Comparison of the effectiveness of Acceptance and Commitment-Based Therapy (ACT) and Quality of Life therapy (QOLT) on self-destructive behaviors and emotional cognitive regulation in substance abusers

Document Type : Research Paper

Authors

1 Department of psychology, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran

2 Department of psychology, Quchan Branch, Islamic Azad University, Quchan, Iran

Abstract

Introduction: The purpose of this study was to compare the effectiveness of Acceptance and Commitment-Based Therapy and Quality of Life therapy (QOLT) on self-destructive behaviors and emotional cognitive regulation in substance abusers.
Materials and Methods:In this clinical trial, forty-five men with substance dependency aged over than 20 years who referred to the Mashhad Substance Abuse Clinics during 2019 and they were undergoing treatment selected through convenient sampling method. The selected men were randomly divided into 3 groups (two experimental groups and one control group). The experimental groups received Acceptance and Commitment Therapy (ACT) or quality of life skills training and the control group received no training. Data were collected using the Cognitive Emotion Regulation Questionnaire (CERQ) and the Self-Destructive behaviors questionnaire. Data analyzed through descriptive statistics, covariance analysis and SPSS software.
Results: The results showed that the therapeutic methods used in this study were effective on self-destructive behaviors and cognitive emotion regulation (p < 0.01). Also, the results showed no significant difference between the two treatments. 
Conclusion: According to the results of this study, Acceptance and Commitment-Based Therapy and Quality of Life therapy (QOLT) are effective on self-destructive behaviors and emotional cognitive regulation in substance abusers.

