The Impact of Acceptance and Commitment Therapy (ACT) on the Extravagance and Methamphetamine Abuse in Patients with Bipolar Disorder and Borderline Personality Disorder

Document Type : پژوهشی

Authors

• Asghar Kamran ¹
• Maryam Mananipeykani ²
• sead reza Mirmahdie ³

¹ Instructor, Department of Psychology, Payame Noor University, Tehran, Iran

² Expert, Department of Psychology, Payam Noor University, Tehran, Iran

³ Associate Professor, Department of Psychology, Payame Noor Tehran, Iran.

10.22067/tpccp.2023.72838.1179

Abstract

Introduction
A mental damage that can be observed in the users of methamphetamine is bipolar disorder, which happens because of high consumption of the drug. Another psychological problem observed among methamphetamine abusers is borderline personality disorder. People with bipolar disorder and borderline personality disorder need appropriate interventions, and acceptance and commitment treatment (ACT) can be a good choice. This study aimed to explore the impact of commitment and acceptance treatment on extravagant and methamphetamine abuse in people with bipolar disorder and borderline personality disorder.
Method
This quasi-experimental research used a pre-test and post-test and a control group design, including four groups (two experimental groups and two control groups). The inclusion criteria were: at least four months had passed since the participants had been hospitalized for withdrawal methamphetamine, they had been diagnosed as people with bipolar disorder or borderline personality disorder, they did not take psychiatric drugs during the treatment, and they did not participate in other therapeutic interventions at the same time. The exclusion criteria were: the participant did not want to continue the therapy, the participant with bipolar disorder and borderline personality disorder have other disorders, and the participant age is over 55. The aims of the study were explained to the participants and their written consent was obtained. They were explained that all information of the participants will remain confidential and will be used only for research purposes.
The statistical population of this research included all people with bipolar and borderline personality disorder admitted to Karamat Camp in Mobarakeh city of Isfahan in 2021. The population includes those who both used methamphetamine and suffered extravagance. From among the people with bipolar disorder and borderline personality disorder, 60 people (30 people for each group) were selected using available sampling and they were randomly divided into experimental and control groups. They were selected after performing Millon Clinical Multiaxial Inventory questionnaire and diagnosed by a psychiatrist and a psychologist of the camp. The participants were evaluated both in pre-test and post-test phases.
The experimental groups participated in therapeutic commitment and acceptance interventions for 9 sessions, one and a half hours, three sessions per week. The control groups did not participate in any type of intervention. During the sessions, there was no drop in the number of participants. SPSS 23 was used for analysis of covariance.
The measuring instruments were: a) Millon Inventory 3, designed by Millon (1994). The most recent version of this questionnaire consists of 175 items, scored under 28 separate scales; b) Personal Control Scale, known as PCS (Shua Kazemi, 2010). This test consists of 15 items and evaluates the degree of personal control over drug abuse (in past and now). This test includes two sets of questions. The person’s conditions over the past 90 days is examined in the first part and his conditions when starting drug abuse is examined in the second part; C) Clarke and Mortimer’s Extravagance Questionnaire (Clarke & Mortimer, 2013). This questionnaire consists of 19 items. The sum of scores will be between 19 and 95. The range 9-44 shows appropriate management of life expenditures, 45-68 shows medium expenditures, and 69-95 indicates extravagance and being thoughtfulness after the expenditure.
Results
The results showed that ACT was effective for metaphemtamine abuse treatment in the experimental group with bipolar disorder (p<0.05), but it was not effective for extravagance treatment (P>0.05). Moreover, ACT impacts the metamphetmaine abuse and extravagance control in the experimental group with borderline personality disorder (P<0.05), while there was no change in the control groups.
Discussion and Conclusion
The results confirm the effectiveness of Acceptance and Commitment Treatment (ACT) for the treatment of methamphetamine abuse in people with bipolar and the treatment of methamphetamine abuse and extravagance in people with borderline personality disorder. It is suggested that ACT-based therapeutic interventions be used in addiction treatment centers. Moreover, it is suggested that researchers try to find the best model for methamphetamine abuse treatment by comparing ACT method with other treatment methods. This study focused on people with bipolar and borderline personality disorder and it is suggested that future studies explore the relationship between methamphetamine abuse and ten types of personality disorder.
 

