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Comparison of the Effectiveness of Mindfulness-Based Stress Reduction Group Therapy With Acceptance and Commitment Therapy on Severity of Pain and Health-Related Quality of Life in Patients With Migraine

Tahereh Haji Seyed Javadi, Najmeh Aghareb Parast, Sahar Shahsavani, Mir Javad Chehraghi, Leila Razavi, Soheila Rahmani, Somayeh Nejati




Objective: Considering the prevalence of migraine and its detrimental effects on functioning, physical health, and quality of life as well as its psychosocial and social risks, the purpose of this study was to compare the effectiveness of mindfulness-based stress reduction treatment with treatment based on acceptance and commitment on the severity of pain and health-related quality of life in migraine patients.

Methodology: In this study, a semi-experimental design was used with pre-test, post-test, a three-month follow-up, and a control group. Using purposive sampling and considering the inclusion criteria, 45 patients with migraine diagnosis were selected from among those referring to the neurology department of Imam Hossein Hospital in Tehran. They were then randomly assigned to two experimental groups and a control group. The first experimental group received group therapy based on mindfulness (n = 15; 90-minute sessions), the second experimental group received acceptance and commitment based intervention (n = 15; 90-minute sessions), and the control group (n = 15) received no intervention. All subjects responded to pain intensity and health-related quality of life questionnaires before the intervention (pre-test), after the intervention (post-test), and 3 months after the intervention (follow-up). Collected data were analyzed by one-way ANOVA.

Findings: The findings showed that mean scores for the two experimental groups were significantly different from the control group in the post-test and follow-up phases in terms of severity of pain and health-related quality of life, while the mean scores for the two experimental groups did not differ significantly. The results emphasize the importance of these interventions for chronic diseases and offer new horizons in clinical interventions.

Conclusion: The results of this study showed that mindfulness-based stress reduction therapy and acceptance and commitment therapy can positively affect the severity of pain and health-related quality of life in migraine patients, and any of them can be used to improve the above-mentioned variables.


Mindfulness-based therapy; Acceptance; Commitment, The severity of pain; Health-related quality of life; Migraine.


Kaiser EA, Russo AF. CGRP and migraine: Could PACAP play a role too? Neuropeptides 2013; 47(6): 451-61.

Aggarwal M, Puri V, Puri S. Serotonin and CGRP in migraine. Annal of Neurosciences 2012; 19(2):88-94.

The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 2013; 33(9): 629-808.

Brett R. Et al. Dietary and Lifestyle Changes in the Treatment of a 23-Year-Old Female Patient with Migraine. J Chiropr Med [Internet]. National University of Health Sciences, 2015; 14(3): 205–11.

Gordon-smith K. Et al. Rapid cycling as a feature of bipolar disorder and comorbid migraine. J Affect Disord [Internet]. Elsevier; 2015; 175: 320–4.

Sadeghian H, Karimzadeh F, Jafarian M. Mechanisms involved in pathophysiology of different types of migraines. The Neuroscience Journal of Shefaye Khatam 2013; 1(9): 50-54.

Pietrobon D, Moskowitz MA. Pathophysiology of migraine. Annu Rev Physiol 2013; 75: 365-91.

Zarea K, Rahmani M, Hassani F, Hakim A. Epidemiology and associated factors of migraine headache among Iranian medical students: A descriptive-analytical study. Clinical Epidemiology and Global Health. 2018 Sep 1;6(3):109-14.

Kim SY, Park SP. The role of headache chronicity among predictors contributing to quality of life in patients with migraine: a hospital-based study. The journal of headache and pain. 2014 Dec;15(1):68.

Kollewe K1, Escher CM2, Wulff DU3, Fathi D2,4,5, Paracka L2, Mohammadi B5,6, Karst M7, Dressler D2. Long-term treatment of chronic migraine with OnabotulinumtoxinA: efficacy, quality of life and tolerability in a real-life setting.J Neural Transm (Vienna). 2016 May;123(5):533-40.

Shaik MM, Hassan NB, Tan HL, Gan SH. Quality of life and migraine disability among female migraine patients in a tertiary hospital in Malaysia. BioMed research international. 2015;2015.

Shahrestani M, Ghanbari B, Nemati SH,Rabardar H. The effectiveness of mindfulness based cognitive group therapy on improvement of perceived stress of infertility and irrational cognitions in infertile women with IVF treatment. Global J Health Sci. 2012; 15: 28-38.

