Comparison of the Effectiveness of Mindfulness-Based Therapy and Transactional Analysis on Sexual Function and Sexual Satisfaction in Female Patients with Bipolar Disorder

Authors

    Fatemeh Pidad PhD Student, Department of Psychology, Bojnourd Branch, Islamic Azad University, Bojnourd, Iran
    Mehdi Ghasemi Motlagh * Assistant Professor, Department of Psychology, Bojnord Branch, Islamic Azad University, Bojnord, Iran avestaps@yahoo.com
    Abdollah Mafakheri Assistant Professor, Department of Psychology, Payame Noor University, Tehran, Iran.
https://doi.org/10.61838/kman.aftj.6.3.3

Keywords:

Transactional analysis, Sexual function, Bipolar disorder, Sexual Satisfaction, Mindfulness-Based Therapy

Abstract

Objective: The aim of this study was to compare the effectiveness of mindfulness-based therapy and transactional analysis on sexual function and sexual satisfaction in female patients with bipolar disorder.

Methods: In this study, 20 women with bipolar disorder who referred to the Gyrus Specialty Neurology and Psychiatry Clinic in Tehran from April to August 2022 were selected through purposive sampling and randomly assigned to three groups: mindfulness-based therapy, transactional analysis therapy, and a control group. All participants completed the Female Sexual Function Index (FSFI) by Rosen et al. (2000) and the Sexual Satisfaction Scale by Larson et al. (1998) before and after the intervention. The mindfulness-based therapy group underwent eight 90-to-120-minute sessions held twice a week, while the transactional analysis group received treatment in nine 60-to-120-minute sessions held twice a week. Data were analyzed using descriptive statistics and repeated measures analysis.

Findings: The results indicated that both mindfulness-based therapy and transactional analysis therapy had an effect on sexual function and sexual satisfaction in female patients with bipolar disorder. Moreover, a comparison of the effectiveness of the two therapeutic approaches across all dimensions showed that mindfulness-based therapy had a greater impact on sexual function and sexual satisfaction in female patients with bipolar disorder compared to transactional analysis.

Conclusion: Therefore, the use of mindfulness-based therapy is recommended in psychology clinics.

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References

Aaberg, V. (2016). The state of sexuality education in baccalaureate nursing programs. Nurse Education Today, 44, 14-19. https://doi.org/10.1016/j.nedt.2016.05.009

Aggarwal, S., Grover, S., & Chakrabarti, S. (2019). A comparative study evaluating the marital and sexual functioning in patients with schizophrenia and depressive disorders. Asian Journal of Psychiatry, 39, 128-134. https://doi.org/10.1016/j.ajp.2018.12.021

Agustus, P., Munivenkatappa, M., & Prasad, P. (2017). Sexual Functioning, Beliefs About Sexual Functioning and Quality of Life of Women with Infertility Problems. Journal of Human Reproductive Sciences, 10(3), 213-220. https://doi.org/10.4103/jhrs.JHRS_137_16

American Psychiatric Association. (2019). American psychiatric association. https://www.medscape.com/viewcollection/34853

Babaei, E., Abbasi, A., Mir Mohammadi, M., & Entezari, S. (2018). Investigating the relationship between sexual schemas and sexual performance with marital conflicts of women involved in domestic violence. Journal of Zanak Medical Sciences and Kurdistan University of Medical Sciences, 96-87. http://zanko.muk.ac.ir/article-1-436-en.html

Bahrami, N., Yaqubzadeh, A., Sharif Nia, H., Soleimani, M. A., & Hagh Dost, A. z. (2016). Psychometric characteristics of the Persian version of the Larson sexual satisfaction questionnaire in a sample of Iranian infertile couples. Iranian Journal of Epidemiology, 12(2), 18-31. https://doi.org/10.1016/j.nedt.2016.02.112

Berne, E. (1996). Principles of transactional analysis. Indian Journal of Psychiatry, 38(3), 154-159. https://journals.lww.com/indianjpsychiatry/abstract/1996/38030/principles_of_transactional_analysis.8.aspx

