The Effectiveness of Acceptance and Commitment Therapy on Pain Acceptance and Pain Perception in Patients with Painful Diabetic Neuropathy: A Randomized Controlled Trial
Open accessAbstract
INTRODUCTION: Neuropathic pain is a complex phenomenon in patients with diabetes. These patients have many problems, such as psychological problems, high-level pain perception, and pain acceptance. This study aimed to evaluate the effectiveness of acceptance and commitment therapy on pain acceptance and pain perception in patients with painful diabetic neuropathy. METHODS: This study was performed according to the clinical trial method. The sample size was 50 participants. In this study, participants were divided into interventional and control groups. According to the diagnosis of neurologists, all participants received conventional medications to manage neuropathic pain. The intervention group received acceptance and commitment therapy for eight sessions. The results in the three phases of pre-test, post-test, and follow-up were evaluated. After completing the study, to comply with ethical standards, the control group received psycho-education. The tools used were the McGill Pain Questionnaire (MPQ) and the Chronic Pain Acceptance Questionnaire (CPAQ). Statistical analysis includes mean, standard deviation, and repeated-measures (ANOVA) conducted by SPSS software version 22. RESULTS: The results demonstrated that in the post-test and follow-up phases, acceptance and commitment therapy could improve pain acceptance and reduce pain perception in the intervention group compared to the control group (P < 0.01). CONCLUSION: The results indicated that acceptance and commitment therapy could be used as a psychological intervention besides pharmacotherapy to improve pain acceptance and reduce pain perception in patients with painful diabetic neuropathy. CLINICAL TRAIL REGISTRATION: This study was registered at the Iranian Registry of Clinical Trials (IRCT20180205038630N4).
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Nonjudgmental acceptance is very important because individuals with high acceptance can easily notice their emotions, thoughts, and feelings without trying to control, avoid, or escape them, which has positive results when facing painful daily challenges including illness.
“( طاهری و همکاران 1399 ) نیز اذعان داشتند پذیرش بدون قضاوتگری بسیار مهم است؛ چراکه افراد دارای پذیرش بالا می توانند بهراحتی متوجه هیجانات، افکار و احساسات خود بدون تلاش برای کنترل، اجتناب یا فرار از آنها شوند که نتایج مثبتی هنگام مواجهه با چالشهای دردناک روزمره اعم از مواجهه با بیماری دارد ] 24 [ .”
From The Effect of Acceptance and Commitment Therapy on the Psychological Consequences of Anxiety, Pain Intensity, and Fatigue in Women with Fibromyalgia: Study with the Effect of Waiting (2022) · cites this paper as [24]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredAn 8-week ACT therapy course decreased stress and other psychological health indices in people with IBD in a randomized controlled experiment.
“An 8-week ACT therapy course decreased stress and other psychological health indices in people with IBD in a randomized controlled experiment.”
From The Effect of Acceptance and Commitment Therapy on Psychological Nursing of Acute Cerebral Infarction with Insomnia, Anxiety, and Depression (2022) · cites this paper as [9]
The Methods (Participants and Randomization; page unavailable) describe a randomized trial of eight ACT sessions in patients with painful diabetic neuropathy, not IBD. The Discussion reports improved pain acceptance and reduced pain perception, but does not report reduced stress or other psychological health indices; eight sessions also do not establish an eight-week course. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAcceptance and commitment therapy (ACT) is considered a third-wave of CBT and can be used alongside more traditional CBT.
“It is considered a third-wave of CBT and can be used alongside more traditional CBT [41–43].”
From A Consideration of the Psychological Aspects to Managing Patients with Painful Diabetic Neuropathy: An Insight into Pain Management Services at a Tertiary Centre in the UK (2021) · cites this paper as [41]
The Introduction identifies ACT as a third-wave cognitive behavioral therapy. The paper does not say ACT can be used alongside traditional CBT; its Conclusions instead discuss using ACT alongside pharmacotherapy. Page numbers are not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMany clients, despite being highly motivated and working hard, could not overcome disturbing thoughts and feelings and achieve necessary success.
“However, therapists have seen many clients who, despite being highly motivated and working hard to recover, could not overcome the disturbing thoughts and feelings and achieve the necessary success.”
From Assessing the Effects of Acceptance-commitment and Psychodrama Therapies in Nurses With Social Anxiety Disorder. (2023) · cites this paper as [10]
The Discussion says that patients may try to control or avoid pain without reducing it, which supports the general point that effort to overcome an unpleasant experience can fail. It does not say that therapists observed many highly motivated, hardworking clients who could not overcome disturbing thoughts and feelings or achieve recovery. (LLM, conf=0.77)
Experimental — accuracy not yet measuredThe present study's results overlapped with studies on the effectiveness of ACT on other psychological symptoms in various diseases.
“نتایج پژوهش حاضر با استناد به پژوهشهای انجامشده در زمینه اثربخشی درمان مزبور بر سایر نشانگان روانشناختی در بیماریهای مختلف همپوشانی داشت ] 23-28 [ .”
Multiple studies in Iran and abroad have confirmed the effectiveness of ACT.
“مطالعات متعددی در ایران و خارج از کشور بر کارآمدی درمان مذکور صحه گذاشتهاند ] 31-36 ، 28 ، 24 ، 23 [ .”
A recent study of 50 individuals with pDN based in Iran showed improved pain acceptance following intervention after 3 months.
“A recent study of 50 individuals with pDN based in Iran showed improved pain acceptance following intervention after 3 months [41].”
Sometimes, despite treatment success, after a few months, clients lost motivation and felt no significant changes in feelings about their lives.
“Sometimes, despite the treatment's success, after a few months, they lost their motivation and felt that, in the long run, there were no significant changes in their feelings about their lives [10].”
From Assessing the Effects of Acceptance-commitment and Psychodrama Therapies in Nurses With Social Anxiety Disorder. (2023) · cites this paper as [10]
The Results report pain perception and pain acceptance at a three-month follow-up, but do not report whether participants lost motivation or felt unchanged about their lives. The Discussion (page not available) explicitly says emotional functioning was not measured. Searches for the claim’s wording and for motivation and long-term feelings found no supporting passage. (LLM, conf=0.78)
Experimental — accuracy not yet measured
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“showed improved pain acceptance following intervention after 3 months [41].”
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- Authors
- Taheri, A. A., Foroughi, A. A., Mohammadian, Y., Ahmadi, S. M., Heshmati, K., Hezarkhani, L. A., & Parvizifard, A. A.
- Affiliations
- Kermanshah University of Medical Sciences (IR)
- Corresponding author
- Parvizifard, Ali Akbar
- ORCID
- Venue
- Diabetes Therapy
- Published
- 2020-06-12
- Volume
- 11
- Issue
- 8
- Pages
- 1695-1708
- ISSN
- 1869-6953 (ISSN-L)
- 1869-6961
- PMC
- PMC7376796
- OpenAlex
- W3034312489
- Cited by
- 28
- References
- 51
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 9 · 2022: 4 · 2021: 5 · 2020: 1
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diabetes Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Deputy for Research and Technology, Kermanshah University of Medical Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- acceptance and commitment therapy, diabetic neuropathic pain, pain acceptance, pain perception, psychological intervention, psychoeducation, McGill Pain Questionnaire, Chronic Pain Acceptance Questionnaire, diabetes mellitus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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