Investigating the effectiveness of unified transdiagnostic treatment on reducing cognitive-behavioral avoidance and self-care activities in patients with type 2 diabetes

Document Type : Research Paper

Authors

1 PhD student, Department of Consulting, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran

2 Assistant Professor, Department of Psychology, Dezful Branch, Islamic Azad University, Dezful, Iran. (Corresponding Author)

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

4 Assistant Professor, Department of Consulting, Arak Branch, Islamic Azad University, Arak, Iran.

Abstract

Introduction: Considering that diabetes brings mental, physical, personal, family and social relationships and people's understanding of their health, so the purpose of this research is to investigate the effectiveness of integrated transdiagnostic treatment on cognitive-behavioral avoidance and self-care activities in patients with diabetes. It is type 2 diabetes.
Methods: The research method was experimental and a pre-test-post-test design was used with a control group. The statistical population of the research includes all married men and women suffering from type 2 diabetes in Ahvaz, who were members of the Diabetes Association of this city in 1400. To collect information from this statistical population, 40 of these patients were selected using diagnostic interview, oral interview and based on the entry and exit criteria, screening and purposefully and after matching by pairwise method and Individuals were randomly assigned to 2 groups of 20 people, (experimental group with integrated meta-diagnostic treatment method (20 people) and control group (20 people). Research tools include cognitive-behavioral avoidance scale (Ettenberg and Dobson, 2004) and The scale of diabetes self-care activities was (Tobert et al., 2000). The data were analyzed through multivariate (MANCOVA) and univariate (ANCOVA) analysis of covariance.
Results: The results showed that integrated transdiagnostic treatment on avoidance Cognitive-behavioral and self-care activities are effective (p<0.05).
Conclusion: It seems that this intervention can reduce cognitive-behavioral avoidance and increase self-care activities in patients with type 2 diabetes.

Keywords

References

  1.  