Keywords

• Methamphetamine Abuse
• Extravagance
• Bipolar Disorder
• Borderline Personality Disorder

20.1001.1.22516352.1402.13.1.9.1

Main Subjects

• Clinical psychology

---

References

Arjmand Ghujur, K., Mahmoud A, M., Khanjani, Z., & Bakhshipour, A. (2019). Effectiveness of Acceptance and Commitment Therapy (ACT) in Relapse Prevention in Methamphetamine Addict Patients. Yafteh, 21(1), 38-51. https://sid.ir/paper/79957/en (In Persian)

Berking, M., Neacsiu, A., Comtois, K. A., & Linehan, M. M. (2009). The impact of experiential avoidance on the reduction of depression in treatment for borderline personality disorder. Behaviour research and therapy, 47(8), 663-670. https://doi.org/10.1016/j.brat.2009.04.011

Bowyer, J. F., Pogge, A. R., Delongchamp, R. R., O’Callaghan, J. P., Patel, K. M., Vrana, K. E., & Freeman, W. M. (2007). A threshold neurotoxic amphetamine exposure inhibits parietal cortex expression of synaptic plasticity-related genes. Neuroscience, 144(1), 66-76. https://doi.org/10.1016/j.neuroscience.2006.08.076

Cavicchioli, M., Rugi, C., & Maffei, C. (2015). Inability to withstand present-moment experiences in borderline personality disorder: a meta-analytic review. Clinical Neuropsychiatry, 12(4), 101-110. https://doi.org/10.1037/t27764-000

Chapman, A. L., Dixon-Gordon, K. L., & Walters, K. N. (2011). Experiential avoidance and emotion regulation in borderline personality disorder. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 29(1), 35-52. https://doi.org/10.1007/s10942-011-0124-6

Chegini, M., Delavar, A., & Garrayi, B. (2013). psychometric characteristics of millon clinical multiaxial inventory-iii. journal of psychology, 8(29), 135-162. https://sid.ir/paper/120293/en

Clarke, P. D., & Mortimer, G. (2013). Self-gifting guilt: an examination of self-gifting motivations and post-purchase regret. Journal of Consumer Marketing. https://doi.org/10.1108/JCM-05-2013-0566

Dabaghi, P., Asgharnejad, F., Atef, A., Kazem, V., & Bolhari, J. (2007). The effectiveness of group cognitive therapy based on mindfulness observational thinking and activation of spiritual schemas in preventing relapse of opioid use. Iranian Journal of Psychiatry and Clinical Psychology, 13, 366-375. (In Persian)

Ekhtiari, H. (2013). Length of Methamphetamine Abuse and Sustained Attention Disorders among Methamphetamine Abusers. Quarterly Journal of Research on Addiction, 17. (In Persian)

Feiz, D., Bagheri G, h., & radfar, S. (2018). Examining the factors affecting on customer complaint behavior: with the mediator role of post-purchase regret in the fashion clothing Industry. New Marketing Research Journal, 8(2), 199-216. https://doi.org/10.22108/nmrj.2018.109676.1613 (In Persian)

Garcia, F. D., & Thibaut, F. (2010). Sexual addictions. The American journal of drug and alcohol abuse, 36(5), 254-260. https://doi.org/10.3109/00952990.2010.503823

Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behavior therapy, 37(1), 25-35. https://doi.org/0005-7894/06/025–035$1.00/0

Halgin, R. P., & Whitbourne, S. K. (2003). Abnormal Psychology, Clinical Perspectives on Psychological Disorders (4th ed.).

Hayes, S., Strosahl, K., & Wilson, K. (2012). Acceptance and Commitment Therapy: Second addition, the process and practice of mindful change. . Gulford. https://www.guilford.com/books/Acceptance-and-Commitment-Therapy/Hayes-Strosahl-Wilson/9781462528943

Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 44(1), 1-25. https://doi.org/10.1016/j.brat.2005.06.006

Iverson, K. M., Follette, V. M., Pistorello, J., & Fruzzetti, A. E. (2012). An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms. Personality Disorders: Theory, Research, and Treatment, 3(4), 415. https://doi.org/10.1037/a0023703

