The Effectiveness of Acceptance and Commitment Therapy on Cognitive Emotion Regulation and Experiential Avoidance in Individuals with Leprosy in Tabriz

Authors

    Fatemeh Mohaddes Ardabili Master's Student, Department of Psychology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
    Ameneh Sadat Kazemi * Assistant Professor, Department of Psychology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran. sadat.kazemi@yahoo.com
    Narges Rasouli Assistant Professor, Department of Psychology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
https://doi.org/10.61838/kman.jarac.7.3.4

Abstract

Objective: The present study aimed to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on cognitive emotion regulation and experiential avoidance in individuals with leprosy in Tabriz.

Methods and Materials: The research method was a quasi-experimental design with a pretest-posttest control group. The study population consisted of all individuals with leprosy in Tabriz in 2023. After a clinical interview and considering the inclusion and exclusion criteria, 32 participants were selected through convenience sampling and randomly assigned to experimental (n=16) and control (n=16) groups. Both groups were assessed using the Cognitive Emotion Regulation Questionnaire (Garnefski et al., 2002) and the Acceptance and Action Questionnaire (Bond et al., 2011). The experimental group received eight sessions of ACT over two months, with one 90-minute group therapy session per week. At the end of the treatment, both groups completed the cognitive emotion regulation and experiential avoidance questionnaires again. The data were analyzed using multivariate covariance analysis.

Findings: The results of the data analysis showed a significant difference between the experimental and control groups in terms of cognitive emotion regulation and experiential avoidance in individuals with leprosy (P<0.01). After the intervention, the level of maladaptive emotion regulation and experiential avoidance in the experimental group significantly decreased compared to the pretest and control group, while adaptive emotion regulation in the experimental group significantly increased compared to the pretest and control group, leading to significant changes in cognitive emotion regulation and experiential avoidance.

Conclusion:  Therefore, the findings suggest that ACT affects cognitive emotion regulation and experiential avoidance in individuals with leprosy. The results of this study highlight some of the capabilities of this method in treating cognitive emotion regulation and experiential avoidance, demonstrating its potential as an effective therapy for individuals with leprosy.

 

Downloads

Download data is not yet available.

References

Abdi, S., Babapoor Khiraddin, J., & Fathi, H. (2010). The relationship between cognitive emotion regulation styles and general health in students. Scientific Research Journal of the Army University of Medical Sciences, 8(4), 258-264.

Amaral, L. K. D. S., Felippe, L. A., Gonçalves, G. H., & Christofoletti, G. (2021). Activity limitations in leprosy and their association to cognition and neuropsychiatric symptoms. Revista Brasileira de Enfermagem, 74, e20200649. https://doi.org/10.1590/0034-7167-2020-0649

Ameri, N., & Najafi, M. (2021). The mediating role of psychological distress (stress, anxiety, and depression) in the relationship between experiential avoidance and obsessive-compulsive symptoms. Psychological studies, 17(4), 11-31.

Azami, Y., Sohrabi, F., Barjalli, A., & Chopan, H. (2014). Effectiveness of emotion regulation training based on the Gross process model in reducing impulsivity in individuals dependent on substances. Addiction Research Quarterly, 8(30), 128-142.

Barcelos, R. M. F. M., Sousa, G. S. D., Almeida, M. V. D., Palacio, F. G. L., Gaíva, M. A. M., & Ferreira, S. M. B. (2021). Leprosy patients quality of life: a scoping review. Revista da Escola de Enfermagem da USP, 55, e20200357. https://doi.org/10.1590/1980-220x-reeusp-2020-0357

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance. Behavior therapy, 42(4), 676-688. https://doi.org/10.1016/j.beth.2011.03.007

Bonkass, A. K., Fastenau, A., Stuetzle, S., Boeckmann, M., & Nadiruzzaman, M. (2024). Psychosocial interventions for persons affected by Leprosy: A systematic review. PLOS Mental Health, 1(3), e0000091. https://doi.org/10.1371/journal.pmen.0000091

