Emotional Distress Tolerance Research Articles

Emotional Disorders, Distress Tolerance and Suicide Risk: A Mediation Model.

Background: Suicide has been linked to psychopathology, particularly emotional disorders. This study seeks to investigate the mediating role of distress tolerance in the relationship between emotional symptoms and suicide risk. Method: The sample included 1014 adults (33.82% male; M = 33.0, SD = 15.15). Four mediation analyses were performed, controlling for sex, for depressive, anxious, somatizing and obsessive symptoms measured with the Brief Symptom Checklist as the independent variable, distress tolerance, measured with the Distress Tolerance Scale as the mediating variable, and the risk of making a suicide attempt, measured with Risk of Suicide, as the dependent variable. Results: Distress tolerance partially mediated the relationship between emotional symptoms and suicide risk, with Appraisal and Absorption scales positively mediating, and Tolerance negatively mediating. Conclusions: Tolerance of distress plays a role in risk of suicide attempts. Distress tolerance needs to be addressed as a key transdiagnostic factor in reducing suicidal risk.

Investigating the Relationship between Emotion Regulation Strategies and Anxiety Caused by COVID-19 in Employees of Rehabilitation Centers

Background and Objectives: In the current situation, it is essential to determine the level of anxiety in medical and non-medical employees due to the pandemic. Therefore, this research aims to assess the relationship between corona anxiety, emotion regulation strategies, and stress tolerance among the staff of rehabilitation centers in Tehran Province, Iran. Methods: This study was descriptive, cross-sectional, and correlational. The statistical population of the present study included the entire staff of rehabilitation centers served by the Welfare Organization of Tehran Province in 2022. Using simple random sampling, 10 rehabilitation centers were selected as study centers. Subsequently, 200 employees of these centers were selected and tested using Morgan’s sampling table (the male age of the participants was 31.5 years). The data collection instruments included the corona disease anxiety scale, the emotional distress tolerance questionnaire (2005), and the March emotional self-regulation strategies scale (2007). Data were analyzed by SPSS software, version 26. Results: The results showed that the mean of corona anxiety was 18.94 out of a maximum of 54 and the proportion of psychological symptoms of corona anxiety was higher than physical symptoms. The highest score from the participant’s point of view from dimensions of distress tolerance was assigned to the subjective assessment of distress. The mean score for distress tolerance was 52.68 out of a maximum of 75 points and the mean score for employees’ emotion regulation strategies was 134.37 points, which shows that the use of emotional self-regulation strategies is strong. The results of the current research showed that corona anxiety decreases significantly by increasing distress tolerance, absorption of negative emotions, regulation of efforts to relieve distress and distress tolerance, and corona anxiety also decreases significantly. Also, with the increase in the level of emotion regulation strategies, the anxiety of corona decreases significantly. Distress tolerance showed a negative correlation with corona anxiety, and with the improvement of distress tolerance, corona anxiety decreased (P=0.014). Conclusion: Based on the results, increasing and improving distress tolerance and emotional regulation strategies significantly reduced corona anxiety. Also, the experiences and work of experts with more work experience alongside the younger and less experienced forces and their cooperation prepared the ground to reduce the effects of corona anxiety, as well as to improve the level of stress tolerance and emotion regulation strategies of employees.

The association between posttraumatic stress disorder symptom severity and distress tolerance in traumatic stress treatment.

Distress tolerance, or the perceived ability to tolerate negative emotional states, is often associated with posttraumatic stress disorder (PTSD) such that higher distress tolerance is generally associated with less severe PTSD symptom levels. As distress tolerance is often considered a risk and maintenance factor in distress disorders, examining the association between changes in distress tolerance and changes in PTSD symptoms may have clinical relevance. The present study examined the associations between PTSD symptom severity and distress tolerance across three assessment points over 12 weeks among 212 patients receiving outpatient psychotherapy services. Using random-intercept cross-lagged panel modeling (RI-CLPM), concurrent and prospective associations between PTSD and distress tolerance were examined. PTSD symptoms at Time 1 and Time 2 significantly predicted distress tolerance at Time 2, β = -.296, and Time 3, β = -.395, respectively. Distress tolerance did not predict subsequent PTSD symptom severity. Exploratory analyses examined distress tolerance and four PTSD symptom clusters over time. Patterns of results differed across clusters, though it was consistent that only PTSD symptom clusters predicted subsequent distress tolerance and not vice versa. The results support the interrelationship of changes in psychopathology and emotional distress tolerance and indicate that distress tolerance may be an important factor in symptom remission during PTSD treatment.

