Comparison of the effectiveness acceptance and commitment therapy and transdiagnostic therapy on sexual function and components of personality type D. in people with cardiovascular disease

Subject Areas : Psychology

Majid Amiri ¹ , hasan khoshakhlagh ² , Parinaz Sadat Sajadian ³ , Hasan Rezaei_Jamaloei ⁴

1 - Ph.D student, Department of Psychology, Naein Branch, Islamic Azad University, Naein, Iran.
2 - Asistant Professor,, Department, of Psychology, Naein Branch, Islamic Azad University, Naein,,Iran.
3 - Assistant Professor, Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran.
4 - Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran.

Received: 2023-04-19 Accepted : 2023-08-14 Published : 2023-11-22

Keywords: sexual function, Transdiagnostic Therapy, acceptance and commitment therapy, D Personality Type and Cardiovascular Disease,

Abstract :

The aim of the study was to compare the effectiveness of acceptance and commitment therapy and transdiagnostic therapy on sexual function and personality type D components in cardiovascular patients.The research method was semi-experimental with a pre-test-post-test design and a 2-month follow-up with the experimental and control groups. 51 cardiovascular patients in Isfahan city in 1401 were selected using the purposeful sampling method and randomly assigned to two experimental groups and one control group(Three groups of 16 people). The research tools were the Rosen (2002)Male Sexual Performance Questionnaire and the Denolt(2005) Personality Type D Questionnaire. The experimental groups received the treatment in 9 sessions of 90 minutes and once a week, and the control group was waiting for the treatment. The data were analyzed using the statistical method of analysis of variance with repeated measurements. The effectiveness of acceptance and commitment therapy and transdiagnostic therapy was on sexual function and personality type D components in cardiovascular patients (P<0.001) and there was no significant difference between the effectiveness of both methods.

References:

Abdelmalek, A. (2020). The Effectiveness of Acceptance and Commitment Therapy in Reducing Avoidant Personality Disorder, and its effect on Life Orientation for university students. Journal of Scientific Research in Education, 21(7), 54-110. https://doi.org/10.21608/jsre.2020.107627.

Ahmadi, A, Ghaemi, F, & Farrokhi, N. (2019). Comparison of the effectiveness of mindfulness training and acceptance and commitment therapy on sexual function in men with cancer in Isfahan. Journal of Psychological Sciences, 18(83), 2185-2192. https://sid.ir/paper/93183/fa. (In Persian)

Arenhall, E., Kristofferzon, M.-L., Fridlund, B., Malm, D., & Nilsson, U. (2011). The male partners' experiences of the intimate relationships after a first myocardial infarction. European Journal of Cardiovascular Nursing, 10(2), 108-114. https://doi.org/10.1016/j.ejcnurse.2010.05.003.

Bakhshi Bajestani, A., Shahabizadeh, F., Vaziri, S., & Lotfi Kashani, F. (2021). he Effectiveness of Acceptance and Commitment Therapy on Distress and Psy chosomatic Symptoms in Patients with type D personality and Gastrointestinal Dysfunction. Razavi International Journal of Medicine, 9(3), 85-90. https://dx.doi.org/10.30483/ rijm.2021.254235.1077. (In Persian)

Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Latin, H. M., Ellard, K. K., & et al. (2017). Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. Oxford University Press. doi:10.1001/jamapsychiatry.2017.2164.

Baumhäkel, M., Schlimmer, N., Kratz, M., Hacket, G., Jackson, G., & et al. (2011). Cardiovascular risk, drugs and erectile function–a systematic analysis. International Journal of Clinical Practice, 65(3), 289-298.https://doi.org/10.1111/j.1742-1241.2010. 02563.x.

Bispo, G. S., de Lima Lopes, J., & de Barros, A. L. (2013). Cardiovascular changes resulting from sexual activity and sexual dysfunction after myocardial infarction: integrative review. Journal of Clinical Nursing, 22(23-24), 3522-3531. https://doi.org/10.1111/jocn.12356.

Boothby, C. A., Santana, M. J., Norris, C. M., Campbell, T. S., & Rabi, D. M. (2021). Sexual Activity After Acute Coronary Syndrome: A Qualitative Approach to Patient and Partner Experiences. The Journal of Cardiovascular Nursing, 36(5), E71. https://doi.org/10.1097%2 FJCN.0000000000000815.

