ARTICLE INFO

Article Type

Original Research

Authors

Yaghoobi   A. (*1)
Karimi   K. (1)






(*1) Department of Psychology, Faculty of Social Sciences and Economics, Bu Ali Sina University, Hamedan, Iran

Correspondence

Address: Faculty of Social Sciences and Economics, Bu Ali Sina University, Shahid Mostafa Ahmadi Roshan Street, Hamedan, Iran. Postal Code: 6516738695
Phone: +98 (81) 38381264
Fax: +98 (81) 38380628
yaghobi41@yahoo.com

Article History

Received:  January  27, 2020
Accepted:  May 4, 2021
ePublished:  June 17, 2020

BRIEF TEXT


…[1]. Stressors have many destructive effects on the physical and mental health of individuals [2]. One of the effects of these limitations in mental health is psychological well-being, which may affect the lives of veterans [3].

Health has physical, psychological, social, and spiritual dimensions According to the definition of the World Health Organization [4]. The psychological dimension is of special importance to feel well-being and balance in life. ...[5-8]. The adverse effects of war continue due to the stresses caused by war and its destructive effect on the individual psyche [9]. The development of new non-pharmacological interventions in the rehabilitation of these individuals is essential [2]. One of the behavioral therapies is acceptance and commitment-based therapy. ...[10, 11]. Severe behavioral limitations are the principle of psychopathology from the perspective of ACT [12]. Acceptance and commitment-based therapy is one of the mindfulness-based behavioral therapies. ...[13]. The core of acceptance and commitment therapy is empirical avoidance, which most interventions is based on it. Experimental avoidance is a phenomenon that occurs when a person is unwilling to remain in contact with particular private experiences and takes steps to alter the form or frequency of these events and their motivating situations [14]. ...[15-20].

This study aimed to determine the effectiveness of acceptance and commitment-based treatment on the psychological well-being of chemical veterans in Kermanshah.

This is a quasi-experimental study.

The study was carried out on all-male chemical veterans in Kermanshah province (Dalahou city) in 2017 through a pre-test and post-test design with a control group.

The sample size was estimated based on the minimum sample size in experimental studies (n=15 in each group) [21]. According to determining the proper community representative and the generalizability of the findings, the sample size was determined to be 50 people (n=25 in each group). The subjects were selected by purposive sampling and categorized into test and control groups.

The research tool was the psychological well-being questionnaire of Reef [22]. The 18-item questionnaire, usable for all cultures, was used in this study. Each factor was assessed by 3 items using the 18-items questionnaire. The factor structures of the 3, 9, and 14-items scales were examined. The results showed an acceptable fit of these versions with the data. Also, the reliability of the 14-item scale showed reliability in 0.60-0.78. The internal consistency of the 9-item scales was lower than that of the 14-item scale and was acceptable (0.53-0.68). The results of the 3-item scale also showed that this scale is internally heterogeneous [23]. Cronbach's alpha coefficients for the subscales of self-acceptance, positive relationships, autonomy, environmental mastery, objective life, and personal growth have been reported in 0.74, 0.81, 0.79, 0.72, 0.84, and 0.74 levels, respectively [24]. After obtaining the necessary licenses to communicate with the veterans, the research aim was explained to the Ethics Committee of the Bu-Ali Sina University, and ethical approval was obtained. The test group received the acceptance and commitment therapy-training package of Ferman and Herbert in 10 sessions of 45 minutes throughout 2 and half months [25]. The subjects were received descriptions on psychological flexibility, acceptance and awareness, cognitive separation, self-visualization, personal story, values clarification plus committed action. The control group also had meetings with the examiner without receiving specific treatment. At the end of the intervention, a post-test was conducted using the same questionnaires used in the pre-test at 2-week intervals.Data were analyzed using SPSS 22 software. Multivariate analysis of covariance (MANCOVA) test was used to evaluate the effectiveness of acceptance and commitment-based therapy (independent variable) on the psychological well-being of veterans (dependent variable).

The average age of the subjects was 56.31±3.46 and 55.84±3.18, respectively in the test and control groups. In terms of ethnicity, the participant individuals in this research were Kurdish. 18 (72%) and 7 (28%) subjects of the test group had high school and diploma degrees, respectively. 20 (80%) and 5 (20%) subjects of the control group had high school and diploma degrees, respectively. 5 (20%) and 20 (80%) subjects of the test group were unemployed and self-employed (stockman, gardener, and farmer), respectively. 6 (24%) and 19 (76%) subjects of the control group were unemployed and self-employed (stockman, gardener, and farmer), respectively. The participants of this research were under the support of the Martyrs and Veterans Affairs Foundation. The mean scores of psychological well-being components increased for the test group in the post-test (Table 2). The findings of psychological well-being subscales were analyzed using the multivariate covariance test. Before performing this test, the homoscedasticity was assessed using the Levin test. The results revealed the homoscedasticity of the positive relationships (p=0.62; F=0.32), autonomy (p=0.23; F=0.95), environmental mastery (p=0.71; F=0.14), personal growth (p=0.86; F=0.08), objective life (p=0.10; F=1.15) and self-acceptance components (p=0.32; F=0.74).The box test was used to check the consistency of the covariance matrix. The results showed the equality of the covariance matrix (p=0.31; F=1.24; M BOX=32.41). The results of multivariate analysis of covariance on post-test scores of psychological well-being components by controlling the effect of pre-test showed that there is a significant difference between Pillai's trace, Wilk's lambda, Hoteling and Roy's largest root tests (p<0.002; F=8.04). To realize this difference, analysis of covariance was performed on psychological well-being subscales (Table 3). There was a significant difference between test and control groups in the subscales of positive relationships (p<0.001; F=14.42), environmental mastery (p<0.001; F=14.02), objective life (p<0.001; F=13.01), self-acceptance (p<0.001; F=14.68), autonomy (p<0.002; F=12.35) and personal growth (p<0.002; F=12.02). This difference indicates the positive effect of acceptance and commitment-based intervention on the development of psychological well-being components.

Findings showed that acceptance and commitment-based therapy is effective in improving the scores of psychological well-being subscales of the test group compared to the control group. This result was following previous researches [15-17]. Acceptance and commitment therapy is based on mindfulness meditation practices for the mental representation of situations beyond human control, using breathing and thinking. It can improve the psychological well-being of the individual [26]. This type of treatment helps veterans become aware of their thoughts and emotions and abandon previous incompatible solutions to achieve consistent goals and leaving their self-destructive conflict [27]. Mental health experts believe that mindfulness leads to the conscious practice development and reduction of judgmental approach and inactivity [28]. ...[29]. Acceptance and commitment therapy encourage noticing and observing whatever is present without excessive judgment. It is known as the process of knowing. This experience in the present helps to experience the world changes as they are, not as the mind makes them [30]. …[31-33].

It is suggested that psychotherapists consider this type of intervention in their treatment ways. It is also suggested that researchers perform this type of intervention in larger sample size, in both genders, and compared it to other intervention approaches to provide a richer resource for psychotherapists.

One of the limitations of this study was the lack of cooperation of some veterans due to physical problems. It led to the purposive and single-gender sampling, which has limited the generalization of the results.

Acceptance and commitment therapy training promote the level of psychological well-being in chemical warfare victims.

Researchers are grateful to all the veterans who participated in this research as subjects and the support of the officials of the Martyrs and Veterans Affairs Foundation of Kermanshah province.

There is no conflict of interest.

none

This article is retrieved from a student project of the Bu Ali Sina University in Hamadan.

TABLES and CHARTS

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