    1. Bogusch LM, O'Brien WH. The effects of mindfulness-based interventions on diabetes-related distress, quality of life, and metabolic control among persons with diabetes: a meta-analytic review. Behavioral Medicine. 2019;45(1):19-29.
    2. Wienand I, Rakic M, Shaw D, Elger B. The beneficence of hope: findings from a qualitative study with gout and diabetes patients. Journal of bioethical inquiry. 2018;15:211-8.
    3. Snorgaard O, Poulsen GM, Andersen HK, Astrup A. Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes. BMJ Open Diabetes Research and Care. 2017;5(1):e000354.
    4. Bullard KM, Cowie CC, Lessem SE, Saydah SH, Menke A, Geiss LS, et al. Prevalence of diagnosed diabetes in adults by diabetes type—United States, 2016. Morbidity and Mortality Weekly Report. 2018;67(12):359.
    5. Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. The lancet. 2017;389(10085):2239-51.
    6. Pearson S, Wills K, Woods M, Warnecke E. Effects of mindfulness on psychological distress and HbA 1c in people with diabetes. Mindfulness. 2018;9:1615-26.
    7. Ayoubi J, Bigdeli I, Mashhadi A. The Effect of Mindfulness-Integrated Cognitive Behavior Therapy on Quality of Life, Psychological Distress and Adherence in Patients with Type 2 Diabetes Health Psychology. 2020;9(34):75-94.
    8. WHO CO. World health organization. Diabetes. 2020.
    9. faal m, atef vahid t, MadadiTaeme z, shaaban n, amani o. The Effectiveness of Accepted and Commitment Group Therapy on Psychological Flexibility and Family Communication Patterns in Women with Type 2 Diabetes. Journal of Nursing Education. 2019;7(4):41-9.
    10. Aghajani S, SAMADIFARD H, Narimani M. The Role of Cognitive Avoidance Components and Metacognitive Belief in the Prediction of Quality of Life in Diabetic Patients. Health Psychology. 2017;6(21):142-56.
    11. Ottenbreit ND, Dobson KS. Avoidance and depression: the construction of the Cognitive–Behavioral Avoidance Scale. Behaviour research and therapy. 2004;42(3):293-313.
    12. Krieger T, Altenstein D, Baettig I, Doerig N, Holtforth MG. Self-compassion in depression: Associations with depressive symptoms, rumination, and avoidance in depressed outpatients. Behavior therapy. 2013;44(3):501-13.
    13. Fehm L, Margraf J. Thought suppression: specificity in agoraphobia versus broad impairment in social phobia? Behaviour Research and Therapy. 2002;40(1):57-66.
    14. Sexton KA, Dugas MJ. The cognitive avoidance questionnaire: validation of the English translation. Journal of anxiety disorders. 2008;22(3):355-70.
    15. Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. Journal of consulting and clinical psychology. 2007;75(2):336.
    16. MacLeod CM. The concept of inhibition in cognition. 2007.
    17. Dimidjian S, Barrera Jr M, Martell C, Muñoz RF, Lewinsohn PM. The origins and current status of behavioral activation treatments for depression. Annual review of clinical psychology. 2011;7:1-38.
    18. Dannahy L, Stopa L. Post-event processing in social anxiety. Behaviour Research and Therapy. 2007;45(6):1207-19.
    19. Nooyens AC, Baan CA, Spijkerman AM, Verschuren WM. Type 2 diabetes and cognitive decline in middle-aged men and women: the Doetinchem Cohort Study. Diabetes care. 2010;33(9):1964-9.
    20. Holaway RM, Heimberg RG, Coles ME. A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder. Journal of anxiety disorders. 2006;20(2):158-74.
    21. Brands AM, Biessels GJ, De Haan EH, Kappelle LJ, Kessels RP. The effects of type 1 diabetes on cognitive performance: a meta-analysis. Diabetes care. 2005;28(3):726-35.
    22. Lustman P, Gavard J. Chapter 24; Psychosocial Aspects of Diabetes in Adult Populations. Diabetes in America, Table of Contents. Washington University School of Medicine, St. Louis, MO: 507-517. 2012.
    23. Seyed Nour S, Homaei R. Effectiveness of Group Cognitive-Behavioral Therapy on the Self-Care Behaviors, Psychological Wellbeing, and Hope of Patients with Type II Diabetes. Journal of Clinical Nursing and Midwifery. 2019;8(1):265-75.
    24. Trief PM, Grant W, Elbert K, Weinstock RS. Family environment, glycemic control, and the psychosocial adaptation of adults with diabetes. Diabetes care. 1998;21(2):241-5.
    25. Toljamo M, Hentinen M. Adherence to self‐care and social support. Journal of clinical nursing. 2001;10(5):618-27.
    26. Davies MJ, D’Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2018;61:2461-98.
    27. Steinsbekk A, Rygg LØ, Lisulo M, Rise MB, Fretheim A. Group based diabetes self‐management education compared to routine treatment, waiting list control or no intervention for people with type 2 diabetes mellitus. Cochrane Database of Systematic Reviews. 2015(6).