Cross-cultural translation and validation of the Chinese version Distress Tolerance Scale for adolescents with chronic physical disease.

Chronic physical disease (CPD) makes life filled with many negative events in adolescents, but not all adolescents experiencing negative life events proceed to develop emotional distress, only those with low emotional distress tolerance (EDT). A valid and reliable scale to measure EDT in CPD adolescents is important for caring for their emotional distress. Therefore, the purpose of this study is to translate the 15-item English version Distress Tolerance Scale (DTS) into a Chinese version and then validate the scale for measuring EDT of adolescents with CPD. The 15-item English version DTS was translated into a Chinese version using the translation guidelines for cross-cultural research. Two cohorts of adolescents with CPD were recruited from four hospitals in southern Taiwan, with the first cohort including 124 adolescents with CPD employed to conduct exploratory factor analysis, corrected item-total correlation and reliability testing, while the second cohort, consisting of 238 adolescents with CPD, was utilized to examine confirmatory factor analysis and concurrent validity. The two-factor nine-item Chinese version DTS for Adolescents with CPD (C-DTS-A) was developed. Lower scores of the C-DTS-A were significantly associated with higher diabetes distress, poorer self-management, and worse glycaemic control; their correlation coefficients sequentially were -.40, .17 and -.23. Cronbach's α and the test-retest reliability of the two-factor C-DTS-A ranged from .81 to .87 and from .79 to .89, respectively. The two-factor nine-item C-DTS-A with good cross-cultural translation quality was a reliable and valid scale to assess EDT for adolescents with CPD.

Validity of the distress tolerance inventory in predicting response to the Cold-Pressor Test

ABSTRACT Distress intolerance—a broad band dispositional variable has been shown to serve as a transdiagnostic risk factor for psychopathology. We investigated the predictive validity of the physical and emotional subscales of the Distress Tolerance Inventory (DTI) on behavioral responding (immersion time) and moment-to-moment subjective distress ratings to the Cold-Pressor Test. College students (N = 134) completed self-report questionnaires indexing physical and emotional distress tolerance and then completed a cold pressor challenge. The DTI displayed convergent validity with several well-established self-report measures assessing distress tolerance (i.e. DTS, PCS, DIS). Participants’ scores on the DTI physical subscale (but not the DTS or DTI emotional subscale) predicted participants’ immersion time on the cold pressor challenge, thus supporting the construct validity of the DTI physical distress subscale. The DIS also predicted immersion time, though its internal consistency was marginal. These data suggest that the DTI is a valid measure for both emotional and physical distress tolerance and should be considered as a viable alternative to the DTS, especially for investigative domains involving physical distress such as chronic pain, or screening personnel for physically demanding tasks.

Resilience and Vulnerability: Understanding Distress Tolerance and Mindfulness among Tribals with Alcohol Use Disorder in India

