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Background and purpose: Female nurses are exposed to many problems due to their working situation. This will make them vulnerable to stress, burnout, and emotional exhaustion. In this study we structurally analyzed burnout among nurses while considering acceptance, commitment, and emotion regulation. Material and Methods: This descriptive-correlational study was conducted in May 2013 and included 180 nurses working in a hospital located in city of Isfahan. A total of 119 cases was randomly selected using Morgan table. Maslach Burnout Inventory (MBI), Acceptance and Commitment Therapy (ACT), and Cognitive Emotion Regulation Questionnaire (CERQ) were used to collect the data. Data was then analyzed using SPSS and Lisrel program. Results: The results indicated a significant correlation between burnout, emotion regulation, and acceptance and commitment. Structural equation modeling showed direct relationships between burnout and ACT and emotion regulation and ACT. We also found ACT with a mediation effect in the relationship between burnout and emotion regulation. Conclusion: This study showed emotion regulation and ACT as the main indicators for burnout.

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Background and purpose: Studies have shown that increasing self-efficacy could predict the treatment success for weight loss. This study assessed the efficacy of Acceptance and Commitment Therapy (ACT) on weight self-efficacy lifestyle in obese women in Isfahan. Materials and methods: A quasi-experimental pretest/post-test control group design was conducted on all obese women (BMI≥30) in Isfahan in spring 2014. Convenience sampling was performed and 30 obese women were selected according to our defined inclusion criteria. They were randomly assigned either in a control or experimental group (n=15 per group). The Weight Efficacy Lifestyle Questionnaire was completed by the participants in pre-test, post-test and follow-up stages. The experimental group attended ACT classes for 8 sessions/ 90 min. Results: Significant differences were found in weight self-efficacy lifestyle in all subscales including food availability, social pressure, physical discomfort, negative emotions, and positive activities in experimental group during all stages. Conclusion: According to this study, ACT could improve weight self-efficacy lifestyle as a predicting index of weight loss in obese women. Therefore, this treatment could be beneficial when performed in conjunction with other weight loss interventions.

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Background and purpose: Body dysmorphic disorder is one of the common disorders in which adolescents pay excessive attention to their appearances. It causes disruptions to both individual and social life. This study investigated the efficacy of acceptance and commitment therapy (ACT) on body dissatisfaction and fear of negative evaluation in high school girls with body dysmorphic disorder.

Materials and methods: An experimental study (pre-test, post-test design) was performed in which 30 female high school students with body dysmorphic disorder were recruited. The participants were selected using multistage random sampling and divided into experimental (n=15) and control (n=15) groups. The experimental group attended an eight-week ACT programme (1.5 hr) while the control group received no intervention. Structured Clinical Interview for DSM IV (SCID-I), body dissatisfaction questionnaire, and fear of negative evaluation questionnaire were used in pre-test and posttest stages.

Results: ACT produced significant reductions in body dissatisfaction (P<0.01) and fear of negative evaluation (P<0.01) in post-test.

Conclusion: Based on this study, ACT therapy could be used as an efficient intervention for reduction of body dissatisfaction and fear of negative evaluation in high school girls with body dysmorphic disorder.

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Background and purpose: One of the important features of a successful and long-term marriage is marital commitment. Self-compassion could well predict improvements in marital relations. The aim of this study was to examine the relationship between original family health and self-compassion with marital commitment.

Materials and methods: A descriptive correlational study was performed in 372 married individuals selected by multiple cluster sampling. Data was collected using the Family of Origin Scale (FOS) and Self-Compassion Scale. Data analysis was done applying Pearson’s correlation coefficient and multiple linear regressions.

Results: The mean age of the participant was 37±7.42 years. The results showed a significant positive correlation between marital commitment and health of the original family, self–kindness, common humanity, and mindfulness subscales (P< 0.01). We found a significant negative correlation between marital commitment and health of the original family, self-judgment, isolation, and over- identification subscales (P< 0.01). Also health of the original family and subscales of self-kindness, common humanity, self-judgment and mindfulness could highly predict marital commitment.

Conclusion: Health of the original family and self-compassion play important roles in improving marital relationships. Therefore, self-compassion focused therapies could increase mental health and create self-compassionate behavior and consequently enhance marriage durability.

