The Effectiveness of Acceptance and Commitment based Therapy on Depression, Psychological Health and Life Expectancy of the Elderly with Nonclinical Depression

Document Type : Original Article

Authors

1 MA Student of General Psychology, Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran

2 Assistant Professor, Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran

10.22126/jap.2020.5748.1470

Abstract

Elderly seems to be one of the challenging periods of life due to a decrease of physical and psychological functions and the elderly with nonclinical depression face many problems including an increase of depression and a decrease of health and life expectancy. Therefore, the current research aimed to determine the effectiveness of acceptance and commitment based therapy on depression, psychological health and life expectancy of the elderly with nonclinical depression. This study was a quasi-experimental with pretest and posttest with control group design. The research population included all the elderly with non-clinical depression referring to the psychological service centers and clinics in Ahvaz, Iran in the spring of 2020. The sample included 50 people selected according to including and excluding criteria, using purposive sampling method and were randomly assigned into two equal groups. The experimental group received 10 sessions of 90 minutes acceptance and commitment therapy and the control group was in a waiting list for training. The research tools were the geriatric depression scale (Yasavage & Sheikh), psychological health scale (Najjarian & Davodi) and life expectancy scale (Snyder et. al.). Data were analyzed using ANCOVA in SPSS-19. The findings indicated that the experimental group was significantly different in terms of all three variables of depression, psychological health and life expectancy. In the other words, acceptance and commitment therapy led to a reduction in depression and an improvement of psychological health and life expectancy in the elderly with nonclinical depression (p < 0.05). According to the results of the present study, therapists and health professionals can take advantages of acceptance and commitment therapy in health-related interventions, especially to reduce depression and improve psychological health and life expectancy.

References
Abbasi, M., Khazan, K., Pirani, Z., & Ghasemi Jobaneh, R. (2016). Effectiveness of treatment based on acceptance and commitment on cognitive-emotional functions of veterans. Iranian Journal of War and Public Health, 8(4), 203-208. [Persian]
Aajami, Z., Kazazi, L., Toroski, M., Bahrami, M., & Borhaninejad, V. (2020). Relationship between depression and cognitive impairment among elderly: A cross-sectional study. Journal of Caring Sciences, 9(3), 148-153. [Persian]
Alemi S, Malihialzackerini S, Abolmaali Alhoseini K, Khabiri M. Comparison of the effectiveness of mindfulness training and massage-aromatherapy on rising psychological health of elderly women with chronic pain. Iranian Journal of Health Education and Health Promotion, 7(4), 359-370. [Persian]
Asghari, N., Maddahi, M. E., Kraskian Mojemnari, A., & Sahaf, R. (2019). Effectiveness of acceptance and commitment group therapy on physical and psychological symptoms of elderly women. Journal of Nursing Education, 8(3), 62-70. [Persian]
Beck, A. T., & Clarck, D. A. (1988). Anxiety and depression: An information processing perspective. Journal of Anxiety Research, 1(1), 23-36.
Bunyathikan, T., Soonthornchaiya, R., & Charenboon, T. (2020). The effects of an acceptance and commitment therapy program on the depressive symptoms of elderly patients with major depressive disorder. The Journal of Psychiatric Nursing and Mental Health, 34(2), 118-131.

