Effectiveness of Group Therapy Based on Acceptance and Commitment in Reduction of Distress and Pain Catastrophizing Among Diabetic Patients with Chronic Pain

Diabetes is one of the chronic diseases with high mortality and economic costs. In this disease, there is an increase in the sensitivity of the nervous system to pain stimuli and development of diabetic hyperalgesia. Patients with diabetes usually suffer from psychological symptoms after the diagnosis and during the treatment process. In addition, during the adaptation to illness, the patients experience psychological distress (i.e., anxiety, depression, and stress). In the meantime, catastrophizing in these patients can increase the sensitivity to pain and attention to pain. Therefore, this study aimed to investigate the effectiveness of group therapy based on acceptance and commitment in the reduction of distress and pain catastrophizing among these patients.

This is a pretest and posttest semi-experimental study with control and random groups. The present study was carried out on all diabetic patients with chronic pain, including 30 men and women, referring to the Pain Clinic and Amiralmomenin Hospital of Zabol, Iran, in the second 6 months of 2017 using targeted sampling and clinical interview. The subjects entered the treatment process according to the inclusion and exclusion criteria. The samples were randomly assigned to 15 subjects in the experimental and 15 patients in the control groups. The instrument of this study was the Kessler Psychological Distress Scale, Sullivan Catastrophizing Scale, and Acceptance and Commitment Therapy (ACT). The ACT included eight psychotherapy sessions based on the acceptance and commitment the experimental group received by the psychologist. However, the control group did not receive any intervention.

According to the obtained results, the two groups were significantly different in terms of distress and pain catastrophizing in the posttest stage with the control of the pretest effect (P<0.0001).

The obtained results of this study indicated the effectiveness of group therapy based on acceptance and commitment in the reduction of distress and pain catastrophizing among diabetic patients with chronic pain. Therefore, the use of this treatment technique should be considered by psychologists and other therapists in this field.