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Cited by 16Music Therapy and HealthMindfulness and Compassion InterventionsCardiac Health and Mental Health

The efficacy of acceptance and commitment therapy (ACT) matrix on depression and psychological capital of the patients with irritable bowel syndrome

Open access
Mirsharifa, Seyyed Mehdi, Mirzaian, Bahram, Dousti, Yarali·2019·Open Access Macedonian Journal of Medical Sciences
DOI 10.3889/oamjms.2019.076PMC PMC6390158
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Abstract

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. © 2019 Seyyed Mehdi Mirsharifa, Bahram Mirzaian, Yarali Dousti.

Integrity signals

Registry

Crossref · 10.3889/oamjms.2019.076

Cites

36 of 36 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

7 of 24 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Negative emotions can alter bowel movement activity and produce IBS symptoms.

    “The bowel nervous system is very sensitive to the changes mental status, in a way that negative emotions can cause changes in movement activities of the bowel and create bowel symptoms such as symptoms occur in IBS [33].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [33] source

      The indexed Introduction, Methods, and Results on the journal page discuss acceptance and commitment therapy for women with chronic pain, not bowel movement or IBS. Searches for negative emotions, bowel motility, and IBS found no passage addressing the cited claim; the page links to a PDF whose text is not present in the indexed passages. (LLM, conf=0.70)

      Experimental — accuracy not yet measured
  • Premisecitation

    Each component of psychological capital is related to physical illnesses.

    “It is believed that there is a relationship between each of psychological capital components and physical diseases [17], [18].”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [17] source

      The theoretical background identifies the four components of psychological capital and discusses their relationships with psychological well-being and burnout, not physical diseases. Searches for physical illness and physical diseases found no passage linking each component to physical disease; the available copy is not truncated. The passages have section labels but no page numbers. (LLM, conf=0.72)

      Experimental — accuracy not yet measured
    • cites [18]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Findingown data

    Pretest scores of none of the variables influenced posttest scores.

    “It is observed in covariance’s’ part that pretests of none of the variables had any effect on posttest score.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The effect size for change resources was 0.959.

    “The effect size is calculated to be 0.959 for change resources which is a strong amount and shows the effects of therapy (Table 5).”
    Quote in the paperSubstantial claim
  • Findingown data

    The group effect was significant for psychological capital and depression scores (η2 = 0.959, p < 0.0001).

    “As is observed in table 4, the group effect is significant for psychological capital and depression scores (η2 = 0.959 and p < 0.0001).”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 14
  • May combine two claims. 17
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    IBS is among the most common functional gastrointestinal disorders globally.

    “Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders which is characterised by bloating, abdominal pain or discomfort and mixed symptoms of constipation or diarrhoea [1], [2].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [1] source
    • cites [2] source

      The Background passage (indexed under References; page unavailable) identifies IBS as a functional gastrointestinal disorder. It does not say that IBS is among the most common such disorders globally; searches for that prevalence claim found no supporting passage in our copy. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    ACT improves quality of life and mental state in cancer patients.

    “Also, it has been previously shown that ACT has a positive effect on quality of life and mental state of cancer patients [8].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [8] source

      The METHOD section, under “Psychotherapy in Cancer Patients” (page unavailable), recommends psychotherapy for mild-to-moderate depression and names cognitive-behavioral and supportive-expressive group therapy. Searches for ACT and acceptance and commitment therapy found no passage addressing whether ACT improves cancer patients’ quality of life or mental state. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    In ACT, mental awareness practices, self-regard, and body awareness strengthen the person's relationship with feelings and increase acceptance of internal experiences.

    “In ACT, the change and relationship reformation of the person with his/her feelings are strengthened through mental awareness practices, self-regard and awareness of body conditions. In this regard, efforts are made to increase acceptance of thoughts, beliefs, emotions and sentimental, physical perceptions [8].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [8] source

      The Methods section discusses psychotherapy for depression in cancer patients but does not describe acceptance and commitment therapy (ACT) or the awareness and acceptance practices claimed. A search for ACT, mindfulness, and bodily awareness found no passage addressing those practices; the Discussion’s reference to the Affordable Care Act concerns health-care policy, not ACT. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Optimistic people solve problems and marriages more successfully, are not passive toward problems, and view others more positively.

    “Hence, it can be said that optimistic people act more successfully in solving their problems and in their marriage, and do not take a passive position towards the problems and have a more positive viewpoint towards others [40], [41].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [40] source
    • cites [41] source

      The Introduction and Discussion address barriers and facilitators to patient education by nurses, not optimism or marriage; no page numbers are available in our copy. Searches for optimistic people’s problem-solving, marital success, passivity, and views of others found no passage addressing the claim. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Depressed patients tend to seek reasons for their depression, increasing rumination and negative self-criticism.

