Comparing the effectiveness of acceptance and commitment therapy based on matrix and behavioral activation therapy on depression and quality of life

Document Type : Research Paper

Authors

1 Ph.D. student, Department of Psychology, Faculty of Humanities, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran

2 Department of Psychology, Faculty of Humanities, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran

Abstract

Introduction: This study aimed to compare the efficacy of group psychotherapy based on acceptance and commitment by matrix method and group behavioral activation therapy on depression and quality of life in depressed university students.
Materials and Methods: In this clinical trial, 45 university students with depression were selected during June and July 2018 and randomly divided in 3 groups (behavioral activation, group psychotherapy based on acceptance and commitment and the control). The experimental groups received 6 weekly sessions based on matrix acceptance and commitment and behavioral activation. All participants completed the Beck Depression Scale (BDI-II) and the WHO Quality of Life Questionnaire (WHOQOL-BREF) in three stages: pre-test, post-test, and one-month follow-up. Data were analyzed using multivariate covariance analysis.
 Results: The results showed that matrix acceptance and commitment therapy and behavioral activation therapy have significant impacts on reducing symptoms of depression and increased quality of life. There was no significant difference between the two experimental groups in terms of depression (P= 0.411). The results also remained at a one-month follow-up.
 Conclusion: It seems that group psychotherapy based on acceptance and commitment by matrix method and group behavioral activation therapy can decrease depression and increas quality of life in depressed university students.

