The Effectiveness of Cognitive Behavioral Hypnotherapy on Executive Functions, Emotion Regulation, Self-Blame and Stigma in Alzheimer’s Disease

Document Type : Research Article

Authors

1 Department of Counseling, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

2 Department of General Psychology, Payame Noor University, Ardabil Branch, Ardabil, Iran

3 Department of Clinical Psychology, Faculty of Humanities, Islamic Azad University, Ardabil Branch, Ardabil, Iran

4 Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran

5 Department of Counseling, University of Mohaghegh Ardabili, Ardabil, Iran

10.30476/whb.2026.107590.1360

Abstract

Background: Alzheimer’s disease is a progressive neurodegenerative disorder that disrupts executive functions and emotional regulation, often leading to self-blame and perceived stigma in elderly patients. Therefore, the present study was conducted to evaluate the effectiveness of Cognitive Behavioral Hypnotherapy (CBH) in enhancing executive functions, improving cognitive emotion regulation, and reducing self-blame and stigma in elderly women with mild-to-moderate Alzheimer’s disease.
Methods: This was a quasi-exprimental study with two-group pretest–posttest design. It was conducted from August 2024 to March 2025 on 90 women diagnosed with Alzheimer’s disease, recruited through convenience sampling technique from specialized Alzheimer’s centers in Tehran, Tabriz, and Ardabil (Iran). The study participants were assigned to either an experimental group receiving Cognitive Behavioral Hypnotherapy (CBH) or a control group receiving standard care. The intervention consisted of 12 individual CBH sessions held once a week, focusing on cognitive restructuring, guided imagery, emotional reframing, and post-hypnotic suggestions aimed at enhancing cognitive and emotional regulation. Outcome measures included Wisconsin Card Sorting Test (WCST), Cognitive Emotion Regulation Questionnaire (CERQ), Self-Blame Questionnaire (SBQ), and Affiliate Stigma Scale (ASS), administered before and after the intervention. Data were analyzed using IBM SPSS version 27 through independent and paired sample t-tests, ANCOVA, and repeated measures analysis.
Results: The experimental group showed significant improvements in executive functions and cognitive emotion regulation compared with the control group. Specifically, participants completed more categories on the WCST (mean difference=1.770, P<0.001) and made fewer perseverative errors (mean difference=−9.232, P<0.001). They also showed better cognitive emotion regulation (CERQ: mean difference=20.367, P<0.001). In addition, self-blame (SBQ: mean difference=−8.127, P<0.001) and stigma (ASS: mean difference=−18.068, P<0.001) were significantly reduced compared with the control group.
Conclusions: Cognitive Behavioral Hypnotherapy significantly enhanced executive functions, improved cognitive emotion regulation, and reduced self-blame and perceived stigma in elderly women with mild-to-moderate Alzheimer’s disease. It is recommended that the CBH protocol from this study be implemented as a standard non-pharmacological intervention in Iranian memory clinics, with weekly sessions conducted in quiet settings to enhance executive functions and reduce self-blame and perceived stigma in mild-to-moderate Alzheimer’s patients.

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