Medical Journal of Mashhad university of Medical Sciences

Medical Journal of Mashhad university of Medical Sciences

Comparing the Efficacy of Systematic Desensitization and expressive Desensitization on Generalized Anxiety Disorder and exam Anxiety among Students

Document Type : Research Paper

Authors
Mozhgan badiee aval 1
batoul bahrami 2
mitra rafiee shafigh 3
1 Postdoc Student in psychosomatic medicine and Psychotherapy, University of Freiburg, Germany / Mashhad University of Medical Sciences, Mashhad, Iran
2 M.A. in general Psychology, medical School, Mashhad University of Medical Sciences, Mashhad, Iran
3 PhD student in Health Psychology, Islamic Azad University, Torbat-e- Jam Branch, Torbat-e- Jam, Iran
10.22038/mjms.2021.17805
Abstract
Abstract
Introduction: The aim of this study was to compare the effectiveness of systematic desensitization and expressive desensitization on general anxiety and exam anxiety in students.
Material and Methods:The present study was a quasi-experimental study with a pre-test-post-test design and the statistical population was all high school students referred to a private psychology clinic in Mashhad in the first half of 2020 (suffering from generalized anxiety disorder with comorbid exam anxiety disorder) using the Cochran statistical formula 20 people with systematic desensitization method and 20 people with expressive desensitization method and 20 people in the control group were randomly assigned. The treatment was performed in 11 sessions of 90 minutes, weekly and individually for all individuals (except the control group) by the first author (with 8-month follow-up). Measurement tools included the Beck-II Anxiety and the Sarason exam Anxiety Questionnaires. Statistical analysis of data was performed using SPSS-23 software.
Results:Multivariate analysis of covariance showed that systematic desensitization and expressive desensitization methods were effective in improving exam anxiety in the post-test and follow-up phase (8 months) (p <0.001) and also between the two experimental groups in post-test and follow-up scores (8 months) exam anxiety did not show a significant difference (p> 0.05). The results also showed that the expressive desensitization method significantly improved the general anxiety among subjects (p <0.001), but there was not observed a significant difference between the two groups of systematic desensitization and control group in the post-test and follow-up scores (8 months) (p <0.05).
Conclusion: expressive desensitization is an effective and new way to improve general anxiety disorder with and without correlation of exam anxiety.
Keywords
General Anxiety
Exam Anxiety
systematic desensitization
expressive desensitization
  1. Iverach L, Jones M, McLellan LF, Lyneham HJ,
    Menzies RG, Onslow M, Rapee RM. Prevalence of
    anxiety disorders among children who stutter.
    Journal of Fluency Disorders. 2016 Sep 1;49:13-28.
  2. 2. James, A. C., James, G., Cowdrey, F. A., Soler, A.,
    & Choke, A. Cognitive behavioural therapy for
    anxiety disorders in children and
    adolescents. Ebates Systematic Reviews, 2015, 2.
    DOI:10.1002/14651858.CD004690.pub4.
    3. Garnefski N, Legerstee J, Kraaij V, van Den
    Kommer T, Teerds JA. Cognitive coping strategies
    and symptoms of depression and anxiety: A
    comparison between adolescents and adults.
    Journal of adolescence. 2002 Dec 1;25(6):603-11.
    4. Peterman JS, Carper MM, Kendall PC. Anxiety
    disorders and comorbid sleep problems in schoolaged youth: review and future research directions.
    Child Psychiatry & Human Development. 2015
    Jun;46(3):376-92.
    5. Samalot-Rivera A. The effect of social skill
    instruction on sport and game related behaviors of
    children and adolescents with emotional or
    behavioral disorders (Doctoral dissertation, The
    Ohio State University).
    6. Schimmenti A, Bifulco A. Linking lack of care in
    childhood to anxiety disorders in emerging
    adulthood: the role of attachment styles. Child and
    Adolescent Mental Health. 2015 Feb;20(1):41-8.
    7. Von Der Embse N, Barterian J, Segool N. Test
    anxiety interventions for children and adolescents:
    A systematic review of treatment studies from
    2000–2010. Psychology in the Schools. 2013
    Jan;50(1):57-71.
    8. Segool NK, Carlson JS, Goforth AN, Von Der
    Embse N, Barterian JA. HEIGHTENED TEST
    ANXIETY AMONG YOUNG CHILDREN:
    ELEMENTARY SCHOOL
    STUDENTS’ANXIOUS RESPONSES TO
    HIGH‐STAKES TESTING. Psychology in the
    Schools. 2013 May;50(5):489-99.
    9. Cunha M, Paiva MJ. Text anxiety in adolescents:
    The role of self-criticism and acceptance and
    mindfulness skills. The Spanish journal of
    psychology. 2012 Jul;15(2):533-43.
