The effectiveness of combined therapy on overcompensation coping strategies in histrionic personality disorder patients

Seyyedeh Sahar Asgari Ghalebin; Sajad Bashrpour; Seyyedeh Mehsa Mousavi

doi:10.31211/rpics.2023.9.1.287

Autores

Seyyedeh Sahar Asgari Ghalebin Universidade de Mohaghegh Ardabili, Departamento de Psicologia, Ardabil, Irão https://orcid.org/0009-0006-1833-1301
Sajad Bashrpour Universidade de Mohaghegh Ardabili, Departamento de Psicologia, Ardabil, Irão https://orcid.org/0000-0002-2920-2605
Seyyedeh Mehsa Mousavi Universidade de Mohaghegh Ardabili, Departamento de Psicologia, Ardabil, Irão https://orcid.org/0000-0003-3676-2691

DOI:

https://doi.org/10.31211/rpics.2023.9.1.287

Palavras-chave:

Perturbação Histriónica da Personalidade, Terapia do Esquema, Terapia de Aceitação e Compromisso, Estratégia de Hipercompensação, Quási-experimental

Resumo

Objetivo: O objetivo deste estudo foi avaliar a eficácia de uma combinação de Terapia do Esquema e ACT (Terapia de Aceitação e Compromisso) na redução de estratégias de hipercompensação associadas a esquemas mal adaptativos precoces em pacientes diagnosticados com perturbação histriónica da personalidade (PHP). Métodos: Foi utilizado um desenho quase-experimental com grupo de comparação, envolvendo pré-teste, pós-teste e uma avaliação de acompanhamento de dois meses. Trinta indivíduos foram escolhidos por amostragem por conveniência e, em seguida, aleatoriamente atribuídos ao grupo de intervenção ou ao grupo de espera. O grupo de intervenção recebeu dez sessões de terapia combinada de 90 minutos, enquanto o grupo de controlo estava numa lista de espera. O MCMI-III (Inventário Multiaxial Clínico de Millon-III) e o YCI (Inventário de Compensação de Young) foram utilizados como instrumentos de pesquisa. A análise de covariância multivariada foi utilizada para controlar as diferenças pré-tratamento entre os grupos de intervenção e de espera e para avaliar o efeito da intervenção nas medidas de resultado. Resultados: O grupo de intervenção apresentou pontuações na escala de Divulgação do MCMI-III significativamente mais baixas e níveis mais baixos de YCI imediatamente pós-tratamento e na avaliação de acompanhamento de dois meses, em comparação com o grupo de controlo em lista de espera. Os tamanhos do efeito para essas comparações foram grandes a muito grandes, indicando uma melhoria significativa e clinicamente relevante no grupo de intervenção. Conclusões: Os resultados sugerem que a Terapia do Esquema combinada com ACT pode ser eficaz na redução de estratégias de compensação excessiva em pacientes com PHP. As limitações do estudo incluem a ausência de amostragem aleatória na primeira fase de triagem. Futuras pesquisas devem visar replicar esses achados com amostras maiores e populações diversas.

Downloads

Não há dados estatísticos.

Referências

American Psychiatric Association. (Eds.). (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed). American Psychiatric Association.

Arntz, A., Klokman, J., & Siesweda, S. (2005). An experimental test of the schema mode model of borderline personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 36, 226–239. https://doi.org/crvrgt

Arntz, A., & van Genderen, H. (2020). Schema therapy for borderline personality disorder. John Wiley & Sons.

Asgari Qhalebin, S., Saed, A., Ebrahimi, L., & Khudabakhsh Pirklani, R. (2021). The effectiveness of combining schema group therapy and acceptance and commitment therapy on reducing early maladaptive schemas and improving students' schematic mentalities with borderline personality pattern. Scientific Research in Psychology, Educational Sciences and Social Sciences, 23(1), 54–38. https://bit.ly/40QkG0I

Bach, P. A., Gaudiano, B., Pankey, J., Herbert, J. D., & Hayes, S. C. (2006). Acceptance, mindfulness, values, and psychosis: applying acceptance and commitment therapy (ACT) to the chronically mentally ill. In R. A. Baer (Ed.), Mindfulness-based treatment approaches: Clinician's guide to evidence base and applications (pp. 93–116). Elsevier Academic Press. https://doi.org/bvcv4x

Bamelis, L., Evers, S., & Arntz, A. (2012). Design of a multicentered randomized controlled trial on the clinical and cost effectiveness of schema therapy for personality disorders. BMC Public Health, 12, 1–12. https://doi.org/fxq298

Beck, A., Davis, D., & Freeman, A. (2015). Cognitive therapy of personality disorder. Guilford. https://bit.ly/3Kmf8Ec

Chakhssi, F., Janssen, W., Pol, S. M., Van Dreumel, M., & Westerhof, G. J. (2015). Acceptance and commitment therapy group-treatment for non-responsive patients with personality disorders: An exploratory study. Personality and Mental Health, 9(4), 345–356. https://doi.org/f7vrft

