Studying the Effectiveness of Mindful Self-Compassion (MSC) Training on Psychological Distress (Stress, Anxiety, and Depression) in Mothers of Children with Phenylketonuria (PKU)

Phenylketonuria (PKU) is a rare inherited disorder caused by a deficiency or dysfunction of the enzyme phenylalanine hydroxylase, disrupting the conversion of phenylalanine to tyrosine. High levels of phenylalanine in the plasma of these individuals lead to nerve damage, brain abnormalities, mental retardation, epilepsy, and behavioral problems. Metabolic and psychological problems caused by the disease make mothers with PKU children susceptible to adverse psychological reactions. One of the effective strategies that plays an essential role in the adaptation and regulation of emotion or change in the occurrence and intensity or continuation of feelings and emotions related to anxious life events is self–compassion. This kind of compassion facilitates emotional change toward caring for and supporting oneself in difficult life situations. Self–compassion weakens self–attack, increases self–acceptance, and reduces emotional turmoil, making the person more relieved and healed. This study aimed to investigate the effectiveness of the Mindful Self–compassion (MSC) program on the dimensions of psychological distress (stress, anxiety, and depression) of mothers with PKU children.

The research method was experimental with a pretest–posttest and a 3–month follow–up design with a control group. The statistical population included all mothers with children suffering from PKU who were referred to the support center for metabolic patients in Zanjan Province, Iran, and received dietary products without phenylalanine in April 1400. Thirty qualified volunteer mothers were selected by the available sampling method and randomly replaced into the experimental and control groups (15 people in each group). The inclusion criteria of mothers of children with phenylketonuria were as follows: being 20 to 50 years old, having at least a third–grade junior high school education, not receiving psychological services and individual counseling outside of sessions, providing informed consent to participate in the meetings, and having commitment and interest in regular participation in the training course. The exclusion criteria were as follows: unwillingness to continue participating in the research process, suffering from medical diseases such as asthma, allergies, or contracting the COVID–19 virus during the sessions, and absence of more than two sessions in the intervention process. The research tools in the pretest, posttest, and follow–up were the researcher–made questionnaire of mother–child demographic characteristics and the Depression, Anxiety, and Stress Scale (DASS–21) (Lovibond and Lovibond 1995). The MSC program was presented according to the model of Neff and Germer (2019) in 8 sessions for the experimental group. The obtained data were analyzed with descriptive (mean and standard deviation) and inferential statistics (the Chi–square test, repeated measures analysis of variance, and Bonferroni post hoc test) in SPSS software version 24. The significance level of the tests was set at 0.05.

The results showed that after the implementation of the MSC program, there was a significant difference between the experimental and control groups regarding anxiety (p=0.049) and stress (p=0.038) scores. In the experimental group, there was a significant difference between the pretest and posttest and between the pretest and follow–up mean scores of the mentioned variable (p<0.001). However, there was no significant difference between the posttest and follow–up scores (p=0.083). It indicated the stability of the intervention effect on the stress variable in the follow–up stage.

Based on the results of the research, the mindful–self–compassion program was effective in reducing the anxiety and stress of mothers with children with phenylketonuria. Therefore, this program can be used to improve their psychological distress.