Comparison of the effectiveness of cognitive-behavioral therapy and motivational interviews on social psychological adjustment, cortisol hormone and cognitive emotion regulation in coronary heart disease patients

Document Type : Research Paper

Authors

1 PhD student in Health Psychology, Islamic Azad University (United Arab Emirates) (Author)

2 Department of Clinical Psychology, Kharazmi University

3 professor, Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran

4 , Cardiovascular Surgeon, Shahid Rajaei Cardiovascular Center.

Abstract

Introduction: Cardiovascular disease is a serious, chronic and life-threatening disease in the world. Therefore, this study is designed to evaluate the effectiveness of cognitive-behavioral therapy and motivational interviews on social psychological adjustment, cortisol levels and cognitive emotion regulation in coronary heart disease patients.
Methods: For this purpose, a community of women aged 30 to 50 with cardiovascular disease referred to Shahid Rajaei Medical Center in Tehran, 45 people were selected in an accessible way and randomly in experimental and control groups (each group 15 People) were placed. The dependent variables were measured twice before and after the test using the Social Psychological Adjustment Scale, the IBL salivary cortisol kit, and the Cognitive Emotion Regulation Questionnaire.
Results: Frequent measurement analysis of variance showed that both cognitive-behavioral intervention and motivational interview groups improved psychosocial adjustment, decreased cortisol in patients with coronary heart disease, and improved cognitive emotion regulation compared to the control group in both postoperative stages. Examination and follow-up have been significant.
Conclusion: Both treatments were equally effective in improving patients' psychosocial adjustment, but motivational interviews were more effective in reducing cortisol than cognitive-behavioral therapy, and cognitive-behavioral therapy was more effective than motivational interviews in improving cognitive emotion regulation.

