[Home ] [Archive]   [ فارسی ]  
:: Main :: About :: Current Issue :: Archive :: Search :: Submit :: Contact ::
Main Menu
Journal Information::
Articles archive::
Publication Ethics::
Peer Review Process::
Indexing Databases::
For Authors::
For Reviewers::
Contact us::
Site Facilities::
Google Scholar Metrics

Citation Indices from GS

AllSince 2019

Search in website

Advanced Search
Receive site information
Enter your Email in the following box to receive the site news and information.
Registered in



:: Volume 30, Issue 2 (6-2022) ::
Journal of Ilam University of Medical Sciences 2022, 30(2): 82-96 Back to browse issues page
Comparison of Effectiveness of Acceptance and Commitment Therapy (ACT) and Compassion-Focused Therapy (CFT) on Internalized Shame in Patients with Vitiligo
Mahdi Solimanpour1 , Alireza Pirkhaefi * 2, Kianosh Zahrakar3
1- Department of Human Science, Science and Research Branch, Islamic Azad University, Tehran, Iran
2- Department of Clinical Psychology, Faculty of Medicine, Garmsar Branch, Islamic Azad University, Garmsar, Iran , apirkhaefi@gmail.com
3- Department of Counseling, Faculty of Psychology and Educational Science, Kharazmi University, Tehran, Iran
Abstract:   (1892 Views)
 Introduction: Skin diseases, not only may have physical consequences but also costly psychological consequences in one’s life. The present study was conducted to compare the effect of group counseling with the approaches of Compassion-Focused Therapy (CFT) and Acceptance and Commitment Therapy (ACT) on the internalized shame of patients with vitiligo.
Material & Methods: This was a quasi-experimental study with pre-test and post-test design and follow-up and control groups. The study population consisted of all women with vitiligo who were referred to Razi Hospital, in Tehran, in 1399. A total of 45 persons who met the inclusion criteria were purposefully selected and randomly divided into 3 groups of 15 people each (two experimental groups and one control group). The study tool included Cook's Internalized Shame Scale (1993). Descriptive statistics and repeated measures analysis of variance was used to test the research hypotheses. The data were analyzed using SPSS software (version 20).
(Ethic code: R.IAU.SRB.REC.1399.125)
Findings: Both CFT and ACT therapeutic approaches were effective in reducing internalized shame in patients with vitiligo, compared to the control group. A comparison of the two approaches showed no significant differences between the two experimental groups of CFT and ACT in terms of all components of shyness, self-esteem, and internalized shame.
Discussion & Conclusion: Based on the obtained results, the above-mentioned treatments can be used to improve the psychological status of patients with vitiligo.
Keywords: Acceptance and commitment therapy, Compassion therapy, Shame, Vitiligo
Full-Text [PDF 1150 kb]   (707 Downloads)    
Type of Study: Research | Subject: psychology
Received: 2021/09/7 | Accepted: 2022/02/12 | Published: 2022/06/5
1. Yamaguchi Y, Hearing VJ. Melanocytes and their diseases. Cold Spring Harb Perspect Med. 2014;4: a017046. doi: 10.1101/cshperspect. a017046
2. Nagarajan A, Masthan MK, Sankar LS, Narayanasamy AB, Elumalai R. Oral manifestations of vitiligo. Indian J Dermatol 2015; 60:103. doi: 10.4103/0019-5154.147844
3. Mohamed E, Said E, Sayed D, Awad S, Ahmed M. Auditory system dysfunction in patients with vitiligo: is it a part of a systemic autoimmune process? Egyptian J Otolaryngol 2017; 33: 594–602.doi: 10.4103/ejo.ejo_6_17.
4. Basra MK, Fenech R, Gatt RM, Salek MS, Finlay AY. The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol 2008;159: 997-1035. doi: 10.1111/j.1365-2133.2008.08832. x.
5. Ahmed I, Ahmed S, Nasreen S. Frequency and pattern of psychiatric disorders in patients with vitiligo. J Ayub Med Coll Abbottabad. 2007; 19:19-21.
6. Mattoo SK, Handa S, Kaur I, Gupta N, Malhotra R. Psychiatric morbidity in vitiligo: prevalence and correlates in India. J Eur Acad Dermatol Venereol 2002; 16:573-8. doi: 10.1046/j.1468-3083.2002. 00590.x
7. Ezzedine K, Eleftheriadou V, Whitton M, van Geel N. Vitiligo. Lancet 2015; 386:74-84. doi: 10.1016/S0140-6736(14)60763-7
