Effectiveness of Emotional-Focused Therapy on Pain Acceptance and the Mental Health Dimensions among Patients with Urticaria

Zahra Bahreini, Gholamreza Sanagouye-Moharer



Background and Objective: Chronic urticaria is a disease could result in irritation and disability among patients. The purpose of this study was to determine the effectiveness of emotion-focused therapy on pain acceptance and the mental health dimensions among patients with urticaria.

Materials and Methods: This study was of semi-experimental design with pretest-post-test and control group. The population of this study included all patients with urticaria who were referred to Imam Khomeini Hospital in Tehran in 2017, among whom 60 were randomly selected and assigned to two experimental and control groups, each containing 30. The experimental group participated in eight sessions of emotional-focused therapy. Chronic pain acceptance questionnaire and general health questionnaire were completed by both groups. Data were analyzed using covariance analysis in SPSS software version 22.

Results: The mean (SD) age of the respondents was 41.3 (6.4) years. The mean (SD) score of the health problems of the experimental group was 47.4 (8.5) in the pretest, which decreased to 40.5 (5.3) in the post-test and the mean (SD) of not accepting pain in the experimental group was 30.1 (4.1) pretest, which decreased to 27.19 (3.5) but the mean (SD) of both variables in the pre-test and post-test of the control group did not show a significant difference.

Conclusion: It can be concluded that emotional-focused group therapy improved pain acceptance and mental health dimensions of patients with Urticaria.

DOI: http://doi.org/10.22037/ch.v7i2.23801


Mental Health, Pain, Urticaria, Emotions

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Movahedi M, Tavakol M, Hirbod-Mobarakeh A, Gharagozlou M, Aghamohammadi A, Tavakol Z, Momenzadeh K, Nabavi M, Dabbaghzade A, Mosallanejad A, Rezaei N. Vitamin D deficiency in chronic idiopathic urticaria. Iranian Journal of Allergy, Asthma and Immunology. 2015;14(2):222-7.

Shin M, Lee S. Prevalence and causes of childhood urticaria. Allergy, asthma & immunology research. 2017;9(3):189-90.

Di Lorenzo G, Leto-Barone MS, La Piana S, Seidita A, Rini GB. Chronic spontaneous urticaria: an autoimmune disease? A revision of the literature. Clinical and experimental medicine. 2013;13(3):159-64.

Rostamy MM. Prevalence of the Helicobacter pylori infection in chronic urticaria. Journal of Pakistan Association of Dermatology. 2016;20(3):142-5.

Atefi N, Rahimi M, Peyghambari S, Ghourchian S. Psychological status in patients with chronic urticaria. Medical Journal of The Islamic Republic of Iran (MJIRI). 2011;25(4):200-4.

Gericke J, Metz M, Ohanyan T, Weller K, Altrichter S, Skov PS, Falkencrone S, Brand J, Kromminga A, Hawro T, Church MK. Serum autoreactivity predicts time to response to omalizumab therapy in chronic spontaneous urticaria. Journal of Allergy and Clinical Immunology. 2017;139(3):1059-61.

Auyeung P, Mittag D, Hodgkin PD, Harrison LC. Autoreactive T cells in chronic spontaneous urticaria target the IgE Fc receptor I subunit. Journal of Allergy and Clinical Immunology. 2016;138(3):761-8.

Chang TW, Chen C, Lin CJ, Metz M, Church MK, Maurer M. The potential pharmacologic mechanisms of omalizumab in patients with chronic spontaneous urticaria. Journal of Allergy and Clinical Immunology. 2015;135(2):337-42.

Diamond GM, Shahar B, Sabo D, Tsvieli N. Attachment-based family therapy and emotion-focused therapy for unresolved anger: The role of productive emotional processing. Psychotherapy. 2016;53(1):34.

