The Effectiveness of Short-Term Object Relations Therapy on the Severity of Cognitive Fatigue in Patients with Multiple Sclerosis (MS): A Randomized Clinical Trial
Keywords:
Multiple Sclerosis, Cognitive Fatigue, Object Relations Therapy, Psychodynamic Intervention, Randomized Clinical TrialAbstract
Purpose: The present study aimed to determine the effectiveness of short-term object relations therapy in reducing the severity of cognitive fatigue among patients with Multiple Sclerosis (MS).
Methods and Materials: This study employed an applied, quantitative design using a randomized quasi-experimental pretest–posttest structure with a control group and a three-month follow-up phase. The statistical population included patients diagnosed with MS who were referred to healthcare centers in Isfahan during 2025–2026. A total of 36 participants were selected through convenience sampling and randomly assigned to an experimental group (n = 18) and a control group (n = 18). The experimental group received short-term object relations group therapy based on a structured 14-session protocol delivered over seven weeks, while the control group received no intervention. Data were collected using the Fatigue Severity Scale at three time points: pretest, posttest, and follow-up. Statistical analyses were conducted using SPSS version 29, including descriptive statistics, Kolmogorov–Smirnov and Levene’s tests for assumptions, and repeated measures analysis of variance (ANOVA) and covariance (ANCOVA) where necessary.
Findings: The results of repeated measures ANOVA indicated a significant main effect of group (F = 34.55, p < 0.001, η² = 0.504), a significant main effect of time (F = 41.69, p < 0.001, η² = 0.551), and a significant interaction effect between time and group (F = 73.93, p < 0.001, η² = 0.685) on cognitive fatigue severity. Bonferroni post hoc comparisons revealed significant reductions in cognitive fatigue from pretest to posttest (p < 0.001) and from pretest to follow-up (p < 0.001), as well as a smaller but significant difference between posttest and follow-up (p = 0.037) in the experimental group.
Conclusion: Short-term object relations therapy is an effective intervention for reducing cognitive fatigue in patients with MS, producing significant and sustained improvements that highlight the importance of addressing emotional and relational processes in the management of fatigue-related symptoms.
Downloads
References
Akbari, Z., & Talebi, G. (2025). Effectiveness of Object Relations Therapy on Self-Concept and Physical Appearance Perfectionism in People with Body dysmorphic disorder. Journal of Applied Psychological Research. https://doi.org/10.22059/japr.2025.386121.645078
Caligor, E., Preti, E., Stern, B. L., Sowislo, J. F., & Clarkin, J. F. (2023). Object relations theory model of personality disorders. American Journal of Psychotherapy, 76(1), 26-30.
Dailey, D. L., Keffala, V., & Sluka, K. A. (2015). Do Cognitive and Physical Fatigue Tasks Enhance Pain, Cognitive Fatigue, and Physical Fatigue in People With Fibromyalgia? Arthritis care & research, 67(2), 288-296. https://doi.org/10.1002/acr.22417
Holtzer, R., Shuman, M., Mahoney, J. R., Lipton, R. B., & Verghese, J. (2010). Cognitive Fatigue Defined in the Context of Attention Networks. Aging Neuropsychology and Cognition, 18(1), 108-128. https://doi.org/10.1080/13825585.2010.517826
Krupp, L. B., & Elkins, L. E. (2000). Fatigue and declines in cognitive functioning in multiple sclerosis. Neurology, 55(7), 934-939. https://doi.org/10.1212/WNL.55.7.934
Maleki, S., Leilabadi, L., & Kooshki, S. (2025). Efficacy of mentalization based group therapy on object relations and difficulties in emotion regulation: Outcome for individuals with dependent personality syndrome. Journal of Applied Psychological Research. https://doi.org/10.22059/japr.2023.352891.644491
Mayordomo, R., Viguer, P., Sales, A., & Satorres, E. (2024). Cognitive fatigue and emotion regulation in online learning contexts. Learning and Individual Differences, 104, 102198. https://doi.org/10.1016/j.lindif.2023.102198
Omidi Cheshmeh Kabood, A., Sepahvandi, M., & Mirderikvand, F. (2025). Examining the effect of object relations on fibromyalgia symptoms: the mediating role of alexithymia and self-compassion. J Psychol Sci, 24(151), 33-54. https://psychologicalscience.ir/article-1-2755-en.html
Rafiei, Z., & Mikaeili, F. (2019). Examining the Effect of Cognitive Fatigue on Cognitive Flexibility Considering the Mediating Role of Need for Cognition in Female Students. Quarterly Journal of Cognitive Psychology, 7(1), 43-60. https://doi.org/10.32598/shenakht.7.1.43
Rostami, M., Bulut, S., Coelho, O., & Riyono, B. (2024). Living with Fibromyalgia: A Phenomenological Study of Pain, Fatigue, and Coping. Journal of Personality and Psychosomatic Research (JPPR), 2(1), 16-23. https://doi.org/10.61838/kman.jppr.2.1.4
Sarlak, N. (2024). Structural relationships of social anxiety and object relations mediated by alexithymia in patients with asthma. 6(82), 71-80. https://en.civilica.com/doc/2124189/
Sarlak, N., & Talebi, G. (2024). The effectiveness of short-term object relations group therapy on panic, obsessive-compulsive personality disorder, and narcissistic personality disorder in patients with asthma. 10(3), 315-326.
Sarlak, N., & Talebi, G. (2025). Effectiveness of Short-Term Object Relations Group Intervention on Self-Awareness, Social Anxiety and Alexithymia in Patients with Asthma. Research in Clinical Psychology and Counseling, 15(1), 135-158. https://doi.org/10.22067/tpccp.2025.88949.1671
Shafigh, S., & Talebi, G. (2024). The effectiveness of group psychotherapy with a dynamic-interpersonal approach on thought suppression in individuals with obsessive-compulsive disorder. 67(3), 1204-1218.
Summers, F. (2024). Object relations theories and psychopathology: A comprehensive text. Routledge. https://doi.org/10.4324/9781003265795
Zarrati, I., Bermas, H., & Sabet, M. (2020). Correlation between Childhood Trauma and Suicidal Ideation by Mediation of Mental Pain and Object Relations. Journal of Health Promotion, 9(3), 34-48. https://psychstudies.alzahra.ac.ir/article_7902.html?lang=en
Zeidi, M., & Shariat, A. (2023). Understanding and Explaining the Phenomenon of Cognitive Fatigue in Managers of Knowledge-Based Companies. Organizational Knowledge Management, 6(20), 209-239.
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 Ghazal Mesghali , Athar Abasian Najafabadi , Baharak Jahandar (Author); Gholamreza Talebi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
