Comparison of the Effectiveness of Compassion-focused Therapy and Quality of Life Therapy on Self-Criticism and Psychopathological Symptoms in Patients with Major Depressive Disorder

Document Type : Original Article

Authors

Department of Psychology, Faculty of Humanities, Neyshabur Branch, Islamic ‎Azad University, Neyshabur, Iran

10.30483/rijm.2021.254147.1003

Abstract

Background: The main feature of Major Depression Disorder (MDD) is mood swings between sadness (from minor disappointment to extreme despair) for several days, weeks, months, or even years. This work tries to compare the effectiveness of compassion-focused therapy and quality of life-therapy on self-criticism and psychopathological symptoms in patients with MDD.
Methodology: This work is a quasi-experimental study (pre-test, post-test, and follow-up test with a control group). The subjects include 45 MDD patients admitted in psychological advisory centers in Neyshabur, all of whom are selected by convenience sampling method and randomly divided into three groups: the compassion-focused therapy group, the quality of the life-therapy group, and the control group. The members of the CFT group and quality of life-therapy respectively received 8 and 10 therapy sessions, while the control group members were put on a waiting list. The research tools are as follows Self-Criticism Scale, Depression-Anxiety-Stress Scale (DASS-21), and Beck-Depression Inventory-II (BDI-II). The participants were tested before therapy intrusions, immediately after the sessions, and two-month after the ending session. Data were analyzed according to the variance analysis test by repetitive measurements and SPSS-24 Software.
Results: The results show that both therapies are effective in reducing self-criticism (p < 0.001) and psychopathological symptoms (p < 0.001); however, this effect was significantly higher in the CFT group as compared to the quality of life-therapy group (p < 0.001).
Conclusion: Given the biological and psychological infrastructure of MDD, using quality of life-therapy and self-compassion approaches (in addition to medication) can be effective in reducing MDD symptoms.

