The effectiveness of dialectical behavior therapy and rational emotive behavior therapy in irrational believes treatment among young male prisoners who have antisocial personality disorder in Ilam Prison

Parisa Asmand; Shahram Mami; Reza Valizadeh

doi:10.4103/2347-9019.151305

REVIEW ARTICLE

Year : 2015 | Volume : 3 | Issue : 2 | Page : 68-73

The effectiveness of dialectical behavior therapy and rational emotive behavior therapy in irrational believes treatment among young male prisoners who have antisocial personality disorder in Ilam Prison

Parisa Asmand¹, Shahram Mami², Reza Valizadeh³
¹ Young Researchers Club, Ilam Branch, Ilam, Iran
² Department of Psychology, Islamic Azad University, Ilam Branch, Ilam, Iran
³ Department of Psychiatrist, Medical Sciences University of Ilam, Ilam, Iran

Date of Web Publication

12-Feb-2015

Correspondence Address:
Parisa Asmand
Young Researchers Club, Ilam Branch, Islamic Azad University, Ilam
Iran

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/2347-9019.151305

Abstract

Antisocial personality have some clear symptoms as impulsivity, unstable emotions, aggression, drinking, use of drug, early initiation of sexual behavior making some difficulties and problems in their relationship with family members and those who have interaction with them and at least in the society. According to the mentioned symptoms of this personality disorder in the present research, it has been tried to solve these problems by comparing with the effectiveness of Dialectical Behaviour Therapy (DBT) and Rational Emotional Behaviour Therapy (REBT) in Irrational Treatment, Anxiety among young male prisoners who have antisocial personality in Ilam prison. The present emi-experimental project has been done by pretest and posttest selected purposely 64 subjects that have been selected purposely between 18-40 years among male prisoners in Ilam prison. Three questionnaires have been used which are as follow: Millon Clinical Questionnaire, Johns Irrational Beliefs and Back Anxiety questionnaire. In the study of the effectiveness of the therapies. The results showed that DBT has affected on all irrational beliefs (P < 0.05) and REBT only has affected on changing some beliefs. According to the findings obtained appears to be a DBT, therapeutic efficacy Is more efficient than REBT in irrational believes treatment, people with antisocial personality disorder.

Keywords: Antisocial personality disorder, dialectical behavior therapy, rational emotional behavior therapy

How to cite this article:
Asmand P, Mami S, Valizadeh R. The effectiveness of dialectical behavior therapy and rational emotive behavior therapy in irrational believes treatment among young male prisoners who have antisocial personality disorder in Ilam Prison. Int J Health Syst Disaster Manage 2015;3:68-73

How to cite this URL:
Asmand P, Mami S, Valizadeh R. The effectiveness of dialectical behavior therapy and rational emotive behavior therapy in irrational believes treatment among young male prisoners who have antisocial personality disorder in Ilam Prison. Int J Health Syst Disaster Manage [serial online] 2015 [cited 2023 Sep 21];3:68-73. Available from: https://www.ijhsdm.org/text.asp?2015/3/2/68/151305

