The Effectiveness of Acceptance and Commitment Therapy on Death Anxiety, Happiness and Resilience in the Elderly

Aging is one of the most important stages of human life, and people at this stage are faced with various issues, among which issues such as death anxiety, happiness and resilience appear to be the most common issues of mental health in the elderly that can be improved using appropriate interventions. Therefore, the current study aims to examine the effectiveness of acceptance and commitment therapy (ACT) on death anxiety, happiness and resilience in the elderly. This was a quasi-experimental study with the pretest-posttest control group design. The statistical population of the present study included all the elderly living in Lahijan, Iran, among whom 30 people were selected using convenience sampling method and randomly assigned into the experimental and control groups. Both groups completed the Templer’s death anxiety, Oxford happiness, and Conner and Davidson’s resilience questionnaires in pretest and posttest phases. Experimental group underwent eight 60-minute sessions of ACT, while control group received no treatment at this time. Data were analyzed by univariate analysis of covariance (ANCOVA), the results of which revealed that there was a significant difference between the experimental and control groups in terms of death anxiety, happiness and resilience in the posttest phase. Put in other words, ACT resulted in a decrease of death anxiety and an increase of happiness and resilience in the elderly. According to the results of the current study, ACT can be used as an effective treatment method to improve the mental health of the elderly.
References
Abdolazimi, M., & Niknam, M. (2019). The Effectiveness of acceptance and commitment therapy on social support perception and body dissatisfaction in the elderly. Journal of Aging Psychology, 5(1), 13-25. [Persian]
Alipour, A., & Nurbala, A. (1999). A Preliminary investigation of the reliability and validity of the Oxford Happiness Questionnaire in students of Tehran universities. Thought and Behavior Quarterly, 5(1), 55-64. [Persian]
Andalib Kourayem, M., & Mahmoodinia, S. (2021). The Quality of life in the elderly: The Role of resiliency and mindfulness. Aging Psychology, 7(2), 167-179. [Persian]
Argyle, M., & Crossland, J. (1987). Dimensions of positive emotions. British Journal of Social Psychology, 26, 127-137.
Argyle, M., Martin, M., R., & Crossland, J. (1989). Happiness as a function of personality and social encounters. In J. P. Forgas & R. J. M. Innes (Eds.). Recent Advances in Social Psychology: An International Perspective, 28, 189-203.
Argyle.M. (2001). The Psychology of Happiness. Great Britain: Routledge.
Arch, J., Fishbein, J., Ferris, M., Mitchell, J., Levin, M., Slivjak, E., Andorsky, D., & Kutner, S. (2020). Acceptability, feasibility, and efficacy potential of a Multimodal acceptance and commitment therapy intervention to address psychosocial and advance care planning needs among anxious and depressed adults with metastatic cancer. Journal of Palliative Medicine, 11(5), 540-555.
Attari, B., Munirpour, N., & Zarghami Hajbi, M. (2017). The Relationship of happiness with self-acceptance, gratitude and forgiveness in the elderly: The Mediating role of self-efficacy. Aging Psychology, 4(3), 197-211. [Persian]
Ayn Beygi, A., Soleimanian, A., & Jajarmi, M. (2020). The Comparison of the effectiveness of acceptance and commitment therapy and existentialism therapy on increasing psychological capital in the elderly. Aging Psychology, 6(2), 165-178. [Persian]
Bernal-Manrique, K., García-Martín, M., & Ruiz, F. (2020). Effect of acceptance and commitment therapy in improving interpersonal skills in adolescents: A Randomized waitlist control trial. Journal Contextual Behavaral science, 17(3), 86-94.
Bent, R., & A-Eliver, G. (2019). Acceptance and commitment therapy. London. Tolo Majd Publications, ISBN: 978-622-696026-7.
Conner, M., & Davidson, T. (2003). Development of a new resilience scale: The Conner-davidson resilience scale (CD-RISC). Depression and Anxiety, 18, 76-82.
Forman, E., Shaw, J., Goetter, E., Herbert, J., Park, J., & Yuen, E. (2012). Long-term follow-up of a randomized controlled trial comparing acceptance and commitment therapy and standard cognitive behavior therapy for anxiety and depression. Behavior Therapy, 43(4), 11-809.
Francis, L. J., Brow, L. B., Lester, D., & Philipchalk, R. (1998). Happiness as stable extraversion: A Cross-cultural examination of the reliability and validity of the oxford happiness Inventory among students in the U. K., U. S. A., Australian, and Canada. Personality and Individual Differences, 24, 167- 171.
Furnham, A., & Brewin, C. (1990). Personality and happiness. Personality and Individual Differences, 11, 761-763.
Golestanifar, S., & Dasht Bozorgi, Z. (2020). The Effectiveness of acceptance and commitment based therapy on depression, psychological health and life expectancy of the elderly with nonclinical depression. Aging Psychology, 6(3), 191- 203. [Persian]
Hatamian, P., Karami, J., & Moradi, A. (2017). The Effect of resilience, self- efficacy, and social support on job satisfaction among the employed, middle-aged and elderly. Iranian Journal of Ageing, 12(3), 300-311. [Persian]
Hayes, S., Strosahl, K., Bunting, K., Twohig, M., & Wilson, G. (2004). What is acceptance and commitment therapy? A Practical guide to acceptance and commitment therapy, 15(4), 3–29.
Hayes, S., Strosahl, K., & Wilson, K. (2011). Acceptance and commitment therapy: The Process and practice of mindful change. Guilford press.
