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2018 Volume 9 Issue 4

The Effectiveness of Acceptance and Commitment-Based Therapy on Anger, Anxiety and Hostility for Heart Surgery Patients

Mohamadi Kheyran-Alnesa, Bahram Mirzaian and Dousti Yar-Ali

Aims: The purpose of this study was to evaluate the effectiveness of Acceptance and Commitment-Based Therapy (ACBT) on anger, anxiety and hostility in heart surgery patients. Materials and Methods: The present study was quasi-experimental (pre-test, post-test) with experimental and control groups. A follow-up test was conducted two months after the post-test. The statistical population consisted of all patients referring to Vali-e-Asr Hospital in Ghaemshahr during January-February 2017 having a heart surgery and medical record (N = 112). According to the research method, which is a quasi-experimental design, 30 persons were selected through "available sampling" and randomly were assigned to the intervention and control group (15 participants in each group) by inclusion and exclusion criteria. The tools used in this study include Spielberger's Anger Scale (1988), Redford - Williams Hostility Inventory (RWHI) (1981), Beck anxiety (1988), which were provided to the groups for pre-test. After pretest, treatment for the heart surgery patients was performed in the intervention group by a trained psychiatrist doctor student based on ACBT protocol, and the control group did not receive any treatment. We collected data directly after the intervention (first posttest) and 2 months later (second posttest) in both groups. For the research hypotheses test, covariance analysis and SPSS-21 software were used. Results: The results of covariance analysis indicated that ACBT had a significant effect on all three psychological variables studied in the post-test. Conclusion: ACBT has decreased the anger, anxiety and hostility of heart surgery patients in the intervention group.


Alawizadeh F, Shakerian A. Adherence-based treatment and commitment to reducing symptoms of stress, anxiety and depression in women with experience of exaggerated relationships (emotional, sexual). Journal of Psychiatric Nursing, 2016; 4(6): 14-8.

Alizadeh S Aghakhani N, Hemmati Maslakpak M, Khademvatan K, (2018), “a study of the effect of self -

      care program based on orem’s model on the quality of life in patients with heart failure”, Pharmacophore, 9(2), 97-102.

Al-Yassin S.A, Kakasoltani F, Farhani-Far M. The Effectiveness of Acceptance and Commitment Therapy on Anxiety, Quality of Life and Self-efficacy in Patients with Pre-Anxiety Syndrome. Nursing Development in Health, 2016; 7(2): 27-35.

Amin-Wand S. The Effectiveness of Group Treatment of Acceptance and Commitment on Reducing Anxiety and Increasing Resilience and Life Expectancy in Patients Admitted to UCI in Rasoul Akram Hospital, Rasht. Graduate Thesis, Islamic Azad University, Rasht Branch, 2015.

Annunziata AJ, Green JD, Marx BP. Acceptance and commitment therapy for depression and anxiety. Encyclopedia of Mental Health. New York: Williams & Wilkins. 2015.

Bach, P., & Hayes, S. C. (2002). The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 70, 1129- 1139

Baradaran M, Zare H, Ali-Pour A, Farzad W.A. Comparison of the effectiveness of treatment based on commitment and acceptance and motivational interview on reduction of anxiety, depression, psychological pressure and increase of hope in patients with essential hypertension. Journal of Clinical Psychology, 2016; 32(4):95-105.

Barefoot JC. Developments in the measurement of hostility. In Friedman HS, editor. Hostility, coping and health. Washington DC: American Psychological Association; 1992.p. 13-31.

Basampoor S.S. The effect of preoperative training on the anxiety of patients undergoing open heart surgery, Payesh Quarterly Journal, 2009; 3(2): 139-144.

Behrouz B, Boali F, Heidarizadeh N, Farhadi M. The Effectiveness of Acceptance and Commitment Therapy on Psychological Symptoms, Coping Styles and Quality of Life in Type II Diabetic Patients. Journal of Health, 2016; 7(2): 236-256.

Bleil ME, Mccaffery JM, Muldoon MF, Sutton-tyrrell KIM, Manuck SB. Anger related personality traits and carotid artery atherosclerosis in untreated hypertensive men. Psychosom Med 2004; 66: 633-9.

Dembroski TM, MacDougall JM, Williams RB, Haney TL, Blumenthal JA. Components of Type A, hostility, and angerin: relationship to angiographic findings. Psychosomatic Medicine 1985;47(3):219-33.

Doosti P, Gholami S, Torabian S. The Effectiveness of Acceptance and Commitment Therapy on Aggression Reduction in Students with Internet Addiction. Health and Care, 2016; 18(1): 72-63.