Introduction

The first one is personality disorder cluster B which antisocial personality disorder is one of its subgroups ^[6] which is more concentrated on, due to the criminal behaviours. ^[7] This is a complex disorder which has the following features: Sever lack of interest, ^[8] Reckless disregard to safety of self or others (Frederick, 2005) ^[33] flippancy and flattery and the ability of playing with other people's, feeling lack of exciter and causeless manner and impulsive behavior, ^[9] disability of learning or experiment function, disturbed inter personal relationships, lack of conscience (Ghoddoosi, 2002) ^[10] , repentance of irresponsible behaviours (Yousefi, 2009), ^[11] perverted reactions and conditioning toward punishment, robbery, telling lies, argument, going away from home and school (Yousefi, 2010), ^[11] insubordination and mutiny ^[2] and drug abuse ¹ . ^[12] In this group, sexual behaviours began earlier than other people. Alcohol, drug abuse (Akbari, 2008) and quarreling ^[14] are also other characteristics of this group. These behaviours are long lasting in the young too. In this period, instability of occupation and irresponsibility of family management, in compatibility toward the society regulations are added to the aforementioned behaviours too (Khademi, 2011) ^[15] which are related to family factors and relationships, ^[12] life condition, ^[14] parenting method, etc. ^[13] This disorder which is common among 3% of men 1% of women (Frederick, 2005) ^[12] is of two categories: With anxiety and without anxiety. Deception, aggression and impulsive behaviours are common in the group with anxiety. Robbery, lack of regret and weapon use are common in group without anxiety. Improper cognitive and ultra-cognitive beliefs about themselves and their personality includes no balance between their positive and negative dimensions (Khademi, 2011). ^[15] Therefore, those people who have antisocial personality are one dimensional regarding different fields, which is the dimension that satisfies their personal profits. Naturally, such a personality characteristics produce many problems for other people who have relationship with these characters, so their surrounding is motivated to find a therapy. So, according to these characteristics, the therapist should engage the patient with suitable thought and behaviours and reduce the egotism and being absolute of their behaviours the first step. So, it is necessary to direct and organize the therapy process to carry out the mentioned factors. Cognitive therapy can be considered as a proper scientific therapy is a thorough one in spite of carried out studies (Akbari, 2009) one of the cognitive therapy is Dialectical Behaviours Therapy (DBT) which was introduced in 1993 by Marsha Linhan which acts as cognitive therapy. ^[17] At first, this therapy was used for borderline personality disorder which its effectiveness is confirmed by APA (Lynch, 2003). ^[18] Since the therapy program is a structural and has a simple function for the therapist, it is considered as a useful therapy for other personality disorder therapy according to carried out studies. (Solar, 2009) ^[19] which has a successful function in the therapy of disorder especially nervous eating, ^[20] drug abuse, ^[21] ADHD, ^[22] people with suicide thought, ^[23],[24] Depression, ^[22] (Lynch, 2003) disturbance of mind and stress reduction ^[25] Another therapy which is introduced by Albert Alice is Rational Emotional Behaviours Therapy (REBT) based on cognitive behaviours therapy. Internal factors of individuals are referred as a cognitive therapy, he believes that the activating events are not important, but the beliefs and deduction of events by people are important. It means that this is our deduction which has some consequences. So, this therapy can be useful as a determining and informative factor (Proucheska, 2007). ^[26],[27] Then with regarding to the importance of the issue (properties of the persons having antisocial personality disorder and involvement of the person, family and finally the society), and with regarding to this fact that there haven't been any exact investigations about affirmed efficiency disorder of the mentioned therapy in treating the same disorders as antisocial personality and his history, based on done studies in information station of journals Most existing therapies to combat some of the symptoms of antisocial personality disorder, such as reducing alcohol addict handled and The only therapy, occupational therapy, self-help groups, which are approved in accordance with specific controlled conditions. Therefore, with regard to the epidemiology of this disorder (Kaplan, 2007). Also, given the prevalence of this disorder among prisoners ^[16] and Lack of sufficient knowledge, experience and resources management in prisons. Also, The high crime rate (Ghoddoosi, 2001) and criminal behaviours. ^[12] Among this type of personality disorder seems, to have a healthier society and need further investigation to develop more effective therapies. The aim of the present study is the study of the effectiveness of DBT and REBT in irrational treatment among young male prisoners who have antisocial personality in Ilam prison, according to the importance and effectiveness of the mentioned method therapies in the same disorder therapy.

