Comparison the Effect of Transcranial Direct Current Stimulation and Cognitive-Behavioral Therapy on Obsessive Compulsive Symptom, Obsessive Beliefs and Guilty Feeling in Obsessive-Compulsive Disorder

Document Type : Research Paper

Authors

1 Department of Psychology, Khuzestan Pardis Science and Research Campus,Islamic Azad University, Ahvaz, Iran.

2 Department of Psychology, Ahvaz branch, Islamic Azad University, Ahvaz, Iran.

3 2. Department of Psychology, Ahvaz branch, Islamic Azad University, Ahvaz, Iran.

4 Assistant Professor, Department of Psychology, Islamic Azad University, Ahvaz Branch. Ahvaz, Iran.

5 Department of Psychology, Roodehen branch, Islamic Azad University, Roodehen, Iran.

Abstract

Introduction: the purpose of this study was to compare the effect of transcranial direct current stimulation and cognitive-behavioral therapy on obsessive compulsive symptom, obsessive-compulsive beliefs and guilty feelings in people with obsessive-compulsive disorder in Tehran.
Methods: The research method is quasi-experimental research (pre-test-post-test design with control group). The statistical population included all patients with obsessive-compulsive disorder referred to psychiatric centers and psychological services and counseling in Tehran. The sample size was 30 people who were divided into three groups (two experimental groups and one control group). The first experimental group received transcranial direct current stimulation for 24 sessions of 20 minutes. In the second experimental group, cognitive-behavioral therapy was performed for 10 sessions of 90 minutes and the control group did not receive any intervention. Research data were collected using the Yale Brown Obsessive Compulsive Scale (1986),  Obsessive-Verity Questionnaire (2011), and guilty feelings of Kauger and Jones (1998). For data analysis, univariate analysis of covariance (ANCO) and multivariate analysis of covariance (MANCOVA) were used by SPSS-v.21.
Results: the results showed that both brain electrical stimulation treatments from the skull and cognitive-behavioral therapy separately reduced obsessive-compulsive beliefs and guilty feelings in people with obsessive-compulsive disorder (P< 0.05).
Conclusion: among the two treatments, the treatment of transcranial direct current stimulation was more effective than cognitive-behavioral therapy in reducing the obsessive compulsive symptom and guilty feelings, but it was more effective in reducing the cognitive-behavioral beliefs of obsessive beliefs; these results were also observed after one-month follow-up period.

