@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2018;10(3):115-120
ISSN: 2008-2630 Iranian Journal of War & Public Health 2018;10(3):115-120
Effectiveness of Acceptance and Commitment Therapy (ACT) on Thought Control Strategy and Quality of Life in Veterans with Post-traumatic Stress Disorder (PTSD)
ARTICLE INFO
Article Type
Original ResearchAuthors
Razavi Saadat S.F. (1)Makvandi B. (*)
Pasha R. (1)
Hosseini S.H. (2)
(*) Psychology Department, Psychology & Educational Sciences Facutly, , Psychology & Educational Sciences Facutly, Khuzestan Research Science Branch, Islamic Azad University, Ahvaz, Iran
(1) Psychology Department, Psychology & Educational Sciences Facutly, Khuzestan Research Science Branch, Islamic Azad University, Ahvaz, Iran
(2) Psychiatry Department, Medical Faculty, Mazandaran University of Medical Sciences, Sari, Iran
Correspondence
Address: Psychology Department, Human Sciences Facutly, Khuzestan Research Science Branch, Islamic Azad University, Airport Trolley, Ahvaz, IranPhone: +98 (61) 33377904
Fax: -
makvandi_b@yahoo.com
Article History
Received: August 17, 2017Accepted: January 21, 2018
ePublished: August 29, 2018
ABSTRACT
Aims
Quality of life is an ideal goal of health care, and a treatment is effective when it increases the quality of life. The aim of this study was to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) on thought control strategy and quality of life in veterans with Post-traumatic Stress Disorder (PTSD).
Materials & Methods In this experimental study with pre-test post-test and follow-up design with control group in 2016 to 2017, 28 veterans with PTSD from the Martyr Foundation and Veterans Affairs in Sari were selected by convenience sampling method and randomly divided into two experimental and control groups (Each group included 14 individuals). The research tools were quality of life (SF-36) and Thought Control Questionnaires (TCQ). The experimental group received ACT during 8 sessions (Each sessions took 120minutes) each week. The control group did not receive any treatment. After the sessions were completed, a post-test was carried out and follow-up was made after 3 months. The data were analyzed by SPSS 20 software, using multivariate covariance analysis and Tukey's post hoc test.
Findings The mean scores of quality of life (F=11.281; p=0.003) and thought control strategies (F=38.016; p=0.0001) were significantly different in pre-test and post-test of the two groups. Meanwhile, the quality of life follow-up scores (F=5.541; p=0.027) and thought control strategies (F=39.796; p=0.0001) showed a significant increase compared to the pre-test.
Conclusion ACT is effective in increasing quality of life and in derceasing thought control strategy in veterans with PTSD.
Materials & Methods In this experimental study with pre-test post-test and follow-up design with control group in 2016 to 2017, 28 veterans with PTSD from the Martyr Foundation and Veterans Affairs in Sari were selected by convenience sampling method and randomly divided into two experimental and control groups (Each group included 14 individuals). The research tools were quality of life (SF-36) and Thought Control Questionnaires (TCQ). The experimental group received ACT during 8 sessions (Each sessions took 120minutes) each week. The control group did not receive any treatment. After the sessions were completed, a post-test was carried out and follow-up was made after 3 months. The data were analyzed by SPSS 20 software, using multivariate covariance analysis and Tukey's post hoc test.
Findings The mean scores of quality of life (F=11.281; p=0.003) and thought control strategies (F=38.016; p=0.0001) were significantly different in pre-test and post-test of the two groups. Meanwhile, the quality of life follow-up scores (F=5.541; p=0.027) and thought control strategies (F=39.796; p=0.0001) showed a significant increase compared to the pre-test.
Conclusion ACT is effective in increasing quality of life and in derceasing thought control strategy in veterans with PTSD.
Keywords:
Acceptance and Commitment Therapy ,
Thought Control Strategies ,
Quality of Life,
Post-traumatic Stress Disorder ,
CITATION LINKS
[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington County: Amer Psychiatric Pub Incorporated; 2013.
[2]Ahmadi K, Shahidi S, Nejati V, Karami G, Masoomi M. Effects of Chronic Illness on the Quality of Life in Psychiatric out patients of the Iraq-Iran War. Iran J psychiatry. 2013;8(1):7.
