Document Type : Research Paper
Authors
shahidbeheshti
Abstract
The aim of the present study was to compare the effectiveness of Cognitive- Behavior (CBT) group therapy (Borkovec model) and mindfulness based cognitive therapy (MBCT) on signs and symptoms of generalized anxiety disorder (GAD) and cognitive mediators. An experimental design with control group and random assignment using pre and post-test and a four month follow up was used. The statistical population comprised of women with generalized anxiety disorder who had at least one primary school age daughter in Tehran. Participants’ selection was based on availability. First of all, several primary girl schools were purposefully selected from all primary girl school of Tehran. All mothers were asked to complete the GAD-7 questionnaire. Those mothers who scored above the cut- off point of seven were selected as generalized anxiety disorder (91 women). This was confirmed by a diagnostic structured interview after which participants were asked to take part in the research (32 women). In this research the following measurement tools were used: Generalized Anxiety Disorder Scale (GAD-7), Pennsylvania State Worry Questionnaire (PSWQ), Why Worry Scale (WW-II), data were analyzed using repeated measure analyze of variance. Results showed that both CBT and MBCT were effective in reducing GAD signs and symptoms and its cognitive mediators in post- test and follow up. so these two methods were effective in reducing GAD signs and symptoms and its cognitive mediators
Keywords
امیدی، عبداالله؛ طباطبایی، اعظم؛ سازرو، سید علی؛ عکاشه، گودرز. (1382). همهگیر شناسی اختلالات روانی در مناطق شهری در شهرستان نطنز. فصلنامه اندیشه و رفتار، 8، 4، 39-32.
فرست، مایکل؛ اسپیتزر، گیبون؛ میریام، ویلیامز. (1384). مصاحبه بالینی ساختاریافته برای اختلالهای محور I درDSM-IV. (SCID-I) ترجمه: ونداد شریفی , و همکاران . تهران: مهرکاویان.
نایینیان، محمد رضا؛ شعیری، محمد رضا؛ شریفی، معصومه و هادیان، مهری. (1390). بررسی پایایی و اعتبار مقیاس 7 سوالی اختلال اضطراب فراگیر(GAD-7). مجله دانشور رفتار ،3(4)، 50-41.
شریفی، علی اکبر. (1391). راهنمای ام سی ام آی. میلون 3. تهران: روان سنجی.
شیرین زاده دستگیری، صمد .(1385). مقایسه باورهای فراشناختی و مسئولیت پذیری دربین بیماران دچاراختلال وسواسی- اجباری، اضطراب منتشر و افراد بهنجار. پایان نامه کارشناسی ارشد روانشناسی بالینی، دانشگاه شیراز.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Andrews, G., Hobbs, M.J., Borkovec, T.D., Beesdo, K., Craske, M.G., Heimberg, R.G., Rapee, R.M., Ruscio, A.M., Stanley, M.A., 2010. Generalized worry disorder: a review of DSM-IV generalized anxiety disorder and options for DSM-V. Depression and Anxiety, 27, 134- 145.
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143.
Barrera, T. L., Norton, P. J. (2009). Quality of life impairment in generalized anxiety disorder, social phobia, and panic disorder. Anxiety Disorders, 23, 1086–1090.
Borkovec, T.D., & Inz, T. (1990). The nature of worry in generalized anxiety disorder: A Prominence of thought activity. Behavior Research and Therapy, 28,153-158.
Borrovec, T. D., Newman, M. G., & Castonguay, L. G. (2004). Cognitive-behavioral therapy for generalized anxiety disorder with integration from interpersonal and experiential therapies. Journal of Lifelong Learning in Psychiatry2, 3,392-401.
Borrovec, T. D., Newman, M. G., & Castonguay, L. G. (2004). Cognitive-behavioral therapy for generalized anxiety disorder with integration from interpersonal and experiential therapies. Journal of Lifelong Learning in Psychiatry2, 3,392-401.
Borkovec, T. D., & Costello, E. (1993). Efficacy of applied relaxation and cognitive behavioral therapy in the treatment of generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 61, 611-619.
Brown, T. A., Barlow, D.H., &Liebowitz, M.R. (1990). The empirical basis of generalized anxiety disorder. American Journal of Psychiatry, 151, 1222-1280.
Carter, M. M., Mitchell, F. E., & Sbrocco, T. (2012). Treating ethnic minority adults with anxiety disorders: Current status and future recommendations. Journal of Anxiety Disorders, 26(4), 488–501.