Chisumpa, V. H., & Odimegwu, C. O. (2018). Decomposition of age- and cause-specific adult mortality contributions to the gender gap in life expectancy from census and survey data in Zambia. SSM - Population Health, 5, 218-226.
Coto-Lesmes, R., Fernandez-Rodriguez, C., & Gonzalez-Fernandez, S. (2020). Acceptance and commitment therapy in-group format for anxiety and depression. A systematic review. Journal of Affective Disorders, 263, 107-120.
Davison, T. E., Eppingstall, B., Runci, S., O’Connor, D. W. (2017). A pilot trial of acceptance and commitment therapy for symptoms of depression and anxiety in older adults residing in long-term care facilities. Aging and Mental Health, 21(7), 766-773.
Esmaeilishad, B. (2020). The effectiveness of self-care training on quality of life, self-care behaviors and blood sugar in elderly lacking self-care behaviors. Journal of Aging Psychology, 6(1), 1-11. [Persian]
Fang, S., & Ding, D. (2020). The efficacy of group-based acceptance and commitment therapy on psychological capital and school engagement: A pilot study among Chinese adolescents. Journal of Contextual Behavioral Science, 16, 134-143.
Flujas-Contreras, J. M., & Gomez, I. (2018). Improving flexible parenting with acceptance and commitment therapy: A case study. Journal of Contextual Behavioral Science, 8, 29-35.
Forman, E. M., & Herbert, J. D. (2008). New directions in cognitive behavior therapy: Acceptance based therapies. In: O’donohue O, Fisher JE, editors. Cognitive behavior therapy: Applying empirically supported treatments in your practice. (2nd edition), Hoboken, NJ: Wiley Publisher.
Franco, C., Amutio, A., & Manas, I., Gazquez, J. J., & Perez-Fuentes, M. D. (2017). Reducing anxiety, geriatric depression and worry in a sample of older adults through a mindfulness-training program. Terapia Psicologica, 35(1), 71-79.
Gruppen, E. G., Connelly, M. A., Sluiter, W. J., Bakker, S. J. L., & Dullaart, R. P. F. (2019). Higher plasma GlycA, a novel pro-inflammatory glycoprotein biomarker, is associated with reduced life expectancy: The prevend study. Clinica Chimica Acta, 488, 7-12.
Herhaus, B., Kersting, A., Brahler, E., & Petrowski, K. (2020). Depression, anxiety and health status across different BMI classes: A representative study in Germany. Journal of Affective Disorders, 276, 45-52.
Hill, M. L., Schaefer, L. W., Spencer, S. D., & Masuda, A. (2020). Compassion-focused acceptance and commitment therapy for women with restrictive eating and problematic body-checking: A multiple baseline across participants study. Journal of Contextual Behavioral Science, 16, 144-152.
Izadpanah Kakhak M, Samari A, Tozandehjani H. (2019). The role of loneliness and positive meta-emotion in predicting life expectancy of elderly men. Iranian Journal of Psychiatric Nursing, 7(4), 25-31. [Persian]
Jia, H., Zack, M. M., Gottesman, I. I., & Thompson, W. W. (2018). Associations of smoking, physical inactivity, heavy drinking, and obesity with quality-adjusted life expectancy among US adults with depression. Value in Health, 21(3), 364-371.
Joe, G. W., Lehman, W. E. K., Rowan, G. A., Knight, K., & Flynn, P. M. (2019). The role of physical and psychological health problems in the drug use treatment process. Journal of Substance Abuse Treatment, 102, 23-32.
Khodabakhsh Pirkalani R, Ramezan Saatchi L, Maleki Majd M. (2019). The effectiveness of mindfulness-based cognitive therapy (MBCT) on depression, death anxiety and life expectancy in elderly women. Journal of Gerontology, 3(2), 11-20. [Persian]
Liu, J., Chang, L., Wu, S., & Tsai, P. (2015). Resilience mediates the relationship between depression and psychological health status in patients with heart failure: A cross-sectional study. International Journal of Nursing Studies, 52(12), 1846-1853.
Mehryar, M. (2020). The effectiveness of acceptance and commitment therapy (ACT) on promoting mental health and quality of life in elderly women. Journal of Gerontology, 4(3), 21-29. [Persian]
Moradi, A., Hatamian, A., Hatamian, P., & Morvvati, F. (2019). The relationship between practice religious beliefs and hope with elderly life satisfaction. Rooyesh-e-Ravanshenasi, 8(1), 183-190. [Persian]
Najarian, B., & Davodi, I. (2001). Development and reliability of SCL-25 (short form of SCL-90-R). Journal of Psychology, 5(2), 136-49. [Persian]
Negahban, Z., Arab, M., Tajvar, M., Rahimi Foroshani, A., & Rashidian, A. (2015). A study of the mental health of the elderly in Tehran and its relationship with their social capital. Journal of Healthcare Management, 6(1), 79-88. [Persian]