Keywords


  1. Yohannes, A. M., Willgoss, T. G., Baldwin, R. C., &
    Connolly, M. J. Depression and anxiety in chronic
    heart failure and chronic obstructive pulmonary
    disease: prevalence, relevance, clinical implications
    and management principles. International journal of
    geriatric psychiatry,2010 . 25(12), 1209-1221.
    2.Rocha, N. S. D., & Fleck, M. P. Evaluation of quality
    of life in adults with chronic health conditions: the
    role of depressive symptoms. Brazilian Journal of
    Psychiatry, 2010. 32(2), 119-124.
    3. Ahmadi, N., Reza Masouleh, S., Shekani, Z., &
    Kazem Nezhad Leili, E. Hemodynamic changes and
    related factors in patients undergoing coronary artery
    bypass grafting surgery. Journal of Holistic Nursing
    and Midwifery, 2012. 22(2), 1-10.
    4. Von Haehling, S., Anker, M. S., & Anker, S. D.
    Prevalence and clinical impact of cachexia in chronic
    illness in Europe, USA, and Japan: facts and numbers
    update 2016. Journal of cachexia, sarcopenia and
    muscle, 2016. 7(5), 507-509.
    5.Moradi, T., & ADIB, H. M. The effect of a multimodal preparation package on anxiety in patients
    undergoing coronary angiography. International
    Cardiovascular Research Journal, 2015. 9(1):10-16.
    6. Khalili, D., Sheikholeslami, F. H., Bakhtiyari, M.,
    Azizi, F., Momenan, A. A., & Hadaegh, F. The
    incidence of coronary heart disease and the population
    attributable fraction of its risk factors in Tehran: a 10-
    year population-based cohort study. PloS one, 2014.
    9(8), e105804.
    7.Burnette, D., Duci, V., & Dhembo, E. Psychological
    distress, social support, and quality of life among
    cancer caregivers in Albania. Psycho‐oncology, 2017.
    26(6), 779-786.
    8.Tal, Azar; Majlisi, Fereshteh; Rahimi Foroushani,
    Abbas; Mohebbi, Bahram; Shojaeizadeh, Davood;
    Salehi No, Alireza. Cognitive adaptation of type 2
    diabetic patients referred to the affiliated hospitals of
    Tehran University of Medical Sciences in compliance
    with treatment. Journal of Health System Research
    1391; 11(6), 1068-1077. [In Persian]
    9. Naderi Roush, Nadreh; Abed Saeedi, Jila; Besharat,
    Mohammad Ali; Darvishpour Kakhki, Ali; Alavi
    Majd, Hamid. An overview of patterns and theories of
    disease adaptation. Payesh Magazine, 2014; 13 (6),
    687-693.
    10. De Ridder, D., Geenen, R., Kuijer, R., & van
    Middendorp, H. Psychological adjustment to chronic
    disease. The Lancet, 2008. 372(9634), 246-255.
    11. Karataş, T., & Bostanoğlu, H. Perceived social
    support and psychosocial adjustment in patients with
    coronary heart disease. International journal of
    nursing practice, 2017. 23(4), e12558.
    12. Zeighami Mohammadi, Sharareh; Tajvidi,
    Mansoureh; Ghazizadeh, Sharareh. The relationship
    between spiritual health and quality of life and mental
    health of young people with beta thalassemia major.
    Journal of Blood Research, 1393؛ 11 (2), 147-154. [In
    Persian]
    13. Rafiei, Hossein; Alipour, Razieh. The
    Relationship between Mental Health, Social
    Psychological Adaptation, and Disease in Patients
    admitted to the Cardiovascular Department of Bu Ali
    Sina Medical Center in Qazvin in 1395. Report of the
    research project approved by Qazvin University of
    Medical Sciences. 1395. [In Persian]
    14. Arnott, Robert. Seven ways to prevent and treat
    heart disease. Translated by Majid Najafi Zini and
    Rasamak Amini. Tehran: Book Therapy Publications.
    1391. [In Persian]
    15. Calat, James. Physiology of nerves and glands.
    Translated by Hadi Bahirai. Tehran: Arasbaran
    Publications. 1396. [In Persian]
    16. Yousefi, Rahim; Asghari, Hamid; Taghiani,
    Elahe. Comparison of primary maladaptive schemas
    and cognitive emotion regulation in heart patients and
    normal individuals. Journal of Zanjan University of
    Medical Sciences, 1395. 24 (10), 130-143. [In
    Persian]
    17. Soltani Shal, Reza; Agham Mohammadian
    Sharabaf, Mohammad Reza. Investigating the role of
    psychological variables and the importance of
    psychotherapy in the psychological pathology of heart
    patients. Journal of Zanjan University of Medical
    Sciences, 1394. 23 (96), 109-121. [In Persian]
    18. Aldao, A., Sheppes, G., & Gross, J. J. Emotion
    regulation flexibility. Cognitive Therapy and
    Research, 2015. 39(3), 263-278.
    19. Kring, A. M., & Sloan, D. M. Emotion
    regulation in psychopa-thology: A transdiagnostic
    approach to etiology and treatment. New York, NY.
    Guilford Press. Krompinger, JW, Moser, JS, &
    Simons, RF (2008). Modulations of the
    electrophysiological response to pleasant stimuli by
    cognitive reappraisal. Emotion, 2010. 8, 132-137.
    20. Jani, Mustafa; Salehi, Bahman; Al-Yasin, Ali;
    Davoodi, Hossein. The effectiveness of cognitivebehavioral group therapy on quality of life in
    cardiovascular patients. Journal of Arak University of
    Medical Sciences, 1396. 20 (3), 22-30. [In Persian]
    21. Houghton, Kate; Case, Paul and Clark, Kirk.
    Cognitive behavioral therapy. Translated by
    Habibollah Ghasemzadeh. Tehran: Arjmand. 1397.
    [In Persian]
    22. Reavell, J., Hopkinson, M., Clarkesmith, D., &
    Lane, D. A. Effectiveness of Cognitive Behavioral
    Therapy for Depression and Anxiety in Patients with
    Cardiovascular Disease: A Systematic Review and
    Meta-Analysis. Psychosomatic medicine, 2018.
    80(8), 742-753.
    23. Jazaieri, H., Goldin, P. R., & Gross, J. J.
