Effectiveness of Schema Therapy on Psychological Distress and Self-defeating Behaviors in Women with Dependent Personality Traits: A Quasi-Experimental Study
Jul 2026· Journal of Health Reports and Technology· Vol 12· 0 citations· 28 references
Abstract
Background: Schema therapy has been proposed as an integrative intervention that targets both emotional symptoms and maladaptive behavioral patterns; however, empirical evidence of its effectiveness for these outcomes remains limited. Objectives: This study aimed to evaluate the effectiveness of a schema therapy-based intervention in reducing psychological distress and self-defeating behaviors among women with dependent personality traits. Methods: This quasi-experimental study used a pretest–posttest design with a control group. The study population comprised women with dependent personality traits who were referred to psychological counseling centers in Rasht, Iran. A total of 34 participants were recruited through convenience sampling and assigned to an intervention group (n = 17) or a control group (n = 17). The intervention group received 8 sessions of group-based schema therapy based on the mode model, whereas the control group received no intervention. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10), and self-defeating behaviors were measured using a self-report questionnaire. Data were analyzed using independent-samples t tests and effect sizes (Cohen d) in SPSS version 26. Results: The results showed significant reductions in psychological distress and self-defeating behaviors in the intervention group compared with the control group at posttest (P < 0.05). Large effect sizes were observed for both psychological distress and the total self-defeating behavior score, indicating clinically meaningful improvement. Conclusions: Schema therapy appears to be an effective intervention for reducing psychological distress and self-defeating behaviors among women with dependent personality traits. These findings support the use of schema-based interventions in mental health settings.
The present study aimed to compare the effectiveness of Cognitive Behavioral Therapy (CBT) and Schema Therapy (ST) on reducing catastrophizing in young adults with depressive symptoms. This applied study employed a quasi-experimental pretest–posttest design with a control group and a two-month follow-up period. The statistical population consisted of young adults diagnosed with depressive disorder who referred to counseling and psychological clinics in District 1 of Tehran between December 2024 and June 2025. From 224 eligible individuals, 45 participants meeting the inclusion criteria were selected using purposive sampling and randomly assigned to three groups: CBT (n = 15), ST (n = 15), and control (n = 15). Both intervention groups participated in eight structured group therapy sessions based on standardized treatment protocols, while the control group received no psychological intervention during the study period. Data were collected using validated self-report measures assessing depressive symptoms and catastrophizing. Statistical analysis was conducted using repeated measures analysis of variance (ANOVA) and Bonferroni post hoc tests in SPSS version 26, after verifying statistical assumptions. The results of repeated measures ANOVA indicated a significant main effect of time (p < 0.001) and a significant time × group interaction effect (p < 0.001) on catastrophizing, while the main effect of group was not statistically significant (p > 0.05). Bonferroni post hoc comparisons showed that both CBT and ST groups had significantly lower posttest catastrophizing scores compared to the control group (p < 0.001). However, no statistically significant difference was observed between the CBT and ST groups at posttest (p > 0.05). Pairwise comparisons across time demonstrated significant reductions in catastrophizing from pretest to posttest and from pretest to follow-up in both intervention groups (p < 0.001), with maintenance of treatment effects at follow-up. Both Cognitive Behavioral Therapy and Schema Therapy were effective in significantly reducing catastrophizing in young adults with depressive symptoms, and their effects were sustained over time; however, no significant difference was found between the two interventions in terms of overall effectiveness.