    10. Fathi A, Barmehziar S, Mohebi S. Survey Test
    Anxiety in Pre-university Students in Qom and Its
    Related Factors in 2016. Education Strategies in
    Medical Sciences. 2017 Oct 10;10(4):270-6.
    11. Karami M, Dehdashti A & Bahrami M. Prevalence
    of test anxiety in students of Semnan University of
    Medical Sciences in 2016: A short report. Journal
    of Rafsanjan University of Medical Sciences, June
    2018; 17: 282-275. (Persian).
    12. Saeid N. Determining the role of emotion
    regulation in predicting test anxiety and student
    problem solving ability. medical journal of
    mashhad university of medical sciences. 2019 Nov
    22;62(December):74-83.
    13. Sieber JE. Defining test anxiety: Problems and
    approaches. Test anxiety: Theory, research, and
    applications. 1980:15-40.
    14. Eum K, Rice KG. Test anxiety, perfectionism,
    goal orientation, and academic performance.
    Anxiety, Stress, & Coping. 2011 Mar
    1;24(2):167-78.
    15. Bodas J, Ollendick TH. Test anxiety: A crosscultural perspective. Clinical Child and Family
    Psychology Review. 2005 Mar;8(1):65-88.
    16. Spielberger CD, Anton WD, Bedell J. The nature
    and treatment of test anxiety. Emotions and
    anxiety: New concepts, methods, and applications.
    2015 May 1:317-44.
    17. Badali R, Aghdasi AN. The Investigation of the
    Group-Therapeutically Effect on the Selection
    Theory to Reduce the Students’ Examination
    Anxiety. International Journal of Educational
    Sciences. 2017 Sep 2;18(1-3):175-80.
    18. Safikhani A, Najian Tabriz N, Mordadi H, Khezri
    Moghadam N, Fazilatpour H, Derakhtkar A.
    Effectiveness of group psychotherapy based on
    acceptance and commitment on test anxiety of dual
    citizenship students with test anxiety in the second
    half of 2017 in Shiraz. Journal of Zanko Medical
    Sciences. 2019 Apr 10; 20 (64): 64-73. (Persian).
    19. Pourhamidi S, Rezaei A, Baqoli H. Comparison of
    the effectiveness of cognitive-behavioral therapy
    and cognitive-behavioral hypnotherapy in reducing
    the symptoms of anxiety and improving the quality
    of life of first-year high school students with test
    anxiety. Journal of Psychological Methods and
    Models. 2019 May 22; 10 (35): 17-39. (Persian).
    20. SHEYDAEI AS, FATEMIPUOR H. THE EFFECT
    OF MINDFULNESS TRAINING ON REDUCING
    STUDENTS’TEST ANXIETY.
    21.Jenaabadi H, Nastiezaie N, Jalalzaei S. The effect
    of time management training on student’s test
    anxiety. Journal of nursing education. 2016 May
    10;5(1):12-22.
    22. Keshavarz Afshar, H, Haj Hosseini, M & Ghadimi,
    S. The effect of Gestalt therapy on generalized
    anxiety and student test anxiety. Quarterly Journal
    of Culture, Counseling and Psychotherapy, Winter
    2016, 7 (28): 102-85. (Persian).
    23.Can PB, Dereboy Ç, Eskın M. Comparison of the
    Effectiveness of Cognitive Restructuring and
    Systematic Desensitization in Reducing HighStakes Test Anxiety. Turkish Journal of Psychiatry.
    2012 Mar 1;23(1).
    24. Sapp M. Test anxiety: Applied research,
    assessment, and treatment interventions. University
    Press of America; 2013 Nov 20.
    25. Dodeen H. Assessing test‐taking strategies of
    university students: developing a scale and
    estimating its psychometric indices. Assessment &
    Evaluation in Higher Education. 2008 Aug
    1;33(4):409-19.
    26. Peterfreund, E. The process of psychoanalytic
    therapy: Models and strategies. Journal of the
    American Psychoanalytic Association, 2016, 33,
    250-253. Doi: 10.1177/0003065116669938.
    27. Schröder, T., Cooper, A., & Naidoo, R. 7 Intensive
    Short-term Dynamic Psychotherapy
    (ISTDP). Formulation in Action: Applying Psychological Theory to Clinical Practice, 2015,
    99. DOI: 10.1515/9783110471014-009.
    28. Sifneos PE. Short-term dynamic psychotherapy:
    Evaluation and technique. Springer Science &
    Business Media; 2013 Nov 22.
    29. Otmer, Z. & Otmer, A. Principles of Clinical
    Interview Based on DSM-5 Volume One: Basic
    Principles. 2018, Arjmand Pub.