    28. Mensing C, Boucher J, Cypress M, Weinger K, Mulcahy K, Barta P, et al. National standards for diabetes self-management education. Diabetes care. 2005;28(suppl_1):s72-s9.
    29. Karimi S, Delavar A, khaemi F, Dortaj F. The Effect of Hope Therapy on Self-Care in Patients with Type II Diabetes. Community Health Journal. 2019;13(2):33-4
    30. Rawal LB, Tapp RJ, Williams ED, Chan C, Yasin S, Oldenburg B. Prevention of type 2 diabetes and its complications in developing countries: a review. International journal of behavioral medicine. 2012;19:121-33.
    31. Polonsky WH. Emotional and quality-of-life aspects of diabetes management. Current diabetes reports. 2002;2(2):153-9.
    32. Varkovitzky RL, Sherrill AM, Reger GM. Effectiveness of the unified protocol for transdiagnostic treatment of emotional disorders among veterans with posttraumatic stress disorder: A pilot study. Behavior modification. 2018;42(2):210-30.
    33. Barlow DH, Ellard KK, Fairholme CP. Unified protocol for transdiagnostic treatment of emotional disorders: Workbook: Oxford University Press; 2010.
    34. Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson-Hollands J, Carl JR, et al. Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior therapy. 2012;43(3):666-78.
    35. Aldao A. Emotion regulation strategies as transdiagnostic processes: a closer look at the invariance of their form and function= Estrategias de regulación emocional como procesos transdiagnósticos: una visión más detenida sobre la invarianza de su forma y fun. 2012.
    36. Norton PJ, Barrera TL. Transdiagnostic versus diagnosis‐specific CBT for anxiety disorders: A preliminary randomized controlled noninferiority trial. Depression and anxiety. 2012;29(10):874-82.
    37. McLaughlin KA, Nolen-Hoeksema S. Rumination as a transdiagnostic factor in depression and anxiety. Behaviour research and therapy. 2011;49(3):186-93.
    38. Bullis JR, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Carl JR, Barlow DH. The unified protocol for transdiagnostic treatment of emotional disorders: Preliminary exploration of effectiveness for group delivery. Behavior Modification. 2015;39(2):295-321.
    39. Bilek EL. An Open Trial Investigation of Emotion Detectives: A Transdiagnostic Group Treatment for Children with Anxiety and Depression: University of Miami; 2011.
    40. Riccardi CJ. Randomized Pilot Study of a Brief Transdiagnostic Treatment for Anxiety Disorders. 2012.
    41. Newby JM, McKinnon A, Kuyken W, Gilbody S, Dalgleish T. Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clinical psychology review. 2015;40:91-110.
    42. Steele SJ, Farchione TJ, Cassiello-Robbins C, Ametaj A, Sbi S, Sauer-Zavala S, et al. Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. Journal of psychiatric research. 2018;104:211-6.
    43. Ellard KK, Fairholme CP, Boisseau CL, Farchione TJ, Barlow DH. Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and behavioral practice. 2010;17(1):88-101.
    44. Boisseau CL, Farchione TJ, Fairholme CP, Ellard KK, Barlow DH. The development of the unified protocol for the transdiagnostic treatment of emotional disorders: A case study. Cognitive and Behavioral Practice. 2010;17(1):102-13.
    45. Joormann J, Gotlib IH. Emotion regulation in depression: Relation to cognitive inhibition. Cognition and Emotion. 2010;24(2):281-98.
    46. nasri m, ahadi h, dortaj f. Effectiveness of Transdiagnostic Treatment on Rumination and Cognitive Avoidance in Patients with Type 2 Diabetes. Journal of Psychological Studies. 2018;14(2):41-56.
    47. Mohseni-Ezhiyeh A, Malekpour M, Ghamarani A. The effect of transdiagnostic treatment on mothers of children with autism spectrum disorder. 2016.
    48. Zemestani M, Imani M. Effectiveness of transdiagnostic treatment on depression/anxiety symptoms and emotion regulation. Contemporary Psychology. 2016;11(1):21-32.
    49. Moghanloo VA, Moghanloo RA, Moazezi M. Effectiveness of acceptance and commitment therapy for depression, psychological well-being and feeling of guilt in 7-15 years old diabetic children. Iranian journal of pediatrics. 2015;25(4).
    50. Abdi R, Bakshi A, Mahmoud Alilou M. Efficacy of Unified Transdiagnostic Treatment on Reduction of Transdiagnostic Factors and Symptoms Severity in Emotional Disorders. Psychological Methods and Models. 2013;4(13):1-27.
medical journal of mashhad university of medical sciences
Volume 66, Issue 2
July and August 2023
Pages 278-290

Files

Share

How to cite

Statistics