The Effectiveness of Cognitive Emotion Regulation Training on Cognitive Abilities of Women with Obsessive-Compulsive Disorder

Obsessive–Compulsive disorders are common in society and negatively affect an individual's function. This disorder is a relatively common neuropsychiatric disorder characterized by intrusive thoughts or images or repetitive actions or behaviors. These obsessions and compulsions are time–consuming and cause distress and dysfunction. Cognitive theories emphasize the role of cognitive factors in this disorder. Today, the nervous involvement of human emotion has drawn increasing attention in basic neuroscience. Emotion is essential in the quality and variety of everyday human experiences. How to interact and influence emotion in areas of cognition is a new research topic. Considering the importance of the problem of cognitive functions in obsessive patients, as well as the effectiveness and efficiency of treatment based on emotion regulation on cognitive disabilities in various disorders, this study aimed to evaluate the effectiveness of cognitive emotion regulation training on cognitive disabilities of patients with obsessive–compulsive disorder.

The research was a quasi–experimental study with a pretest–posttest design follow–up phase with a control group. The statistical population consisted of 169 women aged 20 to 45 years living in Kermanshah City, Iran, who were disrupted by intellectual and practical obsessions based on the Yale–Brown Obsessive–Compulsive Scale (Goodman et al., 1989) and Structured Clinical Interview (First et al., 1996). The patients were detected by the cluster sampling method. First, Kermanshah was divided into 5 regions (north, south, east, west, and center). Then one neighborhood was randomly selected from each region. Then, some blocks were selected from each neighborhood. Afterward, the study questionnaires were distributed to all even numbers in those blocks, from the beginning of the alley to the end. Individuals with a score above 9 were interviewed, and 169 women were eventually diagnosed with obsessive–compulsive disorder. The individuals were then randomly assigned to 2 groups, 20 in the cognitive emotion regulation training group and 20 in the control group. The pretest was administered to both groups. The two groups were matched based on age, education, and socioeconomic status. Both groups completed the Cognitive Abilities Questionnaire (Nejati, 2013) in four stages: pretest, posttest, first follow–up, and second follow–up. The experimental group received 10 group therapy sessions of cognitive emotion regulation training, once per week and 90 minutes each session. The control group did not receive any experimental intervention. After the intervention, the posttest was administered to both groups, and after 1 month, the first follow–up test, and two months after the first follow–up, the second follow–up was performed. To analyze the data, descriptive statistics (mean and standard deviation) and inferential statistics (analysis of variance with repeated measurements and Bonferroni post hoc test) were performed in SPSS version 25. The significance level of the tests was considered to be 0.05.

The results showed that in the posttest, the first follow–up, and the second follow–up, there was a significant difference in the effect of cognitive emotion regulation training on the components of planning (p<0.001), memory (p<0.001), cognitive flexibility (p<0.001), inhibitory control (p<0.001), decision–making (p<0.001), and social cognition (p<0.001) in the experimental group compared to the control group. Nevertheless, this difference in the component of selective attention was not significant (p=0.078). Also, the differences between the average components of planning (p<0.001), memory (p<0.001), cognitive flexibility (p<0.001), inhibitory control (p<0.001), decision–making (p<0.001), and social cognition (p<0.001) in the pretest and posttest situations were significant. However, the average difference of the mentioned components in the posttest and first follow–up situations was not significant (p>0.05). Also, the difference between the mean of the subscales of memory and inhibitory control in the posttest and second follow–up situations was not significant (p>0.05), i.e., the intervention was stable over time.

According to the findings of this research, the principles of cognitive emotion regulation training can be used to improve the cognitive problems of people with obsessive–compulsive disorder.