Chadwick, P., Kaur, H., Swelam, M., Ross, S., & Ellett, L. (2021). Experience of Mindfulness in People with Bipolar Disorder: A Qualitative Study. Psychother Res, 21(3), 277-285. https://doi.org/10.1177/00221678231168667

Çınaroğlu, M. (2024). Psychotherapies for the Treatment of Bipolar Disorder. Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 16(2), 373-382. https://doi.org/10.18863/pgy.1332919

Clarkson, P., Deah, A., Wayne, L. C., DuBow, A., Melun, J.-P., & Juster, R.-P. (2013). Transactional analysis psychotherapy: An integrated approach Conventional versus Mindfulness-based Interventions for Anxiety and Worry: A Review and Recommendations Current Psychiatry Research and Reviews Formerly: Current Psychiatry Reviews Chapter 21 - Allostatic load: Implications for the pathophysiology, evolution, and treatment of bipolar disorder Neurobiology of Bipolar Disorder (Vol. 16). Routledge Academic Press. https://doi.org/10.4324/9780203753996-8 10.2174/2666082216666200220121648 10.1016/j.neubiorev.2007.10.005

Clayton, D., & Burlingame, G. M. (2024). Evidence-Based Group Therapy for Mood Disorders: Treatment for Depression and Bipolar Disorders. Group Dynamics Theory Research and Practice, 28(3), 132-147. https://doi.org/10.1037/gdn0000218

Fatehi, N., Gholami Hassanaroudi, M., & Nazanin, A. (2021). The mediating role of marital forgiveness and mental well-being in the relationship between mindfulness and sexual satisfaction of married men and women in Tehran: a descriptive study. Journal of Rafsanjan University of Medical Sciences, 20(6), 645-660. https://doi.org/10.52547/jrums.20.6.660

Gabrielle, F. F. (2024). The Psychopathology Among the Offspring of Schizophrenia and Bipolar I Disorder Patients in an Egyptian Sample: A Comparative Study. International Journal of Social Psychiatry, 70(3), 482-488. https://doi.org/10.1177/00207640231216354

Haghighi Cheli, A., Mohtashami, J., Zadehmodares, S., & Arabborzu, Z. (2019). The effect of transactional analysis group behavioral therapy on infertile women's marital satisfaction. Crescent J Med Biol Sci, 6, 375-380. https://doi.org/17.1328/j.neubiorev.2019.07.16

Hassas, O., Mashhadi, A., Shamloo, Z. S., & Bordbar, M. R. F. (2024). Emotional Schema Therapy for Bipolar Disorder: Improving Emotional Schemas, Quality of Life, Cognitive Emotion Regulation, and Symptom Management. International Journal of Cognitive Therapy, 17(3), 347-368. https://doi.org/10.1007/s41811-023-00196-8

Hazlett-Stevens, H. (2022). Clinical Significance of Stress, Depression, Anxiety, and Worry Symptom Improvement Following Mindfulness-based Stress Reduction. Obm Integrative and Complementary Medicine, 7(2), 5-14. https://doi.org/07.75219/jrums.2022.08.09

Hoge, E. A., Reese, H. E., Oliva, I. A., Gabriel, C. D., Guidos, B. M., Bui, E., Simon, N. M., & Dutton, M. A. (2020). Investigating the Role of Interpretation Bias in Mindfulness-Based Treatment of Adults With Generalized Anxiety Disorder. Front. Psychol., 11, 82. https://doi.org/10.3389/fpsyg.2020.00082

Honari, R. (2014). Impact of Transactional Analysis Group Training on Marital Satisfaction of Women's Referred to Counseling Centers and Cultural Centers of Isfahan: Journal of Biological Sciences. Journal of Biological Sciences, 6(5), 191-196. https://doi.org/07.1568/fpsyg.2014.00398

