Comparison of the Effectiveness of Paradoxical Timetable Therapy and Cognitive Behavioral Therapy on Reducing Symptoms in Women with Generalized Anxiety Disorder
Subject Areas : Woman and family
Faezeh
Peimanpak
1
(Ph.D. Student in Counseling, Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran (Corresponding author) f.peimanpak@alzahra.ac.ir)
Mahsima
Pourshahriari
2
(Associate Professor, Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran)
Abbas
Abdollahi
3
(Assistant Professor, Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran)
Keywords: According to the author of this article, there has been no conflict of interest,
Abstract :
Purpose: In respect of diagnosis and therapy, generalized anxiety disorder is one of the most frequent anxiety disorders, as well as one of the most difficult and resistant. Cognitive-behavioral therapy is one of the most frequent therapies for this disorder. The aim of this study was to examine the efficacy of paradoxical timetable treatment and cognitive-behavioral therapy in treating women with generalized anxiety disorder.Method: In this study, the single-case experimental Was used used. The population of the present research included women with generalized anxiety disorder who referred to the Sadra Clinic and had an active case in the summer and autumn of 2021. Among these, three patients received paradoxical timetable therapy, and three patients received cognitive-behavioral therapy. The sample of this research selected through convenience sampling.Generalized anxiety disorder scale-7 items used for collecting data. Chart analysis, reliable change index, clinical significance and Improvement percentage of paradoxical time table was used for data analysis. Data were analyzed using SPSS-26 software.Findings: The results showed that both paradoxical timetable treatment and cognitive-behavioral therapy were effective in reducing the symptoms of generalized anxiety disorder. Comparing the two treatment methods according to the obtained results and comparing the percentage of paradoxical timetable treatment subjects, the improvement rate for the three subjects in this method is 71%, 79% and 71% and the recovery percentage of cognitive-behavioral therapy subjects for the three subjects is 44%, 52% and 48%, also the percentage of total improvement in paradoxical timetable treatment in three patients is on average 74% and the percentage of total improvement in cognitive-behavioral therapy in three patients is 48%. According to the findings of the study, treatment of paradoxical timetable is an acceptable and quick method to decrease the symptoms of generalized anxiety, and can be used as a recommended treatment.
باچر، جیمز؛ مینکا، سوزان و هولی، جیل (2014). آسیب‌شناسی روانی (جلد: 1). ترجمه: سیدمحمدی، یحیی (1392). تهران: ارسباران.
بشارت، محمدعلی (1399). پارادوکس + برنامه زمانی = درمان (مدل کامل درمان اختلال‌های روان‌شناختی). تهران: انتشارات رشد.
بهشتی، نگار؛ زمستانی، مهدی و رضاعی، فرزین (1397). مقایسه اثربخشی درمان شناختی رفتاری معطوف بر عدم تحمل ابهام و درمان دارویی بر مؤلفه‌های نگرانی، عدم تحمل ابهام و اجتناب شناختی در مبتلایان به اختلال اضطراب فراگیر. مجله روان‌پزشکی و روانشناسی بالینی ایران. ۲۴ (۳)، 240-255.
شهریاری، حسنیه؛ زارع، حسین؛ علی‌اکبری دهکردی، مهناز و صرامی فروشانی، علیرضا (1397). اثربخشی مداخلات شناختی-رفتاری در درمان اختلال اضطراب فراگیر: یک مطالعه مروری با رویکرد فرا تحلیل. مجله دانشگاه علوم پزشکی رفسنجان، ۱۷ (۵)، 461-478.
گال، مردیت؛ گال، والتر و گال، جویس (2005). روشهای تحقیق کمی و کیفی در علوم تربیتی و روانشناسی (جلد دوم). ترجمه: نصر، احمدرضا؛ عریضی، حمیدرضا؛ ابوالقاسمی، محمود؛ باقری، خسرو؛ علامتساز، محمدحسین؛ پاکسرشت، محمد جعفر؛ دلاور، علی؛ کیامنش، علیرضا و خوینژاد، غلامرضا (1393). تهران: سمت.