Background: Alcohol use disorder may be directly or indirectly related to mindfulness and distress tolerance, and these factors are often targeted in treatment. However, such evidence has yet to be established among tribal. The research aimed to investigate the levels and relationships of mindfulness, distress tolerance, and dependence severity among tribal individuals with alcohol use disorder. Methodology: Two hundred tribals with alcohol use disorder were recruited at three tertiary health-care centers in three districts and assessed with the sociodemographic and clinical pro forma, Cognitive and Affective Mindfulness Scale-Revised (CAMSR), the Severity of Dependence Scale (SDS), and Distress Tolerance Scale (DTS). Results: The mean score on the SDS, CAMSR, and DTS was 4.99, 23.52, and 33.44, respectively. There were no statistically significant relationships between the measure of mindfulness scores and dependence severity scores. However, the perceived capacity to endure emotional suffering and negative emotions consuming one’s focus was significantly inversely linked to the severity of dependence. Conclusion: There are lower distress tolerance and mindfulness levels among tribals with alcohol use disorder. The severity of alcohol use has no significant link with mindfulness, but has inversely linked with emotional distress tolerance and attention absorption by negative emotions.

The Effectiveness of Emotion-Focused Therapy on Emotional Suppression and Distress Tolerance in Divorced Women

Objective: The aim of the present study was to determine the effectiveness of emotion-focused therapy on emotional suppression and distress tolerance in divorced women. Methods and Materials: The current study was a quasi-experimental design with pre-test, post-test, and follow-up phases, including a control group. The statistical population consisted of all divorced women residing in Shiraz in 2021, who had been legally divorced for at least 6 months and up to 2 years. A total of 40 individuals were selected from this population based on inclusion criteria using purposive sampling from those who visited the Aban Clinic in Shiraz in 2021. These individuals were randomly assigned to two experimental groups and one control group (20 participants in each group). The experimental group underwent ten 90-minute sessions of emotion-focused therapy, while the control group did not receive any therapeutic intervention. Data were collected using the Weinberger Emotional Suppression Questionnaire (2010) and the Simons and Gaher Distress Tolerance Scale (2005) and analyzed using repeated measures ANOVA via SPSS software version 23. Findings: The results indicated the impact of emotion-focused therapy on emotional suppression (F=204.1, P=0.001) and distress tolerance (F=48.120, P=0.001), with the persistence of these effects in the follow-up phase. Conclusion: Based on the findings of this study, emotion-focused therapy can be considered a complementary treatment alongside other therapeutic methods to reduce emotional suppression and increase distress tolerance in divorced women.

Distress tolerance and lifetime frequency of non-suicidal self-injury (NSSI): A systematic review and meta-analysis.

NSSI has recently been recognized as a significant health issue given its documented association with psychopathology and across a broad spectrum of psychiatric disorders. It has been found that individuals experiencing heightened emotions, which is referred to as an emotional cascade, are more likely to engage in self-injury behaviour due to low levels of distress tolerance (DT). The current meta-analysis using PRISMA guidelines sought to quantify the strength of the association between DT and lifetime frequency of NSSI using 22 eligible studies (N= 14,588; F = 60.7%; age =23.35 ±7.30), mainly from the United States. The correlation between emotional DT and NSSI was a small negative correlation (r = -.14), and it was non-significant for behavioural DT and NSSI (r = .02). Also, the effect-size was significant for studies that used interview-based measure of NSSI (r= -.24), and it was non-significant when self-report measures of NSSI (r =-.11) utilized. The association between DT and NSSI was significant and negative across the general population (r= -.47), university students (r= -.17), and inpatients (r= -.27); surprisingly, it was significant and positive among adolescents or high school students (r= .17). The observed effect-sizes were independent of publication year, mean age and its standard deviation, study quality, female proportion, DT, NSSI measures reliability, and clinical status. Future studies on NSSI should consider DT as a spectrum from distress intolerance to distress over-tolerance, given that it seems it has different functions when different samples (e.g., adolescents) are studied.

Association between personality traits and symptoms of depression and anxiety via emotional regulation and distress tolerance.

