Comparisson of the therapeutic Intervention effects of Acceptance and Commitment Therapy and Mindfulness on the Biological, Psychological and Social Indicators of Women Aged 35 to 65 with Human Papillomavirus

Authors
Payame Noor University (PNU), Tehran, Iran.
Abstract
The purpose of this study was to compare the effectiveness of therapeutic interventions of acceptance and commitment and mindfulness on the biological, psychological and social indicators of women with human papillomavirus.This study was a semi-experimental method with a pre-test-post-test design and a two-month follow-up period. The statistical population included all female patients with human papilloma virus who lived in Dubai and visited Al-Shafa Behavioral Diseases Clinic .Through purposive sampling, 45 subjects were selected and randomly allocated to either the ACT, mindfulness or the control group (n = 15 per group). Then the subjects of the two experimental groups were subjected to training based on acceptance and commitment therapy and training based on mindfulness for 8 sessions of 90 minutes. The data collection tool was DASS-21 (1993), Marlowe and Crown's (1996) Social Desirability Scale. the results, a tangible difference was spotted between the groups in the pre-and post-test stage and considering time impact on the mean virous (η2=0.888, F=222.695, p<0.001), depression (η2=0.953, F=562.146, P<0.001), anxiety (η2=0.760, F=88.843, P<0.001), stress (η2=0.953, F=405.704, P<0.001), and social desirability (η2=0.26, F=9.820, P<0.001). In general, the results showed that both methods of educational intervention were effective in women.

Keywords

Abdirasulovna, A. Z., Ghadwaje, A. (2023). Human Papillomavirus: A Review Study of the Effect on Mental Health of Patients Infected with HPV. International Journal of Collaborative Research on Internal Medicine & Public Health, 15(3), 1-2. https://doi.org/ doi: 10.35248/ 1840-4529.23.15(3).1-2.
Ajilchi, B., Mohebi, M., Zarei, S., Kisely, S. (2022). Effect of a mindfulness programme training on mental toughness and psychological well-being of female athletes. Australasian Psychiatry, 30(3), 352-356. https://doi.org/10.1177/10398562211057075. [Persian].
Alizadeh, L., Ghahremani, F., khalili, S. M., Havaei, M., Hajirafiei, E., Riazi, H. and Keshavarz, Z. (2023). The association of human papillomavirus vaccine with premature ovarian failure: A systematic review. The Iranian Journal of Obstetrics, Gynecology and Infertility, 25(12), 114-123. Doi: 10.22038/ijogi.2023.21798. [Persian]
Arashlouei, A. Z., Irani, M., Maghsoudi, S. H., Honarvar, Z., Salmani, N., & Ahmadi, A. (2025). Investigating the effect of awareness‐raising based on acceptance and commitment therapy on the quality of life of women living with HPV (human papilloma virus). British Journal of Health Psychology, 30(3), e70007. [Persian].
Azadi, M. M., Manshaee, G., Golparvar, M. (2019). Comparing the effectiveness of mobile social network-based mindfulness interventions with acceptance and commitment therapy (ACT) and mindfulness therapy on depression, anxiety, stress among patients with type 2 diabetes. Journal of Diabetes Nursing, 7(2), 775-792. URL: http://jdn.zbmu.ac.ir/article-1-354-en.html. [Persian].
Azimi, M., Mansourieh, N. (2023). the effectiveness of mindfulness-based cognitive therapy on pain catastrophizing, psychological distress, and rumination in women with cancer in Tabriz. Women and Family Studies. https://doi.org/10.30495/jwsf.2023.1994672.1892. [Persian]
Bagherinia, M., Dolatian, M., Mahmoodi, Z. Ozgoli, G. (2023). Prevalence of genital human papillomavirus in suburban women: A systematic review and meta-analysis. The Iranian Journal of Obstetrics, Gynecology and Infertility, 26(7), 80-93. doi: 10.22038/ijogi.2023.23301. [Persian].
Bidaki, R., Ghanei, N., Haj Mohamadkarimi, M., Poursamimi, M., Bozorg, B., Kolahi, N., Bozorg, M. (2023). The Rate of Social Acceptance in Psoriasis Patients: A Cross-Sectional Study in Iran. Journal of Iranian Medical Council, 6(3), 479-487. http://dx.doi.org/10.18502/jimc.v6i3.12852. [Persian].
