Investigate the Efficacy and comparison of accelerated Short-Term Psychodynamic and Cognitive Behavioral Therapy on Improving Ego Functions in patients with Generalized Anxiety Disorder

Document Type : Original Article

Authors

1 Ph. D. student in General Psychology, Department of Psychological, Islamic Azad University of Rudehen, Rudehen, Iran.

2 Associate Professor, Department of Psychological, Islamic Azad University of Rudehen, Rudehen, Iran.

3 Assistant Professor, Department of Psychological, Islamic Azad University of Rudehen, Rudehen, Iran.

Abstract


Abstract
Introduction: The purpose of this research was to investigate the effectiveness and comparison of accelerated Short -Term Psychodynamic and cognitive behavioral therapy on improving ego functions in patients with generalized anxiety disorder in Tehran.
Method: The current study was a semi-experimental study with a pre-test-post-test and follow-up design with a control group. The statistical population of the study consisted of all men and women aged 25-50 in Tehran who had referred to the psychotherapy clinic due to complaints of anxiety. Among the statistical population, 60 people were selected by purposive sampling, and this number was randomly selected into two experimental groups (40 people) and a control group (20 people). Accelerated short-term dynamic psychotherapy (AEDP) was implemented for 20 people for 4 90-minute sessions and cognitive behavioral therapy (CBT) was implemented for 20 people for 9 70-minute sessions. In order to collect the research data, Black Ego Function Questionnaire (EFA) was used. The data were analyzed using repeated measures analysis of variance. The significance level of statistical tests was considered 0/05.
Results: The results obtained from the analysis of variance of repeated measures show the significant effect of short-term dynamic psychotherapy accelerated with cognitive behavioral therapy on the improvement of ego functions in patients with generalized anxiety disorder, in the post-test and follow-up phase in the experimental group. compared to the control group (P≤0.01(. According to the comparative comparison between the two educational approaches, accelerated short-term dynamic psychotherapy has been more effective than cognitive behavioral therapy on differentiation.
Conclusion: According to the results of this research, it can be said that one of the basic approaches in improving ego functions in patients with generalized anxiety disorder is short-term dynamic psychotherapy accelerated with cognitive behavioral therapy.

Keywords

Main Subjects


  1. References

    term imepitoin treatment reduces stress level in dogs with generalized anxiety disorder. Journal of Veterinary Behavior. 2020; 38: 67-73. https://doi.org/10.1016/j.jveb.2020.05.006.

