he Effectiveness of Acceptance and Commitment Therapy on Distress and Psychosomatic Symptoms in Patients with type D personality and Gastrointestinal Dysfunction

Document Type : Original Article

Authors

1 PhD Student, Department of Psychology, Birjand Branch, Islamic Azad University, Birjand, Iran.

2 Associate Professor, Department of Psychology, Birjand Branch, Islamic Azad University, Birjand, Iran.

3 Associate Professor, Department of Psychology, Roodehen Branch, Islamic Azad University, Roodehen, Iran.

10.30483/rijm.2021.254235.1077

Abstract

Background: Anxiety disorders and psychological manifestations play a significant role in the incidence of psychosomatic disorders. Moreover, Personality traits are one of the psychological constructs associated with psychosomatic symptoms.
Objective: This study aimed to determine the effectiveness of acceptance and commitment therapy on distress and psychosomatic symptoms in patients with gastrointestinal dysfunction with type D personality.
Methods: The present study was a semi-experimental pre-test, post-test design with a control group and follow-up. The statistical population in this study was all patients with functional gastrointestinal disorders (FGID) who were referred to behavioral sciences research center in Isfahan in 2019, 30 patients were selected by targeted sampling method (patients with gastrointestinal dysfunction, except gastrointestinal cancer patients, who had a high de-personality score). Data were obtained using the D-14 personality type scale, ROME III questionnaire, psychological distress, and stress-anxiety-depression disorders (DASS-21). Data analysis was performed using repeated measure analysis of variance by spss.22.
Results: The results showed that acceptance and commitment therapy was effective in decreasing distress (p <0.001) and psychosomatic symptoms (p <0.001) in patients with gastrointestinal dysfunction with type D personality.
Conclusion: It can be concluded that acceptance and commitment therapy effectively distress and psychosomatic symptoms of patients with gastrointestinal dysfunction with type D personality and improve psychological problems in patients with gastrointestinal dysfunction.

