The efficacy of integrated meta-diagnosis therapy on their differentiation and the difficulty of regulating excitement in patients with anxiety syndrome

Document Type : Research Paper

Authors

1 M.Sc, Family Counseling, Faculty of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.

2 Professor, Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.

3 Associate Professor of Psychology, Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.

Abstract

Introduction: integrated meta-diagnosis therapy a structured and short-term approach designed to improve emotional, cognitive, and behavioral problems. This protocol emphasizes how to experience and respond to excitements, which seeks to improve the non-matching efforts of excitement, cognition and behavior                                                                                                                                           
Methods: This study aimed to The efficacy of integrated meta-diagnosis therapy on    their differentiation and the difficulty of regulating excitement in patients with anxiety syndrome  The research method was quasi-experimental, with pre-monogram-post-sampling design. The sampling method was available with a sample of 24 subjects. After a structured interview, and the implementation of the Squaren self-differentiation    questionnaire and the difficulty in regulating the excitement of Gross, they were randomly assigned to two experimental and control groups                  
Result: the   results showed that Barlow's integrated diagnostic protocol not only increased the level of differentiation in the experimental group compared to the control group, but also significantly reduced the level of difficulty of the excitement of the experimental group compared to the control group Gets                                                                                                                                                                
Conclusion: As a result, whileintegrated meta-diagnosis therapy increases the degree of differentiation that leads to improved emotional regulation, there is also a negative correlation between the level of differentiation and the difficulty of adjusting the excitement, and with increasing differentiation, the difficulty of adjusting thrill decreases. 

Keywords


 
1- Barlow DH, editor. Clinical handbook of psychological disorders: A step-by-step treatment manual. Guilford publications; 2014 Feb 27.
2- Gross JJ, Jazaieri H. Emotion, emotion regulation, and psychopathology: An affective science perspective. Clinical Psychological Science 2014; 2(4):387-401.
3- Basharat, Mohammad Ali, Farahmand, Hadi. The mediating role of difficulties in emotion regulation on the relationship between attachment pathologies and symptoms of depression and anxiety. Thought and Behavior in Clinical Psychology 2017; 11:44. (Persian)
4- Omran MP. Relationships between cognitive emotion regulation strategies with depression and anxiety. Open Journal of Psychiatry 2011; 1(03):106.
5- Roemer L, Lee JK, Salters-Pedneault K, Erisman SM, Orsillo SM, Mennin DS. Mindfulness and emotion regulation difficulties in generalized anxiety disorder: Preliminary evidence for independent and overlapping contributions. Behavior therapy 2009; 40(2):142-54.
6- Mirzaie K, Abdollahi M H, Shahgholian M. The Relationship between Metacognitive Beliefs, Social Anxiety and Shyness: The Role of Emotion Regulation Strategies. Rph  2014; 7 (2) :13-22.(Persian)
7- Rodríguez-González M, Skowron EA, Cagigal de Gregorio V, Muñoz San Roque I. Differentiation of self, mate selection, and marital adjustment: Validity of postulates of Bowen theory in a Spanish sample. The American Journal of Family Therapy. 2016; 44(1):11-23.
8- Ellard KK, Fairholme CP, Boisseau CL, Farchione TJ, Barlow DH. Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice 2010; 17(1):88-101.
9- Craske MG. Transdiagnostic treatment for anxiety and depression. Depression and anxiety 2012; 29(9):749-53.
10- Alferd A, Nikson-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A metaanalytic review. Clin Psychol Rev 2010; 30:217-37.
11- Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Conklin LR, Boswell JF, Ametaj A. The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA psychiatry 2017; 74(9):875-84.
12- Krycak RC, Murdock NL, Marszalek JM. Differentiation of self, stress, and emotional support as predictors of psychological distress. Contemporary Family Therapy 2012; 34(4):495-515.
13- Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment 2004; 26(1):41-54.
14- Coutinho J, Ribeiro E, Ferreirinha R, Dias P. The Portuguese version of the Difficulties in Emotion Regulation Scale and its relationship with psychopathological symptoms. Archives of Clinical Psychiatry (São Paulo) 2010; 37(4):145-51.

