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Comparison of the Effect of Dialectical Behavior Therapy, Acceptance and Commitment Therapy mindfulness-based Stress Reduction on Irritable Bowel Syndrome Symptoms, Quality of Life, Anxiety and Depression: A Pilot Randomized Controlled Trial

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Abstract

This study aimed to compare dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT) and mindfulness based stress reduction (MBSR) effects on irritable bowel syndrome (IBS) symptoms, quality of life (QOL), anxiety and depression among patients with IBS. Eighty three eligible patients with a Rome- IV diagnosis were randomly allocated in DBT, MBSR, ACT, and control groups (n = 22 per group). All the patients were evaluated for IBS symptoms by IBS Severity Scoring System (IBS-SSS), QOL by irritable bowel syndrome quality of life (IBS-QOL), anxiety by Beck’s Anxiety Inventory (BAI) and depression by Beck Depression Inventory- II (BDI-II) on the studied groups at the time of their inclusion in the study and 8 weeks after it. Each of the intervention groups took part in 8 group sessions. Conversely, the control group were evaluated without any intervention. 54 male and 29 female in 4 groups completed the study: DBT (n = 20), MBSR (n = 19), ACT (n = 22), and control groups (n = 22). The results showed significant differences between the groups based on the variables of the IBS-SSS, IBS-QOL, BAI and BDI-II (p < 0.05). Furthermore, the ACT intervention had considerably lower levels of IBS symptoms, anxiety, and depression compared to the other groups; also, the significant impacts of the QOL variable showed the higher scores of the ACT compared to the treatment groups. The therapies could not be applied to other groups of people. Other shortcomings were the absence of a follow-up strategy. This research offers preliminary evidence that ACT is more successful than other therapy groups in reducing IBS symptoms, anxiety and sadness, and improving QOL in IBS patients.

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Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Drossman DA. Functional gastrointestinal disorders: what’s new for Rome IV? Lancet Gastroenterol Hepatol. 2016;1:6–8.

    Article  PubMed  Google Scholar 

  2. Sugaya N, Nomura S, Shimada H. Relationship between cognitive factors and anxiety in individuals with irritable bowel syndrome. Int J Behav Med. 2012;19:308–15.

    Article  PubMed  Google Scholar 

  3. Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10(7):712–721e4.

    Article  PubMed  Google Scholar 

  4. Surdea-Blaga T, Băban A, Dumitrascu DL. Psychosocial determinants of irritable bowel syndrome. World J Gastroenterol. 2012;18:616–26.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hunt MG, Wong C, Aajmain S, Dawodu I. Fecal incontinence in people with self-reported irritable bowel syndrome: prevalence and quality of life. J Psychosom Res. 2018;113:45–51.

    Article  PubMed  Google Scholar 

  6. Ballou S, Bedell A, Keefer L. Psychosocial impact of irritable bowel syndrome: a brief review. World J Gastrointest Pathophysiology. 2015;6:120–3.

    Article  Google Scholar 

  7. Weaver KR, Melkus GD, Fletcher J, Henderson WA. Perceived stress, its physiological correlates, and quality of life in patients with irritable bowel syndrome. Biol Res Nurs. 2018;20(3):312–20.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Banerjee A, Sarkhel S, Sarkar R, Krishna G. Dhali anxiety and depression in irritable bowel syndrome. Indian J Psychol Med. 2017;39(6):741–5.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bercik P, Collins SM, Verdu EF. Microbes and the gut-brain axis. Neurogastroenterol Motil. 2012;24:405–13.

    Article  CAS  PubMed  Google Scholar 

  10. Kennedy PJ, Clarke G, Quigley EM, Groeger JA, Dinan TG, Cryan JF. Gut memories: towards a cognitive neurobiology of irritable bowel syndrome. Neurosci Biobehav Rev. 2012;36:310–40.

    Article  PubMed  Google Scholar 

  11. Sugaya N, Nomura S, Shimada H. Relationship between cognitive factors and anxiety in individuals with irritable bowel syndrome. Int J Behav Med.2012;19:308–15.

  12. Cho HS, Park JM, Lim CH, Cho YK, Lee IS, Kim SW, et al. Anxiety, depression and quality of life in patients with irritable bowel syndrome. Gut Liver. 2011;5:29–36.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Linehan MM. Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press; 1993a.

    Google Scholar 

  14. Hayes SC, Villatte M, Levin M, Hildebrandt M. Open, aware, and active: contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annu Rev Clin Psychol. 2011;7:141–68.

    Article  PubMed  Google Scholar 

  15. Heitkemper MM, Cain KC, Burr RL, Jun SE, Jarrett ME. Is childhood abuse or neglect associated with symptom reports and physiological measures in women with irritable bowel syndrome? Biol Res Nurs. 2013;13(4):399–408.

