Document Type : Research Paper

Authors

1 PhD in Educational Psychology, University of Tehran, Tehran, Iran.

2 PhD in Health Psychology, University of Tehran, Tehran, Iran.

3 Assistant Professor, Department of Educational Psychology, University of Tehran, Tehran, Iran.

10.22054/jpe.2023.71499.2524

Abstract

Abstract
This research aims to evaluate the effectiveness of Schema Therapy on cognitive emotion regulation and Emotional Behavior Regulation in mothers with children with learning disabilities. Based on purpose the research was applied with a semi-experimental design with pre-test, and post-test. The statistical population of the study was mothers of children with learning disabilities in Tehran in the first six months of 1400. The sample consisted of 30 mothers who were selected as the final sample by purposive sampling method and were randomly divided into two groups of experiments and control (each Group 15 mothers). Cognitive Emotion Regulation Questionnaire by Garnefski and Kraaij (2002) and Emotional Behavior Regulation by Garnefski and Kraaij (2019) were used. The experimental group received eight sessions of mindfulness-based cognitive therapy and the control group received no therapy. The results of covariance analysis showed that the Perceived Stress and Emotional Behavior Regulation was significantly different in the experimental group (P0.01). So Schema Therapy can be used effectively on cognitive emotion regulation and Emotional Behavior Regulation in mothers with children with learning disabilities.
Keywords: Schema Therapy, Cognitive Emotion Regulation, Emotional Behavior Regulation.
 
 
 
Extended Abstract
Introduction
Learning disability is a neurodevelopmental disorder with biological roots that has three characteristics of reading, writing and mathematics. This disorder affects the normal pattern of learning (American Psychiatric Association, 2013). Research has shown that parents of children with learning disabilities experience more stress and difficulties in dealing with adverse situations compared to other parents (Gupta, 2007; Suzuki, Kobayashi, Moriyama, Kaja, & Enakagi, 2013). Stress is a general reaction to environmental demands and pressures and is associated with the limitation of people's emotional resources to effectively cope with these demands (Emond, Eyck, Kasmerelli, Robinson, Stillar, & Bledrein, 2016; Anioja & Aniojoti, 2016). Therefore, cognitive and behavioral regulation of emotion is necessary for parents with children with learning disabilities.
Emotion regulation includes adjusting or maintaining experiences and expressing negative and positive emotions and indicates the type of emotion experienced, its occurrence, intensity, duration, and how to express it (Gross, 1998; Gross and Thompson, 2007). In this research, has been noted to two dimensions of cognitive and behavioral regulation of emotion. Cognitive regulation of emotion is the way of cognitive processing of a person when facing unfortunate and stressful events (Garnefski, Ban and Kraij, 2005). The cognitive regulation of emotion can be defined as the cognitive method of managing emotionally stimulated information (Pathoff, Garnevsky, Miklosi, Domingos-Sánchez et al., 2016). People who have the cognitive skills of emotional regulation can reduce or manage negative emotions well, and there is a significant relationship between emotion regulation by reducing self-harm and reducing emotional problems such as symptoms of depression, anxiety, and stress. There is (Zofari and Khademi Ashkazari, 2019). Behavioral emotion regulation also evaluates the behavioral strategies that people use to regulate their emotions after stressful or negative events. According to the findings of Garnevsky and Kraich (2019) and Tona (2020), distraction, active coping, and seeking social support are more adaptive methods to cope with stressful events, while avoidance and ignoring are less adaptive strategies.
There are different approaches to helping mothers with children with learning disabilities, and one of these approaches is schema therapy. Schema therapy was founded by Yang, Klosko, and Vishar (2003) and its main goal is to change and improve the initial maladaptive schemas and it is possible to create a healthy schema (Peters et al., 2021). In the approach of schema therapy, the focus is on increased awareness and insight and the understanding of the role of schemas in maintaining problem-causing situations, as well as adjusting the activation and action of schemas (Heuntjen, Rijkboer and Arntz, 2019). Despite conducting numerous researches on the effect of schema therapy, research findings on the effect of schema therapy on mothers with children with learning disabilities are very limited. Therefore, considering the existing gap and the importance of providing effective interventions in the field of cognitive and behavioral regulation of emotion, the present study aims to investigate the effect of schema therapy on the cognitive and behavioral regulation of emotion in mothers with children with learning disabilities.
Research Question
Is schema therapy effective on cognitive and behavioral emotion regulation of mothers with children with learning disabilities?
Literature Review
Hertz and Evans (2021), showed that schema therapy through cognitive, behavioral, interpersonal and experimental interventions has reduced depressive rumination and avoidance behaviors, as well as increased the frequency of positive mood. Dadmo et al. (2018), also showed in research that schema therapy is one of the most important treatments in the treatment of personality disorders, and with schema therapy techniques, emotion regulation can be created in these people.
Methodology
The current research was semi-experimental and the research design was pre-test-post-test with a control group. The statistical population of this study included mothers of children with learning disabilities in Tehran in the first six months of 1400. The research sample included 30 mothers of children with learning disabilities, whose children attended exceptional elementary schools. Among the volunteer mothers, 30 mothers were randomly selected based on the entry and exit criteria. Then, cognitive and behavioral emotion regulation questionnaires were presented to them. Then these 30 mothers were randomly replaced in the experimental and control groups (15 mothers in the experimental group and 15 mothers in the control group). In the next step, the mothers in the experimental group received schema therapy for two months, while the control group did not benefit from this intervention during the research process. After the end of the intervention period, both groups answered the mentioned questionnaires again and the results of the two groups were analyzed with statistical methods of univariate covariance analysis.
Results
The mean and standard deviation of the dependent variables of the research in the pre-test and post-test stages, separated by two experimental and control groups, are presented in Table 1.
Table 1. The mean and standard deviation of the scores of cognitive emotion regulation and Emotional Behavior Regulation in two stages of measurement according to the experimental and control groups
 




