The Effectiveness of Compassion-Focuced Therapy on Self-Blame, Distress Tolerance, Self-Conscious Emotion and Conflict Resolution Styles in Patients with Cancer in Isfahan

Subject Areas : Clinical

Yeganeh Yavari ¹ , hassan khosh akhlagh ² , Mohammad Reza Sherabafchizadeh ³

1 - Psychology, Islamic Azad University of Naein, Naein, Iran
2 - Academic member, Islamic Azad University of Naein, Naein, Iran
3 - Assistant Professor, Psychosomatic Research Center, Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran

Received: 2021-12-05 Accepted : 2022-08-13 Published : 2024-08-04

Keywords: compassion-focuced therapy, self-blame, distress tolerance, self-conscious emotion, conflict resolution styles, cancer,

Abstract :

The aim of this study was to determine the effectiveness of compassion-focuced therapy on self-blame, distress tolerance, self-conscious emotion and conflict resolution styles in patients with cancer in Isfahan. The method of this research was quasi-experimental with a pretest-posttest design with a control group. The statistical population included all patients with cancer in Isfahan province in 2019 that 30 patients with cancer were selected by convenience sampling and randomly asingment into experimental and control groups (n = 15). Cognitive Emotion Regulation Strategies Questionnaire (Garnefski & Kraaij, 2007), Distress Tolerance Questionnaire (Simons & Gaher, 2005), Self-Conscious Emotion Questionnaire (Tangney, Dearing, Wagner, & Gramzow, 1989), Conflict Resolution Questionnaire (Weeks, 1994), used as a pre-test, then experimental group underwent Compassion- Focuced Therapy in 8 sessions of 90 minutes for two months and the control group did not receive any intervention. At the end, post-test was performed on both groups and the data were analyzed using Spss-23 statistical software and analysis of covariance. Findings showed that therapeutic intervention decreased the score of self-blame and self-conscious emotion and increased the score of distress tolerance and conflict resolution styles in the experimental group compared to the control group (P <0.05). Therefore, one can conclud Compassion therapy is effective on self-blame, distress tolerance, self-conscious emotion and conflict resolution styles of cancer patients in Isfahan. Therefore, it is suggested that it be used as an effective, selective, low-cost and feasible intervention and as a short and preventive way by counselors and psychotherapists to reduce the psychological problems of cancer patients.

References:

Abi-Habib, R., & Luyten, P. (2013). The role of dependency and self-criticism in the relationship between anger and depression. Journal of Personality and Individual Differences, 55(8), 921-925.
Alighanavati, S., Bahrami, F., Godarzi, K., & Rouzbahani, M. (2018). Effectiveness of compassion-based therapy on rumination and concern of women with breast cancer. Journal of Health Psychology, 7(27), 152-168. [in Persian]
Albertson, E. R., Neff, K. D., & Dill Shackle ford, K. E. (2015). Selfcompassion and body dissatisfaction in women: A randomized controlled trial of a brief meditation intervention. Journal of Mindfulness , 6(3), 444- 454.
Ameri, Z., Askari, P., Heidarei, A., & Bakhtiarpour, S. (2021). The effectiveness of spirituality therapy training on tolerance to distress and death anxiety among patients with leukemia: A pilot study. Journal of Salamat -I IJTIMĀĪ (Community Health), 8(2), 275-287. [in Persian]
Anoushirvani, E., Razeghi, N., Nouhi, S., & Aghae, H. (2021). Effectiveness of compassion-based therapy on self-criticism and sexual schemas in women with breast cancer. Iranian Journal of Cancer Care, 2(2), 3-12. [in Persian]
Azadi, R., Ahadi, H., & Hatami, H. R. (2020). The Relationship of Psychological Wellbeing and Psychological Hardiness With the Mediating Role of Social Support in Women With Breast Cancer. Quarterly of the Horizon of Medical Sciences (HMS)‎, 27(1), 18-33. [in Persian]
Azizi, A., Mir Derikvan, F., & Mohamadi, J. (2015). Comparison of personality factors and cognitive emotional regulation in gastric and lung cancer patients and normal subjects. Razi Journal of Medical Sciences, 22(132), 1-9. [in Persian]
Bakhshalizadeh Irani, F., Shahidi, S., & Hazini, A. (2020). Psychological experiences of terminal cancer patients with an emphasis on their concerns and needs: A phenomenological study. Journal of Research in Psychological Health, 14(2), 20-33. [in Persian]
Besharat, M. A., & Bazzazian, S. (2015). Psychometri properties of the cognitive emotion regulation questionnaire in a sample of Iranian population. Journal of Advances in Nursing & Midwifery, 24(84), 61-70.
Braehler, C., Gumley, A., Harper, J., Wallace, S., Norrie, J., & Gilbert, P. (2013). Exploring change processes in compassion focused therapy in psychosis: Results of a feasibility randomized controlled trial. British Journal of Clinical Psychology, 52(2), 199-214.
Baniasadi, F,. Poursharifi, H,. Borjali, A,. Mofid, B. (2021). The effectiveness of acceptance and commitment therapy on psychological distress in people with prostate cancer. Journal of Prevent Med; 8 (1), 22-12. [in Persian]
Carneiro, ÉM,. Moraes, GV,. Terra, GA. (2016). Effectiveness of Spiritist Passe (Spiritual Healing) on the Psychophysiological Parameters in Hospitalized Patients. Journal of Advances in mind-body medicine;30(3):4-10.
Chaudhuri, P., & Datta, A. (2018). Making sense of self-conscious and emotion: Linking theory of mind and emotion in women with breast cancer. Journal of Annals of Oncology, 29, 560-561.
Dinger, U., Barrett, M. S., Zimmermann, J., Schauenburg, H., Wright, A. G., Renner, F., . . . Barber, J. P. (2015). Interpersonal problems, dependency, and self-criticism in major depressive disorder. Journal of Clin Psychol, 71(1), 93-104.
Ebrahimpourghavi, M., Sharifidaramadi, P., & Pezeshk, S. (2020). The effectiveness of emotional regulation on depression in children with cancer. Journal of Child Mental Health, 6(4), 220-230. [in Persian]
Edwards, B., & Ung, L. (2002). Quality of life Instruments for caregivers of patients with cancer. Journal of Cancer Nursing, 25(5), 342-349.
Etebarian, A., & Pourvali, Z. (2008). To determine the relationship between self-monitoring and conflict solving strategies; A case study of employees of Khurasgan Islamic Azad University. Journal of New Approach In Educational Administration, 1(2), 113-133. [in Persian]
Exline, J. J., Park, C. L., Smyth, J. M., & Carey, M. P. (2011). Anger toward God: Social-cognitive predictors, prevalence, and links with adjustment to bereavement and cancer. Journal of personality and social psychology, 100(1), 129.
Fisher, R., & Ury, W. (1991). Getting to Yes: Negotiating an agreement without giving in. (2nd ed.). London. Random House Business Books.
Garnefski, N., Van Den Kommer, T., Kraaij, V., Teerds, J., Legerstee, J., & Onstein, E. (2002). The relationship between cognitive emotion regulation strategies and emotional problems: comparison between a clinical and a non‐clinical sample. European Journal of Personality, 16(5), 403-420. doi:10.1002/per.458
Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in psychiatric treatment, 15(3), 199-208.
Gilbert, P. (2010). Compassion focused therapy: Distinctive features: Routledge.
Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6-41.
Gilbert, P. (2015). The evolution and social dynamics of compassion. Social and personality psychology compass, 9(6), 239-254.
