The Efficacy of Acceptance and Commitment Therapy (ACT) Matrix on Depression and Psychological Capital of the Patients with Irritable Bowel Syndrome


  • Seyyed Mehdi Mirsharifa Department of Psychology, Sari Branch, Islamic Azad University, Sari, Iran
  • Bahram Mirzaian Department of Psychology, Sari Branch, Islamic Azad University, Sari, Iran
  • Yarali Dousti Department of Psychology, Sari Branch, Islamic Azad University, Sari, Iran



Acceptance and Commitment Therapy, Depression, Psychological Capital, Irritable Bowel Syndrome


BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders, worldwide. Psychological disorders are common among patients with IBS.

AIM: This study aims to investigate the efficacy of acceptance and commitment therapy (ACT) matrix on depression and psychological capital of patients with IBS.

MATERIAL AND METHODS: In a quasi-experimental study, a total number of 30 patients with IBS were selected using convenience sampling. Those patients who meet the inclusion criteria were randomly assigned to control and experimental groups (15 patients in each group). Data were collected using the Beck Depression Inventory (BDI) and the Psychological Capital Questionnaire (PCQ). The experimental group was subjected to the acceptance and commitment therapy (ACT) amtrix, but the control group do not receive this treatment. Questionnaires were completed before (pre-test) and after (post-test) the intervention by patients in two groups. All patients in two groups responded to the questionnaires and returned them to the researcher. Data were analyzed using chi-square test, independent t-test, analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA).

RESULTS: Analyzing the data showed that there were significant differences regarding depression and psychological capital between experimental and control group, before and after the study (p < 0.05).

CONCLUSION: Using ACT matrix is a useful modality to improve the depression and psychological capital among patients with IBS.


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Blanchard EB, Lackner JM, Sanders K, Krasner S, Keefer L, Payne A, et al. A controlled evaluation of group cognitive therapy in the treatment of irritable bowel syndrome. Behav Res Ther. 2007; 45(4):633-48. PMid:16979581 DOI:

Ebrahimi A, Naddafnia L, Neshatdust HT, Talebi H, Afshar H, Mail HD, Adibi P. The Effectiveness of Cognitive Behavioral Therapy on Symptoms Intensity, Quality of Life, and Mental Health in Patients with Irritable Bowel Syndrome. Int J Body Mind Culture. 2015; 2(2):76-84.

Chey WD, Maneerattaporn M, Saad R. Pharmacologic and complementary and alternative medicine therapies for irritable bowel syndrome. Gut Liver. 2011; 5(3):253-66. PMid:21927652 PMCid:PMC3166664 DOI:

Videlock EJ, Chang L. Irritable bowel syndrome: current approach to symptoms, evaluation, and treatment. Gastroenterol Clin North Am. 2007; 36(3):665-85. PMid:17950443 DOI:

Faeli A, Mohammadifar MA, Azizpour M, Dabiri R. Comparison of personality traits and quality of life in people with irritble bowel syndrom and normal people. Clinical Psychology. 2017; 9(1):1-10.

Strain JJ. The psychobiology of stress, depression, adjustment disorders and resilience. World J Biol Psychiatry. 2018; 19(sup1):S14-S20. DOI:

Forman EM, Herbert JD, Moitra E, Yeomans PD, Geller PA. A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behav Modif. 2007; 31(6):772-99. PMid:17932235 DOI:

Voinov B, Richie WD, Bailey RK. Depression and chronic diseases: it is time for a synergistic mental health and primary care approach. Prim Care Companion CNS Disord. 2013; 15(2):PCC.12r01468. DOI:

Simon GE. Treating depression in patients with chronic disease: recognition and treatment are crucial; depression worsens the course of a chronic illness. West J Med. 2001; 175(5):292-3. PMid:11694462 PMCid:PMC1071593 DOI:

Whitehead WE, Palsson OS, Levy RR, Feld AD, Turner M, Von Korff M. Comorbidity in irritable bowel syndrome. Am J Gastroenterol. 2007; 102(12):2767-76. PMid:17900326 DOI:

Gholamrezaei A, Minakari M, Nemati K, Daghaghzadeh H, Tavakkoli H, Dehcord MH. Extra-intestinal Symptoms and their Relationship to Psychological Symptoms in Patients with Irritable Bowel Syndrome. Govaresh. 2011; 15(2):88-94.

