Determining the Efficacy of Acceptance and Commitment Therapy on Increasing the Psychological Well-being, Life Expectancy, and Psychological Flexibility of Patients with Acquired Immunodeficiency Syndrome

Acquired immunodeficiency syndrome (AIDS), a chronic and debilitating disease, affects different aspects of a person's life. Besides the physical aspects of this disease, patients diagnosed with AIDS, are faced with psycho–emotional stresses, such as anxiety, depression, sleep disorders, suicidal ideation, sexual dysfunction, impaired daily functioning, psychosocial stress, and psycho–existential stress. Most patients report low life expectancy, often accompanied by more physical and mental problems. Psychological well–being and psychological flexibility are two other important factors in the life of patients with chronic disorders. One of the modern treatments drawing therapists' attention in the last decade is acceptance and commitment therapy (ACT). Therefore, this study aimed to investigate the effectiveness of ACT in improving psychological well–being, life expectancy, and psychological flexibility in HIV–infected individuals.

The research method was quasi–experimental with a pretest–posttest and a 3–month follow–up design with a control group. The statistical population consisted of women and men suffering from AIDS with an active file in Tehran Blood Transfusion Organization in 2018 and were eligible to enter the study. The inclusion criteria were having an active file as an HIV patient, having an age range of 18–45 years, lacking history of psychiatric disorders, not using psychiatric drugs, not undergoing psychological treatment in the past six months, and not being a drug or alcohol addict. On the other hand, patients skipping more than two treatment sessions were excluded. Thirty–four cases were selected by purposive sampling and randomly assigned into two groups of acceptance and commitment therapy (n=17) and control (n=17). While conducting the research, two people from the intervention group and two from the control group were excluded due to their unwillingness to continue the sessions and the absence of more than two sessions. Finally, the data obtained from 30 subjects were analyzed. The participants were evaluated at three intervals: before the intervention, after the intervention, and follow–up (three months after the intervention). Participants were assessed with the Psychological Well–being Scale (Ryff, 1995), Life Expectancy Scale (Schneider et al., 1991), and Acceptance and Action–II Questionnaire (Bond et al., 2011). To analyze the data, in addition to descriptive statistics (mean, standard deviation, frequency, and percentage), an analysis of variance and repeated measures were performed. For comparing qualitative variables (i.e., education and marital status) between the groups, the Chi–square test used SPSS version 20 for data analysis. The significance level of statistical tests was 0.05.

The results showed significant differences between the scores of the stages (pretest, posttest, and follow–up) in the two groups (intervention and control) in the variables of life expectancy, psychological flexibility, and psychological well–being (p<0.001). A significant difference was observed in the variables of life expectancy and psychological flexibility, and psychological well–being between the three time points (p<0.001). Also, the general examination of the difference between the two groups showed a significant difference between the groups in the variables of psychological well–being (p<0.001), life expectancy (p<0.001), and psychological flexibility (p=0.029).

Based on the study results, ACT improves psychological well–being, life expectancy, and psychological flexibility in HIV–infected individuals. Therefore, therapists are recommended to utilize this treatment method to mitigate the psychological problems of these patients.