Comparison of the Efficacy of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy (Experience-Based Therapy Package) on Anxiety, Depression and Quality of Life in Female Patients with Irritable Bowel Syndrome

Document Type : Research Paper

Authors

1 Department of Psychology, Faculty of Educational Sciences and Psychology , University of Isfahan, Isfahan, Iran.

2 Department of Psychology, Faculty of Educational Sciences and Psychology, University of Isfahan, Isfahan, Iran

3 Department of Counselling , Faculty of Educational Sciences and Psychology, University of Isfahan, Isfahan, Iran

Abstract

The purpose of this study was to compare the effectiveness of commitment and acceptance therapy (experience-based therapy package) with cognitive behavioral therapy in reducing anxiety and depression and increasing quality of life in female patients with irritable bowel syndrome. The research method was applied in terms of purpose and semi-experimental in terms of data collection, and was conducted in the form of a pre-test-post-test and a two-month follow-up with the control group. The statistical population includes all patients with irritable bowel syndrome who presented to the clinics of gastroenterologists in Isfahan in 2018-19. The statistical sample consisted of 39 female patients with IBS who were randomly selected and then randomly assigned to the experimental and control groups. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Patients with Irritable Bowel Syndrome-Quality of Life (QOL-IBS) were used. Data analysis was performed using SPSS-21 software and analysis of variance with repeated measures. The results showed that both treatments had a significant effect on reducing anxiety, depression, and improving patients’ quality of life, and that this effect was stable until follow-up. Further (p < 0.01), but there was no significant difference between the treatment groups, so the use of either of these treatments is recommended as adjunctive therapy depending on the patient's condition and acceptability.