Luthans F, Luthans KW, Luthans BC. Positive psychological capital: Beyond human and social capital. Business Horizons. 2004; 47(1): 45-50. DOI:

Yamaguchi A. Influences of social capital on health and well-being from qualitative approach. Glob J Health Sci. 2013; 5(5):153-61. PMid:23985117 PMCid:PMC4776875 DOI:

Chen Q, Wen Z, Kong Y, Niu J, Hau KT. Influence of Leaders' Psychological Capital on Their Followers: Multilevel Mediation Effect of Organizational Identification. Front Psychol. 2017; 8:1776. PMid:29075218 PMCid:PMC5643467 DOI:

Harms PD, Vanhove A, Luthans F. Positive projections and health: An initial validation of the implicit psychological capital health measure. Applied Psychology. 2017; 66(1):78-102. DOI:

Kheyrjoo A, Farshbaf T, Seffat M, Aalaee F. Comparison of tolerance of ambiguty of psychological capital and coping styles of cardiac patients and healthy people. Quarterly Journal of Health Psychology. 2017; 6(18):141-152.

Manzano-García G, Ayala JC. Relationship between Psychological Capital and Psychological Well-Being of Direct Support Staff of Specialist Autism Services. The Mediator Role of Burnout. Front Psychol. 2017; 8:2277. PMid:29312101 PMCid:PMC5744169 DOI:

Jiménez FJ. Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. International Journal of Psychology and Psychological Therapy. 2012; 12(3):333-58.

Lundgren T, Dahl J, Yardi N, Melin L. Acceptance and commitment therapy and yoga for drug-refractory epilepsy: a randomized controlled trial. Epilepsy & Behavior. 2008; 13(1):102-8. PMid:18343200 DOI:

Wu LM, Sheen JM, Shu HL, Chang SC, Hsiao CC. Predictors of anxiety and resilience in adolescents undergoing cancer treatment. J Adv Nurs. 2013; 69(1):158-66. PMid:22489627 DOI:

Wetherell JL, Afari N, Rutledge T, Sorrell JT, Stoddard JA, Petkus AJ, et al. A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain. 2011; 152(9):2098-107. PMid:21683527 DOI:

Rajabi GH. Psychometry properties of short form matters of Beck depression inventory. Iranian Psychologists. 2005; 1(4):1-7.

Mohhebi N, SHahani M, Pashsa Sharifi H. The relationship of psychological capital (hope, optimism, resiliency and self-efficacy) with the achievement goals and academic performance of the first-year students. Curriculum Planning Knowledge & Research in Educational Sciences. 2014; 11(13):61-79.

Mohamadi J, Mir Drikvand F, Azizi A. Efficacy of Mindfulness on Anxiety and Depression in Patients with Irritable Bowel Syndrome. J Mazandaran Univ Med Sci. 2015; 25 (130):52-61.

Wynne B, McHugh L, Gao W, Keegan D, Byrne K, Rowan C, Hartery K, Kirschbaum C, Doherty G, Cullen G, Dooley B. Acceptance and Commitment Therapy Reduces Psychological Stress in Patients With Inflammatory Bowel Diseases. Gastroenterology. 2018. PMid:30452919 DOI:

Tsai M, Yard S, Kohlenberg RJ. Functional analytic psychotherapy: a behavioral relational approach to treatment. Psychotherapy (Chic). 2014; 51(3):364-71. PMid:24773095 DOI:

González-Fernández S, Fernández-Rodríguez C. Acceptance and Commitment Therapy in Cancer: Review of Applications and Findings. Behav Med. 2018:1-15. PMid:29558259 DOI:

Baghban A, SHeybani A, Javdani M. Treatment based on acceptance and commitment to the perception of illness and psychological capital in people with type 2 diabetes. Ofogh-e Danesh. 2017; 23(2):135-140. DOI:

Ljótsson B, Andréewitch S, Hedman E, Rück C, Andersson G, Lindefors N. Exposure and mindfulness based therapy for irritable bowel syndrome–an open pilot study. J Behav Ther Exp Psychiatry. 2010; 41(3):185-90. PMid:20079485 DOI:

Gillanders D, Ferreira NB, Angioni E, Carvalho SA, Eugenicos MP. An implementation trial of ACT-based bibliotherapy for irritable bowel syndrome. Journal of Contextual Behavioral Science. 2017; 6(2):172-7. DOI:

Mirzaee V, Sayyadi B, Hasani Moghaddam V. Comparison of depression patients with irritable bowel syndrom and non- infected patients in referrals to the offices of Rafsanjan specialists in the summer of 2010. Journal of Rafsanjan University of Medical Science. 2012; 11(3):259-268.

Kovács Z, Kovács F. Depressive and anxiety symptoms, dysfunctional attitudes and social aspects in irritable bowel syndrome and inflammatory bowel disease. Int J Psychiatry Med. 2007; 37(3):245-55. PMid:18314852 DOI:

Sabour S, Kakabraee K. The Effectiveness of Acceptance and Commitment Therapy on Depression, Stress and Indicators of Pain in Women with Chronic Pain. Iranian Journal of Rehabilitation Research in Nursing. 2016; 2(4):1-9. DOI:

Masuda A, Hayes SC, Sackett CF, Twohig MP. Cognitive defusion and self-relevant negative thoughts: Examining the impact of a ninety year old technique. Behav Res Ther. 2004; 42(4):477-85. PMid:14998740 DOI:

Bagheri P, Saadati N, Fatollahzadeh N, Darbani S. The Effectiveness of Group Acceptance and Commitment Therapy on Self-Efficacy and Social Adjustment of Elderly Retired. Journal of Geriatric Nursing. 2017; 3(2):103-117. DOI:

Baradaran M, Zare H, Alipuor A, Farzad V. Comparison of Effectiveness of Acceptance and Commitment Therapy and Motivational Interviewing on Decreasing Anxiety, Depression, Stress and Increasing Hope in Essential Hypertensive Patients. Clinical Psychology. 2016; 8(4):95-105.

Vahidinekoo M, Gahangir P. The Relationship of Metacognitive Beliefs and Resiliency of Mothers with Hyperactive Children, a Cross-Sectional Study. Imperial Journal of Interdisciplinary Research. 2016; 2(8):349-352.

Samani S, Jokar B, Sahragard N. Effects of Resilience on Mental Health and Life Satisfaction. Iranian Journal of Psychiatry & Clinical Psychology. 2007; 13(3):290-295.

Laurent HK, Kim HK, Capaldi DM. Prospective effects of interparental conflict on child attachment security and the moderating role of parents' romantic attachment. J Fam Psychol. 2008; 22(3):377-88. PMid:18540766 PMCid:PMC2693387 DOI:

Marchand JF. Husbands' and wives' marital quality: The role of adult attachment orientations, depressive symptoms, and conflict resolution behaviors. Attach Hum Dev. 2004; 6(1):99-112. PMid:14982681 DOI:

Karimi Moonaghi H, Emami Zeydi A, Mirhaghi A. Patient education among nurses: bringing evidence into clinical applicability in Iran. Invest Educ Enferm. 2016; 34(1):137-151. PMid:28569983 DOI:



How to Cite

Mirsharifa SM, Mirzaian B, Dousti Y. The Efficacy of Acceptance and Commitment Therapy (ACT) Matrix on Depression and Psychological Capital of the Patients with Irritable Bowel Syndrome. Open Access Maced J Med Sci [Internet]. 2019 Feb. 2 [cited 2023 Sep. 27];7(3):421-7. Available from:



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