The Role of Acceptance and Commitment-based Group Therapy on Pain Tolerance and State-trait Anxiety in Gastrointestinal Cancer Patients

• Mahdi Fatemizadeh

  Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran

• Farideh Ghavasi

  Department of Psychology, Islamic Azad University of Bojnourd, North Khorasan, Iran

• Benyamin Siran Hesari

  Department of English language, Faculty of Teaching English as a Foreign Language, Imam Reza International University, Mashhad, Iran

• Iman Akbarzadeh

  Department of Chemical and Petroleum Engineering, Biotechnology Research Center, Sharif University of Technology, Tehran, Iran

• Nasim Nadi Moghadam

  Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran

• Masoomeh Shirzad

  Drug Design and Bioinformatics Unit, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran

The main purpose of this study was to investigate the impact of acceptance and commitment group therapy on pain tolerance and state-trait anxiety in patients with gastrointestinal cancer. This quasi-experimental study was performed with pretest, posttest and control group. There were 24 participants in the study, 12 of them in the control group and other 12 in the experimental group. The experimental group received eight sessions of acceptance and commitment based therapy and the control group received no psychotherapy. The instruments used in this study were short-form McGill Pain questionnaire-2 and state-trait anxiety questionnaire. Results showed an increase in pain tolerance and decrease in anxiety in patients in the experimental group.

cancer, living well with advanced cancer. European journal of cancer (Oxford, England : 1990) 2008 Jul; 44(10): 1414-24. https://doi.org/10.1016/j.ejca.2008.02.024

Costa DS, Mercieca‐Bebber R, Rutherford C, Gabb L, King MT. The impact of cancer on psychological and social outcomes. Australian Psychologist 2016; 51(2): 89-99. https://doi.org/10.1111/ap.12165

Jensen W, Baumann FT, Stein A, Bloch W, Bokemeyer C, de Wit M, et al. Exercise training in patients with advanced gas-trointestinal cancer undergoing palliative chemotherapy: a pi-lot study. Supportive Care in Cancer 2014; 22(7): 1797-806. https://doi.org/10.1007/s00520-014-2139-x

Chambers SK, Baade P, Youl P, Aitken J, Occhipinti S, Vinod S, et al. Psychological distress and quality of life in lung cancer: the role of health‐related stigma, illness appraisals and social constraints. Psycho‐Oncology 2015; 24(11): 1569-77. https://doi.org/10.1002/pon.3829

Canxia X, Shen S, Ling Q. A Discussion about Effect of Psychological Factor and Social Factor on the Prevention and Treatment of Gastrointestinal Tumor. Chinese Journal of Clinical Psychology 1993 (02).

Winterling J, Wasteson E, Arving C, Johansson B, Glimelius B, Nordin K. Factors associated with psychological distress and grief resolution in surviving spouses of patients with advanced gastrointestinal cancer. Supportive care in cancer 2010; 18(11): 1377-84. https://doi.org/10.1007/s00520-009-0753-9

Chung J, Ju G, Yang J, Jeong J, Jeong Y, Choi MK, et al. Prevalence of and factors associated with anxiety and depression in Korean patients with newly diagnosed advanced gastrointestinal cancer. The Korean journal of internal medicine 2018; 33(3): 585. https://doi.org/10.3904/kjim.2016.108

Hiratzka J, Rastegar F, Contag AG, Norvell DC, Anderson PA, Hart RA. Adverse event recording and reporting in clinical trials comparing lumbar disk replacement with lumbar fusion: a systematic review. Global spine journal 2015; 5(06): 486-95. https://doi.org/10.1055/s-0035-1567835

Hayes SC, Strosahl KD. A practical guide to acceptance and commitment therapy: Springer Science & Business Media; 2004. https://doi.org/10.1007/978-0-387-23369-7

Prevedini AB, Presti G, Rabitti E, Miselli G, Moderato P. Acceptance and commitment therapy (ACT): the foundation of the therapeutic model and an overview of its contribution to the treatment of patients with chronic physical diseases. G Ital Med Lav Ergon 2011; 33(1 Suppl A): A53-A63.

