The Comparison of the Effectiveness of Positive Therapy and Acceptance and Commitment Therapy on the Anxiety and Depression of the Elderly Living in Nursing Homes

Document Type : Original Article

Authors

1 Dept of Psychology, Faculty of Literature and Humanities, Payame Noor University of Tehran, Iran

2 Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Siegen, Germany

10.22126/jap.2022.7763.1623

Abstract

Experiencing physical disability, dissidents and loss of relatives, the elderly seems to think more about the death, and if this goes beyond its normal limits, it causes them to feel depressed and helpless. Therefore, the purpose of this study was to compare the effectiveness of positive therapy (PT) and acceptance and commitment therapy (ACT) on death anxiety and depression in the elderly. This was a quasi-experimental study with pretest-posttest and follow-up design with a control group. The statistical population of the current study included all the elderly (75-55 years old) living in the nursing homes of Tehran, Iran, among which Kahrizak nursing home was selected by convenience sampling, where 30 people (three groups of 10 individuals) were selected using convenience sampling and according to inclusion and exclusion criteria of the study, and randomly assigned into two experimental and one control groups. The Magyar-Moe’s PT and Hayes's ACT were conducted in shape of eight 90-minute sessions (twice a week). The follow-up phase test was performed one month after the post-test phase. Templer’s death anxiety and Beck’s depression questionnaires were used to collect data. Data were analyzed using univariate analysis of covariance and Bonferroni post-hoc test in SPSS-22 software. The results demonstrated that compare to control group, both PT and ACT groups had lower scores of death anxiety and depression in posttest and follow-up. That is both therapeutic methods resulted in the reduction of death anxiety and depression in the elderly. Besides, the results of post-hoc test revealed that PT is more effective in the reduction of depression in both posttest and follow-up phases. However, this difference did not hold for death anxiety. According to the mentioned results, PT and ACT can be used in order to improve the death anxiety and depression in the elderly living in nursing homes.
References
Abedi, N., Tashk, A., Khezri Moghadam, N, and Ebrahimi, M, (2019, April). The effectiveness of administration based on acceptance and commitment on the anxiety of the death of the elderly. Paper presented in the National Conference on Research and Innovation in Psychology, with a special look on the third wave therapies approach, Babylonia. [Persian]
Ahmadi, V., & Valizadeh, H. (2021). The Effectiveness of adjustment based on admission and commitment on quality of life and anxiety of the elderly death. Aging Pychology, 7 (2), 166-153. [Persian]
Bagherzadeh, M. (2021). Predictive anxiety of death and existential anxiety based on anxiety sensitivity in the elderly in the time of the disease of Corona, Masters of the Art, Islamic Azad University. [Persian]
Barghi Irani, M., Abbasi, M., Khanbabai Ghaleii, C., and Rezaei, Sh. (2019, September). The effect of a positive treatment on death anxiety and loneliness of the elderly. The article provided in the fourth National Conference on Psychology of Payame Noor University, Rasht. Retrieved from https://civilica.com/doc/1126558/ [Persian]
Forman, E. M., & Here, D. (2008). Cognitive behavior therapy: Applying empirically supported treatments in your practice (2nd ed.). Wiley.