The Big Five personality traits have shown associations with symptoms of depression and anxiety among college students, but it is unclear which factors mediate these relationships. Past research suggests that psychological distress is closely related to difficulties in affect regulation (e.g., low distress tolerance). Therefore, the present study examined the associations between personality traits and depression and anxiety via emotion regulation and distress tolerance. Participants were 694 (81.4% females; Mean age = 23.12 [SD 2.75]) Argentinian college students who completed an online survey examining mental health and personality variables. A sizeable percentage of students endorsed moderate to severe symptoms of depression (45.1%) or anxiety (25.9%). Utilizing path analyses, we found that appraisal, a dimension of distress tolerance, atemporally mediated the association between emotional stability and symptoms of depression/anxiety (i.e., higher levels of emotional stability → higher appraisal distress tolerance → fewer symptoms of depression/anxiety). Further, expressive suppression (a dimension of emotion regulation) significantly mediated the associations between personality traits (i.e., agreeableness and extraversion) and symptoms of depression (higher levels of agreeableness/extraversion → lower use of expressive suppression → fewer symptoms of depression). Taken together, the results suggest that higher levels of emotional stability, extraversion and agreeableness could protect students from the development of symptoms of depression/anxiety via lower maladaptive emotion regulation strategies and higher distress tolerance (particularly appraisal). These findings highlight the relevance of intervention strategies specifically tailored to improve distress tolerance and emotion regulation for those students undergoing mental health problems.

Contrast Avoidance and General Anxiety Disorder: Theory and Assessment

This review delves into the intricate relationship between General Anxiety Disorder (GAD) and emotion regulation (ER), with the Contrast Avoidance Model (CAM) serving as a core theoretical framework. This research investigates emotional inflexibility, distress tolerance, and avoidance of emotional contrast through continuous worrying as features of ER difficulties in GAD. CAM argues that individuals diagnosed with GAD sustain a negative emotional state relying on worry, avoiding rapid shifts to negative feelings. Relevant diagnostic indices are potential instruments for detecting contrast avoidance tendencies in people with GAD. At the same time, this review emphasizes the necessity of addressing emotion regulation in the context of GAD, as well as the promise of complementary and alternative medicine as a theoretical framework and diagnostic tool in furthering our understanding of the illness. Although there are limitations, including the need for further validation of diagnostic indices and the recognition that GAD is a complex, multifaceted disorder, this comprehensive study contributes to the ongoing enhancement of the assessment, diagnosis, and treatment of GAD, and ultimately improves the well-being of those affected by this debilitating disorder.

Investigating the mediating influence of distress tolerance on the relationship between existential thinking, sense of coherence, and the severity of mourning among families who lost a loved one to COVID-19: A cross-sectional study.

The objective of the current study was to examine how distress tolerance functions as a mediator in the relationship between existential thinking, sense of coherence, and the severity of mourning experienced by families who have lost a loved one to COVID-19. The present study employed a descriptive correlational research design, targeting family members of those who passed away due to COVID-19 in the city of Mianeh in 2022. A sample of 160 individuals was selected for statistical analysis. The research instruments used in this study consisted of Flensberg's sense of coherence questionnaire (2006), Simmons and Gaher's emotional distress tolerance questionnaire (2005), Sugbart and Scott's grief experience questionnaire (1989), and Branton Scherer's existential thinking questionnaire (2006). The collected data were analyzed using path analysis, as well as SPSS and Amos software. The findings of the study revealed a significant correlation coefficient between existential thinking (r = 0.465), sense of coherence (r = 0.401), and distress tolerance (r = 0.521) with the severity of mourning experienced by families who lost a loved one to COVID-19. Moreover, the results indicated a positive and significant relationship (p > 0.01) between distress tolerance and sense of coherence (r = 0.126), as well as between distress tolerance and existential thinking (r = 0.059) among the bereaved families. However, the bootstrap test results suggested that distress tolerance did not mediate the relationship between sense of coherence and the severity of mourning in the families of COVID-19 victims. Consistent with prior research, the current study's findings indicated that both existential thinking and sense of coherence had a direct impact on the severity of mourning experienced by families who lost a loved one to COVID-19. Additionally, the results revealed that the influence of existential thinking on the severity of mourning was mediated indirectly by increasing distress tolerance.

