The Effectiveness of Acceptance and Commitment–Based Training on Anger Rumination and Marital Satisfaction among Couples with Obsessive–Compulsive Disorder

Leila Fotovat; Maryam Talebi; Sepideh Jannati; Mohammadreza Nasaji; Kamran Pourmohammad Ghouchani

Authors

Leila Fotovat Department of General Psychology, Imam Khomeini International University, Qazvin, Iran. Author https://orcid.org/0009-0004-0881-8285
Maryam Talebi Department of Psychology, ShQ.C. Islamic Azad University, Shahr-e Qods, Iran. Author https://orcid.org/0009-0006-4799-6679
Sepideh Jannati Department of Clinical Psychology, Shi.C. Islamic Azad University, Shiraz, Iran. Corresponding Author https://orcid.org/0009-0004-0681-2656
Mohammadreza Nasaji Department of General Psychology, Ka.C., Islamic Azad University, Karaj, Iran. Author https://orcid.org/0009-0001-4654-3356
Kamran Pourmohammad Ghouchani Department of clinical psychology, Ki.C., Islamic Azad University, Kish, Iran. Author https://orcid.org/0000-0003-4590-0224

Keywords:

Acceptance and Commitment Therapy, Anger Rumination, Marital Satisfaction, Obsessive–Compulsive Disorder, Couples

Abstract

This study aimed to determine the effectiveness of Acceptance and Commitment–Based Training on anger rumination and marital satisfaction among couples with obsessive–compulsive disorder. The present study employed a quasi-experimental pretest–posttest design with an experimental group and a control group. The statistical population consisted of couples with obsessive–compulsive disorder who attended specialized counseling and psychotherapy centers in Tehran in 2026. Using convenience sampling, 32 individuals comprising 16 couples were selected and randomly assigned to an experimental group and a control group, with 16 participants, equivalent to eight couples, in each group. Data were collected using the Anger Rumination Scale developed by Sukhodolsky et al. (2001) and the 47-item short form of the ENRICH Marital Satisfaction Questionnaire. The experimental group participated in eight 60-minute sessions of Acceptance and Commitment–Based Training, whereas the control group received no experimental intervention during the same period. Data were analyzed using descriptive statistics and analysis of covariance after examination of the relevant statistical assumptions. After controlling for corresponding pretest scores, analysis of covariance showed a significant effect of group membership on anger rumination, F(1, 29) = 38.19, p < .001, partial η² = .568, indicating significantly lower posttest anger-rumination scores in the experimental group than in the control group. A significant intervention effect was also observed for marital satisfaction, F(1, 29) = 37.91, p < .001, partial η² = .567, with the experimental group demonstrating significantly higher posttest marital-satisfaction scores than the control group. These effect sizes indicated substantial intervention effects on both dependent variables. Acceptance and Commitment–Based Training was effective in reducing anger rumination and increasing marital satisfaction among couples with obsessive–compulsive disorder. The intervention may therefore provide a useful psychological approach for addressing repetitive anger-related cognition and improving relational functioning in couples experiencing obsessive–compulsive difficulties.

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References

Antonak, R. F., Livens, H., & Antonak, C. (2023). A review of research on psychosocial adjustment to impairment in persons with traumatic brain injury. Journal of Head Trauma Rehabilitation, 8, 87-100. https://doi.org/10.1097/00001199-199312000-00009

Arnold, T., Haubrick, K. K., Klasko-Foster, L. B., Rogers, B. G., Barnett, A., Ramirez-Sanchez, N. A., & Gaudiano, B. A. (2022). Acceptance and Commitment Therapy informed behavioral health interventions delivered by non-mental health professionals: A systematic review. Journal of Contextual Behavioral Science, 24, 185-196. https://doi.org/10.1016/j.jcbs.2022.05.005

Asghari Barmaei, S. (2025). The Effectiveness of an Acceptance and Commitment-Based Educational Intervention on Psychological Flexibility and Marital Stability in Couples in Arak. Ninth International Conference on Modern Approaches to Management, Psychology, and Humanities in the 21st Century, Tehran.