Keywords


1.         Riemann D, Krone LB, Wulff K, Nissen C. Sleep, insomnia, and depression. Neuropsychopharmacology. 2020;45(1):74-89.
2.         Fathi-Ashtiani A, Ahmadi A, Ghobari-Bonab B, Azizi MP, Saheb-Alzamani SM. Randomized trial of psychological interventions to preventing postpartum depression among Iranian first-time mothers. International journal of preventive medicine. 2015;6(3): 109-117.
3.         Valstar M, Gratch J, Schuller B, Ringeval F, Lalanne D, Torres Torres M, Scherer S, Stratou G, Cowie R, Pantic M. Depression, mood, and emotion recognition workshop and challenge. InProceedings of the 6th international workshop on audio/visual emotion challenge 2016: 16 (pp. 3-10).
4.         Miller AH, Raison CL. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature reviews immunology. 2016 Jan;16(1):22.
5.         Taylor LK, Merrilees CE, Goeke-Morey MC, Shirlow P, Cummings EM. Trajectories of adolescent aggression and family cohesion: The potential to perpetuate or ameliorate political conflict. Journal of Clinical Child & Adolescent Psychology. 2016;45(2):114-28.
6.         Sing CY, Wong WS. The effect of optimism on depression: The mediating and moderating role of insomnia. Journal of health psychology. 2011;16(8):1251-8.
7.         Juang LP, Alvarez AA. Discrimination and adjustment among Chinese American adolescents: Family conflict and family cohesion as vulnerability and protective factors. American Journal of Public Health. 2010;100(12):2403-9.
8.         Lazarus AA. Multimodal therapy. Handbook of psychotherapy integration. 2005;2:105-20.
9.         van Kessel K, Moss-Morris R, Willoughby E, Chalder T, Johnson MH, Robinson E. A randomized controlled trial of cognitive behavior therapy for multiple sclerosis fatigue. Psychosomatic medicine. 2008;70(2):205-13.
10.       Khandaker GM, Zuber V, Rees JM, Carvalho L, Mason AM, Foley CN, et al. Shared mechanisms between coronary heart disease and depression: findings from a large UK general population-based cohort. Molecular psychiatry. 2020;25(7):1477-86.
11.       Elahi S. HERE BE DRAGONS: EXPLORING THE. The Postnormal Times Reader. 2019:168.
12.       Bandura A. Moral disengagement: How people do harm and live with themselves: Worth Publishers; 2016.
13.       Gilbert P. Depression: The evolution of powerlessness: Routledge; 2016.
14.       Falconer CJ, King JA, Brewin CR. Demonstrating mood repair with a situation‐based measure of self‐compassion and self‐criticism. Psychology and Psychotherapy: Theory, Research and Practice. 2015 Dec;88(4):351-65.
15.       López A, Sanderman R, Smink A, Zhang Y, Van Sonderen E, Ranchor A, et al. A reconsideration of the Self-Compassion Scale’s total score: self-compassion versus self-criticism. PloS one. 2015;10(7):e0132940.
16.       Gilbert P. Explorations into the nature and function of compassion. Current opinion in psychology. 2019;28:108-14.
17.       Navarro-Gil M, Lopez-del-Hoyo Y, Modrego-Alarcón M, Montero-Marin J, Van Gordon W, Shonin E, Garcia-Campayo J. Effects of attachment-based compassion therapy (ABCT) on self-compassion and attachment style in healthy people. Mindfulness. 2020 Jan;11(1):51-62..
18.       Haberler G. Prosperity and depression: A theoretical analysis of cyclical movements: Routledge; 2017.
19.       Kılıç A, Hudson J, McCracken LM, Ruparelia R, Fawson S, Hughes LD. A Systematic Review of the Effectiveness of Self-Compassion-Related Interventions for Individuals With Chronic Physical Health Conditions. Behavior Therapy. 2020 Aug 13.
20.       Carroll AJ, Christon LM, Rodrigue JR, Fava JL, Frisch MB, Serber ER. Implementation, feasibility, and acceptability of quality of life therapy to improve positive emotions among patients with implantable cardioverter defibrillators. Journal of Behavioral Medicine. 2020:1-11.
21.       Ramezani MA, Ahmadi K, Ghaemmaghami A, Zamani S, Saadat SH, Rahiminejad SP. Evaluation of quality of life therapy effectiveness in contrast to psycho-sexual education on sexual self-concept of Iranian women. Iranian Red Crescent Medical Journal. 2018;20(S1).
22.       Beck AT, Steer RA, Brown G. Beck depression inventory–II. Psychological Assessment. 1996.
23.       Frisch MB. Evidence-based well-being/positive psychology assessment and intervention with quality of life therapy and coaching and the Quality of Life Inventory (QOLI). Social Indicators Research. 2013;114(2):193-227.
24.       Karimi Z, Rezaee N, Shakiba M, Navidian A. The Effect of Group Counseling Based on Quality of Life Therapy on Stress and Life Satisfaction in Family Caregivers of Individuals with Substance Use Problem: A Randomized Controlled Trial. Issues in mental health nursing. 2019;40(12):1012-8.
25.       Saeedi M, Ashktorab T, Shamsikhani S, Saatchi K. The  effect  of  progressive  muscle  relaxation  on  insomnia  severity  of   hemodialysis   patients. . Journal   of   Complementary  Medicine 2013;1:159-70.
26.       Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological assessment. 1998;10(2):176.
27.       Dabsoun K, Mohammadkhani P. The Beck Depression Inventory-II in patients with major Depression in partial Recovery. Quarterly Journal of Rehabilitation.2008(8):290-299.
28.       Boersma K, Håkanson A, Salomonsson E, Johansson I. Compassion focused therapy to counteract shame, self-criticism and isolation. A replicated single case experimental study for individuals with social anxiety. Journal of Contemporary Psychotherapy. 2015;45(2):89-98.
29.       O'Gorman KD, MacIntosh R. Research methods for business and management: Goodfellow Publishers Limited; 2014.
30.       Gonzalez-Hernandez E, Romero R, Campos D, Burychka D, Diego-Pedro R, Baños R, et al. Cognitively-based compassion training (CBCT®) in breast cancer survivors: A randomized clinical trial study. Integrative cancer therapies. 2018;17(3):684-96.
31.       Harris KL. Compassion focused therapy for shame-prone individuals: an eight-week group therapy investigation. Routledge; 2017.
32.       Elaine B, Hollins M. Exploration of a training programme for student therapists that employs Compassionate Mind Training (CMT) to develop compassion for self and others. The Arts in Psychotherapy. 2016;22:5-13.