Ghadmpour, A., Moradizadeh, S., & Shah Karami, M. (2019). Evaluation of the effectiveness of mindfulness training on reducing loneliness and death anxiety in the elderly in Siddiq Center of Khorramabad. Razi Journal of Medical Sciences, 26 (4), 44-53. [Persian]
Ghanei, R., Parizad, N., & Sayehmiri, K. (2016). The relationship between depression and metabolic syndrome: systematic review and meta-analysis study. Iranian Red Crescent, 18(6), 243-265. [Persian]
Golestanifar, S., & Dashtbozorgi, Z. (2019). The  Effectiveness of administration based on acceptance and commitment on depression, psychological health and life expectancy with non-final depression. Aging Pychology, 6(3), 191-223.
Hamidi, O., Seifi Ghozlu, J., Sharifi, G., & Lavasani, M. (2013). The relationship between the personal values and death anxiety among MS patients. Journal of Psychology, 17(4), 365-380. [Persian]
Hayes, SC. (2019). Acceptance and commitment therapy: towards a unified model of behavior chang, World Psychiatry, 18(2), 226-237.
Hoshyar, F., Hoshyar, J., & Shiri, K. (2015, June). The effectiveness of cognitive-behavioral therapy on depression and death anxiety in the elderly of Pasargad.Paper  presented in National Conference on the Third Millennium and Humanities, Shiraz. Retrieved from https://civilica.com/doc/398833/ [Persian]
Hossein Nazzari, N., Nejat, H., & Safarian Tusi M. (2022). Comparison of the effectiveness of the treatment of therapy with admission and commitment treatment on the anxiety of the elderly death. Aging Pychology, 8 (1), 25-38. [Persian]
Imran, A., Azidah, A., Asrenee, A., & Rosediani, M. (2014). Prevalence of depression and its associated factors among elderly patients in outpatient clinic of Universiti Sains Malaysia Hospital. The Medical Journal of Malaysia, 64(2),134-139.
Kabiri Nasab, Yad., & Abdollahzadeh, H. (2017, November). The Effect of adoption and commitment on quality of life, depression and dimension of the elderly. Paper presented in Sixth Congress of Iranian Psychology, Tehran. [Persian]
 Khudabakhshi Kolaei, A., Heidari, F., & Zanganeh Motlagh, F. (2018). The effectiveness of group prayer-combination therapy and positivist psychology on semantics and death anxiety in elderly women with physical disabilities. Research in religion and health, 2(4), 16-28. [Persian]
Kim, O., Byeon, Y-S., Kim, J-H., Endo, E., Akahoshi, M., & Ogasawara, H. (2009). Loneliness, depression and health status of the institutionalized elderly in Korea and Japan. Asian Nursing Research, 3(2), 63-70.
Krause, N. (2006). Gratitude toward God, stress, and health in late life. Research on Aging, 28 (2), 163-183.
Lopez, S. J., Snyder, C. R., & Pedrotti, J. T. (2006). Hope: many definitions, many measures. In C. R. Snyder & S. J. Lopez (Eds.), Positive psychological Assessment: A handbook of models and measures (PP. 91-106). American Psychological Association.
Magyar Moe, J. L. (2009). Therapist's Guide to Positive Psychological Interventions. Cambridge: Academic Press.
Masoudi, S. H., Hatami, H., Modares Gharavi, M., & Bani Jamali, Sh. (2016). The Mediating role of early maladaptive schemas in relationship between attachment styles and anxiety of death among cancer patients. Thought & Behavior in Clinical Psychology, 9(39), 37-46. [Persian]
Momeni, K., Amani, R., Majzoobi, M. R., & Mohebi, Z. (2014). The Effectiveness of structured group reminiscence on depression and self-esteem of older women. International Journal of Behavioral Sciences, 8(3), 287-294. [Persian]
