Effects of Group Acceptance and Commitment Therapy on Substance-Induced Depression Symptoms in Addicted Men

Those who struggle with substance dependence and abuse also suffer from other comorbid health conditions. Psychological disorders accompanying substance dependence have detrimental effects on biopsychosocial and domestic health. Depression is a barrier to withdrawal and exploiting available coping resources. To treat depression, various approaches have been explored, including psychotherapy, pharmacotherapy, and combination therapies. One of these interventions is acceptance and commitment therapy (ACT). This treatment aims to achieve a more valuable and satisfying life by increasing psychological resilience rather than simply focusing on cognitive reconstruction. Although the effectiveness of psychological therapies in improving depressive symptoms has been emphasized in numerous studies, to our knowledge, no study has examined the effect of this treatment exclusively on the known dimensions of depression induced by substance abuse. So, this study aimed at investigating the effects of group ACT on the reduction of depression symptoms in addicted men with substance–induced depressive disorder (SIDD).

This research was a quasi–experimental study with a pretest–posttest design and a control group. The statistical population consisted of all men diagnosed with substance–induced depression who were referred to addiction treatment centers in Isfahan City, Iran, in 2016. A total of 30 substance–dependent men with moderate to severe depression levels diagnosed based on the Beck Depression Inventory–II (BDI–II; Beck et al., 1996) were selected by purposive sampling method and randomly assigned to the experimental and control groups (n=15 for each group). The inclusion criteria were as follows: being 20 to 40 years old, having depressive symptoms during or shortly after substance use, obtaining moderate to severe depression scores based on BDI–II, lacking severe physical problems preventing them from regularly attending the treatment sessions, and signing a consent letter to participate in the study. The exclusion criteria were as follows: non–cooperation and non–fulfillment of assignments presented in treatment sessions, absence for more than two sessions, physical illnesses found through initial interviews with individuals, and the opinion of the center's consultant. BDI–II was administered in the pretest and posttest for both groups. ACT intervention was provided for the experimental group in eight 90–min sessions. The posttest was conducted at the end of the eighth session for the control and experimental groups. Data analysis was performed by descriptive statistics and inferential statistics using SPSS software version 21. Regarding descriptive statistics, frequency tables, mean and standard deviation were calculated. Regarding inferential statistics, an analysis of covariance was performed. In this analysis, the pretest was considered the covariance. The significance level in all tests was considered 0.05.

The results showed a significant difference between the experimental group and the control group regarding the depressive symptoms (p<0.001) as well as cognitive (p<0.001), affective (p<0.001), and physical (p<0.001) dimensions. The effects of ACT on reducing depressive symptoms and cognitive, affective, and physical dimensions were 63%, 61%, 67%, and 77%, respectively.

Based on the study results, group ACT improved dysfunctional negative beliefs, feelings, and physical symptoms due to depression in drug addicts and ultimately reduced cognitive, affective, and physical symptoms of depression in the experimental group. Therefore, group ACT can be an effective intervention to improve SIDD.