Comparing the Effectiveness of Paradoxical Schedule and Acceptance and Commitment Therapy on Defense Mechanisms and Social Anxiety Symptoms of People with Social Anxiety Disorder Symptoms

Document Type : Research Paper

Authors

1 PhD student, Department of Psychology, Birjand Branch, Islamic Azad University, Birjand, Iran.

2 Associate Professor, Psychology Education Department, Roudhan Branch, Islamic Azad University, Tehran, Iran.

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

Abstract

The present study was conducted with the aim of comparing the effectiveness of the paradoxical schedule and the acceptance and commitment therapy on defense mechanisms and social anxiety symptoms of people with social anxiety disorder symptoms. The research method was a single-subject experimental design. The statistical population included undergraduate psychology students of the Islamic Azad University, Khorramabad branch, after obtaining a high score of social anxiety, diagnosis with a structured interview, and compliance with the entry and exit criteria, 6 people were selected as available sampling. By determining the baseline, the sample members were randomly assigned to two experimental groups of acceptance and commitment therapy, paradoxical schedule and a control group. The intervention sessions were conducted in twelve 90-minute sessions for the experimental groups separately, and the control group did not receive any intervention. The follow-up period was carried out in two phases of one month and two months. In order to collect data, the defensive styles questionnaire of Andrews et al (1993) and the social anxiety questionnaire of Conor et al (2000) were used. Data analysis was performed using trend, stability, percentage of non-overlapping and overlapping data. The results showed that there is a significant difference between the effectiveness of the paradoxical schedule and acceptance and commitment therapy on defense mechanisms and social anxiety symptoms. As the acceptance and commitment therapy compared to the paradoxical schedule, had a greater effect on defense mechanisms and social anxiety symptoms; Its effects were stable in the follow-up stages. T