Bullis, J. R., Sauer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Carl, J. R., & et al. (2015). The unified protocol for transdiagnostic treatment of emotional disorders: Preliminary exploration of effectiveness for group delivery. Behavior Modification, 39(2), 295-321. https://doi.org/ 10.1177/0145445514553094.

Byrne, M., Murphy, P., D’Eath, M., Doherty, S., & Jaarsma, T. (2017). Association between sexual problems and relationship satisfaction among people with cardiovascular disease. The Journal of Sexual Medicine, 14(5), 666-674. https://doi.org/ 10.1016/j.jsxm.2017.03.252.

Davison, T. E., Eppingstall, B., Runci, S., & O'Connor, D. W. (2017). A pilot trial of acceptance and commitment therapy for symptoms of depression and anxiety in older adults residing in long-term care facilities. Aging & Mental Health, 21(7), 766-773. https://doi.org/10.1080/13607863.2016.1156051.

Dávolos, I., Naya, E. G., & Marcilla, M. M. (2021). Sexual activity after myocardial revascularization surgery. Current Problems in Cardiology, 46(3), 100660. https://doi.org/10.1016/j.cpcardiol.2020.100660.

Denollet, J. (2005). DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosomatic Medicine, 67(1), 89-97. DOI: 10.1097/01.psy.0000149256.81953.49

Derakhshan, A., Haghayegh, S. A., Afshar Zanjani, H., &, & Adibi, P. (2022). Efficacy of Acceptance and Commitment Therapy on the Quality of Life and Personality Type D Characteristics in the Patients with Ulcerative Colitis [Research]. Journal of Research in Behavioural Sciences, 20(3), 425-437. http://rbs.mui.ac.ir/article-1-1169-fa.html.

Dusenbury, W., Hill, T. J., Mosack, V., & Steinke, E. E. (2020). Risk factors, depression, and drugs influencing sexual activity in individuals with and without stroke. Rehabilitation Nursing Journal, 45(1), 23-29. DOI: 10.1097/RNJ. 0000000000000145.

Epifanio, M. S., La Grutta, S., Alfano, P., Marcantonio, S., Piombo, M. A., Ammirata, M.,.. . & Di Blasi, M. (2023, January). Sexual Satisfaction and Quality of Life in Cardiovascular Patients: The Mediating Role of Anxiety. In Healthcare, 11(3). 290-302. https://doi.org/10.3390/healthcare11030290.

Fakhri, A. m., Morshedi, H., & , & Soleymanian, A. (2014). Psychometric Properties of Iranian Version of Male Sexual Function Index. Jundishapur Scientific Medical Journal, 12(6), 655-663. https://jsmj.ajums.ac.ir/article_49959_c7adaf816568d346871becbc9c4616ff.pdf.

Fang, S.-C., Wu, Y.-L., & Tsai, P.-S. (2020). Heart rate variability and risk of all-cause death and cardiovascular events in patients with cardiovascular disease: a meta-analysis of cohort studies. Biological Research for Nursing, 22(1), 45-56. https://doi.org/10.1177/1099800419877442.

Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., et al. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior Therapy, 43(3), 666-678. https://doi.org/10.1016/j.beth.2012.01.001.

Firoozi, M., & Biranvandi, M. (2018). Integrate Metacognition for cognitive emotional regulation in patients with cardiovascular disease  [Applicable]. Scientific Magazine Yafte, 20(2), 93-102. http://yafte.lums.ac.ir/article-1-2617-fa.html.

Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of Contextual Behavioral Science, 18, 181-192. https://doi.org/10.1016/ j.jcbs.2020.09.009.

Grabovac, I., Smith, L., Yang, L., Soysal, P., Veronese, N., et al. (2020). The relationship between chronic diseases and number of sexual partners: an exploratory analysis. BMJ Sexual & Reproductive Health, 46(2), 100-107. http://dx.doi.org/10.1136/ bmjsrh-2019-200352.

Grossman, R. A., & Ehrenreich-May, J. (2020). Using the unified protocol for transdiagnostic treatment of emotional disorders with youth exhibiting anger and irritability. Cognitive and Behavioral Practice, 27(2), 184-201. https://doi.org/10.1016/j.cbpra. 2019.05.004.

Gupta, B., & Thyloth, M. (2021). Role of Multimodal Psychotherapeutic Approaches in Bisexual Adult Man: A Case Study. Journal of Psychosexual Health, 3(1), 81-87. DOI: 10.1177/ 2631831821994253.