Assaz, D. A., Tyndall, I., Oshiro, C. K., & Roche, B. (2023). A process-based analysis of cognitive defusion in acceptance and commitment therapy. Behavior therapy, 54(6), 1020-1035. https://doi.org/10.1016/j.beth.2022.06.003

Barraca, J., Polanski, T., Duarte-Diaz, A., & Perestelo-Perez, L. (2024). Acceptance and commitment therapy for couples: A systematic review and meta-analysis. Journal of Contextual Behavioral Science, 100867. https://doi.org/10.1016/j.jcbs.2024.100867

Barraca, J., Polanski, T., Duarte-Díaz, A., & Perestelo-Pérez, L. (2025). Acceptance and Commitment Therapy for Couples: A Systematic Review and Meta-Analysis. Journal of Contextual Behavioral Science. https://doi.org/10.1016/j.jcbs.2024.100867

Bekaan, S., & Safarzadeh, S. (2023). Effectiveness of Emotion-Based Marital Life Enrichment Training during Pregnancy on Love, Sacrificial Behaviors, and Sexual Health Literacy among Young Couples. Women and Family Cultural-Educational Journal, 18(62), 121-141.

Binandeh, E. S. (2021). Comparing the Effectiveness of Acceptance and Commitment Therapy and Cognitive Behavioral Therapy on Dental Anxiety, Cognitive Emotion Regulation, and Oral Health-Related Quality of Life among People with Dental Anxiety [Doctoral dissertation, Islamic Azad University, Khorramshahr-Persian Gulf International Branch].

Border, R., Allen, J., & Vize, C. (2022). Anger rumination and interpersonal functioning: A meta-analytic review. Journal of Social and Personal Relationships, 39(7), 2150-2173.

Bustan, R., Riyono, B., Amalia, R. M., & Amelia, Z. (2024). The Need for Islamic Counseling Services for Couples with Marital Problems. Tazkiya Journal of Psychology, 12(1), 27-38. https://doi.org/10.15408/tazkiya.v12i1.31601

Eshaqabadi, F., Asayesh, M. H., & Qamari, M. (2024). Effectiveness of Acceptance and Commitment Therapy on Marital Conflicts, Emotional Divorce, and Self-Differentiation among Women with Marital Distress. International Journal of Body, Mind and Culture, 12(1), 267-273.

Faraji, S., Agah Heris, M., & Sheibani, H. (2021). Effectiveness of Acceptance and Commitment-Based Training on Cognitive Avoidance and Marital Satisfaction among Women with Marital Problems. Social Cognition, 10(19), 119-134.

Hashemizadeh, F. S., Atashpour, S. H., & Farhadi, H. (2025). Comparison of the Effectiveness of Paradox Therapy with Scheduling and Matrix of Acceptance and Commitment Therapy on Family Adaptability and Mental Well-being of Women with Couple Conflicts. Journal of Cognitive Psychology and Psychiatry, 11(6), 106-122. https://doi.org/10.32598/shenakht.11.6.106

Hosseini, S., Tajik Esmaeili, A., Sanaei Zaker, B., & Rasouli, M. (2022). Comparing the Effectiveness of Acceptance and Commitment Couple Therapy and Gottman Couple Therapy on Marital Intimacy among Couples with Marital Conflict. Journal of Psychological Science, 21(110), 287-304.

Izadi, R., & Abedi, M. (2023). Acceptance and commitment therapy (ACT) (1st ed.). Jungle Publications.

