The Comparision of Emotion Regulation and Cognitive Flexibility in Nonclinical Sampls of Adolescents with Symptoms of Generalized Anxiety Disorder and Social Anxiety Disorder

Document Type : Original Article


1 Assistant Professor, Department of Psychology and Educational Sciences, Arak University

2 Clinical Psychology, Islamic Azad University of Arak, Arak, Iran


Introduction:Two disorders of generalized anxiety and social anxiety are among prevalent disorders in the children and adolescents. The present research conducted with the aim of comparing the difficulties in emotion regulation and cognitive flexibility between adolescence with symptoms of generalized anxiety and social anxiety disorders.
Method: In an expo-facto design among high school students of Khorramabad city, two groups were selected based on the cut of point scores of generalized anxiety and social anxiety scales, as well as, psychologist diagnosis. All subjects compared by their scores in difficultiy in emotion regulation and cognitive flexibility scales.
Results: Results of a Multivariate Analysis of Variance indicated significant difference in the liner composition of dependent variables of two groups. Univariate analysis of variance also indicated that students with generalized anxiety disorder tend to show more difficulty in emotion regulation strategies, while lack of emotional awareness, as well as, higher levels (less difficulties) of cognitive flexibility (in alternatives) was evedent in social anxiety adolescents.  No other significant differences observed between two groups.
Conclusion: Generalized anxiety and social anxiety in adolescents were different in terms of difficulties in emotion regulation, and cognitive flexibility. Hence  evaluation, diagnostic and therapeutic consideratin based on these differences for both disorders seems necessary.