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Background and purpose: Breast cancer is the most common cancer in Iranian women. Two main psychological complaints in cancer patients are depression and anxiety which have negative impacts on their quality of life. Acceptance and commitment therapy provides the involved patients with the skills to respond to these uncontrollable experiences and commitment to personal values. The purpose of this study was to review the clinical trials conducted on the effect of this method on depression, anxiety, and quality of life of these patients in Iran.
Materials and methods: This systematic review and meta-analysis investigated all clinical trials conducted between 2005 and 2017 in Iran. Electronic databases were searched, including Since Direct, Scopus, Pubmed, Google Scholrar, SID, Mag iran, Iran doc, Medex, and Cochrane.
Results: In final investigation, 8 articles were reviewed (three on quality of life and five on depression and anxiety). The studies included people aged 20- 60 years old, all followed pre-test and post-test designs and two studies had performed follow-up interventions.
 Conclusion: Acceptance and commitment therapy could empower breast cancer patients and enhance their ability in accepting the disease, reduce anxiety, and depression and improve their quality of life. Nevertheless, further research consisting of more population and interventions in different stages of the disease are needed. Studies on male cancer patients could be beneficial too. Using more appropriate tools can also provide more reliable results.

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Background and purpose: Postpartum depression is a health problem and its prevalence is higher in women with unwanted pregnancy. This condition causes many psychological problems. The present study aimed at investigating the effect of counseling based on acceptance and commitment therapy (ACT) on postpartum depression in unwanted pregnancies.
Materials and methods: A clinical trial with pre-test, post-test control group design and two-month follow-up was performed. The participants (n=52) were randomly selected from comprehensive health centers in Arak, Iran with a median depression score and unwanted pregnancy in delayed postpartum period (2-6 months). They were assigned into either a control group (n=26) or an intervention group (n=26). Data were collected using a demographic questionnaire, Beck Depression Inventory, and unwanted pregnancy. Beck Depression Inventory was completed before, immediately, and two months after the intervention by both groups. The intervention group attended eight weekly ACT sessions
(90 min). Data were analyzed using descriptive statistics applying Chi-square and Mann-Whitney U tests.
Results: Depression scores in intervention group and control group were 17.3±4.2 and 26.5±3.1, respectively, immediately after the intervention. Following two months intervention, the depression scores were significantly different between the controls and intervention group (25.61±3.4 vs. 12.4±3.8, P<0.05).
Conclusion: In contrast to expensive and long-term treatments, ACT could be used as an effective intervention in treatment of postpartum depression.
 
 (Clinical Trials Registry Number: IRCT20180118038424N1)

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Background and purpose: There is paucity of information on the effect of acceptance and commitment therapy on emotional dysregulation and sleep quality. So, the present study was done to evaluate the effectiveness of acceptance and commitment therapy on emotional dysregulation and sleep quality in patients with chronic insomnia.
Materials and methods: A quasi- experimental research with one-group pretest-posttest design was performed in 15 individuals with chronic insomnia attending Sleep Disorders Research Center affiliated to Kermanshah University of Medical Sciences, 2018. Insomnia had been confirmed by polysomnography and diagnostic interview. Then, acceptance and commitment therapy was delivered in eight weekly individual sessions. Pittsburgh Sleep Quality Index and Difficulties in Emotion Regulation Scale were administered. Data were analyzed applying Repeated Measures Analysis of Variance (ANOVA).
Results: Linear trends in changes in sleep quality and emotional dysregulation were found to be significant at pretest, post-test, and follow-up (P<0.001). The results also indicated that acceptance and commitment treatment had a significant effect on the subscales of emotional dysregulation (P <0.05) which could even persist through time.
Conclusion: According to current study, acceptance and commitment therapy can improve sleep quality in patients with chronic insomnia and also reduce emotional dysregulation in these patients.
 
(Clinical Trials Registry Number: IRCT20150822023705N11)

 
 

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 Background and purpose: Stigma and burden of care in caregivers of patients with schizophrenia have negative effects on the patient and their families. This research aimed to determine the effect of self-care training based on Acceptance and Commitment Therapy (ACT) on perceived stigma and caregiver burden of schizophrenic patients.
Materials and methods: This randomized clinical trial included 80 caregivers of schizophrenia patients in Sari Zare Hospital. Participants in intervention group received self-care training based on ACT in 8 sessions twice a week, while the control group received only routine care. The scores for stigma and care burden were measured in both groups before and after the intervention using Shamsaei stigma questionnaire and Zarit Burden Interview (ZBI, 22-item). T-test and paired t-test and descriptive statistical methods were used to analyze the data.
Results: The mean changes of the total score for perceived stigma before and after the intervention were found to be significantly different between the intervention group (65.45±6.79) and the control group (80.25±10.34)(P<0.05). Also, intergroup comparison showed a significant difference in mean changes of the total scores for burden of care before and after the intervention between the intervention group (44.35 ± 6.37) and the control group (55.05 ±10.29) (P <0.05).
Conclusion: According to current study, self-care training based on Acceptance and Commitment Therapy will improve perceived stigma and reduce burden of care in caregivers of patients with schizophrenia and such non-invasive interventions are recommended.

