Determining the Effectiveness of Metacognitive Therapy on Mental Rumination, Emotion Regulation, and Psychological Symptoms in Female Patients with High Blood Pressure Referring to the Health Care Clinic of North West Oil Industry

High blood pressure is one of the most common chronic diseases and the world's third leading cause of death. More than one in five adults worldwide have high blood pressure. Primary hypertension is thought to be caused by psychological and physiological factors. Psychophysiological factors include rumination, emotion regulation, and psychosomatic symptoms. Metacognitive therapy is an emerging therapy that emphasizes reducing ineffective cognitive processes and facilitating metacognitive processing instead of focusing on the content of thinking. The main goal of metacognitive therapy is to enable patients to interact with their thoughts differently, develop flexible metacognitive control and awareness, and prevent processing through worry, rumination, and threatening feminism. This study aimed to determine the effectiveness of metacognitive therapy on mental rumination, emotion regulation, and psychological symptoms of female patients with high blood pressure in the health care clinic of the northwestern oil industry.

The research method was quasi–experimental with a pretest–posttest with a 3–month follow–up design with a control group. The statistical population was all female patients with hypertension referred to the northwestern oil industry health clinic in 2020. From the above population, 30 people were selected by the available sampling method and randomly assigned to experimental (15 people) and control (15 people) groups. The inclusion criteria include satisfaction with participating in group meetings, no substance abuse, and minimum diploma education. The age range was 40–55 years, and the exclusion criteria were the absence of more than two sessions in the experimental group and non–participation and cooperation during the sessions. The experimental group underwent metacognitive therapy for 10 sessions, and the control group received no intervention. Measuring instruments were Ruminative Response Scale (Nolen–Hoeksema & Morrow, 1991), Psychosomatic Complaints Scale (Takata & Sakata, 2004), and the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004). Data analysis using descriptive statistics indicators, including mean and standard deviation, and inferential statistics, including the Chi–square test, independent t test, and analysis of variance with repeated measurements, was done in SPSS software version 22. The significance level of the tests was considered 0.05.

The results showed that in the experimental group compared to the control group, the mean scores of the variables of non–acceptance of emotions, lack of emotional awareness, limited access to emotional strategies, psychosomatic symptoms, and mental rumination in the posttest and follow–up stages were significantly lower than the pretest (p<0.05). However, no significant difference was observed between the mean scores of the follow–up and posttest stages in the mentioned variables, indicating the intervention's continued effectiveness in the follow–up stage (p>0.05).

According to the findings, metacognitive therapy through strategies such as practicing disconnected mindfulness, delaying mental rumination, examining positive beliefs, continuing to challenge positive beliefs, and identifying negative beliefs reduces the difficulty in regulating emotion and rumination and psychosomatic symptoms.