The relationship between cognitive flexibility and cognitive fusion with the borderline personality disorder symptoms
Researcher Bulletin of Medical Sciences,
Vol. 25 No. 1 (2020),
21 September 2020
,
Page e9
Abstract
Since researches have shown that maladaptive cognition plays a role in the beginning and maintenance Borderline Personality Disorder (BPD), this research aims to evaluate the relationship between cognitive flexibility and cognitive fusion with borderline personality disorder symptoms. 356 students of Mazandaran University of Medical Sciences who studied in the academic year of 2017-2018 were selected using cluster sampling method and they completed Cognitive Flexibility inventory (CFI), Cognitive Fusion Questionnaire (CFQ) and Schizotypal Trait Questionnaires (STB). There was a positive and significant relationship between cognitive fusion and borderline personality disorder (BPD) (p<0.01). The correlation between cognitive flexibility and borderline personality disorder and subscales was significant and negative (p<0.01, p<0.05). Cognitive flexibility and cognitive fusion and their subscales can predict the BPD factors. It is suggested that psychological interventions, especially cognitive-behavior therapy (CBT) and Acceptance and Commitment Therapy (ACT), are used to increase the cognitive flexibility and reduce cognitive fusion of students with borderline personality symptoms
Keywords:
- Cognitive flexibility; Cognitive Fusion; Borderline personality Disorder
How to Cite
Hajitabar Firouzjaei , N. ., Soltani, E. ., & Dastgheib , S. A. . (2021). The relationship between cognitive flexibility and cognitive fusion with the borderline personality disorder symptoms. Researcher Bulletin of Medical Sciences, 25(1), e9. Retrieved from https://ojs2.sbmu.ac.ir/index.php/rbms/article/view/34714
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27. Bolderston H (2013). Acceptance and commitment therapy: cognitive fusion and personality functioning. University of Southampton, Psychology, Doctoral Thesis.
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29. Hatice Odacı & Özkan Cikrikci,. Cognitive Flexibility Mediates the Relationship between Big Five Personality Traits and Life Satisfaction, Applied Research in Quality of Life, 2019;14(5) :1229-1246.
30. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.
31. Hayes SC. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy. 2016;47(6):869-85
32. Gillanders DT, Bolderston H, Bond FW, Dempster M, Flaxman PE, Campbell L, et al. The development and initial validation of the cognitive fusion questionnaire. Behavior therapy. 2014;45(1):83-101.
33. Zettle RD, Hayes SC. Dysfunctional control by client verbal behavior: The context of reason-giving. The Analysis of Verbal Behavior. 1986;4(1):30-8.
34. Gaudiano BA, Herbert JD. Believability of hallucinations as a potential mediator of their frequency and associated distress in psychotic inpatients. Behavioural and Cognitive Psychotherapy. 2006;34(4):497-502.
35. Twohig MP. The application of acceptance and commitment therapy to obsessive-compulsive disorder. Cognitive and Behavioral Practice. 2009;16(1):18-28.
36. Herbert JD, Forman EM. The evolution of cognitive behavior therapy. Acceptance and Mindfulness in Cognitive Behavior Therapy. 2011:1.
37. Gillanders DT, Sinclair AK, MacLean M, Jardine K. Illness cognitions, cognitive fusion, avoidance and self-compassion as predictors of distress and quality of life in a heterogeneous sample of adults, after cancer. J Context Behav Sci. 2015;4:300–11.
38. Sole E, Tome-Pires C, de la Vega R, Racine M, Castarlenas E, Jensen MP, et al. Cognitive Fusion and Pain Experience in Young People. Clin J Pain. 2016;32(7):602–8.
39. Reuman L, Jacoby RJ, Abramowitz JS. Cognitive Fusion, Experiential Avoidance, and Obsessive Beliefs as Predictors of ObsessiveCompulsive Symptom Dimensions. Inter Cog Ther. 2016;9:1–14.
40. Soltani E, Hosseini Z, Naghizadeh P. Relationship Between Experiential Avoidance and Cognitive Fusion to Social Interaction Anxiety in Students, Shiraz E-Med J. 2018 ; 19(6):e62496.
41. Morton J, Snowdon S, Gopold M, Guymer E. Acceptance and Commitment Therapy Group Treatment for Symptoms of Borderline Personality Disorder: A Public Sector Pilot. Cognitive and Behavioral Practice 2012, 19, 4: 527-54.
42. Chakhssi F, Janssen W, Pol S M , van Dreume M l , Westerhof G J. Acceptance and Commitment Therapy Group-Treatment for Non-Responsive Patients With Personality Disorders: An Exploratory Study. Personal Ment Health 2015;9(4):345-56. DOI: 10.1002/pmh.1311.
43. Morgan T A , Aljabari R. Using Acceptance and Commitment Therapy in the Treatment of Borderline Personality Disorder: Rationale, Preliminary Evidence, and Future Directions. Current Treatment Options in Psychiatry 2019,6, 271–283.
44. Shareh H, Farmani A, Soltani E. Investigating the Reliability and Validity of the Cognitive Flexibility Inventory (CFI-I) among Iranian University Students. Practice in Clinical Psychology. 2014;2(1):43-50.
