Volume 24, Issue 4 (3-2026)
TB 2026, 24(4): 84-102 |
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karimi zarchi M, Mohamadkhani P, demehri F, Saiedmanesh M. The Effectiveness of Metacognitive Interpersonal Therapy and Acceptance and Commitment Therapy on Difficulties in Emotion Regulation and Perfectionism of People with Obsessive-Compulsive Personality Disorder. TB 2026; 24 (4) :84-102
URL: http://tbj.ssu.ac.ir/article-1-3789-en.html
URL: http://tbj.ssu.ac.ir/article-1-3789-en.html
Science and Arts University , pa.mohammadkhani@uswr.ac.ir
Keywords: Compulsive Personality Disorder, Acceptance and Commitment Therapy, Emotional Regulation, Perfectionism
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The Effectiveness of Metacognitive Interpersonal Therapy and Acceptance and Commitment Therapy on Difficulties in Emotion Regulation and Perfectionism of People with Obsessive-Compulsive Personality Disorder
Mahdi karimi zarchi (Ph.D.s)1, parvaneh Mohamadkhani (Ph.D.)2, Farangis Demehri (Ph.D.)3, Mohsen Saiedmanesh (Ph.D.)4
1.Ph.D. Student in Psychology, Department of Psychology, Faculty of Humanities, Science and Arts University, Yazd, Iran
2.Corresponding Author: Professor, Department of Psychology, Rehabilitation Sciences and Social Health University, Tehran, Iran E-mail: pa.mohammadkhani@uswr.ac.ir Tel: +98 -9121777653
3.Assistant Professor, Department of Psychology, Faculty of Humanities, Science and Arts University, Yazd, Iran
4.Associate professor, Department of Psychology, Faculty of Humanities, Science and Arts University, Yazd, Iran
Abstract
Introduction: Obsessive-compulsive personality disorder is one of the most common personality disorders that has a profound impact on the individual and social functioning of sufferers. The aim of this study was to compare the effectiveness of Metacognitive Interpersonal Therapy (MIT) and Acceptance and Commitment Therapy (ACT) in improving difficulties in emotion regulation and perfectionism in individuals with Obsessive-Compulsive Personality Disorder.
Methods: This research was conducted using a quasi-experimental method with a pre-test, post-test, and three-month follow-up design with a control group. The statistical population included individuals with obsessive-compulsive personality disorder who visited the counseling centers of Yazd in 2024. The sample consisted of 41 participants selected through convenience sampling and randomly assigned to three groups: MIT (n=13), ACT (n=14), and control (n=14). The experimental groups received interventions over 10 weekly sessions, while the control group received no treatment. The study instruments included the Difficulties in Emotion Regulation Scale (DERS) and Perfectionism Scale.
Results: The results of repeated measures analysis of variance showed that there was a significant difference between the post-test scores of emotion regulation difficulty (F=255/410, p<0/01) and perfectionism (F=356/950, p<0/01) of the three groups. Also, Bonferroni post-test showed that interpersonal metacognitive therapy was more effective than acceptance and commitment therapy in improving emotion regulation difficulty and reducing perfectionism.
Conclusion: MIT could be used as a more effective intervention compared to ACT for addressing emotional and cognitive challenges in individuals with obsessive-compulsive personality disorder.
Keywords: Compulsive Personality Disorder, Acceptance and Commitment Therapy, Emotional Regulation, Perfectionism
1-American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR. 5th ed. Washington, DC: American Psychiatric Publishing. 2022;772-774
2-Paulus FW, Ohmann S, Möhler E & et al. Emotional dysregulation in children and adolescents with psychiatric disorders: A narrative review. Front Psychiatry. 2021; 12:628252.
3-Yap K, Mogan C, Moriarty A & et al. Emotion regulation difficulties in obsessive-compulsive disorder. J Clin Psychol. 2018;74(4):695–709.
4-Lorscheid DN, Hofmann SG, Hayes SC. Learning Process-Based Therapy: A Skills Training Manual for Targeting the Core Processes of Psychological Change in Clinical Practice. Oakland, CA: New Harbinger Publications. 2021;86-87
5-Gordon-King K, Schweitzer RD, Dimaggio G. Metacognitive Interpersonal Therapy for Personality Disorders: The case of a man with obsessive–compulsive personality disorder and avoidant personality disorder. J Contemp Psychother. 2019; 49:39–47.
