Iranian Journal of War and Public Health

eISSN (English): 2980-969X
eISSN (Persian): 2008-2630
pISSN (Persian): 2008-2622
Volume 15, Issue 2 (2023)                   Iran J War Public Health 2023, 15(2): 141-149 | Back to browse issues page

Print XML PDF HTML Full-Text (HTML)


How to cite this article
Salmanipoor R, Pirkhaefi A, Peymani J, Foroghi A. Effectiveness of the Therapeutic Reconsolidation Process Model on Executive Functions, Cognitive Flexibility, and Schemas Related to Post-traumatic Stress in Neuropsychiatric Veterans above 25%. Iran J War Public Health 2023; 15 (2) :141-149
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Rights and permissions
1- Department of Psychology, Faculty of Humanities, Islamic Azad University, Sanandaj Branch, Sanandaj, Iran
2- Department of Psychology, Faculty of Paramedicine, Islamic Azad University, Garmsar Branch, Garmsar, Iran
3- Department of Psychology, Faculty of Humanities, Islamic Azad University, Karaj Branch, Karaj, Iran
4- Department of Psychology, Faculty of Humanities, Kermanshah University of Medical Sciences, Kermanshah, Iran
* Corresponding Author Address: Department of Psychology, Faculty of Paramedicine, Islamic Azad University, Student Street, Daneshgah Square, Garmsar Branch, Garmsar, Iran. Postal Code: 3581631167 (
Abstract   (373 Views)

Aims: Post-traumatic stress disorder in people traumatized by war includes a set of clinical symptoms such as cognitive, emotional, behavioral, and physical symptoms. This study aimed to determine the effectiveness of training the therapeutic reconsolidation process model on improving executive functions, increasing cognitive flexibility, and modifying schemas related to post-traumatic stress disorder in neuropsychiatric veterans above 25%.
Materials & Methods: This semi-experimental study in a pre-test, post-test design with a control group and a 45-day follow-up was conducted on the neuropsychiatric veterans above 25%. 40 people were randomly selected and assigned into the experimental (n=20) and control (n=20) groups. The therapeutic reconsolidation process model training was held for the experimental group in 12 sessions (90 minutes once a week). The research tools included the Post-Traumatic Stress Disorder Checklist, Leahy Emotional Schema Scale, Wisconsin Card Sorting Test, Stroop Color and Word Test, and Cognitive Flexibility Questionnaire. Data were analyzed using SPSS 24 software.
Findings: In different study stages, there was a significant increase in the mean scores of response inhibition in the Stroop test, subscales of cognitive flexibility, compatible emotional schemas, and correct answers in the Wisconsin test, and a significant decrease in the mean scores of incompatible emotional schemas and incorrect answers in Wisconsin test, in the experimental group compared to the control group (p<0.05).
Conclusion: The therapeutic reconsolidation process model is effective in improving executive functions, increasing cognitive flexibility, and modifying schemas related to post-traumatic stress disorder in neuropsychiatric veterans above 25%.