Hokmabadi, M.E., Bigdeli, I., Asghari Ebrahim Abad, M.J., Asadi, J.  (2020). Comparing the Effectiveness of Schema Therapy and Acceptance and Commitment Therapy on Personality Type D and Adherence to Treatment in Patients with Coronary Artery Disease. Clinical Psychology Journal, 12(1), 26-35. https://doi.org/10.22075/ jcp.2020.12459.1217.

Hasanzadeh, M., Akbari, B., &, & Abolghasemi, A. (2019). Efficiency of Acceptance and Commitment Therapy on Psychological Well-being and Sexual Function in Women with Infertility History [Original Research]. Avicenna Journal of Nursing and Midwifery Care, 27(4), 250-259. https://doi.org/10.30699/ajnmc.27.4.250.

Hayes, S. C., & Strosahl, K. D. (2005). A practical guide to acceptance and commitment therapy. Springer Science+ Business Media.

Horvath, Z., Smith, B. H., Sal, D., Hevesi, K., & Rowland, D. L. (2020). Body image, orgasmic response, and sexual relationship satisfaction: Understanding relationships and establishing typologies based on body image satisfaction. Sexual medicine, 8(4), 740-751. https://doi.org/10.1016/ j.esxm.2020.06.008.

Kennedy, K. A., & Barlow, D. H. (2018). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: An introduction. https://psycnet.apa.org/doi/10.1093/med-psych/9780190255541.003.0001.

Khosrowshahi H., M. B., Hassanzadeh R. (2018). The effectiveness of treatment based on acceptance and commitment on disease perception in coronary heart patients. Disability Studies, 9(1), 1-7. https://doi.org/https://sid.ir/paper/968093/fa.

Koch, T., Ehring, T., & Liedl, A. (2020). Effectiveness of a transdiagnostic group intervention to enhance emotion regulation in young Afghan refugees: A pilot randomized controlled study. Behaviour Research and Therapy, 132, 103689. https://doi.org/10.1016/j.brat.2020.103689.

Kupper, N., & Denollet, J. (2018). Type D personality as a risk factor in coronary heart disease: a review of current evidence. Current Cardiology Rreports, 20, 1-8.  https://doi.org/10.1007/s11886-018-1048-x.

Levine, G. N., Steinke, E. E., Bakaeen, F. G., Bozkurt, B., Cheitlin, M. D., et al. (2012). Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation, 125(8), 1058-1072. https://doi.org/10.1161/CIR. 0b013e3182447787.

Lv, H., Tao, H., Wang, Y., Zhao, Z., Liu, G., et al. (2020). Impact of type D personality on major adverse cardiac events in patients undergoing percutaneous coronary intervention: The mediating role of cognitive appraisal and coping style. Journal of Psychosomatic Research, 136, 110192. https://doi.org/10.1016/j.jpsychores.2020.110192.

Madadi, F. (2019). The Effectiveness of Acceptance and Commitment Therapy on the Psychological Capital and Sexual Self-Efficacy of Infertile Women University of Mohaghegh Ardabili.

Maulvi Z, G. A., Elah Bakshian A, Asghari Jafarabadi M, Sattarzadeh N, et al. (2021). Sexual function in patients with coronary artery disease referred to the heart clinic of Shahid Madani Hospital in Tabriz. Journal of Urmia College of Nursing and Midwifery, 18, 965-976. https://sid.ir/paper/ 415927/fa.

McCracken, L. M., Sato, A., & Taylor, G. J. (2013). A trial of a brief group-based form of acceptance and commitment therapy (ACT) for chronic pain in general practice: pilot outcome and process results. The Journal of Pain, 14(11), 1398-1406. https://doi.org/10.1016/j.jpain.2013.06.011.

Mohagheghian, M., Kajbaf, M. B., & Maredpour, A. (2021). The Effectiveness of Acceptance and Commitment Therapy on Sexual arousal, Intimacy and Self-concept of Female Sexual Interest/Arousal Disorder, a Randomized Controlled Trial. International Journal of Applied Behavioral Sciences, 8(1), 50-59. https://sid.ir/paper/ 704412/en.

Mousavi, S. Z., & Pakizeh, A. (2021). Prediction of Mental Disorders Based on Type D personality in College Students. Clinical Psychology Studies, 11(43), 25-44. https://doi.org/10.22054/jcps. 2021.60505.2569.

