Comparison Of the Effect of Mindfulness and Self-Differentiation Trainings on The Level of Assertiveness of Anxious Educational Students
Main Article Content
Keywords
Mindfulness-based stress reduction (MBSR), Self-Differentiation, Assertiveness, Anxiety, students
Abstract
Background & Objective : The presence of anxiety and lack of assertiveness leads to disruption in academic performance, destruction of intelligence and learning abilities, reduction of abstract thinking and stagnation of talents, and also by creating economic problems, it will bring harmful effects to the individual, family and society. Therefore, the aim of the present study was to Comparison of the effect of mindfulness and self-differentiation trainings on the level of assertiveness of anxious medical students.
Materials and Methods: The statistical sample included 45 female Educational students in Tabriz university in 2021-2022, who had low assertiveness and high anxiety. They were selected by convenience sampling and then randomly assigned into two experimental groups (15 people) and a control group (15 people). Mindfulness-based stress reduction training was applied to the first group (8 sessions; one 90-minute session per week) and to the second group, self-differentiation training (8 sessions; one 90-minute session per week) and the control group did not receive training. All people in the sample group filled out the Gambrill and Ritchie assertiveness test questionnaire in the pre-test and post-test stages and the Kettle anxiety questionnaire in the pre-test stage. One-variable covariance analysis was used to analyze the data. Analysis of covariance was used to analyze the data.
Findings: The results showed that the average assertiveness scores of anxious medical students in the mindfulness training group based on stress reduction compared to the self-differentiation training group and in the self-differentiation training group compared to the control group in the post-test significantly decreased (p<0.05).
Conclusion: The results showed that mindfulness training based on stress reduction is more effective than self-differentiation training in improving assertiveness of anxious medical students.
References
1. Abdolahzade Estakhry G, Heidarzadeh A, Yazdani s, Taheri Ezbarami Z. Identification of Top Medical School's Educational Structure in the World. Research in Medical Education. 2014;6(2):19-27. doi: 10.18869/acadpub.rme.6.2.19 .
2. Tian-Ci Quek T, Wai-San Tam W, X. Tran B, Zhang M, Zhang Z, Su-Hui Ho C, et al. The global prevalence of anxiety among medical students: a meta-analysis. International journal of environmental research and public health. 2019;16(15):2735 .
3. Pokhrel NB, Khadayat R, Tulachan P . Depression, anxiety, and burnout among medical students and residents of a medical school in Nepal: a cross-sectional study. BMC psychiatry. 2020;20(1):1-18 .
4. Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of internal medicine. 2007;146(5):317-25 .
5. LeDoux J. Anxious: Using the brain to understand and treat fear and anxiety: Penguin; 2016 .
6. Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Daini S. Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms. Eur Rev Med Pharmacol Sci. 2013;17(Suppl 1):55-64 .
7. Eysenck MW, Derakshan N, Santos R, Calvo MG. Anxiety and cognitive performance: attentional control theory .Emotion. 2007;7(2):336 .
8. Moran TP. Anxiety and working memory capacity: A meta-analysis and narrative review. Psychological bulletin. 2016;142(8):831 .
9. Runswick OR, Roca A, Williams AM, Bezodis NE, North JS. The effects of anxiety and situation-specific context on perceptual–motor skill: A multi-level investigation. Psychological Research. 2018;82:708-19 .
10. Hope V, Henderson M. Medical student depression, anxiety and distress outside N orth A merica: a systematic review. Medical education. 2014;48(10): 963-979.
11. Larijani T, Aghajani M, Baheiraei A, Neiestanak N. Relation of assertiveness and anxiety among Iranian University students. Journal of psychiatric and mental health nursing. 2010;17(10):893-9 .
12. Wolpe J. Reciprocal inhibition: Major agent of behavior change. 1995 .
13. Mohagheghi M, Pourmohamadreza-Tajrishi M, Shahshahanipour S, Movallali G, Vahedi M. The Effectiveness of Assertiveness Training on Anxiety Symptoms in School-Age Children With Specific Learning Disorder. Archives of Rehabilitation. 2021;22(4):408-29. doi: 10.32598/rj.22.4.487.15 .
14. Speed BC, Goldstein BL, Goldfried MR. Assertiveness training: A forgotten evidence‐based treatment. Clinical Psychology: Science and Practice. 2018;25(1):e12216 .