Esteve R, Ramírez-Maestre C, López-Martínez AE. Adjustment to chronic pain: the role of pain acceptance, coping strategies, and pain-related cognitions. Annals of Behavioral Medicine. 2007;33(2):179-88.

Dillon A, Timulak L, Greenberg LS. Transforming core emotional pain in a course of emotion-focused therapy for depression: A case study. Psychotherapy Research. 2018;28(3):406-22.

Gu J, Strauss C, Bond R, Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical psychology review. 2015; 37:1-2.

Mendes I, Rosa C, Stiles WB, Caro Gabalda I, Gomes P, Basto I, Salgado J. Setbacks in the process of assimilation of problematic experiences in two cases of emotion-focused therapy for depression. Psychotherapy Research. 2016;26(6):638-52.

Metz M, Ohanyan T, Church MK, Maurer M. Omalizumab is an effective and rapidly acting therapy in difficult-to-treat chronic urticaria: a retrospective clinical analysis. Journal of dermatological science. 2014;73(1):57-62.

Pascual-Leone A, Yeryomenko N, Sawashima T, Warwar S. Building emotional resilience over 14 sessions of emotion focused therapy: Micro-longitudinal analyses of productive emotional patterns. Psychotherapy Research. 2017; 3(2):1-5.

Pinto-Gouveia J, Costa J, Marôco J. The first 2 years of rheumatoid arthritis: The influence of acceptance on pain, physical limitation and depression. Journal of Health Psychology. 2015;20(1):102-12.

McCracken LM, Vowles KE. Psychological flexibility and traditional pain management strategies in relation to patient functioning with chronic pain: an examination of a revised instrument. The Journal of Pain. 2007;8(9):700-7.

Ribeiro AP, Mendes I, Stiles WB, Angus L, Sousa I, Gonçalves MM. Ambivalence in emotion-focused therapy for depression: The maintenance of problematically dominant self-narratives. Psychotherapy Research. 2014;24(6):702-10.

Smith AM, Sieberg CB, Odell S, Randall E, Simons LE. Living life with my child’s pain: The parent pain acceptance questionnaire (PPAQ). The Clinical journal of pain. 2015;31(7):633.

Steinmann R, Gat I, Nir-Gottlieb O, Shahar B, Diamond GM. Attachment-based family therapy and individual emotion-focused therapy for unresolved anger: Qualitative analysis of treatment outcomes and change processes. Psychotherapy. 2017;54(3):281.

Brenning KM, Braet C. The emotion regulation model of attachment: An emotionspecific approach. Personal Relationships. 2013 Mar;20(1):107-23.

Bonanno GA, Burton CL. Regulatory flexibility: An individual differences perspective on coping and emotion regulation. Perspectives on Psychological Science. 2013 Nov;8(6):591-612.

Berking M, Ebert D, Cuijpers P, Hofmann SG. Emotion regulation skills training enhances the efficacy of inpatient cognitive behavioral therapy for major depressive disorder: a randomized controlled trial. Psychotherapy and Psychosomatics. 2013;82(4):234-45.

Timulak L, McElvaney J. Emotion-focused therapy for generalized anxiety disorder: An overview of the model. Journal of Contemporary Psychotherapy. 2016;46(1):41-52.

Viane I, Crombez G, Eccleston C, Poppe C, Devulder J, Van Houdenhove B, De Corte W. Acceptance of pain is an independent predictor of mental well-being in patients with chronic pain: empirical evidence and reappraisal. Pain. 2003;106(1-2):65-72.

Garnefski N, Kraaij V. Cognitive coping and goal adjustment are associated with symptoms of depression and anxiety in people with acquired hearing loss. Int J Audiol. 2012;51(7):545-50.

Zhao ZT, Ji CM, Yu WJ, Meng L, Hawro T, Wei JF, Maurer M. Omalizumab for the treatment of chronic spontaneous urticaria: a meta-analysis of randomized clinical trials. Journal of Allergy and Clinical Immunology. 2016;137(6):1742-50.


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