Nezamdoust Sedehi, M., Borjali, A., Poursharifi, H., Kraskian Mujembari, A., & Seirafi, M. (2018). The relationship between hope and sense of coherence with psychosocial well-being among older people: Mediating role of attitude toward death. Journal of Aging Psychology, 4(3), 179-195. [Persian]
Nimbi, F. M., Rossi, V., Tripodi, F., Luria, M., Flinchum, M., Tambelli, R., & Simonelli, C. (2020). Genital pain and sexual functioning: Effects on sexual experience, psychological health, and quality of life. The Journal of Sexual Medicine, 17(4), 771-783.
Pirhayati, Z., & Barghi Irani, Z. (2017). The effectiveness of acceptance and commitment based treatment on mental health and cognitive function in elderly people with age-related Macula degradation. Journal of Aging Psychology, 3(2), 137-146. [Persian]
Potter, R., O'Keeffe, V., Leka, S., Webber, M., & Dollard, M. (2019). Analytical review of the Australian policy context for work-related psychological health and psychosocial risks. Safety Science, 111, 37-48.
Pourabdol, S., Abbasi, M., Pirani, Z., & Abbasi, M. (2015). The relationship between life expectancy and psychological well-being with quality of life in the elderly. Journal of Aging Psychology, 1(1), 57-65. [Persian]
Qi, D., & Wu, Y. (2018). Does welfare stigma exist in China? Policy evaluation of the Minimum Living Security System on recipients’ psychological health and wellbeing. Social Science & Medicine, 205, 26-36.
Reangsing, C., Rittiwong, T., & Schneider, J. K. (2020). Effects of mindfulness meditation interventions on depression in older adults: A meta-analysis. Aging and Mental Health, 15, 1-10.
Rostami, M., Rasouli, M., & Kasaee, A. (2019). Comparison of the effect of group counseling based on spirituality-based therapy and acceptance and commitment therapy (ACT) on improving the quality of life the elderly. Biannual Journal of Applied Counseling, 9(1), 87-110.
Sagna, A. O., Kemp, M. L. S., DiNitto, D. M., & Choi, N. G. (2020). Impact of suicide mortality on life expectancy in the United States, 2011 and 2015: age and sex decomposition. Public Health, 179, 76-83.
Seyyedjafari, J., Jeddi, M., Mousavi, R., Hoseyni, E., & Shakibmehr, M. (2019). The effectiveness of compassion-focused therapy on elderly life expectancy. Journal of Aging Psychology, 5(2), 157-168. [Persian]
Shrestha, K., Ojha, S. P., Dhungana, S., & Shrestha, S. (2020). Depression and its association with quality of life among elderly: An elderly home- cross sectional study. Neurology, Psychiatry and Brain Research, 38, 1-4.
Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., Yoshinobu, L., Gibb, J., Langelle, C., & Harney, L. P. (1991). The will and the ways: Development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60(4), 570-585.
Tabakhnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics. (5th edition), Boston: Pearson Education Inc.
Tabe Bordbar, F., Banisi, P., & Asadi, R. (2019). The prediction of death anxiety in the elderly based on personality types and mental health. Journal of Aging Psychology, 5(3), 239-249. [Persian]
Wharton, E., Edwards, K. S., Juhasz, K., & Walser, R. D. (2019). Acceptance-based interventions in the treatment of PTSD: Group and individual pilot data using acceptance and commitment therapy. Journal of Contextual Behavioral Science, 14, 55-64.
Xiang, X., Danilovich, M. K., Tomasino, K. N., & Jordan, N. (2018). Depression prevalence and treatment among older home health services users in the United States. Archives of Gerontology and Geriatrics, 75, 151-157.
Yesavage, J. A., & Sheikh, J. I. (1986). Geriatric depression scale (GDS): Recent evidence and development of a shorter version. Journal of Clinical Gerontologist, 5(1-2), 165-173.
Yousefi Afrashteh, M., & Sharifi, K. (2015). The relationship between depression, perceived stress and social support with quality of life in elderly with Alzheimer's disease. Journal of Aging Psychology, 1(2), 1-10. [Persian]
Yuan, Y., Li, J., Jing, Z., Yu, C., Zhao, D., Hao, W., Zhou, C. (2020). The role of mental health and physical activity in the association between sleep quality and quality of life among rural elderly in China: A moderated mediation model. Journal of Affective Disorders, 273, 462-467.
Zhao, X., Zhang, D., Wu, M., Yang, Y., Xie, H., Li, Y., Jia, J., & Su, Y. (2018). Loneliness and depression symptoms among the elderly in nursing homes: A moderated mediation model of resilience and social support. Psychiatry Research, 268, 143-151