Hajiazizi, A., Bahmani, B., Tavakoli Manzari, V., Mahdi, N., & Barshan, B. (2017). Effectiveness of group logotherapy on death anxiety and life expectancy of the elderly living in boarding houses in Kerman. Iranian Journal of Ageing, 12(2), 220-231. [Persian]
Hagh Ranjbar, F., Kakavand, A., Barjali, A., & Bermas, H. (2011). Resilience and quality of life of mothers with mentally retarded children. Journal of Health and Psychology, 1(1), 177-187. [Persian]
Helliwell, J., Huang, H., Wang, S., & Norton, M. (2021). World happiness, trust and deaths under covid-19. World Happiness Report, 13–57.
Howells, A., Ivtzan, I., & Eiroa-Orosa, F. (2016). Putting the ‘app’in happiness: a randomised controlled trial of a smartphone-based mindfulness intervention to enhance wellbeing. Journal of Happiness Studies, 17(1), 163-185.
Hosseinzadeh, E., & Khodabakhshi-Kolaee, A. (2017). The Relationship between senses of humor and Mindfulness with anxiety of death in elderly men refer to jahandidegan center of seven regions of municipality in Tehran city. Journal of Health Literacy, 2(3), 177-186. [Persian]
Heravi, M., Hatami, M., & Ahadi, H. (2020). Design and psychometrics of the elderly Happiness Questionnaire. Elder, 15 (4), 1-22. [Persian]
Jamadar, C., & Kumari, A. (2019). Forgiveness and death anxiety in tribes. Motivation and Emotion, 12(1), 152-166.
Karami, J., Sanjabi, A., & Karimi, P. (2015). Predicting life satisfaction based on resilience and happiness in the elderly. Aging Psychology, 2(4), 229-236. [Persian]
Manzomeh, SH., & Akbari, B. (2019). Comparison of the effect of mindfulness-based cognitive therapy (MBCT) and progressive muscle relaxation (PMR) on general health indicators in the mothers of children with leukemia. Quarterly Journal of Child Mental Health, 6(2), 13-26. [Persian]
Meerow, S., & Newell, J. (2019). Urban resilience for whom, what, when, where, and why? Urban Geography, 40(3), 309-329.
Moghbel Esfahani, S., & Haghayegh, S. (2019). The Effectiveness of acceptance and commitment therapy on resilience, meaning in life, and family function in family caregivers of patients with Schizophrenia. Horizon of Medical Sciences, 25 (4), 298-311.
Mohammadi, Masoud. (2006). Investigating factors on resilience in people at risk of substance abuse (Unpublished Doctoral Thesis). University of Welfare and Rehabilitation Sciences. Tehran. [Persian]
Narimani, M., & Samadifar, H. (2016). Social health in the elderly: The Role of self-esteem, self-efficacy and happiness. Aging Psychology, 3(3), 199-206. [Persian]
Ploughman, M., Downer, M., Pretty, R., Wallack, E., Amirkhanian, S., Kirkland, M., et al. (2020). The Impact of resilience on healthy aging with multiple sclerosis. Quality of Life Research, 29(10), 79-2769.
Salaripour, M., Maktabi, G., & Alipour Birgani, S. (2017). The Relationship between emotional intelligence and religious orientation with death anxiety in retired male employees of Khuzestan Steel Industries Company in Ahvaz. Allameh Tabatabai University's Culture and Counseling Psychotherapy Quarterly, 9(33), 99-117. [Persian]
Samani, S., Jokar, B., & Sahragerd, N. (2006). Resilience, mental health and life satisfaction. Iranian Journal of Psychiatry and Psychology, 13(3), 290-295. [Persian]
Seyedjaafari, J., Motamedi, A., Sadr, M., Ulemaei, M., & Hashemian, S. (2016). The Effectiveness of education based on acceptance and commitment on the resilience of the elderly. Aging Psychology, 3(1), 21-29. [Persian]
Sarıkaya, Y., & Baloğlu, M. (2016). The development and psychometric properties of the turkish death anxiety scale (TDAS). Death studies, 40(7), 419-431.
Sábado, T., & Gómez-Benito, J. (2002). Psychometric properties of the Spanish form of Templer's death anxiety scale. Psychology Replication crisis, 91(2), 20-116.
Segal, D., Qualls, Sh., Smyer, M. (2018). Aging and mental health: John wiley & sons. https://doi.org/10.1002/9781119133186.
Sun, Y., & Huang, J. (2019). Psychological capital and innovative behavior: Mediating effect of psychological safety. Social Behavior and Personality, 47(9), 1-7.
Stryzhak, O. (2020). The Relationship between education, income, economic freedom and happiness. SHS Web of Conferences, 75, 1–6.
Talebi, M. A., Sabzevari, P., Nobakhti Qalani, L., & Zarei Mahmoudabadi, H. (2020, September). Comparison of existential anxiety and life expectancy in the elderly with normal care in Isfahan. International Conference on Psychology and Culture of Life. [Persian]
Templer, D. (1970). The Construction and validation of a death anxiety scale. The Journal of General Psychology, 82(2), 165-177.
Valizadeh, H., & Ahmadi, V. (2021). The Effectiveness of acceptance and commitment-based therapy on the quality of life and death anxiety in the elderly. Aging Psychology, 7(2), 153- 166. [Persian]
Varaee, P., Momeni, Kh., & Moradi, A. (2018). Prediction of psychological well-being based on attitude toward religion and death anxiety in the elderly men of Kermanshah's part-time elderly care center. Journal of Research on Religion & Health, 4(2), 54- 68. [Persian]
Zhao, R. (2020). Quantifying the cross-sectional relation of daily happiness sentiment and stock return: Evidence from US. Physica A: Statistical Mechanics and Its Applicationspl, 538, Article 12262.