Document Type : Original Article

Authors

1 PhD Candidate in the Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran

2 Assistant Professor, Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran

10.30476/smsj.2025.101094.1471

Abstract

Introduction: Cancer and the fear of its recurrence significantly impact individual performance and quality of life. This study aimed to compare the effectiveness of cognitive-behavioral therapy and mindfulness-based therapy on fear of recurrence, body image, and disease perception in women with breast cancer.
Methods: This quasi-experimental study examined the effect of cognitive-behavioral therapy and mindfulness-based therapy using a pre-test and post-test design with three groups of 15 participants each. The study included women with breast cancer referred to Karaj psychiatric treatment centers in Karaj during the first 6 months of 2022. The data were collected using the Bradbett Disease Perception questionnaire, the Multidimensional Body-Self Relations Questionnaire (MBSRQ), and the Fear of Cancer Recurrence Scale. Data analysis was performed using SPSS software version 22. 
Results: The results indicated that the mean scores for fear of recurrence, body image, and disease perception were higher in the pre-test than in the post-test stages across the cognitive-behavioral therapy group, the mindfulness-based therapy group, and the control group. The mean difference between the cognitive-behavioral therapy group and the control group was 39.31 for fear of recurrence and 56.06 for body image, showing a significant difference (P=0.01). Mindfulness-based cognitive therapy led to reduced dissatisfaction decreased body-related concerns, and lower fear of negative evaluation in the experimental group than in the control group.
Conclusion: Mindfulness-based cognitive therapy could modify body image and reduce the fear of negative evaluation, thereby improving the quality of life for women with breast cancer.