    Article  Google Scholar 

  16. Menon P, Chaudhari B, Saldanha D, Devabhaktuni S, Bhattacharya L. Childhood sexual abuse in adult patients with borderline personality disorder. Ind Psychiatry J. 2016;25(1):101–6.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Azizi A, Mohamadi J. Mindfulness efficacy efficacy on the perception of the disease and the quality of life of patients with irritable bowel syndrome. J Ilam Univ Med Sci. 2018;25(6):1–9.

    Google Scholar 

  18. Mohammadi J, Azizi A. Dialectical behavior therapy group on the perception of the disease and quality of life of patients with irritable bowel syndrome. J Ilam Univ Med Sci. 2017;25(2):18–26.

    Google Scholar 

  19. Mahdipour MZ, Davoudi A. Comparison of the effectiveness of psychological-pharmaceutical combined therapy with drug therapy on mental health, improving quality of life and symptoms reduction in patients with irritable bowel syndrome in ahwaz. 2012;3.

  20. Ito M, Muto T. Effectiveness of acceptance and commitment therapy for irritable bowel syndrome non-patients: a pilot randomized waiting list controlled trial. J Context Behav Sci. 2020;15:85–91.

    Article  Google Scholar 

  21. Gillanders D, Ferreira NB, Angioni E, Carvalho SA, Eugenicos MP. An implementation trial of ACT-based bibliotherapy for irritable bowel syndrome. J Contextual Behav Sci. 2017;6:172–7.

    Article  Google Scholar 

  22. Zomorodi S, Abdi S, Tabatabaee SK. Comparison of long-term effects of cognitive-behavioral therapy versus mindfulness-based therapy on reduction of symptoms among patients suffering from irritable bowel syndrome. Gastroenterol Hepatol Bed Bench. 2014;7(2):118–24.

    PubMed  PubMed Central  Google Scholar 

  23. Idusohan-Moizer H, Sawicka A, Dendle J, Albany M. Mindfulness-based cognitive therapy for adults with intellectual disabilities: an evaluation of the effectiveness of mindfulness in reducing symptoms of depression and anxiety. J Intellect Disabil Res. 2015;59(2):93–104.

    Article  CAS  PubMed  Google Scholar 

  24. Zernicke KA, Campbell TS, Blustein PK, Fung TS, Johnson JA, Bacon SL, Carlson LE. Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized wait-list controlled trial. Int J Behav Med. 2012;20(3):385–96.

    Article  Google Scholar 

  25. Naliboff BD, Smith SR, Serpa JG, Laird KT, Stains J, Connolly LS, Labus JS, Tillisch K. Mindfulness-based stress reduction improves irritable bowel syndrome (IBS) symptoms via specific aspects of mindfulness. Neurogastroenterol Motil. 2020;32(9):e13828.

    Article  PubMed  Google Scholar 

  26. Spina A, Mazzarella C, Dallio M, Romeo M, Pellegrino R, Durante T, Romano M, Loguercio C, Di Mauro M, Federico A, Gravina AG. The lesson from the First Italian Lockdown: impacts on anxiety and depressive symptoms and Sleep Quality in patients with remission of inflammatory bowel disease. Rev Recent Clin Trials. 2022;17(2):109–19.

    Article  PubMed  Google Scholar 

  27. Palsson OS, Whitehead WE, van Tilburg MAL, Chang L, Chey W, Crowell MD, et al. Development and validation of the Rome IV diagnostic questionnaire for adults. Gastroenterology. 2016b;150(6):1481–91.

    Article  Google Scholar 

  28. Linehan MM. Skills training manual for treating borderline personality disorder. New York, NY: Guilford Press; 1993b.

    Google Scholar 

  29. Kabat-Zinn J. Full catastrophe living: the program of the stress reduction clinic at the university of Massachusetts medical center. New York: Delta; 1990.

    Google Scholar 

  30. Bach P. In: Moran D, editor. Act in practice: case conceptualization in acceptance and commitment therapy. Oakland: New Harbinger Publications; 2008.

    Google Scholar 

  31. Francis CY, Morris J, Whorwell PJ. The irritable bowel severity Scoring System: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997;11:395–402.

    Article  CAS  PubMed  Google Scholar 

  32. Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL. Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Dig Dis Sci. 1998;43(2):400–11.

    Article  CAS  PubMed  Google Scholar 

  33. Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression inventories -IA and -II in psychiatric outpatients. J Pers Assess. 1996;67:588–97.

