Effectiveness of Cognitive-Behavioral Stress Management on Distress Tolerance, Pain Perception and Interleukin-12 in MS Patients مقاله

نویسنده مسئول: Dortaj، Afsaneh ؛

نویسنده: Aliakbari Dehkordi، Mahnaz ؛ Naser Moghadasi، Abdorreza ؛ Alipour، Ahmad ؛

Iranian Journal of Health Psychology Autumn 2020, Volume 3 - Number 2 ، ب (وزارت علوم (‎14 صفحه - از 15 تا 28 )

کلیدواژه ها: MS distress tolerance Pain perception cognitive-behavioral stress management Interleukin-12

چکیده:

Objective: This study aimed to assess the effectiveness of Cognitive-Behavioral Stress Management (CBSM) on distress tolerance, pain perception, and interleukin-12 (IL-12) in patients with Multiple Sclerosis (MS). Method: The present study was a quasi-experimental design with pretest-posttest and follow-up with control group. The statistical population included all female patients with relapsing-remitting MS who had referred to Neuroscience and Rehabilitation Research Centers of Tehran University of Medical Sciences. 20 patients were selected by convenience sampling and were randomly assigned into experimental (10 patients) and control groups (10 patients). The experimental group received the CBSM. Participants completed scales. To measure IL-12, the Enzyme-Linked Immunosorbent Assay (ELISA) was used. The data were analyzed using multivariate analysis of covariance (MANCOVA) and Bonferroni post-hoc test. Results: CBSM increased the distress tolerance and components of pain perception (perceived influence of important people and doing daily affairs) (p <0.001) and it decreased pain severity and IL-12. Also, these changes remained stable during follow-up. Conclusions: CBSM is an effective to influence on distress tolerance, pain perception, and IL-12 in MS patients.

خلاصه ماشینی:

Individuals with MS have high levels of distress intolerance (Alschuler & Beier, 2015; Kafaki, Moafi, Golestani, Bekineh, & Ebrahimi, 2017; Heffer-Rahn & Fisher, 2018; Hayek et al. Therefore, in this study, CBSM was used to evaluate whether it is effective in improving distress tolerance, pain perception, and interleukin-12 in MS patients by reducing or managing stress. However, stress management intervention is effective in improving psychological and immune factors, pain (Nazemi, Bahrami Ehsan, Alipour, & Bayat, 2018), and negative emotions (Javanmard & Goli, 2018). Table 3 shows the results of the effect of CBSM on distress tolerance, pain perception components, and interleukin-12 in the posttest and follow- up stages after controlling for the pretest. During CBSM, patients with MS are taught cognitive techniques (such as identifying negative and irrational thoughts and replacing positive logical thoughts and hopeful mental schemas) and behavioral techniques to control and manage stress (such as training muscle relaxation that activates the parasympathetic system) (Jandaghi, Neshatdoost, Kalantari, and Jabal Ameli, 2012), which changes patient’s attitudes (so that my disease can be controlled and I will recover, and pain has no effect on my life and activities), achieves relaxation, and consequently, reduces the negative pain perception and its severity and increase positive attitudes about people influencing them and engaging in daily activities. Stress management interventions, cognitive- behavioral therapy, or CBSM may be appropriate strategies for positive changes in patients with MS (Reynard, Sullivan, & Rae-Grant, 2014) and reduction of inflammatory cytokines (Antoni et al.

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