Vowles KE, McCracken LM, O’Brien JZ. Acceptance and values-based action in chronic pain: a three-year follow-up analysis of treatment effectiveness and process. Behaviour research and therapy 2011; 49(11): 748-55. https://doi.org/10.1016/j.brat.2011.08.002

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. Behavior therapy 2013; 44(2): 180-98. https://doi.org/10.1016/j.beth.2009.08.002

Dworkin RH, Turk DC, Revicki DA, Harding G, Coyne KS, Peirce-Sandner S, et al. Development and initial validation of an expanded and revised version of the Short-form McGill Pain Questionnaire (SF-MPQ-2). PAIN® 2009; 144(1-2): 35-42. https://doi.org/10.1016/j.pain.2009.02.007

Kachooei AR, Ebrahimzadeh MH, Erfani-Sayyar R, Salehi M, Salimi E, Razi S. Short Form-McGill Pain Questionnaire-2 (SF-MPQ-2): a cross-cultural adaptation and validation study of the Persian version in patients with knee osteoarthritis. Archives of bone and joint surgery 2015; 3(1): 45.

Spielberger CD. State‐Trait anxiety inventory. The Corsini encyclopedia of psychology 2010: 1. https://doi.org/10.1002/9780470479216.corpsy0943

Zeynalova N, Schimpf S, Setter C, Yahiaoui-Doktor M, Zeynalova S, Lordick F, et al. The association between an anxiety disorder and cancer in medical history. Journal of affective disorders 2019; 246: 640-2. https://doi.org/10.1016/j.jad.2018.12.019

Mirzaeidoostan Z, Zargar Y, Zandi Payam A. The Effectiveness of Acceptance and Commitment Therapy on Death Anxiety and Mental Health in Women With HIV in Abadan City, Iran. Iranian Journal of Psychiatry and Clinical Psychology 2019; 25(1): 2-13. https://doi.org/10.32598/ijpcp.25.1.2

Gale C, Oakley-Browne M. Anxiety disorder. BMJ 2000; 321(7270): 1204-7. https://doi.org/10.1136/bmj.321.7270.1204

Martin S, Wolters PL, Toledo‐Tamula MA, Schmitt SN, Baldwin A, Starosta A, et al. Acceptance and commitment therapy in youth with neurofibromatosis type 1 (NF1) and chronic pain and their parents: A pilot study of feasibility and preliminary efficacy. American journal of medical genetics Part A 2016; 170(6): 1462-70. https://doi.org/10.1002/ajmg.a.37623

Mohabbat-Bahar S, Maleki-Rizi F, Akbari ME, Moradi-Joo M. Effectiveness of group training based on acceptance and commitment therapy on anxiety and depression of women with breast cancer. Iranian journal of cancer prevention 2015; 8(2): 71.

Roth AJ, Massie MJ. Anxiety and its management in advanced cancer. Current Opinion in supportive and palliative care 2007; 1(1): 50-6. https://doi.org/10.1097/SPC.0b013e32813aeb23

Hulbert‐Williams NJ, Storey L, Wilson KG. Psychological interventions for patients with cancer: psychological flexibility and the potential utility of Acceptance and Commitment Therapy. European journal of cancer care 2015; 24(1): 15-27. https://doi.org/10.1111/ecc.12223

Forsyth JP, Eifert GH. The mindfulness and acceptance workbook for anxiety: A guide to breaking free from anxiety, phobias, and worry using acceptance and commitment therapy: New Harbinger Publications; 2016.

Mahmoudi F, Maddahi M, Poursharifi H, Meschi F. Comparison of the Effectiveness of Acceptance and Commitment Group Therapy and Cognitive-Behavioral Group Therapy on Quality of Life, Anxiety and Depression in Patients with Functional Indigestion. Journal of Health Promotion Management 2019; 8(4): 43-52.

• PDF