8. Lee YB, Lee JH, Lee SY, Yu DS, Han KD, Park YG. Association between vitiligo and smoking: A nationwide population-based study in Korea. Sci Rep 2020;10 :6231. doi: 10.1038/s41598-020-63384-y.
9. Kwinter J, Pelletier J, Khambalia A, Pope E. High-potency steroid use in children with vitiligo: a retrospective study. J Am Acad Dermatol 2007; 56:236-41. doi: 10.1016/j.jaad.2006.08.017.
10. Glassman SJ. Vitiligo, reactive oxygen species and T-cells. Clin Sci (Lond) 2011; 120:99-120. doi: 10.1042/CS20090603.
11. Chen YT, Chen YJ, Hwang CY, Lin MW, Chen TJ, Chen CC, et al. Comorbidity profiles in association with vitiligo: a nationwide population-based study in Taiwan. J Eur Acad Dermatol Venereol 2015; 29:1362-9. doi: 10.1111/jdv. 12870.
12. Sawant NS, Vanjari NA, Khopkar U. Gender Differences in Depression, Coping, Stigma, and Quality of Life in Patients of Vitiligo. Dermatol Res Pract 2019; 6879412. doi: 10.1155/2019/ 6879412
13. Erfan G, Albayrak Y, Yanik ME, Oksuz O, Tasolar K, Topcu B, et al. Distinct temperament and character profiles in first onset vitiligo but not in alopecia areata. J Dermatol 2014;41:709-15. doi: 10.1111/1346-8138.12553.
14. Nogueira LS, Zancanaro PC, Azambuja RD. Vitiligo and emotions. A Bras Dermatol 2009; 84:41-5. English, Portuguese. doi: 10.1590/s0365-05962009000100006.
15. Cavalera C, Pepe A, Zurloni V, Diana B, Realdon O, Todisco P, et al. Negative social emotions and cognition: Shame, guilt and working memory impairments. Acta Psychol (Amst) 2018; 188:9-15. doi: 10.1016/j.actpsy.2018.05.005
16. Gilbert P. Shame in psychotherapy and the role of compassion focused therapy. Washington, DC: American Psychological Association; 2011. doi:10.1037/12326-014.
17. Angulo J, Fleury V, Péron JA, Penzenstadler L, Zullino D, Krack P. Shame in Parkinson'S Disease: A Review. J Parkinsons Dis 2019; 9:489-499. doi: 10.3233/JPD-181462.
18. Almomani N, Abdulmajeed I, Rahman SU, Alakkam A. Quality of Life and Affective Health of Patients with Vitiligo. J Sleep Dis Ther 2015; 4: 1-8. doi:10.4172/2167-0277.1000190
19. Morrison B, Burden-Teh E, Batchelor JM, Mead E, Grindlay D, Ratib S. Quality of life in people with vitiligo: a systematic review and meta-analysis. Br J Dermatol 2017;177: e338-e339. doi: 10.1111/bjd.15933
20. Salman A, Kurt E, Topcuoglu V, Demircay Z. Social Anxiety and Quality of Life in Vitiligo and Acne Patients with Facial Involvement: A Cross-Sectional Controlled Study. Am J Clin Dermatol 2016; 17:305-11. doi: 10.1007/s40257-016-0172-x
21. Ahmadi R, Sajjadian I, and Jafari F. The effectiveness of compassion-based therapy on anxiety, depression and suicidal ideation in women with vitiligo. Skin Beauty Quarterly 2019; 10: 18-29.
22. SharifiKia T, ahangar e, Askari Z, and Taha M. The effectiveness of positive psychotherapy on the sense of hope and psychological well-being of patients with vitiligo. Develop Psychol 2019; 8: 133-142.
23. Shahmoradi Z, Khaleghipour Sh, and Masjedi M. Comparison of the effectiveness of "schema therapy" and "mindfulness-based cognitive therapy" on maladaptive schemas and general health of patients with vitiligo. Health Promotion Management Quarterly 2018; 7: 42-52.
24. Zakeri M, Hassani M, and Ismaili N. The effectiveness of emotion process regulation training on psychological distress in people with vitiligo. J Health Psychol 2017; 6: 39-56.
25. Gilbert P. The origins and nature of compassion focused therapy. Br J Clin Psychol 2014;53:6-41. doi: 10.1111/bjc.12043
26. Krieger T, Reber F, von Glutz B, Urech A, Moser CT, Schulz A, et al. An Internet-Based Compassion-Focused Intervention for Increased Self-Criticism: A Randomized Controlled Trial. Behav Ther 2019; 50:430-45. doi: 10.1016/j.beth.2018.08.003.
27. Wynne B, McHugh L, Gao W, Keegan D, Byrne K, Rowan C, et al. Acceptance and Commitment Therapy Reduces Psychological Stress in Patients with Inflammatory Bowel Diseases. Gastroenterol 2018; 156: 935-45. doi: 10.1053/j.gastro.2018. 11.030
28. Rahmanian M, Nejad Ali R, and Orki, M.The effectiveness of "acceptance and commitment-based therapy" on cognitive regulation of emotion and body image anxiety in women with binge eating disorder. Health Promot Manage Quart 2018; 7: 33-40. doi: 10.22070/cpap.2020.2941