Comparison of psychological distress, emotional regulation difficulties and distress tolerance in pregnant women with and without thyroid disorder

Comparison of psychological distress, emotional regulation difficulties and distress tolerance in pregnant women with and without thyroid disorder

Metacognitions About Health in Relation to Coronavirus Anxiety: The Mediating Role of Cognitive Attentional Syndrome and Distress Tolerance.

The current study aimed to investigate the mediating role of cognitive attentional syndrome (CAS) and distress tolerance in the relationship between health-related metacognitions and coronavirus anxiety. The sample of this study consisted of 462 participants (381 female). Participants voluntarily completed self-report questionnaires on each of the variables mentioned above. The results of the structural modeling analysis showed that health-related metacognitions have a significant effect on the mediator variable of distress tolerance and CAS. Also, health-related metacognitions had a direct effect on coronavirus anxiety. Also, based on the results of the bootstrap test, it can be argued that health-related metacognitive beliefs, apart from their direct effect, play an important role in coronavirus anxiety, with CAS acting as a mediator. This study provides insights into the relationships among metacognitive beliefs, coronavirus anxiety, CAS, and distress tolerance. In particular, dysfunctional metacognitive beliefs, including an individual's beliefs about the uncontrollability of disease-related thoughts, are risk factors that could negatively affect mental health, leading to coronavirus anxiety. In addition, the association of dysfunctional beliefs with maladaptive behaviors resulting from the cognitive attentional syndrome is also involved in predicting and causing coronavirus anxiety. Given the insignificant role of emotional distress tolerance in the psychopathology of COVID-19 anxiety, the findings emphasize the importance of cognitive factors in this context.

Just try it: Preliminary results of a six-month therapy for borderline personality disorder.

Borderline Personality Disorder (BPD) is labeled as a personality disorder with impulsivity issues regarding relationships, risky behavior, and emotional dysregulation. This personality disorder is still considered to be hard-to-treat condition even though responses to treatment have improved significantly. In this field, Dialectical Behavioral Therapy is recognized as one of the most efficient therapeutical approaches, and some versions adapted from this gold-standard treatment proved their effectiveness in clinical settings. We tested the 6-month cognitive behavioral therapy (CBT) protocol ECCCLORE, composed of three modules, respectively, working on emotional regulation, distress tolerance, and relationships-in a French context to compare its effectiveness to Treatment As Usual. We recruited 56 patients with a BPD diagnosis in a day-care unit, 34 receiving ECCCLORE and 22 receiving TAU. We assessed BPD traits, impulsivity, aggressiveness, suicidal risk, and hopelessness. Our results revealed the effectiveness of the 6-month ECCCLORE protocol to decrease BPD symptoms and associated clinical dimensions. We also noted the persistence of its effect after a 1-year follow-up. Shortened CBT treatment protocols tend to prove their efficiency for symptom reduction in BPD. Further research is needed to replicate these results.

The Mediating Role of Mindfulness in the Relationship Between Emotional Distress Tolerance and Coping Styles in Turkish University Students

The Mediating Role of Mindfulness in the Relationship Between Emotional Distress Tolerance and Coping Styles in Turkish University Students

Brief Report: The Effect of Health Hardiness on Fear of Covid-19 in Nurses: Investigating the Mediating Role Tolerance of Emotional Distress

Background: Nurses have the most communication with patients with Covid-19 disease who are always afraid of the disease and its consequences. Therefore, the present study aimed to investigating the effect of health hardiness on fear of Covid-19 in nurses with the mediating role tolerance of emotional distress. Methods: The method of this research was descriptive-correlational. The statistical population of the present study consisted of all 351 female nurses of Imam Khomeini and Taleghani hospitals in Urmia in the spring of 2021. According to the target population, 205 nurses were selected based on Krejcie and Morgan table and according to the available method. In this study, the fear of Covid-19 questionnaire of Ahorsu et al. [2020], the health hardiness questionnaire of Gebhardt et al. [2001] and the emotional distress tolerance questionnaire of Simons and Gaher [2005] were used. Data were analyzed by Pearson correlation and stepwise regression. Results: The findings showed that health hardiness and tolerance of emotional distress are involved in fear of Covid-19. Also, according to the values ​​obtained from [effect], health hardiness have an effect of -0.364 on Fear of Covid-19 and tolerance of emotional distress -0.178 have an effects on Fear of Covid-19 [p≤0.01]. Health hardiness on Fear of Covid-19 with the mediating role of Tolerance of emotional distress has an effect equal with -0.528. Conclusion: This study showed that cognitive factors in proportion to emotional factors have a greater effect in fear of Covid-19 in nurses.

