In collaboration with Payame Noor University and Iranian Health Psychology Association

Document Type : Scientific Research

Authors

1 Department of Health Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran

2 Assistant Professor, Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran

3 Associate Professor, Department of Clinical Psychology, Allameh Tabatabai University, Tehran, Iran

4 Associate Professor of Educational Psychology, Department of Educational Psychology, Kharazmi University, Tehran, Iran

5 Associate Professor of Rheumatology, Tehran Azad University of Medical Sciences, North Branch, Tehran. Iran.

Abstract

Objective: The prevalence of fibromyalgia in women and comorbid psychological disorders such as anxiety and sleep disorders lead to disruption of physical therapy and reduced function of patients' healthy lives. The Purpose of this study was to investigate the effect of acceptance and commitment group therapy on anxiety, sleep and pain intensity in patients with fibromyalgia. Method: In this semi-experimental study with a pre-test, post-test and quarterly follow-up plan, 34 patients with fibromyalgia were selected by available sampling in 2018 at Bu Ali Hospital in Tehran and randomly assigned to two groups of 20 experimental and control (waiting list). Through 8 sessions, acceptance and commitment group therapy training was performed for experimental group. At the same time, the control group did not receive any intervention. Participants answered Beck Anxiety Questionnaire, McGill Pain, and Choline Spy Sleep Disorders before and after training. Analysis of covariance and repeated measures were used to analyze the data. Findings: The results of analysis of covariance and repeated measures showed that acceptance and commitment group therapy have a significant effect on reducing the symptoms of anxiety, sleep and pain intensity in patients with fibromyalgia (p-value <0.001). Conclusion: The results of the present study showed that acceptance and commitment therapy by creating and developing acceptance and psychological flexibility, can reduce patients' psychological damage and lead to a reduction in pain, sleep disorders and anxiety.