Cassidy, J., Lichtenstein-Phelps, J., Sibrava, N. J., Thomas Jr.C. B., Borkovec,T. D. (2009). Generalized Anxiety Disorder: Connections With Self-Reported Attachment. Behavior Therapy, 40, 23–38.
Chambless, D. L, Baker, M. J, Baucom, D. H, Beutler, L. A, et al. (1998). Update on Empirically Validated Therapies, II. The Clinical Psychologist, 51, 3-16.
Chiesa, A., Serretti, A. (2011). Mindfulness Based Cognitive Therapy for Psychiatric Disorders: A Systematic Review and Meta-analysis. Psychiatry Research, 187(3), 441-453.
Craigie, M. A., Ree, C. S., Marsh, A. (2008).Mindfulness-based Cognitive Therapy for Generalized Anxiety Disorder: A Preliminary Evaluation. Behavioural and Cognitive Psychotherapy, 36, 553–568.
Crits-Christoph, P., Newman, M. G., Rickels, K., Gallop, R., Gibbons, M. B. C., Hamilton, J. L., . & Pastva, A. M. (2011). Combined medication and cognitive therapy for generalizedanxiety disorder. Journal of Anxiety Disorders, 25(8), 1087–1094.
Dugas, M. J., Marchand, A., & Ladouceur, R. (2005). Further validation of a cognitive-behavioral model of generalized anxiety disorder: Diagnostic and symptom specificity. Journal of Anxiety Disorder, 19,329-343.
Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty i etiology and maintenance. In: R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: advances in research and practice (pp. 143–163). New York: Guilford.
Dugas, M. J., & Koerner, N. (2005). Cognitive-behavioral treatment for generalized anxiety disorder: current status and future directions. Journal of Cognitive Psychotherapy, 19, 61–68.
Erickson, T. & Newman. M. G. (2002, November). Emotional expression in GAD analogues based on an emotional disclosure task. Paper presented at the 3th annual meeting of the association for advancement of behavior therapy, Reno, NV.
Evans, S., Ferrando, S., Findler, M., Stowell , C., Smart , C., Haglin , D.(2008). Mindfulness based cognitive therapy for generalized anxiety disorder. J Anxiety Disorder, 22, 716-721.
Heimberg, R. G., Turk, C. L., & Mennin, D. S. (2004). Generalized anxiety disorder: Advances in research and practice. New York: Guilford.Borkovec, T. D., & Ruscio, A. M. (2001). Psychotherapy for generalized anxiety disorder. Journal of Clinical Psychiatry, 62(Suppl. 11), 37–45.
Finucane, A., & Mercer, S. W. (2006). An exploratory mixed methods study of the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care. BMC Psychiatry, 6(14).
Hlowka, D. W., Dugas, M. J., Francis, K., & Laugesen, N. (2000). Measuring Beliefs about
Worry: A Psychpmetric Evaluation of the Why Worry-II Questionnare: Poster Session Presented at the Annual Convention for Asspciation for Advancement of Behavior Therapy. New Orleans, LO.
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.
Kim, Y. W., Lee, S. H., Choi, T.K., Suh, S.Y., Kim, B., Kim, C. M., Cho, S. J., Kim, M. J., Yook, K., Ryu, M., Song, S. K., Yook, K. H. )2009(. Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depression and Anxiety, 26, 601–606.
Ladouceur, R., Gosselin, P., &Dugas, M. J. (2000). Experimental manipulation of intolerance of uncertainty: A study of a theoretical model of worry. Behaviour Research and Therapy, 38, 933-941.
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495.
Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008). Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: evaluation in a randomized controlled trial. Journal of Consulting and Clinical Psychology, 76(6), 1083–1089.
Shapiro, S. L., Schwartz, G.E., & Bonnre, G. (1998). Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral medicine, 21, 581-599.
Segal, Z. V., Williams, J. M. G. and Teasdale, J. D. (2002).Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford Press.
Siegel, D. Y. (2010). The mindful therapist: A clinician’s guide to mind sight and neural integration. New York: W.W. Norton& Company.
Sextn, K. A & Dugas, M. J. (2004). An Investigation of Factor Leading to Cognitive in Worry . Poster Presented at the 38th annual Convention for the Association for Advancement Behavior Therapy: New Orleans, L. A. November 17-20.
Spitzer, R, L., Kroenke, K.; Williams, J. B. W.; and Bernd, Lo¨we (2006). A Brief Measure for Assessing Generalized Anxiety Disorder The GAD-7. ARCH INTERN MED. 166
)