A Comparison of the Effectiveness of Mentalization-Based Therapy (MBT) and Affect Phobia Therapy (APT) in Reducing Depressive Symptoms in Women with Borderline Personality Disorder

Document Type : Original Article

Authors

1 PhD student in Psychology, Qom Branch, Islamic Azad University, Qom, Iran

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

3 Associate Professor, Department of Psychology, Qom Branch, Islamic Azad University, Qom, Iran

Abstract

Aim: The present study aimed to determine the effectiveness of Mentalization-based therapy (MBT) in comparison with Affect Phobia Therapy (APT) in reducing depressive symptoms in women with borderline personality disorders. Methods: The study had a quasi-experimental method with a pretest-posttest design and follow-up with a control group. The statistical population consisted of 120 women with borderline personality disorder symptoms who visited counseling centers in Qom from August and October 2020. After screening with the Goldberg Depression Questionnaire (1971) and interviews according to DSM-5 criteria, 60 women were selected by purposive sampling and were randomly assigned to two experimental groups and a control group (20 per group). The first experimental group received mentalization-based therapy by Batman and Funagi (2016), and the second experimental group received affect phobia therapy by McCullough in eight 90-minute sessions, one session per week, and the control group was placed on a waiting list. Data were analyzed using repeated-measures analysis of variance (ANOVA). Results: The results indicated the effects of mentalization-based therapy intervention (F=18.41, P=0.001) with an effect size of 0.36, and affect phobia therapy intervention (F=20.35, P=0.001) with an effect size of 0.38 on women's depression, and the stability of the effects at the follow-up stage. Conclusion: The affect phobia therapy along with medication can be used for patients with depression.

