مقایسه اثربخشی درمان کاهش استرس مبتنی بر ذهن‌آگاهی و درمان متمرکز بر شفقت بر علائم روان‌تنی و سلامت جسمانی بیماران مبتلا به فشار خون بالا

سیدعلی اصغر سیدابراهیمی; طیبه  فردوسی; داود  نوده ئی

Authors

SeyedAliAsghar SeyedEbrahimi PhD Student in Clinical Psychology, Aras International Campus, University of Tehran Author https://orcid.org/0000-0003-2048-8907
Tayebeh Ferdousi Associate Professor, Department of Psychology, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran https://orcid.org/0009-0004-8351-402X
Davud Nodehi Assistant Professor, Behavioral Sciences Research Center, Lifestyle Research Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran Author https://orcid.org/0000-0003-2185-6134

Keywords:

Mindfulness-Based Stress Reduction, Compassion-Focused Therapy, Psychosomatic Symptoms, Physical Health, Hypertension

Abstract

Hypertension is associated not only with cardiovascular morbidity but also with psychological stress, somatic complaints, and poorer perceived health. This study compared mindfulness-based stress reduction (MBSR) and compassion-focused therapy (CFT) for psychosomatic symptoms and physical health in patients with hypertension. This quasi-experimental study used a pretest-posttest-follow-up design with a control group. Forty-five patients with hypertension in Kashan, Iran, were recruited by convenience sampling in 2025 and randomly allocated to MBSR, CFT, or usual-care control groups (n = 15 each). The intervention groups attended eight weekly sessions. Outcomes were assessed using the 39-item Psychosomatic Symptoms Questionnaire and the 14-item Physical Health Questionnaire. Posttest outcomes were compared using analysis of covariance adjusted for baseline scores; follow-up values were summarized descriptively. After adjustment for baseline scores, the group effect was significant for psychosomatic symptoms, F(2, 41) = 44.52, p < .001, partial η² = .68, and physical health, F(2, 41) = 41.28, p < .001, partial η² = .67. Adjusted psychosomatic-symptom means were 51.84, 54.76, and 76.10 for MBSR, CFT, and control, respectively; adjusted physical-health means were 57.62, 55.84, and 42.14. Follow-up means in both intervention groups remained descriptively close to posttest values. Because complete adjusted pairwise comparisons were unavailable, superiority of either active intervention was not inferred. MBSR and CFT were associated with favorable self-reported outcomes and may be considered complementary to usual hypertension care. Interpretation should remain cautious because of the small convenience sample, reliance on self-report, and incomplete pairwise statistical output.

References

Babak, A., Mousavi, S. Z., Dana Siadat, Z., & Pournamati, S. (2022). Effects of mindfulness-based stress reduction on blood pressure, mental health, and quality of life in hypertensive adult women: A randomized clinical trial study. Journal of Tehran University Heart Center, 17(3), 127-133. https://doi.org/10.18502/jthc.v17i3.10845

Blom, K., Baker, B., How, M., Dai, M., Irvine, J., Abbey, S., Abramson, B. L., Myers, M. G., Kiss, A., Perkins, N. J., & Tobe, S. W. (2014). Hypertension analysis of stress reduction using mindfulness meditation and yoga: Results from the HARMONY randomized controlled trial. American Journal of Hypertension, 27(1), 122-129. https://doi.org/10.1093/ajh/hpt134

Chen, Q., Liu, H., & Du, S. (2024). Effect of mindfulness-based interventions on people with prehypertension or hypertension: A systematic review and meta-analysis of randomized controlled trials. BMC Cardiovascular Disorders, 24, 104. https://doi.org/10.1186/s12872-024-03746-w

Gilbert, P. (2009). The compassionate mind: A new approach to life's challenges. Constable & Robinson. https://www.researchgate.net/profile/Susan-Stuntzner/publication/281900130_Book_Review_Paul_Gilbert_2009_The_Compassionate_Mind_A_New_Approach_to_Life's_Challenges/links/56ddd61508aed4e2a99c5f30/Book-Review-Paul-Gilbert-2009-The-Compassionate-Mind-A-New-Approach-to-Lifes-Challenges