15. Alghamdi NG. Anxiety and assertiveness in females: a comparison of medical and non-medical university students. Mediterranean Journal of Social Sciences. 2015;6(3 S2):84 .
16. Plessen CY, Karyotaki E, Cuijpers P. Exploring the efficacy of psychological treatments for depression: a multiverse meta-analysis protocol. BMJ open. 2022;12(1):e050197 .
17. Salehian M H. The predictive role of psychological toughness and adaptability on the actual well-being of mothers with handicapped children, Journal of African Health Sciences. 2022; 22(1), 611-8.
18. Salehian M H, Hosseinzadeh Peyghan, R., ShafaeianFard, R., hajeaflaton Mofrad, S. The Effects of Mental Imagery and Physical Practice on Learning a Dart Throwing in Children with ADHD, Journal of Modern Psycholgy, 2023; 4(8), 1-7 .
19. Pirsaghi F, Nazari AM, Hajihassani M, Nad-Alipour H. The Effect of Self-Differentiation Therapy on Assertiveness of Female Students of Allameh Tabataba’i University. Clinical Psychology Studies. 2014;4(16):19-34 .
20. Hosseinzadeh Peyghan, R, Salehian, MH, Khajeaflaton Mofrad, S. The Effects of Model’s Skill Level on Learning a Basketball Skill in Children with Autism. Journal of Modern Psycholog. 2022; 3(2): 13-21.
21. Mirsyfi Fard La-S, Akhbari F. The Effectiveness of the Mindfulness-Based Stress Reduction Program in Improving Mindfulness and Assertiveness in Students with Social Anxiety. Biquarterly Journal of studies and Psychological news in Adolescents and Youth. 2021;2(1):83-95 .
22. McCarney RW, Schulz J, Grey AR. Effectiveness of mindfulness-based therapies in reducing symptoms of depression: A meta-analysis. European Journal of Psychotherapy & Counselling. 2012;14(3):279-99 .
23. Uysal N, Çalışkan BB. The effects of mindfulness‐based stress reduction on mindfulness and stress levels of nursing students during first clinical experience. Perspectives in Psychiatric Care. 2022;58(4):2639-45 .
24. Salehian, MH, Yadolazadeh, A, Ranjbari, S. Comparison of the effect of Hope Therapy Based on Cognitive-Spiritual Approach and Tai chi Exercises on Anxiety due to Corona Disease in students. Pars Journal of Medical Sciences. 2022; 20 (1): 74-84
25. Barghi Irani Z. The effects of mindfulness-based stress reduction (MBSR) on fear of negative evaluation, changing attitude towards life and assertiveness in neglected adolescents. Quarterly Journal of Child Mental Health. 2020;7(1):15-31 .
26. Da Silva CCG, Bolognani CV, Amorim FF, Imoto AM. Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: a systematic review and meta-analysis. Systematic Reviews. 2023;12(1):1-28 .
27. Aherne D, Farrant K, Hickey L, Hickey E, McGrath L, McGrath D. Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement. BMC medical education. 2016;16(1):1-11 .
28. Cary E, Bergen-Cico D, Sinegar S, Schutt M, Helminen E, Felver J. Self-regulation mediates effects of adapted mindfulness-based stress reduction on anxiety among college students. Journal of American College Health. 2023:1-11 .
29. Ghadiri, S., Salehian MH. Anticipation of Emotion Regulation and Psychological Well-being on Athletic Performance of Professional and Semi-professional Athletes. Sport Psychology Studies. 2019; 8(29): 151-170.
30. Thomas R, Shelley-Tremblay J, Joanning H. Anxiety Explains Self-Differentiation: Implications for Bowenian Approaches to Marriage and Family Therapy. The American Journal of Family Therapy .2021; 49(5): 534-549.
31. Carr A. Family therapy: Concepts, process and practice: John Wiley & Sons; 2012 .
32. Salehian, MH, Yadolazadeh, A., Ranjbari, S. Comparison of the effect of cognitive-spiritual method of hope therapy and tai chi exercises on anxiety caused by corona disease in university students. Pakistan Journal of Medical and Health Sciences. 2021; 15(3): 938-947.
33. Peleg-Popko O. Bowen theory: A study of differentiation of self, social anxiety, and physiological symptoms. Contemporary Family Therapy. 2002;24:355-69 .