Keywords


حسینی، اسماعیل. پویان، محمد. ولی زاده، علیرضا. مرادی، علیرضا. (1397).  مدل‌سازی دینامیکی اثربخشی درمان‌های شناختی رفتاری موج سوم و داروهای ضدافسردگی بر اختلال افسردگی اساسی. فصلنامه پژوهش در سلامت روان‌شناختی. 4 (16):  12-27.
خوریانیان، مهدی. حیدری، لیلا. طبیبی، زهرا. آقا محمدیان شعرباف، حمیدرضا. (1391). اثربخشی روان‌درمانی پویشی کوتاه‌مدت فشرده بر کاهش نشانه‌ها و ابراز گری هیجانی در بیماران مبتلابه افسردگی. اندیشه و رفتار. 7 (26):37-46.
سوری، پروانه. شکر زاده، شهره. (1398). بررسی ابعاد آسیب‌شناسی شخصیت و توانایی‌های شناختی در افراد با اختلال شخصیت مرزی. رویش روان‌شناسی. 7(40):163-153
عینی، ساناز. نریمان، محمد. عطا دخت، اکبر. بشر پور، سجاد. صادقی موحد، فریبا. (1397). مقایسه اثربخشی درمان مبتنی بر ذهنی سازی و درمان شناختی- تحلیلی بر بهبود روابط موضوعی افراد مبتلابه اختلال شخصیت مرزی. نشریه پژوهشکده علوم بهداشتی جهاد سازندگی. 17(3): 287-275.
فرج زاده، زهرا. کرامتی نیا، فریدون. سعادت جو، علیرضا. (1397). تأثیر آموزش گروهی مقابله با افسردگی به شیوه شناختی- رفتاری بر افسردگی پرستاران بیمارستان‌های آموزشی بیرجند. نشریه آموزش پرستاری. 7(6): 46-39
محمودعلیوند، مجید. هاشمی، تورج. بیرامی، منصور. بخشی پور، عباس. شریفی، محمدامین. (1397). نقش بدرفتاری دوران کودکی و آلکسی تایمی در پیش بینی اختلال شخصیت مرزی: مطالعه‌ای در جمعیت غیر بالینی. پژوهش‌های روان‌شناختی. 21(2): 73-96.
محمودی قهساره، مصطفی. آقا محمدیان شعرباف، حمیدرضا. دهقانی، محمود. حسن‌آبادی، حسین. (1393). اثربخشی روان مدت پویشی کوتاه درمانی روان کننده با روش تنظیم اضطراب در درمان مردان مبتلابه هراس اجتماعی. مجله روا نپزشکی و روان‌شناسی بالینی ایران. 20(2):120-111.
.References
Baker, R. Thomas, S. Thomas, P. W. Gower, P. Santonastaso, M. Whittlesea, A.  (2010). The Emotional Processing Scale: Scale refinement and abridgement (EPS-25).  Journal of Psychosomatic Research, 68: 83-91
Bateman A, Fonagy P. (2016). Mentalization - based treatment for personality disorders: a practical guide. Oxford, UK: 1 st Edition Oxford University Press: Uk, 2016
Bateman A, Fonagy, P. (2013). Impact of clinical severity on outcomes of mentalisation -based treatment for borderline personality disorder. British Journal of Psychiatry, 203:221 -227
Bateman, A, Campbell, C, Luyten, P, Fonagy, P. (2018). A mentalization-based approach to common factors in the treatment of borderline personality disorder.  Curr Opin Psychol.  21:44–9.
Bateman, A. W., Gunderson, J., & Mulder, R. (2015).  Treatment of personality disorder.  Lancet, 385, 735–743. 
De Roten, Y. Ambresin, G. Herrera, F. Fassassi, S. Fournier, N. Preisig, M. & Despland, J. N. (2017). Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: Results of a randomized controlled trial. Journal of affective disorders, 209: 105-113
Dvorak, R. D. Sargent, E. M. Kilwein, T. M. Stevenson, B. L. Kuvaas, N. J. & Williams, T. J. (2014). Alcohol use and alcohol-related consequences: associations with emotion. Am J Drug Alcohol Abuse, 4(2): 125-130
Edel, MA, Raaff, V. Dimaggio, G, Buchheim, A, Brune, M. (2017). Exploring the effectiveness of combined mentalization-based group therapy and dialectical behaviour therapy for inpatients with borderline personality disorder - A pilot study. The British Journal of Clinical Psychology ,56:1-15
Ferankl, M. Wennberg, P. Berggraf, L. Philips, B. (2018).  Affect Phobia Therapy for Mild to Moderate Alcohol Use Disorder:The Cases of “Carey,” “Michelle,” and “Mary”.  Pragmatic Case Studies in Psychotherapy, (1):214-257.
Frankl, M. (2017). Psychotherapy for substance use disorders--the importance of affects.Unpublished doctoral dissertation, Faculty of Arts and Sciences, Linkoping University, Linkoping, Sweden. available at:http://liu.diva-portal.org/smash/get/diva2:1159275/FULLTEXT01.pdf.
Frankl, M. Philips, B. Berggraf, L. Ulvenes, P. Johansson, R. & Wennberg, P. (2016).Psychometric properties of the Affect Phobia Test. Scandinavian Journal of Psychology,57, 482–488.
Gimeno, E, Chiclana, C. (2016). Borderline personality disorder in adolescence. Prevention and early intervention from a cognitive analytic approach. European Psychiatry, 33: S505
Gimeno, E, Chiclana, C. (2017). Cognitive analytic therapy and mentalizing function. European Psychiatry, 41: S776
Goldberg, DP. Hillier, VF. (1979). A scaled version of the General Health Questionnaire. Psychol Med. 9(1):139-45. PMID: 424481
Hall, M.  A.  Riedford, K.  M. (2017).  Borderline Personality Disorder: Diagnosis and Common Comorbidities.  The Journal for Nurse Practitioners, 13(9): 455-456.
Hall, M.  A. Riedford, K.  M. (2017).  Borderline Personality Disorder: Diagnosis and Common Comorbidities.  The Journal for Nurse Practitioners, 13(9): 455-456.
MC, Müllauer, PK, Gaugeler, R, Senft, B, Andreas, S. (2018). Improvements in mentalization predict improvements in interpersonal distress in patients with mental disorders. J Clin Psychol , 74: 2276-86
Jonhnsson, R. , Bjorklund ,M.  Hornborg, CH.  Karlsson, S.  Hesser, H.  Ljotsson, B.  Rousseau, A.  Frederick, R.  Andersson, G. (2013).  Affect-focused psychodynamic psychotherapy for depressionand anxiety through the Internet: a randomized controlled trial. Peer J, 18: 1-22.
Kalleklev, J, Karterud, S. (2018). A comparative study of a mentalization-based versus a psychodynamic group therapy session. Group Analysis. 2018;51(1):44-60
Magnavita, N. (2007).Anxiety and depression at work.  the A/D Goldberg Questionnaire, G Ital Med Lav Ergon. 29(3):670-1.
McCullough,L. Kuhn,N. Kaplan,A. Wolf,J. Lanza Hurley,C. (2003). Treating affect phobia.Publish by the Guilford press. A division of Guilford publications ,Inc. 72 Spring street ,New York, London ,NY 10012.
Oliveira, C.D, Rahioui, H, Smadja, M, Gorsane, M.A, Louppe, F. (2017). Mentalization based treatment and borderline personality disorder. L'Encéphale , 43:340 -345
Osborn, K. Ulvenes, P. Wampold, B. & McCullough, L. (2014). Creating change through focusing on affect: Affect Phobia Therapy. In N. Thoma & D. McKay (Eds.), Working with emotions in cognitive behavioral therapy: Techniques for clinical practice (pp. 146-174). New York: Guilford Press.
 Parekh, A. Smeeth, D, Milner, Y, Healthcare, ST. (2017) undefined. The role of lipid biomarkers in major depression. Healthcare (Basel), 5(2):31-40
Parker,G. Roy, K. L. (2001). Adolescent depression: A review Australian Newzeland Journal ofpsychology. 35(5) ,572-580.
Petersen, R, Brakoulias, V, Langdon, R. (2016). An experimental investigation of mentalization ability in borderline personality disorder. Comprehensive Psychiatry ,16:12 -21
Rossouw, T., & Fonagy, P. (2012). Mentalization-Based Treatment for Self-Harm in Adolescents: A Randomized Controlled Trial. Mentalization J American Academy of Child & Adolescent Psychiatry , 51(12): 1304-13.
Saunders, R. Buckman, J. E. Cape, J. Fearon, P. Leibowitz, J. & Pilling, S. (2019). Trajectories of depression and anxiety symptom change during psychological therapy. Journal of affective disorders, 249: 327-335
 Singhal, G. (2017). neuroscience BB-F in cellular, undefined. Microglia: an interface between the loss of neuroplasticity and depression. frontiersin.org [Internet]. [cited 2020 Jul 29]; Available from: https://www.frontiersin.org/articles/10.3389/fncel.20 17.00270/full
World Health Organization. (2018). Available from: http://www. who. int/en/news-room/fact-sheets/detail/depression.
Yirmiya, R. Rimmerman, N. (2015). neurosciences RR-T in, 2015 undefined. Depression as a microglial disease. Elsevier [Internet]. [cited 2020 Jul 29]; Available from: https://www.sciencedirect.com/science/article/pii/S0 166223615001769