    30. H Hamidpour H, Dolatshai B, Shahbaz AP,
    Dadkhah A. The efficacy of schema therapy in
    treating women's Generalized Anxiety disorder.
    Iranian journal of psychiatry and clinical
    psychology. 2011.
    31.Beck AT, Steer RA, Carbin MG. Psychometric
    properties of the Beck Depression Inventory:
    Twenty-five years of evaluation. Clinical
    psychology review. 1988 Jan 1;8(1):77-100.
    32. Kaviani H, Mousavi AS. Psychometric properties
    of the Persian version of Beck Anxiety Inventory
    (BAI). Tehran University Medical Journal. 2008
    May.
    33. Sarason IG. The test anxiety scale: Concept and
    research (No. SCS-CS-003). Washington Univ
    Seattle Dept Of Psychology. ISO. 1977;690:1-44.
    34.Beyabangard, A. Test Anxiety. 2nd ed. Tehran:
    Farhange Eslami Press. 2007.
    35. Sapp M. Cognitive-behavioral counseling:
    Applications for African-American middle school
    students who are academically at-risk. Journal of
    Instructional Psychology. 1994 Jun 1;21(2):161.
    36. Prochaska JO, Norcross JC. Systems of
    psychotherapy: A transtheoretical analysis. Oxford
    University Press; 2018 Feb 1.
    37. McCullough L. Short‐term psychodynamic therapy
    as a form of desensitization: Treating affect
    phobias. In Session: Psychotherapy in Practice:
    Psychotherapy in Practice. 1999 Dec;4(4):35-53.
    38. Abdel-Wahab RG. The Impact of Flooding and
    Systematic Desensitization Therapy on Reducing
    Social Anxiety Disorder among Student Teachers
    (Doctoral dissertation, Fayoum University).
    39.Bulantika SZ, Wibowo ME, Jafar M. Group
    counseling with systematic desensitization
    techniques and thought-stopping techniques to
    reduce social anxiety. Jurnal Bimbingan Konseling.
    2018 Sep 6;7(2):106-12.
    40. Spielberger CD, editor. Anxiety: Current trends in
    theory and research. Elsevier; 2013 Oct 22.
    41.Iossi L. Strategies for reducing math anxiety in
    post-secondary students.
    42. Szafranski DD, Barrera TL, Norton PJ. Test anxiety
    inventory: 30 years later. Anxiety, Stress & Coping.
    2012 Nov 1;25(6):667-77.
    43.Brown LA, Forman EM, Herbert JD, Hoffman KL,
    Yuen EK, Goetter EM. A randomized controlled
    trial of acceptance-based behavior therapy and
    cognitive therapy for test anxiety: A pilot study.
    Behavior modification. 2011 Jan;35(1):31-53.
    44.Benor DJ, Ledger K, Toussaint L, Hett G, Zaccaro
    D. Pilot study of emotional freedom techniques,
    wholistic hybrid derived from eye movement
    desensitization and reprocessing and emotional
    freedom technique, and cognitive behavioral
    therapy for treatment of test anxiety in university
    students. Explore. 2009 Nov 1;5(6):338-40.
    45. Mardpour A, Najafi M & RafatMah M.
    Comparison of the effectiveness of systematic
    desensitization therapies, study skills and
    combination methods to reduce test anxiety. Journal
    of Clinical Psychology, Spring 2012, Fourth Year,
    1 (13): 64-55. (Persian).
    46. Pecoraro A. Cognitive behavioral, psychoanalytic,
    and psychophysiological factors associated with
    high test anxiety among college students. ProQuest;
    2007.
    47. Obi JS, Oguzie AE. Effects of systematic
    desensitization technique on generalized anxiety
    among adolescents in Enugu East Local
    Government. Enugu State, Nigeria. iJournals:
    International Journal of Social Relevance &
    Concern. 2019;7(5):1-9.
    48. Docan-Morgan T, Schmidt T. Reducing public
    speaking anxiety for native and non-native English
    speakers: The value of systematic desensitization,
    cognitive restructuring, and skills training. CrossCultural Communication. 2012 Oct 31;8(5):16-9.
    49. Zettle RD. Acceptance and commitment therapy
    (ACT) vs. systematic desensitization in treatment of
    mathematics anxiety. The psychological record.
    2003 Apr;53(2):197-215.
    50. Morakinyo A. Relative efficacy of systematic
    desensitization, self statement monitoring and
    flooding on students test anxiety. Unpublished
    PhD. Thesis. University of Ibadan. 2003.
Medical Journal of Mashhad university of Medical Sciences
Volume 64, Issue 1
March and April 2021
Pages 2265-2276