    Treating social anxiety disorder with CBT: Impact on
    emotion regulation and satisfaction with life.
    Cognitive Therapy and Research, 2017. 41(3), 406-
    416.
  2. 24. Rosengren, D. B. Building motivational
    interviewing skills: A practitioner workbook.
    Guilford Publications. 2017.
    25. Shoushtari, Azadeh; Mohammad Rezaei, Ali;
    Taheri, Elham. The effectiveness of cognitivebehavioral group therapy on emotional regulation,
    metacognitive beliefs and the mental rumination of
    divorced women. Journal of Mental Health Principles,
    1395. 18 (6), 321-328. [In Persian]
    26. Mahmoudi, Masoumeh; Mohammadkhani,
    Parvaneh; Ghobari Bonab, Bagher; Bagheri, Fariborz.
    The effectiveness of cognitive-behavioral therapy
    group on stress coping strategies in caring relatives of
    Alzheimer's patients. Elderly: Iranian Journal of
    Aging, 1395. 11 (1), 190-2011. [In Persian]
    27. Samadzadeh, Nasim; Poursharifi, Hamid;
    Babapour Khairuddin, Jalil. Evaluation of the
    effectiveness of cognitive-behavioral therapy on
    psychosocial adjustment with disease and symptoms
    of depression in people with type 2 diabetes.
    Quarterly Journal of Clinical Psychology Studies,
    1393. 5 (17), 77-96. [In Persian]
    28. Kazrani, Fatemeh . The effectiveness of
    cognitive-behavioral group therapy on reducing
    anxiety and depression in female heart patients in
    Kermanshah, 3rd National Conference on Strategies
    for Development and Promotion of Educational
    Sciences, Psychology, Counseling and Education in
    Iran, Tehran, Association for Development and
    Promotion of Basic Sciences and Techniques, 2016.
    https: / /www.civilica.com/Paper-PCCONF03-
    PCCONF03_068.html
    29. Rosengren, David. Motivational interview
    skills. Translated by Shima Tamnaei Far. Tehran:
    Arjmand Publications. 1393. [In Persian]
    30. Lempola, L. Improving self-care adherence in
    chronic heart failure patients through motivational
    interviewing (Doctoral dissertation, The College of
    St. Scholastica). 2015.
    31. Miller, W. R., & Rose, G. S. Motivational
    interviewing and decisional balance: contrasting
    responses to client ambivalence. Behavioural and
    cognitive psychotherapy, 2015. 43(2), 129-141.
    32. Miller, W. R., & Rollnick, S. Motivational
    interviewing: Helping people change. Guilford press.
    2012.
    33. Brothers, Majid; Zare, Hossein; Alipour,
    Ahmad; Farzad, Valiullah. The effectiveness of
    motivational interviews on psychological and
    physical indicators in patients with basal blood
    pressure. Journal of Research in Mental Health
    Research, 1395. 10 (4), 11-19. [In Persian]
    34. Ghasemipoor, Yadaleh; Bahrami Ehsan, Hadi;
    Abbaspour, Somayeh; Poursharifi, Hamid. The
    effectiveness of motivational interviews on satisfying
    basic psychological needs in patients with open
    coronary artery vascular surgery. Journal of Clinical
    Psychology, 1390. 3 (2), 43-54. [In Persian]
    35. Motabi, Fereshteh; Fati, Laden. Therapeutic
    drawing in behavioral cognitive theory. Tehran:
    Shahrivar Publishing. 1397. [In Persian]
    36. Ledley, Billing, Peter; McCabe, Randy;
    Anthony, Martin. (2018). Cognitive-behavioral
    therapy group. ISBN-13: 978-1606234044.p131
    37. Rollnick, S., Miller, W. R., & Butler, C.
    Motivational interviewing in health care: helping
    patients change behavior. Guilford Press. 2008.
    38. Leah, Robert. Cognitive Behavioral
    Techniques for Depression and Anxiety Disorders.
    Translated by Samira Masoumian. Tehran: Ibn Sina.
    (Published in original language, 2014).
    39. Deci EL, Ryan RM. The “what” and the “why”
    of goal pursuits: Human needs and the
    selfdetermination of behavior. Psychol Inq. 2000;
    (11):227-268.
    40. Foote J, DeLuca A, Magura S, Warner A,
    Grand A, Rosenblum A. A group motivational
    treatment for chemical dependency. J Subst Abuse
    Treat. 1999; (17): 181-192
    41. Tobin VJ. Facilitating exercise behaviour
    change: A self-determination theory and
    motivational interviewing perspective. University of
    Walse: Bangor; 2003.
    42. Ledly, Hymberg & Marx. (2019). Making
    cognitive-behavioral therapy work : clinical process for
    new practitioners. Publisher : The Guilford Press;
    Third Edition (July 4, 2018). ISBN-13 : 978-
    1462535637.p140
    43. Van den Akker, L. E., Beckerman, H.,
    Collette, E. H., Eijssen, I. C. J. M., Dekker, J., & de
    Groot, V. (2018). Effectiveness of cognitive
    behavioral therapy for the treatment of fatigue in
    patients with multiple sclerosis: A systematic review
    and meta-analysis. Journal of Psychosomatic
    Research, 90, 33-42.
    44. Ambar Kulshreshtha, Margarethe
    Goetz, Alvaro Alonso, Amit J. Shah, J. Douglas
    Bremner, Jack Goldberg, and Viola Vaccarino,
    )2019( Association Between Cardiovascular Health
    and Cognitive Performance: A Twins Study. The
    publisher's final edited version of this article is
    available at J Alzheimers Dis J Alzheimers Dis.
    71(3): 957–968. doi: 10.3233/JAD-190217
    45. Sillay, Stanberg, Cicella, Ruth and Drake,
    2017 Socioeconomic status and cardiovascular
    disease: risks and implications for care. Nature
    Reviews Cardiology, 6(11), 712.
    46. Abela, J. R. Z., & Hankin, B. L. (2008).
    Cognitive vulnerability to depression Handbook of
    depression in children and adolescents (pp. 34-78).
    New York: Guilford Publications.
  3.