جستجوی مقالات مرتبط با کلیدواژه « Generalized Anxiety Disorder (GAD) » در نشریات گروه « پزشکی »

Anxiety disorders, including Anxiety disorders, including Generalized Anxiety Disorder (GAD), are among the most common disorders that have affected many people. The way of analyzing and interpreting the events, tolerating or not the ambiguous situation and metacognitive beliefs can predict GAD. The purpose of this research was the role of emotional processing, tolerance of ambiguity and metacognitive beliefs in predicting GAD in nurses of Sardasht Health Network.

The statistical population included all nurses working in the Sardasht health network (including hospital, specialized clinics and health centers in the city).  A total of 155 nurses were selected as the final sample of the study using the available sampling method.  The data collection tools were emotional processing, ambiguity tolerance, metacognitive beliefs and anxiety symptoms questionnaires. The present study was a descriptive and correlational study and the data was analyzed through Pearson's correlation coefficient and multivariate regression.

Statistical findings showed that emotional processing, ambiguity tolerance and metacognitive beliefs together explain 63.2% of the variance of GAD. Also, the findings show that all three predictive variables have a significant contribution in predicting GAD; so that the variable of cognitive processing (p = 0.01, β = 0.433), ambiguity tolerance (p = 0.01, β = 0.101), and metacognitive beliefs (p = 0.01, 0.503 = β) positively predicts GAD.

According to the findings, emotional processing, tolerance of ambiguity and metacognitive beliefs play a role in causing GAD; Accordingly, by changing the type of emotional processing and increasing the ability to tolerate ambiguity and changing defective metacognitive beliefs, it helped to reduce GAD.

In Iran, women more than men suffer from depressive and anxiety disorders. Comorbid generalized anxiety disorder (GAD) and major depression disorder (MDD) is the most common form of comorbidity involving depression and anxiety. One of the essential problems of this comorbidity is more symptom severity in comparison to MDD and GAD alone, and this might lead to higher illness severity and chronicity. Common interventions for GAD and MDD are cognitive behavior therapy (CBT), transdiagnostic psychotherapy, and pharmacotherapy. However, these two disorders are typically treated separately, and there is a dearth of information on tackling them in comorbid conditions. This study aimed to compare the effectiveness of CBT, transdiagnostic psychotherapy, and pharmacotherapy on depressive and anxiety symptoms in women with comorbid MDD and GAD.

In this study, a single case study using multiple baseline design with follow–up was implemented. Individual baseline acted as control periods. Following individual baseline, treatments were delivered weekly, with each treatment session lasting up to 50 min. On completion of treatments, the patients were followed up for 1 and 3 months. Six women with comorbid MDD and GAD who came for treatment to counseling centers and psychiatrist's office in Marivan City, Iran from the beginning to the end of autumn 2019, were enrolled in the study and randomly assigned in three treatment groups. All patients met the Diagnostic and statistical manual of mental disorders (DSM–5) criteria for MDD and GAD. The inclusion criteria were as follows: having signs and symptoms of both disorders (MDD and GAD), being older than 18 years, and having consent to participate in the research. The exclusion criteria were unwillingness to continue the treatment, not completing the research questionnaires, and identifying any new disorder at each stage of the treatment. The study measures included Beck Depression Inventory (BDI–II) (Beck et al., 1996) and Beck Anxiety Inventory (BAI) (Beck & Steer, 1990). CBT and transdiagnostic psychotherapy consisted of 12 sessions, one session per week. Pharmacotherapy, consisted of a combination of Alprazolam and Sertraline presented. The obtained data were analyzed with reliable change index (RCI) and recovery percentage. Leeds reliable change indicator software was used to calculate the reliable change index.

Results showed that symptoms of depression and anxiety significantly were reduced by all three treatments. Improvements of patient's anxiety were 57% in CBT, 50% in transdiagnostic, and 63% in pharmacotherapy. According to Blanchard and Schwarz's (1988) criteria, the recovery percentage of all patients was higher than 50. Therefore, the improvements in anxiety symptoms have been significant in all six patients. Also, the RCI was higher than the Z value (1.96), so with 95% confidence, we can say that the improvement was due to therapeutic interventions. In the follow–up phase, improvements in anxiety were maintained and improvement percentage of CBT, transdiagnostic, and pharmacotherapy were 50%, 51%, and 60%, respectively. Based on results, improvements in depression symptoms for CBT, transdiagnostic, and pharmacotherapy were 64%, 55%, and 56%, respectively. These results were maintained in the follow–up phase at 57%, 52%, and 50%, respectively. As seen, all improvement percentages in the intervention and follow–up phase were above 50 and therefore, based on Blanchard and Schwarz's criteria, these results were clinically significant. The RCI was greater than 1.96, in the intervention and follow–up phases indicating that improvements in depression symptoms were statistically significant.

Although all three treatments caused significant improvements in anxiety and depression symptoms, pharmacotherapy was slightly more effective in treating anxiety and CBT was slightly more effective in treating depression. Based on these results, when treating comorbid GAD and MDD, if the symptoms of anxiety are more severe, pharmacotherapy is preferred and if the symptoms of depression are more severe, CBT is preferred.

