[Home ] [Archive]   [ فارسی ]  
:: Main :: About :: Current Issue :: Archive :: Search :: Submit :: Contact ::
:: Volume 4, Issue 4 (Military Caring Sciences 2018) ::
MCS 2018, 4(4): 236-248 Back to browse issues page
The Effect of Mindfulness-Based Stress Reduction Intervention on Psychological Flexibility, Distress Tolerance, and Re-Experiencing the Trauma in Veterans with Post-Traumatic Stress Disorder
Kazemi. H1 , Farzaneh Shojaei Miss 2, Mohammad Soltanizadeh Mr3
1- Ph.D. in Psychology, Assistant Professor, Iran, Tehran, International Center University, Psychiatry Department.
2- Iran, Isfahan, International Center University.
3- Assistant Professor, Iran, Isfahan, International Center University, Psychiatry Department.
Abstract:   (7244 Views)

Introduction: In Iran, a large number of veterans have post-traumatic stress disorder and many attempts were made to assess a variety of psychological treatments in this regard; the mindfulness-based stress reduction intervention is one of the methods that might be helpful.
Objective: The current study aimed at investigating the effect of mindfulness-based stress reduction intervention on psychological flexibility, distress tolerance, and re-experiencing the trauma in veterans with post-traumatic stress disorder.
Methods and Material: The current semi-experimental study was conducted in 2016 using pretest and posttest, and a control group. The study population included the veterans with post-traumatic stress disorder referred to Rajaei Hospital of Najafabad, Isfahan Province, Iran. A sample of 40 veterans were selected and randomly divided into the 2 groups of experimental and control. The data collection instruments were the acceptance and action questionnaire, distress tolerance scale, and secondary traumatic stress scale; both groups filled out the questionnaires in pretest. The experimental group was exposed to the mindfulness-based stress reduction therapy. Then, both group refilled out the same questionnaires in posttest.
Results: The data were analyzed with MANCOVA. The results revealed that the mindfulness-based stress reduction therapy had positive effects on distress tolerance (F=4.16, P<0.05) and re-experiencing the trauma (F=10.92, P<0.05), but there was no significant difference in psychological flexibility between the groups (F=2.14, P>0.05). The effectiveness in the subscale of distress tolerance (tolerance, absorption, evaluation, and set) and secondary traumatic stress (intrusion, avoidance, and arousal) was significant. The mean ± standard deviation (SD) of flexibility scores in pretest and posttest in the experimental group was 33.21±4.08 and 36.32±3.34, and in the control group was 33.48±5.83 and 33.17±5.57, respectively. Regarding distress tolerance in the experimental group the mean ± SD was 32.62±7.68 and 39.87±8.05, and in the control group was 34.77±9.66 and 9.66±10.00 in the pretest and posttest, respectively. About re-experiencing the trauma, the mean ± SD in the experimental group was 62.86±7.47 and 57.24±10.64, and in the control group was 57.24±10.64 and 54.76±12.52 in the pretest and posttest, respectively.
Discussion and Conclusion: The results showed a significant positive effect of the mindfulness-based stress reduction therapy on the increase of distress tolerance and decrease of post-traumatic stress disorder. Mindfulness training enables the individuals to merely observe and accept their emotional experiences and there is no need for making any changes. The result obtained from the analysis of psychological flexibility was probably due to small sample size of the current study.

