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The Effect of Cognitive-Behavioral Therapy on Reducing Perfectionism and the Cognitive Error of Thought-Action Fusion in Women with Obsessive-Compulsive Disorder
Feresheh Reza, Javanshir Asadi, Arastoo Mirani, Afsaneh Khajevand Khoshli,
Volume 13, Issue 1 (Volume 13, Issue 1, Spring 2025 2025)
Abstract
The aim of the present study was to investigate the effect of cognitive-behavioral therapy on reducing perfectionism and thought-action fusion in women with obsessive-compulsive disorder with a two-month follow-up. The research method was a quasi-experimental design with a pretest-posttest-follow-up and control group. Among the women referring to Sarohana Clinic in Pasdaran district of Tehran, 30 were purposively selected and randomly assigned to two groups of 15 (cognitive-behavioral therapy and control). The research instruments included the Ahvaz Perfectionism Questionnaire, the Thought-Action Fusion Scale (TAFS), Spielberger's Overt and Covert Anxiety Questionnaire, and the Maudsley Checklist. The cognitive-behavioral therapy intervention was implemented in 8 weekly 90-minute group sessions. The post-test was conducted immediately and the follow-up was conducted two months after the end of the sessions. The data were analyzed by multivariate and univariate analysis of covariance. The findings showed that cognitive-behavioral therapy significantly reduced perfectionism, thought-action fusion (moral dimensions, possibility for self and others), and anxiety at post-test and two-month follow-up, and these effects remained stable until the follow-up stage. The present study showed that cognitive-behavioral therapy can be used as an effective and sustainable intervention in reducing harmful cognitive variables in women with obsessive-compulsive disorder.

A Comparison of the Effectiveness of Emotion-Focused Therapy and Metacognitive Therapy on Cognitive-Emotional Constructs (Thought-Action Fusion and Intolerance of Uncertainty) in Female Students with Obsessive–Compulsive Disorder
Hava Mahmoudzadeh Kenari, Dr Afsaneh Khajevand Khoshli, Dr Javanshir Asadi,
Volume 13, Issue 2 (Volume 13, Issue 2, September 2025 2025)
Abstract
Obsessive–compulsive disorder (OCD) in adolescents is associated with maladaptive cognitive–emotional patterns, including thought–action fusion and intolerance of uncertainty, which can impair academic performance and interpersonal relationships. This study aimed to compare the effectiveness of emotion-focused therapy and metacognitive therapy on these constructs in adolescent girls with OCD. The quasi-experimental study employed a pretest–posttest design with a control group and included 45 high school girls in Babolsar, selected through purposive sampling and randomly assigned to three groups of 15 participants each. Interventions consisted of eight weekly 90-minute group sessions. Data were collected using the Thought–Action Fusion Scale and the Intolerance of Uncertainty Questionnaire and analyzed using multivariate analysis of covariance (MANCOVA). Results indicated that both interventions significantly reduced thought–action fusion and intolerance of uncertainty compared to the control group, and pairwise comparisons showed that metacognitive therapy was more effective in reducing thought–action fusion, whereas emotion-focused therapy was relatively more effective in reducing outcomes related to intolerance of uncertainty. These findings suggest that targeted psychotherapeutic interventions can improve maladaptive cognitive–emotional patterns associated with OCD in adolescents and reduce anxiety and compulsive behaviors. The results provide guidance for selecting tailored treatments based on individual clinical needs and for designing school- and clinic-based intervention programs.

Predicting Rumination Based on Cognitive and Cognitive-Emotional Processes: The Role of Cognitive Flexibility, Emotional Schemas, and Emotion Regulation Self-Efficacy among Female University Students
Mojtaba Pooragha, Samereh Asadi Majareh,
Volume 13, Issue 4 (Volume13, Issue 4 2026)
Abstract

The present study aimed to predict rumination based on cognitive and cognitive-emotional processes, with particular emphasis on the roles of cognitive flexibility, emotional schemas, and emotional self-efficacy among female university students. This descriptive-correlational study employed a predictive research design. The statistical population consisted of all female students at the Rasht Branch of Islamic Azad University during the second semester of the 2024–2025 academic year, from whom 400 participants were selected through convenience sampling. Data were collected using the Leahy Emotional Schema Scale (LESS), the Cognitive Flexibility Inventory (CFI) developed by Dennis and Vander Wal, the Emotional Self-Efficacy Scale developed by Hosseinchari et al., and the Ruminative Responses Scale (RRS) developed by Nolen-Hoeksema and Morrow. Data analysis was conducted using Pearson's correlation coefficient and stepwise multiple regression analysis. The findings indicated a significant positive relationship between emotional schemas and rumination, whereas cognitive flexibility and emotional self-efficacy were significantly and negatively associated with rumination . Furthermore, the results of the stepwise regression analysis revealed that the components of control, guilt, perception of alternative options, simplification of emotions, blaming others, and lack of control jointly explained 61% of the variance in rumination. Among these variables, the control component, as a dimension of cognitive flexibility, emerged as the strongest predictor of rumination. Overall, the findings suggest that cognitive and cognitive-emotional processes play a fundamental role in explaining rumination, and that variables related to cognitive control, emotional processing, and emotional self-efficacy are among its most important predictors. Accordingly, enhancing cognitive flexibility, modifying maladaptive emotional schemas, and strengthening emotional self-efficacy may serve as key targets for cognitive and cognitive-behavioral interventions aimed at reducing rumination and promoting the mental health of university students.


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