Keywords

ثاقبی سعیدی، ک.، ابوالقاسمی، ع و اکبری، ب (2020). اثربخشی آموزش‌های مهربانی با خود و مثبت نگری بر کیفیت خواب و کاهش شدت درد در دختران مبتلا به قاعدگی دردناک اولیه. مجله طب مکمل، 9(4), 8-8.
حناساب زاده اصفهانی، م.، یزدان دوست، ر.، اصغرنژادفرید، ع. ا؛ و غرایی، ب. (1390). شناخت درمانی مبتنی بر ذهن آگاهی در مورد بیماران افسرده خودکشی گرا (یک مطالعه کیفی). مجله علوم رفتاری, 5(1), 33-38.
زاهدی، ز.، امانی، ا.، عزیزی، آ.، نصیری هانیس، غ.، زارعین، ف و ویژه رواری، ن. (2020).
مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و درمان راه‌حل مدار بر کیفیت زندگی و افسردگی دختران جوان. مطالعات روانشناختی,16(2).
صالحی، ن. نشاط‌دوست، ح؛ و افشار، ح. تأثیر گروه‌درمانی مبتنی بر پذیرش و تعهد بر شاخص‌های روانشناختی (افسردگی، اضطراب و استرس) در زنان مبتلا به فیبرومیالژیا. مجله تحقیقات علوم رفتاری، 16 (1)، 78-83.
صفرزاده، س و سواری، ک. (2020). کاربست تئوری‌درمانی پذیرش و تعهد (ACT) بر رگه شخصیتی اضطرابی، الکسی‌تایمیا و تبعیت از درمان در زنان مبتلا به سرطان پستان. نشریه علمی روانشناسی بالینی و شخصیت، 18(1), 17-27.
مرتضایی شمیرانی، ش.، تاجری، ب.، ثنایی ذاکر، ب.، سوداگر، ش.، و مسچی، ف (2020). اثربخشی گروه‌درمانی مبتنی بر تعهد و پذیرش بر عادات زندگی، رفتار خوردن بیماری و شیوه زندگی ارتقاء دهنده سلامت در زنان مبتلا به چاقی. مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد، 62 ویژه (روانشناسی), 536-547.
ویسکرمی، ح،. خدایی، س؛ و غضنفری، ف (2020). مقایسه اثربخشی گروه‌درمانی فراشناختی و درمان مبتنی بر پذیرش و تعهد بر تحریف‌های شناختی و نشانگان اضطراب اجتماعی دانشجویان. یافته, 21(4), 86.
Asmundson, G. J., Vlaeyen, J. W. S., Vlaeyen, J. W., & Crombez, G. (2004). Understanding and treating fear of pain. Oxford University Press, USA.
Bach, P. A., & Moran, D. J. (2008). ACT in practice: Case conceptualization in acceptance and commitment therapy. New Harbinger Publications.
Bair, M. J., & Krebs, E. E. (2020). Fibromyalgia. Annals of internal medicine, 172(5), ITC33-ITC48.
Beck, A. T., Steer, R. A., & Carbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77-100.
Bevers, K., Watts, L., Kishino, N. D., & Gatchel, R. J. (2016). The biopsychosocial model of the assessment, prevention, and treatment of chronic pain. US Neurol, 12(2), 98-104.
Casale, R., Sarzi-Puttini, P., Botto, R., Alciati, A., Batticciotto, A., Marotto, D., & Torta, R. (2019). Fibromyalgia and the concept of resilience. Clin. Exp. Rheumatol, 37(Suppl 116),105-113.
Casey, M.-B., Smart, K., Segurado, R., Hearty, C., Gopal, H., Lowry, D., Flanagan, D., McCracken, L., & Doody, C. (2018). Exercise combined with Acceptance and Commitment Therapy (ExACT) compared to a supervised exercise programme for adults with chronic pain: study protocol for a randomised controlled trial. Trials, 19(1), 1-14.
Casey, M. B., Cotter, N., Kelly, C., Mc Elchar, L., Dunne, C., Neary, R., Lowry, D., Hearty, C., & Doody, C. (2020). Exercise and Acceptance and Commitment Therapy for Chronic Pain: A Case Series with One‐Year Follow‐Up. Musculoskeletal Care, 18(1), 64-73.
Chou, R., Turner, J. A., Devine, E. B., Hansen, R. N., Sullivan, S. D., Blazina, I., Dana, T., Bougatsos, C., & Deyo, R. A. (2015). The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Annals of internal medicine, 162(4), 276-286.
Davis, B. (2005). Mediators of the relationship between hope and well-being in older adults. Clinical nursing research, 14(3), 253-272.
Duggleby, W., Williams, A., Holstlander, L., Thomas, R., Cooper, D., Hallstrom, L. K., & Ghosh, S. (2014). Hope of rural women caregivers of persons with advanced cancer: guilt, self-efficacy and mental health. Rural and Remote Health, 14(1), 126.
Espie, C. A., Kyle, S. D., Miller, C. B., Ong, J., Hames, P., & Fleming, L. (2014). Attribution, cognition and psychopathology in persistent insomnia disorder: outcome and mediation analysis from a randomized placebo-controlled trial of online cognitive behavioural therapy. Sleep Medicine, 15(8), 913-917.
Feliu-Soler, A., Montesinos, F., Gutiérrez-Martínez, O., Scott, W., McCracken, L. M., & Luciano, J. V. (2018). Current status of acceptance and commitment therapy for chronic pain: a narrative review. Journal of pain research, 11, 2145.
Finan, P. H., Goodin, B. R., & Smith, M. T. (2013). The association of sleep and pain: an update and a path forward. The Journal of Pain, 14(12), 1539-1552.
Frank, J. (1968). The role of hope in psychotherapy. International journal of psychiatry, 5(5), 383-395.
Ghadam, H. S. H., Rahnejat, A. M., Taghva, A., Ebrahimi, M. R., Donyavi, V., & Ghasemzadeh, M. R. (2020). Effectiveness of Acceptance and Commitment Therapy in Reducing Symptoms of Anxiety, Depression, and Suicidal Ideation in Iranian Veterans Referred to a Military Psychiatric Hospital.
Godfrey, E., Wileman, V., Holmes, M. G., McCracken, L. M., Norton, S., Moss-Morris, R., Noonan, S., Barcellona, M., & Critchley, D. (2020). Physical therapy informed by acceptance and commitment therapy (PACT) versus usual care physical therapy for adults with chronic low back pain: a randomized controlled trial. The Journal of Pain, 21(1-2), 71-81.
