Psychotherapeutic Interventions Improve Emotional Competencies in Multiple Sclerosis

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Researchers sought to investigate the impact of ACT and MSR on symptoms and emotional competencies in patients with MS.

Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Stress Reduction (MBSR) psychotherapeutic interventions may help patients with multiple sclerosis (MS) by reducing secondary symptoms and enhancing emotional competencies, according to study findings published in Multiple Sclerosis and Related Disorders.

Patients with MS tend to experience more insomnia, depression, fatigue, paresthesia, and have difficulty with emotional competencies than the general population. For this study, researchers at Stanford University and Isfahan University of Medical Sciences evaluated whether novel psychotherapeutic interventions may improve these secondary symptoms.

Researchers recruited adults (N=78) with MS registered at the Isfahan Neuroscience Research Center in Iran. Participants were randomly assigned to receive ACT (n=26), MBSR (n=25), or waitlist (n=25). ACT and MBSR were delivered weekly for 8 weeks with each session lasting 90-120 minutes. At baseline and weeks 4 and 8, patients were evaluated for insomnia, depression, fatigue, paresthesia, and emotional competencies.

The ACT, MBSR, and control cohorts were aged mean 37.21 (standard deviation [SD], 9.83), 38.80 (SD, 6.01), and 40.20 (SD, 10.72) years, respectively; the male:female ratios were 3:23, 4:21, and 7:18, respectively; and median Expanded Disability Status Scale (EDSS) scores were 1.75 (range, 0-5.5), 2.00 (range, 0-4.0), and 2 (range, 0-5.0), respectively.

Overall, significant time effects were observed for depression, insomnia, paresthesia, perception and acknowledgement of own emotions, emotional expressivity (all P <.001), and perception of others’ emotions (P <.01).

Significant group effects were observed for depression (P <.05), insomnia (P <.001), paresthesia (P <.01), perception and acknowledgement of own emotions (P <.05), regulation and control of own emotions (P <.05), and emotional expressivity (P <.01).

Time-by-group interactions were observed for depression (P <.001), insomnia (P <.05), fatigue (P <.05), paresthesia (P <.01), perception and acknowledgement of own emotions (P <.001), and perception of others’ emotions (P <.001).

Compared between active interventions, neither the ACT nor the MBSR program was significantly favored over the other for any outcomes (all P ≥.11) and the interventions had small or trivial effect sizes (all d <.46).

This study may have been limited by the choice of using waitlist as the control condition, instead of another intervention which included social interaction.

This study found that both the ACT and MBSR psychotherapeutic interventions associated with significant improvements to depression, insomnia, paresthesia, and emotional competencies compared with waitlist.

“Psychotherapeutic interventions such as these should be considered as a means of decreasing symptoms and increasing emotional competencies among individuals with MS,” the researchers stated. However, there is little evidence to support 1 intervention over the other. Additional study of ACT and MBSR in the setting of MS is needed.

Reference

Sadeghi-Bahmani D, Esmaeili L, Mokhtari F, et al. Effects of Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Stress Reduction (MBSR) on symptoms and emotional competencies in individuals with Multiple Sclerosis. Mult Scler Relat Disord. Published online July 6, 2022. doi:10.1016/j.msard.2022.104029