Cognitive Flexibility and Psychological Function in Asthmatics

Mohammad Bagher, Kajbaf; Siahpoush Monfared, Moslem

doi:10.30473/hpj.2025.74525.6245

Document Type : Scientific Research

Authors

¹ Professor of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.

² Ph.D. Student in Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran

10.30473/hpj.2025.74525.6245

Abstract

Objective: The present study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on perceived stress, cognitive flexibility, and psychological functioning among patients with asthma. Asthma is not only a chronic respiratory condition but also a disorder that exerts a profound psychological burden on individuals, often leading to heightened stress, maladaptive coping strategies, and diminished quality of life. Therefore, addressing psychological aspects alongside medical treatment is of paramount importance. Method: This research employed a quasi-experimental design with pre-test and post-test assessments and a control group. The study population comprised asthma patients who attended specialized asthma and allergy clinics in Khoramabad during 2022. Using purposive sampling, 30 eligible participants were selected based on specific inclusion and exclusion criteria. The inclusion criteria required having a confirmed asthma diagnosis within the past year, being between 20 and 45 years of age, willingness and ability to regularly attend therapeutic sessions, and sufficient literacy to respond to questionnaires. Exclusion criteria included absence from more than two therapeutic sessions, lack of cooperation, unwillingness to continue participation, comorbid medical or psychological conditions, substance abuse, or incomplete responses to research instruments. Participants were randomly assigned into two equal groups (n = 15 per group). The experimental group received eight structured sessions of group-based ACT, while the control group continued to receive only routine medical treatment. Data were collected using three standardized self-report measures: the Perceived Stress Scale (PSS), the Cognitive Flexibility Inventory (CFI), and the Depression-Anxiety-Stress Scale (DASS-21). Pre-test questionnaires were administered to both groups before the intervention, and post-tests were administered after completion of the therapeutic sessions. Statistical analyses were conducted using descriptive indicators, paired and independent t-tests, as well as multivariate analysis of covariance (MANCOVA) via SPSS version 26. Results: The average age of participants was 39.76 ± 11.05 years in the experimental group and 39.66 ± 9.74 years in the control group. The results of paired-sample t-tests indicated that, following the ACT intervention, participants in the experimental group experienced statistically significant improvements in perceived stress, cognitive flexibility, and psychological functioning (P<0.05). In contrast, no significant changes were observed within the control group. Furthermore, independent t-test results confirmed that there were no significant differences between the two groups in pre-test scores, ensuring initial homogeneity. Assumptions of normality and equality of variances were also met, as confirmed by the Kolmogorov-Smirnov and Levene’s tests (P>0.05). MANCOVA results revealed significant between-group differences in the post-test phase, favoring the experimental group, with an effect size (Eta squared) of 0.66. This suggests that approximately 66% of the observed changes in outcome measures were attributable to the ACT intervention. Conclusion: The findings demonstrate that Acceptance and Commitment Therapy is an effective psychological intervention for asthma patients. By reducing perceived stress and enhancing cognitive flexibility, ACT contributes to improved psychological functioning and overall well-being. These results underscore the importance of integrating psychological therapies such as ACT into comprehensive asthma management programs, thereby addressing both physical and psychological dimensions of the illness. Future research is recommended to replicate these findings with larger samples and to explore the long-term effects of ACT in chronic respiratory conditions.

Keywords

Main Subjects

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Cognitive Flexibility and Psychological Function in Asthmatics

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Volume 14, Issue 55November 2025Pages 41-56

Volume 14, Issue 55
November 2025
Pages 41-56