Medical Journal of Mashhad university of Medical Sciences

Medical Journal of Mashhad university of Medical Sciences

Comparison of the effectiveness of acceptance and commitment therapy, emotional schema therapy and drug therapy on the pain aspects of patients with fibromyalgia

Document Type : Research Paper

Authors
zahra dadbin 1
Neda Alibeygi 2
Kamran Azma 3
Fariborz Bagheri 4
1 PhD student, Department of Psychology, Science and Research branch, Islamic Azad University, Tehran, Iran
2 Assistant Professor, Department of Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
3 Department of Medicine, Aja University of Medical Sciences, Tehran, Iran
4 Associate Professor, Department of Psychology, Islamic Azad University, Science and Research Branch, Tehran, Iran
10.22038/mjms.2020.49468.2880
Abstract
Introduction: Fibromyalgia is a chronic musculoskeletal syndrome characterized by widespread pain, hotspots, fatigue, and sleep disturbances that also affects the psychological aspect of the individual; In addition to medication, psychotherapy can be used to treat patients with fibromyalgia. this study was conducted to compare the effectiveness of acceptance and commitment therapy, emotional schema therapy and drug therapy on the pain aspects of patients with fibromyalgia.
Methods: The research method was quasi-experimental with pre-test-post-test design with two experimental and control groups. From the community of women with fibromyalgia disorder in the city of Tehran in 1397-1398, 45 people were selected as a sample using the available sampling method and were randomly assigned to three research groups. A multifaceted (Cranes et al,1985) pain questionnaire was used to measure pain. Acceptance and commitment interventions, emotional schema therapy and medication were used for the experimental groups. The research data were analyzed using repeated measurements and follow-up tests.
Results: The results showed that the combination of acceptance and commitment therapy with drug therapy was more effective than drug therapy alone (p≤0/005). Also, combining schema, emotional therapy with drug therapy was more effective than drug therapy (p≤0/005). There was no significant difference between the combination of acceptance and commitment therapy with drug therapy and the combination of treatment plan and drug therapy (p≥0/005).
Conclusion: In order to improve patients with fibromyalgia, it is possible to use the treatment of acceptance and commitment, as well as emotional therapy plan along with medication.
Keywords
Fibromyalgia
Medication
Acceptance and Commitment Therapy
Emotional Schema Therapy
  1. Hayes SC, Wilson KG, Gifford EV, Bissett R, Piasecki M, Batten SV, Byrd M, Gregg J. A preliminary trial of
    twelve-step facilitation and acceptance and commitment therapy with polysubstance-abusing methadonemaintained opiate addicts. Behavior therapy. 2004 ;35(4):667-88.
    2. Trainor H, Baranoff J, Henke M, Winefield H. Functioning with fibromyalgia: The role of psychological flexibility
    and general psychological acceptance. Australian Psychologist. 2019; 54(3):214-24.
    3. Khatibi Aghda, E., Hollisaz, M. T., Asheghan, M., Shamseddini, A., Sobhani, V., & Labbaf, S. Quality of life in
    fibromyalgia syndrome referred to clinic of Physical Medicine and Rehabilitation in Baqiyatallah Hospital,
    Tehran. Iranian Journal of War and Public Health, 2013; 6(1), 20-26.
    4. Manshaee G, Haji Mohammad Kazemi S, Ghamarani A. Prediction Model of Quality of Life Promotion on the
    Basis of Emotion Expression, Spiritual Intelligence and Pain acceptance in Female Patients with Fibromyalgia.
    JAP. 2018; 9 (2) :60-73
    5. Rowe CA, Sirois FM, Toussaint L, Kohls N, Nöfer E, Offenbächer M, Hirsch JK. Health beliefs, attitudes, and
    health-related quality of life in persons with fibromyalgia: mediating role of treatment adherence. Psychology,
    health & medicine. 2019 Sep 14;24(8):962-77.
    6. Amutio A, Franco C, Sánchez-Sánchez LC, Pérez-Fuentes MD, Gázquez-Linares JJ, Van Gordon W, MoleroJurado MD. Effects of mindfulness training on sleep problems in patients with fibromyalgia. Frontiers in
    psychology. 2018; 9:1365.
    7. Clauw DJ. Fibromyalgia: a clinical review. Jama. 2014 Apr 16;311(15):1547-55.
    8. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles
    M, Clark P, Fam AG. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia.
    Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1990;33(2):160-72.
    9. Carbonell-Baeza A, Ruiz JR, Aparicio VA, Ortega FB, Delgado-Fernández M. The 6-minute walk test in female
    fibromyalgia patients: relationship with tenderness, symptomatology, quality of life, and coping strategies. Pain
    Management Nursing. 2013 ;14(4):193-9.
    10. 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.
    11. Wu YL, Chang LY, Lee HC, Fang SC, Tsai PS. Sleep disturbances in fibromyalgia: A meta-analysis of casecontrol studies. Journal of psychosomatic research. 2017; 96:89-97.
    12. Ljótsson B, Atterlöf E, Lagerlöf M, Andersson E, Jernelöv S, Hedman E, Kemani M, Wicksell RK. Internetdelivered acceptance and values-based exposure treatment for fibromyalgia: a pilot study. Cognitive behaviour
    therapy. 2014;43(2):93-104.