Main Subjects

1- Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual Research Review: A meta‐analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry. 2015; 56(3): 345-65.
2- Ghaderi B, Mohammadkhani SH & Hassanabadi HR. Cognitive and metacognitive predictors of anxiety in adolescents. J Clin Psychol. 2016; 7(4): 13-26.
3- Association AP. Diagnostic and Statistical Manual of Mental Disorders DSM 4 TR (Text Revision): American Psychiatric Association. 2003.
4- Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatric Clinics. 2009; 32(3): 483-524.
5- Cremers HR, Roelofs K. Social anxiety disorder: a critical overview of neurocognitive research. Wiley Interdisciplinary Reviews: Cognitive Science. 2016; 7(4): 218-32.
6- O’Toole MS, Zachariae R, Mennin DS. Social anxiety and emotion regulation flexibility: considering emotion intensity and type as contextual factors. Anxiety, Stress, & Coping. 2017; 30(6): 716-24.
7- Cole PM, Martin SE, Dennis TA. Emotion regulation as a scientific construct: Methodological challenges and directions for child development research. Child development. 2004; 75(2): 317-33.
8- Suveg C, Zeman J. Emotion regulation in children with anxiety disorders. Journal of Clinical Child and Adolescent Psychology. 2004; 33(4): 750-59.
9- Gross JJ. Emotion regulation in adulthood: Timing is everything. Current directions in psychological science. 2001; 10(6): 214-19.
10- Gross JJ. Emotion regulation: Current status and future prospects. Psychological Inquiry. 2015; 26(1): 1-26.
11- Rutherford HJ WN, Laurent HK, Mayes LC.  Emotion regulation in parenthood. Dev Rev. 2015; 36 :1-14.
12- Greenberg LS BE. An emotion-focused approach to the overregulation of emotion and emotional pain. J Clin Psychol. 2001; 57(2): 197-211.
13- Salters-Pedneault K RL, Tull MT, Rucker L, Mennin DS. . Evidence of broad deficits in emotion regulation associated with chronic worry and generalized anxiety disorder. Cogn Ther Res. 2006; 30(4): 469-80.
14- Abedighelichgheshlaghi M SAYHT. he structural modeling of anxiety and depression disorders in Urumiya children and adolescent girls. J Clin Psychol. 2018; 10(3): 49-61.
15- Akhavan-Abiri F SMG-FM. Structural relationships between attachment style and psychological distress: mediating role of cognitive emotion regulation. J Clin Psychol. 2018; 10(3): 63-75.
16- Keil V AJ, Tuschen‑Caffier B, Schmitz J.  . Children with social anxiety and other anxiety disorders show similar deficits in habitual emotional regulation: Evidence for a transdiagnostic phenomenon. Eur Child Adolesc Psychiatry. 2017; 26: 749-57.
17- Dickstein DP, Nelson E, McClure EB, Grimey ME, Knopf L, Brotman MA, et al.  Cognitive flexibility in phenotypes of pediatrics bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2007; 46(3): 341-55.
18- Martin MM, Rubin RB. Development of a communication flexibility measure. Psychol Rep. 1995; 76: 623-6.
19- Whiting DL, Deane FP, Simpson GK, McLeod HJ, Ciarrochi J. Cognitive and psychological flexibility after a traumatic brain injury and the implications for treatment in acceptance-based therapies: A conceptual review. Neuropsychol Rehabil. 2017; 27(2): 263-99.
20- Ionescu T. T. I. Exploring the nature of cognitive flexibility. New Ideas Psycho. 2012; 30(2) :190-200.
21- Roberts ME, Barthel FMS, Lopez C, Tchanturia K, Treasure JL. Development and validation of the Detail and Flexibility Questionnaire (DFlex) in eating disorders. Eat Behav. 2011; 12(3): 168-74.
22- Lee JK, Orsillo SM. Investigating cognitive flexibility as a potential mechanism of mindfulness in Generalized Anxiety Disorder. J Bhave Ther Exp Psychiatry. 2014; 45(1): 208-16.
23- Fazeli M, Ehteshamzadeh P, Hashemi Sheikh Shabani SE. The effectiveness of cognitive behavior therapy on cognitive flexibility of depressed people. Thought Behave Clin Psychol. 2015; 9(34): 27-36.
24- Carthy T HN, Apter A, Edge MD, Gross JJ. Emotional reactivity and cognitive regulation in anxious children. Behav Res Ther. 2010; 48(5): 384-93.
25- Feldner MT, Zvolensky MJ, Eifert GH, Spira AP. Emotional avoidance: An experimental test of individual differences and response suppression using biological challenge. Behav Res Ther. 2003; 41(4): 403–411. 26- Ginsburg GS SL, Masia-Warner C, Hedtke K. Anxiety disorders in children: Family matters. Cognit Behav Pract. 2004; 11: 28-43.
27- Werner KH GP, Ball TM, Heimberg RG, Gross JJ. . Assessing emotion regulation in social anxiety disorder: The emotion regulation interview. J Psychopathol Behav Assess. 2011; 33(3): 346-54.
28- Rodebaugh TL HR. Emotion regulation and the anxiety disorders: Adopting a self-regulation perspective. In: Vingerhoets JJM, Nyklíček I, Denollet J, editor. Emotion Regulation Boston, MA. 2008; 140–9.
29- Mennin DS, Heimberg RG, Turk CL, Fresco DM.Preliminary evidence for an emotion regulation deficit model of generalized anxiety disorder. Behav Res Ther. 2005; 43: 1281-310.
30- Mennin DS, McLaughlin KA, Flanagan TJ. Emotion regulation deficits in generalized anxiety disorder, social anxiety disorder, and their co-occurrence. J Anxiety Disord. 2009; 23: 866–71.
31- Turk CL, Heimberg RG, Luterek JA, Mennin DS, Fresco DM. Delineating emotion regulation deficits in generalized anxiety disorder: A comparison with social anxiety disorder  Cognit Ther Res. 2005; 29: 89–106.
32- Arlt J, Yiu A, Eneva K, Drymanb MT, RG, Heimberg Chena EY. Contributions of cognitive inflexibility to eating disorder and social anxiety symptoms.. Eat Behav. 2016; 21: 30-2.
33- Dugas MJ, Marchand A, Ladouceur R. (2005). Further validation of a cognitive-behavioral model of generalized anxiety disorder: Diagnostic and symptom specificity. J Anxiety Disord. 2005; 19(3): 329-43.
34- Kusec A KN. Cognitive flexibility in generalized anxiety disorder and its impact on interpretation biases. Can J Exp Psychol. 2014; 68(4): 278.
35- Deveney CM DP. A preliminary investigation of cognitive flexibility for emotional information in major depressive disorder and non-psychiatric controls. Emot. 2006; 6(3): 429-37.
36- Spitzer RL KK, Williams JBW, Lo¨we, B. A Brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006; 166 :1092-7.
37- Naeinian MR SM, Sharif M, Hadian M. . To study reliability and validity for a brief measure for assessing Generalized Anxiety Disorder (GAD-7) Clinical Psy & Personality. 2011; 3(4): 41-50.
38- Masia-Warner C SE, Pincus DB, Klein RG, Heimberg RG, Liebowitz MR. . The Liebowitz social anxiety scale for children and adolescents: An initial psychometric investigation. . J Am Acad Child Adolesc Psychiatry. 2003; 42(9): 1076-84.
39- Dadsetan P, Anari A. Social anxiety disorders and drama-therapy. Dev Psychol (J Iranian Psychol). 2008; 4(14):115-23.
40- Dennis JP, Vanderwall JS. The cognitive flexibility inventory: Instrument development and estimates of reliability and validity. Cognit Ther Res. 2010; 34(3): 241-53.
41- Shareh H, Farmani A, Soltani E. Investigating the reliability and validity of the Cognitive Flexibility Inventory (CFI-I) among Iranian university students. Pract Clin Psychol. 2014; 2(1): 43-50.
42- Gratz KL, Roemer L.Multidimentional assessment of emotion regulation and dysregulation development, factor structure and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2004; 26(1): 41-54.
43- Alavi K MGM, Amin-Yazdi, SA & Salehi Fadardi, J. Effectiveness of group dialectical behavior therapy (based on core mindfulness, distress tolerance and emotion regulation components) on depressive symptoms in university students J Fandam Ment Health. 2011; 13(2): 124-35.