Keywords


اسدالهی، ف.، نشاط دوست، ح.، کلانتری، م.، مهرابی، ح.، افشار، ح.، دقاق زاده، حامد. (1393).بررسی اثربخشی معنویت درمانی بر علایم جسمی بیماران زن مبتلا به سندرم روده تحریک پذیر، نحقیقات علوم رفتاری.‎12(3)، 327-317.
پرهیزگار، م.، مرادی‌منش، ف.، سراج خرمی، ن.، و احتشام‌زاده، پ. (2020). اثربخشی «تحریک جریان مستقیم فرا جمجمه‌ای» بر درد، کیفیت زندگی مرتبط با سلامت، اضطراب و افسردگی زنان دارای سندرم رودۀ تحریک‌پذیر. مدیریت ارتقای سلامت. 9(3)، 21-10.
حقایق، ع.، کلانتری، م.، صولتی دهکردی، ک.، مولوی، ح.، و طالبی، م. (1386). اثربخشی گروه‌درمانی شناختی-رفتاری بر بهبود کیفیت زندگی مرتبط با سلامت بیماران مبتلا به نشانگان رودۀ تحریک‌پذیر. پایان‌نامۀ کارشناسی ارشد روانشناسی بالینی. دانشگاه اصفهان.
رضایی، م. (1400). بررسی تجارب بیماران مبتلا به سندرم رودۀ تحریک‌پذیر و مقایسۀ اثربخشی درمان مبتنی بر این تجارب با درمان شناختی رفتاری بر اضطراب، افسردگی و کیفیت زندگی بیماران. پایان‌نامۀ دکتری حرفه‌ای روان‌شناسی. دانشکدۀ علوم تربیتی و روانشناسی. دانشگاه اصفهان.
دابسون، ک؛ محمدخانی، پ (1386). مختصات روانسنجی پرسشنامه افسردگی بک-2 در مبتلایان به اختلال افسردگی اساسی در دوره بهبودی نسبی.‎ آرشیو توانبخشی، 8(29)، 86-80.
زمردی، س.، و رسول‌زاده طباطبایی، ک. (1392). مقایسۀ اثربخشی درمانگری شناختی-رفتاری و درمانگری مبتنی بر ذهن‌آگاهی بر بهبود کیفیت زندگی بیماران مبتلا به سندرم رودۀ تحریک‌پذیر. فصلنامۀ روان‌شناسی بالینی. 13(4)، 79-64.
صولتی دهکردی، ک.، ادیبی، پ.، و قمرانی، الف. (1387). اثربخشی درمان شناختی-رفتاری توأم با دارودرمانی بر کیفیت زندگی، فراوانی و شدت علائم در بیماران مبتلا به سندرم رودۀ تحریک‌پذیر. فصلنامۀ روان‌شناسی تحلیلی شناختی. 13(5)، 70-55.
کامکار، ع.، گلزاری، م.، فرخی، ن.، و آقایی، ش. (1390). اثربخشی درمان شناختی-رفتاری مدیریت استرس بر شدت علائم بیماران مبتلا به سندرم رودۀ تحریک‌پذیر. ارمغان دانش. 16(4)، 36-25.
Andalib, L., & Farokhzadian, A. A. (2019). The effectiveness of acceptance and commitment therapy on the severity of symptoms and quality of life in soldiers with irritable bowel syndrome. Journal of Military Medicine21(1), 44-52.
Bai, Z., Luo, S., Zhang, L., Wu, S., & Chi, I. (2020). Acceptance and commitment therapy (ACT) to reduce depression: A systematic review and meta-analysis. Journal of Affective Disorders260, 728-737.
Beck, A. T., & Clark, D. A. (1997). An information processing model of anxiety: Automatic and strategic processes. Behaviour Research and Therapy35(1), 49-58.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of consulting and clinical psychology56(6), 893.
Beck, A. T., Steer, R. A., & Brown, G. K. (1987). Beck depression inventory. New York:: Harcourt Brace Jovanovich.
Blanchard, E. B., & Scharff, L. (2002). Psychosocial aspects of assessment and treatment of irritable bowel syndrome in adults and recurrent abdominal pain in children. Journal of consulting and clinical psychology70(3), 725.
Blanchard, E. B., Lackner, J. M., Sanders, K., Krasner, S., Keefer, L., Payne, A., ... & Dulgar-Tulloch, L. (2007). A controlled evaluation of group cognitive therapy in the treatment of irritable bowel syndrome. Behaviour research and therapy45(4), 633-648.
Chilcot, J., & Moss-Morris, R. (2013). Changes in illness-related cognitions rather than distress mediate improvements in irritable bowel syndrome (IBS) symptoms and disability following a brief cognitive behavioural therapy intervention. Behaviour Research and Therapy51(10), 690-695.
Ebrahimi, A., Afshar, H., Doost, H. T. N., Mousavi, S. G., & Moolavi, H. (2012). Attitude scale and general health questionnaire subscales predict depression?. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences17(1), 40.
Ferreira, N. B., Gillanders, D., Paul, G., & Morris, M. E. (2018). Pilot study of acceptance and commitment therapy for irritable bowel syndrome: a preliminary analysis of treatment outcomes and processes of change. Clinical Psychologist, 22(3), 241-250
Jang, A. L., Hwang, S. K., & Kim, D. U. (2014). The effects of cognitive behavioral therapy in female nursing students with irritable bowel syndrome: a randomized trial. European Journal Gastroenterol Hepatol, 26(8), 918 -926.
Gaynes, B. N., & Drossman, D. A. (1999). The role of psychosocial factors in irritable bowel syndrome. Baillière’s Clinical Gastroenterology, 13(3), 437–452.
Hunt, M., Moshier, S., & Milonova, M. (2009). Brief cognitive-behavioral internet therapy for irritable bowel syndrome. Behavior Research Therapy, 47(5), 797–802.
Haghayegh, A., Kalantary, M., Molavi, H., & Talebi, M. (2010). Efficacy of cognitive behaviour therapy on the quality of life of patient with IBS with predominant pain and diarrhea types. Journal of Psychology, 14(3), 95-110.
Kennedy, T. M., Chalder, T., McCrone, P., Darnley, S., Knapp, M., & Jones, R. H. (2006). Cognitive behavioural therapy in addition to antispasmodic therapy for irritable bowel syndrome in primary care: randomized controlled trial. Health Technology Assessment, 10(19), 1-67.
Lackner, J. M., Gudleski, G. D., Dimuro, J., Keefer, L., & Brenner, D. M. (2013). Psychosocial predictors of self-reported fatigue in patients with moderate to severe irritable bowel syndrome. Behavioral Research and Therapy, 51, 323-331.
Pashing, S., & Khosh Lahjeh Sedgh, A. (2019). Comparison of effectiveness of acceptance commitment therapy and metacognitive therapy on reducing symptoms, psychological capital and quality of life of patients suffering from irritable bowel syndrome. Medical Science Journal of Islamic Azad University, 29(2), 22-34.
Patrick, D. L., Drossman, D. A., Frederick, I. O., DiCesare, J., & Puder, K. L. (1998). Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Digestive Diseases and Sciences43(2), 400–411.
Sperber, A. D., & Drossman, D. A. (2012). Irritable bowel syndrome: a multidimensional disorder cannot be understood or treated from a unidimensional perspective. Therap Adv Gastroenterol, 5(7), 387–393.