Comparing the Effects of Dialectical Behavior Therapy and Mindfulness-Based Cognitive Therapy on Alexithymia in Males with Substance Use Disorder

Social deviations and related issues existed as long as human history. Substance Use Disorder (SUD) is among the causes of social deviation, physiologically and psychologically; it adversely affects individuals’ all functioning aspects. SUD treatment programs impose a high economic burden on societies. The etiology and prevention of the factors affecting SUDs are essential. According to studies, there is a significant difference concerning the components of alexithymia between individuals with SUDs and the healthy population. Alexithymia is a personality trait that includes defects in cognitive emotions, descriptive emotions, and objective thinking (inclined to an imaginative manner of thinking). It also indicated the lack of words to express emotions. Therefore, the current study aimed to compare the effects of Dialectical Behavior Therapy (DBT) and Mindfulness–Based Cognitive Therapy (MBCT) on alexithymia in individuals with SUD.

This was an experimental study with pretest–posttest–follow–up and a control group design. The statistical population of this study included all males with SUDs in Ardabil City, Iran who were referred to the Welfare Office for treatment in 2017–2018. In total, 45 eligible subjects were selected by the convenience sampling method and randomly divided into 3 groups (DBT, MBCT, control). The inclusion criteria of the study were as follows: receiving a definitive diagnosis of SUDs for more than one year; receiving no psychotherapy and pharmacotherapy before entering the study; male gender; an age of >17 years; having an educational level of diploma to the doctoral degree, and providing informed consent forms to participate in the research. The exclusion criteria of the study included not attending treatment sessions, presenting severe psychiatric disorders, generating suicidal ideation, having debilitating diseases, such as cancer and hepatitis, and unwillingness to participate in the study. The instrument used in this study for data collection was the Toronto Alexithymia Scale (Bagby et al., 1994). DBT was performed in 8 sessions based on the package of McKay et al. (2018); eight sessions of MBCT were also conducted as per the package of Segal et al. (2013). However, no intervention was provided to the control group. Descriptive statistics, such as mean and standard deviation, as well as inferential statistics, including repeated–measures Analysis of Variance (ANOVA) and Least Significant Difference (LSD) posthoc test were used to analyze the obtained data in SPSS. The significance level of the tests was considered to be 0.05.  

The obtained results suggested that the mean changes of alexithymia remained significant over time (p<0.001); group effect and time*group interaction effect were also significant (p<0.001). In the experimental groups, the difference between pretest and posttest scores was significant (p<0.001); however, in the control group, there was no significant difference between pretest and posttest scores (p=0.484). There was a significant difference in the mean posttest and follow–up values between the DBT (p=0.016) and the MBCT (p=0.013) groups, highlighting that the effects of the interventions did not last until the follow–up phase.

According to the present study data, DBT and MBCT were effective in reducing alexithymia in males with SUDs. Therefore, these approaches can be used to treat alexithymia disorder in individuals with SUDs; consequently, they can prevent the recurrence of SUDs.