34. Sasani M, Fathi Aghdam G, Rezazadeh M. Comparing the Effectiveness of Self-Differentiation and Really Therapy Training on Intimacy, Compatibility and Assertiveness of Married Women. Journal of Excellence in counseling and psychotherapy. 2020;9(34):1-19 .
35. Karkhane P, Jazayeri R, Bahrami F, Fatehizadeh M. The study of the effectiveness of the Bowen Self-differentiation counseling on the assertiveness of married women in Isfahan. 2015 .
36. Liu S-w, Luo L, Wu M-c, Wang R, Wu Y-p. Correlation between self-differentiation and professional adaptability among undergraduate nursing students in China. International Journal of Nursing Sciences. 2016;3(4):394-7 .
37. Zhao S, Li J. The Relationship Between College Students’self-Differentiation And Anxiety In The Perspective Of Ideological And Political Education. Psychiatria Danubina. 2021;33(suppl 7):280-2 .
38. Huang L, Liang Y, MA X, Long X, Zhao X. The Association between self-differentiation andmental health among medical students. Chinese Journal of Medical Education Research.2018; 853-858.
39. Gambrill ED, Richey CA. An assertion inventory for use in assessment and research. Behavior therapy. 1975;6(4):550-61 .
40. Rezapour Mirsaleh Y, Aboutorabi Kashani P, Ebrahimi Ghavam S. Effectiveness of Assertive Skills Training on Improvement of Assertion and Self-esteem of Third to Fifth Grade Low-assertive Girl Students in Tehran. Clinical Psychology and Personality. 2013;10(2):77-90 .
41. Bowen S, Chawla N, Grow J, Marlatt GA. Mindfulness-based relapse prevention for addictive behaviors: Guilford Publications; 2021 .
42. Mareiniss DP. Decreasing GME training stress to foster residents’ professionalism. Academic Medicine. 2004;79(9):825-31 .
43. González Fragoso C, Guevara Benítez Y, Jiménez Rodríguez D, Alcázar Olán RJ. Relationship between assertiveness, academic performance and anxiety in a sample of Mexican students in secondary education. Acta colombiana de Psicología. 2018;21(1):116-38 .
44. Aghababa A, Kashi A. Effect of Mindful Meditation on the Mindfulness' State, Flow State and Sport Performance on Table Tennis Players. 2018 .
45. Wielgosz J, Goldberg SB, Kral TR, Dunne JD, Davidson RJ. Mindfulness meditation and psychopathology. Annual review of clinical psychology. 2019;15:285-316 .
46. Kabat-Zinn J. Full catastrophe living, revised edition: how to cope with stress, pain and illness using mindfulness meditation: Hachette uK; 2013 .
2. Tian-Ci Quek T, Wai-San Tam W, X. Tran B, Zhang M, Zhang Z, Su-Hui Ho C, et al. The global prevalence of anxiety among medical students: a meta-analysis. International journal of environmental research and public health. 2019;16(15):2735 .
3. Pokhrel NB, Khadayat R, Tulachan P . Depression, anxiety, and burnout among medical students and residents of a medical school in Nepal: a cross-sectional study. BMC psychiatry. 2020;20(1):1-18 .
4. Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of internal medicine. 2007;146(5):317-25 .
5. LeDoux J. Anxious: Using the brain to understand and treat fear and anxiety: Penguin; 2016 .
6. Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Daini S. Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms. Eur Rev Med Pharmacol Sci. 2013;17(Suppl 1):55-64 .
7. Eysenck MW, Derakshan N, Santos R, Calvo MG. Anxiety and cognitive performance: attentional control theory .Emotion. 2007;7(2):336 .
8. Moran TP. Anxiety and working memory capacity: A meta-analysis and narrative review. Psychological bulletin. 2016;142(8):831 .
9. Runswick OR, Roca A, Williams AM, Bezodis NE, North JS. The effects of anxiety and situation-specific context on perceptual–motor skill: A multi-level investigation. Psychological Research. 2018;82:708-19 .
10. Hope V, Henderson M. Medical student depression, anxiety and distress outside N orth A merica: a systematic review. Medical education. 2014;48(10): 963-979.