Goyal, M., Singh, S., Sibinga, E. M. S., Gould, N. F., Rowland-Seymour, A., Sharma, R., Berger, Z., Sleicher, D., Maron, D. D., Shihab, H. M., Ranasinghe, P. D., Linn, S., Saha, S., Bass, E. B., & Haythornthwaite, J. A. (2014). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357-368. https://doi.org/10.1001/jamainternmed.2013.13018

Heidari, Z., Feizi, A., Rezaei, S., Roohafza, H., & Adibi, P. (2021). Psychosomatic symptoms questionnaire (PSQ-39): A psychometric study among the general population of Iranian adults. BMC Psychiatry, 21, 269. https://doi.org/10.1186/s12888-021-03278-z

Hughes, J. W., Fresco, D. M., Myerscough, R., van Dulmen, M. H. M., Carlson, L. E., & Josephson, R. (2013). Randomized controlled trial of mindfulness-based stress reduction for prehypertension. Psychosomatic Medicine, 75(8), 721-728. https://doi.org/10.1097/PSY.0b013e3182a3e4e5

Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Delacorte Press. https://psycnet.apa.org/record/2006-04192-000

Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144-156. https://doi.org/10.1093/clipsy.bpg016

Kalahi, P., Salehi, M., Maddahi, M. E., & Sepah Mansour, M. (2022). Effectiveness of a mindfulness-based stress reduction program on state anxiety, trait anxiety, and blood pressure in coronary heart disease patients with hypertension. Advances in Cognitive Sciences, 24(1), 147-159. https://icssjournal.ir/browse.php?a_id=1387&sid=1&slc_lang=en

Khosravi, E., & Ghorbani, M. (2016). Effectiveness of mindfulness-based stress reduction on perceived stress and blood pressure in women with hypertension. Feyz Journal of Kashan University of Medical Sciences, 20(4), 361-368.

Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., Chapleau, M. A., Paquin, K., & Hofmann, S. G. (2013). Mindfulness-based therapy: A comprehensive meta-analysis. Clinical Psychology Review, 33(6), 763-771. https://doi.org/10.1016/j.cpr.2013.05.005

Kirby, J. N., Tellegen, C. L., & Steindl, S. R. (2017). A meta-analysis of compassion-based interventions: Current state of knowledge and future directions. Behavior Therapy, 48(6), 778-792. https://doi.org/10.1016/j.beth.2017.06.003

Lacourt, T., Houtveen, J., & van Doornen, L. (2013). Functional somatic syndromes, one or many? An answer by cluster analysis. Journal of psychosomatic research, 74(1), 6-11. https://doi.org/10.1016/j.jpsychores.2012.09.013

Lacourt, T. E., Houtveen, J. H., & van Doornen, L. J. P. (2013). "Functional somatic syndromes, one or many?" An answer by cluster analysis. Journal of Psychosomatic Research, 74(1), 6-11. https://doi.org/10.1016/j.jpsychores.2012.09.013

Leaviss, J., & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychological Medicine, 45(5), 927-945. https://doi.org/10.1017/S0033291714002141

Saeidian, K., Sohrabi, A., & Zemestani, M. (2019). Effectiveness of compassion-focused therapy on blood pressure and quality of life in women with hypertension. Journal of Ilam University of Medical Sciences, 27(1), 161-169.

Schat, A. C. H., Kelloway, E. K., & Desmarais, S. (2005). The Physical Health Questionnaire (PHQ): Construct validation of a self-report scale of somatic symptoms. Journal of Occupational Health Psychology, 10(4), 363-381. https://doi.org/10.1037/1076-8998.10.4.363

Spruill, T. M. (2010). Chronic psychosocial stress and hypertension. Current Hypertension Reports, 12(1), 10-16. https://doi.org/10.1007/s11906-009-0084-8

Wessely, S., Nimnuan, C., & Sharpe, M. (1999). Functional somatic syndromes: One or many? The Lancet, 354(9182), 936-939. https://doi.org/10.1016/S0140-6736(98)08320-2

World Health Organization. (2025). Hypertension.