The Comparison of the Effectiveness of Metacognitive Therapy and Emotion Efficacy Therapy on Depression and Self-Care in Non-Clinical Depressed Elderly

Document Type : Original Article

Authors

Department of Psychology, Sari Branch, Islamic Azad University,Sari,Iran

Abstract

The elderly are exposed to psychological and social harms due to various physical, occupational, and social limitations and the symptoms of depression are common during this period that can increase their vulnerability. Consequently, The aim of this study was to compare the effectiveness of metacognitive therapy and emotion efficacy therapy on the level of depression and self-care ability in non-clinical depressed elderly. The design of the present study was quasi-experimental with pretest-posttest and control group. The statistical population included all the elderly with depressive symptoms who were members of Jahangidegan House of Sari, Iran in 2019, Among whom, 45 were selected using purposive sampling method as well as inclusion criteria and assigned randomly into two experimental and one control group (15 people in each group). The experimental groups underwent eight 90-minute metacognitive therapy and emotion efficacy therapy. Data collection tools included Geriatric Depression Scale (Yesavage et al.) and the Elderly Self-Care Questionnaire (Hemati maslak pak & Hashemloo). Data were analyzed using analysis of covariance in SPSS-21 software. The results showed that metacognitive therapy and emotion efficacy therapy are effective in improving depressive symptoms and self-care ability of non-clinical depressed elderly (P <0.05), but there is no significant difference between the effectiveness of these two treatments. According to the results of this study, metacognitive therapy and emotion efficacy therapy can be effective interventions in improving depressive symptoms and strengthening self-care ability in the depressed elderly.

References
Abbasi, M., Ghadampour, A., & Hojati, M. (2017). The Role of self-care, resilience and despair on depression in the elderly with heart diseases. Aging Psychology3(3), 181-188. [Persian]
Akbari, M., & Hosseini, Z. (2019). Meta-analysis comparing the effectiveness of third wave behavioral therapies on depression in Iran: A comparison of acceptance and commitment-based therapies, mindfulness-based therapies and metacognitive therapies (2001-2007). Journal of Clinical Psychology & Personality, 17(1), 175-189. [Persian]
Asadzadeh, A., & Alilo, M. (2017). The Study of the effectiveness of metacognitive therapy on depressive symptoms and life expectancy of women with breast cancer.Clinical Psychology Studies, 8(29), 69-95. [Persian]
Banjongrewadee, M., Wongpakaran, N., Wongpakaran, T., Pipanmekaporn, T., Punjasawadwong, Y., & Mueankwan, S. (2020). The Role of perceived stress and cognitive function on the relationship between neuroticism and depression among the elderly: a structural equation model approach. BMC Psychiatry20(1), Article 25.
Bender, A., & Ingram, R. (2018). Connecting attachment style to resilience: Contributions of self-care and self-efficacy. Personality and Individual Differences, 130(1), 18-20
Chen, M. F., Wang, R. H., & Hung, S. L. (2015). Predicting health-promoting self-care behaviors in people with pre-diabetes by applying Bandura social learning theory. Applied Nursing Research. 28(4), 299-304
Cheng, M. Y., Wang, M. J., Chang, M. Y., Zhang, R. X., Gu, C. F., & Zhao, Y. H. (2020). Relationship between resilience and insomnia among the middle-aged and elderly: mediating role of maladaptive emotion regulation strategies. Psychology, Health & Medicine, 3(1), 1-12.
Cludius, B., Mennin, D., & Ehring, T. (2020). Emotion regulation as a transdiagnostic process. Emotion20(1), 37-44.
Ghadampour, E. G., Azizi, A., & Mohammadi, J. (2016). The Efficacy of Detached Mindfulness in Meta-Cognitive Therapy on Postpartum Depression. Journal of Nursing Education5(5), 17-22. [Persian]
Hanson, R. (2009). Buddha's brain: The Practical neuroscience of happiness, love, and wisdom. New Harbinger Publications.
Hemmati Maslak Pak, M., & Hashemlo, L. (2015). Design and psychometric properties of a self-care questionnaire for the elderly. Iranian Journal of Ageing10(3), 120-131. [Persian]
Imani, A., Dastgiri, S., & Azizi Zeinalhajlou, A. (2015). Population aging and burden of diseases (A Review). Depiction of Health, 6 (2), 43-54. [Persian]