Keywords


1. January J, Madhombiro M, Chipamaunga S, Ray S, Chingono A, Abas M. Prevalence of depression and anxiety among undergraduate university students in low- and middle-income countries: a systematic review protocol. Syst Rev 2018; 7(1): 57.
2. Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res 2013; 47(3): 391-400.
3. Brenneisen Mayer F, Souza Santos I, Silveira PS, Itaqui Lopes MH, de Souza AR, Campos EP, et al. Factors associated to depression and anxiety in medical students: a multicenter study. BMC Med Educ 2016; 16(1): 282.
4. Bigelow AE, Beebe B, Power M, Stafford AL, Ewing J, Egleson A, et al. Longitudinal relations among maternal depressive symptoms, maternal mind-mindedness, and infant attachment behavior. Infant Behav Dev 2018; 51: 33-44.
5. Lewinsohn PM. Clinical and theoretical aspects of depression, in innovative treatment methods in psychopathology. Calhoun KS, Adams HE, Mitchel KM. (editors). New York, NY: Wiley; 1974: 63-120.
6. Beck AT. Cognitive models of depression. In: Leahy RL, Dowd ET. (editors). Clinical advances in cognitive psychotherapy: Theory and application. New York: Springer; 2002: 29-61.
7. Frank E, Anderson B, Reynolds CF 3rd, Ritenour A, Kupfer DJ. Life events and the research diagnostic criteria endogenous subtype. A confirmation of the distinction using the Bedford College methods. Arch Gen Psychiatry 1994; 51(7): 519-24.
8. Malibary H, Zagzoog MM, Banjari MA, Bamashmous RO, Omer AR. Quality of Life (QoL) among medical students in Saudi Arabia: a study using the WHOQOL-BREF instrument. BMC Med Educ 2019; 19(1): 344.
9. Gan GG, Yuen Ling H. Anxiety, depression and quality of life of medical students in Malaysia. Med J Malaysia 2019; 74(1): 57-61.
10. Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College students: Mental health problems and treatment considerations. Acad Psychiatry 2015; 39(5): 503-11.
11. Hulbert-Williams NJ, Storey L, Wilson KG. Psychological interventions for patients with cancer:
psychological flexibility and the potential utility of Acceptance and Commitment Therapy. Eur J Cancer Care (Engl) 2015; 24(1): 15-27.
12. Bagherzadeh Ledari R, Masjedi A, Bakhtyari M, Zarghami M, Nouri R, Hosseini H. A comparison between the effectiveness of acceptance and commitment treatment and behavioral activation treatment for depression on symptoms severity and rumination among patients with treatment-resistant depression. Iran J Psychiatry Behav Sci 2018; 12(3): e10742.
13. Kingery JN, Bodenlos JS, Lathrop JA. Facets of dispositional mindfulness versus sources of social support predicting college students' psychological adjustment. J Am Coll Health 2020; 68(4): 403-10.
14. González-Fernández S, Fernández-Rodríguez C, Paz-Caballero MD, Pérez-Álvarez M. Treating anxiety and depression of cancer survivors: Behavioral activation versus acceptance and commitment therapy. Psicothema 2018; 30(1): 14-20.
15. Fernández-Rodríguez C, Villoria-Fernández E, Fernández-García P, González-Fernández S, Pérez-Álvarez M. Effects of behavioral activation on the quality of life and emotional state of lung cancer and breast cancer patients during chemotherapy treatment. Behav Modif 2019; 43(2): 151-80.
16. Polk KL, Schoendorff B, Webster M, Olaz FO. The essential guide to the ACT Matrix: A step-by-step approach to using the ACT Matrix model in clinical practice. Oakland, California: New Harbinger; 2016: 1.
17. By Byrne SP, Haber P, Baillie A, Costa DSJ, Fogliati V, Morley K. Systematic reviews of mindfulness and acceptance and commitment therapy for alcohol use disorder: should we be using third wave therapies? Alcohol Alcohol 2019; 54(2): 159-66.
18. Strosahl KD, Robinson PJ. The mindfulness and acceptance workbook for depression: Using acceptance and commitment therapy to move through depression and create a life worth living. Oakland, California: New Harbinger; 2017: 1.
19. González Fernández S, Fernández Rodríguez C, Padierna Sánchez C, Besteiro González JL, Pérez Álvarez M. [Behavioral activation in cancer: Review of treatments and evidences]. Revista Argentina de Clínica Psicológica 2019; 2: 140-53. (Spanish)
20. Farchione TJ, Boswell JF, Wilner JG. Behavioral activation strategies for major depression in transdiagnostic cognitive-behavioral therapy: An evidence-based case study. Psychotherapy (Chic) 2017; 54(3): 225-30.
21. Lejuez CW, Hopko DR, Acierno R, Daughters SB, Pagoto SL. Ten year revision of the brief behavioral activation treatment for depression: revised treatment manual. Behav Modif 2011; 35(2): 111-61.
22. First MB, Spitzer RL, Gibbon M, Williams JB. User's guide for the structured clinical interview for DSM-IV axis I disorders SCID-I: clinician version. Washington. D.C.: American Psychiatric Publication; 1997.
23. Sharifi V, Asadi SM, Mohammadi MR, Amini H, Kaviani H, Semnani Y, et al. [Reliability and feasibility of the Persian version of the structured diagnostic interview for DSM-IV (SCID)]. Journal of advances in cognitive science 2004; 6(1-2): 10-22. (Persian)
24. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56(6): 893-7.
25. Beck AT, Clark DA. Anxiety and depression: An information processing perspective. Anxiety Stress Coping 1988; 1(1): 23-36.
26. Zemestani M, Davoodi I, Mehrabi-Zadeh Honarmand M, Zargar Y. [Effectiveness of group behavioral
activation on depression, anxiety and rumination in patients with depression and anxiety]. Journal of clinical psychology 2014; 5(4): 73-84. (Persian)
27. Nejat SA, Montazeri A, Holakouie Naieni K, Mohammad KA, Majdzadeh SR. [The World Health
Organization quality of Life (WHOQOL-BREF) questionnaire: Translation and validation study of the Iranian version]. Journal of school of public health and institute of public health research. 2006; 4(4): 1-12.
28. Dehghani A, Rezaei Dehnavi S. [The effectiveness of acceptance and commitment therapy on quality of life among patients under MMT]. Ofogh e danesh 2018; 24(3): 246-52. (Persian)
29. Moradi K, Dehghani A. [Effectiveness of acceptance and commitment therapy on happiness and social desirability of women in seminary]. The women and family cultural education 2018; 12(42): 113-26. (Persian)
30. Narimani M, Alamdari E, Abolghasemi A. [The study of the efficiency of acceptance and commitment-based therapy on the quality of infertile women’s life]. Journal of family counseling and psychotherapy 2014; 4(3): 388-404. (Persian)
31. Grácio J, Almeida S, Oliveira-Maia AJ. Embracing the placebo effect in the treatment of depression: from neuropsychiatry to psychotherapy. The Neurobiology-Psychotherapy-Pharmacology Intervention Triangle: The need for common sense in 21st century mental health. Poland: Vernon; 2019: 71.
32. Pass L, Lejuez CW, Reynolds S. Brief behavioural activation (brief BA) for adolescent depression: a pilot study. Behav Cogn Psychother 2018; 46(2): 182-94.
33. Weersing VR, Brent DA, Rozenman MS, Gonzalez A, Jeffreys M, Dickerson JF, et al. Brief behavioral therapy for pediatric anxiety and depression in primary care: a randomized clinical trial. JAMA Psychiatry 2017; 74(6): 571-78.
34. McCauley E, Gudmundsen G, Schloredt K, Martell C, Rhew I, Hubley S, et al. The adolescent behavioral activation program: adapting behavioral activation as a treatment for depression in adolescence. J Clin Child Adolesc Psychol 2016; 45(3): 291-304.
35. Chu BC, Crocco ST, Esseling P, Areizaga MJ, Lindner AM, Skriner LC. Transdiagnostic group behavioral activation and exposure therapy for youth anxiety and depression: Initial randomized controlled trial. Behav Res Ther 2016; 76: 65-75.
36. Dimidjian S, Barrera M Jr, Martell C, Muñoz RF, Lewinsohn PM. The origins and current status of behavioral activation treatments for depression. Annu Rev Clin Psychol 2011; 7: 1-38.
37. Cuijpers P, van Straten A, Andersson G, van Oppen P. Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. J Consult Clin Psychol 2008; 76(6): 909-22.
38. Hopko DR, Lejuez CW, Ryba MM, Shorter RL, Bell JL. Support for the efficacy of behavioural activation in treating anxiety in breast cancer patients. Clin Psychol 2016; 20(1): 17-26.
39. Alijanzadeh Tonkaboni M, Bagheri M. [Comparative examine of effectiveness of training behavioral activation and education based on acceptance and commitment on increasing psychological well-being among
high school boy students of Grade nine in Kerman]. Journal of psychology and psychiatry 2019; 6(1):75-86.
40. McIndoo CC, File AA, Preddy T, Clark CG, Hopko DR. Mindfulness-based therapy and behavioral activation: A randomized controlled trial with depressed college students. Behav Res Ther 2016; 77: 118-28.