The effectiveness of dialectical behavior therapy compared to integrative psychotherapy in defensive styles and internet addiction

Document Type : Original Article


1 PhD Student in Counseling Department, Science and Research Branch, Islamic Azad University, Tehran, Iran

2 Associate Professor, Department of Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran

3 Professor of Counseling Department, Allameh Tabatabai University, Tehran, Iran


Aim: This study is aimed to determine the comparison of the effectiveness of dialectical behavior therapy with integrated psychotherapy in defensive styles and Internet addiction. Method: The research method was quasi-experimental with a pretest-posttest design and one-month follow-up with the control group. And the statistical population consisted of all high school students in district one of Tehran province 2017-2018. In this population, 60 students with high scores in Internet addiction were purposefully selected and were placed randomly in two study groups and one control group (20 people in each group). The research tools included the Internet Addiction Test (Young, 1999) and the defense styles of Andrews, Singh, and Bond (2014). The first study group received eight sessions of 90 minutes and one session per week of integrated psychotherapy package of Lotfi, Kashani, and Vaziri (2015), and the second study group received dialectical behavioral therapy package of Linehan (1987). The data were analyzed using repeated measures analysis. Results: The results showed that dialectical behavior therapy intervention is effective on Internet addiction score (F = 61.21, P = 0.001), developed component (F = 4.28, P = 0.046), underdeveloped component (34 F = 6.6, P = 0.017) and neurotic component (F = 4.51, P = 0.041). And integrated psychotherapy intervention is effective on Internet addiction score (F = 54.07, P = 0.001), developed component (F = 10.09, P = 0.003), underdeveloped component (F = 6.80, P = 0.041) and neurotic component (F = 13.44, P = 0.001).This effect has been stable in the follow-up stage. Conclusion: According to the results, it can be concluded that both dialectical therapy and integrated psychotherapy were effective in defense styles and reducing Internet addiction of the participants of the research compared to the control group. But there is no significant difference between the two therapies.