Boloorsaz. M. H., Jafari, E., Moghadamzadeh, A. (2025). The Effectiveness of Acceptance and Commitment Therapy on Anxiety Sensitivity, Perceived Pain Intensity and Emotion Management in Elderly Women with Rheumatoid Arthritis. Health Psychology, 13(52), 81-96. https://doi.org/10.30473/hpj.2025.70492.6009. [Persian].
Chan, D. N. S., Choi, K. C., Lee, P. P. K., So, W. K. W. (2025). The Effects of Motivational Interviewing on Promoting Human Papillomavirus Vaccination Initiation and Completion Among South Asian Mother/Daughter Dyads: A Pilot Randomised Controlled Trial. International Journal of Behavioral Medicine, 1-12.
Christodoulou, V., Flaxman, P. E., Morris, E. M., Oliver, J. E. (2024). Comparison of mindfulness training and acceptance and commitment therapy in a workplace setting: results from a randomized controlled trial. European Journal of Work and Organizational Psychology, 33(3), 368-384.
da Silva, C. C. G., Bolognani, C. V., Amorim, F. F., Imoto, A. M. (2023). Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: a systematic review and meta-analysis. Systematic Reviews, 12(1), 1-28. https://doi.org/10.1186/s13643-023-02244-y
Dehghanpour, N., Musizadeh, T., Kazemzadeh, R., Nazari, V. (2025). The effectiveness of acceptance and commitment therapy on anxiety sensitivity and alexithymia in patients with trichotillomania and excoriation disorder. Journal of Research in Psychological Health, 19(2), 1-15. [Persian].
Elliot, A. J., Gallegos, A. M., Moynihan, J. A., Chapman, B. P. (2019). Associations of mindfulness with depressive symptoms and well-being in older adults: the moderating role of neuroticism. Aging & mental health, 23(4), 455-460. https://doi.org/10.1080/13607863.2017.1423027
Fiorillo, D., McLean, C., Pistorello, J., Hayes, S. C., Follette, V. M. (2017). Evaluation of a web-based acceptance and commitment therapy program for women with trauma-related problems: A pilot study. Journal of Contextual Behavioral Science, 6(1), 104-113. https://doi.org/10.1080/13607863.2017.1423027
Galeshi, M., Shirafkan, H., Yazdani, S., Motaghi, Z. (2025). Effectiveness of motivational interview on psychological distress of women with human papilloma virus: a randomized clinical trial. BMC women's health, 25(1), 1-8. [Persian].
Ghaffari Cherati, A. A., Ghannadzadehghan, P. D., Hasanzadeh, P. D., Abbasi, P. D. (2021). The Impact of Acceptance and Commitment Therapy on Social Acceptance and Loneliness of Women. Quarterly Journal of Family and Research, 18(2), 107-120. https://www.noormags.ir/view/fa/articlepage/1809954/. [Persian].
Ghanbari Z., mohseninasab Z., taati M., mohebiarya M., torabi A. (2024). Comparing the effectiveness of schema therapy and stress reduction based on mindfulness on emotional ataxia, self-control and psychological well-being in women victims of domestic violence. Research in psychological health, 17 (4):50-6. URL: http://rph.khu.ac.ir/article-1-4421-fa.html. [Persian].
Ghanbari, Z. (2025). The Effectiveness of Cognitive Therapy Based on Mindfulness on Cognitive Flexibility and Chronic Pain in Patients with Dyspepsia. Health Psychology, 13(52), 97-110. doi: 10.30473/hpj.2025.69307.5930. [Persian].
Godarzi, A., Moghadam, H. E., Momenzadeh, C. (2024). Comparison of the Effectiveness of Spiritual Therapy and Acceptance and Commitment Therapy (ACT) on Illness-Related Worries. International Journal of Education and Cognitive Sciences, 5(2), 134-142. [Persian].
Hamzehgardeshi, Z., Jahanfar, S., Khani, S., Elyasi, F., Behnampour, N., Mohammadi, K. M., Moghassemi, M. (2023). Relationship between Psychological Disorders and Persistence of Human Papillomavirus Infection: A Scoping Review. Current Psychosomatic Research, 1(3), 266-287.https://doi.org/10.32598/cpr.1.3.131.1. [Persian].