Keywords


1. Hajli A, Zakaria MA, Hojjat Kermani S. [Mens attitude towards substance abuse in the country]. Iranian
journal of social issues 2010; 1(2): 112-82. (Persian)
2. Narimani M, Pourasmaili A. [Comparison of mood and spiritual intelligence in addicts, methadone and non
addicts]. Journal of addiction abuse research 2012; 6: 9-23. (Persian)
3. Sourizaei M, Khalatbari J, Keikhayfarzaneh MM, Raisifard R. The prevention of substance abuse, methods,
challenges and researches. Indian journal of sciences and technology 2011; 8: 1000-1003.
4. Counter Narcotics Headquarters. [cited 1998]. Available from; Counter Narcotics Headquarters.html
5. World Office on Substances; 2017.
6. Ahmadi J, Hasani M. [Prevalence of substance use among Iranian high school students]. National Library of
Medicine National Institutes of Health 2003; 28(2): 375-9. (Persian)
7. World Health Organization. [cited 2015]. Available from; https://www.who.int/
8. Rostami AM, Ahmadi S. [Psychology of addiction based on DMS 5]. Tehran: Elam; 2014. (Persian)
9. Jalilian F, Mirzaei Alavijeh M, Amoei MR, Zinat Motlagh F, Hatamzadeh N, Allahverdipour H. [Prevalence
and pattern of substance abuse among prisoners in Kermanshah city]. Iranian journal of health education and
health promotion 2013; 1(2): 41-50. (Persian)
10. Sadok BA, Sadok WA, Ruiz P. [Synopsis of psychiatry: Behavioral sciences/ clinical psychiatry]. Rezaei F.
(translator). Tehran: Arjmand; 2016. (Persian)
11. Aldo A, Nolen-Hoeksema S, Schweizer S. Emotional regulasion strategies across psychopatology. Clin
Psychol Rev 2010; 30: 217-37.
12. Thorberg FA, Lyvers M. Negative mood regulation (NMR) expectancies, mood, and affect intensity among
clients in substance disorder treatment facilities. Addict Behav 2005; 31: 811-20.
13. Azami Y, Sohrabi F, Borjali A, Chopan H. [Effectiveness of teaching emotion regulation based on gross model
in reducing impulsivity in substance dependents]. Journal of research on addiction 2014; 8: 127-40. (Persian)
14. Khantzian EJ. The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence.
Am J Psychiatry 1985; 142(11): 1259-64.
15. Fox HC, Axelrod SR, Paliwal P, Sleeper J, Sinha R. Difficulties in emotion regulation and impulse control
during cocaine abstinence. Subst Alcohol Depend 2007; 89: 298-301.
16. Ejei J, Lavasani GHA, Erami M. [Comparison of emotional regulation in substance abusers and normal
subjects]. Journal of psychology 2015; 19(2): 136-46. (Persian)
17. Najafi M, Mohammadi Far M, Abdollahi M. [Emotional performance deficit and tendency to substance abuse:
The role of the components of emotion regulation, tolerance, and sensation seeking]. Journal of social health and
addiction 2015; 2(5): 53-68. (Persian)
18. Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. In:
Cameron LD, Leventhal H. (editors). Self-regulation of health and illness behavior; London: Roultedge Taylor
and Francis Group; 2003: 42-64.
19. Esmaeilinasab M, Andami Khoshk A, Azarmi H, Samarokhi A. [Difficulties in emotion regulation and distress
tolerance predictive role in addiction vulnerability students]. Journal of research on addiction 2014; 8: 49-63.
(Persian)
20. Keough ME, Riccardi CJ, Timpano KR, Mitchell MA, Schmidt NB. Anxiety symptomatology: The
association with distress tolerance and anxiety sensitivity. Behav Ther 2010; 4: 567-74.
21. Pourafkari N. [Comprehensive of dictionary psychology-psychiatry]. Tehran: Farhangmoaser; 2007. (Persian)
22. Shirinzadeh-Dastgiry S. [Comparison of metacognition beliefs and responsibility in obsessivecompulsive
disorder pations, generalized anxiety disorder and normal people Shiraz]. Dissertation. Shiraz University, 2006:
40-42. (Persian)
23. Agha Mohammadian Sharabaf HR, Rasoulzadeh Tabatabai K. [Social psychology of health]. Mashhad; 2002.
(Persian)
24. Lee EB, An W, Levin ME, Twohig MP. An initial meta-analysis of acceptance and commitment therapy for
treating substance use disorders. Psychology Faculty Publications; 2015: 1-7.
25. Froushani MA, Akrami N. The relationship between cognitive emotion regulation and tendency to addiction
in adolescents. Int J Educ Psychol Res 2017; 3: 245-9.
26. Zahed A, Alahqalilu K, Abolghasemi A, Norimani M. The relationship between emotion regulation strategies
and interpersonal behavior among substance abusers. Journal of addiction research 2010; 11: 99-113. (Persian)
27. Nardella A, Falcone G, Giordano G, Erbuto D, Migliorati M, Innamorati M, et al. Suicide and substance and
alcohol addiction: Self-destructive behaviours. An observational study on clinic hospital population. Eur
Psychiatry 2017; 41: 400.
28. Jangi P, Ramak N, Sangani A. [Comparative study of self-destructive behaviors, irrational beliefs, and
emotional distress tolerance in two male groups of recovering from addiction to narcotics and stimulants]. Iranian
journal of forensic medicine 2019; 25(1): 17-22. (Persian)
29. Kashefi T. [On the relationship between meta cognitive beliefs and the self-destructive behavior among
addicts]. Journal of Torbat-e-Heydariyeh University of Medical Sciences 2013; 1(2): 39-45. (Persian)