Keywords


1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American 
Psychiatric Pub; 2013 May 22. https://doi.org/10.1176/ 
appi.books.9780890425596
2. A-tjak JG, Davis ML, Morina N, Powers MB, Smits 
JA, Emmelkamp PM. A meta-analysis of the efficacy of 
acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics. 2015;84(1):30-6. https://doi. 
org/10.1159/000365764
3. Biondi M, Bersani FS, Pasquini M. The Role of Integrated Interventions in Psychosomatic Diseases. InPerson 
Centered Approach to Recovery in Medicine 2019 (pp. 
263-277). Springer, Cham. https://doi.org/10.1007/978-3-
319-74736-1_14
4. Blackledge JT, Ciarrochi J, Deane FP, editors. Acceptance and commitment therapy: Contemporary theory research and practice. AustralianAcademic Press; 2009.
5. Casagrande M, Boncompagni I, Forte G, Guarino A, 
Favieri F. Emotion and overeating behavior: effects of 
alexithymia and emotional regulation on overweight and 
obesity. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2020 Oct;25(5):1333-45. https:// 
doi.org/10.1007/s40519-019-00767-9
6. Chandran S, Prakrithi SN, Mathur S, Kishor M, Rao 
TS. A review of functional gastrointestinal disorders: A 
primer for mental health professionals. Archives of Mental Health. 2018 Jul 1;19(2):70. https://doi.org/10.4103/ 
AMH.AMH_25_18
7. Chojnacki C, Kaczka A, Gasiorowska A, Fichna J, 
Chojnacki J, Brzozowski T. The effect of long-term melatonin supplementation on psychosomatic disorders in 
postmenopausal women. J Physiol Pharmacol. 2018 Apr 
1;69:297-304.
Bakhshi Bajestani A. et al.
90 Razavi Int J Med. 2021; 9(3):e1077
8. Givehki R, Afshar H, Goli F, Scheidt CE, Omidi A, 
Davoudi M. Effect of acceptance and commitment therapy 
on body image flexibility and body awareness in patients 
with psychosomatic disorders: a randomized clinical trial. Electronic physician. 2018 Jul;10(7):7008. https://doi. 
org/10.19082/7008
9. Vickers NJ. Animal communication: when i’m 
calling you, will you answer too?. Current biology. 
2017 Jul 24;27(14):R713-5. https://doi.org/10.1016/j. 
cub.2017.05.064
10. Hemming L, Haddock G, Shaw J, Pratt D. Alexithymia and its associations with depression, suicidality, and 
aggression: an overview of the literature. Frontiers in 
psychiatry. 2019 Apr 11;10:203. https://doi.org/10.3389/ 
fpsyt.2019.00203
11. Hughes LS, Clark J, Colclough JA, Dale E, McMillan
D. Acceptance and commitment therapy (ACT) for chronic pain. The Clinical journal of pain. 2017 Jun 1;33(6):552-
68. https://doi.org/10.1097/AJP.0000000000000425
12. Hulbert‐Williams NJ, Storey L, Wilson KG. Psychological interventions for patients with cancer: psychological flexibility and the potential utility of Acceptance and 
Commitment Therapy. European journal of cancer care. 
2015 Jan;24(1):15-27. https://doi.org/10.1111/ecc.12223
13. Losada A, Márquez-González M, Romero-Moreno 
R, Mausbach BT, López J, Fernández-Fernández V, Nogales-González C. Cognitive–behavioral therapy (CBT) 
versus acceptance and commitment therapy (ACT) for dementia family caregivers with significant depressive symptoms: Results of a randomized clinical trial. Journal of 
consulting and clinical psychology. 2015 Aug;83(4):760. 
https://doi.org/10.1037/ccp0000028
14. Mironova O, Polyakova O, Ushkov F. Impact of compelled contacts on psychosomatic disorders of employees 
of organizations. Economic and social development: Book 
of Proceedings. 2017 Oct 30:878-85.
15. Kanten P, Gümüştekin G, Kanten S. Exploring the 
Role of A, B, C and D Personality Types on Individuals 
Work-Related Behaviors and Health Problems: A Theoretical Model. International Journal of Business and Management Invention. 2017;6(7):29-37.
16. Pluijmers EM, Denollet J. Type D personality as a 
predictor of poor health outcomes in patients with cardiovascular disease. Netherlands Heart Journal. 2017 Apr 
1;25(4):286-7. https://doi.org/10.1007/s12471-017-0949-
4
17. Scott W,McCracken LM. Psychological flexibility, acceptance and commitment therapy, and chronic pain. Current Opinion in Psychology. 2015 Apr 1;2:91-6. https:// 
doi.org/10.1016/j.copsyc.2014.12.013
18.YoonSJ.Influence oftype D personality, dietary assessment and increase exposure toward endocrine disrupting 
chemicals on the dysmenorrhea. Journal of the Korean Society of Maternal and Child Health. 2018 Jan 1;22(1):17-
24. https://doi.org/10.21896/jksmch.2018.22.1.17
19. Staniute M, Brozaitiene J, Burkauskas J, Kazukauskiene N, Mickuviene N, Bunevicius R. Type D personality, mental distress, social support and health-related quality of life in coronary artery disease patients with 
heart failure: a longitudinal observational study. Health 
and quality of life outcomes. 2015 Dec;13(1):1-1. https:// 
doi.org/10.1186/s12955-014-0204-2
20. Swain J, Hancock K, Dixon A, Bowman J. Acceptance and Commitment Therapy for children: A systematic review of intervention studies. Journal of Contextual 
Behavioral Science. 2015 Apr 1;4(2):73-85. https://doi. 
org/10.1016/j.jcbs.2015.02.001
21. Tilaki M, Taher M, Mojarrad A, Jafari Sani B. Efficacy 
of acceptance and commitment therapy on psychological 
flexibility and alexithymia of women with chronic pain. 
Journal of Psychological Studies. 2018 Oct 23;14(3):163-
78.
22. Trompetter HR, Bohlmeijer ET, Veehof MM, Schreurs 
KM. Internet-based guided self-help intervention for 
chronic pain based on Acceptance and Commitment 
Therapy: a randomized controlled trial. Journal of behavioral medicine. 2015 Feb 1;38(1):66-80. https://doi. 
org/10.1007/s10865-014-9579-0
23. Trompetter HR, Lamers SM, Westerhof GJ, Fledderus M, Bohlmeijer ET. Both positive mental health and 
psychopathology should be monitored in psychotherapy: Confirmation for the dual-factor model in acceptance and commitment therapy. Behaviour research and 
therapy. 2017 Apr 1;91:58-63. https://doi.org/10.1016/j. 
brat.2017.01.008
24. Twohig MP, Levin ME. Acceptance and commitment therapy as a treatment for anxiety and depression: 
a review. Psychiatric clinics. 2017 Dec 1;40(4):751-70. 
https://doi.org/10.1016/j.psc.2017.08.009
25. Hayes-Skelton SA, Roemer L, Orsillo SM. A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety 
disorder. Journal of consulting and clinical psychology. 
2013 Oct;81(5):761. https://doi.org/10.1037/a0032871
26. Malas O, Lucas I, Lario J, Aluja A. Psychometric 
properties of the Catalan version of DS14 scale for assessing Type-D personality. Anuario de Psicología. 2018 Jan 
1;48(1):1-8. https://doi.org/10.1016/j.anpsic.2018.04.001
27. Velasco-Benítez CA, Calderón-Guerrero OG, 
Ramírez-Villamizar J. Functional gastrointestinal disorders in schoolchildren with chronic abdominal pain 
in a pediatric digestive endoscopy unit. Universidad y 
Salud. 2020 Apr;22(1):52-7. https://doi.org/10.22267/ 
rus.202201.174
28. Scholten S, Velten J, Bieda A, Zhang XC, Margraf
J. Testing measurement invariance of the Depression, 
Anxiety, and Stress Scales (DASS-21) across four countries. Psychological Assessment. 2017 Nov;29(11):1376. 
https://doi.org/10.1037/pas0000440
29. Twohig MP, Vilardaga JC, Levin ME, Hayes SC. 
Changes in psychological flexibility during acceptance and commitment therapy for obsessive compulsive disorder. Journal of Contextual Behavioral Science. 2015 Jul 1;4(3):196-202. https://doi.org/10.1016/j. 
jcbs.2015.07.00