لک، زهرا؛ معاضدیان، آمنه؛ حسینی‌المدنی، سید علی؛ صداقت، معصومه و عامری، سمیرا (1391). اثربخشی آموزش مدیریت استرس به شیوه شناختی رفتاری بر کاهش اضطراب معتادان مبتلا به اختلال اضطراب فراگیر. فصلنامه علمی اعتیاد پژوهی، ۶ (۲۴)، 69-84.
نریمانی، محمد؛ درویش حقجو، حسین؛ توکلی پله شاه، مهتاب و ابوالقاسمی، عباس (1391). میزان شیوع اختلال اضطراب فراگیر و بررسی تفاوت جنسیتی درمیزان شیوع اختلال اضطراب فراگیر، چهارمین کنگره بینالمللی سایکوسوماتیک، اصفهان، https://civilica.com/doc/188445
نیکان، عبدالصمد؛ لطفی کاشانی، فرح؛ وزیری، شهرام و مجتبایی، مینا (1400). مقایسه برنامه زمانی پارادوکسی و درمان شناختی رفتاری بر نگرانی و نشخوار فکری افراد دچار اضطراب اجتماعی. رویش روانشناسی، ۱۰ (۱)، 1-14.
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93-107. doi:10.31887/DCNS.2017.19.2/bbandelow
Besharat, M. A. & Naghipoor, M. (2019). The Application of a New Model of Paradox Therapy for the Treatment of Illness Anxiety Disorder: A Case Report. Journal of Systems and Integrative Neuroscience, 6: 1-5. doi:10.15761/JSIN.1000213
Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and anxiety, 35(6), 502-514.
Cuijpers, P., Cristea, I. A., Weitz, E., Gentili, C., & Berking, M. (2016). The effects of cognitive and behavioural therapies for anxiety disorders on depression: A meta-analysis. Psychological Medicine, 46(16), 3451-3462. doi:10.1017/S0033291716002348
Daitch, C. (2018). Cognitive Behavioral Therapy, Mindfulness, and Hypnosis as Treatment Methods for Generalized Anxiety Disorder. Am J Clin Hypn, 61(1), 57-69. doi:10.1080/00029157.2018.1458594
DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder. Ann Intern Med, 170(7), Itc49-itc64. doi:10.7326/aitc201904020
Hall, J., Kellett, S., Berrios, R., Bains, M. K., & Scott, S. (2016). Efficacy of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression. Am J Geriatr Psychiatry, 24(11), 1063-1073. doi:10.1016/j.jagp.2016.06.006
Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., & Wang, J. (2018). Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. J Psychiatr Res, 107, 1-10. doi:10.1016/j.jpsychires.2018.09.018
Johnson, S. U., Ulvenes, P. G., Øktedalen, T., & Hoffart, A. (2019). Psychometric Properties of the General Anxiety Disorder 7-Item (GAD-7) Scale in a Heterogeneous Psychiatric Sample. Front Psychol, 10, 1713. doi:10.3389/fpsyg.2019.01713
Jones, S. L., Hadjistavropoulos, H. D., & Soucy, J. N. (2016). A randomized controlled trial of guided internet-delivered cognitive behaviour therapy for older adults with generalized anxiety. Journal of Anxiety Disorders, 37, 1-9. doi:10.1016/j.janxdis.2015.10.006
LeBlanc, N. J., Bartuska, A., Blanchard, L., Baker, A., & Bui, E. (2021). Cognitive-Behavioral Treatment for Generalized Anxiety Disorder: Theoretical Foundations and Empirically Supported Strategies. Psychiatric Annals, 51(5), 210-215.
Lorimer, B., Kellett, S., Nye, A., & Delgadillo, J. (2021). Predictors of relapse and recurrence following cognitive behavioural therapy for anxiety-related disorders: a systematic review. Cogn Behav Ther, 50(1), 1-18. doi:10.1080/16506073.2020.1812709
Newman, M. G., Zainal, N. H., & Hoyer, J. (2020). Cognitive‐Behavioral Therapy (CBT) for Generalized Anxiety Disorder (GAD). Generalized Anxiety Disorder and Worrying: A Comprehensive Handbook for Clinicians and Researchers, 203-230.