Hudson, W. W., Harrison, D. F., & Crosscup, P. C. (1999). A short‐form scale to measure sexual discord in dyadic relationships. Journal of Sex Research, 17(2), 157-174. https://doi.org/04.32569/jrums.1999.129

Janiri, D., Luzio, M. D., Montanari, S., Hirsch, D., Simonetti, A., Moccia, L., Conte, E., Contaldo, I., Veredice, C., Mercuri, E., & Sani, G. (2024). Childhood Trauma and Self-Harm in Youths With Bipolar Disorders. Current Neuropharmacology, 22(1), 152-158. https://doi.org/10.2174/1570159x21666230213155249

Kabat-Zinn, J. (2009). Wherever you go, there you are: Mindfulness meditation in everyday life. Hachette Books. https://www.amazon.de/-/en/Wherever-You-There-Are-Mindfulness/dp/1401307787

Kammerer-Doak, D., & Rogers, R. (2021). Female Sexual Dysfunction. In Pelvic Floor Disorders (pp. 909-921). Springer. https://doi.org/10.1097/AOG.0b013e31816bbe85

Kamran, A., Mirmehdi, S. R., & Ghaffari Tehjiri, M. (2022). The effectiveness of mindfulness on improving interpersonal relationships and reducing impulsivity in bipolar disorder. Knowledge and research in applied psychology(87), 198-189. https://sid.ir/paper/1032176/en

Karami, J., Shalani, B., & Hoveyzi, N. (2017). Relationship between Sexual Self-Esteem and Sexual Dysfunction with Marital Satisfaction in Nurses Hopitals Kermanshah City (Iran). Qom University of Medical Sciences Journal, 11(9), 86-93. https://www.researchgate.net/publication/332962166

Keyvan, S. H., Zandi, A., Firouzi, M., & Shariatzadeh Junidi, G. (2022). Effectiveness of interactional behavior analysis (TA) therapy on depression, anxiety and mindfulness in women. The eighth national conference of modern studies and research in the field of educational sciences, psychology and counseling in Iran,

Koerner, K., & Jacobson, N. J. (2019). Evaluation of the effectiveness of mindfulness-based therapy on the quality of sexual relations. Current Direction in Psychological Science, 10(4), 111-122. https://doi.org/10.1016/j.seizure.2019.10.010

Kopeykina, I., Kim, H. J., Khatun, T., Boland, J., Haeri, S., Cohen, L., & Galynker, I. (2016). Hypersexuality and couple relationships in bipolar disorder: A review. Journal of affective disorders, 195, 1-14. https://doi.org/10.1016/j.jad.2016.01.035

Larson, J. H., Anderson, S. M., Holman, T. B., & Niemann, B. K. (1998). A longitudinal study of the effects of premarital communication, relationship stability, and self-esteem on sexual satisfaction in the first year of marriage. Journal of sex & marital therapy, 24(3), 193-206. https://doi.org/10.1080/00926239808404933

Lee, Y. M., Florez, E., Tariman, J., McCarter, S., & Riesche, L. (2015). Factors related to sexual behaviors and sexual education programs for Asian-American adolescents. Applied Nursing Research, 28(3), 222-228. https://doi.org/10.1016/j.apnr.2015.04.015

Litzinger, S., & Kristina, G. (2015). Exploring relationships among communication, sexual satisfaction, and marital satisfaction. Journal of Sex and Marital Therapy, 31(5), 409-424. https://doi.org/10.1080/00926230591006719

Mahini, E. A., Hosseyni, S. A., Ebrahimkhani, M., Mohammadi, M., & Shokri, S. (2024). Bipolar Disorder and Its Factors. Advances in Social Sciences Research Journal, 11(9), 01-11. https://doi.org/10.14738/assrj.119.17524

Malverdi Desjardi, Z., Taheri Sedeh, F., & Shibani Nougabi, A. (2022). The effectiveness of mindfulness-based therapy on the quality of sexual relationships and negative self-future thoughts in Isfahan couples. New Ideas of Psychology Quarterly, 13(17), 229-212. http://jnip.ir/article-1-724-en.html