(Clinical Trials Registry Number: IRCT20171203037723N6)

 

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 Background and purpose: Borderline personality disorder is one of the most common disorders of mental health conditions. The aim of this study was to evaluate the effectiveness of transference-focused psychotherapy and acceptance and commitment treatment on neuroticism and impulsivity in individuals with borderline personality disorder.
Materials and methods: In an applied quasi experimental study, we used single subject design involving ABA design in which a behavior is studied at baseline (A), during treatment (B), and after treatment (A). The statistical population included all patients with borderline personality disorder attending Sari Zare Psychiatric Hospital and Sari Mana Clinic in May to June 2020 (n=32). Eleven patients
were selected using convenience sampling and were randomly allocated to transference-focused psychoanalysis (n=4), acceptance and commitment-based therapy (n=4) or control group (n=3). Data were collected in five stages: baseline, mid-stage, progress stage, treatment termination stage, and follow-up for one year (100 sessions) using the NEO five-factor personality questionnaire and Barat impulsivity questionnaire. Data analysis was performed applying repeated measures and Kruskal-Wallis test.
Results: In the repeated measurement test, a significant difference was seen in cognitive impulsivity between the two groups compared to the control group (P=0.025). According to Kruskal-Wallis test, transference-focused psychoanalysis was prioritized.
Conclusion: Considering that these two treatment methods do not aim to reduce symptoms, our final results showed that transference-focused psychoanalysis was more effective. But, further studies are need to generalize current findings.
 

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Background and purpose: Anxiety and depression are determinants of the prognosis of coronary artery disease(CAD). Spiritual well-being and religious commitment affect people's mental well-being. Due to the limitations of previous similar studies in the difference in demographic characteristics of participants with CAD patients, it was necessary to repeat these studies in coronary artery disease patients. In this study, the state of spiritual well-being and religious commitment and their relationship with anxiety and depression in coronary artery disease patients referred to Fatemeh Zahra Hospital (Mazandaran Cardiology Center) in 1400 and 1401 were investigated.
Materials and methods: In this cross-sectional descriptive-analytical study, 159 heart and CAD patients referred to Fatemeh Zahra Hospital (Mazandaran Cardiology Center) were selected by conventional sampling method. Demographic and well-being variables including age, gender, marital status, education level, employment status, and history of psychiatric diseases and substance abuse were measured using the data collection form. The participants answered the questionnaires of the Hospital Anxiety and Depression Scale (HADS) (with validity in the anxiety component t260=21.32 and depression t260=23.41 and reliability in the anxiety component r=0.75 and depression r=0.71), the scale of the practice of religious beliefs (Mabad) (reliability confirmed with Cronbach's alpha coefficient of 91.0 and criterion-related validity coefficient of .0.84) and Palutzian Ellison's spiritual well-being (validity confirmed by content validity and reliability with Cronbach's alpha coefficient of 0.89). Data were analyzed with the help of Stata 14 statistical software at the significance level of P<0.05. Independent T-test and ANOVA tests were used to compare quantitative scores between study groups, and the Chi-square test was used to compare the frequency of qualitative variables between groups. The relationship between the variables was measured by Pearson's correlation coefficient test.
Results: Findings: The average age of the participants was 57.82±14.0 and 33.33% of the sample were men. The religious commitment score of the participants was in the range of 97-10 with an average of 63.73±19.10 (high commitment level). 23% of participants had low religious commitment and 77% had high religious commitment. The religious well-being score of the participants was in the range of 60-34 with an average of 55.28±6.38 and the existential well-being score of the participants was in the range of 60-13 with an average of 43.07±11.24. Also, the spiritual well-being score of the participants was at the average level with a range of 120-54 and an average of 98.35±14.54. 51% of the participants had average spiritual well-being and 49% had high spiritual well-being. The hospital anxiety score of the participants was in the range of 0-21 with an average of 8.23±5.67 (at the level of mild anxiety). 44.2% of the participants had no anxiety, 16% had mild anxiety, 19.2% had moderate anxiety, and 20.5% had severe anxiety. The hospital depression score of the participants was in the range of 0-21 with an average of 7.35±5.06 (at the level of mild depression). 46.4% of the participants had no depression, 14.6% had mild depression, 12.1% had moderate depression, and 26.7% had severe depression. A negative correlation was found between the severity of spiritual well-being and the severity of depression with a Pearson coefficient of -0.62 (P<0.001) and the severity of anxiety (-0.48, P<0.001). The relationship between the intensity of religious commitment with the intensity of anxiety (P=0.87) and the intensity of depression (P=0.12) was not significant.
Conclusion: Considering the reduction of anxiety and depression scores in samples with higher spiritual well-being scores, it is recommended to focus more on improving the spiritual well-being level of CAD patients by medical staff, as well as group training programs and spiritual self-care training programs after discharge. Follow. Psychotherapy sessions with a spiritual approach can also be useful.