A Comparison of the Effectiveness of Dialectical Behavior Therapy (DBT) and Mindfulness Training in Improving Sleep Quality and Reducing Distress Tolerance in Drug-addicted Treatment Seekers

Document Type : Original Article

Authors

1 Department of Psychology, Science and Research Branch, Islamic Azad University, Ahvaz, Iran

2 Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran.

Abstract

Introduction: The present study aimed to compare the effectiveness of dialectical behavior therapy and mindfulness training in improving the sleep quality and reducing distress tolerance in drug-addicted treatment seekers.
Methods: The research method was quasi-experimental with pretest-posttest design and control group. Using a convenience sampling method, 120 men who were admitted in the mid-term residential addiction treatment center in Baghmalek city were first selected, and then 80 individuals were randomly assigned to three experimental and one control groups (n=20 per group). Experimental groups received twelve 45-minute sessions of mindfulness training, dialectical behavior therapy, and a combination of mindfulness and dialectical behavior therapy. The control group did not receive any intervention training program. All participants responded to the Pittsburgh Sleep Quality Index (PSQI) and Distress Tolerance Scale (DTS) at the beginning of the study, at the end of intervention and one month after the treatment (one-month follow-up). The multivariate analysis of covariance and one-way analysis of variance were utilized to analyze the data. SPSS software was used for data analysis. A significance level of 0.05 was considered statistically significant.
Results: Dialectical behavior therapy and mindfulness training were effective in reducing distress tolerance (F= 124.33, p= 0.0001) and improving sleep quality (F= 37.03, p= 0.001). The combination of dialectical behavior therapy and mindfulness training had no significant effect on distress tolerance (p= 0.071) and sleep quality (p= 0.090).
Conclusion: Both methods had similar effects on the participants. The follow-up results indicated lasting effects of dialectical behavior therapy and mindfulness training on sleep quality and distress tolerance.
 