Nagel, J., Chavanon, M.-L., Binder, L., Pieper, A., Wachter, R., et al. (2021). How family history of premature myocardial infarction affects patients at cardiovascular risk. Health Psychology, 40(11), 754–763. https://doi.org/10.1037/hea0001128.

Ona, P. E. Z. (2020). Acceptance and Commitment Therapy for Borderline Personality Disorder: A Flexible Treatment Plan for Clients with Emotion Dysregulation. New Harbinger Publications. 1684031796, 9781684031795.

Otared, N., Mikaeili, N., Mohajeri, N., & Vojoudi, B. (2017). The Effect of Unified Transdiagnostic Treatment on Anxiety Disorders and Comorbid Depression: Single-Case Design [Research]. Journal of Torbat Heydariyeh University of Medical Sciences, 4(4), 54-62. http://jms.thums. ac.ir/article-1-383-fa.html.

Pourghane, P., Amiri Nejad, P., & Razavi Tousi, S. M. T. (2021). Effect of Cardiac Rehabilitation on Sexual Satisfaction of Patients After Coronary Artery Bypass Graft Surgery [Research]. Journal of Guilan University of Medical Sciences, 30(1), 2-13. https://doi.org/10.32598/jgums.30.1.1469.2.

Rosen, R. C. (2002). Assessment of female sexual dysfunction: review of validated methods. Fertility and Sterility, 77, 89-93. https://doi.org/ 10.1016/S0015-0282(02)02966-7.

Ryan, A. K., Pakenham, K. I., & Burton, N. W. (2020). A pilot evaluation of a group acceptance and commitment therapy‐informed resilience training program for people with diabetes. Australian Psychologist, 55(3), 196-207. https://doi.org/ 10.1111/ap.12429.

Sakiris, N., & Berle, D. (2019). A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clinical Psychology Review, 72, 101751. https://doi.org/10.1016/j.cpr.2019.101751.

Sauer-Zavala, S., Bentley, K. H., Steele, S. J., Tirpak, J. W., Ametaj, A. A., et al. (2020). Treating depressive disorders with the Unified Protocol: A preliminary randomized evaluation. Journal of Affective Disorders, 264, 438-445. https://doi.org/ 10.1016/j.jad.2019.11.072.

Smith, B. P., Coe, E., & Meyer, E. C. (2021). Acceptance and commitment therapy delivered via telehealth for the treatment of co-occurring depression, PTSD, and nicotine use in a male veteran. Clinical Case Studies, 20(1), 75-91. https://us.sagepub.com/en-us/journals-permissions.

Spencer, S. D., & Masuda, A. (2020). Acceptance and commitment therapy as a transdiagnostic approach to treatment of behavioral health concerns: A concurrent multiple baseline design across participants. Clinical Case Studies, 19(3), 163-179. https://doi.org/10.1177/1534650119897412

Steele, S. J., Farchione, T. J., Cassiello-Robbins, C., Ametaj, A., Sbi, S., et al. (2018). Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. Journal of Psychiatric Research, 104, 211-216. https://doi.org/10.1016/ j.jpsychires.2018.08.005.

Steptoe, A., Jackson, S. E., & Wardle, J. (2016). Sexual activity and concerns in people with coronary heart disease from a population-based study. Heart, 102(14), 1095-1099. http://dx.doi.org/10.1136/ heartjnl-2016-309505.

Tabatabai AS., S. A., , & Motamedi M. (2017). Effectiveness of Acceptance and Commitment Therapy on Sexual Function, Sexual Self-Consciousness and Sexual Assertiveness among Women with Sexual Dysfunction. RBS, 15, 84-92. http://rbs.mui.ac.ir/article-1-519-en.html.

Talkovsky, A. M., Green, K. L., Osegueda, A., & Norton, P. J. (2017). Secondary depression in transdiagnostic group cognitive behavioral therapy among individuals diagnosed with anxiety disorders. Journal of Anxiety Disorders, 46, 56-64. https://doi.org/10.1016/j.janxdis.2016.09.008

Timmermans, I., Versteeg, H., Duijndam, S., Graafmans, C., Polak, P., & et al. (2019). Social inhibition and emotional distress in patients with coronary artery disease: The Type D personality construct. Journal of Health Psychology, 24(14), 1929-1944. https://doi.org/10.1177/1359105317709513.