Keywords


References
Abbasi, M., Khazan, K., Pirani, Z., & Ghasemi Jobaneh, R. (2016). Effectiveness of treatment based on acceptance and commitment on cognitive-emotional functions of veterans. Iranian Journal of War and Public Health, 8(4), 203-208. [Persian]
Aajami, Z., Kazazi, L., Toroski, M., Bahrami, M., & Borhaninejad, V. (2020). Relationship between depression and cognitive impairment among elderly: A cross-sectional study. Journal of Caring Sciences, 9(3), 148-153. [Persian]
Alemi S, Malihialzackerini S, Abolmaali Alhoseini K, Khabiri M. Comparison of the effectiveness of mindfulness training and massage-aromatherapy on rising psychological health of elderly women with chronic pain. Iranian Journal of Health Education and Health Promotion, 7(4), 359-370. [Persian]
Asghari, N., Maddahi, M. E., Kraskian Mojemnari, A., & Sahaf, R. (2019). Effectiveness of acceptance and commitment group therapy on physical and psychological symptoms of elderly women. Journal of Nursing Education, 8(3), 62-70. [Persian]
Beck, A. T., & Clarck, D. A. (1988). Anxiety and depression: An information processing perspective. Journal of Anxiety Research, 1(1), 23-36.
Bunyathikan, T., Soonthornchaiya, R., & Charenboon, T. (2020). The effects of an acceptance and commitment therapy program on the depressive symptoms of elderly patients with major depressive disorder. The Journal of Psychiatric Nursing and Mental Health, 34(2), 118-131.
Chisumpa, V. H., & Odimegwu, C. O. (2018). Decomposition of age- and cause-specific adult mortality contributions to the gender gap in life expectancy from census and survey data in Zambia. SSM - Population Health, 5, 218-226.
Coto-Lesmes, R., Fernandez-Rodriguez, C., & Gonzalez-Fernandez, S. (2020). Acceptance and commitment therapy in-group format for anxiety and depression. A systematic review. Journal of Affective Disorders, 263, 107-120.
Davison, T. E., Eppingstall, B., Runci, S., O’Connor, D. W. (2017). A pilot trial of acceptance and commitment therapy for symptoms of depression and anxiety in older adults residing in long-term care facilities. Aging and Mental Health, 21(7), 766-773.
Esmaeilishad, B. (2020). The effectiveness of self-care training on quality of life, self-care behaviors and blood sugar in elderly lacking self-care behaviors. Journal of Aging Psychology, 6(1), 1-11. [Persian]
Fang, S., & Ding, D. (2020). The efficacy of group-based acceptance and commitment therapy on psychological capital and school engagement: A pilot study among Chinese adolescents. Journal of Contextual Behavioral Science, 16, 134-143.
Flujas-Contreras, J. M., & Gomez, I. (2018). Improving flexible parenting with acceptance and commitment therapy: A case study. Journal of Contextual Behavioral Science, 8, 29-35.
Forman, E. M., & Herbert, J. D. (2008). New directions in cognitive behavior therapy: Acceptance based therapies. In: O’donohue O, Fisher JE, editors. Cognitive behavior therapy: Applying empirically supported treatments in your practice. (2nd edition), Hoboken, NJ: Wiley Publisher.
Franco, C., Amutio, A., & Manas, I., Gazquez, J. J., & Perez-Fuentes, M. D. (2017). Reducing anxiety, geriatric depression and worry in a sample of older adults through a mindfulness-training program. Terapia Psicologica, 35(1), 71-79.
Gruppen, E. G., Connelly, M. A., Sluiter, W. J., Bakker, S. J. L., & Dullaart, R. P. F. (2019). Higher plasma GlycA, a novel pro-inflammatory glycoprotein biomarker, is associated with reduced life expectancy: The prevend study. Clinica Chimica Acta, 488, 7-12.
