Effectiveness of Mindfulness-Based Relapse Prevention Group Therapy and Treatment as Usual on Positive and Negative Perfectionism in Men with Opioid Use Disorder: A Comparative Investigation

Document Type : Research Paper

Authors

1 Department of Clinical and Health Psychology, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran

2 Department of Counseling, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran

3 Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran

4 MD, Iranian National Center for Addiction Studies(INCAS), Tehran University of Medical Sciences(TUMS), Tehran, Iran

Abstract

The purpose of this study was to compare mindfulness-based relapse prevention (MBRP) group therapy and treatment as usual (TAU) in terms of their effectiveness on positive and negative perfectionism in men with opioid use disorder (OUD). The method of this study, due to its purpose, is an applied research and its method, in terms of the way of data collection, is an experiment with a pre-test-post-test. The population included men with opioid use disorder who were referred to Iranian National Center for Addiction Studies in Tehran in 2018. 36 patients were selected as the sample and randomly assigned to two groups: one group received a combination of MBRP group therapy and TAU and the other was treated with TAU only. Participants completed the Positive and Negative Perfectionism Scale (PANPS) at pretest, posttest, and follow-up. Data were statistically analyzed using a mixed-design ANOVA model. SPSS software (version 22) was used for data analysis. The results showed that none of the intergroup, intragroup, and interactive sources of variation in positive perfectionism were statistically significant. For negative perfectionism, the differences between the study phase groups were significant. The Bonferroni method was applied to examine the difference scores in the test phases and showed that the mean score decreased significantly in the posttest and follow-up phases compared with the pretest. According to these results, MBRP was effective in reducing negative perfectionism, but we cannot find any differences in the effectiveness of the therapies. These results indicate that MBRP can be considered an effective therapeutic approach for reducing negative perfectionism in individuals with OUD.