Hayes, Steven. C. (2020). Climbing our hills: A beginning conversation on the comparison of Acceptance and commitment therapy and traditional cognitive behavioral therapy. Clinical Psychology: Science and Practice, 15, 286-295. doi.org/10.1111/j.1468-2850.2008.00139.x
Homayounfar, N., Taghipuor, B., Serajmohammadi, P., Dida, L., Abdi, F., Ahadi E.(2023). The Effectiveness of Mindful self-Compassion Training on Worry and Distress Tolerance in the Mothers of Children with Intellectual Disability. Research in psychological health, 16 (4) :16-30. http://rph.khu.ac.ir/article-1-4298-fa.html. [Persian].
Isanejad, O., Azadbakht, F. (2019). Comparison of the Effectiveness of Acceptance and Commitment Therapy and Mindfulness-Based Cognitive Therapy Approaches on the Quality of Life and Resiliency among Disabled Veterans’ Wives with War-Related Posttraumatic Stress Disorder (PTSD). Journal of military Psychology, 10(38), 57-69.https://www.sid.ir/paper/190074/fa. [Persian]
Jafskesh Moghadam, A., Shahabizadeh, F., Bahrainian, A. (2016). Comparative effectiveness of mindfulness-based psychotherapy versus acceptance or commitment therapy on stress level in dialysis patients. Journal of Advances in Medical and Biomedical Research, 24(107), 84-93. [Persian].
Joharinia, N., Mousavi-Nejad, S. A., Farhadi, A., Safaei, A., Hosseini, S. Y., Sarvari, J. (2023). The Frequency of High-Risk and Low-Risk Human Papillomavirus Genotypes in Different Grades of Cervical Lesions in Shiraz, South-West of Iran. Iranian Journal of Medical Microbiology, 17(2), 161-166. [Persian].
Jones, P., Drummond, P. (2022). Construction and evaluation of a mindfulness-based quality of life and well-being program (MQW) in a randomized trial. Current Psychology, 1-22. https://doi.org/10.1007/s12144-021-02672-w
Kakemam, E., Navvabi, E., Albelbeisi, A. H., Saeedikia, F., Rouhi, A., Majidi, S. (2022). Psychometric properties of the Persian version of Depression Anxiety Stress Scale-21 Items (DASS-21) in a sample of health professionals: a cross-sectional study. BMC health services research, 22(1), 111. [Persian].
Keshmiri, M., Fathi-Ashtiani, A., Jalali, P. (2019). Mediating role of mindfulness in the relationship between depression, anxiety and stress and psychological well-being. Journal of Psychology. https://www.sid.ir/paper/54365/fa. [Persian].
Khoramniya, S., Taheri, A. A., Mohammadpour, M., Foroughi, A. A., Karimzadeh, Y. (2021). The effectiveness of Acceptance and Commitment Therapy (ACT) on interpersonal sensitivity and psychological flexibility in students with social anxiety: A randomized clinical trial. Shenakht Journal of Psychology and Psychiatry, 8(1), 15-27. URL: http://shenakht.muk.ac.ir/article-1-1028-fa.html. [Persian].
Kim, Y., Lee, H., Park, J., Kim, Y. C., Kim, D. H., Lee, Y. M. (2024). EHealth communication intervention to promote human papillomavirus vaccination among middle-school girls: development and usability study. JMIR Formative Research, 8(1), e59087.