    1. Naeinian MR, Shaeiri MR, Sharifi M, Hadian M. To study reliability and validity for a brief measure for assessing generalized anxiety disorder (GAD-7). Biannual Journal of Clinical Psychology & Personality. 2010; 9(1): 41- 50. (In Persian). https://cpcauma3.ir/fa.
    2. Goenka A, Yu SG, Chikkannaiah M, George MC, MacDonald S, Stolfi A, Kumar G. Generalized anxiety disorder: A predictor for poor responsiveness to Botulinum Toxin type a therapy for pediatric migraine. Pediatric Neurology. 2022; 130: 21-27. https://pubmed.ncbi.nlm.nih.gov/35305510.
    3. Buhk A H, Schadegg M J, Dixon L J, Tull M T. Investigating the role of negative and positive emotional avoidance in the relation between generalized anxiety disorder and depression symptom severity. Journal of Contextual Behavioral Science. 2020; 16: 103-108. https://doi.org/10.1016/j.jcbs.2020.03.006.
    4. Wang W, Peng Z, Wang X, Wang P, Li Q, Wang G, et al. Disrupted interhemispheric resting-state functional connectivity and structural connectivity in first-episode, treatment-naïve generalized anxiety disorder. Journal of Affective Disorders. 2019; 251: 280-286. doi: 10.1016/j.jad.2019.03.082.
    5. Fuller-Thomson E, Carrique L, MacNeil A. Generalized anxiety disorder among adults with attention deficit hyperactivity disorder. Journal of Affective Disorders. 2022; 299: 707-714. doi: 10.1016/j.jad.2021.10.020.
    6. Sobański JA, Klasa K, Müldner-Nieckowski Ł, Dembińska E, Smiatek-Mazgaj B, & Rodziński P. Changes in ego strength in patients with neurotic and personality disorders treated with a short-term comprehensive psychodynamic psychotherapy. Psychiatry. 2018; 52(1): 115-127. doi: 10.12740/PP/OnlineFirst/40020.
    7. Petrović ZK, Peraica T, Kozarić-Kovačić D. Comparison of ego strength between aggressive and non-aggressive alcoholics: A cross-sectional study. Croatian Medical Journal. 2018; 59(4): 156-164. doi: 10.3325/cmj.2018.59.156.
    8. Soorani R. The role of spiritual intelligence in the social: Impact of spiritual intelligence on mental health in public high school teachers. jiera. 2018; 12 (Special Issue): 1201–11. [Persian]. https://www.jiera.ir/article_65052.html?lang=en.
    9. Zarei AR, Haghayegh SA. The predict of psychological well-being based on defense mechanisms and adaptation strategies in patients with acquired immunodeficiency syndrome. J Health Psychol. 2016; 5 (20):137 –51. [Persian]. https://journals.pnu.ac.ir/pdf_3496_cb87ea5c91fee98f2a8bafc8bca8cab9.html.
    10. Summers F. Object relations theories and psychopathology: A comprehensive text. Routledge; 2014. https://books.google.com/books?.
    11. Majdara E, Rahimian-Boogar I, Talepasand S, Gregory RJ. Dynamic deconstructive psychotherapy in Iran: A randomized controlled trial with follow-up for borderline personality disorder. Psychoanalytic Psychology. 2021; 38(4): 328–335. https://doi.org/10.1037/pap0000338.
    12. Wolf D, Frederickson J. Intensive short -term dynamic psychotherapy. Washington School of Psychiatry. Retrieved April 8, 2012. From www. davidwolffmd. Com.
    13. Ghanadzadegan F, Rahimian Boogar I, Pourasghar M. Effectiveness of short-term object relation psychotherapy on interpersonal relationships, self-destruct behaviors and personality organization in patients with borderline personality disorder: A clinical trial study. J Gorgan Univ Med Sci. 2020; 22 (4): 30-39
      http://goums.ac.ir/journal/article-1-3731-en.html.
    14. Taghavi F, Mirzaie P, Azandariani M, Rezaei Shojaei S. The Effectiveness of Short-Term Dynamic Psychotherapy on Anxiety, Depression and Happiness in Women with Generalized Anxiety. Medical Journal of Mashhad University of Medical Sciences. 2019; 62, 456- 466. 10.22038/MJMS.2019.15075.
    15. Hojati A, Mojtabaei M, Sarafraz M R. The Effectiveness of Integrated Psychodynamic Group Therapy on Depressed Women's Ego Function. The Islamic Journal of Women and the Family. 2022; 10 (27): 111-126. 4026314012706 (2).pdf.
    16. Moazzami Goudarzi B, Monirpor N, Mirzahoseini H. The he effectiveness of intensive and short-term dynamic psychotherapy on reducing the symptoms and defense mechanisms of obsessive-compulsive and avoidant personality disorders. Medical Journal of Mashhad University of Medical Sciences. 2021; 64 (1): 2482- 2495. 10.22038/MJMS.2021.18145.