Shily Rahemi Nooran, T. Tizdast, Bita Nasrolahi· Mental Health and Lifestyle...· 0 citations
The present study aimed to compare the effectiveness of cognitive behavioral therapy and schema therapy on self-coherence in adolescents with high-risk behaviors. This applied study employed a quasi-experimental design with a pretest–posttest format, including a control group and a follow-up phase. The statistical population consisted of adolescents with high-risk behaviors referred to counseling centers of the Department of Education in Karaj in 2025. A total of 45 participants were selected through purposive sampling based on inclusion criteria and were randomly assigned, after matching demographic characteristics, into two experimental groups and one control group (15 participants in each group). One experimental group received cognitive behavioral therapy and the other received schema therapy across eight structured sessions, while the control group remained on a waiting list. Data were collected using the Integrative Self-Knowledge Questionnaire at three time points: pretest, posttest, and two-month follow-up. Data analysis was conducted using SPSS-27 through descriptive statistics, multivariate analysis of variance, repeated measures analysis of variance, and Bonferroni post hoc tests after verifying statistical assumptions. The results indicated that the main effect of group on self-coherence was not statistically significant (p = 0.440), whereas the main effect of time (p < 0.001) and the interaction effect of time and group (p < 0.001) were statistically significant. Bonferroni post hoc comparisons revealed that both cognitive behavioral therapy and schema therapy groups showed significantly higher self-coherence scores compared to the control group at posttest (p < 0.05), while no significant difference was found between the two experimental groups (p > 0.05). Pairwise comparisons across time demonstrated significant improvements from pretest to posttest and from pretest to follow-up in both intervention groups (p < 0.05), with no significant differences between posttest and follow-up, indicating stability of treatment effects. Both cognitive behavioral therapy and schema therapy were effective in enhancing self-coherence among adolescents with high-risk behaviors, and their effects were maintained over time, although no significant superiority of one approach over the other was observed.
Fahimeh Ghafari Moghadam, Fateme Dehghani-Arani, Elham Zarghami· Mental Health and Lifestyle...· 0 citations
ABSTRACT The present study aimed to compare the effectiveness of schema therapy and dialectical behavior therapy on interpersonal relationships in patients with borderline personality disorder. From a methodological perspective, this research employed a quasi-experimental design with a pretest–posttest control group. The statistical population included all individuals who, with a diagnosis or symptoms of borderline personality disorder, had referred to psychiatric centers, psychological service providers, and clinics in the city of Tehran during the years 2024 to 2025. The study sample consisted of 45 patients selected through purposive nonrandom sampling and subsequently randomly assigned to three groups of 15 participants each (two experimental groups and one control group). The first experimental group received group schema therapy in 16 sessions of 60 minutes each, while the second experimental group underwent group dialectical behavior therapy in 16 sessions of 60 minutes each. The control group did not receive any therapeutic intervention during the course of the study. Data collection instruments included the Structured Clinical Interview for Personality Disorders, the Borderline Personality Questionnaire, and the Interpersonal Relationships Questionnaire developed by Mahmoudi et al. (2016). The collected data were analyzed using repeated-measures analysis of variance. The results indicated a significant difference between the effectiveness of the two therapeutic approaches across the components of interpersonal relationships. Accordingly, it can be concluded that schema therapy, compared to dialectical behavior therapy, demonstrates greater effectiveness in improving interpersonal relationships in patients with borderline personality disorder and can be considered an efficient intervention for enhancing interpersonal functioning in this population.
Parisa Zakerzadeh, T. Tizdast, Tahmoores Aghajanihashjin· Mental Health and Lifestyle...· 0 citations
Introduction: Distress tolerance, as a transdiagnostic construct, plays a pivotal role in the persistence of anxiety disorders. The present study aimed to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and Compassion-Focused Therapy (CFT) on distress tolerance among women with anxiety symptoms.
Methods:This was a quasi-experimental study employing a pretest–posttest control group design. The statistical population consisted of all women with anxiety symptoms referred to counseling centers in Bojnord, Iran, during 2025. A total of 45 participants were selected through convenience sampling and randomly assigned to three groups: ACT, CFT, and control (n=15 per group). The research instruments comprised the Beck Anxiety Inventory and the Distress Tolerance Scale. The experimental groups each received eight 90-minute weekly sessions of ACT and CFT, respectively, while the control group received no intervention.
Results: Analysis of covariance revealed statistically significant between-group differences in the distress tolerance (F=73/64, p=0/001) and all subscales (p<0/001). Effect sizes ranged from 0/32 to 0/78. Post-hoc comparisons indicated that both ACT and CFT produced significant improvements in the total score and all subscales of distress tolerance relative to the control group (p<0/001); however, no statistically significant difference was found between the two interventions (p>0/05).