Gilbert, P., & Simos, G. (2022). Compassion focused therapy: Clinical practice and applications: Routledge.
Gonzalez-Hernandez, E., Romero, R., Campos, D., Burichka, D., DiegoPedro, R., Baños, R., & Cebolla, A. (2018). Cognitively-Based Compassion Training (CBCT) in Breast Cancer Survivors: A Randomized Clinical Trial Study. Journal of Integrative cancer therapies, 41(3), 67-82.
Goebel, S., & Mehdorn, H. M. (2019). Fear of disease progression in adult ambulatory patients with brain cancer: prevalence and clinical correlates. Journal of Supportive Care in Cancer, 27(9), 3521-3529.
Garnefski, N., & Kraaij, V. (2007). The cognitive emotion regulation questionnaire. European Journal of Psychological Assessment, 23, 141–149.
Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and emotional problems. Journal of Personality and Individual differences, 30(8), 1311 -1327
Henning, M. (2003). Evaluation of Conflict Resolution Questionnaire. Master Thesis,Auckland University of Technology
Hamrick, L. A., & Owens, G. P. (2019). Exploring the mediating role of self‐blame and coping in the relationships between self‐compassion and distress in females following the sexual assault. Journal of Clinical Psychology, 75(4), 766-779.
Hermanto, N., Zuroff, D. C., Kopala-Sibley, D. C., Kelly, A. C., Matos, M., Gilbert, P., & Koestner, R. (2016). Ability to receive compassion from others buffers the depressogenic effect of self-criticism: A cross-cultural multi-study analysis. Journal of Personality and Individual Differences, 98, 324-332.
Hsu S.H, Collins S.E, Marlatt G.A. (2013). Examining psychometric properties of distress tolerance and its moderation of mindfulness-based relapse prevention effects on alcohol and other drug use outcomes. Journal of Addict Behav; 38(3): 1852-8.
Irons, C., & Lad, S. (2017). Using compassion focused therapy to work with shame and self criticism in complex trauma. Journal of Australian Clinical Psychologist, 3(1), 47-54.
Leaviss, J., & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Journal of Psychological medicine, 45(5), 927-945.
Kashanaki, H., Dehghani Arani, F., & Ferdousi, T. (2019). Normal and Abnormal Personality Patterns in a Patient with Leukemia: A Clinical Case study. Journal of Research In Psychological Health, 12(4), 80-93. [in Persian]
Kearnery, K. G., & Hicks, R. E. (2017). Self Compassion And Breast Cancer In 23 Cancer Respondents: Is The Way You Relate To Yourself A Factor In Disease Onset And Progress? Journal of Psychology, 8(5), 14- 26.
Khaki, S., Torkan, H., & Sebghatallahi, V. (2020). Comparing pain anxiety, distress tolerance and mindfulness in the people with Iirritable bowel syndrome (IBS) and normal ones. Journal of Analitical-Cognitive Psycholoy, 42, 71-81. [in Persian]
Khatibi, M. (2019). The relation of personality to prosocial behavior: The mediating role of mindfulness and cognitive emotion regulation strategies [Doctoral Dissertation]. Shiraz University, School of Education & Psychology. [in Persian]
Kochaki Amirhendeh, M., Karbalayi, A., & Sabet, M. (2017). The mediating role of anger rumination and self-criticism rumination in relationship between disaffection and marital violence. Journal of Thoughts and Behavior in Clinical Psychology, 12(43), 47-56. [in Persian]
Letafati Beris, R., Ghamari Kivi, H., Kiani, A. R., & Sheykholeslamy, A. (2021). Comparison of the effectiveness of the schema mode therapy and Emotional-focused therapy on styles of conflict resolution, in new married couples with conflict. Rooyesh-e-Ravanshenasi Journal(RRJ), 10(9), 186-192. [in Persian]
Mahmood Alilo, M., Hashemi Nosratabad, T., & Farshbaf Manei Sefat, F. (2015). The effectiveness of play therapy according levy approach in reduction of anxiety in children with diagnosed cancer. Journal of Holistic Nursing and Midwifery 75, 54-62. [in Persian]
Mattingley, S., Youssef, G. J., Manning, V., Graeme, L., & Hall, K. (2022). Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis. Journal of affective disorders.
Neff, K. D., Hsieh, Y.-P., & Dejitterat, K. (2005). Self-compassion, achievement goals, and coping with academic failure. Journal of Self and identity, 4(3), 263-287.
Neff, K. D. (2011). Self-compassion: Stop beating yourself up and leave insecurity behind. New York, NY: HarperCollins
Pourbaferani, M., Etemadi, O., Akbarzadeh, M., & Jazayeri, R. (2015). Evaluating the role of mother personality, maternal marital conflict, mother conflict resolution style and daughter conflict resolution style in predicting of mother-daughter conflict. Journal of Woman and Society, 6(23), 105-126. [in Persian]
Przezdziecki, A., Sherman, K. A., Baillie, A., Taylor, A., Foley, E., & Stalgis‐Bilinski, K. (2013). My changed body: breast cancer, body image, distress and self‐compassion . Journal of Psycho‐Oncology, 22 (8), 1872-1879.
