Exploring the Impact of Cognitive Behavioral Therapy on Cognitive Flexibility and Interpersonal Forgiveness among Individuals Recovered from COVID-19
International Journal of Applied Behavioral Sciences,
Vol. 12 No. 1 (2025),
15 Esfand 2025
,
Page 30-39
https://doi.org/10.22037/ijabs.v12i1.46005
Abstract
Background and Aim:Covid-19 caused many psychological problems. The purpose of this study was to investigate the effectiveness of cognitive-behavioral therapy on cognitive flexibility and interpersonal forgiveness in individuals who have recovered from the virus.
Materials and Methods:A semi-experimental research design with pre-test, post-test, and follow-up assessments was employed, including a control group. The statistical population consisted of all COVID-19 patients who sought treatment at hospitals in MASKED FOR REVIEW in 2022. By availability sampling method, 30 individuals were selected and assigned to the experimental group (n=15) and the control group (n=15). The experimental group underwent nine sessions of cognitive-behavioral therapy. Data collection instruments included the Cognitive Flexibility Questionnaire by Dennis and Vander Wall (2010) and the Interpersonal Forgiveness Questionnaire by Ehtshamzadeh.Covariance analysis was employed to analyze the data, and repeated measures analysis of variance was used to assess the stability of the treatment effects.
Results:The research findings demonstrated that cognitive-behavioral therapy significantly enhanced cognitive flexibility (η² = 0.77, F = 80.71, P = 0.001) and interpersonal forgiveness (η² = 0.72, F = 60.95, P = 0.001) in individuals who have recovered from COVID-19.
Conclusion:It can be concluded that cognitive-behavioral therapy is an effective treatment for improving cognitive flexibility and interpersonal forgiveness in individuals recovered from COVID-19. This can be explained by CBT's ability to reduce cognitive rigidity, promote adaptive thinking, and enhance emotional regulation, which helps individuals forgive others and cope better with the psychological effects of the illness.
- COVID-19
- Cognitive-behavioral therapy
- Cognitive Flexibility
- Interpersonal forgiveness
How to Cite
References
- Zaninotto P, Iob E, Demakakos P, Steptoe A. Immediate and longer-term changes in the mental health and well-being of older adults in England during the COVID-19 pandemic. JAMA Psychiatry. 2022;79(2):151-9.
- Khosravani V, Aardema F, Ardestani SM, Bastan FS. The impact of the coronavirus pandemic on specific symptom dimensions and severity in OCD: a comparison before and during COVID-19 in the context of stress responses. J Obsess Compuls Relat Disord. 2021;29:100626.
- Rosa-Alcázar Á, Parada-Navas JL, García-Hernández MD, Pozza A, Tondi P, Rosa-Alcázar AI. Severity and changes in OCD dimensions during COVID-19: a two-year longitudinal study. Brain Sci. 2023;13(8):1151.
- Colizzi M, Sironi E, Antonini F, Ciceri ML, Bovo C, Zoccante L. Psychosocial and behavioral impact of COVID-19 in autism spectrum disorder: an online parent survey. Brain Sci. 2020;10(6):341.
- Sayed AA, El-Gendy AA, Aljohani AK, Haddad RA, Taher OH, Senan AM, Qashqari AM, Alqelaiti BA, El-Gendy A, Haddad RE, Taher O. The effects of COVID-19 on the mental health of children and adolescents: a review. Cureus. 2024;16(3).
- Afrashtehfar KI, Jurado CA, Al-Sammarraie A, Saeed MH. Consequences of COVID-19 and its variants: understanding the physical, oral, and psychological impact. Int J Environ Res Public Health. 2023;20(4):3099.
- Sankar K, Gould MK, Prescott HC. Psychological morbidity after COVID-19 critical illness. Chest. 2023;163(1):139-47.
- De Miquel C, Domènech-Abella J, Felez-Nobrega M, Cristóbal-Narváez P, Mortier P, Vilagut G, Alonso J, Olaya B, Haro JM. The mental health of employees with job loss and income loss during the COVID-19 pandemic: the mediating role of perceived financial stress. Int J Environ Res Public Health. 2022;19(6):3158.
- Wood CI, Yu Z, Sealy DA, Moss I, Zigbuo-Wenzler E, McFadden C, Landi D, Brace AM. Mental health impacts of the COVID-19 pandemic on college students. J Am Coll Health. 2024;72(2):463-8.
- Baltaci O. Prediction of Fear of COVID-19: Meaning in Life and Psychological Resilience. Educ Pol Anal Strat Res. 2021;16(2):46-58.
- Trinh VT, Nguyen TT, Le LT. Post traumatic growths and resilience indicators during the COVID-19 pandemic. VNUHCM J Soc Sci Hum. 2024;8(4):press-.
- Hemi A, Sopp MR, Bonanno G, Michael T, McGiffin J, Levy-Gigi E. Flexibility predicts chronic anxiety and depression during the first year of the COVID-19 pandemic—A longitudinal investigation of mental health trajectories. Psychol Trauma. 2024;16(6):961.
- Bockelmann P. The benefits of the multicultural mind: the interaction between culture and cognitive flexibility. Montreal: McGill University; 2022.
- Cherry KM, Vander Hoeven E, Patterson TS, Lumley MN. Defining and measuring “psychological flexibility”: a narrative scoping review of diverse flexibility and rigidity constructs and perspectives. Clin Psychol Rev. 2021;84:101973.
- Li J, Dong S, Yu Z, Tian Y, Huang T. Event-based vision enhanced: a joint detection framework in autonomous driving. In: 2019 IEEE International Conference on Multimedia and Expo (ICME); 2019 Jul 8; p. 1396-1401. IEEE.