Neuroticism Drives Associations Between Repetitive Behaviors and Depression in Autistic Adults.

Depression is more prevalent among autistic adults than neurotypical adults, yet risk factors are incompletely understood in this population. Some research groups have focused on relationships between negative repetitive thinking and depression in the autistic population, which may explain elevated prevalence rates in line with general population findings on rumination and internalizing disorders. Little is known about associations between depression and more prototypical repetitive cognitions and/or behaviors characteristic of autism (i.e., insistence on sameness [IS] and repetitive sensorimotor [RSM] behaviors). Therefore, the present study aimed to examine associations between IS, RSM behaviors, and depressive symptoms in 762 autistic adults, and whether observed effects are confounded by additional factors (e.g., demographic factors, trait neuroticism). To test if greater IS scores were associated with greater depressive symptoms on the BDI-II, a Bayesian linear regression was conducted with BDI-II scores (dependent variable) regressed on age, gender, educational level, RSM scores, and IS scores (independent variables). To test the effects of neuroticism on observed relationships, a second regression was conducted that included all predictors from the baseline model and neuroticism. Standardized regression coefficients were tested against an interval null hypothesis of [−0.1, 0.1] to assess for practical significance. Results indicated that IS exhibited a moderate positive relationship with depressive symptoms, while RSM behaviors provided only a slight increase in predictive ability. However in the second model, neuroticism exhibited a strong positive relationship with depressive symptoms, completely attenuating the effect of IS. Associations between RSM behaviors and depressive symptoms did not meet our criteria for practical significance, particularly when neuroticism was added to the model. Neither RSM nor IS moderated the effect of neuroticism on depression. The findings from this study add to the literature on risk factors in the pathway to depression in autism, and suggest opportunities for clinical translation to screening and intervention efforts. Screening for IS in autistic individuals is a common diagnostic practice in clinical and research settings that may be leveraged to also identify those at higher risk for depression, and increasing flexibility in daily life may promote emotional regulation and distress tolerance.

Effectiveness of a hybrid arts-based Cognitive Behavioral Therapy intervention for patients with non-malignant chronic pain.

Chronic Pain (CP) is defined as pain that persists or recurs for more than 3 to 6 months and may be conceived as a health condition in its own right. CP is a frequent condition, affecting an estimated 20% of people worldwide and requires special treatment and care. CP can contribute to depression, anxiety, sleep disturbances, poor quality of life and increased health care costs. Psychosocial approaches based on a cognitive conceptualization of pain can provide a solid foundation for research and clinical work. The development of a 10 week-session group treatment was based on key principles from the literature on Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) and Creative Arts Therapy, integrated with advances in research on CP management framework. The aim of this study is to evaluate a CBT-CP arts-based group intervention for patients with non-malignant CP addressing the biopsychosocial factors that influence pain perception. A total of 100 University Pain Management Unit outpatients participated, 50 in the intervention group and 50 in the control group (treatment as usual). In analyses of the pretest-posttest research design intervention including all participants, treatment gains were observed in almost all domains examined: severity of pain measured by the Brief Pain Inventory, conceptualization of mental pain measured by the Orbach and Mikulincer Mental Pain Scale, tolerance for psychological pain measured by the Tolerance for Mental Pain Scale, anxiety and depression levels measured by the Hospital Anxiety and Depression Scale, and quality of life measured by the WHO Quality of Life-BREF Questionnaire. The participants' mean age was 52.3 years and most were female (84%). Findings suggest that postprogram, there was significant reduction in pain intensity (p<0.001), depressive symptoms (p<0.001), confusion about pain (p=0.037), and improvement of emotional distress tolerance (p=0.012) and global health-related quality of life (p<0.001) in the intervention group. Beneficial effects can be expected from the implementation of an integrated CP intervention (including: creative and CBT techniques) reappraising some of the coping responses defined as adaptive within current psychosocial non-malignant CP regimens.