Golestanifar, S., & DashtBozorgi, Z. (2020). The Effectiveness of Acceptance and Commitment based Therapy on Depression, Psychological Health and Life Expectancy of the Elderly with Nonclinical Depression. Aging Psychology, 6(3), 191-203.
Hamidah, A. H. P. Effectiveness of Acceptance and Commitment Therapy to Reducing Depression in Nursing Home Residents.
Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior therapy, 44(2), 180-198.
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 44(1), 1-25.
Hayes, S. C., Pistorello, J., & Levin, M. E. (2012). Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist, 40(7), 976-1002.
Herth, K. (1992). Abbreviated instrument to measure hope: development and psychometric evaluation. Journal of advanced nursing, 17(10), 1251-1259.
Jafari, R., & Bayrami, M. (2020). Effects of Cognitive Rehabilitation on the Brain Wave Patterns and Symptoms of Obsessive-compulsive Patients. Journal of Clinical Nursing and Midwifery, 8(4), 491-499.
Kazemi, S. H. M., Manshaee, G., & Ghamarani, A. The Effectiveness of Therapy Based on Quality of Life Promotion Model on Pain Anxiety in Female Patients with Fibromyalgia.
Kelson, J., Rollin, A., Ridout, B., & Campbell, A. (2019). Internet-delivered acceptance and commitment therapy for anxiety treatment: systematic review. Journal of medical Internet research, 21(1), e12530.
Lin, J., Scott, W., Carpenter, L., Norton, S., Domhardt, M., Baumeister, H., & McCracken, L. M. (2019). Acceptance and commitment therapy for chronic pain: protocol of a systematic review and individual participant data meta-analysis. Systematic reviews, 8(1), 140.
Lotfi, K. F., Vaziri, S., & Mohammadi, S. S. (2017). The Contribiotion Of Hope and Expectancy of Treatment on Clients’Improvement Feeling.
Luo, B.-J., Qin, H.-Y., & Zheng, M.-C. (2014). Correlation between social relational quality and hope among patients with permanent colostomies. International journal of nursing sciences, 1(4), 405-409.
Marques, S. C., Pais-Ribeiro, J., & Lopez, S. J. (2011). The role of positive psychology constructs in predicting mental health and academic achievement in children and adolescents: A two-year longitudinal study. Journal of Happiness Studies, 12(6), 1049-1062.
O’Hara, D. J. (2011). Psychotherapy and the dialectics of hope and despair. Counselling Psychology Quarterly, 24(4), 323-329.
Padrón, M. A. (2019). The Future of Chronic Pain Management: The Importance of Education and an Interdisciplinary Individualized Patient-Centered Approach.
Palada, V., Gilron, I., Canlon, B., Svensson, C. I., & Kalso, E. (2020). The circadian clock at the intercept of sleep and pain. Pain, 161(5), 894-900.
Parvan, K., Tabrizi, F. J., Rahmani, A., Ghojazadeh, M., Azadi, A., & Golchin, M. (2015). The relationship between Hope and self-esteem in patients with leukemia. Journal of caring sciences, 4(3), 217.
Ranjkesh, F., Nasiri, M., Sharif Nia, S. H., & Goudarzian, A. H. (2019). Validation of the Persian Version of the Sleep Condition Indicator in Pregnant Women. Iranian Journal of Epidemiology, 14(4), 366-374.
Rostami, R., & Dasht Bozorgi, Z. (2019). Effectiveness of Acceptance and Commitment Therapy on Resiliency and Alexithymia of Somatic Symptoms. Practice in Clinical Psychology, 7(2), 87-94
Schreier, A. M., Johnson, L. A., Vohra, N. A., Muzaffar, M., & Kyle, B. (2019). Post-treatment symptoms of pain, anxiety, sleep disturbance, and fatigue in breast cancer survivors. Pain Management Nursing, 20(2), 146-151.
Taheri, A. A., Foroughi, A. A., Mohammadian, Y., Ahmadi, S. M., Heshmati, K., Hezarkhani, L. A., & Parvizifard, A. A. (2020). The Effectiveness of Acceptance and Commitment Therapy on Pain Acceptance and Pain Perception in Patients with Painful Diabetic Neuropathy: A Randomized Controlled Trial. Diabetes Therapy, 1-14.
Terhorst, Y., Braun, L., Titzler, I., Buntrock, C., Freund, J., Thielecke, J., Ebert, D., & Baumeister, H. (2020). Clinical and cost-effectiveness of a guided internet-based Acceptance and Commitment Therapy to improve chronic pain–related disability in green professions (PACT-A): study protocol of a pragmatic randomised controlled trial. BMJ open, 10(9), e034271
Vargovich, A. M., Schumann, M. E., Palmer, B. A., & Sperry, J. A. (2020). Authors’ Response to Comment on “Difficult Conversations: Training Medical Students to Assess, Educate, and Treat the Patient with Chronic Pain”. Academic Psychiatry, 44(1), 113-114.
Veehof, M. M., Trompetter, H. R., Bohlmeijer, E. T., & Schreurs, K. M. G. (2016). Acceptance-and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review. Cognitive behaviour therapy, 45(1), 5-31.
Vowles, K. E., Sowden, G., & Ashworth, J. (2014). A comprehensive examination of the model underlying acceptance and commitment therapy for chronic pain. Behavior therapy, 45(3), 390-401.
Wolfe, F., Clauw, D. J., Fitzcharles, M.-A., Goldenberg, D. L., Katz, R. S., Mease, P., Russell, A. S., Russell, I. J., Winfield, J. B., & Yunus, M. B. (2010, 2010/05/01). The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research, 62(5), 600-610.