6-Sederlund A, Lawrence R, Burns R & et al. Multidimensional models of perfectionism and procrastination: Seeking determinants of both. Int J Environ Res Public Health. 2020;17(14):5099.
7-Tavangar A, Karimi Jahromi F, Shirvani, A. The effectiveness of acceptance and commitment therapy in reducing anxiety and improving social skills in adults with borderline personality disorder. Quarterly Journal of Psychological and Educational Studies. 2024;88: 63–80. [Persian]
8-Hershberger JM, Lewis TF, Zimmerman, I. Acceptance and Commitment Therapy as a conceptual treatment model for obsessive-compulsive personality disorder. Journal of Mental Health Counseling. 2024;46(3):188–212.
9-Parvizian F, Sharifi T, Shekarkan H & et al. Comparison of the effectiveness of schema therapy and acceptance and commitment therapy on emotion regulation in patients with obsessive–compulsive personality disorder. Health Promotion Management Journal. 2022;11(6):79–92. [Persian]
10-Taghavizadeh Ardakani M, Akbari B, Hosseinkhanzadeh A & et al. Acceptance and commitment therapy on perfectionism and emotion regulation in obsessive-compulsive personality disorder. Middle Eastern Journal of Disability Studies. 2020; 10:29.[Persian]
11-Parvizian F, Sharifi T, Shekarkan H & et al. Comparison of the effectiveness of schema therapy and acceptance and commitment therapy on perfectionism in patients with obsessive–compulsive personality disorder. Iranian Journal of Psychiatric Nursing. 2022; 10(3): 115–131.[Persian]
12-Ong CW, Lee EB, Krafft J & et al. A randomized controlled trial of acceptance and commitment therapy for clinical perfectionism. Journal of Obsessive-Compulsive and Related Disorders. 2019;22: 100444.
13-Bowers EM, Twohig MP, Oglesby ME & et al. A randomized controlled trial of self-help acceptance and commitment therapy and cognitive behavioral therapy for perfectionism. Behaviour Research and Therapy. 2025;110: 104806.
14-Khadem Dezfuli Z, Alavi SZ, Shahbazi M. The effectiveness of Acceptance and Commitment Therapy (ACT) on neurotic perfectionism and internalized self-criticism in neurotic perfectionist girls: A single-case experimental study. Shenakht Journal of Psychology and Psychiatry. 2024;10(5):132-147.[persian]
15-Twohig MP, Levin ME, Petersen JM, editos. The Oxford Handbook of Acceptance and Commitment Therapy. New York: Oxford University Press; 2023:143-309.
16. Carcione A, Nicolò G, Semerari A, editor. Complex Cases of Personality Disorders: Metacognitive Interpersonal Therapy. Cham: Springer International Publishing; 2021:35-75.
17-Popolo R, MacBeth A, Canfora F & et al. Metacognitive Interpersonal Therapy in group (MIT-G) for young adults with personality disorders: A pilot randomized controlled trial. Psychology and Psychotherapy: Theory, Research and Practice. 2019;92(3):342–358.
18-Popolo R, MacBeth A, Lazzerini L & et al. Metacognitive interpersonal therapy in group versus TAU + waiting list for young adults with personality disorders: Randomized clinical trial. Personality Disorders. 2022;13(6):619–628.
19-Inchausti F, Moreno-Campos L, Prado-Abril J & et al. Metacognitive Interpersonal Therapy in group for personality disorders: Preliminary results from a pilot study in a public mental health setting. Journal of Contemporary Psychotherapy. 2020; 21(3):155–163.
20-Carcione A, Riccardi I, Bilotta E & et al. Metacognition as a predictor of improvements in personality disorders. Frontiers in Psychology. 2019; 8:10:170.
21-Cheli S, MacBeth A, Popolo R & et al. The intertwined path of perfectionism and self‐criticism in a client with obsessive compulsive personality disorder. J Clin Psychol. 2020;76(11):2055–2066.
22-Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure and initial validation of the difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment. 2004; 26(1):41-54.
23-Khanzadeh M, Saidiyan M, Hosseichary M & et al. Factor structure and psychometric properties of difficulties in emotional regulation scale. Journal of Behavioral Sciences. 2012; 6(1):87-96.[Persian]
24-Besharat MA. Difficulties in Emotion Regulation Scale. Thought & Behavior in Clinical Psychology. 2019; 13(47):89-92.[Persian]
25-Hill RW, Huelsman TJ, Furr RM & et al. A new measure of perfectionism: The Perfectionism Inventory. J Pers Assess. 2004;82(1):80–91.