Keywords

References

  1. Fineberg NA, Apergis-Schoute AM, Vaghi MM, Banca P, Gillan CM, Voon V, Chamberlain SR, Cinosi E,
    Reid J, Shahper S, Bullmore ET. Mapping compulsivity in the DSM-5 obsessive compulsive and related
    disorders: cognitive domains, neural circuitry, and treatment. International Journal of
    Neuropsychopharmacology. 2018 Jan;21(1):42-58.
    2. Politis S, Magklara K, Petrikis P, Michalis G, Simos G, Skapinakis P. Epidemiology and comorbidity of
    obsessive–compulsive disorder in late adolescence: a cross-sectional study in senior high schools in Greece.
    International Journal of psychiatry in clinical practice. 2017 Jul 3;21(3):188-94.
    3. Zohar J, editor. Obsessive compulsive disorder: Current science and clinical practice. John Wiley & Sons;
    2012 May 31.
    4. Liu‐Thwaites N, Thomasson R. Obsessive compulsive disorder (OCD). InPsychiatry: Breaking the ICE 2015
    Sep 26.
    5. Sadock B, Ruiz P. Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences. Walters Kluwer; 2015.
    6. Dadashi M, Bulhari J, Malakouti K, Baian zadeh A. Survey of Obsessive-Compulsive Disorder Symptoms.
    Thoughts and Behavior.2016;2:42-27. (Persian).
    7. Klimke A, Nitsche MA, Maurer K, Voss U. Case report: Successful treatment of therapy-resistant OCD with
    application of Transcranial Alternating Current Stimulation (tACS). Brain Stimulation: Basic, Translational,
    and Clinical Research in Neuromodulation. 2016 May 1;9(3):463-5.
    8. Ghaffari H, Yoonessi A, Darvishi MJ, Ahmadi A. Normal Electrical Activity of the Brain in ObsessiveCompulsive Patients After Anodal Stimulation of the Left Dorsolateral Prefrontal Cortex. Basic and clinical
    neuroscience. 2018 Mar;9(2):135.
    9. Boggio PS, Zaghi S, Fregni F. Modulation of emotions associated with images of human pain using anodal
    transcranial direct current stimulation (tDCS). Neuropsychologia. 2009 Jan 1;47(1):212-7.
    10. Brunoni A, Nitsche M, Loo C. Transcranial direct current stimulation in neuropsychiatric disorders. Cham,
    CH: Springer International Publishing. 2016.
    11. Rezaanjad Asl A, Essa zadegan A, Mikaeli F. Impact of neurological manipulation of prefrontal-posterior
    cortex on lack of cognitive flexibility, Urmia University, Department of Psychology, Faculty of Educational
    Sciences, Shafa Khatam.2015;4(2):1-10. (Persian).
    12. Wolkenstein L, Plewnia C. Amelioration of cognitive control in depression by transcranial direct current
    stimulation. Biological psychiatry. 2013 Apr 1;73(7):646-51.
    13. Toloee S, Rahnama L, Karimi N, Abdollahi I, Jaberzadeh Sh. Study of the effect of brain stimulation or
    unilateral direct flow on two parts of the primary and secondary pharyngeal cortex on upper extremity function
    of Mittal patients in acute stroke. Master's thesis, University of Social Welfare and Rehabilitation Sciences,
    Department of Physiotherapy.2016;23-21. (Persian).
    14. Olatunji BO, Davis ML, Powers MB, Smits JA. Cognitive-behavioral therapy for obsessive-compulsive
    disorder: A meta-analysis of treatment outcome and moderators. Journal of psychiatric research. 2013 Jan
    1;47(1):33-41.
    15. Movahed FS, Goradel JA, Pouresmali A, Mowlaie M. Effectiveness of transcranial direct current stimulation
    on worry, anxiety, and depression in generalized anxiety disorder: a randomized, single-blind
    pharmacotherapy and sham-controlled clinical trial. Iranian Journal of Psychiatry and Behavioral Sciences.
    2018 Jun 1;12(2).
    16. Leeuwerik T, Cavanagh K, Strauss C. Patient adherence to cognitive behavioural therapy for obsessivecompulsive disorder: a systematic review and meta-analysis. Journal of anxiety disorders. 2019 Dec
    1;68:102135.
    17. Abramowitz JS, Arch JJ. Strategies for improving long-term outcomes in cognitive behavioral therapy for
    obsessive-compulsive disorder: Insights from learning theory. Cognitive and Behavioral Practice. 2014 Feb
    1;21(1):20-31.
    18. D'Urso G, Mantovani A, Patti S, Toscano E, de Bartolomeis A. Transcranial direct current stimulation in
    obsessive-compulsive disorder, posttraumatic stress disorder, and anxiety disorders. The journal of ECT. 2018
    Sep 1;34(3):172-81.
  2. 19. Nowakowska‐Domagała K, Chodkiewicz J, Ziółkowski M, Czarnecki D, Gąsior K, Juczyński A, Biedrzycka A.
    The Polish Version of the Yale‐Brown Obsessive–Compulsive Scale, Modified to Reflect Obsessions and
    Compulsions Related to Heavy Drinking (YBOCS‐hd‐PL). Alcoholism: Clinical and Experimental Research.
    2016 Feb;40(2):401-7.
    20. Alice, Albert McLaren, Catherine. rational behavioral therapy. translation by Mehrdad Firuz Bakht. Tehran.
    Publications: Rasa.1385;14. (Persian).
    21. Salkovskis PM, Kobori O. Reassuringly calm? Self-reported patterns of responses to reassurance seeking in
    obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry. 2015 Dec 1;49:203-
    8.
    22. Bloch MH, Landeros-Weisenberger A, Rosario MC, Pittenger C, Leckman JF. Meta-analysis of the symptom