Fahlekar, A., Faal, M., Zahedzadeh, F., Amani, O., & Askari, M. (2020). The effect of acceptance and commitment therapy on emotional regulation and coping strategies in patients with generalized anxiety disorder. Quarterly Journal of Child Mental Health, 6(4), 253-265. https://doi.org/10.29252/jcmh.6.4.23

Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and depression. Personality and individual differences, 30, 1311-1327. https://doi.org/10.1016/S0191-8869(00)00113-6

Hassan, M. (2023). A Comprehensive Review of Physiotherapy Interventions in the Management of Leprosy. Journal for ReAttach Therapy and Developmental Diversities, 6(9s (2)), 1799-1803. https://doi.org/10.53555/jrtdd.v6i9s(2).2581

Haverkort, E., & van't Noordende, A. T. (2022). Health workers' perceptions of leprosy and factors influencing their perceptions in endemic countries: A systematic literature review. Leprosy Review, 93(4), 332-347. https://doi.org/10.47276/lr.93.4.332

Hayes-Skelton, S. A., & Eustis, E. H. (2020). Experiential avoidance. https://doi.org/10.1037/0000150-007

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.

Hooper, N., Dack, C., Karekla, M., Niyazi, A., & McHugh, L. (2018). Cognitive defusion versus experiential avoidance in the reduction of smoking behaviour: an experimental and preliminary investigation. Addiction Research & Theory, 26(5), 414-420. https://doi.org/10.1080/16066359.2018.1434156

Lee, S. A., Jobe, M. C., Mathis, A. A., & Gibbons, J. A. (2020). Incremental validity of coronaphobia: Coronavirus anxiety explains depression, generalized anxiety, and death anxiety. Journal of anxiety disorders, 74, 102268. https://doi.org/10.1016/j.janxdis.2020.102268

Li, X., Ma, Y., Li, G., Jin, G., Xu, L., Li, Y., & Zhang, L. (2024). Leprosy: treatment, prevention, immune response and gene function. Frontiers in Immunology, 15, 1298749. https://doi.org/10.3389/fimmu.2024.1298749

Mirbagheri, S. R., Khosravi, S., & Akrami, M. (2022). Investigating the effectiveness of group acceptance and commitment therapy on death anxiety and emotional distress in women with breast cancer. Journal of Cognitive Psychology and Psychiatry, 9(5), 16-28. https://doi.org/10.32598/shenakht.9.5.16

Na, E., Lee, K., Jeon, B. H., Jo, C., Kwak, U. H., Jeon, Y., & Jeong, J. (2022). Acceptance and commitment therapy for destructive experiential avoidance (ACT-DEA): a feasibility study. International journal of environmental research and public health, 19(24), 16434. https://doi.org/10.3390/ijerph192416434

Prakoeswa, C. R. S., Alinda, M. D., Kusumaputra, B. H., Nasir, A., Yusuf, A., & Listiawan, M. Y. (2021). The Effectiveness of Fear of Leprosy as a Mediator of the Relationship Between Resilience, Coping Resources, and Coping: A Correlation Study Through The Structural Equation Model in Patients with Leprosy. https://doi.org/10.21203/rs.3.rs-1159634/v1

Rajabzadeh, A. (2017). Comparison of rumination, cognitive emotion regulation, and parent communication skills in divorced and normal students Faculty of Educational Sciences and Psychology, Marvdasht Unit].

Rouhi, M., Manzari Tavakoli, A., & Tajrobehkar, M. (2023). Comparison of the effectiveness of acceptance and commitment therapy with dialectical behavior therapy on integrative self-knowledge, emotion regulation, and quality of life in hemodialysis patients. Journal of Cognitive Psychology and Psychiatry, 10(2), 131-146. https://doi.org/10.32598/shenakht.10.2.131

Salazar, M. C. R., & Ballesteros, Á. P. V. (2015). Effect of an ACT Intervention on Aerobic Endurance and Experiential Avoidance in Walkers. Revista Costarricense de Psicología, 34(2), 96-111.

