اثربخشی طرح واره درمانی هیجانی بر تنظیم شناختی هیجان، عدم تحمل بلاتکلیفی و انعطاف پذیری شناختی در افراد مبتلا به اختلال اضطراب فراگیر (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
پژوهش حاضر باهدف اثربخشی طرح واره درمانی هیجانی بر تنظیم شناختی هیجان، عدم تحمل بلاتکلیفی و انعطاف پذیری روان شناختی در افراد مبتلا به اختلال اضطراب فراگیر انجام گرفت. طرح پژوهش، توصیفی – پیمایشی، تحلیلی و شبه تجربی بود. جامعه آماری را تمام بیماران مبتلا به اختلال اضطراب فراگیر مراجعه کننده به مراکز روان پزشکی، روانشناسی و مراکز سلامت شهر ارومیه در سال 1400 تشکیل دادند. نمونه آماری، با روش در دسترس و هدفمند، 30 (15 نفر کنترل و 15 نفر آزمایش) انتخاب شدند. داده ها با پرسشنامه های اختلال اضطراب فراگیر (اسپیتز و همکاران، 2006)، نگرانی ایالت پنسیلوانیا (PSWQ) (می و همکاران، 1990)، عدم تحمل ابهام (باهر و داگاس، 2002)، انعطاف پذیری شناختی (دنیس و ووندروال، 2010) و تنظیم هیجانی شناختی (گارنفسکی، کریج و اسینهوون، 2001) جمع آوری شده و طی روش طرح واره درمانی هیجانی (لی هی، 2012) مورد روان درمانی قرارگرفته و با نرم افزار (SPSS V. 28) تجزیه وتحلیل شدند. نتایج نشان داد که طرح واره درمانی هیجانی بر تنظیم شناختی هیجان، عدم تحمل بلاتکلیفی (ابهام) و انعطاف پذیری روان شناختی در بیماران مبتلا به اختلال اضطراب فراگیر اثربخشی داشت. باید با کمک طرح واره درمانی هیجانی، هیجانات منفی و اضطراب در بیماران دچار اضطراب فراگیر کنترل شده و آن ها را به زندگی عادی در کنار خانواده و جامعه بازگرداند.The Effectiveness of Emotional Schema Therapy on Cognitive Emotion Regulation, Intolerance of Uncertainty and Cognitive Flexibility in People with Generalized Anxiety Disorder
The aim of this study was to evaluate the effectiveness of emotional schema therapy on cognitive emotion regulation, intolerance of uncertainty and cognitive flexibility in people with generalized anxiety disorder. The research design was descriptive-survey, analytical and quasi-experimental. The statistical population was all patients with generalized anxiety disorder who referred to psychiatric, psychological and health centers in Urmia in 2021-2022. Statistical sample, by available and targeted methods, 30 (15 controls and 15 experiments) were selected. Data with questionnaires, Pervasive Anxiety Disorder (Spitz et al., 2006), Pennsylvania State Concern (PSWQ) (May et al., 1990), Intolerance of ambiguity (Bahr and Dougas, 2002), Cognitive flexibility (Dennis and Wonderwall, 2010) and cognitive emotional regulation (Garnowski, Craig and Schinhon, 2001) during the emotional schema therapy method (Lee Hee, 2012), collect and with software (SPSS V. 28) were analyzed. The results showed that emotional schema therapy was effective on cognitive emotion regulation, intolerance of uncertainty (ambiguity) and psychological flexibility in patients with generalized anxiety disorder. With the help of emotional schema therapy, it is necessary to control emotions and anxiety in patients with generalized anxiety disorder and return them to a normal life with family and community.
Keywords: emotional schema therapy, cognitive emotion regulation, intolerance of uncertainty, psychological flexibility, generalized anxiety disorder
Extended
Introduction
Generalized anxiety disorder (GAD) represents a fundamental condition in psychopathology, characterized primarily by excessive, persistent, and uncontrollable worry. Emotion regulation, a specialized form of self-regulation, encompasses both external and internal processes that monitor, evaluate, and modify the initiation, intensity, and duration of emotional responses. Intolerance of Uncertainty (IU) constitutes a cognitive framework describing individuals' difficulty in enduring ambiguous or unpredictable situations. Cognitive flexibility refers to the capacity to adapt cognitive strategies in response to changing environmental demands. Schema Therapy (ST) primarily aims to foster psychological insight and enhance deliberate regulation of maladaptive schemas, with the ultimate objective of modifying these schemas and improving coping strategies.
