Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy on Cortisol Levels and Psychological Distress in Patients with Asthma
Keywords:
Cognitive-Behavioral Therapy, Acceptance and Commitment Therapy, Cortisol, Distress, AsthmaAbstract
Objective: The aim of the present study was to compare the effectiveness of Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) on cortisol levels and psychological distress in patients with asthma.
Methods and Materials: The research design was quasi-experimental, with pre-test and post-test and a control group. The statistical population consisted of all asthma patients who sought treatment and disease management at healthcare centers in Tehran between April and July 2024. A total of 90 patients were selected through convenience sampling and randomly assigned to three groups: the CBT group (30 individuals), the ACT group (30 individuals), and the control group (30 individuals). The data collection tools included salivary cortisol measured through the spitting method and the Kessler Psychological Distress Scale (Kessler et al., 2003). The intervention therapies were conducted in 8 weekly sessions of 90 minutes each, while the control group did not receive any specific treatment during this period. Data were analyzed using Multivariate Analysis of Covariance (MANCOVA).
Findings: The results indicated that both CBT and ACT were effective in reducing cortisol levels and psychological distress in patients with asthma (P < 0.05), and there was no significant difference in the effectiveness of the two therapeutic approaches (P > 0.05).
Conclusion: These findings potentially have important practical implications for professionals and therapists in considering the effectiveness of these therapeutic methods in improving asthma outcomes.
Downloads
References
Abbasi, F., Moradimanesh, F., Naderi, F., & Bakhtiarpour, S. (2020). The effectiveness of schema therapy on emotion regulation and quality of life in individuals with asthma. Journal of the Faculty of Medicine, Mashhad University of Medical Sciences, 63(2), 2446-2454. https://mjms.mums.ac.ir/article_16987.html
Ali Asgari, F., Majid, M., & Saghai, M. (2019). Determining the effectiveness of acceptance and commitment therapy on the quality of life of patients with asthma. Tbilisi, Georgia.
Ansari Bahjat, T., Tasbihsazan, S. R., Khademi, A., & Rezaei, M. K. (2021). The effectiveness of metacognitive therapy on worry, rumination, and asthma control in patients with asthma. Journal of Rehabilitation Research in Nursing, 7(3), 20-29. https://ijrn.ir/article-1-627-fa.html
Bahodirovna, A. D., Abdullah, S. M. H., Razaq, A. A., Tawfeeq Alghazali, T., Jalil, S. H., Al-Hamdani, M. M., Mohsin, R. M., & Fkhry, F. A. (2023). The Effects of Acceptance and Commitment Therapy on Anxiety and Depression in Patients with Asthma. Int J Body Mind Cult, 10(4). https://jnip.ir/article-1-735-fa.html
Balazadeh, L., Mirzaian, B., & Hassanzadeh, R. (2021). Modeling structural relationships of the brain-behavior system on psychological vulnerability with the mediating role of distress tolerance in patients with asthma. Scientific Journal of Researchers, 20(1), 41-50. https://doi.org/10.61186/psj.20.1.41
Bonnert, M., Andersson, E., Serlachius, E., Manninen, I. K., Bergström, S. E., & Almqvist, C. (2020). Exposure-based cognitive behavior therapy for anxiety related to asthma: A feasibility study with multivariate baseline design. Scandinavian journal of psychology, 61(6), 827-834. https://doi.org/10.1111/sjop.12674
Chong, Y. Y., Mak, Y. W., Leung, S. P., Lam, S. Y., & Loke, A. Y. (2019). Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT. Pediatrics, 143(2), e20181723. https://doi.org/10.1542/peds.2018-1723
Engel, S., Laufer, S., Klusmann, H., Schulze, L., Schumacher, S., & Knaevelsrud, C. (2023). Cortisol response to traumatic stress to predict PTSD symptom development - a systematic review and meta-analysis of experimental studies. European Journal of Psychotraumatology, 14(2), 2225153. https://doi.org/10.1080/20008066.2023.2225153
Feldman, J. M., Matte, L., Interian, A., Lehrer, P. M., Lu, S. E., Scheckner, B., Steinberg, D. M., Oken, T., Kotay, A., Sinha, S., & Shim, C. (2016). Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial. Behaviour Research and Therapy, 87, 142-154. https://doi.org/10.1016/j.brat.2016.09.007
Ghasemnejad, S. M., Haqayeq, S. A., Jahaniyan, S., & Rezaei Jamalooei, H. (2021). Comparing the effectiveness of cognitive-behavioral therapy and diaphragmatic breathing exercises on panic symptoms in women with asthma. Journal of Ilam University of Medical Sciences, 29(6), 11-19. https://doi.org/10.52547/sjimu.29.6.11
Giordano, F., Guidotti, S., Giordano, T., & Pruneti, C. (2023). Clinical and psychological aspects in a group of allergic asthma patients and the impact on their health status perception. Health Psychology Report, 11(4), 321-330. https://doi.org/10.5114/hpr/168790
Hayes, S. C., Stroshal, K. D., & Wilson, K. G. (2003). Acceptance and commitment therapy: an experiential approach to behavior change. Guilford Press. https://books.google.com/books/about/Acceptance_and_Commitment_Therapy.html?id=ZCeB0JxG6EcC
Kapoor, U., Tayal, G., Mittal, S. K., Sharma, V. K., & Tekur, U. (2003). Plasma cortisol levels in acute asthma. Indian journal of pediatrics, 70(12), 965-968. https://doi.org/10.1007/BF02723822
Khosrovirad, R., & Malakouti Far, M. (2021). Evaluating the effectiveness of group stress management therapy on the mental health of female patients with asthma. Semnan.