Orvati Aziz, M., Mehrinejad, S. A., Hashemian, K., & Paivastegar, M. (2020). Integrative therapy (short-term psychodynamic psychotherapy & cognitive-behavioral therapy) and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: A randomized controlled trial. Complement Ther Clin Pract, 39, 101122. doi:10.1016/j.ctcp.2020.101122
Schad, J., Lewis, M. W., Raisch, S., & Smith, W. K. (2016). Paradox Research in Management Science: Looking Back to Move Forward. The Academy of Management Annals, 10(1), 5-64. doi:10.1080/19416520.2016.1162422
Stefan, S., Cristea, I. A., Szentagotai Tatar, A., & David, D. (2019). Cognitive-behavioral therapy (CBT) for generalized anxiety disorder: Contrasting various CBT approaches in a randomized clinical trial. Journal of Clinical Psychology, 75(7), 1188-1202. doi:10.1002/jclp.22779
Van Dis, E. A. M., van Veen, S. C., Hagenaars, M. A., Batelaan, N. M., Bockting, C. L. H., van den Heuvel, R. M., . . . Engelhard, I. M. (2020). Long-term Outcomes of Cognitive Behavioral Therapy for Anxiety-Related Disorders: A Systematic Review and Meta-analysis. JAMA psychiatry, 77(3), 265-273. doi:10.1001/jamapsychiatry.2019.3986
_||_
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19 (2), 93-107. doi:10.31887/DCNS.2017.19.2/bbandelow
Besharat, M. A. & Naghipoor, M. (2019). The Application of a New Model of Paradox Therapy for the Treatment of Illness Anxiety Disorder: A Case Report. Journal of Systems and Integrative Neuroscience, 6: 1-5. doi:10.15761/JSIN.1000213
Beheshti, N., Zemestani, M., & Rezaei, F. (2018). Comparing the effectiveness of cognitive behavioral therapy focused on intolerance of uncertainty and pharmacotherapy on worry, intolerance of uncertainty, and cognitive avoidance in patients with generalized anxiety disorder. Iranian Journal of Psychiatry and Clinical Psychology, 24(3), 240-255.
Besharat, M. A. (2017). Paradox + Timetable = Cure (PTC): Perfect model of treatment for psychological disorders (A practical guide). Tehran: Roshd Press.
Butcher, J. N., Mineka, S., Hooley, J.M. (2014). Abnormal Psychology (1) (16 ed.). Tehran: Arasbaran.
Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and anxiety, 35 (6), 502-514.
Cuijpers, P., Cristea, I. A., Weitz, E., Gentili, C., & Berking, M. (2016). The effects of cognitive and behavioural therapies for anxiety disorders on depression: A meta-analysis. Psychological Medicine, 46 (16), 3451-3462. doi:10.1017/S0033291716002348
Daitch, C. (2018). Cognitive Behavioral Therapy, Mindfulness, and Hypnosis as Treatment Methods for Generalized Anxiety Disorder. Am J Clin Hypn, 61 (1), 57-69. doi:10.1080/00029157.2018.1458594
DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder. Ann Intern Med, 170(7), Itc49-itc64. doi:10.7326/aitc201904020
Hall, J., Kellett, S., Berrios, R., Bains, M. K., & Scott, S. (2016). Efficacy of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression. Am J Geriatr Psychiatry, 24(11), 1063-1073. doi:10.1016/j.jagp.2016.06.006
Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., & Wang, J. (2018). Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. J Psychiatr Res, 107, 1-10. doi:10.1016/j.jpsychires.2018.09.018
Gal, Meredith; Gall, Walter and Gall, Joyce (2005). Quantitative and qualitative research methods in educational sciences and psychology (2). Translation: Nasr, Ahmad Reza; Arizi, Hamidreza; Abolghasemi, Mahmoud; Bagheri, Khosrow; Marker, Mohammad Hussein; Paksrasht, Mohammad Jafar; Delaware, Ali; Kiamanesh, Alireza and Khoynejad, Gholamreza (2014). Tehran: Samt.