45. Soltani E, Momenzadeh S, Hoseini SZ, Bahrainian SA. Psychometric properties of the cognitive fusion questionnaire. Pajoohandeh Journal. 2017;21(5):290-7.
46. Claridge G, Broks P. Schizotypy and hemisphere function—I: Theoretical considerations and the measurement of schizotypy. Personality and Individual Differences. 1984;5(6):633-48.
47. Rawlings D, Claridge G, Freeman JL. Principal components analysis of the schizotypal personality scale (STA) and the borderline personality scale (STB). Personality and Individual Differences. 2001;31(3):409-19.
48. Mohammadzadeh A, Goodarzi M, Taghavi M, Mollazadeh M.(2006). The Study of Factor structure, Validity, reliability and Standardization of Borderline Personality Scale (STB) in students of Shiraz University. Persian J Fundam Ment Health. 2006;7(27-28):75-89.
2. Ellison WD, Rosenstein LK Morgan TA, Zimmerman M. Community and Clinical Epidemiology of Borderline Personality Disorder. Psychiatr Clin North Am. 2018 Dec;41(4):561-573.
3. Leichsenring F, Leibing E, Kruse J, New AS, Leweke F (2011). Borderline personality disorder. The Lancet. 377(9759):74-84.
4. Meaney R, Hasking P, Reupert A (2016). Prevalence of Borderline Personality Disorder in University Samples: Systematic Review, Meta-Analysis and Meta-RegressionPsychiatry Res. 260:164-172.
5. Alden, M., & Osti, J. (1989). Cognitive distortions in borderline personality disorder: Therapeutic implications. Transactional Analysis Journal, 19(1), 51-52.
6. Beck, A. T., Freeman, A., et al. (1990). Cognitive therapy for personality disorders. New York: Guilford Press.
7. Linehan M. Cognitive-behavioral treatment of borderline personality disorder: Guilford press; 1993.
8. Keegan E(2004). A cognitive approach of the borderline personality disorder. Vertex. 2004 Dec-2005 Feb;15(58):287-94.
9. Arendarska A, Kucinska M, Pieńkowska S (2006). Borderline personality disorder - Cognitive-behavioural approach, theory and therapy. A literature review. Psychoterapia.
10. Lawrence, K. A., Allen, J. S., & Chanen, A. M. (2011). A study of maladaptive schemas and Borderline Personality Disorder in young people. Cognitive Therapy and Research, 35(1), 30-39.
11. Plante DT, Frankenburg FR, Fitzmaurice GM, Zanarini MC (2013). Relationship between maladaptive cognitions about sleep and recovery in patients with borderline personality disorder. Psychiatry Res. 30;210(3):975-9.
12. Geiger PJ, Peters JR, Sauer-Zavala SE, Baer RA (2013). Relationships among maladaptive cognitive content, dysfunctional cognitive processes, and borderline personality features. J Pers Disord. 27_097.
13. Barazandeh, H., Kissane, D. W., Saeedi, N., & Gordon, M. (2016). A systematic review of the relationship between early maladaptive schemas and borderline personality disorder/traits. Personality and Individual Differences, 94, 130-139.
14. Del Pozo MA, Harbeck S, Zahn S, Kliem S, Kröger C.Cognitive distortions in anorexia nervosa and borderline personality disorder. Psychiatry Res. 2018 Feb;260:164-172.
15. Jacques, S., & Zelazo, P. D. (2005). On the possible socio-communicative roots of cognitive flexibility. In B. Homer, & C. Tamis-Lemonda (Eds.), The development of social understanding and communication (pp. 53-81). Mahwah, NJ: Lawrence Erlbaum Associates.
16. Dennis JP, Vander Wal JS (2010).The cognitive flexibility inventory: Instrument development and estimates of reliability and validity. Cognitive therapy and research. 2010;34(3):2 41.53
17. Gan Y, Liu Y, Zhang Y.(2004). Flexible coping responses to severe acute respiratory syndrome-related and daily life stressful events.Asian J Soc Psychol 7(1):55-66.13.
18. Zong JG, Cao XY, Cao Y, Shi YF, Wang YN, Yan C,et al(2010).Coping flexibility in college students with depressive symptoms.Health Qual Life Outcomes 2010;8:66.
19. Johnson, BT(2009). The Relationship Between Cognitive Flexibility, Coping, and Symptomatology in Psychotherapy. Master's Theses. Marquette University.
20. Al-Jabari, RM(2012). Relationships among self-esteem, psychological and cognitive flexibility, and psychological symptomology. Master's Theses. University of north texas.
21. Tchanturia K, Davies H, Roberts M, Harrison A, Nakazato M, Schmidt U, et al. Poor cognitive flexibility in eating disorders: examining the evidence using the Wisconsin Card Sorting Task. PloS one. 2012;7(1):e28331.
22. 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.
23. Gabrys R L, Tabri N, Anisman H, Matheson K (2018). Cognitive Control and Flexibility in the Context of Stress and Depressive Symptoms: The Cognitive Control and Flexibility QuestionnaireFront Psychol. 9: 2219.