Luu, J., Millard, M., Newby, J., Haskelberg, H., Hobbs, M., & Mahoney, A. (2020). Internet-based cognitive behavioral therapy for treating symptoms of obsessive compulsive disorder in routine care. Journal of Obsessive-Compulsive and Related Disorders, 26, 100561. https://doi.org/10.1016/j.jocrd.2020.100561
Luyster, F. S., Ritterband, L. M., Sereika, S. M., Buysse, D. J., Wenzel, S. E., & Strollo, P. J. (2020). Internet-Based Cognitive-Behavioral Therapy for Insomnia in Adults With Asthma: A Pilot Study. Behavioral Sleep Medicine, 18(1), 10-22. https://doi.org/10.1080/15402002.2018.1518229
Nasiri Kalmarzi, R., Moradi, G., Ismail Majd, S., & Khanpour, F. (2018). The effectiveness of mindfulness-based cognitive therapy on the quality of life and mindfulness of asthma patients. Journal of Cognitive Psychology and Psychiatry, 5(5), 1-14. https://doi.org/10.29252/shenakht.5.5.1
Pateraki, E., & Morris, P. (2017). Effectiveness of cognitive behavioral therapy in reducing anxiety in adults and children with asthma: a systematic review. Journal of Asthma, 3(2), 45-56. https://pubmed.ncbi.nlm.nih.gov/28759284/
Pourhosseini Dehkordi, R., Sajadian, E., & Sharibafchi, M. R. (2019). The effectiveness of compassion-based therapy on perceived stress and psychological distress in women with breast cancer. Health Psychology, 8(31), 37-52. https://hpj.journals.pnu.ac.ir/article_6314.html
Romero-González, M., Marín, E., Guzmán-Parra, J., Navas, P., Aguilar, J. M., Lara, J. P., & Barbancho, M. Á. (2021). Relationship between parental stress and psychological distress and emotional and behavioural problems in pre-school children with autistic spectrum disorder. Anales de pediatria, 94(2), 99-106. https://doi.org/10.1016/j.anpede.2020.03.014
Scott, A. J., Bisby, M. A., Heriseanu, A. I., Salameh, Y., Karin, E., Fogliati, R., Dudeney, J., Gandy, M., McLellan, L. F., Wootton, B., McDonald, S., Correa, A., Titov, N., & Dear, B. F. (2023). Cognitive behavioral therapies for depression and anxiety in people with chronic disease: A systematic review and meta-analysis. Clinical psychology review, 106, 102353. https://doi.org/10.1016/j.cpr.2023.102353
Sicouri, G. (2023). Chapter 14 - Anxiety in youth with asthma and cognitive behavioral therapy. In Childhood, Adolescence, Pregnancy, Adulthood, and Aging (pp. 157-170). https://doi.org/10.1016/B978-0-323-85757-4.00005-5
Vasiliadis, H. M., Chudzinski, V., Gontijo-Guerra, S., & Préville, M. (2015). Screening instruments for a population of older adults: The 10-item Kessler Psychological Distress Scale (K10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7). Psychiatry research, 228(1), 89-94. https://doi.org/10.1016/j.psychres.2015.04.019
Vink, N. H., Boezen, M., Postma, D., & Rosmalen, J. (2013). European Respiratory Journal. European Respiratory Journal, 41(4), 846-852. https://doi.org/10.1183/09031936.00021212
Zargar, F., Rabiei, M., Naderi, Z., & Tarrahi, M. J. (2022). The Effect of Group Acceptance and Commitment Therapy on the Management of Asthma: A Randomized Clinical Trial. Iran J Psychiatry Behav Science, 16(1), e114534. https://doi.org/10.5812/ijpbs.114534
Downloads
Additional Files
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2024 Seyed Soroush Ghaffari (Author); Mohammad Taqi Badeleh Shamooshaki (Corresponding Author); Leila Sadat Azizi Ziabari , Javanshir Asadi (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