Johnson, S. U., Ulvenes, P. G., Øktedalen, T., & Hoffart, A. (2019). Psychometric Properties of the General Anxiety Disorder 7-Item (GAD-7) Scale in a Heterogeneous Psychiatric Sample. Front Psychol, 10, 1713. doi:10.3389/fpsyg.2019.01713
Jones, S. L., Hadjistavropoulos, H. D., & Soucy, J. N. (2016). A randomized controlled trial of guided internet-delivered cognitive behaviour therapy for older adults with generalized anxiety. Journal of Anxiety Disorders, 37, 1-9. doi:10.1016/j.janxdis.2015.10.006
Lak, Z., Moazedian, A., Hosseini, A., Sedaghat, M., Ameri, S. (2012). The effectiveness of cognitive-behavioral stress management training on reducing anxiety in addicts with generalized anxiety disorder. Quarterly Journal of Research on Addiction, 6 (24), 69-83.
LeBlanc, N. J., Bartuska, A., Blanchard, L., Baker, A., & Bui, E. (2021). Cognitive-Behavioral Treatment for Generalized Anxiety Disorder: Theoretical Foundations and Empirically Supported Strategies. Psychiatric Annals, 51 (5), 210-215.
Lorimer, B., Kellett, S., Nye, A., & Delgadillo, J. (2021). Predictors of relapse and recurrence following cognitive behavioural therapy for anxiety-related disorders: a systematic review. Cogn Behav Ther, 50 (1), 1-18. doi:10.1080/16506073.2020.1812709
Narimani, Mohammad; Darvish Haghjoo, Hussein; Tavakoli Pele Shah, Mahtab and Abolghasemi, Abbas (2012). Prevalence of Generalized Anxiety Disorder and Study of Gender Differences in Prevalence of Generalized Anxiety Disorder, 4th International Psychosomatic Congress, Isfahan, https://civilica.com/doc/188445
Newman, M. G., Zainal, N. H., & Hoyer, J. (2020). Cognitive‐Behavioral Therapy (CBT) for Generalized Anxiety Disorder (GAD). Generalized Anxiety Disorder and Worrying: A Comprehensive Handbook for Clinicians and Researchers, 203-230.
Nikan, A., Lotfi Kashani, F., Vaziri, S., & Mojtabaie, M. (2021). Comparison of paradoxical timetable and cognitive behavioral therapy on worry and rumination of individuals with social anxiety. Rooyesh-e-Ravanshenasi Journal (RRJ), 10 (1), 1-14.
Orvati Aziz, M., Mehrinejad, S. A., Hashemian, K., & Paivastegar, M. (2020). Integrative therapy (short-term psychodynamic psychotherapy & cognitive-behavioral therapy) and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: A randomized controlled trial. Complement Ther Clin Pract, 39, 101122. doi:10.1016/j.ctcp.2020.101122
Shahriari, H., Zare, H., Aliakbari Dehkordi, M., & Sarami Foroushani, G. R. (2018). Effectiveness of Cognitive-Behavioral Interventions in the Treatment of Generalized Anxiety Disorder: A Systematic Review and Meta-analysis. Journal of Rafsanjan University of Medical Sciences, 17 (5), 461-478.
Schad, J., Lewis, M. W., Raisch, S., & Smith, W. K. (2016). Paradox Research in Management Science: Looking Back to Move Forward. The Academy of Management Annals, 10 (1), 5-64. doi:10.1080/19416520.2016.1162422
Stefan, S., Cristea, I. A., Szentagotai Tatar, A., & David, D. (2019). Cognitive-behavioral therapy (CBT) for generalized anxiety disorder: Contrasting various CBT approaches in a randomized clinical trial. Journal of Clinical Psychology, 75 (7), 1188-1202. doi:10.1002/jclp.22779
Van Dis, E. A. M., van Veen, S. C., Hagenaars, M. A., Batelaan, N. M., Bockting, C. L. H., van den Heuvel, R. M., . . . Engelhard, I. M. (2020). Long-term Outcomes of Cognitive Behavioral Therapy for Anxiety-Related Disorders: A Systematic Review and Meta-analysis. JAMA psychiatry, 77 (3), 265-273. doi:10.1001/jamapsychiatry.2019.3986