The effectiveness of marital relationship enrichment training on emotional literacy, couple compatibility, marital boredom and distress tolerance in couples

Aim: The purpose of this study was to investigate the effectiveness of marital relationship enrichment training on emotional literacy, couple compatibility, marital burnout and distress tolerance in couples referring to Gonbad clinics. method: The research method was semi-experimental with a pre-test-post-test design and a control and follow-up group. The statistical population of this research is all the couples who referred to Gonbad city clinics in 2019-1400. Available sampling method was used to select the sample. The sample size was considered equal to 32 people, and the subjects were randomly divided into two experimental groups (16 people) and the control group (16 people). In this plan, Johnson's (1997) emotion-oriented couple therapy training was held in eight sessions for 90 minutes. The research tools were Emotional Literacy Questionnaire, Iranian Kimiai Family Psychological Functions Scale (2008), Spanier Marital Adjustment Scale (DAS) (1976), Pines Marital Discomfort Scale (1996) and Simmons and Gaher Distress Tolerance Questionnaire (2005). To analyze the results, repeated measure variance analysis was used. Results: The results showed the effectiveness of marital relationship enrichment training on emotional literacy (F=51.34, P=0.001), couples' compatibility (F=46.03, P=0.001), marital boredom (07/07) F=48, P=0.001) and distress tolerance F=032.86, P=0.001) were effective and this effect was stable in the follow-up phase. Conclusion: Therefore, this intervention can be used as a part of therapeutic interventions effectively in marital adjustment and reducing boredom and increasing distress tolerance of conflicted couples.

Comparing the effectiveness of schema therapy and acceptance and commitment therapy on the tolerance of emotional distress, sexual dysfunction and psychological capital of patients with multiple sclerosis

Aim: The present study was conducted with the aim of comparing the effectiveness of schema therapy and acceptance and commitment therapy on the tolerance of emotional distress, sexual dysfunction and psychological capital in patients with multiple sclerosis. Methods: The current research is a semi-experimental type with a pre-test, post-test and follow-up design with two experimental groups and one control group. The statistical population included all the patients with multiple sclerosis in Central Province in the year 2021, and according to the arrangements made with the MS Association of Arak city, their total number is 1200. In this study, statistical samples of 45 people were selected as available and then randomly assigned to 3 groups of 15 people including treatment plan groups (15 people), treatment based on acceptance and commitment (15 people) and control group ( 15 people) were randomly replaced. The research tools included the emotional distress tolerance questionnaire of Simmons and Gaher (2005), the sexual performance questionnaire of Rosen et al. (2000) and the psychological capital questionnaire of Lutans et al. (1999). Schema therapy was based on Yang et al.'s (2003) 12-session protocol, and commitment and acceptance-based therapy was based on Eifert and Forsyth's (2004) eight-session protocol. Finally, analysis of variance of repeated measures using SPSS version 22 software was used to analyze the data. Results: The results showed that there is a significant difference between the effect of schema therapy and therapy based on acceptance and commitment on the tolerance of emotional distress, sexual dysfunction and psychological capital in patients with multiple sclerosis (P=0.01). The effect was reported to be stable during follow-up. Conclusion: Therefore, it can be said that there is a significant difference between the three groups in the post-test scores after adjusting the pre-test scores, and also, the confirmation results showed that schema therapy and t acceptance and commitment therapy t on the tolerance of emotional distress , sexual performance and psychological capital skewness among patients with multiple sclerosis has been stable.