Razi Journal of Medical Sciences

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Background & Objective: About half of patients with mental disorders have personality disorders. Borderline personality disorder is one of the most severe and serious psychiatric disorders. Borderline personality disorder is the most common personality disorder and among the clinical population with personality disorder, this disorder is observed in 30% to 60% of cases. The term borderline was first used by Adolf Stern (1938) to describe a group of patients who were on the borderline between discrete and mentally disturbed groups. Considering the clinical features of borderline personality disorders in components such as instability in emotion, impulsivity, acting out Which are the basic and problematic components of this disorder, And the common dimention of DBT and ACT models on emotion therapy such as emotion regulation, acceptance of negative and disturbing emotions, In this study, the researcher tries to evaluate and compare the overall effect of these two treatment models on the cognitive dimensions of emotion regulation in this disorder. BPD is a pervasive pattern of instability in interpersonal and self-image relationships and emotional dysregulation, which begins in early adulthood and emerges in a variety of settings and environments. The context of this disorder is different and is associated with the characteristics of agitation and emotional states, anxiety, anger, depression and dangerous behaviors such as self-harm and substance abuse. The main diagnostic criteria for borderline personality disorder is emotional instability, which leads to disproportionate anger, chronic feelings of emptiness and high mood swings, and frequent and intense responses to emotional stimuli. This emotional instability causes the patient to be emotionally aroused in most cases.The result of this high arousal; Behavioral instability, poor emotion control, severe physiological arousal, and disruption of interpersonal relationships.The inability to regulate emotion in these individuals is likely to lead to a tendency to substance abuse. The motivation for drug use in this group of people is mostly due to negative emotions such as depression, anger and anxiety.The purpose of the present study was to compare the effectiveness of acceptance and commitment based group therapy and dialectical behavior therapy on cognitive strategies of emotional regulation in Borderline personality disorder. Methods: The research method of the present study is quasi-experimental-clinical application with pre-test post-test. Participants were selected based on the MCMI-III questionnaire and the structured clinical interview based on the DSM-5 clinical version (SCID-5-PD). To collect data Cognitive Emotion Regulation Questionnaire(CERQ) of Garnefsky were used. To analyze the data, analysis of variance Anova and Bonferroni post hoc test was used to compare the mean of independent variables of therapeutic interventions in experimental groups. Results:The results of this study showed that both acceptance and commitment treatment and dialectical behavior therapy are effective in improving emotional regulation strategies of Borderline personality disorder. both therapeutic approaches increased the score of positive cognitive emotional regulation strategies (positive reconcentration and positive reevalution) And reduce the score of negative cognitive emotional regulation strategies(self blaming, blaming others, rumination and catastrophization)
Discussions: According to the hypothesis of difference in effectiveness of two therapeutic approaches, no significant difference was observed. But regarding the effect size of these two treatment models; according to the value of  F and the Eta coefficient; dialectical behavior therapy model improve strategies of positive focus, rumination, self-blame and blaming others and model based on acceptance and commitment have been more effective in improving positive reevalution, catastrophic and acceptance strategies.
Conclusion: In general, the results of this study showed that the treatment models; based on acceptance and commitment and dialectical behavior therapy (both of the third wave therapies) is effective in improving emotion regulation strategies of borderline personality disorder. Therefore, the application of these two approaches can reduce negative strategies and promote positive  emotional coping strategies for personality disorders. Therefore, it is suggested to  be used these two new treatment models in the treatment of negative and disturbing emotions of personality disorders.
 

Keywords: Acceptance and Commitment Therapy, Dialectical Behavior Therapy, Cognitive Emotional Regulation, Borderline Personality Disorder, Addiction

     

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