Determining the Effectiveness of Acceptance and Commitment Therapy on Anxiety Sensitivity, Psychosomatic Complaints, and Coping Strategies in Female Patients Aged 30-45 Years with Multiple Sclerosis (MS)

People with Multiple Sclerosis (MS) have specific psychological characteristics and psychiatric disorders, such as depression and anxiety disorder, which affect their emotional and personality aspects and suffer from psychosomatic complaints. Patients with MS use fewer problem-solving coping strategies, and their coping strategies are more avoidant or emotional. Anxiety sensitivity is a psychological risk factor that has received much attention in clinical and epidemiological studies of anxiety disorders. Acceptance and commitment therapy, first through education, provides a platform for a more positive attitude toward anxiety-related thoughts and feelings. Then, through mindfulness-based exercises and cognitive defusion, the patient accepts the extent to which these unpleasant feelings are annoying. In this therapy, all efforts to create and nurture a value-based life help the patient learn the desired way of living and ultimately achieve psychological flexibility. This study aimed to evaluate the effectiveness of acceptance and commitment therapy on anxiety sensitivity, psychosomatic complaints, and coping strategies in patients with MS.

The research method was quasi-experiment with a pretest-posttest design with a control group. The statistical population included women with MS who were referred to the MS Association of Urmia in 2019, from whom a sample of 30 people was selected by convenience sampling method and randomly divided into two groups (each group 15 people). The inclusion criteria were diagnosis of MS by a psychiatrist, age range of 30 to 45 years, consent to participate in research, and education of higher than junior high school. The exclusion criteria were severe symptoms of MS, suffering from one of the mental disorders and not participating in the training sessions for the experimental group. Both groups responded in pretest and posttest to the Anxiety Sensitivity Index (Reiss & Mcnally, 1985), Coping Inventory for Stressful Situations (Endler & Parker, 1990), and Dimension of Physical Complaints of Symptom Checklist-90 (Derogatis et al.,1974). For the experimental group, acceptance and commitment therapy was administered in eight sessions of one and a half hours, while the control group did not receive training. Data analysis was done using descriptive (frequency, percentage, mean and standard deviation) and inferential statistics (univariate analysis of covariance, independent t test and the Chi-square test) in SPSS version 23. The significance level of the tests was considered to be 0.05.

The results showed that after adjusting the pretest scores in the posttest, there were significant differences between the experimental and control groups between the components of anxiety sensitivity, including fear of physical worry (p<0.001), fear of lack of cognitive control (p<0.001) and fear of being observed by others (p<0.001), the physical complaint variable (p<0.001) and components of coping strategies variable, including problem-oriented coping (p<0.001), emotion-oriented coping (p<0.001), and avoidance coping (p<0.001).

According to the research findings, acceptance and commitment therapy can be used to reduce anxiety sensitivity, reduce physical complaints and change the coping strategies of patients with MS.