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ahmadi mahali S F, baghbanian S M, Fendreski A, bagheri M. The Effectiveness of Cognitive Behavioral Therapy on Resilience, Distress Tolerance, and Quality of Life in Women with Multiple Sclerosis During the Acute Phase: A Clinical Trial Study. TB 2025; 23 (6) :1-15
URL: http://tbj.ssu.ac.ir/article-1-3657-en.html
URL: http://tbj.ssu.ac.ir/article-1-3657-en.html
Mazandaran University of Medical Sciences , Mbagheri66.mb@gmail.com
Keywords: Cognitive-Behavioral Therapy, Multiple Sclerosis, Resilience, Distress Tolerance, Quality of Life
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The Effectiveness of Cognitive Behavioral Therapy on Resilience, Distress Tolerance, and Quality of Life in Women with Multiple Sclerosis During the Acute Phase: A Clinical Trial Study
Seyed Fatemeh Ahmadi mahali(M.A)1, Seyed Mohammad Baghbanian(Ph.D.)2, Afsane Fendreski(Ph.D.)3, Maede Bagheri(Ph.D)4
1.MA of clinical psychology ,Sari branch , Islamic Azad University of Sari, Sari, Iran
2.Associate Professor Medical Department , Faculty of Medicine, University of medical sciences-medical services of Mazandaran, sari , Iran
3.Assistant Professor of Biostatistics, Department of Epidemiology and Biostatistic, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
4. Corresponding Author :Assistant Professor of Health psychology, Department of psychiatry and psychosomatic research center, Mazandaran University of Medical Sciences, Sari, Iran
Email:bagheri.ma@mazums.ac.ir Tel: +98 -9113546225
Abstract
Introduction: multiple sclerosis (MS) is a neurodevelopmental disorder in which patients experience several cognitive problems in addition to physical problems.the present study aimed to investigate the effectiveness of cognitive behavioral therapy on resilience, distress tolerance and improving the quality of life of women with acute MS Phase.
Methods.The present study was of the pre-test-post-test semi-experimental intervention type accompanied by the control group. 30 women with MS in the acute stage of the disease visiting the super specialized clinic of the bo ali Sina Hospital in Surrey in 1402 to 1403, sampling methods were available and selected based on entry and exit criteria and randomly (lottery method) in two groups of 15 people intervened and controlled.Both groups responded to Connor and Davidson's resilience questionnaires, Simmons wager's tolerance, and quality of life related to MS Hobart patients and colleagues before and after the intervention. The therapeutic intervention was carried out in 8 sessions according to the Heimberg and Becker protocols.Pre-test and post-test data were analyzed using variance analysis(ANCOVA) and SPSS software version 26.
Rusults: cognitive behavioral therapy has had a significant impact on resilience, ( P<0/001,B=9/51), distress tolerance (P<0/001, B=0/245) and quality of life, ( P<0/001,B=-15/31) in women with MS in the acute stage of the disease.
Conclusion: it is suggested that psychological interventions such as cognitive - behavioral therapy are also provided for patients in the acute stage of the disease.
Keywords: cognitive behavioral therapy, multiple sclerosis, resilience, tolerance of distress , quality of life
Conflict of interest: The authors declared no conflict of interest.
Refrences
1-Roozbeh B, Azimi M, Pourmovahed Z. Spiritual Health of Mothers of Children with Cancer and Other Chronic Diseases: A Comparative Study. Journal of Pizhūhish dar dīn va Salāmat (ie, Research on Religion & Health). 2023;9(2):38-49.
2-Mehraban S, Bahmani B, Azkhosh M & et al. Facilitators and Barriers to Adapting to the Disease: The Lived Experience of Patients With Multiple Sclerosis. Archives of Rehabilitation. 2023;24(3):328-45.
3-McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. Jama. 2021;325(8):765-79.
4-Florea A, Maurey H, Le Sauter M & et al, depression, and quality of life in children with multiple sclerosis: a comparative study with other demyelinating diseases. Developmental Medicine & Child Neurology. 2020;62(2):241-4.