Khairabadi, G., Yousefian, Z., Ghasemi, N., Zamani, M., & Marathi, M. (2017). Comparison of citalopram and metacognitive therapy on depression in patients with major depressive disorder. Journal of Isfahan Medical School, 35(447), 1242-1248. [Persian]
Kim, H., Kim, H. S., & Choi, Y. M. (2017). Depression, interpersonal relationship, daily living stress, daily activity disorder, and health related quality of life from the participation of female elderly in health promoting program. Transylvanian Review1(2), 44-56.
Lee, H., Kim, J. M., & Moon, J. Y. (2020). Patient-centered counseling program using health coaching to promote self-care among elderly hypertension patients in the rural area of South Korea. Korean Journal of Health Education37(2), 112-118.
Lee, S. H. (2017). Moderating effects of interpersonal relation and social network on the relationship between depression and health behavior in elderly. Journal of Digital Convergence15(9), 397-406.
Malakouti, K., Fathollahi, P., Mirabzadeh, A., Salavati, M., & Kahani, S. H. (2006). Validation of geriatric depression scale (GDS-15) in Iran. Research in Medicine30(4), 361-369.
Matthew, M., & West, A. (2016). Emotion Efficacy Therapy (Sh. Mohammad Khani, E Akbari, M Khaleghi, Trans.). Ebn-Sina Publications. [Persian]
McKay, M., & West, A. (2016). Emotion efficacy therapy: A brief, exposure-based treatment for emotion regulation integrating ACT and DBT. New Harbinger Publications.
Moritz, S., Jelinek, L., Hauschildt, M., & Naber, D. (2010). How to treat the untreated: effectiveness of a self-help metacognitive training program (myMCT) for obsessive-compulsive disorder. Dialogues in Clinical Neuroscience12(2), 209-217.
Moshfeq, M., & Hosseini, Q. (2013). Future study of demographic changes in Iran during the period 1390 to 1420. Journal of Socio-Cultural Knowledge, 4(13), 21-42. [Persian]
Oh, J. H., & Park, E. (2017). The impact of health literacy on self-care behaviors among hypertensive elderly. Korean Journal of Health Education and Promotion34(1), 35-45.
Restorick Roberts, A., Betts Adams, K., & Beckette Warner, C. (2017). Effects of chronic illness on daily life and barriers to self-care for older women: A mixed-methods exploration. Journal of Women & Aging29(2), 126-136.
Sakiris, N., & Berle, D. (2019). A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clinical Psychology Review72, 101751.
Seo, H., Lee, G. J., Shon, H. C., Kong, H. H., Oh, M., Cho, H., & Lee, C. J. (2020). Factors Affecting compliance with weight-bearing restriction and the amount of weight-bearing in the elderly with femur or pelvic fractures. Annals of Rehabilitation Medicine44(2), 109.
Sun, J. K., & Smith, J. (2017). Self-perceptions of aging and perceived barriers to care: Reasons for health care delay. The Gerontologist57(suppl_2), S216-S226.
Szymanski, J., & O'Donohue, W. (1995). The potential role of state-dependent learning in cognitive therapy with spider phobics. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 13(2), 131-150.
Thomson, R. M., & Katikireddi, S. V. (2018). Mental health and the jilted generation: Using age-period-cohort analysis to assess differential trends in young people's mental health following the Great Recession and austerity in England. Social Science & Medicine214, 133-143.
Thorslund, J., McEvoy, P. M., & Anderson, R. A. (2020). Group metacognitive therapy for adolescents with anxiety and depressive disorders: A pilot study. Journal of Clinical Psychology76(4), 625-645.
Torki, Y., Hajikazemi, E., Bastani, F., & Haghani, H. (2011). General self-efficacy in elderly living in rest-homes. Iran Journal of Nursing, 24(73), 55-62. [Persian]
Uchmanowicz, I., Jankowska-Polańska, B., Mazur, G., & Froelicher, E. S. (2017). Cognitive deficits and self-care behaviors in elderly adults with heart failure. Clinical Interventions in Aging12, 1565.
Vanderlind, W. M., Millgram, Y., Baskin-Sommers, A. R., Clark, M. S., & Joormann, J. (2020). Understanding positive emotion deficits in depression: From emotion preferences to emotion regulation. Clinical Psychology Review76, 101826.
Wells, A. (2011). Metacognitive therapy for anxiety and depression. Guilford press.
Wells, A., & Sembi, S. (2004). Metacognitive therapy for PTSD: A core treatment manual. Cognitive and Behavioral Practice11(4), 365-377.
Wells, A., Fisher, P., Myers, S., Wheatley, J., Patel, T., & Brewin, C. R. (2012). Metacognitive therapy in treatment-resistant depression: A platform trial. Behaviour Research and Therapy50(6), 367-373.
Wells, A., McNicol, K., Reeves, D., Salmon, P., Davies, L., Heagerty, A., Gaffney, H., Heal, C., Shields, G., & Capobianco, L. (2018). Metacognitive therapy home-based self-help for cardiac rehabilitation patients experiencing anxiety and depressive symptoms: study protocol for a feasibility randomised controlled trial (PATHWAY Home-MCT). Trials19(1), 444.
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research17(1), 37-49.
Ziedonis, D. (2019). Looking for the healthy aging pathways to subjective well-being: the road to personal empowerment and enhanced self-care. International Psychogeriatrics31(4), 451-453.
Zis, P., Daskalaki, A., Bountouni, I., Sykioti, P., Varrassi, G., & Paladini, A. (2017). Depression and chronic pain in the elderly: links and management challenges. Clinical Interventions in Aging12, 709.

