Hospital Practices and Research

Abstract Background: Given the high prevalence and chronic nature of psychosomatic disorders, there is a significant need for effective and sustainable psychotherapeutic interventions.
Objectives: This research aimed to investigate the efficacy of Schema Therapy Based on Mindset (STBM) in enhancing distress tolerance among patients presenting with psychosomatic symptoms in Rasht, Ira.
Methods: This randomized controlled clinical trial followed a pre-test, post-test, and 3-month follow-up design included 30 female patients selected via convenience sampling and randomly allocated to the experimental (n = 15) or control (n = 15) group. The experimental group received eight 2-hour sessions of the STBM protocol. Data were collected using the Distress Tolerance Scale (DTS) and analyzed via Repeated Measures Analysis of Variance (RMANOVA) in SPSS-27.
Results: The findings confirmed a statistically significant effect of STBM on improving overall distress tolerance (P < 0.01), with therapeutic gains successfully maintained at 3-month follow-up. The intervention specifically yielded significant improvements in the tolerance, absorption, and appraisal subscales. However, the effect on the regulation subscale was not statistically significant.
Conclusion: STBM appears to be a promising intervention for modifying maladaptive cognitive-emotional patterns. This protocol is recommended as a valuable therapeutic tool for managing psychological distress and enhancing coping mechanisms in patients with psychosomatic symptoms.

Abstract Background: Bulimia nervosa is a complex eating disorder often associated with maladaptive schemas and anxiety sensitivity. Objectives: This study investigated the effectiveness of Compassion-Focused Therapy (CFT) and Emotion-Focused Schema Therapy (EFT) individually on early maladaptive schemas and anxiety sensitivity in women with bulimia nervosa. Methods: This study employed a quasi-experimental, pretest-posttest control group design. The study population consisted of 75 female patients with a confirmed diagnosis of bulimia nervosa, recruited via convenience sampling from those seeking treatment at the Ahvaz Eating Disorders Association. Participants were assigned to one of three groups (n = 25 per group): two experimental groups and a control group. One experimental group received EFT (10 sessions, 90 minutes each), while the other received CFT (8 sessions, 90 minutes each). The control group received no intervention. The Early Maladaptive Schema Questionnaire and the Anxiety Sensitivity Index were used to assess outcomes. Data were analyzed using analysis of covariance (ANCOVA) within SPSS. Results: Results indicated that both treatments significantly reduced early maladaptive schemas and anxiety sensitivity in women with bulimia nervosa. EFT demonstrated greater efficacy, with larger reductions in early maladaptive schemas (η=0.80, P<0.001) and anxiety sensitivity (η=0.74, P<0.001) compared to CFT. The control group showed no significant changes in either outcome. Conclusion: This study revealed that EFT and compassion-focused therapy reduce maladaptive schemas and anxiety sensitivity in women with bulimia nervosa, with the former showing greater efficacy. Future research should explore the mechanisms driving these differential effects and their long-term outcomes. These findings suggest that EFT may be prioritized in clinical settings to effectively target maladaptive schemas and anxiety sensitivity in women with bulimia nervosa.