Background: Migraine, a chronic neurological disorder, significantly impacts women's quality of life through psychological distress. Acceptance and commitment therapy (ACT) enhances distress tolerance and cognitive flexibility by promoting acceptance and value-driven action. Compassion-focused therapy (CFT) fosters self-compassion, reducing self-criticism to alleviate distress and support cognitive flexibility. Objectives: The objective of this study was to compare the effectiveness of ACT and CFT in enhancing distress tolerance and cognitive flexibility in women with migraine. Methods: This quasi-experimental study employed a pre-test-post-test design with a 3-month follow-up and a control group. The statistical population included women diagnosed with migraine in Ahvaz, Iran, in 2023. A sample of 108 participants was selected via convenience sampling from patients attending the Labkhande Zendegi Counseling Center and randomly assigned to three groups (ACT, CFT, and waitlist control; n = 36 per group) using computer-generated random numbers. The experimental groups received 8 weekly 90-minute sessions of either ACT or CFT, while the control group remained on a waitlist. Data were collected using the Distress Tolerance Scale (DTS) and Cognitive Flexibility Inventory (CFI) and analyzed using repeated measures analysis of variance with a significance level of 0.05. Results: Both ACT and CFT significantly improved distress tolerance (ACT: From 29.70 ± 4.13 to 50.40 ± 4.72; CFT: From 30.00 ± 3.99 to 49.35 ± 4.25) and cognitive flexibility (ACT: From 46.06 ± 5.28 to 78.12 ± 5.88; CFT: From 46.60 ± 4.92 to 68.00 ± 5.43) compared to the control group (P < 0.001), with effects maintained at follow-up. The ACT showed a significantly greater improvement in cognitive flexibility compared to CFT (mean difference: 10.12, P < 0.001), but no significant difference was observed for distress tolerance (P = 0.325). Conclusions: The findings indicate that both ACT and CFT are effective in improving distress tolerance and cognitive flexibility in women with migraine, with ACT showing a relative advantage in enhancing cognitive flexibility. These results suggest that clinicians can select either approach based on patient needs, potentially improving psychological management of migraine-related distress.
Foroughi et al. (Sun,) studied this question.
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