Variable


Stage


experimental


control


 




Mean


Standard Deviation


Mean


Standard
Deviation






cognitive emotion regulation


Pretest


13.55


3.04


17.08


.902




Posttest


18.22


.183


17.02


.712




Emotional Behavior Regulation


Pretest


11.61


93.3


68.15


1.98




Posttest


15.37


81.3


.2514


2.04




In order to investigate the effectiveness of schema therapy based on cognitive regulation and emotional behavior, univariate covariance analysis was used. Before conducting this test, the assumptions of the normality of the distribution of scores, the homogeneity of the variance of the variables and the equality of the slope of the regression line were checked and all the assumptions were met.
 
 
Table 2.The results of covariance analysis to compare the cognitive emotion regulation in the experimental group and the control group
 



 

MS


df


F


P-value


Effect size






Pretest


27.37213


1


.34210


0010.


760.




group


40.61689


1


28.309


001.0


840.




error


.5312655


66

 
 
 



total


1174792


69

 
 
 



Table 2 shows the results of covariance analysis to compare the scores of cognitive emotion regulation in the experimental and control groups in the post-test phase. The obtained F value is equal to 309.28 and its significance level is less than 0.001 (p<0.001). Therefore, the null hypothesis is rejected and the research hypothesis is confirmed. Based on this and considering the higher average scores of the experimental group in the post-test, it can be concluded that schema therapy has been effective in increasing the cognitive regulation of emotion.
In the following, the effectiveness of schema therapy on the behavioral regulation of emotions has been investigated using the covariance analysis test.
Table 3. The results of covariance analysis to compare the Emotional Behavior Regulation in the experimental group and the control group



 

MS


df


F


P-value


Effect size




Pretest


27.27413


1


33289.


001.0


74.0




group


40.48689


1


40.404


001.0


.780




error


53/10655


66

 
 
 



total


7479210


69

 
 
 



Table 3 shows the results of the analysis of covariance to compare the emotional regulation scores in the experimental and control groups in the post-test phase. The obtained F value is equal to 404.4 and its significance level is less than 0.001 (p<0.001). Therefore, the null hypothesis is rejected and the research hypothesis is confirmed. Based on this and considering the higher average scores of the experimental group in the post-test, it can be concluded that schema therapy has been effective in increasing the behavioral regulation of emotion.
Discussion
The present study was conducted with the aim of investigating the effectiveness of schema therapy on increasing the cognitive regulation of emotion and the regulation of emotional behavior in mothers with children with learning disabilities. The results showed that schema therapy has a significant effect on increasing the cognitive regulation of emotion and the regulation of emotional behavior in mothers with children with learning disabilities.
Conclusion
The results of this research showed that schema therapy can lead to the reduction of interpersonal problems and emotional instability and emotion regulation by using cognitive therapy. In schema therapy, substituting adaptive management solutions leads to an increase in the regulation of emotions in the individual. In this treatment, by changing incompatible schemas, a person, in facing life events, replaces ineffective coping strategies with adaptive strategies and withdraws his avoidant and negative evaluation. In other words, schema therapy provides conditions for people to use normal and adaptive strategies. Using adaptive strategies increases the mental capacity of people, which in turn improves the regulation of emotions in people.
Acknowledgments
In the end, we would like to express our gratitude to all those who helped the authors in the implementation and compilation of the article.