15- Mirzaie K, Abdollahi MH, Shahgholian M. The Comparison of Confirmatory Factor Analysis Approach and Exploratory Structural Equation Modeling in the Evaluation of Factor Structure of Difficulties in Emotion Regulation Scale. Journal of Research in Behavioural Sciences 2015; 25(1):572-580.(Persian) 

16- Skowron EA, Schmitt TA. Assessing interpersonal fusion: Reliability and validity of a new DSI fusion with others subscale. Journal of marital and family therapy 2004; 29(2):209-22.
17- Friedland TA, Skowren EA. Bowen theory: A study of differentiation of self, social anxiety, and physiological symptoms. Contemporary Family Therapy 2002; 24(2):355-69.
18- Pashasharifi H, Manavipour D, Askari F. Review of psychometric properties of DSI scale. Cognitive Analytical Psychological Quarterly 2014; 5(18):9-22 .‎(Persian)
19- Yousefi N, Etemadi O, BAHRAMI F, Fatehzadeh M, AHMADI SA, Beshlideh K. Structural relationships between self-differentiation and subjective wellbeing, mental health and marital quality 2009; 3(2): 4-14. (Persian)
20- Roemer L, Lee JK, Salters-Pedneault K, Erisman SM, Orsillo SM, Mennin DS. Mindfulness and emotion regulation difficulties in generalized anxiety disorder: Preliminary evidence for independent and overlapping contributions. Behavior therapy 2009; 40(2):142-54.
21- Azizi A, Borjali A, Golzari M. The effectiveness of emotion regulation training and cognitive therapy on the emotional and addictional problems of substance abusers. Iranian Journal of Psychiatry 2010; 5(2):60. (Persian)
22- Alavi K, Modarres GM, Amin YS, Salehi FJ. Effectiveness of group dialectical behavior therapy (based on core mindfulness, distress tolerance and emotion regulation components) on depressive symptoms in university students. Journal of Fundamentals of Mental Health  2011; 13(2):124-135. (Persian)
23- Salehi A, Baghban I, Bahrami F, Ahmadi SA. The effect of emotion regulation training based on dialectical behavior therapy and gross process model on symptoms of emotional problems. Zahedan Journal of Research in Medical Sciences 2012; 14(2):49-55. (Persian)
24- Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review 2010; 30(2):217-37.
25- Joormann J, Gotlib IH. Emotion regulation in depression: Relation to cognitive inhibition. Cognition and Emotion 2010; 24(2):281-98.
26- Widdershoven RL, Wichers M, Kuppens P, Hartmann JA, Menne-Lothmann C, Simons CJ, Bastiaansen JA. Effect of self-monitoring through experience sampling on emotion differentiation in depression. Journal of affective disorders 2019; 244:71-7.
27- Mohammadi A, Birashk B, Gharaie B. Comparison of the effect of group transdiagnostic therapy and group cognitive therapy on anxiety and depressive symptoms. Iranian journal of public health 2013; 42(1):48. (Persian)
28- Lotfi M, Bakhtiyari M, Asgharnezhad-Farid AA, Amini M. Comparison of the effect of transdiagnostic Therapy and cognitive-behavior therapy on patients with emotional disorders: A randomized clinical trial. Zahedan Journal of Research in Medical Sciences 2014; 16(10):15-8. (Persian)
29- Akbari M, Roshan R, Shabani A, Fata L, Shairi MR, Zarghami F. Transdiagnostic treatment of co-occurrence of anxiety and depressive disorders based on repetitive negative thinking: A case series. Iranian journal of psychiatry 2015; 10(3):200. (Persian)
30- Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson-Hollands J, Carl JR, Gallagher MW, Barlow DH. Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior therapy 2012; 43(3):666-78.
