Comparison of the Effectiveness of Short-Term Psychodynamic Therapy and Mindfulness-Based Cognitive Therapy on Rumination and Illness Adaptation in Patients with Psoriasis

Abstract

The present study aimed to compare the effectiveness of short-term psychodynamic therapy (STPP) and mindfulness-based cognitive therapy (MBCT) on ruminative responses in patients with psoriasis. This quasi-experimental research employed a pretest-posttest design with two experimental groups and one control group, along with a three-month follow-up assessment. The study population comprised all male and female patients diagnosed with psoriasis in Tehran during 2024 (year 1403 in the Persian calendar), who were selected via convenience sampling. A total of 45 participants were determined using G*Power software, considering a Type I error rate (α) of 0.05 and a statistical power (1−β) of 0.80. Participants were then randomly assigned to three groups: short-term psychodynamic therapy (n = 15), mindfulness-based cognitive therapy (n = 15), and a waitlist control group (n = 15). All participants completed the Ruminative Responses Scale (RRS) developed by Nolen-Hoeksema (1991). The MBCT intervention was administered based on the protocol by Segal, Williams, and Teasdale (2002), while short-term psychodynamic therapy followed Davanloo's (1995) approach. Both interventions were delivered in eight weekly 90-minute sessions to the respective experimental groups. Data were analyzed using SPSS version 26 through repeated measures analysis of variance. Results indicated a statistically significant difference in the between-subjects factor across pretest, posttest, and follow-up scores for ruminative responses (p < 0.05). Both therapeutic interventions proved effective in reducing rumination among psoriasis patients; however, MBCT demonstrated significantly greater efficacy than STPP in diminishing ruminative responses. The findings also confirmed the stability of treatment effects at the three-month follow-up. Mindfulness-based cognitive therapy exerted a significant impact on reducing the cyclical recurrence of negative illness-related thoughts by modifying ruminative response patterns. Patients learned to observe their distressing emotions and illness-related cognitions nonjudgmentally and without avoidance, adopting an acceptance- and awareness-based stance. Rather than becoming entangled in repetitive, self-focused mental loops characteristic of rumination, participants cultivated present-moment awareness and acceptance, thereby preventing the automatic activation of ruminative responses. These findings underscore that empowering patients to regulate ruminative responses through mindfulness and acceptance constitutes an effective pathway toward more conscious living and realistic acceptance of psoriasis as a chronic condition.