Keywords: Distress Tolerance, Flexibility, Post-traumatic Stress Disorder, Re-experiencing the Trauma, Mindfulness-based Stress Reduction.
Full-Text [PDF 454 kb]   (1945 Downloads)    
Type of Study: Applicable | Subject: Special
Received: 2017/10/27 | Accepted: 2018/02/5 | Published: 2018/04/18
1. Kazemi A. [Educational effectiveness of Mindfulness based cognitive strategies in reducing the symptoms of secondary traumatic stress disorder in wife of veterans]. Thoughts Behav Clin Psychol. 2012;6(23):31-42.
2. Batcher J, Hooley J, Mineka S. [Abnormal Pshychology]. Tehran: Arasbaran Publication; 2014
3. Ebadi M, Azrami S, Shafiee S. [Post-traumatic stress disorder]. J Army Nurs Fac Islamic Republic Iran. 2012;12(2).
4. Mohaghegh-Motlagh S-J, Momtazi S, Musavi-Nasab S-N, Arab A, Saburi E, Saburi A. [Post-traumatic stress disorder in male chemical injured war veterans compared to non-chemical war veterans]. Med J Mashhad Univ Med Sci. 2014;56(6):361-8.
5. Shaykh Bardsiri H, Sarhadi M, Abdollahiar A, Dastress M, Sheikhrabari A, Aminizadeh M. [The Relationship between Personality Characteristics and Post Traumatic Stress Disorder in Emergency Personnel 115 and Emergency Hospital Personnel]. J Faculty Nurs. 2014;8(1):35-42.
6. Imani S, Atef Vahid M, Asgharnejad A. [Relationship between the severity of symptoms of post- traumatic stress disorder and the quality of life component in veterans]. Payesh J. 2014;13(2):211-9.
7. Hayes SC. Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies - Republished Article. Behav Ther. 2016;47(6):869-85. DOI: 10.1016/j.beth.2016.11.006 PMID: 27993338 [DOI] [PubMed]
8. Hu T, Zhang D, Wang J. A meta-analysis of the trait resilience and mental health. Pers Individ Differ. 2015;76:18-27. DOI: 10.1016/j.paid.2014.11.039 [DOI]
9. Mealer M, Jones J, Newman J, McFann KK, Rothbaum B, Moss M. The presence of resilience is associated with a healthier psychological profile in intensive care unit (ICU) nurses: results of a national survey. Int J Nurs Stud. 2012;49(3):292-9. DOI: 10.1016/j.ijnurstu.2011.09.015 PMID: 21974793 [DOI] [PubMed]
10. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2006;44(1):1-25. DOI: 10.1016/j.brat.2005.06.006 PMID: 16300724 [DOI] [PubMed]
11. Alizadeh A, Haji Yousefi A, Farrozhi M, Zoghi H. [Predict Symptoms of depression Based on Psychological Flexibility, rumination and Mindfulness in student]. Shenakht J Psychol Psychiat. 2015:15-29.
12. Karimzadeh J, Latifi Z. [The effect of educational intervention on reducing anxiety, depression and increasing the flexibility of women with asthma in the way of Act]. Second National Conference on Psychology and Behavioral Sciences; Tehran, Iran2014.
13. Fledderus M, Bohlmeijer ET, Fox JP, Schreurs KM, Spinhoven P. The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial. Behav Res Ther. 2013;51(3):142-51. DOI: 10.1016/j.brat.2012.11.007 PMID: 23337183 [DOI] [PubMed]
14. Fledderus M, Bohlmeijer ET, Pieterse ME. Does experiential avoidance mediate the effects of maladaptive coping styles on psychopathology and mental health? Behav Modif. 2010;34(6):503-19. DOI: 10.1177/0145445510378379 PMID: 20660354 [DOI] [PubMed]
15. Vujanovic A, Bernstein A, Zvolencky M. Distress tolerance: Theory, Research & Clinical: Guilfod Publication; 2011.
16. Andameighoshk A. [The role of resilient mediator in the relationship between cognitive emotion regulation and distress tolerance with life satisfaction]. Tehran: Allameh Tabatabai University; 2013
17. Simons JS, Gaher RM. The Distress Tolerance Scale: Development and Validation of a Self-Report Measure. Motiv Emot. 2005;29(2):83-102. DOI: 10.1007/s11031-005-7955-3 [DOI]
18. Vujanovic AA, Bonn-Miller MO, Potter CM, Marshall EC, Zvolensky MJ. An evaluation of the relation between distress tolerance and posttraumatic stress within a trauma-exposed sample. J Psychopathol Behav Assess. 2011;33(1):129-35.
19. Nila K, Holt DV, Ditzen B, Aguilar-Raab C. Mindfulness-based stress reduction (MBSR) enhances distress tolerance and resilience through changes in mindfulness. Ment Health Prev. 2016;4(1):36-41. DOI: 10.1016/j.mhp.2016.01.001 [DOI]
20. Kabat-Zin J. There you are: Mindfulness meditation in everyday life. Wherever you go. New York: Hypersion; 1990.
21. Siegel R. The Mindfulness Solution every day practices for everyday problems. New York: Guilford; 2010.
