Developing the distress tolerance promotion package and comparing its effectiveness with compassion-focused therapy on self-criticism, fear of negative evaluation, and anxiety in women with chronic tension-type headaches

Although distress tolerance plays a significant role in mental and physical health, developing specific interventions regarding an increase in distress tolerance has rarely been paid attention to. The impacts of the compassion-based intervention on psychological features of individuals with psychosomatic conditions have been rarely examined as well.

The goals of the present study were, first, to introduce the distress tolerance promotion package (DTPP) and, second, to compare its effectiveness with compassion-focused therapy (CFT; Gilbert, 2010) in terms of self-criticism, fear of negative evaluation, and anxiety in women with chronic tension-type headaches.

The research was quasi-experimental with the pretest, posttest, and control group design. The statistical population included all women with tension-type headaches referred to headache and neurology clinics in Isfahan in 2019. Forty-eight women with tension-type headaches using purposeful sampling method were selected and randomly assigned to DTPP (n=16), CFT (n=16), and control (n=16) groups. DTPP and CFT groups attended a 90-minute session per week for 8 weeks, whereas the control group received no particular intervention. The participants were assessed using the scales of self-criticism (Gilbert et al., 2004), the fear of negative evaluation (Leary, 1983), and anxiety (Beck et al., 1998) in the pretest and posttest stages.

The MANCOVA results revealed that compared to the control group, DTPP and CFT groups lead to significant improvements in each of the scales of self-criticism, the fear of negative evaluation, and anxiety in the women with tension-type headaches. DTPP was also shown to have a greater positive effect on the reduction of self-criticism compared to CFT.

Based on the findings, the effectiveness of the newly designed distress tolerance promotion package and compassion-focused therapy were approved on self-criticism, fear of negative evaluation, and anxiety in women with chronic tension-type headaches.