depression

Background and Objective: General anxiety disorder (GAD) is the most prevalent chronic anxiety disorders in clinical centers and general population. There are several treatment methods for this disorder that have different challenges ,for example cognitive-behavior therapy is selective treatment for anxiety disorders but it is not improvement and has not patients efficiency in general anxiety disorder. Furthermore, study on the effectiveness of new treatment called third wave that include behavioral and cognitive interventions (known as post modernism), seem necessary in treatment of general anxiety disorder. Acceptance and commitment therapy and functional analytic psychotherapy are two method from third wave that include behavioral and cognitive interventions. Therefore, the purpose of this research was to comparison of the efficacy of acceptance and commitment therapy and functional analytic psychotherapy in decrease anxiety, depression and increase psychological flexibility and communication skill in patients with general anxiety disorder.
Methods: In this study, a quasi-experimental designed with pre-posttest and a four-month follow up was used. For this purpose, 36 subjects were selected via accessible sampling from the clientele who referred to psychological clinics. They were randomly divided into three groups. Two experimental groups were, acceptance and commitment therapy (n=12) and functional analytic psychotherapy (n=12). Both groups received 10 two-hour treatment sessions once a week. Control group had 12 patients participated (waiting list). In order to assess the severity of GAD, depression, communication skill and psychological flexibility different questionnaires included: anxiety disorder questionnaire (GAD-7) (a=87%, r=76%), Beck depression inventory (BDI) (a=87%, r=74%), communication skill questionnaire (CSQ) (r=69.8%) and acceptance and action questionnaire (AAQ) (a=87%, r=80%) were used. Statistical data were analyzed from repeated measures analysis of variance and paired comparison Bonferroni.
Results: Comparison of the treatment groups suggested that there was significant difference between acceptance and commitment therapy group with waiting list group in all scales except in depression variable, but in follow up was not significant (p=0.01). In addition, there was significant difference between functional analytic psychotherapy group and waiting list group in all scales and this difference maintains in follow up (p=0.01). Comparison between experimental groups (acceptance and commitment therapy with functional analytic psychotherapy) in posttest, indicates that there was not significant difference between two groups, except in depression variable, but in follow up was not significant different between acceptance and commitment therapy and functional analytic psychotherapy in anxiety, depression, communication skill and psychological flexibility variables (p<0.01). Based on the results of this study, in posttest, functional analytic psychotherapy was more effective in decrease of depression. However, both acceptance and commitment therapy and functional analytic psychotherapy showed significant changes in general anxiety disorder symptoms.
Conclusion: Attention to efficacy of two approach (acceptance and commitment therapy, and functional analytic psychotherapy) on
improvement of patients with general anxiety disorder under basic anxiety symptoms, this research not only provided an empirical support for functional analytic psychotherapy in treatment of general anxiety disorder but also can be useful for another anxiety disorders. This study propose to combine two approach in treatment of anxiety disorder.

کیده
زمینه و هدف:اخیرا ً مداخلههای رفتاری و شنناختی«منوسنوم»حاضنر بنا هندب مقایسنۀ اثربخشنی کنرده اسنت. پنژوه ، توجنه زینادی از پژوهشنگران را بنه خنودش جلنب
رواندرمانی تحلیلی-کنارکردی (FAP) و درمنان پنذیرش و تعهند (ACT)، دو شنیوه از مداخلنههایاضنطرب، افسنردگی و افنزای سنوم در کناه رفتناری و شنناختی منو
انعطابپذیری روانشناختی و مهارت ارتباطی در اختالل اضطراب فراگیر انجام شده است.
روش بررسی:این مطالعه باشبه طرح پژوهآزمایشی با پیآزمون-پسآزمون و پیگیری بود.۳۶نفر بهگروه درما صورت تصادفی به سهن مبتنی بر پنذیرش و تعهند (1۲=n،)
رواندرمانی تحلیلی-کارکردی (1۲=n) و گروه کنترل (1۲=n) تقسیم شدند. همۀ آزمودنیها با استفاده از پرسنامههایGad-7، افسنردگی«بنک»(وینرای-II)، پنذیرش و
عمل و مهارت ارتباطی ارزیابی شدند. دادهها با استفاده از آنالیز واریانس برای اندازهگیریهای مکرر تحلیل شد.
یافتهها: نتایج تحلیل واریانس اندازهانعطاب اضطراب، افسردگی و افزای گیری مکرر، بیانگر اثربخشی هر دو مدل درمانی بر کاهپذیری روانشناختی و مهارت ارتباطی بنود
(۰٫۰۰1>p). همچنین، طبق نتایج آزمون تعقیبی، بین دو گروه درمانی درپسآزمون فقط در متغیر افسردگی تفاوت معنادار مشاهده شد (۰٫۰۰1>p.)
نتیجهگیری، حمایتی تجربی برای روان : نتایج حاصل از این پژوهدرمانی تحلیلی-کرد. کارکردی در درمان اختالل اضطراب فراگیر فراهم
کلیدواژهها:درمان پذیرش و تعهد، رواندرمانی تحلیلی-کارکردی، اختالل اضطراب فراگیر، افسردگی، انعطابپذیری روانشناختی، مهارت ارتباطی.