29. Fogelkvist M, Gustafsson SA, Kjellin L, Parling T. Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms: A randomized controlled trial. Body Image 2020; 32:155-166. doi: 10.1016/j.bodyim. 2020.01.002
30. Salimi A, Dehfarshteh, A, Zahrakar K, Davarnia R, and Shakermi M. The effectiveness of compassion-focused therapy on the mental health of women with multiple sclerosis. 24 Horizon of Knowledge Magazine 2019; 2: 125-31.
31. Sommers-Spijkerman MPJ, Trompetter HR, Schreurs KMG, Bohlmeijer ET. Compassion-focused therapy as guided self-help for enhancing public mental health: A randomized controlled trial. J Consult Clin Psychol 2018; 86:101-115. doi: 10.1037/ccp0000268.
32. Au TM, Sauer-Zavala S, King MW, Petrocchi N, Barlow DH, Litz BT. Compassion-Based Therapy for Trauma-Related Shame and Posttraumatic Stress: Initial Evaluation Using a Multiple Baseline Design. Behav Ther 2017; 48:207-221. doi: 10.1016/j.beth.2016.11.012
33. Andersen B, & Rusmassen P H. Transdiagnostic group therapy for people with self- critic and low self esteem, based on compassion focused therapy principles. J Compassion Health Care 2017; 4: 185-96. doi:10.1186/s40639-017-0043-1
34. Boersma K, Håkanson A, Salomonsson E, Johansson I.Compassion Focused Therapy to Counteract Shame, Self-Criticism and Isolation. A Replicated Single Case Experimental Study for Individuals with Social Anxiety. J Contemporary Psychother 2015; 45: 89–98. doi:10.1007/s10879-014-9286-8
35. Babaei Garmkhani M, Kasaei A, Kianoosh Z & Esmaeil A. Effectiveness of compassion focused group counseling on emotion regulation strategies and marital satisfaction of betrayal women with cyber infidelity. Family Counsel Psychother 2019; 2: 73- 92. doi :20.1001.1.22516654.1398.
36. Davarnia R, Zahrakar K, Asadpour I, Mohsenzadeh F, and Kasaei Esfahani A. The effectiveness of compassionate group counseling on internalized shame in women affected by marital infidelity (one month follow-up). J Neishabour School Med Sci 2019; 8: 60-76. ‎ doi:10.29252/nkjmd-13022.
37. Rajabi G, Abbasi Gh. Investigating the Relationship between Self-Criticism, Social Anxiety, and the Fear of Failure with Internalized Shame in Students of Clinical Psychology. Res Counsel 2011; 1: 171 -82.
38. Fathollahzadeh N, Majlisi Z, Mazaheri, Z, Rostami M, and Navabi Nejad Sh. The effectiveness of compassion-focused therapy on the inner shame and self-criticism of emotionally abused women. Psychol Studies 2017; 13: 151-168. doi:10.22051/psy.2017.12381.1274.
39. Majumdar S, Morris R. Brief group-based acceptance and commitment therapy for stroke survivors. Br J Clin Psychol 2019; 58:70-90. doi: 10.1111/bjc.12198.
40. Karimi Z, Khodabakhshi Kolaei A, Ehsani A. Comparison of suicidal ideation and stress in patients with vitiligo with people without skin disease: a case-control study. J Skin Beauty 2015; 7: 131-38.
41. Ebrahimifar M, Hosseinian, S, Saffarian T M, and Abedi M. Comparison of the effectiveness of education based on "acceptance and commitment therapy" and "compassion-focused therapy" on self-efficacy, relationship quality and meaning of life in infertile women. Health Promot Manag Quarter 2019; 8: 10-18.
42. Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behav Ther 2013; 44: 180-198.doi: 10.1016/j.beth.2009. 08.002
43. Neff K D. Self-compassion, self-esteem, and well-being. Soc Personal Psychol Compass 2011; 5: 1–12. doi: 10.1111/j.1751-9004.2010.00330.x
Send email to the article author

Add your comments about this article
Your username or Email:


Ethics code: IR.IAU.SRB.REC.1399.125

XML   Persian Abstract   Print

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

Solimanpour M, Pirkhaefi A, Zahrakar K. Comparison of Effectiveness of Acceptance and Commitment Therapy (ACT) and Compassion-Focused Therapy (CFT) on Internalized Shame in Patients with Vitiligo. J. Ilam Uni. Med. Sci. 2022; 30 (2) :82-96
URL: http://sjimu.medilam.ac.ir/article-1-7265-en.html

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 30, Issue 2 (6-2022) Back to browse issues page
مجله دانشگاه علوم پزشکی ایلام Journal of Ilam University of Medical Sciences
Persian site map - English site map - Created in 0.17 seconds with 41 queries by YEKTAWEB 4654