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MEJDS (2020) 10: 30 |
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Foroutan M, Nejat H, Toozandehjani H. Comparing the Effectiveness of Compassion-Focused Therapy and Dialectical Behavior Therapy on Distress Tolerance and Pain Management in Patients with Multiple Sclerosis. MEJDS 2020; 10 :30-30
URL: http://jdisabilstud.org/article-1-1221-en.html
URL: http://jdisabilstud.org/article-1-1221-en.html
1- Department of Psychology, Neyshabour Branch, Islamic Azad University
2- Department of Psychology, Quchan Branch, Islamic Azad University
3- Department of Psychology, Neyshabur Branch, Islamic Azad University
2- Department of Psychology, Quchan Branch, Islamic Azad University
3- Department of Psychology, Neyshabur Branch, Islamic Azad University
Abstract: (2650 Views)
Background & Objective: Multiple Sclerosis (MS) is an inflammatory disease of the central nervous system characterized by the demyelination of the myelin sheath of axons. MS leads to defects or limitations in the transmission of neural impulses. Prevalent comorbid conditions in MS patients include mood and emotional disturbances, with major depressive disorder, bipolar disorder, dysthymia, panic disorder, and generalized anxiety disorder, as the most frequent illnesses. Pain is commonly experienced in these patients. According to studies, pain significantly affects their mental health and quality of life. The present study aimed to compare the effects of Compassion–Focused Therapy (CFT) and Dialectical Behavior Therapy (DBT) on distress tolerance and pain management in patients with MS.
Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of the study included all women with MS, who referred to the Mashhad Welfare Organization Disability Recognition Commission in the first three months of 2017 to receive the Welfare Organization's services. Participating in the study was voluntary. The study sample included 45 women with MS. Fifteen participants were randomly assigned to the control and 30 in the experimental (15 in the DBT and 15 in the CFT groups) groups. The study inclusion criteria were as follows: having at least a high–school diploma degree, being aged from 20 to 50 years, the lack of mental and personality disorders (approved by a clinical interview), not joining other therapeutic programs, no receipt of individual counseling or pharmacotherapy, and voluntarily attending treatment sessions. The study exclusion criteria were having psychological and personality disorders (approved by a clinical interview), consuming psychedelic drugs, co–participating in other therapeutic programs, receiving individual counseling or pharmacotherapy, abstaining from two intervention sessions, and the lack of cooperation in the medical sessions. The experimental groups participated in 12 group therapy sessions. DBT was developed for 12 sessions of 75 minutes (once a week), i.e., conducted on the study subjects per the manual of DBT of Linehan. CFT included 12 sessions of 75 minutes (once a week) based on Gilbert's guide. The study participants completed the Distress Tolerance Scale (Simons, Gaher, 2005), and the Pain Medication Questionnaire (Rosenstile, Keefe, 1983) before and after the interventions. The obtained data were analyzed by descriptive statistics and inferential statistics; Analysis of Covariance (ANCOVA) and Multivariate Analysis of Covariance (MANCOVA) in SPPSS.
Results: The ANCOVA results confirmed the effect of CFT and DBT on distress tolerance and pain management (p<0.001) in the studied subjects. The collected data suggested a significant difference between the effects of CFT and DBT on the dependent variables of distress tolerance and pain management (p<0.001). The DBT method was more effective than CFT on distress tolerance and some subscales of pain management, including attention restoration, pain catastrophizing, and increased activity. CFT was more effective than DBT on some of the pain management subscales, including pain reinterpretation, self–talk, pain ignorance, as well as prayer and hope (p<0.001).
Conclusion: DBT has a clearer structure than the CFT and simultaneously applies behavioral and accreditation techniques. DBT also includes dialectical principles and techniques (e.g., self–observation), i.e., associated with change maintenance. A feature of MS patients is the lack of well–functioning when being distracted from their emotions. Through the DBT process, by combining mindfulness exercises with behavioral exercises, MS patients experience to observe their depressed mood and physiological, behavioral, and emotional consequences without judgment. Besides, in addition to attempting to accept the existence of this state and its tolerance, they learn the mechanism of the passage of this state. Furthermore, by practicing these exercises, they shift to an automatic style of mind. Conducting these exercises will ultimately lead to a distraction from undesirable emotions, such as depressed and anxious moods.
Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of the study included all women with MS, who referred to the Mashhad Welfare Organization Disability Recognition Commission in the first three months of 2017 to receive the Welfare Organization's services. Participating in the study was voluntary. The study sample included 45 women with MS. Fifteen participants were randomly assigned to the control and 30 in the experimental (15 in the DBT and 15 in the CFT groups) groups. The study inclusion criteria were as follows: having at least a high–school diploma degree, being aged from 20 to 50 years, the lack of mental and personality disorders (approved by a clinical interview), not joining other therapeutic programs, no receipt of individual counseling or pharmacotherapy, and voluntarily attending treatment sessions. The study exclusion criteria were having psychological and personality disorders (approved by a clinical interview), consuming psychedelic drugs, co–participating in other therapeutic programs, receiving individual counseling or pharmacotherapy, abstaining from two intervention sessions, and the lack of cooperation in the medical sessions. The experimental groups participated in 12 group therapy sessions. DBT was developed for 12 sessions of 75 minutes (once a week), i.e., conducted on the study subjects per the manual of DBT of Linehan. CFT included 12 sessions of 75 minutes (once a week) based on Gilbert's guide. The study participants completed the Distress Tolerance Scale (Simons, Gaher, 2005), and the Pain Medication Questionnaire (Rosenstile, Keefe, 1983) before and after the interventions. The obtained data were analyzed by descriptive statistics and inferential statistics; Analysis of Covariance (ANCOVA) and Multivariate Analysis of Covariance (MANCOVA) in SPPSS.
Results: The ANCOVA results confirmed the effect of CFT and DBT on distress tolerance and pain management (p<0.001) in the studied subjects. The collected data suggested a significant difference between the effects of CFT and DBT on the dependent variables of distress tolerance and pain management (p<0.001). The DBT method was more effective than CFT on distress tolerance and some subscales of pain management, including attention restoration, pain catastrophizing, and increased activity. CFT was more effective than DBT on some of the pain management subscales, including pain reinterpretation, self–talk, pain ignorance, as well as prayer and hope (p<0.001).
Conclusion: DBT has a clearer structure than the CFT and simultaneously applies behavioral and accreditation techniques. DBT also includes dialectical principles and techniques (e.g., self–observation), i.e., associated with change maintenance. A feature of MS patients is the lack of well–functioning when being distracted from their emotions. Through the DBT process, by combining mindfulness exercises with behavioral exercises, MS patients experience to observe their depressed mood and physiological, behavioral, and emotional consequences without judgment. Besides, in addition to attempting to accept the existence of this state and its tolerance, they learn the mechanism of the passage of this state. Furthermore, by practicing these exercises, they shift to an automatic style of mind. Conducting these exercises will ultimately lead to a distraction from undesirable emotions, such as depressed and anxious moods.
Keywords: Compassion therapy, Dialectical behavior therapy, Distress tolerance, Pain management, Patients with multiple sclerosis.
Type of Study: Original Research Article |
Subject:
Psychology
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