Anheyer D, Leach MJ, Klose P, Dobos G, Cramer H. Mindfulness-based stress reduction for treating chronic headache: A systematic review and meta-analysis. Cephalalgia. 2018 Jan 1:0333102418781795.

Frisvold M.H., Lindquist R,McAlpine C.P. Living Life in the Balance at Midlife: Lessons Learned From Mindfulness. West J Nurs Res, 2012; 34(2): 265-278.

Zare H, Shahriari H, Zare M. Effect of Mindfulness-Based Stress Reduction on Students’ Migraine Pain Intensity. Journal of zabol university of medical sciences and health services. 2014; 6 (3) :30-39.

, Steurer J. Mindfulness-based stress reduction is effective in patients with chronic lumbar backache. Praxis. 2016 Jun;105(12):721-2.

Pettit J, Glickman-Simon R. Osteopathic manipulative therapy for preterm infants, acupuncture for menopausal symptoms, mindfulness-based stress reduction for chronic low back pain, chocolate for ischemic heart disease, berberine for irritable bowel syndrome. Explore: The Journal of Science and Healing. 2016 Sep 1;12(5):388-92.

Crisp CD, Hastings-Tolsma M, Jonscher KR. Mindfulness-based stress reduction for military women with chronic pelvic pain: a feasibility study. Military medicine. 2016 Sep 1;181(9):982-9.

Arefnasab Z, Babamahmoodi A, Babamahmoodi F, Noorbala AA, Alipour A, Panahi Y, Shams J, Rad FR, Khaze V, Ghanei M. Mindfulness-based stress reduction (MBSR) and its effects on psychoimmunological factors of chemically pulmonary injured veterans. Iranian Journal of Allergy, Asthma and Immunology. 2017 Dec 30;15(6):476-86.

Nathan HJ, Poulin P, Wozny D, Taljaard M, Smyth C, Gilron I, Sorisky A, Lochnan H, Shergill Y. Randomized Trial of the Effect of Mindfulness-Based Stress Reduction on Pain-Related Disability, Pain Intensity, Health-Related Quality of Life, and A1C in Patients with Painful Diabetic Peripheral Neuropathy. Clinical Diabetes. 2017 Dec 1;35(5):294-304.

Bakhshani NM, Amirani A, Amirifard H, Shahrakipoor M. The effectiveness of mindfulness-based stress reduction on perceived pain intensity and quality of life in patients with chronic headache. Global journal of health science. 2016 Apr;8(4):142.

Mehrdost Z, Neshat dost T, Abedi H. Effectiveness of acceptance and commitment therapy on the decrease of self-focused attention and improving self-efficacy. J Psychol Modes Methods. 2013; 3: 67-82.

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(2):180-98.

Prevedini AB, Presti G, Rabitti E, Miselli G, Moderato P. Acceptance and commitment therapy (ACT): the foundation of the therapeutic model and an overview of its contribution to the treatment of patients with chronic physical diseases. G Ital Med Lav Ergon. 2011;33.

Muller, R. and Kevin, G. (2016). Effects of a tailored positive psychology intervention on well-being and pain in individuals with chronic pain and a physical disability: a feasibility trial. Journal of pain. 3(1):32-44.

Dindo, L.and Marchman, J. (2015). Depression and disability in migraine: the role of pain acceptance and values-based action. International journal of behavioral medicine. 22(1):109-17.

Bastami M, Gudarzi N, Doran B, Dabaghi P, Bastami M, Effectiveness of Acceptance and Commitment Therapy (ACT) in improving the quality of life in male military personnel with type 2 diabetes, Quarterly Journal of Nurse and Physician in War, Fall 2016, 12 (4): 119-126

Lee CE, Kim S, Kim S, Joo HM, Lee S. Effects of a mindfulness-based stress reduction program on the physical and psychological status and quality of life in patients with metastatic breast cancer. Holistic nursing practice. 2017 Jul 1;31(4):260-9.

Omidi A, Momeni J, Raigan F, Akbari H, Talighi E, The effectiveness of mindfulness-based stress reduction program on quality of life among patients with cardiovascular diseases, Journal of Thought & Behavior in Clinical Psychology, Vol. 10 (No. 42), pp.7-16, 2017

Heshmati R, Ghorbani F. The effect of Mindfulness-Based Stress Reduction (MBSR) program on physical functioning and health related quality of life (HRQOL) in people with coronary artery disease (CAD). Iranian Journal of Cardiovascular Nursing. 2016; 5(3), 16-25.