Herhaus, B., Kersting, A., Brahler, E., & Petrowski, K. (2020). Depression, anxiety and health status across different BMI classes: A representative study in Germany. Journal of Affective Disorders, 276, 45-52.
Hill, M. L., Schaefer, L. W., Spencer, S. D., & Masuda, A. (2020). Compassion-focused acceptance and commitment therapy for women with restrictive eating and problematic body-checking: A multiple baseline across participants study. Journal of Contextual Behavioral Science, 16, 144-152.
Izadpanah Kakhak M, Samari A, Tozandehjani H. (2019). The role of loneliness and positive meta-emotion in predicting life expectancy of elderly men. Iranian Journal of Psychiatric Nursing, 7(4), 25-31. [Persian]
Jia, H., Zack, M. M., Gottesman, I. I., & Thompson, W. W. (2018). Associations of smoking, physical inactivity, heavy drinking, and obesity with quality-adjusted life expectancy among US adults with depression. Value in Health, 21(3), 364-371.
Joe, G. W., Lehman, W. E. K., Rowan, G. A., Knight, K., & Flynn, P. M. (2019). The role of physical and psychological health problems in the drug use treatment process. Journal of Substance Abuse Treatment, 102, 23-32.
Khodabakhsh Pirkalani R, Ramezan Saatchi L, Maleki Majd M. (2019). The effectiveness of mindfulness-based cognitive therapy (MBCT) on depression, death anxiety and life expectancy in elderly women. Journal of Gerontology, 3(2), 11-20. [Persian]
Liu, J., Chang, L., Wu, S., & Tsai, P. (2015). Resilience mediates the relationship between depression and psychological health status in patients with heart failure: A cross-sectional study. International Journal of Nursing Studies, 52(12), 1846-1853.
Mehryar, M. (2020). The effectiveness of acceptance and commitment therapy (ACT) on promoting mental health and quality of life in elderly women. Journal of Gerontology, 4(3), 21-29. [Persian]
Moradi, A., Hatamian, A., Hatamian, P., & Morvvati, F. (2019). The relationship between practice religious beliefs and hope with elderly life satisfaction. Rooyesh-e-Ravanshenasi, 8(1), 183-190. [Persian]
Najarian, B., & Davodi, I. (2001). Development and reliability of SCL-25 (short form of SCL-90-R). Journal of Psychology, 5(2), 136-49. [Persian]
Negahban, Z., Arab, M., Tajvar, M., Rahimi Foroshani, A., & Rashidian, A. (2015). A study of the mental health of the elderly in Tehran and its relationship with their social capital. Journal of Healthcare Management, 6(1), 79-88. [Persian]
Nezamdoust Sedehi, M., Borjali, A., Poursharifi, H., Kraskian Mujembari, A., & Seirafi, M. (2018). The relationship between hope and sense of coherence with psychosocial well-being among older people: Mediating role of attitude toward death. Journal of Aging Psychology, 4(3), 179-195. [Persian]
Nimbi, F. M., Rossi, V., Tripodi, F., Luria, M., Flinchum, M., Tambelli, R., & Simonelli, C. (2020). Genital pain and sexual functioning: Effects on sexual experience, psychological health, and quality of life. The Journal of Sexual Medicine, 17(4), 771-783.
Pirhayati, Z., & Barghi Irani, Z. (2017). The effectiveness of acceptance and commitment based treatment on mental health and cognitive function in elderly people with age-related Macula degradation. Journal of Aging Psychology, 3(2), 137-146. [Persian]
Potter, R., O'Keeffe, V., Leka, S., Webber, M., & Dollard, M. (2019). Analytical review of the Australian policy context for work-related psychological health and psychosocial risks. Safety Science, 111, 37-48.