26-Jamshidi B, Hoseyn-Chari M, Haghighat Sh & et al. Validation of a new perfectionism scale. J Behav Sci. 2009;3(1):35–43.[Persian]
Mahdi karimi zarchi (Ph.D.s)1, parvaneh Mohamadkhani (Ph.D.)2, Farangis Demehri (Ph.D.)3, Mohsen Saiedmanesh (Ph.D.)4
1.Ph.D. Student in Psychology, Department of Psychology, Faculty of Humanities, Science and Arts University, Yazd, Iran
2.Corresponding Author: Professor, Department of Psychology, Rehabilitation Sciences and Social Health University, Tehran, Iran E-mail: pa.mohammadkhani@uswr.ac.ir Tel: +98 -9121777653
3.Assistant Professor, Department of Psychology, Faculty of Humanities, Science and Arts University, Yazd, Iran
4.Associate professor, Department of Psychology, Faculty of Humanities, Science and Arts University, Yazd, Iran
Abstract
Introduction: Obsessive-compulsive personality disorder is one of the most common personality disorders that has a profound impact on the individual and social functioning of sufferers. The aim of this study was to compare the effectiveness of Metacognitive Interpersonal Therapy (MIT) and Acceptance and Commitment Therapy (ACT) in improving difficulties in emotion regulation and perfectionism in individuals with Obsessive-Compulsive Personality Disorder.
Methods: This research was conducted using a quasi-experimental method with a pre-test, post-test, and three-month follow-up design with a control group. The statistical population included individuals with obsessive-compulsive personality disorder who visited the counseling centers of Yazd in 2024. The sample consisted of 41 participants selected through convenience sampling and randomly assigned to three groups: MIT (n=13), ACT (n=14), and control (n=14). The experimental groups received interventions over 10 weekly sessions, while the control group received no treatment. The study instruments included the Difficulties in Emotion Regulation Scale (DERS) and Perfectionism Scale.
Results: The results of repeated measures analysis of variance showed that there was a significant difference between the post-test scores of emotion regulation difficulty (F=255/410, p<0/01) and perfectionism (F=356/950, p<0/01) of the three groups. Also, Bonferroni post-test showed that interpersonal metacognitive therapy was more effective than acceptance and commitment therapy in improving emotion regulation difficulty and reducing perfectionism.
Conclusion: MIT could be used as a more effective intervention compared to ACT for addressing emotional and cognitive challenges in individuals with obsessive-compulsive personality disorder.
Keywords: Compulsive Personality Disorder, Acceptance and Commitment Therapy, Emotional Regulation, Perfectionism
1-American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR. 5th ed. Washington, DC: American Psychiatric Publishing. 2022;772-774
2-Paulus FW, Ohmann S, Möhler E & et al. Emotional dysregulation in children and adolescents with psychiatric disorders: A narrative review. Front Psychiatry. 2021; 12:628252.
3-Yap K, Mogan C, Moriarty A & et al. Emotion regulation difficulties in obsessive-compulsive disorder. J Clin Psychol. 2018;74(4):695–709.
4-Lorscheid DN, Hofmann SG, Hayes SC. Learning Process-Based Therapy: A Skills Training Manual for Targeting the Core Processes of Psychological Change in Clinical Practice. Oakland, CA: New Harbinger Publications. 2021;86-87
5-Gordon-King K, Schweitzer RD, Dimaggio G. Metacognitive Interpersonal Therapy for Personality Disorders: The case of a man with obsessive–compulsive personality disorder and avoidant personality disorder. J Contemp Psychother. 2019; 49:39–47.
6-Sederlund A, Lawrence R, Burns R & et al. Multidimensional models of perfectionism and procrastination: Seeking determinants of both. Int J Environ Res Public Health. 2020;17(14):5099.
7-Tavangar A, Karimi Jahromi F, Shirvani, A. The effectiveness of acceptance and commitment therapy in reducing anxiety and improving social skills in adults with borderline personality disorder. Quarterly Journal of Psychological and Educational Studies. 2024;88: 63–80. [Persian]
8-Hershberger JM, Lewis TF, Zimmerman, I. Acceptance and Commitment Therapy as a conceptual treatment model for obsessive-compulsive personality disorder. Journal of Mental Health Counseling. 2024;46(3):188–212.