Mueller, T. I., Kohn, R., Leventhal, N., Leon, A. C., Solomon, D., Coryell, W. (2013). The course of depression in elderly patients. The American journal of geriatric psychiatry, 12(1), 22-9.
Naghipour, M., Kazemian Moghadam, K., & Haroon Rashidi, H. (2020). The effectiveness of positive psychology on suicidal ideation and death anxiety in the elderly. Psychology of Aging, 6 (4), 367-357. [Persian]
Naziri, gh., Behzadipour, S., & Adibi Parsa, B. (2015, May). The effectiveness of group treatment and commitment based on the acceptance of the depression in the elderly. Paper presented in the first international conference of psychology and consulting (challenges and processes). https://www.civilica.com/doc/765780/ [Persian]
 Nozari, S. (2019). Phenomenology of anxiety and death from Heidegger and Freud's perspective in the phenomenon and treatment of psychological diseases, Masters of the Masters, Allameh Tabataba'i University, Faculty of Psychology and Science. [Persian]
Peterson, C., & Seligman, M, EP. (2004). “Learned helplessness: A thory for the age of person control newyork”: oxford university press.
Roshani, Kh. (2012). Relationship between religious beliefs and life satisfaction with death anxiety in the elderly. Annals of Biological Research, 3(9), 4400-4405. [Persian]
Sadri Demirchi, A., Mohammadi, N., Ramezani, Sh., & Amanzad, Z. (2018). Evaluation of the effectiveness of group spiritual therapy on happiness and psychological hardiness of elderly women. Research in Religion and Health, 4(2), 42-53. [Persian]
 Sajadi, H., Mohaqeqi kamal, H., Vameghi, M., Forozan, A., Rafei, H., & Nosratabadi, M. (2013). Systematic review of prevalence and risk factors associated with depression and its treatment in Iranian elderly. Iranian Journal of Ageing, 7(27), 7-15. [Persian]
Seligman, M. (2010). Authentic happiness: Using the new positive psychology to realize your potential for Lasting Fulfilling. New York: Free Press.
Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60(3), 410–421.
Sharifi Saki, S., Alipour, A., AghaYousefi, A., Mohammadi, M R., & Ghobari Bonab, B. (2020). Relationship of Attachment Styles to God and Depression with Death Anxiety as a Mediator among Women with Breast Cancer, Religion and health, 7(2) ,1-11. [Persian]
Snyder, C. R. (2002). “Hope Theory: Rainbows in the Mind. PsychologicalInquiry, 13(2), 249-275.
Snyder, C.R., & Yamhure, L. C. (2000). Heartland Forgiveness Scale.Unpublished manuscript, UniversityKansas, Lawrence.
Taghipour, O; & Shahabi, M. (2019). The effect of positive education on the resilience and depression group of the elderly of Tehrani residential sites, the Journal of Cultural Psychology, 1 (4), 87-98. [Persian]
 Templer, D. I (1970). The construction and validation of a Death Anxiety scale, Journal of Generalpsychology, v. 82, p. 165-177.
Vesal, M. (2014). Depression prediction based on pain perceptions and sleep quality with the patient's catastrophic interference in patients with elderly articular contemporary, Masters of the Masters, Shiraz University, Faculty of Psychology and Educational Sciences. [Persian]
 Wilson, KG., Sandoz, EK.,& Kitchens, J. (2010). The Valued Living Questionnaire: Defining and measuring valued action within a behavioral framework. Psychol Record, 6(3),249-72.
Yaghobi, M., Peiman, H., Seyedmohamadi, A., & Delpisheh A. (2012). Prevalence of choronic diseases in the elderly in Ilam. Salmand, 6(4),7-13. [Persian]
Zenden, V. (2016). Dysthymia and major depression: distinct conditions or different stages along a one-dimensional continuum? Journal of Cognitive Psychotherapy, 17(4), 335–346.

