The Effectiveness of Acceptance and Commitment Therapy on Depression, Anxiety, and Stress in Patients with Chronic Pain in Ahvaz

Authors

DOI:

https://doi.org/10.22100/ijhs.v7i1.827

Keywords:

Acceptance and commitment therapy (ACT), Depression, Anxiety, Chronic pain, Stress

Abstract

Background: Chronic pain causes various problems and agonies including emotional disorders as well as limited personal, social, and occupational functioning. The present study aimed to investigate the effectiveness of acceptance and commitment therapy (ACT) on depression, anxiety, and stress in patients with chronic pain.

Methods: The research method was experimental with a pre-test, post-test, and follow-up design and a control group. The study population comprised all patients with chronic pain who were referred to the medical centers of Ahvaz in 2018. Using convenience sampling, we selected 30 patients willing to participate in the study and randomly divided them into experimental (n=15) and control (n=15) groups. Both were groups tested at the beginning and end of the intervention program with the Depression, Anxiety, and Stress Scale (DASS-21). The experimental group underwent nine sessions (90-minute sessions per week) of acceptance and commitment therapy. The follow-up was performed after 60 days. Data analysis was done using SPSS version 23.

Results: The mean ± SD of the post-test scores of depression, anxiety, and stress was (12.03±2.82), (10.50±2.34), and (12.50±1.72) in the experimental group and (21.33±1.84), (19.20±4.12), and (26.71±1.18) in the control group, which had significant differences with each other. The results showed that acceptance and commitment therapy effectively decreased depression, anxiety, and stress in patients with chronic pain in the experimental group (Pvalue<0.05).

Conclusions: Acceptance and commitment therapy can be used as an effective intervention program to reduce depression, anxiety, and stress in patients with chronic pain.

Keywords: Acceptance and commitment therapy (ACT), Depression, Anxiety, Stress, Chronic pain.