24. Zarei M, Momeni F, Mohammadkhani P. The Mediating Role of Cognitive Flexibility, Shame and Emotion Dysregulation Between Neuroticism and Depression. Iranian Rehabilitation Journal. 2018; 16 (1):61-68.
25. Morris L, Mansell W (2018).A systematic review of the relationship between rigidity/flexibility and transdiagnostic cognitive and behavioral processes that maintain psychopathology .sage,2018.9(3).
26. Paast N, Khosravi Z, Memari AH, Shayestehfar M, Arbabi M. Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls. Shanghai archives of psychiatry. 2016;28(1):28..
27. Bolderston H (2013). Acceptance and commitment therapy: cognitive fusion and personality functioning. University of Southampton, Psychology, Doctoral Thesis.
28. Imani M, Pourshahbazi M. Prediction of Borderline Personality Disorder Based On Psychological Flexibility Components: Acceptance and Action, Values and Cognitive Defusion. rph. 2017; 10 (4):1-9.
29. Hatice Odacı & Özkan Cikrikci,. Cognitive Flexibility Mediates the Relationship between Big Five Personality Traits and Life Satisfaction, Applied Research in Quality of Life, 2019;14(5) :1229-1246.
30. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.
31. Hayes SC. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy. 2016;47(6):869-85
32. Gillanders DT, Bolderston H, Bond FW, Dempster M, Flaxman PE, Campbell L, et al. The development and initial validation of the cognitive fusion questionnaire. Behavior therapy. 2014;45(1):83-101.
33. Zettle RD, Hayes SC. Dysfunctional control by client verbal behavior: The context of reason-giving. The Analysis of Verbal Behavior. 1986;4(1):30-8.
34. Gaudiano BA, Herbert JD. Believability of hallucinations as a potential mediator of their frequency and associated distress in psychotic inpatients. Behavioural and Cognitive Psychotherapy. 2006;34(4):497-502.
35. Twohig MP. The application of acceptance and commitment therapy to obsessive-compulsive disorder. Cognitive and Behavioral Practice. 2009;16(1):18-28.
36. Herbert JD, Forman EM. The evolution of cognitive behavior therapy. Acceptance and Mindfulness in Cognitive Behavior Therapy. 2011:1.
37. Gillanders DT, Sinclair AK, MacLean M, Jardine K. Illness cognitions, cognitive fusion, avoidance and self-compassion as predictors of distress and quality of life in a heterogeneous sample of adults, after cancer. J Context Behav Sci. 2015;4:300–11.
38. Sole E, Tome-Pires C, de la Vega R, Racine M, Castarlenas E, Jensen MP, et al. Cognitive Fusion and Pain Experience in Young People. Clin J Pain. 2016;32(7):602–8.
39. Reuman L, Jacoby RJ, Abramowitz JS. Cognitive Fusion, Experiential Avoidance, and Obsessive Beliefs as Predictors of ObsessiveCompulsive Symptom Dimensions. Inter Cog Ther. 2016;9:1–14.
40. Soltani E, Hosseini Z, Naghizadeh P. Relationship Between Experiential Avoidance and Cognitive Fusion to Social Interaction Anxiety in Students, Shiraz E-Med J. 2018 ; 19(6):e62496.
41. Morton J, Snowdon S, Gopold M, Guymer E. Acceptance and Commitment Therapy Group Treatment for Symptoms of Borderline Personality Disorder: A Public Sector Pilot. Cognitive and Behavioral Practice 2012, 19, 4: 527-54.
42. Chakhssi F, Janssen W, Pol S M , van Dreume M l , Westerhof G J. Acceptance and Commitment Therapy Group-Treatment for Non-Responsive Patients With Personality Disorders: An Exploratory Study. Personal Ment Health 2015;9(4):345-56. DOI: 10.1002/pmh.1311.
43. Morgan T A , Aljabari R. Using Acceptance and Commitment Therapy in the Treatment of Borderline Personality Disorder: Rationale, Preliminary Evidence, and Future Directions. Current Treatment Options in Psychiatry 2019,6, 271–283.
44. Shareh H, Farmani A, Soltani E. Investigating the Reliability and Validity of the Cognitive Flexibility Inventory (CFI-I) among Iranian University Students. Practice in Clinical Psychology. 2014;2(1):43-50.
45. Soltani E, Momenzadeh S, Hoseini SZ, Bahrainian SA. Psychometric properties of the cognitive fusion questionnaire. Pajoohandeh Journal. 2017;21(5):290-7.
46. Claridge G, Broks P. Schizotypy and hemisphere function—I: Theoretical considerations and the measurement of schizotypy. Personality and Individual Differences. 1984;5(6):633-48.
47. Rawlings D, Claridge G, Freeman JL. Principal components analysis of the schizotypal personality scale (STA) and the borderline personality scale (STB). Personality and Individual Differences. 2001;31(3):409-19.
48. Mohammadzadeh A, Goodarzi M, Taghavi M, Mollazadeh M.(2006). The Study of Factor structure, Validity, reliability and Standardization of Borderline Personality Scale (STB) in students of Shiraz University. Persian J Fundam Ment Health. 2006;7(27-28):75-89.
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