Comparing Effectiveness of group interpersonal psychodynamic psychotherapy and group emotion focused therapy on girl’s adolescent generalized anxiety disorder

Document Type : Original Article

Authors

1 Islamic Azad University, Science and Research Branch of Tehran

2 Baqiyatallah University of Medical Sciences

Abstract

Background & Aims: Generalized anxiety disorder (GAD) is one of the most prevalent disorder among adolescents’ girls and early relationships quality with parents play an important role for its development that it should be considered for treatment. It was aimed to investigate and comparing effectiveness of group interpersonal psychodynamic psychotherapy (GPIP) and group emotion focused therapy (GEFT) on girl’s adolescent generalized anxiety disorder.
 
Methods: The research method was experimental with pre-test, post-test and control group. The statistical population consisted of all 15-17 year-old girls with GAD in Shiraz high schools. Among them, 30 adolescents were randomly selected and randomly assigned to two experimental and control groups. Interventions of experimental groups consisted of 16 sessions of GPIP and 10 sessions of GEFT. All groups were evaluated by GAD-7 questionnaire in pretest, posttests and follow up. The data were analyzed using repeated measure variance and for pairwise comparison using post hoc.
 
Results: Both GPIP and GEFT methods in comparison with the control group caused to significant reduction of GAD in post-treatment. Also, the results showed that in the follow up session, only the scores of the psychodynamic group were significantly lower than the control group, but there was no significant difference between the scores of the emotional-focused and control group.
 
Conclusion:  According to the results of the study, both GPIP and GEFT can be effective in improving the symptoms of generalized anxiety disorder in adolescent girls.