31- Bullis JR, Fortune MR, Farchione TJ, Barlow DH. A preliminary investigation of the long-term outcome of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Comprehensive psychiatry 2014; 55(8):1920-7.
32- Titov N, Dear BF, Schwencke G, Andrews G, Johnston L, Craske MG, McEvoy P. Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial. Behaviour research and therapy 2011; 49(8):441-52.
33- Jankowski PJ, Hooper LM. Differentiation of self: A validation study of the Bowen theory construct. Couple and Family Psychology: Research and Practice 2012; 1(3):226.
34- Barlow DH, Farchione TJ, Sauer-Zavala S, Latin HM, Ellard KK, Bullis JR, Bentley KH, Boettcher HT, Cassiello-Robbins C. Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. Oxford University Press; 2017 Nov 17.
35- Zemestani M, Imani M, Ottaviani C. A preliminary investigation on the effectiveness of unified and transdiagnostic cognitive behavior therapy for patients with comorbid depression and anxiety. International Journal of Cognitive Therapy 2017; 10(2):175-85. (Persian)
36- Zenoozian S, Birashk B, Gharraee B, Asgharnejad Farid AA. Comparison of transdiagnostic group therapy with cognitive group therapy in university students with adjustment disorder. International Journal of Psychology (IPA) 2013; 7(2).
37- Mazaheri M, Daghaghzadeh H, Afshar H, Mohammadi N. The effectiveness of the unified protocol on emotional dysregulation and cognitive emotion regulation strategies in patients with psychosomatic disorders. International Journal of Body, Mind and Culture 2013; 1(1):73-82. (Persian)
38- Abasi I, Fata L, Sadeghi M, Banihashemi S, Mohammadee A. A comparison of transdiagnostic components in generalized anxiety disorder, unipolar mood disorder and nonclinical population. depression 2013; 8:22-3. (Persian)
39- Masjedi A, Saed O, Taremian F, Bakhtyari M, Morsali Y. The efficacy of Transdiagnostic Cognitive Behavior therapy on reducing symptoms severity of Obsessive Compulsive Disorder with co-occurring anxiety and mood disorders. International Journal of Applied Behavioral Sciences 2016; 2(4):1-0. (Persian)
40- Roushani K, Nejad SB, Arshadi N, Honarmand MM, Fakhri A. Examining the efficacy of the unified transdiagnostic treatment on social anxiety and positive and negative affect in students. Razavi International Journal of Medicine, 4 (4). 2016 Nov. (Persian)
41- Mohajerin B, Bakhtiyar M, Olesnycky OS, Dolatshahi B, Motabi F. Application of a transdiagnostic treatment for emotional disorders to body dysmorphic disorder: A randomized controlled trial. Journal of affective disorders 2019; 245:637-44. (Persian)
42- Boswell JF, Farchione TJ, Sauer-Zavala S, Murray HW, Fortune MR, Barlow DH. Anxiety sensitivity and interoceptive exposure: a transdiagnostic construct and change strategy. Behavior therapy 2013; 44(3):417-31.
43- Ellard KK, Fairholme CP, Boisseau CL, Farchione TJ, Barlow DH. Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice 2010; 17(1):88-101.
44- Sauer-Zavala S, Boswell JF, Gallagher MW, Bentley KH, Ametaj A, Barlow DH. The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders. Behaviour research and therapy 2012; 50(9):551-7.
45- Leichsenring F, Salzer S. A unified protocol for the transdiagnostic psychodynamic treatment of anxiety disorders: An evidence-based approach. Psychotherapy 2014; 51(2):224.
46- Norton PJ, Paulus DJ. Toward a unified treatment for emotional disorders: update on the science and practice. Behavior Therapy 2016; 47(6):854-68.
47- Fernandez KC, Jazaieri H, Gross JJ. Emotion regulation: a transdiagnostic perspective on a new RDoC domain. Cognitive therapy and research 2016; 40(3):426-40.