5-Lublin FD, Reingold SC, Cohen JA & et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83(3):278-86.
6-Afrozeh M, Heidarzadeh A, Moghadam-Ahmadi A & et al. The Effectiveness of Stress Control Training on the Quality of Life of Female Patients with Multiple Sclerosis. Community Health Journal. 2023;17(2):84-94.
7-Zhou R, Li H, Yang H & et al. Serological markers exploration and real-world effectiveness and safety of teriflunomide in south Chinese patients with multiple sclerosis. Multiple sclerosis and related disorders. 2022;58:103446.
8-Amini P, Almasi-Hashiani A, Sahraian MA & et al. Multiple sclerosis projection in Tehran, Iran using Bayesian structural time series. BMC neurology. 2021;21(1):235.
9-Frahm N, Fneish F, Ellenberger D & et al. SARS-CoV-2 vaccination in patients with multiple sclerosis in Germany and the United Kingdom: Gender-specific results from a longitudinal observational study. The Lancet Regional Health–Europe. 2022;22.
10-Jahantigh D, Moghtaderi A, Narooie NM. Association between Polymorphism in XRCC7 Gene (G6721T) and Risk of Multiple Sclerosis: A Case-control Study. 2023.
11-Saravani S, Poursamimi J. Comparative Evaluation of Nutritional Pattern and Quality of Life the Subjects with Multiple Sclerosis as an Autoimmune Disease and Some of Its Risk Factors in Zabol City. Journal of Zabol Medical School. 2023.
12-Hale S, Myerson J, Strube MJ & et al. Distress signals: Age differences in psychological distress before and during the COVID-19 pandemic. International journal of environmental research and public health. 2023;20(4):3549.
13-Aboutalebi H, Yazdchi N, Smkhani Akbarinejhad H. Effectiveness of compassion-focused therapy on death anxiety and quality of life among women with multiple sclerosis. Medical Science Journal of Islamic Azad Univesity-Tehran Medical Branch. 2022;32(1):92-101.
14-Molton IR, Koelmel E, Curran M & et al. Pilot intervention to promote tolerance for uncertainty in early multiple sclerosis. Rehabilitation psychology. 2019;64(3):339.
15-Abdollahi R, Rajabi FH, Farkhojasteh VS. Influence of training the skills of establishing an effective communication on resilience and social adjustment in One of the military universitys students. 2021.
16-Tajbakhsh R, Haddadi S, Zeighami Mohammadi S & et al. Comparison of the Effect of" Acceptance and Commitment Therapy" and" Metacognitive Therapy" on the resilience of Women Undergoing Hemodialysis. Journal of Health Promotion Management. 2023;12(3):82-94.
17-Rette DN, Arnold MS, McDonald EM & et al. Influences on childhood depressive symptoms: The effects of trauma and distress tolerance across age and sex groups. Journal of affective disorders. 2021;283:373-6.
18-Shahidi S, Hasanzadeh R, Mirzaian B. The effectiveness of metacognitive therapy on psychological toughness and distress tolerance in female patients with psoriasis. Applied Family Therapy Journal (AFTJ). 2022;3(5):374-88.
19-Haghparast Nasrabadi E, Mirza M, Hoseini M & et al. The effectiveness of mindfulness-based stress reduction on quality of life and anxiety tolerance of heart patients. medical journal of mashhad university of medical sciences. 2021;64(4):3661-72.
20-Kidd T, Carey N, Mold F & et al. A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life. PloS one. 2017;12(10):e0185931.
21-Dortaj A, Aliakbari Dehkordi M, Nasermoghaddasi A & et al. Comparison of the Effectiveness of Cognitive-behavioral Stress Management Training and Acceptance and Commitment Therapy in Distress Tolerance and Perception of Pain in Patients with Multiple Sclerosis: A two-month Follow-up. Journal of Modern Psychological Researches. 2020;14(56):191-212.