The main objective of this research work is to examine the effectiveness of cognitive-behavioral education (CBE) based on intolerance of uncertainty and emotional regulation on behavioral activation/inhibition systems (BIS) and generalized anxiety disorder (GAD) of students with social anxiety disorder.

The target population was 300 students at Islamic Azad University of Birjand in 2020. Of these, 231 students completed the social anxiety, generalized anxiety and intolerance of uncertainty questionnaires. A total of 60 students with high scores of social anxieties were identified. A diagnostic interview was conducted on the candidate students by the purposive sampling technique. Finally, the tested students were randomly split into two experimental (CBE-based on intolerance of uncertainty and emotional regulation) and one control group. The experimental group was trained for ten sessions of an hour and a half for the diagnosis and treatment of reading disorders. Two months after training, post-training questionnaires were distributed between the students. Statistical data analysis was performed by SPSS 25.

Analysis of covariance showed that CBE-based on intolerance of uncertainty and emotional regulation significantly changed BIS (p<0.05). The Bonferroni test showed that mean score values of the activation system increased meaningfully in the experimental group compared with the control group. A statistically significant difference was explored between the mean score values of inhibition systems in the two experimental groups. Analysis of covariance also indicated that CBE-based on intolerance of uncertainty and emotional regulation considerably reduced GAD (p<0.05). The Bonferroni test showed that mean score values of GAD reduced significantly in the experimental group compared with the control group.

The results of this study indicate that CBE is an effective educational approach for treating students who struggle with anxiety disorder. It is recommended that CBE be used in university counseling centers for treating students who struggle with anxiety disorder.

* 3
1- . PhD Student, Research Group of Cognitive Sciences , Alborz Branch, Academic Center for Education, Culture and Research
2- PhD in Psychology, Research Group of Cognitive Sciences Alborz Branch, Academic Center for Education, Culture and Research, Alborz Branch
3- PhD in Clinical Psychology, Assistant Professor Research Group of Cognitive Sciences, Alborz Branch, Karaj, Academic Center for Education, Culture and Research, , E-mail:
Abstract: (1158 Views)
Objectives The purpose of this study was to compare the metacognitive factors between individuals with Obsessive Compulsive Disorder (OCD), Generalized Anxiety Disorder (GAD), dysthymic disorder (Dys), and non-clinical disorders (Normals).
Methods Metacognitive Questionnaire - short form (MCQ-30), Thought Control Questionnaire (TCQ), and Anxious Thought Inventory (ATI) were administered to a sample of 120 individuals (OCD-30; GAD-30; Dys-30 and Normals-30).
Results Results of MANOVA and post-hoc comparison revealed significant differences in metacognitive factors between all groups except attention distraction and cognitive confidence. Post-hoc comparisons also showed that OCD patients have significantly higher scores in punishment and reappraisal subscales than GAD and non-clinical groups. Likewise, GAD patients have significantly higher scores in social and health worry than OCD patients and in positive and negative beliefs about worry and need to control subscales than OCD and non-clinical groups. Also Dys group had significantly higher scores in health and social worry than others. In general, nonclinical sample had lower scores in all metacognitive questionnaires, RSQ, and neuroticism.
Conclusion Metacognitive beliefs and strategies could differentiate between diagnostic groups. Also findings support the Self regulatory executive function model of Wells.

The intolerance of uncertainty model was initially developed as an explanation for worry within the context of generalized anxiety disorder. However، recent research has identified intolerance of uncertainty (IU) as a transdiagnostic maintaining factor across the anxiety disorders. The aim of the present study was to compare the intolerance of uncertainty in patients with generalized anxiety disorder (GAD)، obsessive compulsive disorder (OCD)، panic disorder (PD) and control group. The present study was a cross-sectional and ex-post facto investigation (causal comparative method). Statistical universe constituted all patients had been referred the first to the Bozorgmehr clinic in Tabriz in the 1389_1390. In this study، 30 client with Generalized anxiety disorder (GAD)، 30 client with Obsessive-Compulsive disorder (OCD)، panic disorder (PD) and 30 control group were selected accessibility. The groups were matched in demographic characteristics with other. Data were collected through a structured clinical interview and the Intolerance of Uncertainty Scale (IUS). The gathered data is analyzed by SPSS-17 and descriptive statistic indexs and Multivariate Analysis of Variance (MANOVA). The present study has found that people with GAD، OCD، and PD disorders compared with controls، according to the f=89/6 significance levels of /0001 had higher intolerance of uncertainty، but people with GAD، OCD، and PD disorders were not significantly different in the intolerance of uncertainty. The results showe differences between the (GAD، OCD، and PD) disorders and control groups in the (F=1/7)، significance level0/0001، F=23/5، and significance level 0/002،in the two factors the intolerance of uncertainty questionnaire. In tolerance of uncertainty is not just for generalized anxiety disorder، It construct seen in the obsessive compulsive disorder and panic disorder. It seems cognitive factor of intolerance of uncertainty plays a pivotal role in causing in this disorders. A potential application of these results for the treatment of anxiety disorders are treatable.