Khaja Moghi, N. (1993). Preliminary preparation of Persian form of clinical of Milon's Multiaxial Clinical Questionnaire questionnaire. Psychiatry and Clinical Psychology of Iran(2), 68-69. https://www.noormags.ir/view/fa/articlepage/125510

Khosravi, Z., & Rahmatinejad, P. (2014). The relationship between Borderline Personality Disorder and bipolar disorder type II based on Borderline Personality Organization. Thoughts and Behavior in Clinical Psychology, 9(32), 37-46. (In Persian)

Manzari Tavakoli, f. (2015). Evaluation of the effectiveness of self-compassion-focused group on anxiety and depression in students of Islamic Azad University, Baft Branch. World Conference on Psychology and Educational Sciences, Law and Social Sciences at the beginning of the third millennium. (In Persian)

McCracken, L. M., & Gutiérrez-Martínez, O. (2011). Processes of change in psychological flexibility in an interdisciplinary group-based treatment for chronic pain based on Acceptance and Commitment Therapy. Behaviour research and therapy, 49(4), 267-274. https://doi.org/10.1016/j.brat.2011.02.004

Millon, T., & Davis, R. (1994). Millon’s evolutionary model of normal and abnormal personality: theory and measures. . Differentiating normal and abnormal personality, 79-113. https://doi.org/10.1080/00223891.2015.1055751

Morton, J., Snowdon, S., Gopold, M., & Guymer, E. (2012). Acceptance and Commitment Therapy Group Treatment for Symptoms of Borderline Personality Disorder: A Public Sector Pilot Study. Cognitive and Behavioral Practice, 19(4), 527-544. https://doi.org/10.1016/j.cbpra.2012.03.005

Narenjiha, H., Nouri, R., Akbarian, M., Farahani, M. A., & Mirzamani, M. (2010). The experience of lifetime non-fatal overdose of drugs in Iranian substance abusers. Iranian Journal of Psychiatry and Clinical Psychology, 15(4), 327-333. (In Persian)

New, A. S., Triebwasser, J., & Charney, D. S. (2008). The case for shifting borderline personality disorder to Axis I. Biological Psychiatry, 64(8), 653-659. https://doi.org/10.1016/j.biopsych.2008.04.020

Sadok, K. a. (2013). Summary of Psychiatry, Kaplan and Zadok, based on DSM5 (second edition(2015) ed., Vol. 2). Savalan Publications. .

Sauer, S. E., & Baer, R. A. (2009). Relationships between thought suppression and symptoms of borderline personality disorder. Journal of personality disorders, 23(1), 48-61. https://doi.org/10.1521/pedi.2009.23.1.48

Scott, W., & McCracken, L. M. (2015). Psychological flexibility, acceptance and commitment therapy, and chronic pain. Current opinion in psychology, 2, 91-96. https://doi.org/10.1016/j.copsyc.2014.12.013

Sharifi, A. A., & Namdari, K. (2008). The validity of mcmi-iii (millon, 1994) scales. . knowledge & research in applied psychology, 9(34), 27-38. https://sid.ir/paper/163788/en (In Persian)

Sharp, C., Kalpakci, A., Mellick, W., Venta, A., & Temple, J. R. (2015). First evidence of a prospective relation between avoidance of internal states and borderline personality disorder features in adolescents. European child & adolescent psychiatry, 24(3), 283-290. https://doi.org/10.1007/s00787-014-0574-3

ShoaKazemi, M. A. (2010). Investigating the relationship between attitudes toward addiction and coping strategies in heroin users in Tehran. Scientific Quarterly of Research on Addiction 7(2), 79-90. https://www.noormags.ir/view/fa/articlepage/953762 (In Persian)

Smout, M. F., Longo, M., Harrison, S., Minniti, R., & Wickes, W. (2013). Psychosocial treatment for methamphetamine use disorders: A preliminary randomized controlled trial of cognitive behavior therapy and acceptance and commitment therapy. Routledge. https://doi.org/10.1080/08897071003641578

Wijetunga, M., Bhan, R., Lindsay, J., & Karch, S. (2004). Acute coronary syndrome and crystal methamphetamine use: a case series. Hawaii medical journal, 63(1). https://doi.org/10.1592/phco.26.8.1148.