    13. Vowles KE, McCracken LM. Acceptance and values-based action in chronic pain: a study of treatment
    effectiveness and process. Journal of consulting and clinical psychology. 2008; 76(3):397.
  2. 14. Sabour S, Kakabraee K. The Effectiveness of Acceptance and Commitment Therapy on Depression, Stress and
    Indicators of Pain in Women with Chronic Pain. IJRN. 2016; 2 (4) :1-9
    15. Wicksell RK, Vowles KE. The role and function of acceptance and commitment therapy and behavioral flexibility
    in pain management. Pain management. 2015; 5(5):319-22.
    16. Gross M, Moore ZE, Gardner FL, Wolanin AT, Pess R, Marks DR. An empirical examination comparing the
    mindfulness-acceptance-commitment approach and psychological skills training for the mental health and sport
    performance of female student athletes. International Journal of Sport and Exercise Psychology. 2018;16(4):431-
    51.
    17. Macedo LG, Maher CG, Latimer J, McAuley JH. Motor control exercise for persistent, nonspecific low back pain:
    a systematic review. Physical therapy. 2009;89(1):9-25.
    18. Leahy RL. Emotional schema therapy: a bridge over troubled waters. Acceptance and mindfulness in cognitive
    behavior therapy: Understanding and applying the new therapies. 2011:109-31.
    19. Leahy RL. Resistance: An emotional schema therapy (EST) approach. Cognitive behaviour therapy: A guide for
    the practising clinician. 2009; 2:187-204.
    20. rezaee M, ghazanfari F, reazee F. Effectiveness of Emotional Schema Therapy on Severity of Depression and
    Rumination in People with Major Depressive Disorder. JSSU. 2016; 24 (1) :41-54
    21. Morvaridi M, Mashhadi A, Sepehri Shamloo Z. The effectiveness of group therapy based on emotional schema
    therapy on decrease of anxiety sensitivity in woman with social anxiety disorder. J Neyshabur Univ Med Sci. 2019;
    7 (1) :26-35
    22. The effectiveness of emotional schema therapy on the severity and frequency of physical symptoms and life quality
    of patients with irritable bowel syndrome: single-subject design. DMed. 2016; 24 (4) :77-88
    23. Naderi, Yazdan, Moradi, Alireza, Ramezanzadeh, Fatemeh, Waqfinejad, Maedeh. Emotional schemas (ESs) in
    people with post-traumatic stress disorder (PTSD): as a risk factor in PTSD. Clinical Psychology Studies, 2016; 6
    (22): 1-22.
    24. Berking M, Wupperman P, Reichardt A, Pejic T, Dippel A, Znoj H. Emotion-regulation skills as a treatment target
    in psychotherapy. Behaviour research and therapy. 2008 ;46(11):1230-7.
    25. Delavar A. Research Methods in Psychology and Educational Sciences. Tehran: Virayesh
    26. Kerns RD, Rosenberg R, Jacob MC. Anger expression and chronic pain. Journal of behavioral medicine.
    1994;17(1):57-67.
    27. Cetin AA, Bektas H, Ozdogan M. The West Haven Yale Multidimensional Pain Inventory: Reliability and validity
    of the Turkish version in individuals with cancer. European Journal of Oncology Nursing. 2016; 20:1-9.
    28. Asghari Moghadam, Mohammad Ali, Shairi, Mohammad Reza, Hamedi, Vajiheh, Shahani, Razieh, Mehrabian,
    Narges. Clinical significance of changes in clinical trials of chronic pain. Clinical Psychology, 2011; 3 (1): 63-77.
    29. Lumley, M. A., & Schubiner, H. (2019). Emotional Awareness and Expression Therapy for Chronic Pain:
    Rationale, Principles and Techniques, Evidence, and Critical Review. Current rheumatology reports, 21(7), 30.
    30. Aaron RV, Fisher EA, de la Vega R, Lumley MA, Palermo TM. Alexithymia in individuals with chronic pain and
    its relation to pain intensity, physical interference, depression, and anxiety: a systematic review and meta-analysis.
    Pain. 2019;160(5):994-1006.
    31. Boersma K, Södermark M, Hesser H, Flink IK, Gerdle B, Linton SJ. Efficacy of a transdiagnostic emotion–focused
    exposure treatment for chronic pain patients with comorbid anxiety and depression: a randomized controlled trial.
    Pain. 2019 Aug;160(8):1708.
    32. Izadi. F, Ashrafi. AS, Ashtiani. A. F. The Effectiveness of Emotional Schema Therapy on Reducing Negative
    Emotional Schemas, Emotional Loss, and Physical Symptoms in Physical Symptoms. Behavioral Science
    Research, 17. 332-343, (2).
    33. McCracken LM, Vowles KE, Eccleston C. Acceptance of chronic pain: component analysis and a revised
    assessment method. Pain. 2004;107(1-2):159-66.
    34. Thompson EL, Broadbent J, Bertino MD, Staiger PK. Do pain-related beliefs influence adherence to
    multidisciplinary rehabilitation? a systematic review. The Clinical journal of pain. 2016;32(2):164-78.
    35. razavi S B, abolghasemi S, akbari B, naderinabi B. Effectiveness of Acceptance and Commitment Therapy on
    Feeling Hope and pain management of Women with Chronic pain. JAP. 2019; 10 (1) :36-49
    36. Vesal M, Taher Neshatdoost H. Meta-analysis of psychological intervention`s effectiveness on reduction of pain
    intensity among patients with chronic pain. JAP. 2019; 10 (3) :21-38
    37. Hughes LS, Clark J, Colclough JA, Dale E, McMillan D. Acceptance and Commitment Therapy (ACT) for chronic
    pain. The Clinical Journal of Pain. 2017;33(6):552-68.
Medical Journal of Mashhad university of Medical Sciences
Volume 64, Issue 1
March and April 2021
Pages 2682-2695