Comparing the Effectiveness of Metacognitive Therapy with Short-Term Dynamic Psychotherapy on Sleep Quality, Psychological Distress, and Executive Functions of Nurses with Insomnia

Hatami Barziyan , Marjan; Asadi, Leila; Farsi, Zahra; Goodarzi, Mohammad Ali; Sohrabi Rezvan , Mobina; Nezamabadi , Mojgan

Volume 15 - Articles-1404 MEJDS (2025) 15: 44 | Back to browse issues page

Mendeley

Zotero

RefWorks

Hatami Barziyan M, Asadi L, Farsi Z, Goodarzi M A, Sohrabi Rezvan M, Nezamabadi M. Comparing the Effectiveness of Metacognitive Therapy with Short-Term Dynamic Psychotherapy on Sleep Quality, Psychological Distress, and Executive Functions of Nurses with Insomnia. MEJDS 2025; 15 (0) :44-44
URL: http://jdisabilstud.org/article-1-3597-en.html

Comparing the Effectiveness of Metacognitive Therapy with Short-Term Dynamic Psychotherapy on Sleep Quality, Psychological Distress, and Executive Functions of Nurses with Insomnia

Marjan Hatami Barziyan¹

, Leila Asadi²

, Zahra Farsi³

, Mohammad Ali Goodarzi ^*⁴

, Mobina Sohrabi Rezvan⁵

, Mojgan Nezamabadi⁶

1- Master's Degree in General Psychology, Department of Psychology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
2- Master's Degree in Clinical Psychology, Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
3- Master's Degree in Educational Psychology, Department of Psychology, North Tehran Branch, Islamic Azad University, Tehran, Iran
4- Full Professor, Department of Clinical Psychology, Shiraz University, Shiraz, Iran
5- Master's Degree in Family Counseling, Counseling Department, Central Tehran Branch, Islamic Azad University, Tehran, Iran
6- Master's Degree in General Psychology, Department of Psychology, Arak Branch, Islamic Azad University, Arak, Iran

Abstract: (616 Views)

Abstract
Background & Objectives: One of the major problems faced by nurses is insomnia and sleep disorders. Several factors, such as stress, anxiety, and changes in sleep patterns, can contribute to insomnia in nurses. Additionally, insomnia in nurses is primarily caused by work–related pressures and the environmental conditions in which they work. In addition to insomnia, nurses are at risk for other emotional and cognitive problems, such as psychological distress and executive function deficits. Considering the negative consequences of insomnia, psychological distress, and impaired executive functions in nurses with insomnia, many approaches have been developed to improve these psychological problems. Two of these approaches are metacognitive therapy and short–term dynamic psychotherapy. Comparing these two approaches allows physicians and psychologists to choose the best treatment strategy based on the specific needs and problems of nurses, especially nurses who have insomnia. As a result, it can help improve sleep quality, reduce psychological distress, and enhance executive functions. Accordingly, the present study aimed to compare metacognitive therapy and short–term psychodynamic therapy on sleep quality, psychological distress, and executive functions of nurses with insomnia.
Methods: The present study was quasi–experimental research and employed a pretest–posttest design with a control group. The study population consisted of all nurses working in hospitals in Karaj City, Iran, from August 2024 to March 2025. Using a voluntary sampling method, 45 nurses with insomnia were included in the study as the sample. These individuals were randomly assigned to two experimental groups and one control group (15 people in each group). The inclusion criteria were insomnia, as indicated by a cut–off score of greater than 16 on the Pittsburgh Sleep Quality Index, consent to and cooperation in the study, and regular attendance at therapy sessions. The exclusion criteria included dissatisfaction with and non–cooperation in the study, as well as absence from therapy sessions. The first experimental group received the Metacognitive Therapy Protocol (Wells, 2011), and the second experimental group received Short–Term Dynamic Psychotherapy (Davanloo, 2001). It should be noted that the control group was met at the training location (in a different room from the experimental group's room) and read and reviewed the book. Subjects in all three groups responded to the Pittsburgh Sleep Quality Index (Buysse et al., 1989), the Kessler Psychological Distress Questionnaire (Kessler et al., 2002), and the Barkley Executive Function Questionnaire (Barkley, 2012) at the beginning and end of the study. Data analysis was performed at two levels: descriptive and inferential. At the descriptive level, statistical indicators such as the mean and standard deviation were used. At the inferential level, univariate analysis of covariance and Bonferroni post hoc test were used to examine the research objective. Data were analyzed at a significance level of 0.05 and in SPSS software version 28.
Results: The difference between the experimental and control groups was significant in all three variables of sleep quality (p<0.001), psychological distress (p<0.001), and executive functions (p<0.001) in the posttest phase. However, short–term dynamic psychotherapy had a greater effect on sleep quality (p<0.001) and psychological distress (p=0.008), and metacognitive therapy was more effective in improving executive functions (p=0.004).
Conclusion: It is concluded that both metacognitive therapy and short–term psychodynamic therapy are interventions that have a positive effect on sleep quality, psychological distress, and executive functions of nurses with insomnia. However, short–term psychodynamic therapy is more effective in improving the quality of sleep and psychological distress of these individuals, and metacognitive therapy has a greater role in improving their executive functions.