Keywords


1-Clements-Nolle K, & Rivera CM. (2013). The Epidemiology of Adolescent Health. Handbook of Adolescent Health Psychology. New York, NY: Springer press.  pp. 77-97.
 2-American Psychiatric Association. (2013). Diagnostic and statistical manual disorder. 5th edition. American Psychiatric Publishing, Arlington, Virginia, USA. Interview (CIDI). Int J Methods Psychiatr Res. Vol 13: pp. 93–12.
 3- Burstein, M., Beesdo-Baum, K. & Merikangas, K. R. (2013). Threshold and subthreshold generalized anxiety disorder among US adolescents: prevalence, sociodemographic, and clinical characteristics. Psychological Medicine. Vol 44: pp. 2351-2362.
 4- Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry. Vol 49: pp. 980 –989.
 5-Angst, J., Gamma, A., Baldwin, D.S., Ajdacic-Gross V., Rossler W. (2009). The generalized anxiety spectrum: prevalence, onset, course and outcome. European Archives of Psychiatry and Clinical Neuroscience: Vol 259: pp. 37–45.
 6- Kessler, R. C., Avenevoli, S., Costello, J., Green, J. G., Gruber, M. J., McLaughlin, K. A., Petukhova, M., Sampson, N. A., Zaslavsky, A.M., Merikangas, K. R. (2012) Severity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry. Vol 69: pp. 381–389.
 7- Rubio, G., Lopez-Ibor, J. J. (2007). Generalized anxiety disorder: a 40-year follow-up study. Acta Psychiatr Scand. Vol 115: pp. 372–379.
 8- Copeland, W. E., Angold, A., & Shanahan, L., Costello, E. J. (2014) longitudinal patterns of anxiety from childhood to adulthood: the Great Smoky Mountains study. J Am Acad Child Adolesc Psychiatry: Vol 53: pp. 21–33.
 9- Hale, W. W., Klimstra, T. A., Branje, S. T., Wijsbroek, S. M., Meeus, W. J. (2013). Is adolescent generalized anxiety disorder a magnet for negative parental interpersonal behaviors?  Journal of Depression and Anxity. Vol 30: pp. 849–856.
 10- Ejict, F. V., Brange, S. T., Hale, W. W., & Meeus, W. J. (2012). Longitudinal Associations between Perceived Parent-Adolescent Attachment Relationship Quality and Generalized Anxiety Disorder Symptoms in Adolescence. Journal of Obnormal Child Psychology. Vol 40: pp. 871-883.
 11- امانی رزیتا. نقش کارکرد خانواده در اضطراب و افسردگی نوجوانان. (1394). روانشناسی بالینی و شخصیت (دانشور رفتار سابق). سال 13، شماره 2، صص 77-۸۴.
 12-Fisak, B., Mann, A., Heggeli, K. (2013). The association between perceptions of parent worry and generalised anxiety disorder symptoms in a community sample of adolescents. International Journal of Adolescence and Youth. Vol 18: pp.  226-235
 13- Davila, J., La Greca, A. M., Starr, L. R., Landoll, R. R. (2010).  Anxiety disorders in adolescence. In J. G. Beck (Ed.), Interpersonal processes in the anxiety disorders: Implications for understanding psychopathology and treatment. Washington, DC: American Psychological Association. pp. 67-124
 14- Beesdo, K., Pine, D. S., Lieb, R., Wittchen, H. U. (2010) Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder. Arch Gen Psychiatry. Vol 67: pp. 47–57.
 15- Tasca, G. A., Mikail, S., & Hewitt, P. (2005). Group psychodynamic interpersonal psychotherapy: A manual for time limited treatment of binge eating disorder. In M. E. Abelian (Ed.), Focus on psychotherapy research. Hauppauge, NY: Nova. pp. 159–188.
 16- Tasca, G. A., Ritchie, K., & Balfour, L. (2011). Practice review: Implications of attachment theory and research for the assessment and treatment of eating disorders. Psychotherapy Research: Vol 48: pp. 249–259.
 17- Tasca, G. A., Ritchie, K., Conrad, G., Balfour, L., Gayton, J., Daigle, V., & Bissada, H. (2006). Attachment scales predict outcome in a randomized controlled trial of two group therapies for binge eating disorder: An aptitude by treatment interaction. Psychotherapy Research: Vol 16: pp. 106–121.
 18- Gallagher, M.E., Tasca, G. A., Ritchie, K., Balfour, L., Bissada, H. (2014). Attachment Anxiety Moderates the Relationship Between Growth in Group Cohesion and Treatment Outcomes in Group Psychodynamic Interpersonal Psychotherapy for Women With Binge Eating Disorder. Group Dynamics: Theory, Research, and Practice: Vol 18: pp. 38–52.
19- Hewitt, P. L., Mikail, S. F., Flett, G. L., Tasca, G. A., Flynn, C. A., & Deng, X. et al. (2015). Psychodynamic/interpersonal group psychotherapy for perfectionism: Evaluating the effectiveness of a short-term treatment.  Psychotherapy. Vol 52: pp. 205-217
 20- Tschuschke, V., Anbeh, T., & Kiencke, P. (2007). Evaluation of long term analytic group psychotherapy. International Journal of Group Psychotherapy. Vol 40: pp. 140-159.
 21- Greene, L. R. (2012). Group Therapist as Social Scientist, With Special Reference to the Psychodynamically Oriented Psychotherapist. American Psychologist. Vol 67: pp. 477–489.
 22- Robinson, A.l., Maccague, E.A., Whissell, C. (2014). “That chair work thing was great”: a pilot study of group-based emotion-focused therapy for anxiety and depression. Person-Centered & Experiential Psychotherapies: Vol 13: pp. 263-277
 23- Greenberg L. (2010). Emotion-focused therapy: A clinical synthesis. The Journal of Lifelong Learning in Psychiatry. Vol 3: pp. 32–42.
 24- Turpyn, C. C., Chaplin, T. M., Cook, E. C., Martelli, A. M. (2015): A person-centered approach to adolescent emotion regulation: Associations with psychopathology and parenting. Journal of Experimental Child Psychology. Vol 136: pp. 1–16.
 25- سپهریان آذر فیروزه، اسدی مجره سامره. (1394). آزمون مدل ارتباطی محیط هیجانی خانواده با استرس ادراک‌شده: نقش میانجی دشواری‌های تنظیم هیجان. روانشناسی بالینی و شخصیت (دانشور رفتار سابق). سال 12، شماره 22. صص ۸۹-۱۰۰.
 26- Jounson, S. (2009). Attachment theory and emotionally focused therapy for individuals and couples. In: Obegi, J. H., & Berant, E. (Eds). Attachment Theory and research in clinical work with adults. Guilford Press. pp: 410-434
 27- Timulak, L., & McElvaney, J. (2016).  Emotion-Focused Therapy for Generalized Anxiety Disorder: An Overview of the Model. J Contemp Psychother. Vol 46: pp. 41–52.
 28- Greenberg L.S., Warwar S.H., Malcolm W.M. (2008). Differential Effects of Emotion-Focused Therapy and Psychoeducation in Facilitating Forgiveness and Letting Go of Emotional Injuries. Journal of Counseling Psychology. Vol 55: pp. 185–196.
 29- نائینیان محمدرضا، باباپور جلیل، گروسی فرشی تقی، شعیری محمدرضا، رستمی رضا. (1391). مقایسه تأثیر آموزش نوروفیدبک و دارو درمانی بر کاهش نشانه های اضطراب و کیفیت زندگی بیماران مبتلا به اختلال اضطراب فراگیر. روانشناسی بالینی و شخصیت (دانشور رفتار سابق). سال 7، شماره 2. صص 1-۱۴.
 30- Markin, R. D., & Marmarosh, C. (2010). Application of adult attachment theory to group member transference and the group therapy process. Psychotherapy. Vol 47: pp. 111–121.
 31- Fresco, D. M., Mennin, D. S., Heimberg, R. G., Ritter, M. (2013) Emotion Regulation Therapy for Generalized Anxiety Disorder. Cognitive Behavior Practic. Vol 20: pp. 282-300.
 32- Knekt, P., Lindfors, O., Sares-Jask, L., Vitala, E., & Harkanen, T. (2013). Randomized trial on the effectiveness of long and short-term psychotherapy on psychiatric symptoms and working ability during a 5-year follow-up. Nordic Journal of Psychiatry. Vol 67: pp. 59-68.