Eastwood A., Doering L., Dracup K., Evangelista L., Hays A. (2010) Health-related quality of life: The impact of diagnostic angiography. JHEART & LUNG 3(4), 67-78.

Eifert GH, Heffner M. The effect of acceptance versus control contexts on avoidance of panicrelated symptoms. J Behav Ther Exp Psychiatry.2003 Sep-Dec; 34: 293-312

Farahani M.T, Valid-Allah F, Mokhtari F. Psychometric Properties of Spielberger's Condition-Self-Esteem Questionnaire (Form No. 2). Dissertation thesis, Educational sciences, 2008; 38(4): 188-165.

Gallagher R, McKinley S. Stressors and anxiety in patients undergoing coronary artery bypass surgery. American Journal of Critical Care. 2007;16(3):248-57.

Graham CD, Gillanders D, Stuart S & Gouick J. An acceptance and commitment therapy (ACT) based intervention for an adult experiencing post-stroke anxiety and medically unexplained symptoms. Clinical Case Studies, 2014; 13(3):230-48

Hayes, S.C., Masuda, A., Bissett, R., Luoma,J.,& Guerrero, L.F.(2004). DBT, FAP, ACT: How Emirically Oriented are the New Behavior Thearpy technologies? Behavior Therapy, 35,35-54.

Hayes, S.C., Strosahl, K.D., Wilson, K.G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. 3rd ed. New York, NY:Guilford; p.165-171

Hecker M, Chesney M, Black G, Frautschi N. Coronary-prone behaviors in the Western collaborative group study. Psychosomatic Medicine 1988; 50: 153-64. 

Izadi R. Evaluating and comparing the effectiveness of treatment based on admission and commitment and cognitive-behavioral therapy based on extreme responsibility on obsessive-compulsive symptoms and beliefs, quality of life, psychological flexibility, depression and anxiety in patients with obsessive-compulsive disorder and treatment-resistant practice. PhD dissertation, Psychology, Isfahan University, Faculty of Psychology and Educational Sciences, Psychology Department.

Jahangirpoor M, Mousavi W.A, Khosrow Javid M, Salari A, Rezaei S. The Effect of Group A Mindfulness Training on Depression, Anger, and Anxiety in People with Coronary Heart Disease. Urmia Medical Journal, 2013; 24(9): 730-739.

Khanjani S. Effectiveness of group training based on admission and commitment therapy on ethical disturbances, resiliency and burnout. Shahid Beheshti University of Medical Sciences, Faculty of Medicine, Graduate Student, Clinical Psychology, 2015.

Linehan M. Cognitive-Behavioral treatment of borderline personality disorder. New York:Guilford Press; 1993.

MacDougall JM, Dembroski TM, Dimsdale JE, Hackett TP. Components of Type a, hostility, and anger-in: further relationships to angiographic findings. Health Psych 1985; 4(2): 137-52.

 Marzangi A, Ahangarzadeh Rezaei S, Ghareagaji Asl R. (2018). “Health literacy and its relation to quality of life in people with heart disease” .  International Journal of Pharmaceutical and Phytopharmacological Research, 8(3), pp.25-32.

Ossman WA, Wilson KG, Storaasli RD, McNeill JW. A preliminary investigation of the use of acceptance and commitment therapy in group treatment for social phobia. Int J Psychol & Psychol Ther. 2006 Nov; 6(3):397-416.

Rohi-Hir A, Ghaffari O. The Effectiveness of Acceptance and Commitment (ACT) Treatment in Improving Social Anxiety in People with Social Anxiety Disorder. First Scientific Conference on Educational Sciences and Psychology of Social and Cultural Dangers in Iran, 2014.

Soh NHBC, Roy A. Stress, anxiety, and depression in clinicalpractice of undergraduates and awareness of its effective management -A survey. JAdv PharmEdu Res 2017;7(2):82-85.

Spielberger, C. Johnson, E. Crane, R. Jacobs, C. & Worden, T. (1985). The experience and expression of on anger expression scale. In M. A. Chesney & R. H. Rosenman (Eds.). Anger and hostility in cardiovascular and behavioral disorders. (pp. 5-30). New York: Hemisphere / Mc Craw – Hill

Swain J, Hancock K, Dixon, Koo S, Bowman J. Acceptance and commitment therapy for anxious children and adolescents: study protocol for a randomized controlled trial. (Retrieved 18 OCT 2015, fromhttp:// www. ncbi. nlm. nih.gov/pmc/articles/PMC3662565) 2013.

Yasaee-Sekeh M, Shafi-Abadi A, Vali-Allah F. Comparison of the effectiveness of acceptance and commitment (ACT) therapy with cognitive therapy based on mindfulness (MBCT) on anxiety and depression in hemodialysis patients. 2017; 19(3): 230-220.



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