ARTICLE INFO

Article Type

Original Research

Authors

Asgharnejad Farid   A.A. (*1)
Mirmohammadali   M. (2)
Ahadi   H. (3)
Nasiri   A. (4)






(*1) Department of Psychology, Psychology Faculty, Iran University of Medical Sciences, Tehran, Iran
(2) Department of Psychology, Psychology Faculty, Edalat University, Tehran, Iran
(3) Department of Psychology, Psychology Faculty, Allameh Tabatabaei University, Tehran, Iran
(4) Sadr Psychiatric Hospital, Tehran, Iran

Correspondence

Address: School of Behavioral Sciences and Mental Health, Shahid Mansouri Street, Niyayesh Street, Satarkhan Avenue,Tehran, Iran. Postal code: 1445613111.
Phone: +98 (21) 66551655
Fax: +98 (21) 66551655
asgharnrjad.ali@gmail.com

Article History

Received:  September  12, 2020
Accepted:  January 16, 2021
ePublished:  March 14, 2021

BRIEF TEXT


Mental disorders are a common problem in warriors, veterans, and their families [1].

Veterans, like all human beings, have physical, social, and psychological needs that provide them with life satisfaction [2]. ... [3, 4]. Recent studies have shown that war survivors and their families suffer from a wide range of psychological traumas, such as post-traumatic stress disorder (PTSD), mood and anxiety disorders, aggression, conflict, and depression [5]. ... [6-11]. One of the factors that with a positive effect on the psychosocial needs of veterans is cognitive-behavioral treatment (CBT). ... [12]. Acceptance and commitment therapy (ACT) seems to be another factor that positively affects the psychosocial needs of veterans. ... [13-17].

The purpose of this study was to evaluate the effectiveness of CBT and ACT on the needs of veterans.

This research was an applied study in terms of its purpose and semi-experimental in terms of its implementation method with a pre-test post-test design and a control group.

This research was performed on all psychiatric veterans in Tehran in 2018.

Thirty psychiatric veterans were selected by purposeful sampling based on the criteria as follows: agreement to participate in research, living with the spouse and the lack of hospitalization of the spouse, the age range of 45-55 years, no drug or alcohol addiction, at least a diploma degree, diagnosis of PTSD approved by a psychiatrist and no psychosis. The exclusion criterion was participation in psychotherapy and psychiatric sessions simultaneously. The sample size was determined according to the inclusion criteria and was about 10% of the total population of psychiatric veterans in Tehran. This number was considered purposefully based on the researcher's opinion and according to the inclusion criteria.

Data were obtained based on the following data collection tools: Basic Needs Satisfaction Questionnaire: This scale was developed by the Guardian et al. to measure the sense of support for autonomy, competence, and communication needs with others. … [18, 19]. Post-traumatic Stress Disorder Checklist (PCL): This list was prepared by Wazers et al. [20] according to DSM-IV criteria and includes 17 items, of which 5 items are related to the symptoms of re-experiencing the accident, 7 items are related to the symptoms of numbness and avoidance, and 5 items are related to the symptoms of over-arousal. The Pearson correlation coefficient for determining the reliability of the scale by retest method is 0.886 and the obtained Cronbach's alpha for PTSD-I and PCL-M tests, which were performed simultaneously on 20 people is 0.851. … [21, 22]. Acceptance and Action Questionnaire (AAQ): This questionnaire was used to measure experimental avoidance. Cronbach's alpha coefficient of this questionnaire was reported to be 0.78 on an Iranian sample. After obtaining permission from the Foundation of Martyrs and Veterans of Tehran and referring to and coordinating with Sadr Hospital, 30 participants were randomly assigned to two experimental (10 people) and control (10 people) groups. ACT and CBT sessions were held for the experimental group in ten 90-minute sessions twice a week. The experimental group received CBT and ACT interventions but the control group did not receive any intervention. At the beginning and end of the intervention, questionnaires were distributed among control and experimental groups, and pre-test and post-test data were collected. In order to comply with ethical considerations, therapeutic interventions for the control group were performed after collecting post-test data, and they also benefited from the training (Table 1). Data were analyzed using SPSS 24 software and multivariate analysis of covariance and independent t-test.

The mean total score of veterans in the Basic Needs Satisfaction, AAQ, and PCL questionnaires, in the two groups of CBT and ACT and the control group, before the treatment were not significantly different (p <0.05; Table 2). There was a significant increase in the total post-test scores of the two experimental groups compared with the pre-test in the Basic Needs Satisfaction, AAQ, and PCL questionnaires (p <0.05). In the PCL, there was a significant decrease (p<0.05), but there was no significant change in the mean post-test score of control subjects compared with the pre-test (p<0.05; Table 1). The results of the Kolmogorov-Smirnov test regarding the studied variables (except the relationship with others) showed that the data had a normal distribution (p<0.05). The results of multivariate analysis of covariance showed that there was a significant difference between the CBT and control groups in terms of at least one of the dependent variables of basic psychological needs and its components (autonomy, competence, and communication with others) (0.05>p). There was a significant difference between the CBT and control groups according to the one-way analysis of covariance (MANCOVA) regarding the components of autonomy (p=0.006; F =10.216), competence (p=0.001; F=17.863), relationship with others (=0.388) p; F=5.219), and the whole scale (p=0.001; F=17.162). Therefore, CBT had a significant effect on the basic psychological needs and its components in veterans and increased the capacity of basic needs in CBT-treated veterans compared with the control group. Eta values showed that after CBT, 0.561, 0.551, 0.422, and 0.272 of the variance of the scores of competence, the whole scale, autonomy, and relationship with others were explained by group differences, respectively. Also, the results of MANOVA showed that there was a significant difference between the ACT and control groups in terms of at least one of the dependent variables of basic psychological needs and its components (autonomy, competence, and communication with others). There was a significant difference between the ACT group and control group according to the one-way analysis of covariance (MANCOVA) regarding autonomy (p=0.003; F=13.484), competence (p=0.032; F=5.700), relationship with others (p=0.062; p. 114 (F=4.4) and the whole scale (p=0.000; F=35.675). Therefore, ACT had a significant effect on the basic psychological needs and the components of autonomy and competence of veterans (p<0.05), but this effect was not significant for the communication with others (p>0.05). Eta values showed that after ACT, 0.745, 0.445, 0.290, and 0.180 of variance of the scores of the whole test, autonomy, competence, and communication with others were explained by group differences, respectively.

Based on the obtained results, CBT had a significant effect on the basic psychological needs and its components in veterans and increased the capacity of basic needs in veterans receiving CBT compared with the control group. These results were consistent with the results obtained by Kalhor [23]. … [24-27]. Darharaj et al. [28], Ramezani et al. [29], Merati et al. [30], Sherman & Citmanton [31] and Zolner [32]. They showed that by controlling irrational and dysfunctional thoughts, CBT can reduce stress and give people insight into the role of these thoughts in their stress and replace them with positive thoughts and mental health. Also, based on the findings, it should be said that ACT was able to have a significant impact on the basic psychological needs and its components in veterans. These results were consistent with the studies by Izadi et al. [33], Issa Nejad & Azadbakht [34], Morton et al. [35], Walser et al. [36], and Wirsb et al. [37].

None to declare.

The present study was conducted on veterans in Tehran; thus, the generalization of results to veterans to other parts of the country should be done with caution.

CBT and ACT have an effect on the basic psychological needs of the studied veterans.

The staff and the director of Sadr Psychiatric Hospital and Dr. Mirzaei are appreciated for their spiritual support.

None declared.

None to declare.

None to declare.

TABLES and CHARTS

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