22. Kabat-Zinn J, Hanh TN. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Londan: Delta; 2005.
23. Omidi A, Mohammadi A, Zargar F, Akbari H. Efficacy of mindfulness-based stress reduction on mood States of veterans with post-traumatic stress disorder. Arch Trauma Res. 2013;1(4):151.
24. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011;42(4):676-88. DOI: 10.1016/j.beth.2011.03.007 PMID: 22035996
25. Bride BE, Robinson MM, Yegidis B, Figley CR. Development and Validation of the Secondary Traumatic Stress Scale. Res Soc Work Pract. 2016;14(1):27-35. DOI: 10.1177/1049731503254106 [DOI]
26. Abbasi A, Fati L, Moloodi R, Zarrabi H. [Psychometric Correctness of the Persian Version of the Acceptance and Practice Questionnaire-Second Edition]. Methods Psychol Mod. 2012;2(10):65-80.
27. Alawi H. [The Effectiveness of Group Dialectical Behavioral Therapy in Reducing Depression Symptoms in Mashhad Students]. Mashhad: Ferdowsi University of Mashhad; 1999.
28. Ahmadi K, Rezapur M, Davoudi F, Saberi M. [Secondary Impact Scale (STSS) validity and reliability evaluation for secondary PTSD symptoms in a sample of veterans' wives]. J War Public Health. 2013;5(3):47-57.
29. Redstone L. Mindfulness meditation and aromatherapy to reduce stress and anxiety. Arch Psychiatr Nurs. 2015;29(3):192-3. DOI: 10.1016/j.apnu.2015.03.001 PMID: 26001720 [DOI] [PubMed]
30. Liu X, Wang S, Chang S, Chen W, Si M. Effect of brief mindfulness intervention on tolerance and distress of pain induced by cold-pressor task. Stress Health. 2013;29(3):199-204. DOI: 10.1002/smi.2446 PMID: 22961992 [DOI] [PubMed]
31. Tyler Boden M, Bernstein A, Walser RD, Bui L, Alvarez J, Bonn-Miller MO. Changes in facets of mindfulness and posttraumatic stress disorder treatment outcome. Psychiatry Res. 2012;200(2-3):609-13. DOI: 10.1016/j.psychres.2012.07.011 PMID: 22858251 [DOI] [PubMed]
32. Ghassem Boroujerdi F, Safa M, Karamlou S, Masjedi MR. [Effectiveness of mindfulness based on cognitive therapy, on distress tolerance and dysfunctional attitudes in patients with chronic obstructive pulmonary diseases]. J sychol Health Kharazmi Univ. 2014;8(4):6-7.
33. Ahmadian Fard S. [The Effectiveness of Reducing Mindfulness-Based Stress in Improving Signs of Sleep Quality and Emotional Regulation in Patients with PTSD]. Tabriz Tabriz University; 2013
34. Narimani M, Arianpour S, Abolghasemi A, Ahmadi B. [Comparing Mental education and excitement regulation on mental health of chemical devotees]. J Clin Psychol. 2010;2(4):93-117. 35. Hatamkhani S. [Relationship between mindfulness and psychological flexibility and symptoms of psychological harm]. Tehran: Tarbiat Modares University; 2011.
35. Orzech KM, Shapiro SL, Brown KW, McKay M. Intensive mindfulness training-related changes in cognitive and emotional experience. J Posit Psychol. 2009;4(3):212-22. DOI: 10.1080/17439760902819394 [DOI]
36. Hinton DE, Pich V, Hofmann SG, Otto MW. Acceptance and Mindfulness Techniques as Applied to Refugee and Ethnic Minority Populations With PTSD: Examples From "Culturally Adapted CBT". Cogn Behav Pract. 2013;20(1):33-46. DOI: 10.1016/j.cbpra.2011.09.001 [DOI]
37. Kangasniemi A, Lappalainen R, Kankaanpää A, Tammelin T. Mindfulness skills, psychological flexibility, and psychological symptoms among physically less active and active adults. Ment Health Phys Activ. 2014;7(3):121-7. DOI: 10.1016/j.mhpa.2014.06.005 [DOI]
38. Frewen PA, Evans EM, Maraj N, Dozois DJA, Partridge K. Letting Go: Mindfulness and Negative Automatic Thinking. Cogn Ther Res. 2007;32(6):758-74. DOI: 10.1007/s10608-007-9142-1 [DOI]
Send email to the article author

Add your comments about this article
Your username or Email:


XML   Persian Abstract   Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

H K, shojaei F, soltanizadeh M. The Effect of Mindfulness-Based Stress Reduction Intervention on Psychological Flexibility, Distress Tolerance, and Re-Experiencing the Trauma in Veterans with Post-Traumatic Stress Disorder. MCS. 2018; 4 (4) :236-248
URL: http://mcs.ajaums.ac.ir/article-1-187-en.html

Volume 4, Issue 4 (Military Caring Sciences 2018) Back to browse issues page
مجله علوم مراقبتی نظامی Military Caring Sciences Journal
Persian site map - English site map - Created in 0.05 seconds with 30 queries by YEKTAWEB 4256