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Completed

NCT Number: NCT05759091

Effect of Applying Cognitive Defusion Techniques on Mindful Awareness, Cognitive Fusion and Believability of Delusions Among Clients With Schizophrenia

Schizophrenia causes hallucinations, delusions, and disorganized thinking, resulting in decreased functioning and lifelong therapy.Delusion believability is the degree of belief in the truth of one's subjective experiences as representations of reality. It was unpleasant, typically accompanied by a suspicious, strange tension. Delusional belief is seen as a means of resolving tension and conflict in cognition and experience. Previous studies have shown that cognitive defusion strategies help people become more aware of their surroundings, accept their thoughts and feelings, and become more psychologically adjustable. defusion is crucial in reducing medication-resistant psychotic symptoms such delusions in schizophrenia patients. Therefore, this study aimed to investigate the effects of cognitive defusion techniques on psychological flexibility, mindful awareness, cognitive fusion, and believability of delusions among clients with schizophrenia.

Research Hypothesizes

* Clients who participated in cognitive defusion techniques had more psychological flexibility and mindful awareness than the control group. * Clients who participated in cognitive defusion techniques had less cognitive fusion and delusional believability than the control group.

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Key information

Conditions

Schizophrenia; Psychosis Behavior Behavioral Symptoms Delusions Mental Disorders Nurse's Role Psychotic Disorders Schizophrenia Schizophrenia Spectrum and Other Psychotic Disorders

Sex eligibility

Male

Study type

Interventional

Phase

Not applicable

Primary location

Faculty of Nursing

Alexandria, 002, Egypt

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male clients diagnosed with schizophrenia according to the DSM-V
  • Diagnosed with schizophrenia With no comorbidity.
  • Able to communicate coherently and relevantly.
  • Able to read and write.
  • Willing to participate in the study
  • Duration of illness not exceeding 10 years.

Exclusion criteria

  • Any client in an acute phase or have any neurological disorder that may affect cognitive function were excluded from a study.

Treatment and study plan

cognitive defusion techniques

Behavioral

Defusing from your delusions helps to lessen their negative impact on your behaviour. So defusion is a vital step towards being able to act flexibly, in accordance with core values, instead of being dictated to by inflexible rules, reasons, judgments etc. There are numerous exercises in ACT Companion with a focus on identifying unhelpful thoughts which would benefit from defusion, or building defusion skills, most of which are found in the open up section of the app. Some of these are reading and writing exercises, and some are guided meditation audio recordings.

ACT Companion defusion exercises

  • Letting go
  • Not good enough
  • Thought defusion
  • Observing your thoughts
  • Labelling thoughts and feelings
  • I am having the thought that.....
  • milk.milk.milk exercise
  • silly voice exercise, passenger on the bus, tug of war with a monster

Primary outcomes

  1. The Acceptance and Action Questionnaire-II (AAQII)

    Time frame: up to 14 weeks

    It is a seven-item self-reported scale developed to measure of psychological flexibility, with items targeted to several of the six key processes: defusion, acceptance, and committed action (example item: 'I worry about not being able to control my worries and feelings'.). Each item is followed by a seven-category response scale, started from never true (1), very seldom true (2), seldom true (3), sometimes true (4), frequently true (5), almost always true (6) to always true (7). Higher scores indicate greater psychological inflexibility (total score range: 7-49, calculated as the sum of the item responses). Previous research has reported a Cronbach's of 0.84.

  2. The Cognitive Fusion Questionnaire-7 (CFQ-7)

    Time frame: up to 14 weeks

    It is designed to elicit one's level of cognitive fusion (example item: 'I find it easy to view my thoughts from a different perspective'.). Respondents rate each of 7 items on a 7- Likert scale ranging from 1 'Never true' to 7 'Always true'. Higher scores on the CFQ indicate greater cognitive fusion (total score range: 7-49, calculated as a sum of the responses). Studies demonstrate satisfactory reliability with a Cronbach's of 0.86.

  3. Southampton Mindfulness Questionnaire (SMQ)

    Time frame: up to 14 weeks

    Southampton Mindfulness Questionnaire is a 16-item scale that assesses the relationship one establishes with distressing thoughts and images (e.g., "I am able just to notice them without reacting"). Items are scored on a 7-point Likert scale, ranging from strongly disagree (0) to strongly agree (6). In the original study, the Cronbach's alpha obtained was 0.89.

  4. Psychotic Symptom Rating Scales (PSYRATS-D)

    Time frame: up to 14 weeks

    It consists of 17 items divided into two subscales designed to rate auditory hallucinations and delusions. In this study, only the delusion subscale (PSYRATS-D) was used. The Delusion subscale measures various dimensions of delusion through 6 items divided into emotional characteristics (distress) and cognitive interpretation subscales. The first subscale is for cognitive interpretation (4 items) includes Amount of preoccupation with delusions, Duration of preoccupation with delusions, Conviction, and Disruption to life caused by beliefs. The second subscale is for emotional distress of delusions (2 items) Amount of Distress, and Intensity of Distress. The PSYRATS-AH was rated on a five-point Likert scale ranging from 0 (not endorsing the item) to 4 (fully endorsing the item). With a total score range from 0 to 24. The PSYRATS-D has been found to have high inter-rater reliability (0.99-1) and test-retest reliability (r = 0.70).

Sponsors and collaborators

Lead sponsor

Alexandria University

Other

Registry information

Official study title

The Effect of Applying Cognitive Defusion Techniques on Mindful Awareness, Cognitive Fusion and Believability of Delusions Among Clients With Schizophrenia: A Randomized Control Trial

Important dates

Study start
2022
Primary completion
2022
Study completion
2023
First posted
Mar 8, 2023
Registry last updated
Jul 19, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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