1. Zarkar F, Forozandeh A, Mohammadi A, Bagerayan Sararodi R, Habibi M. Psychological health in veterans of the Iran-Iraq imposed war, 22 years after the war ended. J Res Behav Sci. 2013;10(6):544-53. [Persian] [Link]
2. Ramezani S, Mohammadi N, Sadri Damirchi E, Rahmani S. Effectiveness of cognitive- behavioral therapy on emotional control and signs of suicide in veterans with PTSD. Iran J War Public Health. 2018;10(1):1-7. [Link] [DOI:10.29252/ijwph.10.1.1]
3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM). Arlington: American Psychiatric Association. 2013. [Link] [DOI:10.1176/appi.books.9780890425596]
4. Fidler, W. A. Hoping for Grace: Early trauma, PTSD, and complex PTSD in the military [Dissertation]. Carpinteria, CA: Pacifica Graduate Institute; 2021. [Link]
5. Sadok BJ, Sadock VA, Ruiz P. Kaplan & Sadock's synopsis of psychiatry: behavioral sciences. ‭11th Edition. Rezaei F, translator. Tehran: Arjmand Publications; 2015. [Persian]‬‬‬‬‬‬‬‬ [Link]
6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th Edition. Seyedmohammadi Y, translator. Tehran: Ravan; 2013. [Persian] [Link]
7. Leahy RL. A model of emotional schemas. Cogn Behav Pract. 2002;9(3): 177-90. [Link] [DOI:10.1016/S1077-7229(02)80048-7]
8. Leahy RL. Introduction: emotional schemas, emotion regulation, and psychopathology. Int J Cogn Ther. 2012;5(4):359-61. [Link] [DOI:10.1521/ijct.2012.5.4.359]
9. Leahy R L. Emotional schema therapy. Couns Psychol Psychother. 2021;29(3):45-57. [Link] [DOI:10.17759/cpp.2021290304]
10. Hijazi AM, Keith JA, O'Brien C. Predictors of posttraumatic growth in a multiwar sample of U.S. Combat veterans. Peace Confl J Peace Psychol. 2015;21(3):395-408. [Link] [DOI:10.1037/pac0000077]
11. Christiansen L, Siebner HR. Tools to explore neuroplasticity in humans: Combining interventional neurophysiology with functional and structural magnetic resonance imaging and spectroscopy. Handb Clin Neurol. 2022;184:105-19. [Link] [DOI:10.1016/B978-0-12-819410-2.00032-1]
12. Shafiei M, Mirdarikvand F, Heidarirad H. The structural relationships of self-Compassion, cognitive flexibility and symptoms of post-traumatic stress disorder in victims of trauma in West of Iran. J Res Psychol Health. 2018;12(2):14-29. [Persian] [Link]
13. Keith J, Velezmoro R, O'Brien C. Correlates of cognitive flexibility in veterans seeking treatment for posttraumatic stress disorder. J Nerv Ment Dis. 2015;203(4):287-93. [Link] [DOI:10.1097/NMD.0000000000000280]
14. Cristofori I, Cohen-Zimerman S, Grafman J. Executive functions. Handb Clin Neurol. 2019;163:197-219. [Link] [DOI:10.1016/B978-0-12-804281-6.00011-2]
15. Riccio DC, Millin PM, Bogart AR. Reconsolidation: a brief history a retrieval view, and some recent. Issues. Learn Mem. 2006;13(5):536-44. [Link] [DOI:10.1101/lm.290706]
16. Ecker B. Memory reconsolidation understood and misunderstood. Int J Neuropsychother. 2015;3(1):2-46. [Link] [DOI:10.12744/ijnpt.2015.0002-0046]
17. Ecker B. Clinical translation of memory reconsolidation research: Therapeutic methodology for transformational change by erasing implicit emotional learnings driving symptom production. Int J Neuropsychother. 2018;6(1):1-92. [Link] [DOI:10.12744/ijnpt.2018.0001-0092]
18. Ecker B. Guidelines for creating juxtaposition experiences. Clinical notes [Internet]. Coherence Therapy Clinical; 2016 [cited 2022 May 23]. Available from: [Link]
19. Exton-McGuinness MTJ, Lee JLC, Reichelt AC. Updating memories--the role of prediction errors in memory reconsolidation. Behav Brain Res. 2015;278: 375-84. [Link] [DOI:10.1016/j.bbr.2014.10.011]
20. Gisquet-Verrier P, Riccio DC. Memory integration as a challenge to the consolidation/reconsolidation hypothesis: Similarities, differences and perspectives. Front Syst Neurosci. 2019;12:71. [Link] [DOI:10.3389/fnsys.2018.00071]
21. Ecker B, Bridges SK. How the science of memory reconsolidation advances the effectiveness and unification of psychotherapy. Clin Soc Work J. 2020;48(3):287-300. [Link] [DOI:10.1007/s10615-020-00754-z]
22. Ecker B, Ticic R, Hulley L. Unlocking the emotional brain: Eliminating symptoms at their roots using memory reconsolidation. 1st Edition. New York: Routledge; 2012. [Link] [DOI:10.4324/9780203804377]
23. Nadel L, Lane RD. Neuroscience of enduring change and psychotherapy: an introduction. In: Lane RD, Nadel L, editors. Neuroscience of enduring change. New York: Oxford University Press; 2020. [Link] [DOI:10.1093/oso/9780190881511.003.0001]
24. Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM. The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. In: the 9th Annual Meeting of the International Society for Traumatic Stress Studies. San Antonio, TX: 1993. [Link]
25. Goodarzi MA. Checking the validity and reliability of the Mississippi Post-Traumatic Stress Disorder Scale. J Psychol. 2003;7(2):153-78. [Persian] [Link]
26. Stroop JR. Studies of interference in serial verbal reactions. J Experimen Psychol. 1935:18(6):643-62. [Link] [DOI:10.1037/h0054651]
27. Lezak MD. Neuropsychological assessment. 3rd Edition. New York: Oxford University Press; 1995. [Link]
28. Spreen O, Strauss E. A compendium of neuropsychological tests: Administration, norms, and commentary. New York: Oxford University Press; 1991. [Link]
29. Abidizadegan A, Moradi A, Farnam R. The executive functions in methadone maintenance patients. Adv Cogn Sci. 2009;10(3):75-81. [Persian] [Link]
30. Greve KW. The WCST-64: a standardized short form of the Wisconsin card sorting test. Clin Neuropsychol. 2001;15(2):228-34. [Link] [DOI:10.1076/clin.]
31. Dennis JP, Vander Wal JS. The Cognitive Flexibility Inventory: Instrument development and estimates of reliability and validity. Cogn Ther Res. 2010;34(3):241-53. [Link] [DOI:10.1007/s10608-009-9276-4]
32. Samadi R, Mohammad Razaghi Kashani E, Kami M, Rezaei O. Executive function and attention deficits in post-traumatic stress disorder: a study on Iranian war veterans. Iran Rehabil J. 2018;16(1):17-24. [Link] [DOI:10.29252/nrip.irj.16.1.17]
33. Sahragard M, Alipour A, Zare H, Roshan R, Moudi M. Effectiveness of Powell's cognitive rehabilitation with neurofeedbackin executive functions, memory, and attention to veterans with post-traumatic stress disorder. Iran J War Public Health. 2018;10(4):187-93. [Link] [DOI:10.29252/ijwph.10.4.187]
34. Zare MM, Bagooli H, Kazemi SA, Javidi HA. Comparison of emotional schemes in war veterans suffering post-traumatic stress disorder with depression symptoms, anxiety symptoms and without signs of depression and anxiety. Iran J War Public Health. 2020;12(1):53-61. [Link] [DOI:10.29252/ijwph.12.1.53]
35. Ben-Zion Z, Fine NB, Keynan NJ, Admon R, Green N, Halevi M, et al. Cognitive flexibility predicts PTSD symptoms: observational and interventional studies. Front Psychiatry. 2018;9:477. [Link] [DOI:10.3389/fpsyt.2018.00477]
36. Park M, Chang ER, You S. Protective role of coping flexibility in PTSD and depressive symptoms following trauma. Pers Individ Differ. 2015;82:102-6. [Link] [DOI:10.1016/j.paid.2015.03.007]
37. Ecker B. Erasing problematic emotional learnings: Psychotherapeutic use of memory reconsolidation research. In: Lane RD, Nadel L, editors. Neuroscience of enduring change: Implications for psychotherapy. New York: Oxford University Press; 2020. [Link] [DOI:10.1093/oso/9780190881511.003.0011]
38. Nader K. Reconsolidation and the dynamic nature of memory. Cold Spring Harb Perspect Biol. 2015;7(10):a021782. [Link] [DOI:10.1101/cshperspect.a021782]
39. Weaver S, Kroska EB, Ross MC, Sartin TA, Sellnow KA, Schaumberg K, et al. Sacrificing reward to avoid threat: Characterizing PTSD in the context of a trauma-related approach-avoidance conflict task. J Abnorm Psychol. 2020;129(5):457-68. [Link] [DOI:10.1037/abn0000528]
40. Fu F, Chow A. Traumatic exposure and psychological well-being: The moderating role of cognitive flexibility. J Loss Trauma. 2017;22(1):24-35. [Link] [DOI:10.1080/15325024.2016.1161428]
41. Haim-Nachum S, Levy-Gigi E. A chink in the armor: The influence of training on generalization learning impairments after viewing traumatic stimuli. Cognition. 2019;193:104021. [Link] [DOI:10.1016/j.cognition.2019.104021]
42. Ecker B, Vaz A. Memory reconsolidation and the crisis of mechanism in psychotherapy. New Ideas Psychol. 2022;66(2):100945. [Link] [DOI:10.1016/j.newideapsych.2022.100945]
43. Edwards ER, Liu Y, Ruiz D, Brosowsky NP, Wupperman P. Maladaptive emotional schemas and emotional functioning: evaluation of an integrated model across two independent samples. J Ration Emot Cogn Behav Ther. 2021;39:428-55. [Link] [DOI:10.1007/s10942-020-00379-8]
44. Kiamarsi A, Abolghasemi A, Taherifard M, Alian B. Emotional deregulation, dissociative experiences and cognitive failures in patients with and without posttraumatic stress symptoms. Iran J Health Psychol. 2020;3(1):31-42. [Link]
45. Scher CD, Suvak MK, Resick PA. Trauma cognitions are related to symptoms up to 10 years after cognitive behavioral treatment for posttraumatic stress disorder. Psychol Trauma. 2017;9(6):750-7. [Link] [DOI:10.1037/tra0000258]

Add your comments about this article : Your username or Email: