Clinical Psychology: Research and Practice Innovations

Clinical Psychology: Research and Practice Innovations"

Comparing the Effectiveness of Affect Phobia Therapy and Acceptance and Commitment Therapy on the Emotional Self-awareness and Perception of Suffering in Patients with Chronic Pain Disorders

Document Type : Original Article

Authors
Fatemeh Dafeian 1
Azadeh Choobforoushzadeh 2
1 Ph.D Student, Department of Psychology, Ardakan University, Ardakan, Iran
2 Associate Professor, Department of Psychology, Faculty Humanities and social sciences, Ardakan University, Ardakan, Iran
10.22075/jcp.2024.32896.2816
Abstract
Introduction: The aim of the present study was to compare the effectiveness of affect phobia therapy (APT) and acceptance and commitment therapy(ACT) on the emotional self-awareness and perception of suffering in patients with chronic pain disorders.
Methods: This was a semi-experimental type with a pre-test and post-test design with a control group and a two-month follow-up. The statistical population infertile patients with chronic pain disorders to pain centers Isfahan in 2023. 45 of them were selected by available sampling method and randomly replaced in to three gropes. Data collection tools were emotional self-awareness questionnaire and perception of suffering questionnaire. The first experimental group underwent eight sessions of APT of the McCullough protocol (2003) and the second experimental group underwent eight sessions of ACT protocol of Dahl (2015). The control group was placed on the waiting list. Data analysis was done using of Analysis of covariance with SPSS-23.
Results: The results showed that both interventions were effective in emotional self-awareness and reducing perception of patients with chronic pain disorders in the post-test and follow-up phase (P<0.05). There was significant difference between the two experimental groups in the post-test and follow-up stages in emotional self-awareness and ACT was more effective than APT (P<0.05). There was no significant difference between the two experimental groups in the post-test and follow-up stages in Perception of Suffering (P>0.05).
Conclusions: Both treatments are effective in improving the mental health patients with chronic pain disorders and can be used to reduce psychological problems in pain disorders treatment centers.
Keywords
Affect Phobia Therapy
Acceptance and Commitment Therapy
Emotional Self-awareness
Perception of Suffering
Pain Disorders
Subjects

  1. منابع

    1. Aghili M, Rahatramrodi A. Relationship between Perceived Corona Virus Anxiety, Post-traumatic Stress Disorder and Chronic Pain in Nurses. Journal of Clinical Psychology. 2021; 3(51):89-101. https://doi.org/10.22075/jcp.2021.22770.2095
    2. Schwan J, Sclafani J, Tawfik VL. Chronic Pain Management in the Elderly. Anesthesiology clinics. 2019; 37(3): 547-60. doi: 10.1016/j.anclin.2019.04.012.
    3. Zuhury S, Mason-Robbie V, Walklet E. Cognitive behavioural therapy and acceptance and commitment therapy as management strategies for chronic pain. Journal Health Psychology Update. 2021; 30(1): 1-17. https://eprints.glos.ac.uk/id/eprint/9309
    4. Holzer LA, Huyer N, Friesenbichler J, Leithner A. Body image, self-esteem, and quality of life in patients with primary malignant bone tumors. Arch Orthop Trauma Surg. 2020; 140(1):1-10. DOI: 10.1007/s00402-01-03205-8
    5. Rickardsson J, Gentili C, Holmström L, Zetterqvist V, Andersson E, Persson J, Lekander M. Ljótsson B, Wicksell R. Internet-delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1-year follow-up. European Journal of Pain. 2021; 34(3): 1-6. https://doi.org/10.1002/ejp.1723
    6. Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet (London, England). 2021; 397. 2082-97. doi: 10.1016/S0140-6736(21)00393-7.
    7. Mo P, Chan V, Chan S, Lau J. The role of social support on emotion dysregulation and Internet addiction among Chinese adolescents: -A structural equation model. Addictive Behaviors. 2018; 82: 86-93.
    8. Lee SW, Won S, Jeong B. Moderating effect of emotional awareness on the association between maltreatment experiences and resilience. Personality and Individual Differences. 2019; 148: 38-44. http://dx.doi.org/10.1016/j.paid.2019.05.037
    9. Sun J, Liu Q, Yu S. Child neglect, psychological abuse and smartphone addiction among Chinese adolescents: The roles of emotional intelligence and coping style. Computers in Human Behavior. 2019; 90: 74-8 https://doi.org/10.1016/j.chb.2018.08.032
    10. Mehl S, Hautmann C, Nittel C, Rief W, Kircher T, Lincoln T. Feasibility and efficacy estimate of an emotion-focused version of Cognitive Behavior Therapy (CBT-E) for delusions in comparison to wait list in a single-blinded randomized-controlled pilot trial. Journal Schizophrenia Bulletin Open. 2021; 2(1): 1-9. https://doi.org/10.1093/schizbullopen/sgab035.
    11. Bron Z., Fard F, and Fatahi A. The effectiveness of training mindfulness skills on impulsivity and emotional self-awareness of adolescents with a tendency to addiction. 2022; 65(3): 920-932. https://doi.org/10.22038/mjms.2022.62037.3631. (In Persian)
    12. Docteur A, Gorwood P, Mirabel-Sarron C, Kaya Lefèvre H, Sala L, Duriez P. Mindfulness-based cognitive therapy efficacy in reducing physiological response to emotional stimuli in patients with bipolar I disorder and the intermediate role of cognitive reactivity. Journal of Clinical Psychology. 2021; 77(11): 2442_2454. DOI:10.1002/jclp.23243
    13. Muris P, Otgaar H, Pfattheicher S. Stripping the forest from the rotten trees: compassionate self-responding is a way of coping, but reduced uncompassionate self- responding mainly reflects psychopathology. Mindfulness. 2019; 10 (1): 196-199. https://doi.org/10.1007/s12671-018-1030-0
    14. Brophy K, Brähler E, Hinz A, Schmidt S, Körner A. The role of self-compassion in the relationship between attachment, depression, and quality of life. Journal of Affective Disorders. 2020; 1(260): 45-52. Doi: 10.1016/j.jad.2019.08.066. Epub 2019 Aug 21.
    15. Brähler E, Hinz A, Schmidt S, Körner A. The role of self-compassion in the relationship between attachment, depression, and quality of life. Journal of Affective Disorders. 2019; 260:45-52. https://doi.org/10.1016/j.jad.2019.08.066
    16. Kafinia F, Farhadi H. The effectiveness of group cognitive behavioral therapy on emotional self-awareness and problem-solving ability of students with Internet addiction. Journal of Psychological Sciences. 2019; 19(85): 111-120. http://doi/20.1001.1.17357462.1399.19.85.1.7 (In Persian)
    17. McCullough L, Kuhn N, Kaplan A, Wolf J, Hurley C. Treating affect phobia.Publish by the Guilford press. A division of Guilford publications, Inc. 72 Spring street,New York, London,NY 10012. 2003.
    18. Frankl M, Wennberg P, Berggraf L, Philips B. Affect Phobia Therapy for Mild to Moderate Alcohol Use Disorder: The Cases of "Carey," "Michelle," and "Mary". Journal Pragmatic Case Studies in Psychotherapy. 2020; 15(3): 214-257. DOI:10.14713/pcsp.v15i3.2057
    19. Totzeck C, Teismann T, Hofmann S, Brachel R, Zhang X, Wannemüller A. Affective Styles in Panic Disorder and Specific Phobia: Changes Through Cognitive Behavior Therapy and Prediction of Remission. Journal Behavior therapy. 2020; 51(3): 375-385. doi:1016j.beth.2019.06.006.
    20. Motohamelian SH, Sajjadian I. The effectiveness of treatment based on affect efficiency on pain anxiety and pain acceptance in women with chronic low back pain in Isfahan. Journal of anesthesioligo and pain. 2023; 14(2): 61-74. (In Persian) https://sid.ir/paper/1114893/fa
    21. Saunders, R. Buckman, J. E. Cape, J. Fearon, P. Leibowitz, J. & Pilling, S. Trajectories of depression and anxiety symptom change during psychological therapy. Journal of affective disorders. 2019; 249: 327-335. https://doi.org/10.1016%2Fj.jad.2019.02.043
    22. Zare I, Mohammadi M, Naziri G, Ezzatzadegan Jahromi S. The Effectiveness of Psychodynamic Affect Phobia Therapy on Emotion Regulation and Improvement of Symptoms in Patients with Panic Disorder. armaghanj 2022; 27(2):223-240. http://dx.doi.org/10.52547/armaghanj.27.2.223 (In Persian)
    23. Fogelkvist M, Gustafsson S, Kjellin L, Parling T. Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms: A randomized controlled trial. Body image. 2020; 32: 155-166. doi:10.1016/j.bodyim.2020.01.002. Epub 2020 Jan 27.
    24. Caletti E, Massimo C, Magliocca S. The role of the acceptance and commitment therapy in the treatment of social anxiety: An Affective Disorder, In Press, Journal Pre-proof. 2022; 310: 174-182. doi: 10.1016/j.jad.2022.05.008.
    25. Rickardsson J, Gentili C, Holmström L, Zetterqvist V, Andersson E, Persson J, Lekander M, Ljótsson B, Wicksell R. Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐ European Journal of Pain. 2021; 25(5): 1012-1030. https://doi.org/10.1002/ejp.1723
    26. Roisin S, Hegarty M, Benjamin D, Fletcher T, Conner S, Stebbings G. Treharne Acceptance and commitment therapy for people with rheumatic disease: Existing evidence and future directions. Journal Musculoskeletal Care. 2020; 18(3): 330-341. https://doi.org/10.1002/msc.1464
    27. Afshin A, Sadati Z, Zadeh Hasan F. The effectiveness of acceptance and commitment therapy on body image and eating disorder beliefs in girls. Applied Family Therapy Quarterly. 2023; 3(2): 278-290. doi:10.22034/AFTJ.2023.370133.1824 (In Persian)
    28. Hashemi M, Foruzandeh E, Haiderpur M. The effectiveness of treatment based on acceptance and commitment on emotional distress and commitment to treatment in diabetic patients with depression. 2023; 2(26): 111-130. http://dx.doi.org/10.52547/rbs.20.4.8 (In Persian)
    29. Mohanna S, Talepasand S. The Relationship between Environmental Supports and Emotional Self-awareness with Academic Engagement: the Mediating role of Educational Well-being. Iranian Journal of Medical Education. 2016; 16:31-42 URL: http://ijme.mui.ac.ir/article-1-3795-fa.html (In Persian)
    30. Pak Manesh N, Yavdan M. Predicting academic performance through self-control, autonomy and self-awareness in the second year high school students of Bandar Abbas Shahzastan, Journal of Cognitive Strategies. 2020; 8(14): 37-55. https://doi.org/10.22084/j.psychogy.2020.20757.2084 (In Persian)
    31. Schulz R, Monin J, Czaja S, Lingler J. Measuring the experience and perception of suffering. Journal Gerontologist. 2010; 50(6): 774-784. https://doi.org/10.1093/geront/gnq033
    32. Dahl C, Stuart A, Martel K & Kaplan C. ACT and RFT in relationships: helping clients eager for intimacy and maintain healthy obligations. Translation: Navabinejad Sh, Saadati N. and RostamiM. The first edition, Tehran: the Jungle. 2015. (In Persian)
    33. Ma T, Yuen A, Yang Z. The Efficacy of Acceptance and Commitment Therapy for Chronic Pain. The Clinical Journal of Pain. 2023; 39(3): 147-157. DOI: 10.1097/AJP.0000000000001096
    34. Roslyakova T, Falco M, Gauchet A. An exploratory clinical trial on acceptance and commitment therapy as an adjunct to psychoeducational relaxation therapy for chronic pain. Journal Psychology and Health. 2020; 34(11): 1-9. DOI:10.1080/08870446.2020.1856844
    35. Larsson A, Hartley S, Mchugh L. Arandomised controlled trial of brief web-based acceptance and commitment Therapy on the general mental health, depression, anxiety and strass of college Students. Journal of Contextual Behavioral Scince. 2022; 24: 10-17.http://dx.doi.org/10.1016/j.jcbs.2022.02.005
    36. Julien D, Kieron P. Recasting Psychodynamics into a Behavioral Framework: A Review of the Theory of Psychopathology, Treatment Efficacy, and Process of Change of the Affect Phobia Model. Journal of Contemporary Psychotherapy. 2016; 47: 1-10. DOI:10.1007/s10879-016-9324-9
    37. Sepas L, Dioulag A, Khademi A. Comparison of the Effectiveness Acceptance-Based Therapy and Reality Therapy on Reducing Anxiety Sensitivity in Women with MS. Journal of Culture and Psychotherapy. 2022; 13(51): 86-112. doi /10.22054/qccpc.2022.64043.2808 (In Persian)
    38. Chob frosh A, Fatemi N, Nasimi P. Comparison of the effectiveness of education based on acceptance and commitment and stress reduction program on mindfulness on reducing anxiety and depression of infertile women. 2023; 21(2): 275-288. Doi:20.1001.1.17352029.1402.21.2.6.9 (In Persian)

  • Receive Date 05 January 2024
  • Revise Date 23 April 2024
  • Accept Date 05 May 2024
  • First Publish Date 05 May 2024
  • Publish Date 22 December 2023