    structure of obsessive-compulsive disorder. American Journal of Psychiatry. 2008 Dec;165(12):1532-42.
    23. Segal ZV, Teasdale JD, Williams JM, Gemar MC. The mindfulness‐based cognitive therapy adherence scale:
    Inter‐rater reliability, adherence to protocol and treatment distinctiveness. Clinical Psychology & Psychotherapy.
    2002 Mar;9(2):131-8.
    24. Nourian M, Rezaei Dowlatsahi Gh. Comparison of the efficacy of cognitive rehabilitation protocols based on
    computerized homework assignments with and without electromagnetic transaxle stimulation in improving the
    executive functions of patients with stroke, MSc thesis, Ministry of Science and Research and Technology,
    Shahid Madani University of Azarbaijan, Faculty of Psychology and Educational Sciences.2015;28. (Persian).
    25. Pourfaraj Omran M, Hashemi T, Khanjani T. Comparing sense of responsibility and thought-action blend in
    patients with obsessive-compulsive anxiety. New Cognitive Science. 2012;14(56); 49-56. (Persian).
    26. Ghazie Moradi H. In appreciating Shame: Sociology of Shame in Iran.2015.
    27. Abramowitz JS, Arch JJ. Strategies for improving long-term outcomes in cognitive behavioral therapy for
    obsessive-compulsive disorder: Insights from learning theory. Cognitive and Behavioral Practice. 2014 Feb
    1;21(1):20-31.
    28. Abrantes AM, Brown RA, Strong DR, McLaughlin N, Garnaat SL, Mancebo M, Riebe D, Desaulniers J, Yip
    AG, Rasmussen S, Greenberg BD. A pilot randomized controlled trial of aerobic exercise as an adjunct to OCD
    treatment. General hospital psychiatry. 2017 Nov 1;49:51-5.
    29. Saburi Sh, Mehryar A, Gharib A. Comparison of the effectiveness of cognitive-behavioral techniques,
    clomipramine and their combination in improving patients with obsessive-compulsive disorder. Journal of
    Psychiatry and Clinical Psychology of Iran.1999;4(10):25-34. (Persian).
    30. Shams, Giti, Karam Ghadiri, Ismaili Turkanbouri, Yaghoub, Ebrahim Khani. Validity and reliability of the
    Persian version of the Obsessive Beliefs Questionnaire-44. Cognitive Science News. 2004 Apr 10; 6 (1): 23-36.
    31. Naziri Q. The role of guilt in the process of processing information of obsessive-compulsive patients and
    examining its roots in parenting. Master Thesis. Field of Clinical Psychology. Faculty of Behavioral Sciences
    and Mental Health. Tehran Psychiatric Institute. Iran University of Medical Sciences.1995. (Persian).
    32. Saunders N, Downham R, Turman B, Kropotov J, Clark R, Yumash R, Szatmary A. Working memory training
    with tDCS improves behavioral and neurophysiological symptoms in pilot group with post-traumatic stress
    disorder (PTSD) and with poor working memory. Neurocase. 2015 May 4;21(3):271-8.
    33. Ayat Mehr F, Khani M, Shahram HA, Reza H, Sadeghpour S. Comparison of the effectiveness of
    metacognitive and cognitive-behavioral therapies in reducing the symptoms of forced cooking, anxiety and
    depression. Journal of Psychology and Psychiatry.;3(1):26-43.
    34. Kameli S, Hossein Pour Moghaddam S, Zandi Pour, T, Ghasemzadeh R. Improvement of mental health of
    obsessive-compulsive women through cognitive-behavioral group therapy, Medical System of Islamic Republic
    of Iran. 2018;4:329-338. (Persian).
    35. Dalir M, Alipour A., Zare H, Vali-O- Allah F. Comparison of the effectiveness of cognitive bias adjustment, its
    interpretation and its combination with cognitive-behavioral group therapy in decreasing the severity of
    symptoms, beliefs and obsessive behaviors. Journal of Psychological Achievements (Educational Sciences and
    Psychology). Shahid Chamran University of Ahvaz.2016;22(4);1-24. (Persian).
    36. Basaknezhad S, Hatami M, Zargar Y. The Effectiveness of Cognitive-Behavioral Group Therapy on the
    Confidence of Thought-Action Blend of Thoughts and Guilt in Students. Journal of Behavioral
    Sciences.2013;7(1): 7-12. (Persian).
  3. 37. Okasha A, Rafaat M, Mahallawy N, Nahas GE, Dawla AS, Sayed M, Kholi SE. Cognitive dysfunction in
    obsessive‐compulsive disorder. Acta Psychiatrica Scandinavica. 2000 Apr;101(4):281-5.
    38. Dupuy M, Rouillon F, Bungener C. The role of inhibition in obsessional-compulsive disorders. L'Encephale.
    2013 Feb;39(1):44.
    39. Naziri Q, Dadfar M, Karimi Kisami I. The role of religious attachments, ineffective religious beliefs, guilty
    feelings and ineffective cognitive beliefs in the severity of compulsive obsessive compulsive symptoms. J
    Psychiatry Clin Psychol Iran. 2005;11:283-9.
    40. Chamberlain SR, Blackwell AD, Fineberg NA, Robbins TW, Sahakian BJ. The neuropsychology of obsessive
    compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate
    endophenotypic markers. Neuroscience & Biobehavioral Reviews. 2005 May 1;29(3):399-419.
Medical Journal of Mashhad university of Medical Sciences
Volume 64, Issue 3
September and October 2021
Pages 3357-3371

Files

Share

How to cite

Statistics