    17. Bae JY, Sung HK, Kwon NY, Go HY, Kim TJ, Shin SM, Lee S. Cognitive Behavioral Therapy for Migraine Headache: A Systematic Review and Meta-Analysis. Medicina (Kaunas, Lithuania). 2021; 58(1): 44. DOI: 10.3390/medicina58010044.
    18. Käll A, Bäck M, Welin C, Åman H, Bjerkander R, Wänman M. Therapist-Guided Internet-Based Treatments for Loneliness: A Randomized Controlled Three-Arm Trial Comparing Cognitive Behavioral Therapy and Interpersonal Psychotherapy. Psychotherapy and Psychosomatics. 2021; 90(5): 351-358. doi: 10.1159/000516989. Epub 2021 Jun 28.
    19. Ratanashevorn R, Brown EC. “Alone in the Rain (bow)”: Existential Therapy for Loneliness in LGBTQ+ Clients. Journal of LGBTQ Issues in Counseling. 2021; 15(1): 110-127. https://doi.org/10.1080/15538605.2021.1868375.
    20. kabiri M, Bazzazian S, AmiriMajd M, Ghamari M. Effectiveness of Cognitive Behavioral approach on ego strength and communicational patterns among married women with breast cancer. Health Psychology. 2018; 7 (3): 49-61. https://doi.org/10.30473/hpj.2018.37084.3799.
    21. Aziz MO, Mehrinejad SA, Hashemian K, Paivastegar M. Integrative therapy (short-term psychodynamic psychotherapy & cognitive-behavioral therapy) and cognitive-behavioral therapy in the treatment of generalized anxiety disorder: A randomized controlled trial. Complementary therapies in clinical practice. 2020; 39, 101122.‏ https://doi.org/10.1016/j.ctcp.2020.101122.
    22. Sewart AR, Niles AN, Burklund LJ, Saxbe DE, Lieberman MD, Craske MG. Examining positive and negative affect as outcomes and moderators of cognitive-behavioral therapy and acceptance and commitment therapy for social anxiety disorder. Behavior Therapy. 2019; 50(6): 1112-1124. doi: 10.1016/j.beth.2019.07.001.
    23. Mahoney AE, Hobbs MJ, Newby J, Williams AD, Sunderland M, Andrews G. The Worry Behaviors Inventory: Assessing the behavioral avoidance associated with generalized anxiety disorder. Journal of Affective Disorders. 2016; 203, 256-264. https://doi.org/10.1016/j.jad.2016.06.020.
    24. Kishita N, Laidlaw K. Cognitive behavior therapy for generalized anxiety disorder: Is CBT equally efficacious in adults of working age and older adults? Clinical Psychology Review. 2017; 52, 124-136. https://doi.org/10.1016/j.cpr.2017.01.003.
    25. Sharma P, Mehta M, Sagar R. Efficacy of transdiagnostic cognitivebehavioral group therapy for anxiety disorders and headache in adolescents. Journal of Anxiety Disorders. 46, 78-84. DOI: 10.1016/j.janxdis. 2016; 11.001.
    26. Usefi A, Taher M, Aghae H, Bagherinia H, Sedehi M, Parchami Barjui S, Asadi Amirabadi M R. Body Image Anxiety in Women; Comparison of Two Cognitive-Behavioral and Interpersonal Treatment Approaches, Running Title, Body Image Anxiety in Women. Journal of Sabzevar University of Medical Sciences. 2023; 29(6): 833-846. http://jsums.medsab.ac.ir.
    27. Frederickson J. Co-creating change. Seven Leaves Press; 2013.
    28. Svartberg M, Stiles TC, Seltzer MH. Randomized, controlled trial of the effectiveness of short-term dynamic psychotherapy and cognitive therapy for cluster C personality disorders. American journal of Psychiatry. 2004 May 1; 161(5):810-7. https://doi.org/10.1176/appi.ajp.161.5.810.
    29. Settineri S, Mento C, Santoro D, Mallamace A, Bellinghieri G, Savica V, Ricciardi B, Castellino S, Mallamace D. Ego strength and health: An empiric study in hemodialysis patients. Health. 2012; 4(12): 1328-1333. DOI:10.4236/health.2012.412194.
    30. Singh N, Anand A. EgoStrength and Self-Concept among Adolescents: A Study on Gender Differences. The International Journal of Indian Psychology. 2015; 3 (1): 47-54. https://scholar.google.com/scholar?.
    31. Abbass A, Bechard D. Bringing character changes with Davanloo’s intensive short term dynamic psychotherapy. Ad Hoc Bulletin of Short-Term Dynamic Psychotherapy: Practice and Theory. 2007; January; 11: 26-40. https://www.istdp.ch/sites/default/files/downloadfiles/Abbasbringingcharacter.pdf.