Keywords

Anuja S. P. Anujothi C . (2016). Resilience and Stress in Children and Adolescents with Specific Learning Disability. Nationallibrary of medicine. 25(1), 17_23.
Bauminger, N. & Kimhi-Kind, I. (2008). Social information processing, security of attachment, and emotion regulation in childrenwith learning disabilities. Journal of Learning Disabilities, 41(4), 315–332.
Dadomo, H., Panzeri, M., Caponcello, D., Carmelita, A & Grecucci, A.(2018). Schema therapy for emotional dysregulation in personality disorders: areview. Journal Logo, 31(1), 43–49.
Elias, M. (2004). The connection between social-emotional learning and learning disabilities: Implications for intervention. Learning Disability Quarterly, 27, 1, 53-63.
 
Hashemizadeh Nehi, N., Jajermi, M., and Mahdian, H. (2019). The effectiveness of group schema therapy on academic procrastination and self-regulation in the learning of second grade female students. Clinical Psychology Research, 10(1), 70-87.
 
Herts, K. L., & Evans, S. (2021). Schema Therapy for Chronic Depression Associated with Childhood Trauma: A Case Study. Clinical Case Studies, 1534650120954275.‏
Huntjens, R. J., Rijkeboer, M. M., & Arntz, A. (2019). Schema therapy for Dissociative Identity Disorder (DID): rationale and study protocol. European journal of psychotraumatology, 10(1), 1571377.
Peeters, N., Stappenbelt, S., Burk, W. J., van Passel, B., & Krans, J. (2021). Schema therapy with exposure and response prevention for the treatment of chronic anxiety with comorbid personality disorder. British Journal of Clinical Psychology, 60(1), 68-76.‏
Young, JE., Klosko, JS., & Weishaar, ME.(2003). Schema therapy: A practitioner's guide. Guilford Press.
Young, J. E., Klosko, J. S., & Weishaar, M.E. (2017). Şema Terapi. İstanbul: Litera.
 
Garnefski, N., Baan, N., & Kraaij, V. (2005). Psychological distress and cognitive emotion regulation strategies among farmers who fell victim to the foot-and-mouth crisis. Personality and Individual Differences, 38(6), 1317–1327.
 
Potthoff, S., Garnefski, N., Miklósi, M., Ubbiali, A., Domínguez-Sánchez, F. J., Martins, E. C., Witthöft, M., Kraai, V. (2016). Cognitive emotion regulation and psychopathology across cultures: A comparison between six European countries. Personality and Individual Differences, 25(2), 218-224.
 
American Psychiatric Association. (2013). Diagnostic And Statistical Manual Of Mental Disorders(DSM5). American Psychiatric Publication.
Brown, K.W. & Ryan, R.M. (2003). "The benefits of being present: mindfulness and its role in psychological well-being". Journal of personality and social psychology. 84, 822-848.
Bekhet, A. K., Johnson, N. L., & Zauszniewski, J. A. (2012). Resilience in family members of persons with autism spectrum disorder: A review of the literature. Issues
Mental Health Nurse, 33(10), 650–656. https://doi.org/10.3109/01612840.2012.671441.
 
Crane, R.(2009). Mindfulness based cognitive therapy: The CBT Distinctive Features. London: Routledge.
Emond, M.,  Eycke, K.T., Kosmerly, S., Robinson, A.L., Stillar, A., Blyderveen, S. (2016). The effect of academic stress and attachment stress on stress-eaters and stress-undereaters. Appetite, 100, 210-215.
Gavidia-Payne, S., Denny, B., Davis, K., Francis, A., & Jackson, M. (2015). Parental resilience: A neglected construct in resilience research. The Clinical Psychologist, 19 (3), 111–121. https://doi.org/10.1111/cp.12053.
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299. doi:10.1037/1089-2680.2.3.271
Gross, J. J., Thompson, R. A., (2007). Emotion regulation: Conceptual foundations. In J. J. & Gross, (Ed.), Handbook of emotion regulation (pp. 3–24). New York, NY: Guilford Press.
Gupta, V. B. (2007). Comparison of parenting stress in different developmental disabilities. Journal of Developmental and Physical Disabilities, 19(4), 417–425. https:// doi.org/10.1007/s10882-007-9060-x.
 