Background: Depression is one of the most prevalent psychiatric disorders that imposes a heavy economic, emotional and social burden on patients, families and society.
Objectives: The present study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and cognitive therapy (CT) in treating Iranian women patients with major depressive disorder (MDD).
Methods: Nineteen women outpatients meeting DSM-IV-TR criteria for MDD without any axis 2 disorders were randomly (goal-oriented and convenience sampling) assigned to one of two treatment conditions, i.e. ACT and CT. The intervention in acceptance and commitment therapy group that was conducted was based on the Zeattle manual for major depressive disorder. Twelve therapeutic sessions were administered in the consulting center of Tehran university twice a week. The control group received 12 sessions of cognitive therapy based on Ferry manual twice a week in the consulting center of Tehran university, too. The Beck depression inventory-II-second edition (BDI-II), acceptance and act questionnaire (AAQ-II) and dysfunctional attitude scale (DAS) were administered for pre-treatment, post-treatment and follow-up. The data was analyzed by repeated measures analysis of variance (ANOVA).
Results: ANCOVA results showed that there were significant differences between ACT and CT in dysfunctional attitude. The ACT group demonstrated significant improvement in acceptance in the pre-test and post-test stage. All the participants demonstrated significant improvement in depression.
Conclusions: As ACT improved depression and acceptance of internal experiences, it is recommended for depression as an effective psychotherapy.

Introduction: The purpose of this study was to evaluate the effectiveness of acceptance and commitment therapy on reducing anxiety, depression and post-traumatic stress disorder in women affected by spousal extramarital relationships.
Methods: This is a quasi-experimental study with a pretest-posttest design with control group. The statistical population of the study consisted of all couples affected by extramarital affairs who referred to Birjand Welfare Counseling Center in the second half of 1997. Of these, 30 subjects who met the inclusion criteria were selected through available sampling and randomly assigned to either experimental (n = 15) and control (n = 15) groups. Intervention method was based on commitment and acceptance therapy with 8 sessions of training to the experimental group and the control group received no treatment. Data were collected using the Kian et al. Traumatic Stress Questionnaire (3) and the Lovebond and Lovebond Depression Anxiety Inventory (21). Data analysis was performed using covariance
analysis.
Results: The results of the present study showed an increase in the mean scores of the variables of anxiety, depression and post-traumatic stress in the experimental group at post-test compared to the intervention group (P <0.01).
Conclusion: The results of this study indicate that acceptance and commitment therapy is effective in reducing anxiety, depression and post-traumatic stress disorder in women affected by spouse trans marital relations.
 