Joel, S., Maxwell, J. A., Khera, D., Peetz, J., Baucom, B. R., & MacDonald, G. (2023). Expect and you shall perceive: People who expect better in turn perceive better behaviors from their romantic partners. Journal of personality and social psychology, 124(6), 1230. https://doi.org/10.1037/pspi0000411

Johnson, D., & Bennett, R. (2023). Acceptance and Commitment Therapy: Responses to Frequently Asked Questions. Taylor & Francis. https://doi.org/10.4324/9781003364993

Large, R., Samuel, V., & Morris, R. (2020). A changed reality: Experience of an acceptance and commitment therapy (ACT) group after stroke. Neuropsychological Rehabilitation. https://doi.org/10.1080/09602011.2019.1589531

Laurenceau, J. P., Barrett, L. F., & Pietromonaco, P. R. (2020). Intimacy as an interpersonal process: The importance of self-disclosure, partner disclosure, and perceived responsiveness. Personal Relationships, 27(2), 1-20.

Lindsay, T. (2024). ACT at the End: Acceptance and Commitment Therapy with People at the End of Life. Taylor & Francis. https://doi.org/10.4324/9781003431640

Low, R. S., Overall, N. C., & Hammond, M. D. (2022). Self-regulation, relationship maintenance, and sacrifice among couples. Journal of Family Psychology, 36(4), 503-514.

Moradi Norouzi, A., Asadi, H., Alimoradi, M., Saedi, S., Pakseresht, P., & Mohammadi Moghaddam, P. (2025). The Effectiveness of Acceptance and Commitment Therapy on Marital Burnout, Marital Self-Regulation, and Couple Maintenance Strategies in Married Women with Marital Conflicts. Iranian Evolutionary Educational Psychology Journal, 7(3), 0-0.

Mousavi Shabestari, Z., Sedaghat, M., & Tizdast, T. (2025). Comparing the Effectiveness of Acceptance and Commitment Therapy and Emotion-Focused Couple Therapy on Sexual Satisfaction in Women with Marital Conflict. Rooyesh-e-Ravanshenasi Journal, 14(12), 232-239.

Najibzadegan, A., Bahrinian, S. A., & Shahabizadeh, F. (2024). Effectiveness of Acceptance and Commitment Therapy on Intimacy, Marital Forgiveness, and Burnout among Women Affected by Extramarital Relationships. Applied Family Therapy, 5(3), 11-26.

Navidi, A. (2021). The Effect of Anger Management Training on Anger Self-Regulation Skills, Adjustment, and General Health among Male Secondary School Students in Tehran [Doctoral dissertation, Allameh Tabataba'i University]. Tehran.

Pourmohammad Qouchani, K. (2021). Effectiveness of Cognitive Analytic Therapy on Improving Uncertainty Tolerance and Reducing Worry and Experiential Avoidance among Patients with Obsessive-Compulsive Disorder. Clinical Psychology: Innovations in Research and Practice, 13(4), 65-76. https://doi.org/10.22075/jcp.2021.20257.1868

Rahimi Ahmadabadi, S., Aghamohammadian Sharbaf, H. R., Modarres Gharavi, M., & Karshki, H. (2023). Examining the Effectiveness of Cognitive Behavioral Group Therapy on Reducing Aggression among People with Head Injury. Health Psychology, 2(1), 22-33.

Rajabi, M. S. (2023). Effectiveness of Acceptance and Commitment Therapy on Emotion Regulation, Treatment Adherence, and Food Craving among Patients with Type 2 Diabetes [Master's thesis in Family and Couple Therapy, Islamic Azad University, Khomeini Shahr Branch].

Ramezani, V., & Abdollahi, M. H. (2023). Examining the Relationship between Emotional Intelligence and Anger Expression and Control among Students. Journal of Psychology(1), 66-83.

Reeve, J. (2022). Motivation and Emotion (Y. Seyed Mohammadi, Trans.). Virayesh.

Sadeghi, A. (2021). Examining the Effectiveness of Group Anger Control Training Using a Rational-Emotive-Behavioral Approach on Reducing Aggression [Master's thesis in counseling, University of Tehran].

Sahragard, F. (2024). Determining the Effectiveness of Acceptance and Commitment Therapy on Social Anxiety among Adolescent Girls without Parental Care in Sirjan [Master's thesis in clinical psychology, Islamic Azad University, Sirjan Branch].