[3]Katschnig H, Krautgartner M. Quality of life: A new dimension in mental health care. In: Sartorius N, Gaebel W, López-Ibor JJ, Maj M. Psychiatry in society. New York: Wiley; 2002. pp. 171-92.
[4]Khodadadi N, Baghaie M, Mahmudi H, ShekholEslami F. Quality of life in schizophrenic patients. Zahedan J Res Med Sci. 2012;14(1):61-6.
[5]Schram MT, Baan CA, Pouwer F. Depression and quality of life in patients with diabetes: A systematic review from the European depression in diabetes (EDID) research consortium. Curr Diabetes Rev. 2009;5(2):112-9.
[6]Bradley R, Greene J, Russ E, Dutra L, Westen D. A multidimensional meta-analysis of psychotherapy for PTSD. 2005;162(2):214-27.
[7]Schottenbauer MA, Glass CR, Arnkoff DB, Tendick V, Gray SH. Nonresponse and dropout rates in outcome studies on PTSD: Review and methodological considerations. Psychiatry. 2008;71(2):134-68.
[8]Twohig MP. Acceptance and commitment therapy for treatment-resistant posttraumatic stress disorder: A case study. Cogn Behav Pract. 2009;16(3):243-52.
[9]Foa EB, Riggs D, Gershuny B. Arousal, numbing, and intrusion: Symptom structure of PTSD following assault. Am J Psychiatry. 1995;152(1):116-20.
[10]Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996;64(6):1152-68.
[11]Orsillo SM, Batten SV. Acceptance and commitment therapy in the treatment of posttraumatic stress disorder. Behav Modif. 2005;29(1):95-129.
[12]Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Publication; 1999.
[13]Walser RD, Hayes SC, westrup D. Acceptance and commitment therapy in the treatment of post-traumatic stress disorder and trauma- related problems. Oakland: New Harbinger Publications. 2006;2:146-72.
[14] Kabat-Zinn J, Hanh TN. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Random House Publishing Group; 2009.
[15]Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): Translation and validation study of the Iranian version. Qual Life Res. 2005;14(3):875-82.
[16]Wells A, Davies MI. The Thought Control Questionnaire: A measure of individual differences in the control of unwanted thoughts. Behav Res Ther. 1994;32(8):871-8.
[17]Goodarzi MA, Firoozabadi A. Reliability and validity of the Padua Inventory in an Iranian population. Behav Res Ther. 2005;43(1):43-54.
[18]Afkari Shahrestani Z, Kaeshavarz A, Tabrizi F, Khazaey F. Effectiveness of acceptance and commitment therapy in quality of life of combat veterans. Proceedings of the 9th International Congress of Psychotherapy (Asian Summit on Cultural Values). Tehran: Secretariat of the International Congress of Psychotherapy; 2016. [Persian]
[19]Juarascio AS, Schumacher LM, Shaw J, Forman EM, Herbert JD. Acceptance-based treatment and quality of life among patients with an eating disorder. J Contextual Behav Sci. 2015;4(1):42-7.
[20]Adachi M, Yamaoka K, Watanabe M, Nishikawa M, Hida E, Kobayashi I, et al. Effects of lifestyle education program for type 2 diabetes patients in clinics: Study design of a cluster randomized trial. BMC Pub Health. 2010;10(1):742.
[21]Das-Munshi J, Stewart R, Ismail K, Bebbington PE, Jenkins R, Prince MJ. Diabetes, common mental disorders, and disability: Findings from the UK national psychiatric morbidity survey. Psychosom Med. 2007;69(6):543-50.
[22]Donald M, Dower J, Coll JR, Baker P, Mukandi B, Doi SA. Mental health issues decrease diabetes-specific quality of life independent of glycaemic control and complications: Findings from Australias living with diabetes cohort study. Health Qual Life Outcomes. 2013;11:170.
[23]Redmon JB, Bertoni AG, Connelly S, Feeney PA, Glasser SP, Glick H, et al. Effect of the look a head study intervention on medication use and related cost to treat cardiovascular disease risk factors in individuals with type 2 diabetes. Diabetes care. 2010;33(6):1153-8.