22-Ghafari F, Agah S, Irani S & et al. Relationship between demographic and pathological characteristics on the 5-year survival rate of gastric cancer patients in Tehran province. Tehran University of Medical Sciences Journal. 2022;80(8):670-8.
23-Tabibzadeh F, Azar FS. The Effect of Cognitive-Behavioral Therapy on the Resilience and Obsessive Rumination among Multiple Sclerosis (MS) Patients. Middle Eastern Journal of Disability Studies. 2017;7(1):45.
24-Heidari M, Mami S, Ahmadi V & et al. The effectiveness of schema therapy with cognitive behavioral therapy on self-efficacy and quality of life in women with MS: a clinical trial study. Journal of Applied Family Therapy. 2023;4(1):554-70.
25-Connor KM, Davidson JR. Development of a new resilience scale: The Connor‐Davidson resilience scale (CD‐RISC). Depression and anxiety. 2003;18(2):76-82.
26-Mohammadi M, Jazayeri A, Rafiei A & et al. Investigating the factors affecting resilience in people at risk of substance abuse. Tehran: University of Social Welfare and Rehabilitation Sciences. 2005.
27-Simons JS, Gaher RM. The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and emotion. 2005;29:83-102.
28-Alavi K, Modarres GM, Amin Y & et al. Effectiveness of group dialectical behavior therapy (based on core mindfulness, distress tolerance and emotion regulation components) on depressive symptoms in university students. 2011.
29-Dakani M, Fakhri MK, Hassanzadeh R. The effectiveness of mindfulness-based cognitive therapy on anxiety tolerance and cognitive flexibility in patients with type 2 diabetes. 2021.
30-Hobart J, Lamping D, Fitzpatrick R & et al. The multiple sclerosis impact scale (MSIS-29) a new patient-based outcome measure. Brain. 2001;124(5):962-73.
31-McGuigan C, Hutchinson M. The multiple sclerosis impact scale (MSIS-29) is a reliable and sensitive measure. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75(2):266-9.
32-Ayatollahi P, Nafissi S, Eshraghian M & et al. Cross-cultural adaptation of the multiple sclerosis impact scale (msis-29) for iranian ms patients, evaluation of reliability and validity. Tehran University of Medical Sciences Journal. 2006;64(1):62-8.
33-Rostamnezhad M, Tayyebi PD, Abolghasemi PD & et al. Presentation of a Structural Model Explaining MS Patients’ Quality of Life based on their Lifestyle with the Mediating Role of Psychological Capital. Quarterly Journal of Family and Research. 2021;18(1):87-104.
34-Heimberg RG, Becker RE. Cognitive-behavioral group therapy for social phobia: Basic mechanisms and clinical strategies: Guilford Press; 2002.
35-Gao L, Yu W, Wang C. Effects of Cognitive-Behavioral Therapy on Psychological Resilience, Social Adaptation and Clinical Efficacy of Patients with Bone Tumors. Pakistan Journal of Medical Sciences. 2023;39(4):1045.
36-Baba Vajrala D, JasminDebora MS. The Efficacy of Cognitive Behavior Therapy on Resilience in Acute Coronary Syndrome Patients. Journal of Positive School Psychology. 2022;6(2):5272-9.
37-Isvand M, Baghouli H, Javidi HA & et al. Comparing the effectiveness of cognitive behavioral therapy and acceptance and commitment therapy for rumination, psychological flexibility, resilience, and perceived stress among the women suffering from depression. Psychological Achievements. 2023.
38-Taghizadeh M. Effectiveness of Cognitive Behavioral Therapy group on the resilience of Women with Breast Cancer. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2023;8(3):1-12.
39-Weiss LA, Westerhof GJ, Bohlmeijer ET. Can we increase psychological well-being? The effects of interventions on psychological well-being: A meta-analysis of randomized controlled trials. PloS one. 2016;11(6):e0158092.
40-Aliyari Khanshan Vatan F, Ahadi H, Kalhornia Golkar M & et al. The Effectiveness of Cognitive-Behavioral Therapy in Anxiety and Distress Tolerance in Patients with Coronary Heart Diseases. Iranian Journal of Rehabilitation Research. 2022;8(3):54-65.
