Comparing the Effectiveness of Metacognitive Therapy and Narrative Reconstruction on Dysfunctional Attitudes and Grief Symptoms in Women with Prolonged Grief Disorder

Soheila  Saeed; Ghodratollah Abbasi; Bahram  Mirzaian

Authors

Soheila Saeed Ph.D. Student, Department of Psychology, Sar.C., Islamic Azad University, Sari, Iran Author https://orcid.org/0009-0009-0628-5733
Ghodratollah Abbasi Department of Psychology, Sar.C., Islamic Azad University, Sari, Iran https://orcid.org/0000-0001-9359-0430
Bahram Mirzaian Department of Psychology, Sar.C., Islamic Azad University, Sari, Iran Author https://orcid.org/0000-0002-1032-4389

Keywords:

Prolonged Grief Disorder; Metacognitive Therapy; Narrative Reconstruction; Dysfunctional Attitudes; Grief Symptoms.

Abstract

Purpose: This study aimed to compare the effectiveness of Metacognitive Therapy (MCT) and Narrative Reconstruction (NR) in reducing dysfunctional attitudes and grief symptoms among women diagnosed with Prolonged Grief Disorder (PGD).

Methods and Materials: This quasi-experimental study employed a pre-test, post-test, and three-month follow-up design with a wait-list control group. The statistical population comprised women attending psychological clinics in Western Tehran during 2024–2025. Forty-five eligible participants were selected through purposive sampling and randomly allocated to MCT, NR, and control groups (n = 15 each). The two experimental groups received ten sessions of their respective interventions, whereas the control group received no intervention during the study period. Data were collected using the Dysfunctional Attitudes Scale (DAS-26) and the Prolonged Grief Disorder-13 (PG-13) scale. Mixed-design analysis of variance and Bonferroni post-hoc comparisons were performed using SPSS version 26.

Findings: Mixed ANOVA revealed significant time-by-group interaction effects for dysfunctional attitudes, F(4,84) = 33.71, p < .001, η² = .616, and grief symptoms, F(4,84) = 9.63, p < .001, η² = .314. Bonferroni comparisons showed that both MCT and NR significantly reduced dysfunctional attitudes compared with the control group (MD = 23.435 and 39.697, respectively; p < .001). NR was also significantly more effective than MCT in reducing dysfunctional attitudes (MD = 16.262, p < .001). Both MCT and NR significantly reduced grief symptoms relative to the control group (MD = 3.180 and 4.179, respectively; p < .001); however, the difference between the two interventions was not statistically significant (MD = 0.999, p = .192).

Conclusion: Both MCT and NR are effective interventions for reducing prolonged grief symptoms in women with PGD, whereas NR appears to have greater efficacy in modifying dysfunctional attitudes and underlying maladaptive cognitive schemas. These findings support selecting psychotherapeutic approaches according to the dominant cognitive and emotional mechanisms maintaining prolonged grief.

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