Keywords


References
Abedi, N., Tashk, A., Khezri Moghadam, N, and Ebrahimi, M, (2019, April). The effectiveness of administration based on acceptance and commitment on the anxiety of the death of the elderly. Paper presented in the National Conference on Research and Innovation in Psychology, with a special look on the third wave therapies approach, Babylonia. [Persian]
Ahmadi, V., & Valizadeh, H. (2021). The Effectiveness of adjustment based on admission and commitment on quality of life and anxiety of the elderly death. Aging Pychology, 7 (2), 166-153. [Persian]
Bagherzadeh, M. (2021). Predictive anxiety of death and existential anxiety based on anxiety sensitivity in the elderly in the time of the disease of Corona, Masters of the Art, Islamic Azad University. [Persian]
Barghi Irani, M., Abbasi, M., Khanbabai Ghaleii, C., and Rezaei, Sh. (2019, September). The effect of a positive treatment on death anxiety and loneliness of the elderly. The article provided in the fourth National Conference on Psychology of Payame Noor University, Rasht. Retrieved from https://civilica.com/doc/1126558/ [Persian]
Forman, E. M., & Here, D. (2008). Cognitive behavior therapy: Applying empirically supported treatments in your practice (2nd ed.). Wiley.
Ghadmpour, A., Moradizadeh, S., & Shah Karami, M. (2019). Evaluation of the effectiveness of mindfulness training on reducing loneliness and death anxiety in the elderly in Siddiq Center of Khorramabad. Razi Journal of Medical Sciences, 26 (4), 44-53. [Persian]
Ghanei, R., Parizad, N., & Sayehmiri, K. (2016). The relationship between depression and metabolic syndrome: systematic review and meta-analysis study. Iranian Red Crescent, 18(6), 243-265. [Persian]
Golestanifar, S., & Dashtbozorgi, Z. (2019). The  Effectiveness of administration based on acceptance and commitment on depression, psychological health and life expectancy with non-final depression. Aging Pychology, 6(3), 191-223.
Hamidi, O., Seifi Ghozlu, J., Sharifi, G., & Lavasani, M. (2013). The relationship between the personal values and death anxiety among MS patients. Journal of Psychology, 17(4), 365-380. [Persian]
Hayes, SC. (2019). Acceptance and commitment therapy: towards a unified model of behavior chang, World Psychiatry, 18(2), 226-237.
Hoshyar, F., Hoshyar, J., & Shiri, K. (2015, June). The effectiveness of cognitive-behavioral therapy on depression and death anxiety in the elderly of Pasargad.Paper  presented in National Conference on the Third Millennium and Humanities, Shiraz. Retrieved from https://civilica.com/doc/398833/ [Persian]
Hossein Nazzari, N., Nejat, H., & Safarian Tusi M. (2022). Comparison of the effectiveness of the treatment of therapy with admission and commitment treatment on the anxiety of the elderly death. Aging Pychology, 8 (1), 25-38. [Persian]
Imran, A., Azidah, A., Asrenee, A., & Rosediani, M. (2014). Prevalence of depression and its associated factors among elderly patients in outpatient clinic of Universiti Sains Malaysia Hospital. The Medical Journal of Malaysia, 64(2),134-139.
Kabiri Nasab, Yad., & Abdollahzadeh, H. (2017, November). The Effect of adoption and commitment on quality of life, depression and dimension of the elderly. Paper presented in Sixth Congress of Iranian Psychology, Tehran. [Persian]
 Khudabakhshi Kolaei, A., Heidari, F., & Zanganeh Motlagh, F. (2018). The effectiveness of group prayer-combination therapy and positivist psychology on semantics and death anxiety in elderly women with physical disabilities. Research in religion and health, 2(4), 16-28. [Persian]
Kim, O., Byeon, Y-S., Kim, J-H., Endo, E., Akahoshi, M., & Ogasawara, H. (2009). Loneliness, depression and health status of the institutionalized elderly in Korea and Japan. Asian Nursing Research, 3(2), 63-70.
Krause, N. (2006). Gratitude toward God, stress, and health in late life. Research on Aging, 28 (2), 163-183.
Lopez, S. J., Snyder, C. R., & Pedrotti, J. T. (2006). Hope: many definitions, many measures. In C. R. Snyder & S. J. Lopez (Eds.), Positive psychological Assessment: A handbook of models and measures (PP. 91-106). American Psychological Association.