[24]Makvand Hosseini S, Kasiri M, Najafi M, Shahi M. Effectiveness of cognitive-behavior therapy on mental health of PTSD veterans under pharmaceutical treatment. Iran J War Pub Health. 2015;7(2):67-72.
[25]Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. J Consult Clin Psychol. 2007;75(2):336-43.
[26]Eren I, Erdi Ö, Şahin M. The effect of depression on quality of life of patients with type II diabetes mellitus. Depress anxiety. 2008;25(2):98-106.
[27]Zahid N, Asghar S, Claussen B, Hussain A. Depression and diabetes in a rural community in Pakistan. Diabetes Res Clin Pract. 2008;79(1):124-7.
[28]Huang MF, Courtney M, Edwards H, McDowell J. Factors that affect health outcomes in adults with type 2 diabetes: a cross-sectional study. Int J Nurs Stud. 2010;47(5):542-9.
[29]Matziou V, Tsoumakas K, Vlahioti E, Chrysicopoulou L, Galanis P, Petsios K, et al. Factors influencing the quality of life of young patients with diabetes. Jdiabetes. 2011;3(1):82-90.
[30]Mohabbat-Bahar S, Maleki-Rizi F, Akbari ME, Moradi-Joo M. The effectiveness of group training based on acceptance and commitment therapy on anxiety and depression of women with breast cancer. J Urmia Univ Med Sci. 2016;27(5):365-74. [Persian]
[31]Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL. Pistorello J. Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behav Ther. 2013;44(2):180-98. [Persian]
[32]Shareh H, Alimoradi A. Brain behavioral systems, metacognitive beliefs, and thought control strategies in patients with obsessive-compulsive disorder. J Clin Psychol. 2013;5(3):11-21.
[33] Bennett SA, Beck JG, Clapp JD. Understanding the relationship between posttraumatic stress disorder and trauma cognitions: The impact of thought control strategies. Behav Res Ther. 2009;47:1018-23.
[2]Ahmadi K, Shahidi S, Nejati V, Karami G, Masoomi M. Effects of Chronic Illness on the Quality of Life in Psychiatric out patients of the Iraq-Iran War. Iran J psychiatry. 2013;8(1):7.
[3]Katschnig H, Krautgartner M. Quality of life: A new dimension in mental health care. In: Sartorius N, Gaebel W, López-Ibor JJ, Maj M. Psychiatry in society. New York: Wiley; 2002. pp. 171-92.
[4]Khodadadi N, Baghaie M, Mahmudi H, ShekholEslami F. Quality of life in schizophrenic patients. Zahedan J Res Med Sci. 2012;14(1):61-6.
[5]Schram MT, Baan CA, Pouwer F. Depression and quality of life in patients with diabetes: A systematic review from the European depression in diabetes (EDID) research consortium. Curr Diabetes Rev. 2009;5(2):112-9.
[6]Bradley R, Greene J, Russ E, Dutra L, Westen D. A multidimensional meta-analysis of psychotherapy for PTSD. 2005;162(2):214-27.
[7]Schottenbauer MA, Glass CR, Arnkoff DB, Tendick V, Gray SH. Nonresponse and dropout rates in outcome studies on PTSD: Review and methodological considerations. Psychiatry. 2008;71(2):134-68.
[8]Twohig MP. Acceptance and commitment therapy for treatment-resistant posttraumatic stress disorder: A case study. Cogn Behav Pract. 2009;16(3):243-52.
[9]Foa EB, Riggs D, Gershuny B. Arousal, numbing, and intrusion: Symptom structure of PTSD following assault. Am J Psychiatry. 1995;152(1):116-20.
[10]Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996;64(6):1152-68.
[11]Orsillo SM, Batten SV. Acceptance and commitment therapy in the treatment of posttraumatic stress disorder. Behav Modif. 2005;29(1):95-129.
[12]Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Publication; 1999.
[13]Walser RD, Hayes SC, westrup D. Acceptance and commitment therapy in the treatment of post-traumatic stress disorder and trauma- related problems. Oakland: New Harbinger Publications. 2006;2:146-72.
