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A Comparative Analysis of the Efficacy of Acceptance and Commitment Therapy (ACT) and Metacognitive Therapy (MCT) on Worry and Quality of Life in Women Diagnosed with Generalized Anxiety Disorder

Document Type : Research Article

Authors

1 Department of Psychology, Semnan Branch, Islamic Azad University, Semnan, Iran

2 Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

Abstract

Background: Generalized Anxiety Disorder (GAD) is characterized by an excessive preoccupation with daily life occurrences and situations. This study aimed to compare the effectiveness of Metacognitive Therapy (MCT) and Acceptance and Commitment Therapy (ACT) in reducing worry and improving the quality of life among women diagnosed with GAD.
Methods: A quasi-experimental study was conducted using a pretest and a 3-month follow-up design. The study participants were women with GAD selected through convenient sampling in Tehran, Iran, from September to November 2022. According to the research design, the participants were divided into experimental and control groups (n=17 in each group). The experimental group underwent a 10-session treatment protocol based on ACT, while the control group did not receive any specific treatment. Data collection was accomplished using the Pennsylvania State Worry Questionnaire (PSWQ) to assess worry, the Brief Generalized Anxiety Disorder Scale (GAD-7) to measure generalized anxiety, and the Quality of Life Questionnaire (QOL) to assess the quality of life. Data analysis was performed using SPSS version 25, utilizing analysis of variance and repeated measures at a significance level of 0.05.
Results: Significant differences were observed between the experimental and follow-up phases among the ACT, MCT, and Control groups concerning environmental health variables (P=0.04). The study’s results indicated significant differences in anxiety variables between the three groups (ACT, MCT, and Control) during the experimental and follow-up phases (P=0.001). No significant differences were noted between the ACT, MCT, and control groups regarding changes in physical health at the post-test (P=0.2) and follow-up (P=0.1) phases. In addition, significant differences were found among the three groups (ACT, MCT, and Control) regarding changes in mental health during the pretest and follow-up (P=0.001). This study also revealed significant disparities in social health variables among the three groups (ACT, MCT, and Control) (P=0.001).
Conclusion: In summary, this study suggested that fostering positive thoughts about worrying may contribute to reducing the severity of anxiety disorders in adults. Intriguingly, mindfulness and a focus on the present moment did not appear to be significantly correlated with mild anxiety experiences.

Highlights

How to Cite: Mostafazadeh P, Sotoudehasl N, Ghorbani R. A Comparative Analysis of the Efficacy of Acceptance and Commitment Therapy (ACT) and Metacognitive Therapy (MCT) on Worry and Quality of Life in Women Diagnosed with Generalized Anxiety Disorder. Women. Health. Bull. 2023;10(4):255-265. doi: 10.30476/WHB.2023.99636.1239.