Lahtinen, O., Aaltonen, J., Kaakinen, J., Franklin, L., Hyönä, J. (2023). The effects of app-based mindfulness practice on the well-being of university students and staff. Current Psychology, 42(6), 4412-4421. https://doi.org/10.1007/s12144-021-01762-z
Lee, E. K. P., Wong, B., Chan, P. H. S., Zhang, D. D., Sun, W., Chan, D. C. C., Wong, S. Y. S. (2022). Effectiveness of a mindfulness intervention for older adults to improve emotional well‐being and cognitive function in a Chinese population: A randomized waitlist‐controlled trial. International Journal of Geriatric Psychiatry, 37(1). https://doi.org/10.1002/gps.5616
Ma, L., Wang, Y., Pan, L., Cui, Z., Schluter, P. J. (2022). Mindfulness-informed (ACT) and mindfulness-based programs (MBSR/MBCT) applied for college students to reduce symptoms of depression and anxiety. Journal of Behavioral and Cognitive Therapy, 32(4), 271-289. https://doi.org/10.1016/j.jbct.2022.05.002
Mahdi, A. M., Gholamreza, M., Mohsen, G. (2019). Comparison of the Effectiveness of Mobile Social Network-Based Mindfulness Interventions, Acceptance and Commitment Therapy, and Mindfulness Group Therapy on Depression, Anxiety, and Stress among Type II Diabetic Patients. Journal of Diabetes Nursing (2345-5020), 7(2). [Persian].
Mohseninasab, Z., saket, S., deilami pooya, M., basiti, S., jafari S. (2024). The effectiveness of mindfulness training on executive functions (working memory and attention) and self-efficacy in patients with anxiety disorders. CPJ, 12 (1) :31-45. URL: http://jcp.khu.ac.ir/article-1-3787-fa.html
Moya, E., Larson, L. M., Stewart, R. C., Fisher, J., Mwangi, M. N., Phiri, K. S. (2022). Reliability and validity of depression anxiety stress scale (DASS)-21 in screening for common mental disorders among postpartum women in Malawi. BMC psychiatry, 22(1), 352.
Norouzi, M., Zargar, F., Norouzi, F. (2017). Effectiveness of acceptance and commitment therapy on interpersonal problems and difficulties in emotion regulation among university students. Iranian journal of psychiatry and behavioral sciences, 11(3). .https://doi.org/10.5812/ijpbs.8005. [Persian].
Pahlevan, S., Sepehr, V., Rezaei, A. and Pardehshenas, F. (2022). Frequency of high risk human papillomavirus (HPV) serotypes in cervicovaginal smear of wives of men with genital warts and its relation with Pap smear. The Iranian Journal of Obstetrics, Gynecology and Infertility, 25(10), 46-52. doi: 10.22038/ijogi.2022.21581. [Persian].
Ranjbar M, Ghamari M, Yazdi S M. (2025). Comparing the effectiveness of the educational package based on the acceptance and commitment approach with meaning therapy on the academic vitality of depressed students. Journal of Psychological Science. 24(147), 101-116. URL: http://psychologicalscience.ir/article-1-2412-fa.html. [Persian].
Roohi, R., Soltani, A. A., Zinedine Meimand, Z., Razavi Nematollahi, V. (2019). The effect of acceptance and commitment therapy (act) on increasing the self-compassion, distress tolerance, and emotion regulation in students with social anxiety disorder. Quarterly Journal of Child Mental Health, 6(3), 173-187. URL: http://childmentalhealth.ir/article-1-432-en.html. [Persian].
Saban, K. L., Collins, E. G., Mathews, H. L., Bryant, F. B., Tell, D., Gonzalez, B., Janusek, L. W. (2022). Impact of a Mindfulness-Based Stress Reduction Program on Psychological Well-Being, Cortisol, and Inflammation in Women Veterans. Journal of general internal medicine, 37(Suppl 3), 751-761. https://doi.org/10.1007/s11606-022-07584-4.
Sajadi, S., Fooladchang, M., Yousefi, F., Sheykh alIslami R.(2023). The effectiveness of mindfulness-based education on self-blame and working memory in adolescents. CPJ, 10 (4). URL: http://jcp.khu.ac.ir/article-1-3538-fa.html
Samani, S., Jokar, B. (2007). Evaluation of the reliability and validity of the short form of the Depression, Anxiety and Psychological Stress Scale. Social and Human Sciences, Shiraz University, 26(3 (52) (Special Issue of Educational Sciences), 65-76. SID. https://sid.ir/paper/391033/fa. https://sid.ir/paper/391033/fa. [Persian].