Keywords: Insomnia, Nurses, Psychological distress, Metacognitive therapy, Short–term dynamic psychotherapy, Sleep quality, Executive functions

Full-Text [PDF 369 kb] (70 Downloads)

Type of Study: Original Research Article | Subject: Psychology

References

1. Ye L, Zhang F, Wang L, Chen Y, Shi J, Cai T. Identification of the risk factors for insomnia in nurses with long covid-19. BMC Nurs. 2024;23(1):1–12. [DOI]

2. Morin CM, Buysse DJ. Management of insomnia. N Engl J Med. 2024;391(3):247–58. [DOI]

3. Pachi A, Tselebis A, Sikaras C, Sideri EP, Ivanidou M, Baras S, et al. Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era. AIMS Public Health. 2024;11(1):36–57. [DOI]

4. Tsai K, Lee TY, Chung MH. Insomnia in female nurses: a nationwide retrospective study. Int J Occup Saf Ergon. 2017;23(1):127–32. [DOI]

5. Edwin HS, Trinkoff AM, Mills ME, Zhu S. Psychological distress symptoms in nurses and their intention to leave: a cross‐sectional secondary data analysis. J Adv Nurs. 2025;81(3):1286–99. [DOI]

6. Mehrabi HA, Afshari N. Predicting of psychological distress based on stress coping styles, attitude towards the severity of covid-19 and preventive behaviors in corona epidemics in the people of Isfahan. Journal of Research in Behavioural Sciences. 2022;20(1):48–59. [Persian] [DOI]

7. Arvidsdotter T, Marklund B, Kylén S, Taft C, Ekman I. Understanding persons with psychological distress in primary health care. Scand J Caring Sci. 2016;30(4):687–94. [DOI]

8. Witteveen C. An exploratory study on the perception of the importance of executive functions in nursing [Thesis for MSc]. [Groningen, Netherlands]: University of Groningen; 2023.

9. Jing MJ, Li H, Li CP, Wei XJ, Lin WQ, Zhu SC, et al. The association between working hours with vigilance and executive function of intensive care unit nurses. J Nurs Manag. 2023;2023:1–13. [DOI]

10. Lin B, Liew J, Perez M. Measurement of self-regulation in early childhood: relations between laboratory and performance-based measures of effortful control and executive functioning. Early Child Res Q. 2019;47:1–8. [DOI]

11. Lohndorf RT, Vermeer HJ, Cárcamo RA, De La Harpe C, Mesman J. Preschoolers' problem behavior, prosocial behavior, and language ability in a Latin-American context: the roles of child executive functions and socialization environments. Early Child Res Q. 2019;48:36–49. [DOI]

12. Williams CN, McEvoy CT, Lim MM, Shea SA, Kumar V, Nagarajan D, et al. Sleep and executive functioning in pediatric traumatic brain injury survivors after critical care. Children. 2022;9(5):748. [DOI]

13. Wells A. Metacognitive therapy for anxiety and depression. Guilford Press; 2011.

14. Normann N, Morina N. The efficacy of metacognitive therapy: a systematic review and meta-analysis. Front Psychol. 2018;9:1–14. [DOI]

15. Capobianco L, Nordahl H. A brief history of metacognitive therapy: from cognitive science to clinical practice. Cogn Behav Pract. 2023;30(1):45–54. [DOI]

16. Zafartalab Z, Akbari A, Mohammadi MH. Investigating the effectiveness of short-term, intensive dynamic psychotherapy on sleep quality and defense styles in women with tension-type headache. In: The Second National Conference on Psychotherapy in Iran [Internet]. Ardabil: Azad University; 2023. [Persian]