Keywords

Main Subjects

References

  1. Mekuria K, Mulat H, Derajew H, Mekonen T, Fekadu W, Belete A, Yimer S, Legas G, Menberu M, Getnet A, & Kibret S. High Magnitude of Social Anxiety Disorder in School Adolescents. Psychiatry Journal, 2017; 214: 321-325.
  2. Dalrymple KL, Galione J, Hrabosky J, Chelminski I, Young D, O'brien E, Zimmerman M. Diagnosing social anxiety disorder in the presence of obesity: implications for a proposed change in DSM‐5. Depression and anxiety, 20111; 28(5): 377-382.
  3. Norozi M, Mikaeili Mani F, Isazadegan A. Epidemiology of social anxiety disorder in Urmia University students. Journal of Medical Sciences Studies (Medical Journal of Urmia University of Medical Sciences), 2015; 27(2): 155-166.
  4. Yabande MR, Baghouli H, Sorouqd C, Koreshnia M. Comparing the effectiveness of cognitive behavioral therapy and therapy based on acceptance and commitment on reducing the amount of social anxiety symptoms. Scientific-Research Quarterly of Psychological Methods and Models, 2019; 10(36): 177-196.
  5. Leigh E, Clark DM. Understanding Social Anxiety Disorder in Adolescents and Improving Treatment Outcomes: Applying the Cognitive Model of Clark and Wells (1995). Clinical child and family psychology review, 2018; 21(3): 388–414.
  6. Gültekin BK1, Dereboy IF. the prevalence of social phobia, and its impact on quality of life, academic achievement, and identity formation in university students. Turk Psikiyatri Derg. 2011, 22(3): 150-158.
  7. Boettcher J, Leek L, Matson L, Holmes EA, Browning M, MacLeod C, Carlbring P. Internet-based attention bias modification for social anxiety: a randomized controlled comparison of training towards negative and training towards positive cues. PloS one, 2013; 8(9): 717-720.
  8. Miranda B, Louzã MR. The physician’s quality of life: Relationship with ego defense mechanisms and object relations. Comprehensive Psychiatry, 2015; 63: 22-29.
  9. Schultz DP, Schultz SE. The study of the history of psychology. Cengage Learning (11th Ed.). (pp. 1-20). United States, US: Harcourt College. 2015.
  10. Caletti E, Massimo C, Magliocca S, Moltrasio C, Brambilla P, Delvecchio G. The role of the acceptance and commitment therapy in the treatment of social anxiety: An updated scoping review. Journal of Affective Disorders, 2022; 174-215-218.
  11. Besharat MA, Shahidi S. What is the relationship between? Alexithymia and ego defense styles? A correlational study with Iranian Students. Asian Journal of Psychiatry, 2011; 4: 145-149.
  12. Cramer P. IQ and defense mechanisms assessed with the TAT. Journal of the International Society for the Rorschach, 2015; 36: 40-57.
  13. Porcerelli JH, Cramer P, Porcerelli DJ, Arterbery VE. Defense Mechanisms and Utilization in Cancer Patients Undergoing Radiation Therapy: A Pilot Study. The Journal of Nervous and Mental Disease, 2017; 205: 466-470.
  14. Thurston MD, Goldin P, Heimberg R, Gross JJ. Self-views in social anxiety disorder: The Impact of CBT versus MBSR. Journal of Anxiety Disorders, 2017; 47: 83-90.
  15. Shahbazirad A, Kadampour E, Ghazanfari F, Momeni K. The effectiveness of training based on the cognitive-metacognitive-behavioral model on reducing the symptoms of social anxiety disorder. Studies in Clinical Psychology, 2016; 6(24): 47-61.
  16. Carlin A, Rasgon AL, Lee WH, Leibu E, Frangou S. Bipolar Disorder and Anxiety Disorders Show Overlapping Functional Neural Signatures. In Biological Psychiatry, 2017; 77: 113-117.
  17. Ivanovo E, Lindner P, Ly KH, Dahlin M, Vern mark K, Andersson G., et al. Guided and unguided Acceptance and Commitment Therapy for social anxiety disorder and/or panic disorder provided via the Internet and a smartphone application: A randomized controlled trial.Journal of Anxiety Disorders, 2016; 44(1): 27-35.
  18. Grégoire S, Lachance L, Bouffard T, Dionne F. The use of acceptance and commitment therapy to promote mental health and school engagement in university students: A multisite randomized controlled trial. Behavior Therapy, 2018; 49(3): 360-372.‏
  19. Juvin J, Sadeg S, Julien-Sweerts S, Zebdi R. A Systematic Review: Acceptance and Commitment Therapy for the Parents of Children and Adolescents with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 2021, 211: 1-18.‏
  20. Besharat MA. Evaluating the effectiveness of paradox therapy for the treatment of obsessive-compulsive disorder: A case study. Psychological Studies, 2012; 14(4): 7-36.
  21. Shikatani B, Antony MM, Kuo JR, Cassin SE. The impact of cognitive restructuring and mindfulness strategies on post event processing and affect in social anxiety disorder. Journal of Anxiety Disorders, 2014; 28(6): 570-579.‏
  22. Mohammadi Z., Soleimani A, Fathi Ashtiani A, Ashrafi E, Mokhbari K. The effectiveness of paradoxical schedule treatment on reducing worry, rumination, thought-action confusion and symptoms of patients with obsessive-compulsive disorder. Journal of Disability Studies 2020; 10: 70-75.
  23. Basharat MA. Evaluating the effectiveness of paradox therapy on social anxiety disorder: a case study. Scientific Research Quarterly Journal of Psychological Sciences, 2019; 18(76): 383-396.
  24. Andrews G, Singh M, Bond M. The Defense Style Questionnaire. Journal of Nervous and Mental Disease, 1993; 334: 246-256.
  25. Besharat, MA, Sharifi M, Iravani M. Examining the relationship between attachment styles and defense mechanisms. Journal of Psychology, 2001; 5: 277-289.
  26. Antony MM, Coons MJ, McCabe RE, Ashbaugh A, Swinson RP. Psychometric properties of the social phobia inventory: Further evaluation. Behavioral ResearchTherapy, 2006; 44(8): 1177–1185.
  27. Petersen JM, Davis CH, Renshaw TL, Levin ME, Twohig MP. School-Based Acceptance and Commitment Therapy for Adolescents With Anxiety: A Pilot Trial. Cognitive and Behavioral Practice., 2022; 202: 541-545.
  28. Witlox M, Kraaij V, Garnefski N, Bohlmeijer E, Smit F, Spinhoven P. Cost-effectiveness and cost-utility of an Acceptance and Commitment Therapy intervention vs. a Cognitive Behavioral Therapy intervention for older adults with anxiety symptoms: A randomized controlled trial. PloS one, 2022; 17(1): 262-266.‏
  29. Bai Z, Luo S, Zhang L, Wu S, Chi I. Acceptance and commitment therapy (ACT) to reduce depression: A systematic review and meta-analysis. Journal of Affective Disorders, 2020: 260: 728-737.‏
  30. Gerhart JI, Baker CN, Hoerger M, Ronan GF. Experiential avoidance and interpersonal problems: A moderated mediation model. Journal of Contextual Behavioral Science, 2014; 3(4): 291-298.
  31. Esmaili L, Amiri S, Abedi MR, Molavi H. The effectiveness of therapy based on acceptance and commitment with a focus on compassion on the social anxiety of adolescent girls, Behavior, 2018; 109: 114-117.
  32. Saeed Manesh M, Babaei Z. The effectiveness of group therapy based on acceptance and commitment on the anxiety and self-esteem of 14-18-year-olds with stuttering. Journal of Disability Studies, 2017; 7: 56-56.
  33. Ferreira MG, Mariano LI, de Rezende JV, Caramelli P, Kishita N. Effects of group Acceptance and Commitment Therapy (ACT) on anxiety and depressive symptoms in adults: A meta-analysis. Journal of Affective Disorders, 2022; 506: 455-459.
Medical Journal of Mashhad university of Medical Sciences
Volume 68, Issue 4
May and June 2025
Pages 817-835

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