Effectiveness of Acceptance and Commitment Therapy on Resilience, Self-Deprecation, and Self-Help in People with Chronic Depressive Disorder with Frequent Relapses

Sarvenaz Roshanisefat; Sepideh salehi; Fatemeh Khazaei; Mona Esmaeil Soltani; Sepehr Badrkhan

doi:10.63053/ijhes.204

Authors

Sarvenaz Roshanisefat M.A in Clinical psychology,Islamic Azad University, Tehran Electronics Branch,iran
Sepideh salehi Master of Educational Psychology, Faculty of Educational Sciences and Psychology, Marvdasht Azad University, Fars, Iran :Corresponding Author
Fatemeh Khazaei 3M.A. student in Clinical Psychology, Faculty of Educational Sciences and Psychology, Alzahra University, Tehran, Iran.
Mona Esmaeil Soltani -4Master of Clinical Psychology, Faculty of Welfare and Health Social Sciences, Tehran University of Medical Sciences, Islamic Azad University, Tehran, Iran
Sepehr Badrkhan MA,Faculty of Educational Sciences and Psychology, Zanjan Branch, Islamic Azad University, Zanjan, Iran

DOI:

https://doi.org/10.63053/ijhes.204

Keywords:

Acceptance and Commitment Therapy, Chronic Depression, Resilience, Self-Deprecation, Self-Help, Frequent Relapse

Abstract

Background: Chronic Major Depressive Disorder (MDD) with frequent relapses is a debilitating condition characterized by low resilience, high self-deprecation, and impaired self-help behaviors. Acceptance and Commitment Therapy (ACT), which targets psychological inflexibility, may address these specific deficits. This study aimed to investigate the effectiveness of ACT on resilience, self-deprecation, and self-help in individuals with chronic MDD with frequent relapses.

Methods: This quasi-experimental study employed a pretest-posttest-follow-up design with a control group. The statistical population included all patients aged 25–55 years with chronic MDD and a history of at least three depressive episodes attending psychiatric clinics in Tehran during 2024–2025. A total of 45 participants were selected using purposive sampling and randomly assigned to ACT (n = 15) and waitlist control (n = 15) groups, with 15 participants in each group completing the study. The ACT group received ten 90-minute weekly group sessions. Data collection instruments included the Beck Depression Inventory-II (BDI-II), Connor-Davidson Resilience Scale (CD-RISC), Self-Deprecation Scale (SDS), and Self-Help Behaviors Scale (SHBS). Data were analyzed using repeated-measures ANOVA with SPSS-26.

Results: The ACT group demonstrated significant improvements compared to the control group across all outcome measures. Significant Time × Group interactions were found for resilience (F = 28.45, P < 0.001, η² = 0.48), self-deprecation (F = 32.18, P < 0.001, η² = 0.52), and self-help behaviors (F = 26.73, P < 0.001, η² = 0.46). Improvements were maintained at two-month follow-up (P < 0.001). Effect sizes for ACT were large (d = 2.12 for resilience; d = 2.34 for self-deprecation; d = 1.98 for self-help). Depression severity significantly decreased in the ACT group (F = 35.28, P < 0.001, η² = 0.56).

Conclusion: Acceptance and Commitment Therapy is an effective intervention for improving resilience, reducing self-deprecation, and enhancing self-help behaviors in individuals with chronic depressive disorder with frequent relapses. The therapeutic benefits are sustained over time and are associated with reduced depression severity. ACT should be considered a frontline psychological treatment for chronic, relapsing depression.

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