Comparison of the Effectiveness of a Neuropsychology-Based Therapeutic Package and Acceptance and Commitment Therapy on Pain Catastrophizing, Distress Tolerance, and Emotional Ambivalence in Patients with Multiple Sclerosis

Abstract

Objective: The objective of this study was to compare the effectiveness of a neuropsychology-based therapeutic protocol and Acceptance and Commitment Therapy on pain catastrophizing, distress tolerance, and emotional ambivalence in individuals with multiple sclerosis.

Methodology: A quasi-experimental design with a pre-test, post-test, and two-month follow-up and a control group was implemented. Fifty-one patients with multiple sclerosis were selected through convenience sampling and randomly assigned to three groups: neuropsychology-based intervention, ACT, and control. Standardized questionnaires assessing pain catastrophizing, distress tolerance, and emotional ambivalence were administered. Data were analyzed using mixed ANOVA with repeated measures and Bonferroni post-hoc tests.

Findings: Significant effects of time, group, and time×group interaction were found for all three variables. For pain catastrophizing, time (F=142.31, p<0.001, η²=0.711), interaction (F=5.87, p=0.019), and group (F=6.12, p=0.017) were significant. Distress tolerance also showed significant effects for time (F=120.45, p<0.001, η²=0.675), interaction (F=6.87, p=0.002), and group (F=8.79, p=0.004). For emotional ambivalence, time (F=95.42, p<0.001), interaction (F=8.16, p=0.001), and group (F=7.58, p=0.008) were significant. Post-hoc analyses indicated that the neuropsychology-based group showed greater improvement across all variables compared to the ACT and control groups.

Conclusion: Both interventions were effective in improving psychological outcomes among patients with multiple sclerosis; however, the neuropsychology-based therapeutic package demonstrated stronger and more sustained effects, indicating its potential as a comprehensive and multidimensional treatment approach.