11. Larijani T, Aghajani M, Baheiraei A, Neiestanak N. Relation of assertiveness and anxiety among Iranian University students. Journal of psychiatric and mental health nursing. 2010;17(10):893-9 .
12. Wolpe J. Reciprocal inhibition: Major agent of behavior change. 1995 .
13. Mohagheghi M, Pourmohamadreza-Tajrishi M, Shahshahanipour S, Movallali G, Vahedi M. The Effectiveness of Assertiveness Training on Anxiety Symptoms in School-Age Children With Specific Learning Disorder. Archives of Rehabilitation. 2021;22(4):408-29. doi: 10.32598/rj.22.4.487.15 .
14. Speed BC, Goldstein BL, Goldfried MR. Assertiveness training: A forgotten evidence‐based treatment. Clinical Psychology: Science and Practice. 2018;25(1):e12216 .
15. Alghamdi NG. Anxiety and assertiveness in females: a comparison of medical and non-medical university students. Mediterranean Journal of Social Sciences. 2015;6(3 S2):84 .
16. Plessen CY, Karyotaki E, Cuijpers P. Exploring the efficacy of psychological treatments for depression: a multiverse meta-analysis protocol. BMJ open. 2022;12(1):e050197 .
17. Salehian M H. The predictive role of psychological toughness and adaptability on the actual well-being of mothers with handicapped children, Journal of African Health Sciences. 2022; 22(1), 611-8.
18. Salehian M H, Hosseinzadeh Peyghan, R., ShafaeianFard, R., hajeaflaton Mofrad, S. The Effects of Mental Imagery and Physical Practice on Learning a Dart Throwing in Children with ADHD, Journal of Modern Psycholgy, 2023; 4(8), 1-7 .
19. Pirsaghi F, Nazari AM, Hajihassani M, Nad-Alipour H. The Effect of Self-Differentiation Therapy on Assertiveness of Female Students of Allameh Tabataba’i University. Clinical Psychology Studies. 2014;4(16):19-34 .
20. Hosseinzadeh Peyghan, R, Salehian, MH, Khajeaflaton Mofrad, S. The Effects of Model’s Skill Level on Learning a Basketball Skill in Children with Autism. Journal of Modern Psycholog. 2022; 3(2): 13-21.
21. Mirsyfi Fard La-S, Akhbari F. The Effectiveness of the Mindfulness-Based Stress Reduction Program in Improving Mindfulness and Assertiveness in Students with Social Anxiety. Biquarterly Journal of studies and Psychological news in Adolescents and Youth. 2021;2(1):83-95 .
22. McCarney RW, Schulz J, Grey AR. Effectiveness of mindfulness-based therapies in reducing symptoms of depression: A meta-analysis. European Journal of Psychotherapy & Counselling. 2012;14(3):279-99 .
23. Uysal N, Çalışkan BB. The effects of mindfulness‐based stress reduction on mindfulness and stress levels of nursing students during first clinical experience. Perspectives in Psychiatric Care. 2022;58(4):2639-45 .
24. Salehian, MH, Yadolazadeh, A, Ranjbari, S. Comparison of the effect of Hope Therapy Based on Cognitive-Spiritual Approach and Tai chi Exercises on Anxiety due to Corona Disease in students. Pars Journal of Medical Sciences. 2022; 20 (1): 74-84
25. Barghi Irani Z. The effects of mindfulness-based stress reduction (MBSR) on fear of negative evaluation, changing attitude towards life and assertiveness in neglected adolescents. Quarterly Journal of Child Mental Health. 2020;7(1):15-31 .
26. Da Silva CCG, Bolognani CV, Amorim FF, Imoto AM. Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: a systematic review and meta-analysis. Systematic Reviews. 2023;12(1):1-28 .
27. Aherne D, Farrant K, Hickey L, Hickey E, McGrath L, McGrath D. Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement. BMC medical education. 2016;16(1):1-11 .
28. Cary E, Bergen-Cico D, Sinegar S, Schutt M, Helminen E, Felver J. Self-regulation mediates effects of adapted mindfulness-based stress reduction on anxiety among college students. Journal of American College Health. 2023:1-11 .
29. Ghadiri, S., Salehian MH. Anticipation of Emotion Regulation and Psychological Well-being on Athletic Performance of Professional and Semi-professional Athletes. Sport Psychology Studies. 2019; 8(29): 151-170.