17. Bakhshi Bajestani A, Shahabizadeh F, Vaziri S, Lotfi Kashani F. The effectiveness of short-term psychoanalysis treatment in decreasing psychological distress and psychosomatic symptoms in patients with gastrointestinal dysfunction with personality type D. Journal of North Khorasan University of Medical Sciences. 2022;13(4):1–11. [Persian] [DOI]

18. Ghazagh M, Lotfi Kashani L, Vaziri Sh, Zareh H. Comparison of the effectiveness of acceptance and commitment therapy and intensive short-term dynamic psychotherapy on attention and executive function of patients with lupus erythematosus: a quasi-experimental single-subject study. Razi Journal of Medical Sciences. 2023:30(2):144–32. [Persian] [Article]

19. Sarafraz M, Moradi S. The effect of intensive short-term dynamic psychotherapy (ISTDP) on attachment styles in women with marital conflicts. Journal of Psychology New Ideas. 2022;14(18):1–20. [Persian] [Article]

20. Abbass AA, Kisely SR, Town JM, Leichsenring F, Driessen E, De Maat S, et al. Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database Syst Rev. 2014;2014(7). [DOI]

21. Faghihi T, Zare Y, Kianfarid GH, Ghalavand F. Studying the effectiveness of short-term intensive dynamic psychotherapy on sleep quality and emotional alexithymia in people with insomnia. In: The 7th International Conference on Psychology, Educational Sciences and Children's Rights in the Islamic World [Internet]. Shiraz: Shiraz University; 2022. [Persian]

22. Naghibi SH, Pourhosein R, Sarafraz MR, Sadeghinia A. Effectiveness of intensive short-term dynamic psychotherapy on psychological distress of patients with atopic dermatitis. Journal of Modern Psychological Researches. 2022;17(68):287–95. [Persian] [Article]

23. Sarihi N, Manavipour D, Sdaghatifard M. Comparing the effectiveness of ISTDP intervention program, awareness training, and its application on executive functions. The Journal of Psychological Science. 2020;19(87):339–48. [Persian] [DOI]

24. Socci V, Pino MC, Carcione A, D'Aurizio G, Ferrara M, Tempesta D. The relationships among metacognitive functions, sleep‐related thought‐control strategies and sleep quality: a mediation analysis. Journal of Sleep Research. 2024;33(3):1–9. [DOI]

25. Cheriki R, Ramezani K, Movahedzadeh B. The effectiveness of training based on metacognition on sleep quality and insomnia symptoms in nurses. Journal of Nursing Education. 2022;11(5):10–20. [Persian] [DOI]

26. Fisher PL, Byrne A, Fairburn L, Ullmer H, Abbey G, Salmon P. Brief metacognitive therapy for emotional distress in adult cancer survivors. Front Psychol. 2019;10:1–8. [DOI]

27. Wells A, Reeves D, Heal C, Fisher P, Doherty P, Davies L, et al. Metacognitive therapy home-based self-help for anxiety and depression in cardiovascular disease patients in the UK: a single-blind randomised controlled trial. PLoS Med. 2023;20(1):e1004161. [DOI]

28. Bayegan K, Sotodehasl N, Karami A, Asadzadeh Dahraei H. Comparison of the effectiveness of metacognitive therapy and behavioral activation on executive functions of elderly people with type 2 diabetes. Razavi International Journal of Medicine. 2021;9(3):e1039. [Persian] [DOI]

29. Wu M, Was CA. The relationship between executive functions and metacognition in college students. J Intell. 2023;11(12):220. [DOI]

30. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213. [DOI]

31. Davanloo H. Intensive short-term dynamic psychotherapy: selected papers of Habib Davanloo. John Wiley & Sons; 2001.

32. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76. [DOI]

33. Barkley RA. The assessment of executive functioning using the Barkley Deficits in Executive Functioning Scales. In: Goldstein S, Neglieri J; editors. Handbook of executive functioning. New York, NY: Springer; 2014. [DOI]

34. Farrahi Moghaddam J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath. 2012;16(1):79–82. [DOI]

35. Yaghubi H. Psychometric properties of the 10 questions Version of the Kessler Psychological Distress Scale (K-10). Journal of Applied Psychological Research. 2016;6(4):45–57. [Persian] [Article]

36. Mashhadi A, Mirdoraghi F, Hosainzadeh-Maleki Z, Hasani J, Hamzeloo M. Factor structure, reliability and validity of Persian version of Barkley Deficits in Executive Functioning Scale (BDEFS)- adult version. Journal of Clinical Psychology. 2015;7(1):51–62. [Persian] [Article]