Keywords

  1. Die Trill M. Anxiety and sleep disorders in cancer patients. EJC Suppl. 2013;11(2):216-24.
  2. Zendehdel K, Hassanloo J, Sedighi Z, Nahvijoo A, Malekzadeh R, Mohagheghi M. Improving quality of cancer registration in iran. Part2: Suggesting new national cancer registration program in iran, based on comparative study of 18 countries. Hakim Journal. 2010;12(4):50-7.
  3. Miller G. Incorporating spirituality in counseling and psychotherapy: Theory and technique: John Wiley & Sons; 2003.
  4. Greeson JM. Mindfulness Research Update: 2008. Complement Health Pract Rev. 2009;14(1):10-8.
  5. Harris R. Mindfulness without meditation. Healthcare Counselling and Psychotherapy Journal. 2009;9(4):21-4.
  6. Thompson C. Everyday mindfulness: A guide to using mindfulness to improve your well-being and reduce stress and anxiety in your life. New York: Taylor & Francis; 2010.
  7. Sonmez N, Romm KL, Ostefjells T, Grande M, Jensen LH, Hummelen B, et al. Cognitive behavior therapy in early psychosis with a focus on depression and low self-esteem: A randomized controlled trial. Compr Psychiatry. 2020;97:152157.
  8. Harrington N, Pickles C. Mindfulness and cognitive behavioral therapy: are they compatible concepts? Journal of Cognitive Psychotherapy. 2009;23(4):315-23. doi: 1891/0889-8391.23.4.315.
  9. Kabat-Zinn J. Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice. 2003;10(2):144-56. doi: 10.1093/clipsy.bpg016.
  10. Ma SH, Teasdale JD. Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. J Consult Clin Psychol. 2004;72(1):31-40.
  11. Kabat-Zinn J, Massion AO, Kristeller J, Peterson LG, Fletcher KE, Pbert L, et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992;149(7):936-43.
  12. Smith SK, Zimmerman S, Williams CS, Benecha H, Abernethy AP, Mayer DK, et al. Post-traumatic stress symptoms in long-term non-Hodgkin’s lymphoma survivors: does time heal? J Clin Oncol. 2011;29(34):4526-33.
  13. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60(6):631-7.
  14. Kalantari H, Bagherian Sararoodi R, Afshar H, Khoramian N, Forouzandeh N, Daghagh Zadeh H, et al. Relationship between illness perceptions and quality of life in patients with irritable bowel syndrome. Journal of Mazandaran University of Medical Sciences. 2012;22(90):33-41.
  15. TF C. The psychology of physical appearance: aesthetics, attributes, and image. Body images: development, deviance, and change. 1990:51-79.
  16. Simard S, Savard J. Fear of Cancer Recurrence Inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence. Support Care Cancer. 2009;17(3):241-51.
  17. Kenne Sarenmalm E, Martensson LB, Andersson BA, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. 2017;6(5):1108-22.
  18. Mato S, Saffarinia M, Alipour A. Comparison of the effectiveness of spiritual therapy and cognitive-behavioral therapy on fear of recurrence and white blood cells in women with breast cancer. Rooyesh-e-Ravanshenasi Journal (RRJ). 2023;12(3):153-64.
  19. Yusefi R, Hafezi F, Bakhtiaripour S, Makvandi B. The Comparison of the Effectiveness of Cognitive-Behavioral Hypnosis Therapy and Mindfulness Therapy Based on the Fear of Recurrence in Women with Breast Cancer in Gorgan. Armaghane Danesh. 2021;26(5):757-69.doi: 52547/armaghanj.26.5.757.
  20. Shapiro SL, Bootzin RR, Figueredo AJ, Lopez AM, Schwartz GE. The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: an exploratory study. J Psychosom Res. 2003;54(1):85-91.
  21. Firouzi R, Tizdast T, Khalatbari J, Ghorban Shiroudi S. Relationship between stress coping strategies and difficulties in emotion regulation mediated by marital life quality in married women with breast cancer. Journal of Arak University of Medical Sciences. 2020;23(1):34-47.doi: 32598/JAMS.23.1.6005.1.
  22. Sharbaf Olyaie Z, Toozandehjani H, Dehghani Neyshabouri M. Effectiveness of mindfulness-based cognitive therapy on quality of life and body image in women with breast cancer undergoing mastectomy. Iranian Rehabilitation Journal. 2016;14(3):139-50.doi: 18869/nrip.irj.14.3.139.
  23. Sadri Damirch E, Esmaeili Ghazivaoloii F, Fathi D, Mehraban S, Ahmadboukani S. Effectiveness of group psychotherapy based on admission and commitment to body dysmorphic obsessive-compulsive disorder in women with breast cancer. Iranian Rehabilitation Journal. 2019;17(4):351-8.doi: 32598/irj.17.4.351.
  24. Griffiths C, Williamson H, Zucchelli F, Paraskeva N, Moss T. A Systematic Review of the Effectiveness of Acceptance and Commitment Therapy (ACT) for Body Image Dissatisfaction and Weight Self-Stigma in Adults. J Contemp Psychother. 2018;48(4):189-204.
  25. Periasamy U, Mohd Sidik S, Rampal L, Fadhilah SI, Akhtari-Zavare M, Mahmud R. Effect of chemotherapy counseling by pharmacists on quality of life and psychological outcomes of oncology patients in Malaysia: a randomized control trial. Health Qual Life Outcomes. 2017;15(1):104.
  26. Marco JH, Perpina C, Botella C. Effectiveness of cognitive behavioral therapy supported by virtual reality in the treatment of body image in eating disorders: one year follow-up. Psychiatry Res. 2013;209(3):619-25.
  27. Dehkhodaei S, Alipour A. The effectiveness of cognitive-behavioral therapy and treatment based on acceptance and commitment in adherence to treatment, illness perception and quality of life in hemophilic patients. Scientific Journal of Iran Blood Transfus Organ. 2019;16(4):289-99.
  28. Izydorczyk B, Kwapniewska A, Lizinczyk S, Sitnik-Warchulska K. Psychological Resilience as a Protective Factor for the Body Image in Post-Mastectomy Women with Breast Cancer. Int J Environ Res Public Health. 2018;15(6):1181-96.
  29. Izadi-Ajirlo A, Bahmani B, Ghanbari-Motlagh A. Effectiveness of cognitive behavioral group intervention on body image improving and increasing self-esteem in women with breast cancer after mastectomy. Archives of Rehabilitation. 2013;13(4):72-83.
  30. Lalouei A, Kashani-Zadeh N. Rate of woman’s awareness about self breast examination in Najmieh and Baqiyatollah Hospitals referrers. Archives of Rehabilitation. 2006;7(2):66-9.
  31. Oraki M, Sami P. Investigating the effectiveness of mindfulness-based cognitive therapy on the perception of disease and its severity in patients with multiple sclerosis. Social Cognition. 2016;5(2):107-19.
  32. Male DA, Fergus KD, Cullen K. Sexual identity after breast cancer: sexuality, body image, and relationship repercussions. Curr Opin Support Palliat Care. 2016;10(1):66-74.