Conclusion: ACT and CFT are equally effective and clinically viable transdiagnostic interventions for improving multiple dimensions of distress tolerance in women with anxiety symptoms. Clinicians may draw upon either protocol to enhance distress tolerance capacity in comparable clinical populations.
Azam Akbari, Ali Ebrahimi, Fatemeh Esmaili· The Journal of Tolooebehdash...· 0 citations
Infertility is a significant source of psychological distress. This study aims to evaluate the effectiveness of acceptance and commitment therapy (ACT) in reducing psychological distress and self-critical rumination among infertile women.
A quasi-experimental design with pre-test/post-test and a control group was used. A convenience sample of 50 infertile women from the Urmia Health Center, Iran, were non-randomly allocated to an ACT group (n = 25) or a control group (n = 25). The experimental group received an eight to ten session ACT program, while the control group received no intervention during the study period. Participants completed the Kessler psychological distress scale and the self-critical rumination scale at pre-test and post-test. Data were analyzed using analysis of covariance to compare post-test scores while controlling for pre-test scores and key demographics. A mediation analysis was also conducted. The trial is registered with the Iranian Registry of Clinical Trials (IRCT; https://irct.behdasht.gov.ir/search/result?query = IRCT20250618066207N1).
The results revealed that the ACT group demonstrated statistically significant reductions in both psychological distress [F(1, 44) = 54,177, p-value < 0.001, partial η² = 0.99] and self-critical rumination [F(1, 44) = 15,752, p-value < 0.001, partial η² = 0.99] compared to the control group. The mediation analysis indicated a nonsignificant indirect effect, suggesting that the reduction in psychological distress was not mediated by changes in self-critical rumination (ß = 0.28, 95% CI [−13.71, 14.12]).
This study provides novel evidence that ACT is a highly effective intervention for alleviating psychological distress in infertile women. A unique and valuable contribution is the finding that while ACT reduces both distress and self-critical rumination, the therapeutic benefits for distress are not mediated by a reduction in rumination. This challenges a potential assumption and directs future research to identify the true active mechanisms of ACT in this population.
Hamed Rezakhani Moghaddam, Safura Khajeh Mohammadloo, Marjan Zare· Journal of Public Mental Hea...· 0 citations
The objective of this study was to examine the effectiveness of short-term psychodynamic psychotherapy on object relations problems and borderline personality disorder symptoms and to investigate the mediating role of mentalization capacity in this therapeutic process. This quasi-experimental study employed a pretest–posttest design with follow-up and included an experimental group receiving short-term psychodynamic psychotherapy and a control group placed on a waiting list. Sixty adults diagnosed with borderline personality disorder were recruited from outpatient clinics in Tehran and randomly assigned to the two groups. The experimental group received twelve weekly individual psychotherapy sessions, while the control group received no intervention during the study period. Assessments were conducted at baseline, post-intervention, and six-week follow-up using standardized measures of borderline symptom severity, object relations functioning, and mentalization capacity. Data were analyzed using mixed-design analysis of variance and regression-based mediation analysis with bootstrapping. Mixed-design ANOVA revealed significant Time × Group interaction effects for borderline personality disorder symptoms (F = 48.62, p < .001, η² = .46), object relations problems (F = 52.19, p < .001, η² = .49), and mentalization capacity (F = 45.73, p < .001, η² = .44), indicating substantial improvements in the experimental group that were maintained at follow-up. Mediation analysis demonstrated that increases in mentalization capacity significantly mediated the effects of psychotherapy on reductions in borderline symptoms and object relations difficulties, with significant indirect effects based on bootstrapped confidence intervals. Short-term psychodynamic psychotherapy produces robust and sustained improvements in borderline symptomatology and object relations functioning, and these therapeutic effects are partially explained by enhancements in mentalization capacity, highlighting mentalization as a core mechanism of change.
Moein Sharifian· Mental Health and Lifestyle...· 0 citations
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