41-Hosein Esfand Zad A, Shams G, Pasha Meysami A & et al. The role of mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness in predicting obsessive-compulsive symptoms. Iranian Journal of Psychiatry and Clinical Psychology. 2017;22(4):270-83.
Seyed Fatemeh Ahmadi mahali(M.A)1, Seyed Mohammad Baghbanian(Ph.D.)2, Afsane Fendreski(Ph.D.)3, Maede Bagheri(Ph.D)4
1.MA of clinical psychology ,Sari branch , Islamic Azad University of Sari, Sari, Iran
2.Associate Professor Medical Department , Faculty of Medicine, University of medical sciences-medical services of Mazandaran, sari , Iran
3.Assistant Professor of Biostatistics, Department of Epidemiology and Biostatistic, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
4. Corresponding Author :Assistant Professor of Health psychology, Department of psychiatry and psychosomatic research center, Mazandaran University of Medical Sciences, Sari, Iran
Email:bagheri.ma@mazums.ac.ir Tel: +98 -9113546225
Abstract
Introduction: multiple sclerosis (MS) is a neurodevelopmental disorder in which patients experience several cognitive problems in addition to physical problems.the present study aimed to investigate the effectiveness of cognitive behavioral therapy on resilience, distress tolerance and improving the quality of life of women with acute MS Phase.
Methods.The present study was of the pre-test-post-test semi-experimental intervention type accompanied by the control group. 30 women with MS in the acute stage of the disease visiting the super specialized clinic of the bo ali Sina Hospital in Surrey in 1402 to 1403, sampling methods were available and selected based on entry and exit criteria and randomly (lottery method) in two groups of 15 people intervened and controlled.Both groups responded to Connor and Davidson's resilience questionnaires, Simmons wager's tolerance, and quality of life related to MS Hobart patients and colleagues before and after the intervention. The therapeutic intervention was carried out in 8 sessions according to the Heimberg and Becker protocols.Pre-test and post-test data were analyzed using variance analysis(ANCOVA) and SPSS software version 26.
Rusults: cognitive behavioral therapy has had a significant impact on resilience, ( P<0/001,B=9/51), distress tolerance (P<0/001, B=0/245) and quality of life, ( P<0/001,B=-15/31) in women with MS in the acute stage of the disease.
Conclusion: it is suggested that psychological interventions such as cognitive - behavioral therapy are also provided for patients in the acute stage of the disease.
Keywords: cognitive behavioral therapy, multiple sclerosis, resilience, tolerance of distress , quality of life
Conflict of interest: The authors declared no conflict of interest.
Refrences
1-Roozbeh B, Azimi M, Pourmovahed Z. Spiritual Health of Mothers of Children with Cancer and Other Chronic Diseases: A Comparative Study. Journal of Pizhūhish dar dīn va Salāmat (ie, Research on Religion & Health). 2023;9(2):38-49.
2-Mehraban S, Bahmani B, Azkhosh M & et al. Facilitators and Barriers to Adapting to the Disease: The Lived Experience of Patients With Multiple Sclerosis. Archives of Rehabilitation. 2023;24(3):328-45.
3-McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. Jama. 2021;325(8):765-79.
4-Florea A, Maurey H, Le Sauter M & et al, depression, and quality of life in children with multiple sclerosis: a comparative study with other demyelinating diseases. Developmental Medicine & Child Neurology. 2020;62(2):241-4.
5-Lublin FD, Reingold SC, Cohen JA & et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83(3):278-86.
6-Afrozeh M, Heidarzadeh A, Moghadam-Ahmadi A & et al. The Effectiveness of Stress Control Training on the Quality of Life of Female Patients with Multiple Sclerosis. Community Health Journal. 2023;17(2):84-94.
7-Zhou R, Li H, Yang H & et al. Serological markers exploration and real-world effectiveness and safety of teriflunomide in south Chinese patients with multiple sclerosis. Multiple sclerosis and related disorders. 2022;58:103446.
