The effect of Drugs-Attention Control Training Program on Drug-Related Attentional Bias and Improving other Indices of Recovery. Foundations of Education, 11(2), 29- 56. (in Persian). doi:10.22067/fe.v11i2.2863

Garnefski, N., & Kraaij, V. (2007). The cognitive emotion regulation questionnaire. European Journal of Psychological Assessment, 23(3), 141-149.

Goldsmith, A.A., Tran, G.Q., Smith, J.P., & Howe, S.R. (2009). Alcohol Expectancies and drinking motives in college drinker, Addictive Behavior, 34(6-7), 505-513.

Hayes, S. C., Strosahl, K. D., Bunting, K., Twohig, M., & Wilson, K. G. (2004). What is acceptance and commitment therapy? A practical guide to acceptance and commitment therapy (pp. 3-29): Springer.

Hermann, B. A., Meyer, E. C., Schnurr, P. P., Batten, S. V., & Walser, R. D. (2016). Acceptance and commitment therapy for co-occurring PTSD and substance use: A manual development study. Journal of Contextual Behavioral Science, 5(4), 225-234.

Jahangiri, A., Shirdal, M., & Gharachoorlou, S. (2018). The Effectiveness of Acceptance and Commitment (Act) Therapy on Cognitive-Emotional Regulation and Self-Efficacy in Struggling with Problems in People with Substance Abuse Treated with Methadone. Journal of North Khorasan University of Medical Sciences, 10(2), 41-49. (in Persian)

Karami, N., Amini, N., Behrozi, M., & Jafarinia, G. (2021). The Prediction of Distress Tolerance based on Brain-Behavioral Systems, HEXACO Personality Characteristics and Social Isolation in Substance-Dependent Individuals. Etiadpajohi, 14(58), 265-290. (in Persian)

Karimi Talabari, Z., Noori Khajavi, M., & Rafiei, H. (2013). Reasons of Methadone Maintenance Therapy Drop out in Clients of Iranian National Center for Addiction Studies (INCAS): A Qualitative Study. Iranian Journal of Psychiatry and Clinical Psychology, 18(4), 299-309. (In Persian)

Kelson, J., Rollin, A., Ridout, B., & Campbell, A. (2019). Internet-delivered acceptance and commitment therapy for anxiety treatment: systematic review. Journal of medical Internet research, 21(1), e12530.

Kim, M. S. (2020). Psychiatric symptoms and emotion regulation strategies among the unemployed people in Korea: A latent profile analysis. Plos one, 15(8), e0236937.

Laghi, F., Bianchi, D., Lonigro, A., Pompili, S., & Baiocco, R. (2021). Emotion regulation and alcohol abuse in second-generation immigrant adolescents: the protective role of cognitive reappraisal. Journal of health psychology, 26(4), 513-524.

Lanza, P. V., Garcia, P. F., Lamelas, F. R., & González‐Menéndez, A. (2014). Acceptance and commitment therapy versus cognitive behavioral therapy in the treatment of substance use disorder with incarcerated women. Journal of clinical psychology, 70(7), 644-657.

Latham, G. P., Saari, L. M., Pursell, E. D., & Campion, M. A. (1980). The situational interview. Journal of Applied Psychology, 65(4), 422-427.

Lee, E. B., An, W., Levin, M. E., & Twohig, M. P. (2015). An initial meta-analysis of Acceptance and Commitment Therapy for treating substance use disorders. Drug and alcohol dependence, 155, 1-7.

Lee, J. L., Bertoglio, L. J., Guimarães, F. S., & Stevenson, C. W. (2017). Cannabidiol regulation of emotion and emotional memory processing: relevance for treating anxiety‐related and substance abuse disorders. British journal of pharmacology, 174(19), 3242-3256.

Li, J., Weidacker, K., Mandali, A., Zhang, Y., Whiteford, S., Ren, Q., . . . Du, J. (2021). Impulsivity and craving in subjects with opioid use disorder on methadone maintenance treatment. Drug and Alcohol Dependence, 219, 108483.

Lorkiewicz, S. A., Ventura, A. S., Heeren, T. C., Winter, M. R., Walley, A. Y., Sullivan, M., . . . Saitz, R. (2018). Lifetime marijuana and alcohol use, and cognitive dysfunction in people with human immunodeficiency virus infection. Substance abuse, 39(1), 116-123.

Luoma, J. B., Kohlenberg, B. S., Hayes, S. C., & Fletcher, L. (2012). Slow and steady wins the race: a randomized clinical trial of acceptance and commitment therapy targeting shame in substance use disorders. Journal of consulting and clinical psychology, 80(1), 43-53.