Morris, G. L. (2006). Altered states: Using Transactional Analysis Education to prevent conflict escalation and violence. International Journal of Psychological Studies, 8(4), 51. https://doi.org/10.5539/ijps.v8n4p51

Namli, Z. A. U. K. G., & Tamam, L. (2018). Assessment of Dyadic Adjustment and Sexual Functions in Patients with Bipolar Disorder. Archives of Neuropsychiatry, 55(2), 171-176. https://doi.org/10.5152/npa.2017.19213

Oshaghi, M., & Ahangari, E. (2020). Comparison of coping styles and marital satisfaction in patients with bipolar disorder with normal people. Journal of Medical Sciences and Health Management, 2(3), 1-9. http://sjmshm.srpub.org/article-3-54-en.html

Peta, C. (2017). Disability is not asexuality: the childbearing experiences and aspirations of women with disability in Zimbabwe. Reprod Health Matters, 25(50), 10-19. https://doi.org/10.1080/09688080.2017.1331684

Polenick, C., Zarit, S., Birditt, K. S., & Bangerter, L. R. (2017). Intergenerational support and marital satisfaction: Implications of beliefs about helping aging parents. Journal of marriage and family, 79(1), 131-146. https://doi.org/10.1111/jomf.12334

Porfaraj, M., & Miladi, Z. (2022). The effectiveness of mindfulness-based stress reduction treatment on severity of symptoms and anxiety in patients with generalized anxiety disorder. Journal of Torbat Heydarieh University of Medical Sciences, 10(1), 75-85. http://jms.thums.ac.ir/article-1-1078-en.html

Reed, P. (2015). A transactional analysis of changes in parent and chick behaviour prior to separation of Herring Gulls (Larus Argentatus): A three -term contingency model. Behav Processes, 118, 21-27. https://doi.org/10.1177/0192513X18763226

Rokach, A., & Patel, K. (2021). Human Sexuality: Function, Dysfunction, Paraphilias, and Relationships. Academic Press. https://doi.org/13: 9780128191743

Rosen, R., Brown, C., Heiman, J., & Leiblum, S. (2000). The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther, 26, 191-208. https://doi.org/10.1080/009262300278597

Sardarpur, M., Zagar, Y., Bassak Nejad, S., & Mehrabizadeh Honarmand, M. (2016). The effectiveness of transactional analysis therapy on social intimacy and coping styles with stress among students. J Clin Psychol, 1, 85-102. https://doi.org/10.12850/jomf.18652

Segal, Z., Williams, M., & Teasdale, J. (2018). Mindfulness-based cognitive therapy for depression. Guilford Publications. https://doi.org/10.1037/0022-006X.76.3.524

Stewart, I., & Jones, V. (2021). Interaction analysis: new methods in psychology. Circle. https://doi.org/10.1037/0045.2574.3269.3258

Zamani, M., Tavoli, A., Khasti, Y., Sedighimornani, N., & Zafar, M. (2018). Sexual Therapy for Women with Diabete and Its Impact on Quality of Life. Iranian Journal of Psychiatry, 12(1), 58-69. https://doi.org/10.30476/IJCBNM.2021.91530.1793

Zvelc, G., cerneti, M., & Kosak, M. (2011). Mindfulness-based transactional analysis. Transactional Analysis Journal, 41(3), 241-254. https://doi.org/10.1177/036215371104100306

Additional Files

Published

2025-05-01

Submitted

2025-01-12

Revised

2025-02-21

Accepted

2025-03-03

How to Cite

Pidad, F. ., Ghasemi Motlagh , M., & Mafakheri, A. (2025). Comparison of the Effectiveness of Mindfulness-Based Therapy and Transactional Analysis on Sexual Function and Sexual Satisfaction in Female Patients with Bipolar Disorder. Applied Family Therapy Journal (AFTJ) , 6(3). https://doi.org/10.61838/kman.aftj.6.3.3