8-Amini P, Almasi-Hashiani A, Sahraian MA & et al. Multiple sclerosis projection in Tehran, Iran using Bayesian structural time series. BMC neurology. 2021;21(1):235.
9-Frahm N, Fneish F, Ellenberger D & et al. SARS-CoV-2 vaccination in patients with multiple sclerosis in Germany and the United Kingdom: Gender-specific results from a longitudinal observational study. The Lancet Regional Health–Europe. 2022;22.
10-Jahantigh D, Moghtaderi A, Narooie NM. Association between Polymorphism in XRCC7 Gene (G6721T) and Risk of Multiple Sclerosis: A Case-control Study. 2023.
11-Saravani S, Poursamimi J. Comparative Evaluation of Nutritional Pattern and Quality of Life the Subjects with Multiple Sclerosis as an Autoimmune Disease and Some of Its Risk Factors in Zabol City. Journal of Zabol Medical School. 2023.
12-Hale S, Myerson J, Strube MJ & et al. Distress signals: Age differences in psychological distress before and during the COVID-19 pandemic. International journal of environmental research and public health. 2023;20(4):3549.
13-Aboutalebi H, Yazdchi N, Smkhani Akbarinejhad H. Effectiveness of compassion-focused therapy on death anxiety and quality of life among women with multiple sclerosis. Medical Science Journal of Islamic Azad Univesity-Tehran Medical Branch. 2022;32(1):92-101.
14-Molton IR, Koelmel E, Curran M & et al. Pilot intervention to promote tolerance for uncertainty in early multiple sclerosis. Rehabilitation psychology. 2019;64(3):339.
15-Abdollahi R, Rajabi FH, Farkhojasteh VS. Influence of training the skills of establishing an effective communication on resilience and social adjustment in One of the military universitys students. 2021.
16-Tajbakhsh R, Haddadi S, Zeighami Mohammadi S & et al. Comparison of the Effect of" Acceptance and Commitment Therapy" and" Metacognitive Therapy" on the resilience of Women Undergoing Hemodialysis. Journal of Health Promotion Management. 2023;12(3):82-94.
17-Rette DN, Arnold MS, McDonald EM & et al. Influences on childhood depressive symptoms: The effects of trauma and distress tolerance across age and sex groups. Journal of affective disorders. 2021;283:373-6.
18-Shahidi S, Hasanzadeh R, Mirzaian B. The effectiveness of metacognitive therapy on psychological toughness and distress tolerance in female patients with psoriasis. Applied Family Therapy Journal (AFTJ). 2022;3(5):374-88.
19-Haghparast Nasrabadi E, Mirza M, Hoseini M & et al. The effectiveness of mindfulness-based stress reduction on quality of life and anxiety tolerance of heart patients. medical journal of mashhad university of medical sciences. 2021;64(4):3661-72.
20-Kidd T, Carey N, Mold F & et al. A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life. PloS one. 2017;12(10):e0185931.
21-Dortaj A, Aliakbari Dehkordi M, Nasermoghaddasi A & et al. Comparison of the Effectiveness of Cognitive-behavioral Stress Management Training and Acceptance and Commitment Therapy in Distress Tolerance and Perception of Pain in Patients with Multiple Sclerosis: A two-month Follow-up. Journal of Modern Psychological Researches. 2020;14(56):191-212.
22-Ghafari F, Agah S, Irani S & et al. Relationship between demographic and pathological characteristics on the 5-year survival rate of gastric cancer patients in Tehran province. Tehran University of Medical Sciences Journal. 2022;80(8):670-8.
23-Tabibzadeh F, Azar FS. The Effect of Cognitive-Behavioral Therapy on the Resilience and Obsessive Rumination among Multiple Sclerosis (MS) Patients. Middle Eastern Journal of Disability Studies. 2017;7(1):45.
24-Heidari M, Mami S, Ahmadi V & et al. The effectiveness of schema therapy with cognitive behavioral therapy on self-efficacy and quality of life in women with MS: a clinical trial study. Journal of Applied Family Therapy. 2023;4(1):554-70.