Keywords

References

1. Lewinson JH, Ruiz P, Millman RB, Langrod JG. Substance abuse: A comprehensive textbook. 4thed. Boston: Williams & Wilkin; 2005. p. 674-81.
2. Kimberly JR, McLellan AT. The business of addiction treatment: A research agenda. Journal of Substance Abuse Treatment. 2006;31(3):213-9. doi: 10.1016/j.jsat.2006.06.018.
3. Yan Y, Nabeshima T. Mouse model of relapse to the abuse of drugs: procedural considerations and characterizations. Behav Brain Res. 2009;196(1):1-10. doi: 10.1016/j.bbr.2008.08.017.
4. Edinger JD, Means MK. Cognitive-behavioral therapy for primary insomnia. Clin Psychol Rev. 2005;25(5):539-58. doi: 10.1016/j.cpr.2005.04.003.
5. Zarani F, Esmaeili S, Ghashang N, et al. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders; Development, Review, Prospect. Journal of Research in Behavioural Sciences. 2016;14(1):125-36. [In Persian]
6. Sajjadnia Z, Siavashi E, Kavosi Z, Moznebi S, Ravangard R. Shift Work and Related Health Problems among Medical and Diagnostic Staff of the General Teaching Hospitals Affiliated to Shiraz University of Medical Sciences, 2012. Journal of Health Management & Informatics. 2015;2(3):89-96.
7. Simons JS, Gaher RM. The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and Emotion. 2005;29(2):83-102.
8. O’Cleirigh C, Ironson G, Smits JA. Does distress tolerance moderate the impact of major life events on psychosocial variables and behaviors important in the management of HIV? Behav Ther. 2007;38(3):314-23. doi: 10.1016/j.beth.2006.11.001.
9. Rutherford HJ, Goldberg B, Luyten P, Bridgett DJ, Mayes LC. Parental reflective functioning is associated with tolerance of infant distress but not general distress: evidence for a specific relationship using a simulated baby paradigm. Infant Behav Dev. 2013;36(4):635-41. doi: 10.1016/j.infbeh.2013.06.008.
10. Baker CN, Hoerger M. Parental Child-Rearing Strategies Influence Self-Regulation, Socio-Emotional Adjustment, and Psychopathology in Early Adulthood: Evidence from a Retrospective Cohort Study. Pers Individ Dif. 2012;52(7):800-5. doi: 10.1016/j.paid.2011.12.034.
11. Michalak J, Burg J, Heidenreich T. Don’t forget your body: Mindfulness, embodiment, and the treatment of depression. Mindfulness. 2012;3(3):190-9. doi: 10.1007/s12671-012-0107-4.
12. Bowen S, Chawala N, Marlatt G. Mindfulnessbased relapse prevention for addictive behaviors. London: Guilford Press; 2012. p. 190-9.
13. Yook K, Lee SH, Ryu M, Kim KH, Choi TK, Suh SY, et al. Usefulness of mindfulness-based cognitive therapy for treating insomnia in patients with anxiety disorders: a pilot study. J Nerv Ment Dis. 2008;196(6):501-3. doi: 10.1097/NMD.0b013e31817762ac.
14. Kazemi-Zahrani H, Jalali N. Effectiveness of Mindfulness-Based Relapse Prevention on Distress and Temptation Tolerance in
Methamphetamine Dependent Patients. Journal of Police Medicine. 2019;8(1):21-6.
15. Robins CJ, Koons CR. Dialectical Behavior Therapy of Severe Personality Disorders. Handbook of Personality Disorders. 2004:221.
16. Miller AL, Rathus JH, Linehan MM. Dialectical behavior therapy with suicidal adolescents: Guilford Press; 2006.
17. Linehan MM, Bohus M, Lynch TR. Dialectical behavior therapy for pervasive emotion dysregulation. Handbook of emotion regulation. 2007;1:581-605.
18. Swales MA, Heard HL. Dialectical Behavior Therapy. New York: Ruthedge; 2009.
19. Nadimi M. On the effectiveness of group dialectical behavior therapy in the enhancement of distress tolerance and emotional regulation in substance abusers. Research on Addiction. 2016;9(36):141-60. [In Persian]
20. Rezaei Z, Vahed N, Rasuli-Azad M, Mousavi GA, Ghaderi A. Effect of dialectical behavior therapy on emotion regulation and distress tolerance in people under methadone therapy. KAUMS Journal (FEYZ). 2019;23(1):52-60.
21. Haghayegh SA, Taher Neshatdoost H, Adibi P, Asgari K. Effectiveness of dialectical behavior therapy for patients with sleep disorders Irritable Bowel Syndrome. Journal of Research in Behavioural Sciences. 2012;10(7);663-71. [In Persian]
22. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.
23. Backhaus J, Junghanns K, Broocks A, Riemann D, Hohagen F. Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res. 2002;53(3):737-40. doi: 10.1016/s0022-3999(02)00330-6.
24. Mokarami H, Kakooei H, Dehdashti A, Jahani Y, Ebrahimi H. Comparison of general health status and sleeping quality of shift workers in a car industry workshop 2008. Behbood Journal. 2010;14(3):237-43.
25. Mahdizadeh S, Salari MM, Ebadi A, Aslani J, Naderi Z, Avazeh A, et al. Relationship between sleep quality and quality of life in chemical warfare victims with bronchiolitis obliterans referred to Baqiyatallah hospital of Tehran, Iran. Health Monitor. 2011;10(2):265-21. [In Persian]
26. Shams J, Azizi A, Mirzaei A. Correlation between distress tolerance and emotional regulation with students smoking dependence. Hakim Research Journal. 2010;13(1):11-8.
27. van Son J, Nyklicek I, Pop VJ, Pouwer F. Testing the effectiveness of a mindfulness-based intervention to reduce emotional distress in outpatients with diabetes (DiaMind): design of a randomized controlled trial. BMC Public Health. 2011;11:131. doi: 10.1186/1471-2458-11-131.
28. ASGHARI F, GHASEMI JR, HOSEINI SMS, JAMEI M. Effectiveness of mindfulness training on emotion regulation and quality of life of addict’s wife. 2016. 7(26), 115-132.
29. Linehan MM, Dimeff LA, Reynolds SK, Comtois KA, Welch SS, Heagerty P, et al. Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug Alcohol Depend. 2002;67(1):13-26. doi: 10.1016/s0376-8716(02)00011-x.
30. Narimani M, Bagiyan-Kulemarez M, Bavand-Poouri A, Bakhti M. The Effectiveness of Group Psychotherapy based on Dialectical Behavior Therapy (DBT) on the Degree of Craving and Difficulty in Emotional Self-regulation of Methamphetamine Users. Journal of Clinical Psychology, 2015;6(4):85-101.
31. Britton W, Shapiro S, Penn P, Bootzin R, editors. Treating insomnia with mindfulness-based stress reduction. Sleep; 2003: AMER ACADEMY SLEEP MEDICINE ONE WESTBROOK CORPORATE CENTER STE 920 ….26, 309-310.
32. Masuda A, Tully EC. The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a nonclinical college sample.
Journal of Evidence-Based Complementary & Alternative Medicine. 2012;17(1):66-71. doi: 10.1177/2156587211423400 .
33. Marlatt GA. Buddhist philosophy and the treatment of addictive behavior. Cognitive and behavioral practice. 2002;9(1):44-50. doi: 10.1016/s1077-7229(02)80039-6.
34. Vadivale AM, Sathiyaseelan A. Mindfulnessbased relapse prevention–A meta-analysis. Cogent Psychology. 2019;6(1):1567090.
35. Lengacher CA, Reich RR, Paterson CL, Jim HS, Ramesar S, Alinat CB, et al. The effects of mindfulness-based stress reduction on objective and subjective sleep parameters in women with breast cancer: a randomized controlled trial. Psychooncology. 2015;24(4):424-32. doi: 10.1002/pon.3603.
36. Bogusch LM, Fekete EM, Skinta MD. Anxiety and depressive symptoms as mediators of trait mindfulness and sleep quality in emerging adults. Mindfulness. 2016;7(4):962-70. doi: 10.1007/s12671-016-0535-7.
37. Owens MD, Nason E, Yeater E. Dialectical behavior therapy for multiple treatment targets: a case study of a male with comorbid personality and substance use disorders. International Journal of Mental Health and Addiction. 2018;16(2):436-50. doi: 10.1007/s11469-017-9798-z.
38. Lemma S, Gelaye B, Berhane Y, Worku A, Williams MA. Sleep quality and its psychological correlates among university students in Ethiopia: a cross-sectional study. BMC Psychiatry. 2012;12:237. doi: 10.1186/1471-244X-12-237.
39. Kirchner N. Taking a Mindful Approach to Substance Abuse Treatment Through Dialectical Behavior. Counselor Education Capstones. 2014.
40. Hamedi A, Shahidi SH, Khademi A. The effectiveness of mindfulness and harm reduction counseling on the prevention of recurrent drug use. Research on Addiction. 2014;7(28):101-18. [In Persian].
41. Dimeff LA, Koerner KE. Dialectical behavior therapy in clinical practice: Applications across disorders and settings: Guilford Press; 2007.
Health Management & Information Science
Volume 7, Issue 1
January 2020
Pages 33-41

Files

Share

How to cite

Statistics