Jones, S. A. Finch, M. (2020). A group intervention incorporating mindfulness-informed techniques and relaxation strategies for individuals with learning disabilities. Learning Disabilities., 48(3), 175_189.
Mukhtar, D. Y., Kumara, A., Hastjarjo, T. D., & Adiyanti, M. (2018). Beban pengasuhan yang dialami oleh orang tua yang memiliki anak dengan gangguan spektrumautis. Paper Presented at the Talenta Conference Series: Tropical Medicine (TM).
Suzuki, K., Kobayashi, T., Moriyama, K., Kaga, M., & Inagaki, M. (2013). A framework for resilience research in parents of children with developmental disorders. Asian Journal of Human Services, 5(0), 104–111. https://doi.org/10.14391/ajhs.5.104.
Rahbar  Karbasdehi, F; Abolghasemi, A. and Rahbar Karbasdehi, A. (2019). The effectiveness of schema therapy on psychological resilience and social competence of students with depressive symptoms. Psychological Studies, 15(4), 73-90.
 
Tamiya S. [Multilingualism and child psychiatry: on differential diagnoses of language disorder, specific learning disorder, and selective mutism]. Seishin Shinkeigaku Zasshi. 2014;116(11):907–20.
 
Tuna, E. (2020). Psychometric properties of the Turkish version of the Behavioral Emotion Regulation Questionnaire (BERQ). The Journal of General Psychology, 1-17.‏‏doi: 10.1080/00221309.2020.1752137
Williams, J. M. G., Duggan, D. S., Crane, C., & Fennell, M. J. (2006). Mindfulness‐Based cognitive therapy for prevention of recurrence of suicidal behavior. Journal of clinical psychology. 62(2), 201-210.
Zhao, Y., Li, P., Wang, X., Kong, L., Wu, Y., & Liu, X. (2020). The Chinese Version of the Behavioral Emotion Regulation Questionnaire: Psychometric Properties Among University Students. Neuropsychiatric disease and treatment, 16, 1889–1897. https://doi.org/10.2147/NDT.S25880.Dickhaut, V., & Arntz, A. (2014). Combined group and individual schema therapy for borderline personality disorder: A pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 45(2), 242-251.
Fassbinder, E., Assmann, N., Schaich, A., Heinecke, K., Wagner, T., & Sipos, V. (2019). Effectiveness of outpatient treatment programs for borderline personality disorder: a comparison of Schema therapy and dialectical behavior therapy: study protocol for a randomized trial. BMC psychiatry, 18(1), 341- 349.
Gong, J., & Chan, R. C. (2018). Early maladaptive schemas as mediators between childhood maltreatment and later psychological distress among Chinese college students. Psychiatry research, 259, 493-500.
Hoffart Lunding, S., & Hoffart, A. (2016). Perceived parental bonding, early maladaptive schemas and outcome in schema therapy of cluster c personality problems. Clinical psychology & psychotherapy, 23(2), 107-17.
Renner, F., DeRubeis, R., Arntz, A., Peeters, F., Lobbestael, J. & Huibers, M. J. H. (2018). Exploring mechanisms of change in schema therapy for chronic ‎depression. Journal of Behavior Therapy and Experimental Psychiatry, 58, 97- ‎‎105.‎
Taylor, C. D., Bee, P., & Haddock, G. (2017). Does schema therapy change schemas and symptoms? A systematic review across mental health disorders. Psychology and Psychotherapy: Theory, Research and Practice, 90(3), 456-79.
Tomlinson, R. M., Keyfitz, L., Rawana, J. S., & Lumley, M. N. (2019). Unique contributions of positive schemas for understanding child and adolescent life satisfaction and happiness. Journal of Happiness Studies18(5), 1255-1274.
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy. New York: Guilford Press.
Zafari, Sh. and Khademi Ashkozari, M. (1399). Investigating the structural model of the role of cognitive-emotion regulation strategies, mindfulness and perfectionism in predicting emotional problems in students. Journal of Psychological Sciences, 19 (87), 328-321.