References

1. Moseley GL, Vlaeyen JWS. Beyond nociception: the imprecision hypothesis of chronic pain. PAIN. 2015;156(1).
2. van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology – where do lifestyle factors fit in? British Journal of Pain. 2013;7(4):209-217.
3. Aydede M. Does the IASP definition of pain need updating? PAIN Reports. 2019;4(5).
4. Treede R-D. The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes. PAIN Reports. 2018;3(2).
5. Woolf CJ. What is this thing called pain? The Journal of Clinical Investigation. 2010;120(11):3742-3744.
6. Afzali A, Ebrahimi H, Emamian MH. The prevalence of mental disorders (depression and anxiety) and their related factors among the elderlies in Bastam, 2018. International Journal of Health Studies. 2018;4(3):12-16.
7. Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Progress in neuro-psychopharmacology & biological psychiatry. 2018;87(Pt B):168-182.
8. Kerns RD, Kassirer M, Otis J. Pain in multiple sclerosis: a biopsychosocial perspective. Journal of Rehabilitation Research and Development. 2002;39(2):225-232.
9. Zarei F, Akbarzadeh I, Khosravi A. The Relationship between emotional intelligence and stress, anxiety, and depression among Iranian students. International Journal of Health Studies. 2019;5(3):1-5.
10. Rahnama M, Sajjadian I, Raoufi A. The Effectiveness of Acceptance and Commitment Therapy on Psychological Distress and Medication Adherence of Coronary Heart Patients. Iranian Journal of Psychiatric Nursing. 2017;5(4):34-43.
11. Clark DM. Realizing the Mass Public Benefit of Evidence-Based Psychological Therapies: The IAPT Program. Annual Review of Clinical Psychology. 2018;14:159-183.
12. Mousavi SM, Shabahang R, Khodadadi-Hassankiadeh N. The Effects of Acceptance and Commitment Therapy and Biofeedback on Chronic Psychosomatic Low Back Pain. Caspian Journal of Neurological Sciences. 2019;5(3):118-26.
13. Amir F, Ahadi H, Nikkhah K, Seirafi M. The Effectiveness of Acceptance and Commitment Group Therapy and Group Logotherapy in Reducing Perceived Stress among MS Patients. Caspian Journal of Neurological Sciences. 2017;3(4):175-84.
14. Wynne B, McHugh L, Gao W, Keegan D, Byrne K, Rowan C, et al. Acceptance and Commitment Therapy Reduces Psychological Stress in Patients with Inflammatory Bowel Diseases. Gastroenterology. 2019;156(4):935-45.e1.
15. Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior Therapy. 2013;44(2):180-98.
16. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and Commitment Therapy: Model, processes and outcomes. Behaviour Research and Therapy. 2006;44(1):1-25.
17. Hill ML, Masuda A, Melcher H, Morgan JR, Twohig MP. Acceptance and Commitment Therapy for Women Diagnosed with Binge Eating Disorder: A Case-Series Study. Cognitive and Behavioral Practice. 2015;22(3):367-78.
18. Cho S, Heiby EM, McCracken LM, Lee SM, Moon DE. Pain-related anxiety as a mediator of the effects of mindfulness on physical and psychosocial functioning in chronic pain patients in Korea. The Journal of Pain. 2010;11(8):789-97.
19. Dindo L, Van Liew JR, Arch JJ. Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. Neurotherapeutics. 2017;14(3):546-53.
20. Østergaard T, Lundgren T, Zettle RD, Landrø NI, Haaland VØ. Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms. Frontiers in Psychology. 2020;11:528.
21. EzzatPanah F, Latifi Z. Effectiveness training based on acceptance, commitment and compassion on pain catastrophizing, distress tolerance and post traumatic growth in patients with fibromyalgia syndrome. Quarterly Journal of Health Psychology, 2020;8(32):127-142.
22. Dereix-Calonge I, Ruiz FJ, Sierra MA, Peña-Vargas A, Ramírez ES. Acceptance and commitment training focused on repetitive negative thinking for clinical psychology trainees: A randomized controlled trial. Journal of Contextual Behavioral Science. 2019;12:81-88.
23. Mohammadi, S., Soufi, A. The effectiveness of acceptance and commitment treatment on quality of life and perceived stress in cancer patients. Quarterly Journal of Health Psychology. 2020;8(32):57-72.
24. Kemani MK, Kanstrup M, Jordan A, Caes L, Gauntlett-Gilbert J. Evaluation of an intensive interdisciplinary pain treatment based on acceptance and commitment therapy for adolescents with chronic pain and their parents: a nonrandomized clinical trial. Journal of pediatric psychology. 2018;43(9):981-94.
25. Sheppard SC, Forsyth JP, Hickling EJ, Bianchi J. A novel application of acceptance and commitment therapy for psychosocial problems associated with multiple sclerosis: Results from a half-day workshop intervention. International Journal of MS Care. 2010;12(4):200-6.
26. Sabour S, Kakabraee K. The Effectiveness of Acceptance and Commitment Therapy on Depression, Stress and Indicators of Pain in Women with Chronic Pain. Iranian Journal of Rehabilitation Research in Nursing. 2016;2(4):1-9.
27. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy. 1995;33(3):335-43.
28. Sahebi A, Asghari M, Salari R. Validation of Depression Anxiety and Stress Scale (DASS-21) for an Iranian Population. Developmental Psychology: Iranian Psychologists. 2005;1(4):36-54.
29. Ducasse D, Fond G. La thérapie d'acceptation et d'engagement [Acceptance and commitment therapy]. Encephale. 2015;41(1):1‐9.
30. Khanbabaei N, Zahedi R, Rafiepoor A. The effectiveness of treatment based on acceptance and commitment on the psychological distress and fear of disease progression in patients with rheumatoid arthritis. Quarterly Journal of Health Psychology. 2019;8(30):117-32.
31. Hor M, Aghaie A, Abedi A, Attari A. The effectiveness of acceptance and commitment therapy on depression in patients with type 2 diabetes. Journal of Research in Behavioural Sciences. 2013;11(2):1-12.
32. Ghatrehsamani M, Najafi M, Rahimiab Boogar I. Comparing the effectiveness of acceptance and commitment therapy and physiotherapy on depression, anxiety, and stress in patients with chronic pain. Journal of Psychoscience. 2019;18(74):159-69.
33. Keshavarz H, Zahra R, Abbas M. The effectiveness of Acceptance and Commitment Therapy (ACT) on general anxiety. Payesh (Health Monitor). 2018;17(3):289-96.
34. Shakernegad S, Moazen N, Hamidy M, Hashemi R, Bazzazzadeh N. Effectiveness of Acceptance and Commitment Therapy on Psychological Distress, Marital Satisfaction and Quality of Life in Women with Multiple Sclerosis. Journal of Health & Care. 2017;19(1):7-17.

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Published

2021-01-25

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The Effectiveness of Acceptance and Commitment Therapy on Depression, Anxiety, and Stress in Patients with Chronic Pain in Ahvaz. (2021). International Journal of Health Studies, 7(1), 28-32. https://doi.org/10.22100/ijhs.v7i1.827