    “The depressed patients are usually looking to bring reasons for their depression, which leads to increasing of rumination, and they criticise their experience negatively [33].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [33] source

      The indexed Introduction, Methods, and Results (no page number provided) concern acceptance and commitment therapy for women with chronic pain. Searches for rumination, seeking reasons for depression, and negative self-criticism found no passage in our copy addressing the attributed claim. (LLM, conf=0.72)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    At posttest, adjusted mean depression and psychological capital scores differed significantly between control and experimental groups.

    “Data analysis showed that there is a significant difference between the modified mean of depression and psychological capital scores in the control and experimental groups in the posttest stage.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisenone given

    Depression is frequently comorbid in IBS patients.

    “Depression, as a psychological disorder, is one of the common comorbid diseases in patients with IBS.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In a prior study of 3153 IBS patients, 30.5% had depression.

    “The results of a study which were done in 3153 IBS patients showed that 30.5% of the patients with IBS suffered from depression [10].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] source

  • May combine two claims.

    Premisecitation

    Increasing flexibility by focusing on thoughts and emotions leads to desirable behaviours and less credibility in depressed individuals.

    “Creating flexibility through a focus on field related to thoughts and emotions leads to desirable behaviours and also leads to a reduction of credibility in the depressed [34].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [34] source

  • May combine two claims.

    Study design and conductown data

    The two groups did not differ significantly in age, gender, or marital status.

    “There was not a significant statistical difference between the two studied groups from the aspect of age, gender and marital status (P > 0.05).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The BDI short form has Cronbach's alpha 0.89 and split-half reliability 0.82.

    “Cronbach’s alpha and split-half coefficients were 0.89 and 0.82 respectively for the whole questionnaire [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    ACT can increase efficacy and tolerance and reduce mental symptoms through mechanisms such as acceptance, awareness, and non-judgmental observation.

    “Using ACT can increase efficacy and tolerance as well as reducing mental symptoms, because of some hidden mechanism existing in it such as acceptance, an increase of awareness, sensitivity elimination, being present and observation without judging.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    ACT can enable people to attend to current experiences optimistically.

    “ACT can give the persons the ability to pay attention to the current experiences optimistically, through having freedom in their choices and the responsibility they accept to do a job.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    ACT leads a person to find life rich, meaningful, and significant, improving daily functioning and mental health.

    “ACT causes the person to find his/her life rich, meaningful and significant, which leads to enhancement of daily functions, mental and psychological health.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    In this study, the ACT matrix appeared to help IBS patients reflect on past experiences happily and gain mental stability.

    “Thus, in this study, it seems that ACT matrix helped the IBS patients to reflect their past experiences happily and gain mental stability.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Participants were randomly allocated to intervention and control groups.

    “These patients were randomly assigned to intervention and control groups.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The study's results align with those of several prior studies.

    “The research background shows that the obtained results in this study are consistent with results of Mohammadi et al., [24], Baghban et al., [28], Blanchard et al., [1], Lotsson et al., [29] and Gillanders et al., [30].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [24]
    • cites [28] source
    • cites [1] source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Masuda et al. found that cognitive defusion significantly reduced self-directed negative thoughts.

    “The results showed a significant reduction in the amount of these thoughts by using cognitive-defusion techniques.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] source

  • May combine two claims. The quote only partly states this claim.

    Interpretationown data

    The effect size was strong and indicates the therapy had an effect.

    “The effect size is calculated to be 0.959 for change resources which is a strong amount and shows the effects of therapy (Table 5).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    The two groups did not differ significantly in diarrhoea, constipation, or both.

    “From the aspect of suffering diarrhoea or constipation or both of these conditions, there was not a significant statistical difference between the two groups of patients (p > 0.05) (Table 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The acceptance component of ACT enables IBS patients to accept unpleasant internal experiences, making them seem less threatening and alleviating symptoms.

    “Also, the acceptance component in ACT makes the IBS patients able to accept their unpleasant internal experiences, and this causes the experiences to seem less threatening, and the symptoms are alleviated in the person.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Defusing and avoiding cognitive fusion allows one to live happily and optimistically.

    “Thus, by defusing and not doing cognitive mix-ups, one can live happily and be optimistic.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The ACT matrix intervention is effective for depression and psychological capital in IBS patients.

    “This means that ACT matrix based on acceptance and commitment is effective on depression and psychological capital of the patients suffering IBS.”
    • Also stated in: § CONCLUSION: · plain
      “Using ACT matrix is a useful modality to improve the depression and psychological capital among patients with IBS.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The ACT matrix intervention was delivered with adequate fidelity and therapist competence across all sessions.
    • Rests on an assumption: Participants completed the self-report questionnaires accurately and honestly.
    • Rests on an assumption: The control group's pharmacotherapy was comparable to the intervention group's and remained unchanged.
    • Rests on an assumption: The BDI and PCQ validly measure depression and psychological capital in Iranian IBS patients.
    • Rests on an assumption: The observed effects of the ACT matrix are not due to placebo, expectancy, or non-specific therapeutic factors.