- Alqudah H, Khasawneh MAS. Assessing cognitive flexibility: quantitative insights into the impact of adaptive learning technologies in special education. 2024.
- Bousquet M, Fontaine R, Pennequin V. Effect of belief adherence and argumentation on belief flexibility during childhood, adolescence and young adulthood. In: Proceedings of the International Conference on Education and New Developments. 2024. p. 548.
- Lucas JJ, Moore KA. Psychological flexibility: positive implications for mental health and life satisfaction. Health Promot Int. 2020;35(2):312-20.
- Barcaccia B, Salvati M, Pallini S, Baiocco R, Curcio G, Mancini F, et al. Interpersonal forgiveness and adolescent depression: the mediational role of self-reassurance and self-criticism. J Child Fam Stud. 2020;29(2):462-70.
- Donovan LA, Priester JR. Exploring the psychological processes that underlie interpersonal forgiveness: replication and extension of the model of motivated interpersonal forgiveness. Front Psychol. 2020;11:2107.
- Atwood ME, Friedman A. A systematic review of enhanced cognitive behavioral therapy (CBT‐E) for eating disorders. Int J Eat Disord. 2020;53(3):311-30.
- Blake H, Gupta A, Javed M, Wood B, Knowles S, Coyne E, et al. COVID-well study: qualitative evaluation of supported wellbeing centres and psychological first aid for healthcare workers during the COVID-19 pandemic. Int J Environ Res Public Health. 2021;18(7):3626.
- Cantarero K, Van Tilburg WA, Smoktunowicz E. Affirming basic psychological needs promotes mental well-being during the COVID-19 outbreak. Soc Psychol Personal Sci. 2021;12(5):821-8.
- Shirvani F, Aliakbari M, Alipoor A, Rafiepoor A. Comparison of cognitive-behavioral therapy and acceptance and commitment therapy on resilience and diagnostic factors in patients with chronic pain. Int J Appl Behav Sci. 2021;8(1):21-33.
- Paknahad N, Nikoozadeh EK, Saffarinia M, Rostamian A. The effectiveness of cognitive behavioral therapy on reducing symptoms of depression, pain intensity, and movement limitation in patients with rheumatoid arthritis. Int J Appl Behav Sci. 2024;11(1):26-33.
- Rahmanian M. Effect of cognitive-behavioral therapy (CBT) and transcranial direct current stimulation (tDCS) on body mass index and self-control in overweight women. Int J Appl Behav Sci. 2020;7(3):47-59.
- Bruijniks SJ, DeRubeis RJ, Hollon SD, Huibers MJ. The potential role of learning capacity in cognitive behavior therapy for depression: a systematic review of the evidence and future directions for improving therapeutic learning. Clin Psychol Sci. 2019;7(4):668-92.
- Bidzan-Bluma I, Bidzan M, Jurek P, Bidzan L, Knietzsch J, Stueck M, et al. A Polish and German population study of quality of life, well-being, and life satisfaction in older adults during the COVID-19 pandemic. Front Psychiatry. 2020;11:585813.
- Kendall PC, Peterman JS. CBT for adolescents with anxiety: mature yet still developing. Focus. 2017;15(2):227-39.
- Rutter S, Atkinson C. How educational psychologists use cognitive behavioural therapy interventions: a systematic literature review. Educ Psychol Pract. 2024;40(1):96-120.
- Dennis JP, Vander Wal JS. The cognitive flexibility inventory: instrument development and estimates of reliability and validity. Cogn Ther Res. 2010;34:241-53.
- Kohandani M, Abolmaali Alhosseini K. Factor structure and psychometric properties of Persian version of cognitive flexibility of Dennis, Vander Wal and Jillon. Psychol Models Method. 2017;8(29):53-70.
- Ehteshamzadeh P, Ahadi H, Enayati MS, Heidari A. Construct and validation of a scale for measuring interpersonal forgiveness. Iran J Psychiatr Clin Psychol. 2011.
- Hofmann SG, Smits JA, Rosenfield D, Simon N, Otto MW, Meuret AE, et al. D-Cycloserine as an augmentation strategy with cognitive-behavioral therapy for social anxiety disorder. Am J Psychiatry. 2013;170(7):751-8.
- Lackner JM, Gudleski GD, Radziwon CD, Krasner SS, Firth RS, Naliboff BD, et al. Cognitive flexibility improves in cognitive-behavioral therapy for irritable bowel syndrome but not nonspecific education/support. Behav Res Ther. 2022;154:104033.
- Diamond A. Executive functions. Annu Rev Psychol. 2013;64:135-68.
- Aslan Ş, Türk F. Comparison of concepts of cognitive flexibility and psychological flexibility. Psikiyatri Guncel Yaklasimlar. 2022;14(1):119-30.
- Kashmari A, Shahabizadeh F, Ahi G, Mahmoudi Rad A. Comparing the effectiveness of cognitive-behavioral therapy combined with self-compassion and cognitive motor activities and intervention alone on forgiveness and self-compassion in the elderly. Health Spirt Med Ethics. 2023;10(2):93-102.
- Buğa A. The relationship between rumination about interpersonal offense and psychological well-being: the mediation effect of forgiveness. Int J Prog Educ. 2022;18(6).
- Khayatan S, Aghaei A, Abedi M, Golparvar M. Effectiveness of compassion-acceptance and commitment combined therapy with cognitive-behavioral therapy on interpersonal forgiveness in female patients with type II diabetes. Iran J Diabetes Obes. 2018;10(4):194-203.
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