Keywords


References
Abbasi, M., Ghadampour, A., & Hojati, M. (2017). The Role of self-care, resilience and despair on depression in the elderly with heart diseases. Aging Psychology3(3), 181-188. [Persian]
Akbari, M., & Hosseini, Z. (2019). Meta-analysis comparing the effectiveness of third wave behavioral therapies on depression in Iran: A comparison of acceptance and commitment-based therapies, mindfulness-based therapies and metacognitive therapies (2001-2007). Journal of Clinical Psychology & Personality, 17(1), 175-189. [Persian]
Asadzadeh, A., & Alilo, M. (2017). The Study of the effectiveness of metacognitive therapy on depressive symptoms and life expectancy of women with breast cancer.Clinical Psychology Studies, 8(29), 69-95. [Persian]
Banjongrewadee, M., Wongpakaran, N., Wongpakaran, T., Pipanmekaporn, T., Punjasawadwong, Y., & Mueankwan, S. (2020). The Role of perceived stress and cognitive function on the relationship between neuroticism and depression among the elderly: a structural equation model approach. BMC Psychiatry20(1), Article 25.
Bender, A., & Ingram, R. (2018). Connecting attachment style to resilience: Contributions of self-care and self-efficacy. Personality and Individual Differences, 130(1), 18-20
Chen, M. F., Wang, R. H., & Hung, S. L. (2015). Predicting health-promoting self-care behaviors in people with pre-diabetes by applying Bandura social learning theory. Applied Nursing Research. 28(4), 299-304
Cheng, M. Y., Wang, M. J., Chang, M. Y., Zhang, R. X., Gu, C. F., & Zhao, Y. H. (2020). Relationship between resilience and insomnia among the middle-aged and elderly: mediating role of maladaptive emotion regulation strategies. Psychology, Health & Medicine, 3(1), 1-12.
Cludius, B., Mennin, D., & Ehring, T. (2020). Emotion regulation as a transdiagnostic process. Emotion20(1), 37-44.
Ghadampour, E. G., Azizi, A., & Mohammadi, J. (2016). The Efficacy of Detached Mindfulness in Meta-Cognitive Therapy on Postpartum Depression. Journal of Nursing Education5(5), 17-22. [Persian]
Hanson, R. (2009). Buddha's brain: The Practical neuroscience of happiness, love, and wisdom. New Harbinger Publications.
Hemmati Maslak Pak, M., & Hashemlo, L. (2015). Design and psychometric properties of a self-care questionnaire for the elderly. Iranian Journal of Ageing10(3), 120-131. [Persian]
Imani, A., Dastgiri, S., & Azizi Zeinalhajlou, A. (2015). Population aging and burden of diseases (A Review). Depiction of Health, 6 (2), 43-54. [Persian]
Khairabadi, G., Yousefian, Z., Ghasemi, N., Zamani, M., & Marathi, M. (2017). Comparison of citalopram and metacognitive therapy on depression in patients with major depressive disorder. Journal of Isfahan Medical School, 35(447), 1242-1248. [Persian]
Kim, H., Kim, H. S., & Choi, Y. M. (2017). Depression, interpersonal relationship, daily living stress, daily activity disorder, and health related quality of life from the participation of female elderly in health promoting program. Transylvanian Review1(2), 44-56.
Lee, H., Kim, J. M., & Moon, J. Y. (2020). Patient-centered counseling program using health coaching to promote self-care among elderly hypertension patients in the rural area of South Korea. Korean Journal of Health Education37(2), 112-118.
Lee, S. H. (2017). Moderating effects of interpersonal relation and social network on the relationship between depression and health behavior in elderly. Journal of Digital Convergence15(9), 397-406.
Malakouti, K., Fathollahi, P., Mirabzadeh, A., Salavati, M., & Kahani, S. H. (2006). Validation of geriatric depression scale (GDS-15) in Iran. Research in Medicine30(4), 361-369.
Matthew, M., & West, A. (2016). Emotion Efficacy Therapy (Sh. Mohammad Khani, E Akbari, M Khaleghi, Trans.). Ebn-Sina Publications. [Persian]
McKay, M., & West, A. (2016). Emotion efficacy therapy: A brief, exposure-based treatment for emotion regulation integrating ACT and DBT. New Harbinger Publications.