بشارت، محمد. علی،  شریفی، ماندانا.،  ایروانی، محمود. (1380). بررسی رابطه سبک‌های دلبستگی و مکانیسم‌های دفاعی. مجله روانشناسی. 5(3 پیاپی19): 277-289
پوزش، فریبا.، لطفی کاشانی، فرح؛ وزیری، شهرام. (1391). اثربخشی درمان چهار عاملی بر کاهش پریشانی بیماران مبتلا به سرطان پستان. پایان‌نامه کارشناسی ارشد. دانشگاه آزاد اسلامی واحد رودهن.
جعفری ندوشن، محمد.، علی پور ندوشن، خدیجه. (1391). همبستگی اعتیاد به اینترنت با سلامت عمومی در دانشجویان دانشگاه علوم پزشکی قم. مجله دانشگاه علوم پزشکی قم. 6 (23): 86-90
شریفی نیا، محمدحسین. (1392). الگوهای روان‌درمانی یکپارچه با معرفی رویکرد درمان یکپارچه توحیدی. تهران: انتشارات پژوهشگاه حوزه و دانشگاه
عزیزی، علیرضا،. علی میرزایی، آزاده.، شمس، جمال. (1389). بررسی تحمل پریشانی و تنظیم احساسات با وابستگی دانش آموزان به سیگار. حکیم بهار، 13 (1)، 8-11.
قاسم‌زاده، لیلی،. شهرآرای، مهرناز،. مرادی، علی‌رضا. (1386). بررسی نرخ شیوع اعتیاد به اینترنت در دختران دبیرستانی شهر تهران و مقایسه دختران معتاد و غیر معتاد به اینترنت در متغیرهای تنهایی، عزت‌نفس و مهارت‌های اجتماعی. فصل‌نامه مطالعات فرهنگی- دفاعی زنان، 3(1)، 28-7.
لطفی کاشانی، فرح. (1395). گریز از آگاهی: بحثی در درمان یکپارچه نگر. فصلنامه اندیشه و رفتار، 10(40): 77-88
مک­کی، متیو. وود، جفری و برنتلی، جفری. (1393). تکنیک­های رفتار درمانی دیالکتیکی. ترجمه: حسن حمیدپور، زهرا اندوز و حمید جمعه پور (1393). تهران: ارجمند.
وزیری، شهرام.، لطفی کاشانی، فرح. (1395). اثربخشی رفتار درمانی دیالکتیک بر کاهش علائم اختلال شخصیت مرزی. فصلنامه اندیشه و رفتار در روان‌شناسی بالینی، 7(28): 27-36
Adiele, I., amp; Olatokun, W. (2014). Prevalence and determinants of Internet addiction among adolescents. Computers in Human Behavior, 31, 100-110.
Allen, A. B., & Leary, M. R. (2010). Self‐Compassion, stress, and coping. Social and personality psychology compass, 4(2), 107-118.
Amstadter, A. (2008). Emotion regulation and anxiety disorders. Journal of anxiety disorders, 22(2): 211-221.
Andrada D, Neacsiu A, Jeremy W, Eberle R, Kramer R, Wiesmann T, Linehan M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behav Res Ther; 59(12): 40-51.
Andrews G, Singh M, Bond M. (1993). The Defense Style Questionnaire. J Nery Ment Dis. 181 (4):246-220
Barlow, D.  (2014). Clinical Handbook of psychological disorders.NewYork:  Guilford press
Beckstead, D. J., Lambert, M. J., DuBose, A. P., & Linehan, M. (2015). Dialectical behavior therapy with American Indian/Alaska Native adolescents diagnosed with substance use disorders: Combining an evidence based treatment with cultural, traditional, and spiritual beliefs. Journal Addictive behaviors, 51, 84-87.
Brody S, Carson CM. (2014). Brief report: self-harm is associated immature defense mechanisms but not substance use in a nonclinical Scottish adolescent sample. Journal of Adolescence. 35(3): 765-7.
Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18 (7), 211–237
Burnay, J., Billieux, J., Blairy, S., amp; Laroi, F. (2015). Which psychological factors influence Internet addiction? Evidence through an integrative model. Computers in Human Behavior, 43, 28-34.
Cacioppo, M., Barni, D., Correale, C., Mangialavori, S. Danioni, F., Gori.A. (2019). Do attachment styles and family functioning predict Adolescents' Problematic Internet Use? A relative weight analysis, Journal of child and family studies, 28(5), 1263-1271.
Dalbudak, E., Evren, C., Aldemir, S., Coskun, K. S., Ugurlu, H., & Yildirim, F. G. (2014). Relationship of internet addiction severity with depression, anxiety, and alexithymia, temperament and character in university students. Cyberpsychology, Behavior, and Social Networking, 16(4), 272-278.
Kirchner, N.C. (2014). Taking a Mindful Approach to Substance Abuse Treatment through Dialectical Behavior Therapy Techniques. Unpublished Dissertation, Thesis of Master of Science Degree in counselor Education, Winona State University.
Lin, P.-H., Lee, Y.-C., Chen, K.-L., Hsieh, P.-L., Yang, S.-Y., Lin, Y.-L. (2019). the relationship between sleep quality and internet addiction among female college students. Frontiers in Neuroscience, 13, 599.
Miller, A.L. & Rathus, J. H. & Linehan, M. (2007). Dialectical Behavior therapy with suicidal Adolescents. NewYork/London: Guilford Press.
Miranda, B. and Louza, M.R. (2015). The physician`s ouality of life: Relationship with ego defense mechanisms and object relations. Journal of Comprehensive Psychiatry, 63(5): 22-29.
Mo, PK, Chan VW, Chan SW, Lau J. T (2018), The role of social support on emotion dysregulation and Internet addiction among Chinese adolescents: A structural equation model. Addictive behaviors, 82; 86-93.
Sanders CE, Field TM, Diego M, Kaplan M. (2000). The relationship of internet use to depression and social isolation. Adolescence, 35:237-42
Singh, N., & Anand, A. (2015). Ego-Strength and Self-Concept among Adolescents: A Study on Gender Differences. The International Journal of Indian Psychology, 3, 46-54.
Swales, M, A., Heard, H. L. (2009). Dialectical Behavior Therapy. New York: Routledge.
Vishkin A, Bigman Y, Tamir M. (2014). Religion, emotion regulation, and well-being. Religion and spirituality across cultures, 247-69.
Walach, H.; Buchheld, N.; Buttenmuller, V.; Kleinknecht, N. & Schmidth, S. (2006), "Measuring mindfulness- the Freiburg Mindfulness Inventory (FMI)", Personalityand Individual differences, 40. 1543-1555.
Yang, S.; & Tung, C. (2007). Comparison of Internet addicts and non-addicts in Taiwanese high school. Computr Human Behav, 23, 79-96