Research Question
To what extent does Emotional Schema Therapy (EST) impact cognitive emotion regulation, intolerance of uncertainty (IU), and psychological flexibility in individuals diagnosed with generalized anxiety disorder (GAD)?
Literature Review
Empirical studies demonstrate Schema Therapy's transdiagnostic efficacy across various populations. Abbasi et al. (2019) found significant improvements in both cognitive emotion regulation and quality of life among asthma patients following schema therapy interventions. Supporting these findings, Mohammadi et al. (2019) documented enhanced cognitive flexibility and resilience in generalized anxiety disorder (GAD) patients treated with schema therapy. Furthermore, Khoshnavis et al. (2015) established that schema therapy-based interventions effectively reduced pervasive anxiety, intolerance of uncertainty (IU), and cognitive distortions in university student populations. Collectively, these studies underscore schema therapy's broad therapeutic potential for addressing cognitive-emotional dysregulation across diverse clinical and subclinical groups.
Methodology
This study employed a descriptive-survey, analytical, and quasi-experimental research design. The target population comprised all patients diagnosed with generalized anxiety disorder (GAD) who sought treatment at psychiatric, psychological, and health centers in Urmia during 1400 (2021-2022). Using a combination of convenience and purposive sampling techniques, we selected 30 participants (15 in the experimental group and 15 in the control group) for the study sample.
Assessment instruments included:
Spitzer et al.'s (2006) Generalized Anxiety Disorder Scale
The Pennsylvania State Worry Questionnaire (PSWQ; Meyer et al., 1990)
Buhr & Dugas' (2002) Intolerance of Uncertainty Scale
Dennis & Vander Wal's (2010) Cognitive Flexibility Inventory
Garnefski, Kraaij, & Spinhoven's (2001) Cognitive Emotion Regulation Questionnaire
The experimental group received Leahy's (2012) Emotional Schema Therapy protocol, consisting of nine 90-minute sessions. All instruments demonstrated good reliability, with Cronbach's alpha coefficients of 0.801, 0.799, 0.811, 0.803, and 0.815 respectively. Data analysis was conducted using SPSS software (version 28).
Results
The Box test showed that the condition of homogeneity of the variance-covariance matrix was met in both pre-test and post-test conditions. Bartlett's test confirmed that the research data had a normal distribution. Levene's test indicated a significant difference between pre-test and post-test scores across research variables measuring the effectiveness of emotional schema therapy, and Wilks's lambda test further verified this difference. The multivariate analysis of variance revealed a significant difference between the two groups in their pre-test to post-test changes on the research variables assessing emotional schema therapy effectiveness.
Chart 1: The difference between the investigated groups in the pre-test and post-test
As shown in Chart 1, the experimental group's mean scores were higher than the control group's in both pre-test and post-test measurements. Furthermore, the post-test averages exceeded the pre-test values across all variables following emotional schema therapy implementation. These results demonstrate that emotional schema therapy effectively improves cognitive emotion regulation, reduces intolerance of uncertainty (ambiguity), and enhances psychological flexibility in patients with generalized anxiety disorder.
Discussion
The results demonstrated that emotional schema therapy effectively promotes cognitive emotion regulation and adaptive functioning, while enhancing tolerance of uncertainty (ambiguity) and psychological flexibility. This therapeutic approach helps patients maintain emotional equilibrium necessary for daily functioning while reducing stress, worry, and anxiety symptoms. The findings confirmed its significant efficacy for generalized anxiety disorder (GAD) patients. Emotional schema therapy proved particularly functional as it emphasizes emotional control - enabling anxious individuals to better manage distress. By regulating negative emotional responses, patients can achieve greater psychological stability.
Conclusion
Emotional schema therapy proves particularly effective for addressing cognitive emotion regulation, intolerance of uncertainty, and psychological flexibility in patients with generalized anxiety disorder (GAD). This therapeutic approach enables clinicians to help patients overcome negative emotions, reduce anxiety and stress, and ultimately restore normal functioning through enhanced emotional understanding and regulation.
Acknowledgments
The authors gratefully acknowledge all participants and individuals who contributed to this research study. We sincerely appreciate their valuable cooperation and involvement in making this investigation possible.
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