Derakhshan, S., Daliri, F., & Gholamzade, S. (2020). The effectiveness of acceptance and commitment group therapy (ACT) on emotion regulation difficulties and self-harm behaviors of people with borderline personality disorder. Rooyesh, 9 (4), 39–46. https://bit.ly/3UjRFYD

Foster, C., Berthollier, N., & Rawlinson, D. (2014). A systematic review of potential mechanisms of change in psychotherapeutic interventions for personality disorder. Journal of Psychology & Psychotherapy, 4, 1–15. https://doi.org/gd3vkw

French, J. H., & Shrestha, S. (2021). Histrionic personality disorder. StatPearlsPublishing. https://bit.ly/43fR9Pr

Gol, A., Aghamohammadian Sharbaf, H., Sedaghat, F., & Rasooli, H. (2019). The effectiveness of schema therapy on the symptoms, severity of early maladaptive schemas, confirm-seeking and self-concept in histrionic personality disorder. Journal of Fundamentals of Mental Health, 21, 387–397. https://bit.ly/3KG0DfB

Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior Therapy, 44(2), 180–198. https://doi.org/c757f7

Hsu, L. (2005). Using critiques of the MCMI to improve MCMI research and interpretations. In R. J. Craig (Ed.), New directions in interpreting the Millon clinical multiaxial inventory-III (MCMI-III). Wiley.

Jacob, G. A., Arntz, A. (2013). Schema therapy for personality disorders — A review. International Journal of Cognitive Therapy, 6, 171–185. https://doi.org/f42hxx

Johnston, C., Dorhay, M. J., Courtney, D., Bayles, T., & O’Kane, M. (2009). Dysfunctional schema modes, childhood trauma and dissociation in borderline personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 40, 248–255. https://doi.org/cjmpkh

Karaosmanoğlu, H. A., Soygüt, G., & Kabul, A. (2013). Psychometric properties of the Turkish Young Compensation Inventory. Clinical Psychology & Psychotherapy, 20(2), 171–179. https://doi.org/c6s7qm

Krattenmacher, T., Kühne, F., Führer, D., Beierlein, V., Brähler, E., Resch, F., Klitzing, K. V., Flechtner, H., Bergelt, C., Romer, G., & Möller, B. (2013). Coping skills and mental health status in adolescents when a parent has cancer: A multicenter and multi-perspective study. Journal of Psychosomatic Research, 74, 252–259. https://doi.org/f2g7z6

Lev, A. (2011). A new group therapy protocol combining acceptance and commitment therapy (ACT) and schema therapy in the treatment of interpersonal disorders: A randomized controlled trial. The Wright Institute. https://bit.ly/3ZVA3n3

Mazaheri Nejad Fard, G., Hossein Sabet, F., & Borjali, A. (2019). The effectiveness of acceptance and commitment therapy on interpersonal dependence and action control in people with dependent personality disorder. Journal of Applied Psychological Research, 10, 161–176. https://doi.org/j5bj

McKay, M., Lev, A., & Skeen, M. (2012). Acceptance and Commitment Therapy for interpersonal problems: Using mindfulness, acceptance, and schema awareness to change interpersonal behaviors. New Harbinger Publication.

Millon, T. (1994). Millon Clinical Multiaxial Inventory-III manual (3rd ed.). National Computer Systems.

Millon, T., Millon, C., Davis, R., & Grossman, S. (2006). MCMI-III manual (3rd ed.). Pearson Assessments.

Novais, F., Araújo, A., & Godinho, P. (2015). Historical roots of histrionic personality disorder. Frontiers in Psychology, 6, Article 1463. https://doi.org/f7t7m7

Perrotta, G. (2019). Psychological trauma: Definition, clinical contexts, neural correlations and therapeutic approaches. Recent discoveries. Current Research in Psychiatry and Brain Disorders, 2019(1), 1–6. https://bit.ly/3zMjy21

Perrotta, G. (2021). Histrionic personality disorder: Definition, clinical profiles, differential diagnosis and therapeutic framework. Archives of Community Medicine & Public Health, 7(1), 001–005. https://doi.org/j5bk

Ritzl, A., Csukly, G., Balázs, K., & Égerházi, A. (2018). Facial emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders. Psychiatry Research, 270, 154–159. https://doi.org/gf9x4v

Sharifi, A. A. (2003). Standardization of Millon-III multi-axis clinical questionnaire in Isfahan [Unpublished master’s thesis]. University of Esfahan.

Smith, S. F., & Lilienfeld, S. O. (2017). Histrionic personality disorder. Elsevier Inc.

Winsper, C., Bilgin, A., Thompson, A., Marwaha, S., Chanen, A. M., Singh, S. P., Wang, A., & Furtado, V. (2020). The prevalence of personality disorders in the community: A global systematic review and meta-analysis. The British Journal of Psychiatry, 216(2), 69–78. https://doi.org/gf5fh2

Young, J. E. (1995). The Young Compensation Inventory. Cognitive Therapy Centre of New York.

Young, J. E. (1999). Cognitive therapy for personality disorders: A schema-focused approach (3rd ed.). Professional Resource Press/Professional Resource Exchange.

Young, J. E. (2014). Schema therapy inventories and related materials. Version 2.5. Schema Therapy Institute

Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press.