Ardito RB, Pirro PS, Re TS, Bonapace I, Menardo V, Bruno E, Gianotti L. Mindfulness-based stress reduction program on chronic low-back pain: a study investigating the impact on endocrine, physical, and psychologic functioning. The Journal of Alternative and Complementary Medicine. 2017 Aug 1;23(8):615-23.

Lindsay EK, Creswell JD. Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT). Clinical Psychology Review. 2017 Feb 1; 51:48-59.

Janssen M, Heerkens Y, Kuijer W, Van Der Heijden B, Engels J. Effects of Mindfulness-Based Stress Reduction on employees’ mental health: A systematic review. PloS one. 2018 Jan 24;13(1): e0191332.

Brown DB, Bravo AJ, Roos CR, Pearson MR. Five Facets of Mindfulness and Psychological Health: Evaluating a Psychological Model of the Mechanisms of Mindfulness. Mindfulness. 2015;6(5):1021–1032. [PMC free article] [PubMed].

Mohammadi L, Salehzade Abarghoei M, Nasirian M. [Effectiveness of acceptance and commitment therapy on cognitive emotion regulation in men under methadone treatment]. J Shahid Sadoughi Univ Med Sci. 2015;23(9):853-61.

Reese ED, Zielinski MJ, Veilleux JC. Facets of mindfulness mediate behavioral inhibition systems and emotion dysregulation. Personality and Individual Differences. 2015; 72:41–46.

Barbaro N, Pickett SM. Mindfully Green: Examining the effect of connectedness to nature on the relationship between mindfulness and engagement in pro-environmental behavior. Personality and Individual Differences. 2016; 93:137–142.

Klein R, Dubois S, Gibbons C, Ozen LJ, Marshall S, Cullen N, Bédard M. The Toronto and Philadelphia Mindfulness Scales: Associations with Satisfaction with Life and Health-Related Symptoms. International Journal of Psychology and Psychological Therapy. 2015;15(1):133–142.

Thao, N. Le. (2014). Mindfulness-Based Adventure Camp for Military Youth. Journal of Extens, 52,2.

Zarnaghash M, Mehrabi M, Bashdileh K, Davoodi I, Marashi A, The Effectiveness of Mindfulness-Based Stress Reduction on Quality of Life and Resiliency of Veterans Spouses in Ahvaz, Journal of Psychological Methods and Models, 2016; 7(23): 83-99

Darvish Baseri L, DashtBozorgi Z. Effectiveness of Group Therapy Based on Acceptance and Commitment on Cognitive Emotion Regulation and Alexithymia of Patients with Type 2 Diabetes. Iranian Journal of Psychiatric Nursing, 2017; 5 (1) :7-14

Kemani MK, Kanstrup M, Jordan A, Caes L, Gauntlett-Gilbert J. Evaluation of an Intensive Interdisciplinary Pain Treatment Based on Acceptance and Commitment Therapy for Adolescents with Chronic Pain and Their Parents: A Nonrandomized Clinical Trial. Journal of pediatric psychology. 2018 May 17.

Parsa M, Sabahi P, Mohammadifar M, The effectiveness of acceptance and commitment group therapy to improving the quality of life in patients with multiple sclerosis, Journal of Clinical Psychology, 2018; 10(1): 21-28

Gharaie-Ardekani S, Azad-Fallah P, Tavallaie A. The effectiveness of acceptance and commitment therapy on pain experience in women with chronic pain. Journal of Clinical Psychology 2012; 4(2): 39-50. [In Persian].

Rose MR, Norton S, Vari C, Edwards V, McCracken L, Graham CD, Radunovic A, Chalder T. Acceptance and Commitment Therapy for Muscle Disease (ACTMus): protocol for a two-arm randomized controlled trial of a brief guided self-help ACT program for improving quality of life in people with muscle diseases. BMJ open. 2018 Oct 1;8(10): e022083.

Abbasid M, Mahmoudian H, Rezvani Far S. [Comparison of effectiveness between two educational methods of acceptance and commitment and emotional regulation training on psychological well-being in students with dyscalculia]. J Res Educ. 2014;1(1):23-35.


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