Materials and Methods

This is an semi-experimental study which has pre-test and post-test including control and two experimental group, The item but different from cells DBT and REBT and irrational believes treatment, is dependent variable. The study selected purposely was 64 people selected purposely among the prisoners of Ilam prison ageing between 18-40 ages in year 2013. They were recognized as an antisocial person by psychologist after Millon test and the interpretation of test and the structured clinical interview for DSM-IV-II whose conviction period lasts at least next one year. And exclusion criteria and absence of noncompliance. It is mentioned more than twice. The specimens were randomly assigned to treatment groups of 16 persons consisted of DBT and REBT group and one control group. It is mentioned in the control group, the experimental group method with respect to the diagnostic tools that include a clinical interview by a psychiatrist and MCMI-II test. Top of Form 15 patients were considered. It should be noted that all the subjects (Control experiment) with respect to the above analysis, diagnostic tools, has been chosen. Top of form the antisocial personality disorder diagnosis in the sample is obvious. Also, according to interviews conducted by psychiatrists and irrational beliefs samples are also evident. And at the beginning of each test irrational beliefs and to compare irrational beliefs in individual sessions were taken. And test each class individually with each of the 16 sessions of one hour of work and two-week sessions Of these 48 individuals, because of the lack of cooperation of some samples and absent prison and more than two sessions Finally, research collaborations involving 48 patients in the experimental group and cooperate fully in the meetings ended. Notably, the application of treatments based on the original protocol DBT for borderline personality disorder, were little changed and approved by the relevant faculty researcher with the main focus. Control accreditation and REBT thought process orientation with a focus on cognitive distortions has been performed. It should be noted in DBT therapy treatments focus on reducing plasticizers life-threatening behaviours, reduce disruptive behaviours treatment, decrease disruptive behaviours, quality of life, increase behavioursal skills and increase self-esteem and REBT therapy and treatment, focusing on identifying the fundamental beliefs and automatic thoughts Modified radical thoughts and beliefs associated with behavioursal techniques It also should be noted that 20 days after the final therapy session, control and test groups were tested as post-test of the related questionnaires, their results have been mentioned in finding section. For ensuring the correct answers, controlling the conditions and also preventing from inserting similar answer based on the previous mentality, it was tried to provide a calm environment for the testers to answer the questions. Results analyse data, the Kolmogorov-Smirnov test, analysis of variance, independent t-test and correlated t-test was performed using computer software SPSS 21.

Measures

Millon Clinical Multiaxial Inventory III (MCMI-II): This questionnaire contains 175 reliability, retesting, internal uniformity and the validity of foreign studies and in Iran are reported as follow: Final coefficient 85%, retesting coefficient 86% (Garrousi, 2006). ^[30]

Jones Illogical beliefs questionnaire: This questionnaire includes 100 questions which have ten subscales. Each subscale has got 10 questions. Jones in 1962 employing testing method. The validity of this questionnaire is reported as 68% using Chronbakh Investigating the reliability of convergent correlation between this questionnaire and depression, Dotapoush obtained 82% as correlation coefficient.

Results

According to results descriptive statistical which describes some of the characteristics of the statistical society of this study, the age average of them is 20-25 whose frequency is 37.5% in Dialectic group and 50% in rational emotive group. According to this table most of the prisoners take parts in this study, are single whose frequency is 100% and 75% in DBT and REBT respectively. More than 80% of them experienced prison for the second time whose education level is diploma which is 37.5% in both groups 31.2% of two groups are drug addicted. Regarding job and occupation, most of them are businessman and seller which are 56.2% and 50% in DBT and REBT groups respectively.

The results of [Table 1] which studies the illogical beliefs between DBT and REBT in antisocial personality disorder youngsters', which according to one direction variance and the normal distribution of grades according to Kolmogorov-Smirnov test for making comparison between two groups, it shows there is no uniformity in two subscales of illogical beliefs among subjects of DBT and REBT groups as there is no significant difference between 'need to high degree of confirmation' and 'helplessness to changes' which shows the uniformity of these two subscales. The results of comparison between two groups of DBT and REBT show that there is no meaningful differences among to subscales (P ≥ 0.05) and it just shows lack of difference among subjects after the therapy cycle. The comparison of the effectiveness levels of therapy cycle is presented.

Table 1: One-way ANOVA between treatment groups for the study of irrational beliefs REBT and DBT

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In [Table 2]. According to three results and T test and the comparison of the effectiveness of two therapies (DBT and REBT) on illogical beliefs of antisocial personality disorder youngsters, the effectiveness of DBT on illogical beliefs subscales is more, since it has a meaningful effect on all the subscales (P ≤ 0.05). Results of the effectiveness of rational REBT is something different, since it has a meaningful effect just on tendency to reproach (sig = 0.16), reaction to failure (sig = 0.32) and disability toward changes (sig = 0.32). The effectiveness of its meaningfulness high expectation of us and irresponsibility after rational REBT is discussable which shows the meaninglessness of the therapy.