  • May combine two claims.

    Premisereasoning

    ACT is recognized as an effective treatment for depression and anxiety, which are common in IBS.

    “Nowadays, ACT is known as an effective therapy for depression and anxiety which are both common in IBS patients.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    ACT targets avoidance patterns, and reduced experiential avoidance is considered a mediator of depression symptom change.

    “ACT can target the avoidance pattern. During the interventions, reduction of the experimental avoidances are considered as a mediator of change in the symptoms of depression [7].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The PCQ has previously confirmed reliability with Cronbach's alpha 0.85.

    “The reliability of this Questionaire was previously evaluated and confirmed by Cronbach’s alpha 0.85 [24].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24]

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Anxiety is significantly more common in IBS patients than in healthy individuals.

    “Also, it was shown that anxiety is significantly higher in people suffering IBS, in comparison to healthy people [10], [11].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [10] source
    • cites [11]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

27 of 27

  • The paper relies on this without support.

    The ACT matrix intervention was delivered with adequate fidelity and therapist competence across all sessions.

    “The ACT matrix package consists of 6 principles (cognitive defusion, acceptance, being present, observing self, values clarification and committed action) which were presented to the IBS patients during six 90 minutes’ sessions.”

  • The paper relies on this without support.

    Participants completed the self-report questionnaires accurately and honestly.

    “The data were collected using the short-form of Beck Depression Questionnaire and Psychological Capital Questionnaire (PCQ), which were completed by the patients.”

  • The paper relies on this without support.

    The control group's pharmacotherapy was comparable to the intervention group's and remained unchanged.

    “The intervention group, underwent the ACT, in addition to the common pharmacotherapy; but the control group did not receive this therapy and only underwent the common pharmacotherapies.”

  • The paper relies on this without support.

    The BDI and PCQ validly measure depression and psychological capital in Iranian IBS patients.

    “The data were collected using the short-form of Beck Depression Questionnaire and Psychological Capital Questionnaire (PCQ)”

  • The paper relies on this without support.

    The observed effects of the ACT matrix are not due to placebo, expectancy, or non-specific therapeutic factors.

    “The experimental group was subjected to the acceptance and commitment therapy (ACT) amtrix, but the control group do not receive this treatment.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Studies using a 1-day intervention or bibliotherapy program found that ACT reduced depressive mood in IBS.

    “Studies using a 1-day intervention or bibliotherapy program found that ACT reduced depressive mood [108,111].”

    From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [108]

    The Results and Conclusion report that ACT matrix improved depression in patients with IBS. However, Material and Methods describes six 90-minute sessions, not a 1-day intervention or a bibliotherapy program, so the claimed intervention format is not supported by this paper. Page numbers were not available in our copy. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Improvement of psychological capital in IBS patients was observed.

    “and an improvement of the psychological capital (self-perception of success and tolerance to problems) of IBS patients has also been observed [108].”

    From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [108]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Group sizes conflict: 15 per group versus 30 total after 40 eligible

    Major

    The abstract says 30 patients were assigned into two groups of 15, while the Methods section says 40 patients met criteria and were assigned to intervention and control groups. The study cannot simultaneously have 30 and 40 randomized participants without explanation.

  • Different numbers of patients are said to have been assigned to groups

    Major

    The abstract says 30 patients were selected and assigned, 15 per group. The methods say 40 eligible patients were assigned to the groups; they do not describe a subsequent selection of 30 or explain the difference.

  • Pessimism is credited with opposite emotional effects

    Minor

    The discussion first says pessimism produces negative feelings, then says it expands positive feelings and emotions.

3 of 3

Cites

Flagged first, then by citations

1 of the 37 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. 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.
  2. 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.
  3. Rajabi GH. Psychometry properties of short form matters of Beck depression inventory. Iranian Psychologists. 2005; 1(4):1-7.
  4. 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.
  5. 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.
  6. 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.

Cited by

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Related

Authors
Mirsharifa, S. M., Mirzaian, B., & Dousti, Y.
Affiliations
Islamic Azad University Sari Branch (IR)
ORCID
Venue
Open Access Macedonian Journal of Medical Sciences
Publisher
Scientific Foundation Spiroski (publications)
Published
2019-02-02
Volume
7
Issue
3
Pages
421-427
ISSN
1857-9655 (ISSN-L)
DOI
10.3889/oamjms.2019.076
PMC
PMC6390158
OpenAlex
W2912328864
Cited by
16
References
37
Citations by year
2026: 2 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 1
FWCI
2.53
Type
journal article
Language
en
Open access
Licence
Locations
  • Open Access Macedonian Journal of Medical Sciences (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (submittedVersion, cc-by-nc)
  • PubMed Central (submittedVersion, cc-by-nc)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › Music Therapy and Health
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
acceptance and commitment therapy, irritable bowel syndrome, depression, psychological capital, functional gastrointestinal disorders, psychological intervention

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