    Article  CAS  PubMed  Google Scholar 

  34. Abdelaziz HA, Ellakany VI, Ellakany A, Dean YE, Rouzan SS, Bamousa BAA, Shebl MA, Elawady SS, Verma S, Gir D, Sbitli T, Zaki I, Motwani L, Eweis R, Iqbal N, Shah J, Aiash H. The relationship between anxiety and irritable bowel syndrome symptoms among females: a cross-sectional study in Egypt. Med (Baltim). 2023;11(102):e34777.

    Article  Google Scholar 

  35. Lemmens LH, van Bronswijk SC, Peeters F, Arntz A, Hollon SD, Huibers MJ. Long-term outcomes of acute treatment with cognitive therapy v. interpersonal psychotherapy for adult depression: follow-up of a randomized controlled trial. Psychol Med.2018:1–9.

  36. Cohen J. A power primer. Psychol Bull, 112, 155–9.

  37. IBM SPSS Statistics for windows, version 20.0. IBM Corp. Armonk, NY; 2011.

  38. Azizi A, Mohamadi J. Effectiveness of dialectical group behavior therapy on perceived stress and depression in patients with irritable bowel syndrome. J Ardabil Univ Med Sci. 2016;16(1):95–104.

    Google Scholar 

  39. Hayes SC, Strosahl K, Wilson KG, Bissett RT, Pistorello J, Toarmino D, et al. Measuring experiential avoidance: a preliminary test of a working model. Psychol Record. 2004;54:553–78.

    Article  Google Scholar 

  40. Stepp SD, Epler AJ, Jahng S, Trull TJ. The effect of dialectical behavior therapy skills use on borderline personality disorder features. J Personal Disord. 2008;22:549–63.

    Article  Google Scholar 

  41. Feldman G, Harley R, Kerrigan M, Jacobo M, Fava M. Change in emotional processing during a dialectical behavior therapy-based skills group for major depressive disorder. Behav Res Ther. 2009;47:316–21.

    Article  PubMed  Google Scholar 

  42. Shearin EN, Linehan MM. Patient-therapist ratings and relationship to progress in dialectical behavior therapy for borderline personality disorder. Behav Therapy. 1992;23:730–41.

    Article  Google Scholar 

  43. Wicksell RK, Olsson GL, Hayes SC. Psychological flexibility as a mediator of improvement in acceptance and commitment therapy for patients with chronic pain following whiplash. Eur J Pain. 2010;14(10):1059e1–11.

    Article  Google Scholar 

  44. Berrill JW, Sadlier M, Hood K, Green JT. Mindfulness-based therapy for inflammatory bowel disease patients with functional abdominal symptoms or high perceived stress levels. J Crohn’s Colitis. 2014;8(9):945–55.

    Article  Google Scholar 

  45. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13:27–45.

    Article  PubMed  Google Scholar 

  46. Jain S, Shapiro SL, Swanick S, Roesch SC, Mills PJ, et al. A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. Ann Behav Med. 2007;33:11–21.

    Article  PubMed  Google Scholar 

  47. Bowen S, Witkiewitz K, Dillworth TM, Marlatt GA. The role of thought suppression in the relationship between mindfulness meditation and alcohol use. Addict Behav. 2007;32:2324–8.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Raes F, Dewulf D, Heeringen CV, Williams JMG. Mindfulness an dreduced cognitive reactivity to sad mood: evidence from a correlational study and a non-randomized waiting list controlled study. Behav Res Ther. 2009;47:623–27.

    Article  PubMed  Google Scholar 

  49. Davis DM, Hayes JA. What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychother (Chic). 2011;48:198–208.

    Article  Google Scholar 

  50. Ritschel LA, Lim NE, Stewart LM. Transdiagnostic applications of DBT for adolescents and adults. Am J Psychother. 2015;69(2):111–28.

    Article  PubMed  Google Scholar 

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Funding

No funding was received to perform this study.

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Authors and Affiliations

  1. Department of Education and Psychology, Faculty of Humanities, Yasouj University, Yasouj, Iran

    Ali Taghvaeinia & Mansoureh Karami

  2. Department of Psychology, Faculty of Humanities, Lorestan University, Lorestan, Iran

    Amir Azizi

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  1. Ali Taghvaeinia
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  3. Amir Azizi
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Correspondence to Ali Taghvaeinia.

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This study was approved by the Yasouj University of Medical Sciences and the authors declare that they have no conflict of interest.

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Taghvaeinia, A., Karami, M. & Azizi, A. Comparison of the Effect of Dialectical Behavior Therapy, Acceptance and Commitment Therapy mindfulness-based Stress Reduction on Irritable Bowel Syndrome Symptoms, Quality of Life, Anxiety and Depression: A Pilot Randomized Controlled Trial. Psychiatr Q 95, 53–68 (2024). https://doi.org/10.1007/s11126-023-10058-3

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