Park, E.M., Deal, A.M., Check, D.K., Hanson, L.C., Reeder‐Hayes, K.E., Mayer, D.K., & et al. (2016). Parenting concerns, quality of life, and psychological distress in patients with advanced cancer. Journal of Psychooncology; 25(8):942-8.
Panjwani, A. A., Millar, B. M., & Revenson, T. A. (2021). Tolerating uncertainty in the dark: insomnia symptoms, distress, and well-being among parents of adolescents and young adults with cancer. International Journal of Behavioral Medicine, 28(1), 14-20.
Raes, F. (2011). The Effect Of Self Compassion On The Development Of Depression Symptoms In A Nonclinical Sample. Journal of Mindfulness, 11(2), 33- 36.
Rahim, A., Civelek, I., & Liang, F. H. (2018). A process model of social intelligence and problem-solving style for conflict management. International Journal of Conflict Management.
Razmgar, M., & Asghari Ebrahimabad, M. (2021). The role of the conflict management styles in prediction the quality of life for married women with self-control mediation. Quarterly Journal of Women and Society, 11(44), 71-92. [in Persian]
Ros-Morente, A., Mora, C. A., Nadal, C. T., Belled, A. B., & Berenguer, N. J. (2017). An examination of the relationship between emotional intelligence, positive affect and character strengths and virtues. Journal of Anales de Psicología /Annals of Psychology , 34(1), 63-67.
Saeedi, Z., Ghorbani, N., Sarafraz, M., & Sharifian, M.H. (2013). The effect of inducing self-compassion and self-esteem on the level of the experience of shame and guilt. Journal of Contemporary Psychology, 8(1). 91-102. [in Persian]
Stuewig, J., Tangney, JP., Heigel, C., Harty, L., McCloskey, L,. (2010). Shaming .blaming and maiming: functional links among the moral emotions, externalization of blame and aggression. Journal of Research in Personality; 44: 91 -102.
Sadeghi, Z. H., Yazdi-Ravandi, S., & Pirnia, B. (2018). Compassion-focused therapy on levels of anxiety and depression among women with breast cancer: A randomized pilot trial. International Journal of Cancer Management, 11(11). [in Persian]
Sadeghzadeh Mofrad, Z., Dortaj, F., Ghaemi, F., & Farrokhi, N. (2021). The effectiveness of compassion-focused therapy on self-efficacy and psychological well-being of cancer patients. Razi Journal of Medical Sciences, 28(8), 45-61. [in Persian]
Sharifi Saki, S., Alipour, A., AghaYousefi, A. R., Mohammadi, M. R., Ghobari Bonab, B., & Anbiaee, R. (2018). Relationship of patience and self- compassion with depression in patients with breast cancer. Iranian Journal of Breast Diseases, 11(2), 36-45. [in Persian]
Simons, J. S., & Gaher, R. M. (2005). The distress tolerance scale: Development and validation of a self-report measure. Journal of Motivation and emotion, 29(2), 83-102.
Smart, L. M., Peters, J. R., & Baer, R. A. (2016). Development and Validation of a Measure of Self-Critical Rumination. Journal of Assessment, 23(3), 321-332.
Sourmeh, A., Mashhadi, A., & Sepehri Shamloo, Z. (2020). The effectiveness of group-based compassion-focused therapy on depression, anxiety and improving the quality of life in women with feminine cancers. Journal of Multidisciplinary Cancer Investigation, 4(2), 21-27. [in Persian]
Sznycer, D. (2019). Forms and functions of the self-conscious emotions. Journal of Trends in cognitive sciences, 23(2), 143-157.
Tabibzadeh, F., Soleimani, E., & Shiroudi, S. (2021). The effectiveness of compassion-focused therapy on cancer fatigue and self-care behaviors of cancer patients. Rooyesh-e-Ravanshenasi Journal(RRJ), 9(12), 75-84. [in Persian]
Tangney, J. P., & Dearing, R. l. (2004). Shame & guilt. The Guilford Press: New York, London.
Tangney, J.P., Dearing, R.L., Wagner, P.E., & Gramzow, R. (1989). Test of Self-Conscious Affect–3.
Todorov, N., Sherman, K. A., Kilby, Ch, J. (2019). Self Compassion And Hope In The Context Of Body Image Disturbance And Distress In Breast Cancer Survivors. Journal of Psycho- Oncology, 28(3), 2025- 2032.
Weeks, D. (1994). The eight essential steeps to conflict resolution-preserving relationships at work, at home, and in the community. New York: Tarcher-Putnam.
Woien, S.L., Ernst, H. A.H., Patock-Peckham, J., & Nagoshi, C.T. (2003). Validation of the TOSCA to measure shame and guilt. Journal of Personality and Individual Differences, 35(2), 313-326.
Yarmohammadi Vasel, M., Jokar, F., Farhadi, M., & Zoghi paydar, M. (2020). Structural model of relationships between integrative self-knowledge, perception of suffering and quality of life among cancer patients (stages 3 & 4). Journal of Research in Psychological Health, 14(2), 1-19. [in Persian]
Yarbro, C.H., Frogge, M.H., & Goodman, M. (2015). Cancer nursing: Principles and practice. Sudbury, MA: Jones & Bartlett Publishers.
Yoo, Y.S., Hwang, K.H., & Cho, O.H. (2013). Conflict resolution styles, marital intimacy and family functions of breast cancer patients and their spouses. Korean Journal of Adult Nursing, 25(1), 33-40.