Sanchez, T. A., Rizzo Duarte de Carvalho, J., Ramos, L. R., da Fonseca, L. M. B., Gomes, M. K., Jandre dos Reis, F. J., & Gasparetto, E. L. (2021). Brain emotional reactivity with anxiety symptoms in treated leprosy patients: An evaluation of a stigmatized condition. Stigma and Health, 6(3), 354. https://doi.org/10.1037/sah0000278

Sari, P. I., & Pranoto, B. E. (2022). An Analysis of Illocutionary Act and Perlocutionary Act Towards the Queen Elizabeth's Speech Entitled We Will Succeed and Better Days Will Come. Linguistics and Literature Journal, 3(1), 24-33.

Serrano-Coll, H., Velez, J. D., Trochez, D., Beltran, J. C., Suanca, D., Monsalve, F., & Cardona-Castro, N. (2016). Effectiveness of an individual physical rehabilitation programme in a group of patients with Hansen's disease. Leprosy Review, 87(3), 355-367. https://doi.org/10.47276/lr.87.3.355

Shokre, E., & Souilm, N. (2018). Effectiveness of psychiatric nursing program for coping in improving self-concept among leprosy patients. International Journal of Novel Research in Healthcare and Nursing, 5(1), 342-353.

Siagian, J. N., Purwantyastuti, I., & Menaldi, S. L. (2022). Analysis of therapeutic effectiveness and adverse effects of long-term corticosteroids among leprosy patients with reactions: A retrospective cohort study. Sage Open Medicine, 10, 20503121221089448. https://doi.org/10.1177/20503121221089448

Smith, B. M., Smith, G. S., & Dymond, S. (2020). Relapse of anxiety-related fear and avoidance: Conceptual analysis of treatment with acceptance and commitment therapy. Journal of the Experimental Analysis of Behavior, 113(1), 87-104. https://doi.org/10.1002/jeab.573

Somar, P. M. W., Waltz, M. M., & Van Brakel, W. H. (2020). The impact of leprosy on the mental wellbeing of leprosy-affected persons and their family members: a systematic review. Global Mental Health, 7, e15. https://doi.org/10.1017/gmh.2020.3

Taghizadeh, M. (2022). The effectiveness of cognitive-behavioral group therapy on the resilience of women with breast cancer. Quarterly of Nursing, Midwifery, and Paramedical Sciences, 8(3), 1-12.

van Dorst, M. M., van Netten, W. J., Waltz, M. M., Pandey, B. D., Choudhary, R., & van Brakel, W. H. (2020). Depression and mental wellbeing in people affected by leprosy in southern Nepal. Global Health Action, 13(1), 1815275. https://doi.org/10.1080/16549716.2020.1815275

Wen, W., Cui, H., & Ke, Y. (2020). Directors with foreign experience and corporate tax avoidance. Journal of Corporate Finance, 62, 101624. https://doi.org/10.1016/j.jcorpfin.2020.101624

World Health Organization. (2021). Towards zero leprosy: global Leprosy (Hansen's disease) Strategy 2021-2030. World Health Organization.

Yousefi, F. (2006). Investigating the relationship between cognitive emotion strategies and depression and anxiety in students of gifted guidance centers. Research in the Field of Exceptional Children, 6(4), 829-871.

Zakiei, A., Khazaie, H., Rostampour, M., Lemola, S., Esmaeili, M., Dürsteler, K., & Brand, S. (2021). Acceptance and commitment therapy (ACT) improves sleep quality, experiential avoidance, and emotion regulation in individuals with insomnia: results from a randomized interventional study. Life, 11(2), 133. https://doi.org/10.3390/life11020133

Zarling, A., Lawrence, E., & Marchman, J. (2015). A randomized controlled trial of acceptance and commitment therapy for aggressive behavior. Journal of consulting and clinical psychology, 83(1), 199. https://doi.org/10.1037/a0037946

Additional Files

Published

2025-07-01

Submitted

2024-09-01

Revised

2024-11-11

Accepted

2024-11-19

How to Cite

Mohaddes Ardabili, F., Kazemi, A. S., & Rasouli, N. (2025). The Effectiveness of Acceptance and Commitment Therapy on Cognitive Emotion Regulation and Experiential Avoidance in Individuals with Leprosy in Tabriz. Journal of Assessment and Research in Applied Counseling (JARAC), 7(3), 1-11. https://doi.org/10.61838/kman.jarac.7.3.4