Keywords


ابوالقاسمی، ع.، احمدی، م.، و کیامرثی، آ. (1386). بررسی ارتباط فراشناخت و کمال‌گرایی با پیامدهای روان‌شناختی در افراد معتاد به مواد مخدر. مجلۀ تحقیقات علوم رفتاری. 5(2)، 79-73.
بشارت، م. ع. (1384). بررسی رابطۀ کمال‌گرایی مثبت و منفی و مکانیسم‌های دفاعی. پژوهش‌های روان‌شناختی. 1(8)، 21-7.
رضاییان، ح.، حسینیان، س.، و عباس‌آبادی، س. (1393). اثربخشی درمان شناختی مبتنی بر ذهن‌آگاهی بر کمال‌گرایی. پایان‌نامۀ کارشناسی ارشد رشتۀ روان‌شناسی، دانشگاه الزهرا.
رنجبرنوشری، ف.، محمود علیلو، م.، اسدی مجره، س.، قدرتی، ی.، و نجارمبارکی، س. م. (1391). مقایسۀ راهبردهای مقابله با استرس، کمال‌گرایی و خودکارآمدی در افراد مبتلا به اختلال مصرف مواد و افراد بهنجار. اعتیادپژوهی. 7(25)، 56-39.
علیزاده صحرائی، ا. ه.، خسروی، ز.، و بشارت، م. ع. (1388). رابطۀ کارایی خانواده با کمال‌گرایی مثبت و منفی در دانش‌آموزان شهرستان نوشهر. خانواده‌پژوهی. 5(17)، 56-43.
کهن‌پور، ف. (1396). بررسی اثربخشی درمان شناختی مبتنی بر ذهن آگاهی بر کمال‌گرایی منفی دانش‌آموزان. دومین کنگرۀ سراسری تحول و نوآوری در علوم انسانی. 18 خرداد ماه 1396. شیراز. ایران.
میری، س.، و منصوری، ا. (1399). اثربخشی گروه‌درمانی مبتنی بر پذیرش و تعهد بر کمال‌گرایی و اضطراب امتحان دانشجویان. روان‌شناسی بالینی و شخصیت. 15(2)، 26-17.
Azam, M. A. (2015). The Psychophysiology of Maladaptive Perfectionism and Mindfulness Meditation: An Investigation Using Heart Rate Variability. Master of science in kinesiology & health science. York University, Toronto.
Abramowitz, A., & Berenbaum, H. (2007). Emotional triggers and their relation to impulsive and compulsive psychopathology. Personality and Individual Differences, 43(6), 1356-1365.
Bowen, S., Chawala, N., & Marlatt, G. A. (2011). Mindfulness-based relapse pervention for addictive behaviors. The Guilford Press New York London.
Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, J., … & Marlatt, A. (2009). Mindfulness-based relapse prevention for substance use disorders: A pilot efficacy trial. Substance Abuse. 20(4), 295-305.
Brewer, J. A., Elwafi, H. M., & Davis, J. H. (2013). Craving to quit: Psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions. Psychology of Addictive Behaviours: Journal of the Society of Psychologists in Addictive Behaviors, 27(2), 366-379.
Burns, L.R., & Fedewa, B.A. (2005). Cognitive styles: links with perfectionistic thinking. Personality and Individual Differences, 38(1), 103-113.
Carlson, E. N. (2013). Overcoming the barriers to self-knowledge: Mindfulness as a path to seeing yourself as you really are. Perspectives on Psychological Science, 8(2), 173-186.
Chiesa, A., & Serretti, L. (2014). Are mindfulness-based interventions effective for substance use disorders? a systematic review of the evidence. Substance Use & Misuse, 49(5), 492-512.
Cooper, M. L., Frone, M. R., Russell, M., & Mudar, P. (1995). Drinking to regulate positive and negative emotions: A motivated model of alcohol use. Personality and Social Psychology, 69(5), 990-1005.
Dearing, R. L., Stuewig, J., & Tangney, J. P. (2005). On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use. Addictive Behaviors, 30(7), 1392–1404.
Egan, S. J. (2005). An investigation of positive and negative perfectionism. PhD Dissertation in psychology, Curtin University of Technology, school of psychology, Perth, Australia.
Flett, G., Nepon, T., Hewitt, P., & Rose, A. L. (2021). Why perfectionism is antithetical to mindfulness: a conceptual and empirical analysis and consideration of treatment implications. International Journal of Mental Health and Addiction, 19(5), 1625-1645.
Gilbert, S.E. (2014). Using mindful self-compassion to improve self-criticism, self-Soothing, cravings, and relapse in substance abusers in an intensive outpatient program. PhD Dissertation in psychology, The University of Tennessee, Graduate School, Knoxville, United states.
Haase, A. M., Prapavessis, H., & Owens, R. G. (2002). Perfectionism, social physique anxiety and disordered eating: A comparison of male and female elite athletes. Psychology of Sport and Exercise, 3(3), 209–222.
Hewitt, P. L., Flett, G. L., Mikail, S. F., Kealy, D., & Zhang, L. C. (2018). Perfectionism in the therapeutic context: The perfectionism social disconnection model. In J. Stoeber (Ed.), The Psychology of Perfectionism: Theory, Research, Applications (pp. 306–329). Routledge/Taylor & Francis Group.
Holahan, C. J., Moos, R. H., Holahan, C. K., Cronkite, R. C., & Randall, P. K. (2001). Drinking to cope, emotional distress and alcohol use and abuse: A ten-year model. Journal of Studies on Alcohol, 62(2), 190–198.
James, K., & Rimes, K. A. (2018). Mindfulness-based cognitive therapy versus pure cognitive behavioural selfhelp for perfectionism: A pilot randomised study. Mindfulness, 9(3), 801–814.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pan patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33-47.
Keng, S., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review, 31(6), 1041-1056.
Khanna, S., & Greeson, J. (2013). A narrative review of yoga and mindfulness as complementary therapies for addiction. Complementary Therapies for Addiction, 21(3), 244-252.
Luoma, J.B., Kohlenberg, B.S. (2012).  Slow and Steady Wins the Race: A Randomized Clinical Trial of Acceptance and Commitment Therapy Targeting Shame in Substance Use Disorders, Journal of Consulting and Clinical Psychology, 80(1): 43–53.
McCown, W. G., & Carlson, G. (2004). Narcissism, perfectionism and self-termination from treatment in outpatient cocaine users. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 22(4), 329–340
Sancho, M., De Gracia, M., Rodríguez, R. C., Mallorquí-Bagué, N., Sánchez-González, J., Trujols, J., Sánchez, I., Jiménez-Murcia, S., & Menchón, J. M. (2018). Mindfulness-based interventions for the treatment of substance and behavioral addictions: a systematic review. Frontiers in Psychiatry9, article 95.
Shorey, R. C., Brasfield, H., Anderson, S., & Stuart, G. L. (2014). Mindfulness deficits in a sample of subtance abuse treatment seeking adults: A descriptive investigation. Journal of Substance Abuse, 19(1-2), 194-198.
Terry-Short, L. A., Owens, R. G., Slade, P. D., & Dewey, M. E. (1995). Positive and negative perfectionism. Personality and Individual Differences18(5), 663-668.
Tice, D.M., Bratslavsky, E., & Baumeister, R.F. (2001). Emotional distress regulation takes precedence over impulse control: if you feel bad, do it. Journal of Personality and Social Psychology, 80(1), 53-67.
Wang, H. (2017). Positive perfectionism, negative perfectionism, and emotional eating: The mediating role of stress. Eating Behaviors. 26(complete), 45-49.
Wimberley, T.E., Mintz, L.B., & Suh, H. (2015). Perfectionism and mindfulness: effectiveness of a bibliotherapy intervention. Mindfulness, 7(2), 433-444.
World Drug Report 2019 (United Nations publication, Sales No. E.19.XI.8).
Yousefi, E., Azadeh, S.M., & Majlesi, Z. (2016). The effectiveness of mindfulness-based cognitive therapy (MBCT) intervention on mental ruminations, metacognitive beliefs, and perfectionism in patients with obsessive-compulsive disorder in Isfahan province. International Journal of Humanities and Cultural Studies, 1943-1951.