Magyar Moe, J. L. (2009). Therapist's Guide to Positive Psychological Interventions. Cambridge: Academic Press.
Masoudi, S. H., Hatami, H., Modares Gharavi, M., & Bani Jamali, Sh. (2016). The Mediating role of early maladaptive schemas in relationship between attachment styles and anxiety of death among cancer patients. Thought & Behavior in Clinical Psychology, 9(39), 37-46. [Persian]
Momeni, K., Amani, R., Majzoobi, M. R., & Mohebi, Z. (2014). The Effectiveness of structured group reminiscence on depression and self-esteem of older women. International Journal of Behavioral Sciences, 8(3), 287-294. [Persian]
Mueller, T. I., Kohn, R., Leventhal, N., Leon, A. C., Solomon, D., Coryell, W. (2013). The course of depression in elderly patients. The American journal of geriatric psychiatry, 12(1), 22-9.
Naghipour, M., Kazemian Moghadam, K., & Haroon Rashidi, H. (2020). The effectiveness of positive psychology on suicidal ideation and death anxiety in the elderly. Psychology of Aging, 6 (4), 367-357. [Persian]
Naziri, gh., Behzadipour, S., & Adibi Parsa, B. (2015, May). The effectiveness of group treatment and commitment based on the acceptance of the depression in the elderly. Paper presented in the first international conference of psychology and consulting (challenges and processes). https://www.civilica.com/doc/765780/ [Persian]
 Nozari, S. (2019). Phenomenology of anxiety and death from Heidegger and Freud's perspective in the phenomenon and treatment of psychological diseases, Masters of the Masters, Allameh Tabataba'i University, Faculty of Psychology and Science. [Persian]
Peterson, C., & Seligman, M, EP. (2004). “Learned helplessness: A thory for the age of person control newyork”: oxford university press.
Roshani, Kh. (2012). Relationship between religious beliefs and life satisfaction with death anxiety in the elderly. Annals of Biological Research, 3(9), 4400-4405. [Persian]
Sadri Demirchi, A., Mohammadi, N., Ramezani, Sh., & Amanzad, Z. (2018). Evaluation of the effectiveness of group spiritual therapy on happiness and psychological hardiness of elderly women. Research in Religion and Health, 4(2), 42-53. [Persian]
 Sajadi, H., Mohaqeqi kamal, H., Vameghi, M., Forozan, A., Rafei, H., & Nosratabadi, M. (2013). Systematic review of prevalence and risk factors associated with depression and its treatment in Iranian elderly. Iranian Journal of Ageing, 7(27), 7-15. [Persian]
Seligman, M. (2010). Authentic happiness: Using the new positive psychology to realize your potential for Lasting Fulfilling. New York: Free Press.
Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60(3), 410–421.
Sharifi Saki, S., Alipour, A., AghaYousefi, A., Mohammadi, M R., & Ghobari Bonab, B. (2020). Relationship of Attachment Styles to God and Depression with Death Anxiety as a Mediator among Women with Breast Cancer, Religion and health, 7(2) ,1-11. [Persian]
Snyder, C. R. (2002). “Hope Theory: Rainbows in the Mind. PsychologicalInquiry, 13(2), 249-275.
Snyder, C.R., & Yamhure, L. C. (2000). Heartland Forgiveness Scale.Unpublished manuscript, UniversityKansas, Lawrence.
Taghipour, O; & Shahabi, M. (2019). The effect of positive education on the resilience and depression group of the elderly of Tehrani residential sites, the Journal of Cultural Psychology, 1 (4), 87-98. [Persian]
 Templer, D. I (1970). The construction and validation of a Death Anxiety scale, Journal of Generalpsychology, v. 82, p. 165-177.
Vesal, M. (2014). Depression prediction based on pain perceptions and sleep quality with the patient's catastrophic interference in patients with elderly articular contemporary, Masters of the Masters, Shiraz University, Faculty of Psychology and Educational Sciences. [Persian]
 Wilson, KG., Sandoz, EK.,& Kitchens, J. (2010). The Valued Living Questionnaire: Defining and measuring valued action within a behavioral framework. Psychol Record, 6(3),249-72.
Yaghobi, M., Peiman, H., Seyedmohamadi, A., & Delpisheh A. (2012). Prevalence of choronic diseases in the elderly in Ilam. Salmand, 6(4),7-13. [Persian]
Zenden, V. (2016). Dysthymia and major depression: distinct conditions or different stages along a one-dimensional continuum? Journal of Cognitive Psychotherapy, 17(4), 335–346.