30. Sandman CA, Kemp AS. [Opioid antagonists may reverse endogenous opiate "dependence" in the treatment
of self-injurious behavior]. Pharmaceuticals 2011; 4(2): 366-81.
31. Popov Iu V. A concept of self-destructive behavior in adolescents. Int J Ment Health 2002; 31(2): 10-17.
32. Bahrami S, Asghari F. [A controlled trial of acceptance and commitment therapy for addiction severity in
methamphetamine users: preliminary study]. Archives of psychiatry and psychotherapy 2017; 2: 49-55. (Persian)
33. Carroll ME. Changing substance choice through conditioned reinforcement: comment on Alessi, Roll, Reilly,
and Johanson. Experim Clin Psychopharmacol 2002; 10(2): 87-9.
34. Khakbaz H, Farhoudian A, Azkhosh M, Dolatshahi B, Karami H. [The effectiveness of group acceptance and
commitment therapy on emotion regulation in methamphetamine dependent individuals undergoing
rehabilitation]. Int J High Risk Behav Addiction 2016; 5(4): e28329.
35. Dimeff LA, Linehan MM. [Dialectical behavior therapy for substance abusers]. Addict Sci Clin Pract 2008;
4(2): 39-47.
36. Witkiewitz K, Bowen S, Harrop EN, Douglas H, Enkema M, Sedgwick C. Mindfulness-based treatment to
prevent addictive behavior relapse: theoretical models and hypothesized mechanisms of change. Subst Use Misuse
2014; 49(5): 513-24.
37. Mohammadi M, Farhoudian A, Shoaee F, Younesi SJ, Dolatshahi B. [Aggression in juvenile delinquents and
mental rehabilitation group therapy based on acceptance and commitment]. Iranian rehabilitation journal 2015;
13(2): 5-9. (Persian)
38. Wilson Kelly G, Hayes Steven C, Byrd Michelle R. Exploring comapatibilities between acceptance and
commitment therapy and 12-step treatment for sustance abuse. J Ration-Emot Cogn Behav Ther 2000; 18(4): 209-
34.
39. Izadi R, Abedi MR. [Acceptance and commitment based treatment]. Tehran: Jangal; 2012. (Persian)
40. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: Model, processes
and outcomes. Behav Res Ther 2006; 44(1): 1-25.
41. Smout MF, Longo M, Harrison S, Minniti R, Wickes W, White JM. Psychosocial treatment for
methamphetamine use disorders: A preliminary randomized controlled trial of cognitive behavior therapy and
acceptance and commitment therapy. Subst Abuse 2010; 312: 98-107.
42. Luciano MC, Gómez S, Hernández M, Cabello F. [Alcoholismo, trastorno de evitación y Terapia de
Aceptación y Compromiso]. Análisis y Modifi cación de Conducta 2001; 113: 333-72. (Spanish)
43. Gifford EV, Kohlenberg BS, Hayes SC, Antonuccio DO, Piasecki MM, Rasmussen-Hall ML. Acceptance
theory-based treatment for smoking cessation: An initial trial of acceptance and commitment therapy. Behav Ther
2004; 35: 689-706.
44. Frisch MB. [Quality of life therapy, applying a life satisfaction approach to positive psychology and cognitive
therapy]. Khamseh A. (translator). 1st ed. Tehran: Arjmand; 2010: 329-37. (Persian)
45. Momeni F, Moshtagh N, Poorshahbaz A. [Effectiveness of cognitive-behavioral group therapy on improving
quality of life in opiate addicts under methadone maintenance treatment]. Journal of research on addiction 2013;
7: 79-92. (Persian)
46. Gonzalez-Menendez A, Fernandez P, Rodriguez F, Villagra P. Long-term outcomes of acceptance and
commitment therapy in substance- dependent female inmates: a controlled trial. Int J Clin Health Psychol 2014;
14: 18-27.
47. Agha Mohammadian H, Moradian Z, Baensaf N. [Investigation of self-destructive behaviors and their causes
in students of Ferdowsi University of Mashhad]. Journal of clinical psychology research and counseling 2012;
2(2): 5-24. (Persian)
48. Garnefski N, Kraaij V. Cognitive emotion regulation questionnaire- development of a short 18-item version
(CERQ-short). Pers Individ Diff 2006; 41: 1045-53.
49. Besharat MA. [Cognitive emotion regulation questionnaire: Implementation and scoring method].
Transformational psychology (Iranian psychologists) 2016; 13: 221-3. (Persian)
50. Hasani J. [Psychometric properties of cognitive emotion regulation questionnaire]. Clinical psychology 2010
2(2): 73-83. (Persian)
51. Hayes SC, Lillis J. Acceptance and commitment therapy. In: VandenBos GR, Meidenbauer E, Frank-McNeil
J. (editors). Psychotherapy theories and techniques: A reader. American Psychological Association; 2014: 3-8.
52. Eifert GH, Forsyth JP. Acceptance and commitment therapy for anxiety disorders: A practitioner’s treatment
guide to using mindfulness, acceptance, and values-based behavior change strategies. Oakland, CA: New
Harbinger; 2005.
53. Forouzanfar A, Lavasani GA, Shoa Kazemi M. [Effectiveness of acceptance and commitment based group
counseling on distress tolerance and anxiety sensitivity among female substance abusers]. Journal of research on
addiction 2017; 11(4): 135-54. (Persian)
54. Roemer L, Orsillo SM. An acceptance-based behavior therapy for generalized anxiety disorder. In: Orsillo
SM, Roemer L. (editors). Acceptance and mindfulness-based approaches to anxiety: Conceptualization and
treatment. New York: Springer; 2005: 213-40.
55. Berking M, Whitley B. Affect Regulation Training (ART). New York: Springer; 2014.
56. Berking M. [Training emotionaler Kompetenzen]. Heidelberg, Germany: Springer; 2007. (German)