Scott, W., Daly, A., Yu, L., McCracken, L. M. (2017). Treatment of chronic pain for adults 65 and over: Analyses of outcomes and changes in psychological flexibility following interdisciplinary acceptance and commitment therapy (ACT). Pain Medicine, 18(2), 252-264. https://doi.org/10.1093/pm/pnw073
Sethi, S., Ali, A., Ju, X., Antonsson, A., Logan, R., Canfell, K., Jamieson, L. (2021). A systematic review and meta‐analysis of the prevalence of human papillomavirus infection in Indigenous populations–A Global Picture. Journal of Oral Pathology & Medicine, 50(9), 843-854. https://doi.org/10.1111/jop.13201
Shafaei A, Shamsian S A A, Ghodsi M, Sadabadi F, Shahi M. Influence of sexually transmitted infections on the cervical cytological abnormalities among Iranian women: A cross-sectional study. IJRM 2023; 21 (6):491-498. doi: 10.18502/ijrm.v21i6.13636. [Persian].
Sharaf al-Din, Hoda (2010), the relationship between social anxiety, hope and social support with the subjective feeling of well-being in postgraduate students of Khuzestan Science and Research Unit, Master's Thesis in General Psychology, Azad University, Ahvaz Branch. [Persian].
Sheikhlou, M., Sahbahi, F., & Hejazi, S. (2022). Effect of education based on the theory of planned behavior on sexual function of women with human papillomavirus referred to the behavioral diseases clinics of Tehran University of Medical Sciences in 1400. Journal of Nursing Education, 11(5), 46-57. ID. https://sid.ir/paper/1093388/fa. [Persian].
Tajbakhsh, R., Haddadi, S., Zeighami Mohammadi, S., Malihi Alzakerini, S., Borumand, M. (2023). Comparison of the Effect of" Acceptance and Commitment Therapy" and" Metacognitive Therapy" on the resilience of Women Undergoing Hemodialysis. Journal of Health Promotion Management, 12(3), 82-94. [Persian].
Tayebi M., oraki M. (2025). Investigating the Effectiveness of Acceptance and Commitment-Based Therapy (ACT) on Anxiety, Alexithymia and Adherence to Treatment in Adolescent Girls with Gastroesophageal Reflux. Journal of Psychological Science. 24(147), 273-288. URL: http://psychologicalscience.ir/article-1-2311-fa.html [Persian].
Williams, M. Penman, D. (2012). Mindfulness: A practical guide to finding peace in a frantic world. Piatkus. Co. uk. https://kadampa.org/
Yang, Y., Liu, Y. H., Zhang, H. F., Liu, J. Y. (2015). Effectiveness of mindfulness-based stress reduction and mindfulness-based cognitive therapies on people living with HIV: A systematic review and meta-analysis. International Journal of Nursing Sciences, 2(3), 283-294. https://doi.org/10.1016/j.ijnss.2015.07.003
Yasaie Sekeh,M., Shafiabadi, A., Valiollah F.(2017) Comparing the effectiveness of acceptance and commitment therapy (ACT) with mindfulness-based cognitive therapy (MBCT) on anxiety and depression in hemodialysis patients. Journal of Principles of Mental Health. Special issue of the Third International Conference on Recent Innovations in Psychology, Counseling and Behavioral Sciences). pp. 220-230.https://civilica.com/doc/1798624/
Zahrakar, K., Sharei, A., & Salmani, A. (2025). Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Intensive Short-Term Dynamic Psychotherapy on State-Trait Anxiety and Resilience in female Students with Self-Harming Behaviors. Journal of Applied Psychological Research.
Zareii M., bahreinian A., ahi Q, mansouri A.(2024). Comparison of the effectiveness of cognitive therapy based on mindfulness and schema therapy on emotion regulation and distress intolerance of women with obsessive-compulsive symptoms. Research in psychological health, 17 (4):82-100. http://rph.khu.ac.ir/article-1-4421-fa.html[Persian].
Zheng, Y., Zhou, J., Zeng, X., Jiang, M., Oei, T. P. (2022). A new second-generation mindfulness-based intervention focusing on well-being: A randomized control trial of Mindfulness-Based Positive Psychology. Journal of Happiness Studies, 23(6), 2703-2724. https://doi.org/10.1007/s10902-022-00525-2
Zollars, I., Poirier, T. I., Pailden, J. (2019). Effects of mindfulness meditation on mindfulness, mental well-being, and perceived stress. Currents in Pharmacy Teaching and Learning, 11(10), 1022-1028. https://doi.org/10.1016/j.cptl.2019.06.005