9-Parvizian F, Sharifi T, Shekarkan H & et al. Comparison of the effectiveness of schema therapy and acceptance and commitment therapy on emotion regulation in patients with obsessive–compulsive personality disorder. Health Promotion Management Journal. 2022;11(6):79–92. [Persian]
10-Taghavizadeh Ardakani M, Akbari B, Hosseinkhanzadeh A & et al. Acceptance and commitment therapy on perfectionism and emotion regulation in obsessive-compulsive personality disorder. Middle Eastern Journal of Disability Studies. 2020; 10:29.[Persian]
11-Parvizian F, Sharifi T, Shekarkan H & et al. Comparison of the effectiveness of schema therapy and acceptance and commitment therapy on perfectionism in patients with obsessive–compulsive personality disorder. Iranian Journal of Psychiatric Nursing. 2022; 10(3): 115–131.[Persian]
12-Ong CW, Lee EB, Krafft J & et al. A randomized controlled trial of acceptance and commitment therapy for clinical perfectionism. Journal of Obsessive-Compulsive and Related Disorders. 2019;22: 100444.
13-Bowers EM, Twohig MP, Oglesby ME & et al. A randomized controlled trial of self-help acceptance and commitment therapy and cognitive behavioral therapy for perfectionism. Behaviour Research and Therapy. 2025;110: 104806.
14-Khadem Dezfuli Z, Alavi SZ, Shahbazi M. The effectiveness of Acceptance and Commitment Therapy (ACT) on neurotic perfectionism and internalized self-criticism in neurotic perfectionist girls: A single-case experimental study. Shenakht Journal of Psychology and Psychiatry. 2024;10(5):132-147.[persian]
15-Twohig MP, Levin ME, Petersen JM, editos. The Oxford Handbook of Acceptance and Commitment Therapy. New York: Oxford University Press; 2023:143-309.
16. Carcione A, Nicolò G, Semerari A, editor. Complex Cases of Personality Disorders: Metacognitive Interpersonal Therapy. Cham: Springer International Publishing; 2021:35-75.
17-Popolo R, MacBeth A, Canfora F & et al. Metacognitive Interpersonal Therapy in group (MIT-G) for young adults with personality disorders: A pilot randomized controlled trial. Psychology and Psychotherapy: Theory, Research and Practice. 2019;92(3):342–358.
18-Popolo R, MacBeth A, Lazzerini L & et al. Metacognitive interpersonal therapy in group versus TAU + waiting list for young adults with personality disorders: Randomized clinical trial. Personality Disorders. 2022;13(6):619–628.
19-Inchausti F, Moreno-Campos L, Prado-Abril J & et al. Metacognitive Interpersonal Therapy in group for personality disorders: Preliminary results from a pilot study in a public mental health setting. Journal of Contemporary Psychotherapy. 2020; 21(3):155–163.
20-Carcione A, Riccardi I, Bilotta E & et al. Metacognition as a predictor of improvements in personality disorders. Frontiers in Psychology. 2019; 8:10:170.
21-Cheli S, MacBeth A, Popolo R & et al. The intertwined path of perfectionism and self‐criticism in a client with obsessive compulsive personality disorder. J Clin Psychol. 2020;76(11):2055–2066.
22-Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure and initial validation of the difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment. 2004; 26(1):41-54.
23-Khanzadeh M, Saidiyan M, Hosseichary M & et al. Factor structure and psychometric properties of difficulties in emotional regulation scale. Journal of Behavioral Sciences. 2012; 6(1):87-96.[Persian]
24-Besharat MA. Difficulties in Emotion Regulation Scale. Thought & Behavior in Clinical Psychology. 2019; 13(47):89-92.[Persian]
25-Hill RW, Huelsman TJ, Furr RM & et al. A new measure of perfectionism: The Perfectionism Inventory. J Pers Assess. 2004;82(1):80–91.
26-Jamshidi B, Hoseyn-Chari M, Haghighat Sh & et al. Validation of a new perfectionism scale. J Behav Sci. 2009;3(1):35–43.[Persian]
Type of Study: Applicable |
Subject:
Psychology
Received: 2025/06/18 | Accepted: 2025/09/13 | Published: 2026/03/1
Received: 2025/06/18 | Accepted: 2025/09/13 | Published: 2026/03/1
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