Moritz, S., Jelinek, L., Hauschildt, M., & Naber, D. (2010). How to treat the untreated: effectiveness of a self-help metacognitive training program (myMCT) for obsessive-compulsive disorder. Dialogues in Clinical Neuroscience12(2), 209-217.
Moshfeq, M., & Hosseini, Q. (2013). Future study of demographic changes in Iran during the period 1390 to 1420. Journal of Socio-Cultural Knowledge, 4(13), 21-42. [Persian]
Oh, J. H., & Park, E. (2017). The impact of health literacy on self-care behaviors among hypertensive elderly. Korean Journal of Health Education and Promotion34(1), 35-45.
Restorick Roberts, A., Betts Adams, K., & Beckette Warner, C. (2017). Effects of chronic illness on daily life and barriers to self-care for older women: A mixed-methods exploration. Journal of Women & Aging29(2), 126-136.
Sakiris, N., & Berle, D. (2019). A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clinical Psychology Review72, 101751.
Seo, H., Lee, G. J., Shon, H. C., Kong, H. H., Oh, M., Cho, H., & Lee, C. J. (2020). Factors Affecting compliance with weight-bearing restriction and the amount of weight-bearing in the elderly with femur or pelvic fractures. Annals of Rehabilitation Medicine44(2), 109.
Sun, J. K., & Smith, J. (2017). Self-perceptions of aging and perceived barriers to care: Reasons for health care delay. The Gerontologist57(suppl_2), S216-S226.
Szymanski, J., & O'Donohue, W. (1995). The potential role of state-dependent learning in cognitive therapy with spider phobics. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 13(2), 131-150.
Thomson, R. M., & Katikireddi, S. V. (2018). Mental health and the jilted generation: Using age-period-cohort analysis to assess differential trends in young people's mental health following the Great Recession and austerity in England. Social Science & Medicine214, 133-143.
Thorslund, J., McEvoy, P. M., & Anderson, R. A. (2020). Group metacognitive therapy for adolescents with anxiety and depressive disorders: A pilot study. Journal of Clinical Psychology76(4), 625-645.
Torki, Y., Hajikazemi, E., Bastani, F., & Haghani, H. (2011). General self-efficacy in elderly living in rest-homes. Iran Journal of Nursing, 24(73), 55-62. [Persian]
Uchmanowicz, I., Jankowska-Polańska, B., Mazur, G., & Froelicher, E. S. (2017). Cognitive deficits and self-care behaviors in elderly adults with heart failure. Clinical Interventions in Aging12, 1565.
Vanderlind, W. M., Millgram, Y., Baskin-Sommers, A. R., Clark, M. S., & Joormann, J. (2020). Understanding positive emotion deficits in depression: From emotion preferences to emotion regulation. Clinical Psychology Review76, 101826.
Wells, A. (2011). Metacognitive therapy for anxiety and depression. Guilford press.
Wells, A., & Sembi, S. (2004). Metacognitive therapy for PTSD: A core treatment manual. Cognitive and Behavioral Practice11(4), 365-377.
Wells, A., Fisher, P., Myers, S., Wheatley, J., Patel, T., & Brewin, C. R. (2012). Metacognitive therapy in treatment-resistant depression: A platform trial. Behaviour Research and Therapy50(6), 367-373.
Wells, A., McNicol, K., Reeves, D., Salmon, P., Davies, L., Heagerty, A., Gaffney, H., Heal, C., Shields, G., & Capobianco, L. (2018). Metacognitive therapy home-based self-help for cardiac rehabilitation patients experiencing anxiety and depressive symptoms: study protocol for a feasibility randomised controlled trial (PATHWAY Home-MCT). Trials19(1), 444.
Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research17(1), 37-49.
Ziedonis, D. (2019). Looking for the healthy aging pathways to subjective well-being: the road to personal empowerment and enhanced self-care. International Psychogeriatrics31(4), 451-453.
Zis, P., Daskalaki, A., Bountouni, I., Sykioti, P., Varrassi, G., & Paladini, A. (2017). Depression and chronic pain in the elderly: links and management challenges. Clinical Interventions in Aging12, 709.