Pourabdol, S., Abbasi, M., Pirani, Z., & Abbasi, M. (2015). The relationship between life expectancy and psychological well-being with quality of life in the elderly. Journal of Aging Psychology, 1(1), 57-65. [Persian]
Qi, D., & Wu, Y. (2018). Does welfare stigma exist in China? Policy evaluation of the Minimum Living Security System on recipients’ psychological health and wellbeing. Social Science & Medicine, 205, 26-36.
Reangsing, C., Rittiwong, T., & Schneider, J. K. (2020). Effects of mindfulness meditation interventions on depression in older adults: A meta-analysis. Aging and Mental Health, 15, 1-10.
Rostami, M., Rasouli, M., & Kasaee, A. (2019). Comparison of the effect of group counseling based on spirituality-based therapy and acceptance and commitment therapy (ACT) on improving the quality of life the elderly. Biannual Journal of Applied Counseling, 9(1), 87-110.
Sagna, A. O., Kemp, M. L. S., DiNitto, D. M., & Choi, N. G. (2020). Impact of suicide mortality on life expectancy in the United States, 2011 and 2015: age and sex decomposition. Public Health, 179, 76-83.
Seyyedjafari, J., Jeddi, M., Mousavi, R., Hoseyni, E., & Shakibmehr, M. (2019). The effectiveness of compassion-focused therapy on elderly life expectancy. Journal of Aging Psychology, 5(2), 157-168. [Persian]
Shrestha, K., Ojha, S. P., Dhungana, S., & Shrestha, S. (2020). Depression and its association with quality of life among elderly: An elderly home- cross sectional study. Neurology, Psychiatry and Brain Research, 38, 1-4.
Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., Yoshinobu, L., Gibb, J., Langelle, C., & Harney, L. P. (1991). The will and the ways: Development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60(4), 570-585.
Tabakhnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics. (5th edition), Boston: Pearson Education Inc.
Tabe Bordbar, F., Banisi, P., & Asadi, R. (2019). The prediction of death anxiety in the elderly based on personality types and mental health. Journal of Aging Psychology, 5(3), 239-249. [Persian]
Wharton, E., Edwards, K. S., Juhasz, K., & Walser, R. D. (2019). Acceptance-based interventions in the treatment of PTSD: Group and individual pilot data using acceptance and commitment therapy. Journal of Contextual Behavioral Science, 14, 55-64.
Xiang, X., Danilovich, M. K., Tomasino, K. N., & Jordan, N. (2018). Depression prevalence and treatment among older home health services users in the United States. Archives of Gerontology and Geriatrics, 75, 151-157.
Yesavage, J. A., & Sheikh, J. I. (1986). Geriatric depression scale (GDS): Recent evidence and development of a shorter version. Journal of Clinical Gerontologist, 5(1-2), 165-173.
Yousefi Afrashteh, M., & Sharifi, K. (2015). The relationship between depression, perceived stress and social support with quality of life in elderly with Alzheimer's disease. Journal of Aging Psychology, 1(2), 1-10. [Persian]
Yuan, Y., Li, J., Jing, Z., Yu, C., Zhao, D., Hao, W., Zhou, C. (2020). The role of mental health and physical activity in the association between sleep quality and quality of life among rural elderly in China: A moderated mediation model. Journal of Affective Disorders, 273, 462-467.
Zhao, X., Zhang, D., Wu, M., Yang, Y., Xie, H., Li, Y., Jia, J., & Su, Y. (2018). Loneliness and depression symptoms among the elderly in nursing homes: A moderated mediation model of resilience and social support. Psychiatry Research, 268, 143-151
Volume 6, Issue 3 - Serial Number 22
October 2020
Pages 191-203
  • Receive Date: 27 September 2020
  • Revise Date: 02 October 2020
  • Accept Date: 03 October 2020
  • First Publish Date: 03 October 2020