خالصه
مقدمه:پژوهش حاضر با هدف اثربخشي درمان مبتني بر پذيرش و تعهد بر کاهش اضطراب،
افسردگي واسترس پس از سانحه زنان آسیبديده از روابط فرا زناشويي همسر انجام شد.
روش کار:پژوهش نیمه آزمايشي با طرح پیشآزمون–پسآزمون با گروهکنترل است. جامعه
آماری پژوهش را کلیه زوجین آسیبديده از روابط فرا زناشويي که در ششماهه دوم سال79به
مرکز مشاوره بهزيستي شهر بیرجند مراجعه کردند، تشكیل داد. از اينبین تعداد30نفر که شرايط
ورود به پژوهش را داشتند، به شیوه در دسترس انتخاب و به طور تصادفيبه دو گروه آزمايش (65
نفر) و کنترل (65نفر) منتسب شدند. روش اجرای مداخلهی درمان مبتني بر تعهد و پذيرش بهصورت
آموزش در8جلسه به گروه آزمايش بود و گروه گواه هیچ درماني دريافت نكردند. برای گردآوری
دادهها از پرسشنامهاسترس پس از سانحهکیان و همكاران (3)و پرسشنامه افسردگي، اضطراب
الويبوند و الويبوند (26) استفاده شد. تجزيهوتحلیل دادهها با کمک تحلیل کوواريانس انجام شد.
نتایج:نتايج مطالعه حاضر، افزايش میانگین نمرات در متغیرهای اضطراب، افسردگي واسترس پس از
سانحه را در گروه آزمايش در مرحله پسآزمون نسبت بهگروه مداخله نما نشان داد (06/0>p.)
نتیجه گیری:نتايج پژوهش بیانگر آن است که درمان مبتني بر پذيرش و تعهد بر کاهش اضطراب،
افسردگي واسترس پس از سانحه زنان آسیبديده از روابط فرا زناشويي همسر مؤثر است.
کلمات کلیدی:درمان مبتني بر پذيرش و تعهد، اضطراب، افسردگي، استرس پس از سانحه، روابط
 

A prior open trial of acceptance and commitment therapy (ACT) for comorbid social anxiety disorder (SAD) and depression showed clinically significant improvement over the course of 16 sessions. The aim of the current study was to test the feasibility and acceptability of ACT for this population in a pilot randomized trial within a routine practice setting. Patients (n = 26) were randomly assigned to 16 weeks of medication treatment as usual (mTAU) versus mTAU plus ACT (mTAU + ACT). Results showed that a significantly greater percentage of patients in mTAU not only dropped out of the study but also dropped out of treatment at the practice altogether, compared to patients in mTAU + ACT. Overall, results from this study suggest that having a comparison condition of mTAU alone in a randomized trial in a routine practice setting is not feasible and that patients with comorbid forms of SAD may require psychotherapy to remain engaged in treatment in standard clinical practice. Preliminary results for patients within the mTAU + ACT condition on treatment satisfaction and outcomes were comparable to results from the prior open trial, suggesting that ACT itself is worthy of further investigation. Further modifications to the study design may be needed to develop a feasible and acceptable comparison condition against which to test ACT for comorbid SAD in a routine practice setting.

A pilot parallel randomized controlled trial compared a self-acceptance, non-weight-loss intervention, Accept Yourself! (AY), to a weight loss program, Weight Watchers (WW), in order to provide preliminary safety, feasibility, and efficacy data in preparation for a definitive RCT of AY as an intervention to enhance the mental and physical health of larger-bodied women with Major Depressive Disorder (MDD). Adult women with MDD and a Body Mass Index ≥30 were eligible. Nineteen women were randomized by random number table into AY (n = 9) or WW (n = 10). Intake, pretreatment, posttreatment, 3-, 6-, 9-, and 12-month follow-up assessments occurred at a rural academic medical center. Primary outcomes included depression severity and cardiovascular fitness. Chi-square and t-tests assessed attrition and participant preferences for treatment; other analyses used intention-to-treat, linear mixed-effects models for repeated measures, including all participants' available data. Both groups improved in self-reported, F(5, 43.81) = 7.45, p < .001, partial η² = .38, and blinded-clinician-rated depression, F(6, 62.03) = 10.41, p < .001, partial η² = .5. AY was superior to WW in self-reported depression, F(5, 43.81) = 2.72, p = .03, partial η² = .11. Neither group improved in fitness. Eating disorder symptoms and weight gain worsened in WW. AY appeared safe, feasible, and offered initial evidence of efficacy for depression; it should be investigated in a definitive RCT, with modifications to increase potency. WW may not be suitable as a comparator intervention for AY because of risk to participants.