25-Connor KM, Davidson JR. Development of a new resilience scale: The Connor‐Davidson resilience scale (CD‐RISC). Depression and anxiety. 2003;18(2):76-82.
26-Mohammadi M, Jazayeri A, Rafiei A & et al. Investigating the factors affecting resilience in people at risk of substance abuse. Tehran: University of Social Welfare and Rehabilitation Sciences. 2005.
27-Simons JS, Gaher RM. The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and emotion. 2005;29:83-102.
28-Alavi K, Modarres GM, Amin Y & et al. Effectiveness of group dialectical behavior therapy (based on core mindfulness, distress tolerance and emotion regulation components) on depressive symptoms in university students. 2011.
29-Dakani M, Fakhri MK, Hassanzadeh R. The effectiveness of mindfulness-based cognitive therapy on anxiety tolerance and cognitive flexibility in patients with type 2 diabetes. 2021.
30-Hobart J, Lamping D, Fitzpatrick R & et al. The multiple sclerosis impact scale (MSIS-29) a new patient-based outcome measure. Brain. 2001;124(5):962-73.
31-McGuigan C, Hutchinson M. The multiple sclerosis impact scale (MSIS-29) is a reliable and sensitive measure. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75(2):266-9.
32-Ayatollahi P, Nafissi S, Eshraghian M & et al. Cross-cultural adaptation of the multiple sclerosis impact scale (msis-29) for iranian ms patients, evaluation of reliability and validity. Tehran University of Medical Sciences Journal. 2006;64(1):62-8.
33-Rostamnezhad M, Tayyebi PD, Abolghasemi PD & et al. Presentation of a Structural Model Explaining MS Patients’ Quality of Life based on their Lifestyle with the Mediating Role of Psychological Capital. Quarterly Journal of Family and Research. 2021;18(1):87-104.
34-Heimberg RG, Becker RE. Cognitive-behavioral group therapy for social phobia: Basic mechanisms and clinical strategies: Guilford Press; 2002.
35-Gao L, Yu W, Wang C. Effects of Cognitive-Behavioral Therapy on Psychological Resilience, Social Adaptation and Clinical Efficacy of Patients with Bone Tumors. Pakistan Journal of Medical Sciences. 2023;39(4):1045.
36-Baba Vajrala D, JasminDebora MS. The Efficacy of Cognitive Behavior Therapy on Resilience in Acute Coronary Syndrome Patients. Journal of Positive School Psychology. 2022;6(2):5272-9.
37-Isvand M, Baghouli H, Javidi HA & et al. Comparing the effectiveness of cognitive behavioral therapy and acceptance and commitment therapy for rumination, psychological flexibility, resilience, and perceived stress among the women suffering from depression. Psychological Achievements. 2023.
38-Taghizadeh M. Effectiveness of Cognitive Behavioral Therapy group on the resilience of Women with Breast Cancer. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2023;8(3):1-12.
39-Weiss LA, Westerhof GJ, Bohlmeijer ET. Can we increase psychological well-being? The effects of interventions on psychological well-being: A meta-analysis of randomized controlled trials. PloS one. 2016;11(6):e0158092.
40-Aliyari Khanshan Vatan F, Ahadi H, Kalhornia Golkar M & et al. The Effectiveness of Cognitive-Behavioral Therapy in Anxiety and Distress Tolerance in Patients with Coronary Heart Diseases. Iranian Journal of Rehabilitation Research. 2022;8(3):54-65.
41-Hosein Esfand Zad A, Shams G, Pasha Meysami A & et al. The role of mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness in predicting obsessive-compulsive symptoms. Iranian Journal of Psychiatry and Clinical Psychology. 2017;22(4):270-83.
Type of Study: Research |
Subject:
Psychology
Received: 2024/08/13 | Accepted: 2024/12/11 | Published: 2025/02/28
Received: 2024/08/13 | Accepted: 2024/12/11 | Published: 2025/02/28
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