Comparison of the effectiveness of dialectical behavior therapy and compassion therapy on anxiety, disturbance tolerance and emotional regulation in Covid-19 survivors

During an outbreak of a disease such as coronary heart disease, fear of disease and fear of death, along with disruption of daily activities, cause people to become involved with disease anxiety (1). Anxiety about Covid-19 is common, and seems to be due to the fact that it is largely unknown and confusing to people about the virus. Fear of the unknown reduces the perception of safety in humans and has always been anxious for humans. About Covid-19 This lack of scientific information also exacerbates this anxiety (2).Turbulence tolerance, on the other hand, is defined as the capacity to experience and tolerate negative psychological states. Disorder may be the result of cognitive or physical processes, but it manifests as an emotional state that is often characterized by a desire to act to alleviate the emotional experience (3). Therefore, increasing the tolerance of turbulence can help improve the mental health of people, especially the survivors of Quid-19 disease. In addition, it seems that the inability to regulate emotion during threatening and anxious situations can also be an important factor in coronary anxiety. The importance of the subject is such that psychologists define emotion regulation as the process of initiating, maintaining, and modifying one's experience and expression of emotions (4). Due to the above, anxiety control and emotion regulation are very important for survivors of coronary heart disease, so researchers are looking for a way to improve the psychological condition of these people. In this regard, one of the new therapies that treat the third wave. It is well known and has attracted the attention of many psychologists in recent years, it is a dialectical behavior therapy. Which is a cognitive-behavioral method that was first used to treat borderline disease and its core is emotion (6). Also, another new treatment method is compassion therapy. Self-compassion as a way to reduce anxiety associated with mental disorders. Compassionate therapy can play a protective role against depression, anxiety and repressive thinking. This treatment can develop self-compassion and reduce self-critical burden of depression, anxiety and stress, suppress negative thoughts and emotions, and emotional regulation. And be self-controlled. Self-compassion is defined as a three-component construct including kindness to oneself versus self-judgment, human commonalities versus isolation, and mindfulness versus increasing assimilation (8).Considering the above, the effect of corona on anxiety and cognitive regulation of emotion on the one hand, the importance of using a method to control and reduce these symptoms in coronary survivors on the other hand, contradiction in research results and lack of research Research variables Therefore, the researcher seeks to answer the question of whether there is a difference between the effectiveness of dialectical behavior therapy and compassion therapy on anxiety, tolerance of turmoil and emotional regulation in survivors of Covid-19 disease or not?

The present study was quasi-experimental with pre-test and post-test design with  control and test groups. The population of the present study consisted of the survivors of coronary heart disease victims in Mashhad who were members of social networks in the spring and summer of 1399. Inclusion criteria included 3 to 10 months after the death of a family member due to corona, having at least a diploma, not undergoing psychological treatment, not taking psychiatric drugs and no stressful events such as divorce and death of loved ones in three months In the past, being 30 to 60 years old and not having a history of divorce and exclusion criteria included missing more than one session and canceling further cooperation. The questionnaires were designed and provided to the subjects through social networks (Telegram, WhatsApp and Instagram channels) so that people who want to participate in the research can answer the questions. A total of 60 people were selected by available sampling method and randomly replaced in three equal groups (10 pairs in each group). The intervention groups were trained in 10 sessions of 90 minutes separately with dialectical therapy and compassion therapy methods and the control group was placed on a waiting list for training. In this study, data collection tools are: 1. Demographic information questionnaire, 2. Corona anxiety questionnaire (Alipour et al., 1399) (14), 3. Emotional regulation questionnaire (Graz and Roemer, 2004) (15), 4. Turbulence Tolerance Questionnaire (Simmons & Gaher, 2005) (3), 5. Dialectical Behavior Therapy Protocol and 6. Compassion-Based Therapy Protocol. Finally, descriptive statistics (table and graph) and Shapiro-Wilk tests, analysis of covariance and Bonferroni post hoc using SPSS software were used to analyze the data.

The results showed that the statistical significance of Wilkes's lambda test was less than 0.05 and was therefore significant. Therefore, it can be found that there is a significant difference between the groups of dialectical therapy, compassion therapy and control in at least one of the variables of coronary anxiety, disturbance tolerance and emotional regulation. Therefore, according to the above results, there are conditions for using multivariate analysis of covariance.On the other hand, it was found that there was a statistically significant difference between the intervention methods in all three variables of coronary anxiety (CS), perturbation tolerance (DT) and emotional regulation (ER).The results of post hoc testshowed that both dialectical and compassionate therapies significantly reduced coronary anxiety, increased turbulence tolerance and increased emotional regulation in comparison with the control group. Also, dialectical therapy was more effective in reducing coronary anxiety, increasing turbulence tolerance and increasing emotional regulation compared to compassion therapy.

In general, the results showed that: Dialectical therapy significantly reduced coronary anxiety, increased disturbance tolerance and increased emotional regulation. Compassion therapy significantly reduced coronary anxiety, increased turbulence tolerance, and increased emotional regulation. Dialectical therapy is more effective than compassionate therapy in reducing coronary anxiety, increasing turbulence tolerance, and increasing emotional regulation. The findings of the present study are consistent with some of the results of research by Soler et al. (2009) who concluded that dialectical behavior therapy is effective in improving anxiety and emotional instability (16). Also, the results of the present study confirm some of the findings of the study of Steele et al. (2011) who found that dialectical behavior therapy reduces anxiety symptoms (17). In addition, the findings of the present study, along with some of the results of research by Wang et al. (2020) who found that compassion therapy is effective in conceptualizing emotional responses (18). Is consistent. On the other hand, the results of the present study confirm some of the findings of the study of Richard and Ser (2015) who found that dialectical behavior therapy is effective in improving anxiety (9). Also, the findings of the present study are consistent with some of the results of Modarres Gharavi (2011) that receiving dialectical behavior therapy is effective in significantly increasing anxiety tolerance.