30. Thomas R, Shelley-Tremblay J, Joanning H. Anxiety Explains Self-Differentiation: Implications for Bowenian Approaches to Marriage and Family Therapy. The American Journal of Family Therapy .2021; 49(5): 534-549.
31. Carr A. Family therapy: Concepts, process and practice: John Wiley & Sons; 2012 .
32. Salehian, MH, Yadolazadeh, A., Ranjbari, S. Comparison of the effect of cognitive-spiritual method of hope therapy and tai chi exercises on anxiety caused by corona disease in university students. Pakistan Journal of Medical and Health Sciences. 2021; 15(3): 938-947.
33. Peleg-Popko O. Bowen theory: A study of differentiation of self, social anxiety, and physiological symptoms. Contemporary Family Therapy. 2002;24:355-69 .
34. Sasani M, Fathi Aghdam G, Rezazadeh M. Comparing the Effectiveness of Self-Differentiation and Really Therapy Training on Intimacy, Compatibility and Assertiveness of Married Women. Journal of Excellence in counseling and psychotherapy. 2020;9(34):1-19 .
35. Karkhane P, Jazayeri R, Bahrami F, Fatehizadeh M. The study of the effectiveness of the Bowen Self-differentiation counseling on the assertiveness of married women in Isfahan. 2015 .
36. Liu S-w, Luo L, Wu M-c, Wang R, Wu Y-p. Correlation between self-differentiation and professional adaptability among undergraduate nursing students in China. International Journal of Nursing Sciences. 2016;3(4):394-7 .
37. Zhao S, Li J. The Relationship Between College Students’self-Differentiation And Anxiety In The Perspective Of Ideological And Political Education. Psychiatria Danubina. 2021;33(suppl 7):280-2 .
38. Huang L, Liang Y, MA X, Long X, Zhao X. The Association between self-differentiation andmental health among medical students. Chinese Journal of Medical Education Research.2018; 853-858.
39. Gambrill ED, Richey CA. An assertion inventory for use in assessment and research. Behavior therapy. 1975;6(4):550-61 .
40. Rezapour Mirsaleh Y, Aboutorabi Kashani P, Ebrahimi Ghavam S. Effectiveness of Assertive Skills Training on Improvement of Assertion and Self-esteem of Third to Fifth Grade Low-assertive Girl Students in Tehran. Clinical Psychology and Personality. 2013;10(2):77-90 .
41. Bowen S, Chawla N, Grow J, Marlatt GA. Mindfulness-based relapse prevention for addictive behaviors: Guilford Publications; 2021 .
42. Mareiniss DP. Decreasing GME training stress to foster residents’ professionalism. Academic Medicine. 2004;79(9):825-31 .
43. González Fragoso C, Guevara Benítez Y, Jiménez Rodríguez D, Alcázar Olán RJ. Relationship between assertiveness, academic performance and anxiety in a sample of Mexican students in secondary education. Acta colombiana de Psicología. 2018;21(1):116-38 .
44. Aghababa A, Kashi A. Effect of Mindful Meditation on the Mindfulness' State, Flow State and Sport Performance on Table Tennis Players. 2018 .
45. Wielgosz J, Goldberg SB, Kral TR, Dunne JD, Davidson RJ. Mindfulness meditation and psychopathology. Annual review of clinical psychology. 2019;15:285-316 .
46. Kabat-Zinn J. Full catastrophe living, revised edition: how to cope with stress, pain and illness using mindfulness meditation: Hachette uK; 2013 .
Article Sidebar
Published
Jun 1, 2023
Article Details
How to Cite
Nasrin Hadilou, & Shahram Ranjdoust. (2023). Comparison Of the Effect of Mindfulness and Self-Differentiation Trainings on The Level of Assertiveness of Anxious Educational Students. Journal of Population Therapeutics and Clinical Pharmacology, 30(12), 436-448. https://doi.org/10.47750/jptcp.2023.30.12.048
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Nasrin Hadilou, & Shahram Ranjdoust. (2023). Comparison Of the Effect of Mindfulness and Self-Differentiation Trainings on The Level of Assertiveness of Anxious Educational Students. Journal of Population Therapeutics and Clinical Pharmacology, 30(12), 436-448. https://doi.org/10.47750/jptcp.2023.30.12.048