Mahmoudi, H., & Ghaderi, S. (2017). Effectiveness of Acceptance and Commitment Group Therapy in Reducing Depression, Stress, and Anxiety among Ex-Addicts in Tabriz Central Prison. Research on Addiction, 11(43), 195-210. (in Persian)

Mamsharifi, P., Jamehbozorg, A., & Takjoo, J. (2020). The Effectiveness of Cognitive Rehabilitation on Increased Attention and Memory Functions in Heroin Addicts. Research on Addiction, 14(55), 229-243. doi:10.29252/etiadpajohi.14.55.229. (in Persian)

Marceau, E. M., Kelly, P. J., & Solowij, N. (2018). The relationship between executive functions and emotion regulation in females attending therapeutic community treatment for substance use disorder. Drug and alcohol dependence, 182, 58-66.

Masuda, A., Hayes, S. C., Sackett, C. F., & Twohig, M. P. (2004). Cognitive defusion and self-relevant negative thoughts: Examining the impact of a ninety year old technique. Behaviour research and therapy, 42(4), 477-485.

Perry, C., & Lawrence, A. (2017). Addiction, cognitive decline and therapy: seeking ways to escape a vicious cycle. Genes, Brain and Behavior, 16(1), 205-218.

Reese, E. D., & Veilleux, J. C. (2016). Relationships between craving beliefs and abstinence self-efficacy are mediated by smoking motives and moderated by nicotine dependence. Nicotine & Tobacco Research, 18(1), 48-55.

Rose, M. R., Norton, S., Vari, C., Edwards, V., McCracken, L., Graham, C. D., . . . Chalder, T. (2018). Acceptance and Commitment Therapy for Muscle Disease (ACTMus): protocol for a two-arm randomised controlled trial of a brief guided self-help ACT programme for improving quality of life in people with muscle diseases. BMJ open, 8(10), e022083.

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. (in Persian)

Sau, M., Mukherjee, A., Manna, N., & Sanyal, S. (2013). Sociodemographic and substance use correlates of repeated relapse among patients presenting for relapse treatment at an addiction treatment center in Kolkata, India. African Health Sciences, 13(3), 791-799.

Seitz, N.-N., Lochbühler, K., Atzendorf, J., Rauschert, C., Pfeiffer-Gerschel, T., & Kraus, L. (2019). Trends in substance use and related disorders: Analysis of the epidemiological survey of substance abuse 1995 to 2018. Deutsches Ärzteblatt International, 116(35-36), 585.

Setorg, S., Kazemi, H., Raisi, Z. (2014). Effectiveness of meta-cognitive therapy on craving beliefs and substance-related beliefs in substance abuse disorder patients. Etiadpajohi, 7 (28) :147-162.

Singer, P. D. (2016). Factors associated with long-term recovery from substance use disorders: California state university, Thesis for Degree Master of Social Work, Long Beach.

Smallwood, R. F., Potter, J. S., & Robin, D. A. (2016). Neurophysiological mechanisms in acceptance and commitment therapy in opioid-addicted patients with chronic pain. Psychiatry Research: Neuroimaging, 250, 12-14.

Tam, H. L., Shik, A. W. Y., & Lam, S. S. L. (2016). Using expressive arts in relapse prevention of young psychotropic substance abusers in Hong Kong. Children and Youth Services Review, 60, 88-100.

Tang, Y.-Y., Tang, R., & Posner, M. I. (2016). Mindfulness meditation improves emotion regulation and reduces drug abuse. Drug and Alcohol Dependence, 163, 13-18.

Tosifian, n., Ghaderi Begeh-Jan, K., Khaledian, M., & Farrokhi, N. (2018). Structural Modeling of Family Function and Drug Craving in Addicted People under Methadone Maintenance Treatment with an Emphasis on the Mediating Role of Self-Compassion. Etiadpajohi, 11(44), 209-226. (in Persian)

Twohig, M. P., Shoenberger, D., & Hayes, S. C. (2007). A preliminary investigation of acceptance and commitment therapy as a treatment for marijuana dependence in adults. Journal of applied behavior analysis, 40(4), 619-632. doi:10.1901/jaba.2007.619-632

Vakharia, S. P. (2014). Incorporating substance use content into social work curricula: Opioid overdose as a micro, mezzo, and macro problem. Social work education, 33(5), 692-698.

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of personality and social psychology, 54(6), 1063.

Witkiewitz, K., Bowen, S., Douglas, H., & Hsu, S. H. (2013). Mindfulness-based relapse prevention for substance craving. Addictive behaviors, 38(2), 1563-1571.