[14] Kabat-Zinn J, Hanh TN. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Random House Publishing Group; 2009.
[15]Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): Translation and validation study of the Iranian version. Qual Life Res. 2005;14(3):875-82.
[16]Wells A, Davies MI. The Thought Control Questionnaire: A measure of individual differences in the control of unwanted thoughts. Behav Res Ther. 1994;32(8):871-8.
[17]Goodarzi MA, Firoozabadi A. Reliability and validity of the Padua Inventory in an Iranian population. Behav Res Ther. 2005;43(1):43-54.
[18]Afkari Shahrestani Z, Kaeshavarz A, Tabrizi F, Khazaey F. Effectiveness of acceptance and commitment therapy in quality of life of combat veterans. Proceedings of the 9th International Congress of Psychotherapy (Asian Summit on Cultural Values). Tehran: Secretariat of the International Congress of Psychotherapy; 2016. [Persian]
[19]Juarascio AS, Schumacher LM, Shaw J, Forman EM, Herbert JD. Acceptance-based treatment and quality of life among patients with an eating disorder. J Contextual Behav Sci. 2015;4(1):42-7.
[20]Adachi M, Yamaoka K, Watanabe M, Nishikawa M, Hida E, Kobayashi I, et al. Effects of lifestyle education program for type 2 diabetes patients in clinics: Study design of a cluster randomized trial. BMC Pub Health. 2010;10(1):742.
[21]Das-Munshi J, Stewart R, Ismail K, Bebbington PE, Jenkins R, Prince MJ. Diabetes, common mental disorders, and disability: Findings from the UK national psychiatric morbidity survey. Psychosom Med. 2007;69(6):543-50.
[22]Donald M, Dower J, Coll JR, Baker P, Mukandi B, Doi SA. Mental health issues decrease diabetes-specific quality of life independent of glycaemic control and complications: Findings from Australias living with diabetes cohort study. Health Qual Life Outcomes. 2013;11:170.
[23]Redmon JB, Bertoni AG, Connelly S, Feeney PA, Glasser SP, Glick H, et al. Effect of the look a head study intervention on medication use and related cost to treat cardiovascular disease risk factors in individuals with type 2 diabetes. Diabetes care. 2010;33(6):1153-8.
[24]Makvand Hosseini S, Kasiri M, Najafi M, Shahi M. Effectiveness of cognitive-behavior therapy on mental health of PTSD veterans under pharmaceutical treatment. Iran J War Pub Health. 2015;7(2):67-72.
[25]Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. J Consult Clin Psychol. 2007;75(2):336-43.
[26]Eren I, Erdi Ö, Şahin M. The effect of depression on quality of life of patients with type II diabetes mellitus. Depress anxiety. 2008;25(2):98-106.
[27]Zahid N, Asghar S, Claussen B, Hussain A. Depression and diabetes in a rural community in Pakistan. Diabetes Res Clin Pract. 2008;79(1):124-7.
[28]Huang MF, Courtney M, Edwards H, McDowell J. Factors that affect health outcomes in adults with type 2 diabetes: a cross-sectional study. Int J Nurs Stud. 2010;47(5):542-9.
[29]Matziou V, Tsoumakas K, Vlahioti E, Chrysicopoulou L, Galanis P, Petsios K, et al. Factors influencing the quality of life of young patients with diabetes. Jdiabetes. 2011;3(1):82-90.
[30]Mohabbat-Bahar S, Maleki-Rizi F, Akbari ME, Moradi-Joo M. The effectiveness of group training based on acceptance and commitment therapy on anxiety and depression of women with breast cancer. J Urmia Univ Med Sci. 2016;27(5):365-74. [Persian]
[31]Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL. Pistorello J. Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behav Ther. 2013;44(2):180-98. [Persian]
[32]Shareh H, Alimoradi A. Brain behavioral systems, metacognitive beliefs, and thought control strategies in patients with obsessive-compulsive disorder. J Clin Psychol. 2013;5(3):11-21.
[33] Bennett SA, Beck JG, Clapp JD. Understanding the relationship between posttraumatic stress disorder and trauma cognitions: The impact of thought control strategies. Behav Res Ther. 2009;47:1018-23.