Table 2: Correlated t-test the effectiveness of DBT and REBT in irrational believes treatment

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Discussion

The present study aims at an investigation into the effectiveness of DBT and REBT in illogical beliefs therapy, anxiety and depression of antisocial personality disorder among male population of Ilam prison. According to results descriptive statistical, It can be concluded that some of the characteristics like addiction ^[10] and criminal behaviours. ^[7] The results of this study could be explained that, since Antisocial Personality Disorder is diagnosed after the age of 18. Also under investigation with regard to the level of criminal behaviours, antisocial individuals decreased with increasing age. Findings could be due to the greater accuracy of the sample group aged 20-25 years are the most prominent building. And, according to the characteristics of school leaving (Yousefi, 2010). ^[11] People with antisocial personality disorder, low education level and lack of academic education could be observed in this study skins lead to imprisonment the results of [Table 1] which studies the illogical beliefs between DBT and REBT in antisocial personality disorder youngsters, it shows there is no uniformity in two subscales of illogical beliefs among subjects of DBT and REBT groups as there is no significant difference between 'need to high degree of confirmation" and "helplessness to changes' which shows the uniformity of these two subscales. The results of comparison between two groups of DBT and REBT show that there is no meaningful differences among to subscales and it just shows lack of difference among subjects after the therapy cycle. The comparison of the effectiveness levels of therapy cycle is presented in [Table 2]. The effectiveness of DBT on illogical beliefs subscales is more, since it has a meaningful effect on all the subscales. Results of the effectiveness of REBT is something different, since it has a meaningful effect just on tendency to reproach, reaction to failure and disability toward changes The effectiveness of its meaningfulness high expectation of us and irresponsibility after rational REBT is discussable which shows the meaninglessness of the therapy. These results are consistent with results (Riahi, 2010) ^[35] Explaining the results come from REBT, it can be said that. It seems that the courses which were taught to subjects about illogical beliefs are more complex than those which change the clients in a short period of time. In other words, clients must interoperate courses, judge them, accept them and finally apply them which need a long process to be efficient. According to Alice, these beliefs can become permanent and constant when people act according to their illogical beliefs. It acts automatically in hard situations and don't allow people act according to their new and logical acquired beliefs. So, if people want to replace illogical beliefs with the logical one, they will need practice and a period of time, since antisocial personality accompanied by depression (Curwen, 2006) ^[34] . The comparison of anxiety before therapy cycle in two groups of DBT and REBT, with the results and normal distribution of scores are presented explaining the results obtained from DBT on the irrational beliefs of the sample persons, it can be said that with regarding to the effect of the irrational beliefs on the negative emotions of the person and also with regarding to this fact that the persons having antisocial personality disorder are so adherent mentioned and also consider the fact that people with antisocial personality disorder in people who are susceptible repeatedly throughout their lives according to their personality traits felt the rejection. With regard to the content DBT is more efficient than REBT in the treatment of some of the characteristics of people with antisocial personality disorder.

Limitations

Like the other studies, this investigation has some limitations:

No proper and special space for holding the therapy sessions, special issues of the imprisons which sometimes resulted in irregular therapy sessions, special issues of each sample whose continuous presence created some problems, limited access to the therapy protocol which is suitable for the type of disorder and applied therapies, small number of the statistical sample because of limitations and non-predicted problems in the statistical society.

Suggestions

With regarding to the limitations of the investigation which can be effective on non-efficiency of some therapy results, it is recommended to do the therapy in the conditions with the most desirable assistance and conduct research with longer follow-up periods.

Acknowledgement

I would like to express my gratefulness to all managers of the prisons and the social workers who agreed upon to cooperate as the investigation sample and all other persons who helped us in this study.

¹ National Institute for Health and Clinieal Exllence

¹ Dialectical Behavior Therapy

² American Psychiatrist Association

³ Attention Deficit Hyperactivity Disorder

⁴ Emotional - Rational Behavior Therapy

⁵ Pupmed.gov, Psynet.apa.org

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