Middle Eastern Journal of Disability Studies

Background and Objectives: Addiction to drugs and its quitting are always a big concern for people addicted to drugs and their families. Drug addiction is a chronic, progressive, and recurrent disease that includes a set of cognitive, emotional, behavioral, and physiological symptoms, indicating that a drug addict continues to use drugs despite being aware of the consequences. People with substance abuse are twice as likely as normal people to have mood disorders, and anxiety is the most common mood disorder in these people. Anxiety is a warning sign that warns of impending danger and prepares a person to deal with a threat. One of the known mechanisms that affects people's tendency to use and dependence on drugs is impulsivity. Impulsivity includes a wide range of behavioral and cognitive tendencies such as difficulty in delaying or inhibiting the voluntary response, short response threshold, defect in delaying pleasure, and difficulty in paying attention. In this regard, the present study was conducted to compare the effectiveness of acceptance and commitment–based therapy and schema therapy on reducing anxiety and impulsivity in addicts.
Methods: This study is quasi–experimental with a pretest–posttest and a two–month follow–up design with a control group. The statistical population of the study consisted of all male addicts of Article 16 (The anti–narcotics law means the compulsory treatment of drug addicts) who are kept in government centers of Guilan Province, Iran for one to three months for treatment from 2020 to 2021 by order of a judicial official. The research sample consisted of 45 male addicts who were selected by purposive sampling method. The inclusion criteria were as follows: dominant and simultaneous use of heroin and glass, length of stay of three months, not being treated with psychological intervention and being treated with MMT (Methadone Maintenance Treatment). Then, they were randomly divided into three groups based on acceptance and commitment therapy, schema therapy, and control group. The exclusion criteria were as follows: having psychotic disorders, staying less than 3 months in the center, absence of more than two sessions, and unwillingness to continue participating in the study. Fifteen people were counted for each group. Beck Anxiety Inventory–II (Beck et al., 1996) and Barratt Impulsivity Scale (Barratt et al., 1997) were administered at the pretest, posttest, and follow–up stages for three groups. The first experimental group received eight 60–min sessions of acceptance and commitment treatment. For the second group, eight 60–minute sessions of group schema therapy intervention were presented. At the end of the training sessions, the tests were repeated for all three groups, and after two months of posttest, the follow–up test was performed. To statistically analyze the data, descriptive and inferential statistics were used. Mean and standard deviation were used for descriptive analysis of data, and analysis of variance with repeated measures and Bonferroni's post hoc test were used for inferential statistics in SPSS version 22. The significance level of the tests was considered to be 0.05.
Results: The results showed that the change in the three stages of pretest, posttest, and follow–up was significant regardless of the group factor for impulsivity and anxiety variables (p<0.001). The three groups had significant differences in impulsivity and anxiety variables (p<0.001). Also, there was a significant difference between the average scores of the experimental groups and the control group in the dependent variables of impulsivity and anxiety (p<0.001). However, no significant difference was observed between the average scores of impulsivity and anxiety in the two experimental groups (p=0.195 and p=0.999, respectively). Based on the average scores, the effectiveness of these treatments has been stable over two months.
Conclusion: According to study findings, acceptance and commitment–based and schema therapies are effective in reducing impulsivity and anxiety in addicts, and there was no difference between the effectiveness of the two treatments.