Keywords

References
  1. Crocq MA. A history of anxiety: from Hippocrates to DSM. Dialogues Clin Neurosci. 2015;17(3):319-25. doi: 10.31887/DCNS.2015.17.3/macrocq. PubMed PMID: 26487812; PubMed Central PMCID: PMC4610616. ##
  2. Aquin JP, El-Gabalawy R, Sala T, Sareen J. Anxiety Disorders and General Medical Conditions: Current Research and Future Directions. Focus (Am Psychiatr Publ). 2017;15(2):173-181. doi: 10.1176/appi.focus.20160044. PubMed PMID: 31975849; PubMed Central PMCID: PMC6526963. ##
  3. Cohen M, Quintner J, van Rysewyk S. Reconsidering the International Association for the Study of Pain definition of pain. Pain Rep. 2018;3(2):e634. doi: 10.1097/PR9.0000000000000634. PubMed PMID: 29756084; PubMed Central PMCID: PMC5902253. ##
  4. Darley A, Coughlan B, Maguire R, McCann L, Furlong E. A bridge from uncertainty to understanding: The meaning of symptom management digital health technology during cancer treatment. Digit Health. 2023;9:20552076231152163. doi: 10.1177/20552076231152163. PubMed PMID: 36714543; PubMed Central PMCID: PMC9880573. ##
  5. Ots T. The angry liver, the anxious heart and the melancholy spleen. The phenomenology of perceptions in Chinese culture. Cult Med Psychiatry. 1990;14(1):21-58. doi: 10.1007/BF00046703. PubMed PMID: 2340732. ##
  6. Junge A, Wellmann K, Zech A. Prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of German first and lower leagues. Scand J Med Sci Sports. 2023;33(9):1866-1873. doi: 10.1111/sms.14426. PubMed PMID: 37309991. ##
  7. LaFreniere LS, Newman MG. Exposing Worry's Deceit: Percentage of Untrue Worries in Generalized Anxiety Disorder Treatment. Behav Ther. 2020;51(3):413-423. doi: 10.1016/j.beth.2019.07.003. PubMed PMID: 32402257; PubMed Central PMCID: PMC7233480. ##
  8. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40(3):879-91. doi: 10.3758/brm.40.3.879. PubMed PMID: 18697684. ##
  9. Zimmerman M, Morgan TA, Stanton K. The severity of psychiatric disorders. World Psychiatry. 2018;17(3):258-275. doi: 10.1002/wps.20569. PubMed PMID: 30192110; PubMed Central PMCID: PMC6127765. ##
  10. Chapoutot M, Peter-Derex L, Bastuji H, Leslie W, Schoendorff B, Heinzer R, et al. Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for the Discontinuation of Long-Term Benzodiazepine Use in Insomnia and Anxiety Disorders. Int J Environ Res Public Health. 2021;18(19):10222. doi: 10.3390/ijerph181910222. PubMed PMID: 34639523; PubMed Central PMCID: PMC8508349. ##
  11. Ahmadi Ghahnaviyeh L, Bagherian B, Feizi A, Afshari A, Mostafavi Darani F. The Effectiveness of Acceptance and Commitment Therapy on Quality of Life in a Patient with Myocardial Infarction: A Randomized Control Trial. Iran J Psychiatry. 2020;15(1):1-9. PubMed PMID: 32377209; PubMed Central PMCID: PMC7193234. ##
  12. Zhang Z, Leong Bin Abdullah MF, Shari NI, Lu P. Acceptance and commitment therapy versus mindfulness-based stress reduction for newly diagnosed head and neck cancer patients: a randomized controlled trial assessing efficacy for positive psychology, depression, anxiety, and quality of life. Plos One. 2022;17(5):e0267887. doi: 1371/journal.pone.0267887. PubMed PMID: 35536828; PubMed Central PMCID: PMC9089868. ##
  13. Moritz S, Klein JP, Lysaker PH, Mehl S. Metacognitive and cognitive-behavioral interventions for psychosis: new developments. Dialogues Clin Neurosci. 2019;21(3):309-317. doi: 10.31887/DCNS.2019.21.3/smoritz. PubMed PMID: 31749655; PubMed Central PMCID: PMC6829173. ##
  14. Wells A. Metacognitive theory and therapy for worry and generalized anxiety disorder: Review and status. Journal of Experimental Psychopathology. 2010;1(1):jep-007910. doi: 5127/jep.007910. ##
  15. Thorslund J, McEvoy PM, Anderson RA. Group metacognitive therapy for adolescents with anxiety and depressive disorders: A pilot study. J Clin Psychol. 2020;76(4):625-645. doi: 10.1002/jclp.22914. PubMed PMID: 31916590. ##
  16. Capobianco L, Faija C, Husain Z, Wells A. Metacognitive beliefs and their relationship with anxiety and depression in physical illnesses: A systematic review. PLoS One. 2020;15(9):e0238457. doi: 10.1371/journal.pone.0238457. PubMed PMID: 32911486; PubMed Central PMCID: PMC7500039. ##
  17. Aydın O, Obuca F, Çakıroğlu E, Ünal-Aydın P, Esen-Danacı A. The evaluation of the effect of mindfulness and metacognition on anxiety symptoms: A case-control study. Eur Psychiatry. 2022;65(Suppl 1):S394–395. doi: 10.1192/j.eurpsy.2022.998. PubMed Central PMCID: PMC9566926. ##
  18. Mohammadi H, Khalatbari J, Abolmaali K. The Effect of Integrating Cognitive-Behavioral Therapy and Mindfulness Therapy on Lifestyle of Women with Irritable Bowel Syndrome. Women Health Bull. 2021;8(4):220-227. doi: 10.30476/whb.2021.91397.1124. ##
  19. Hayes SC, Pistorello J, Levin ME. Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist. 2012;40(7):976-1002. doi: 10.1177/0011000012460836. ##
  20. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7. doi: 10.1001/archinte.166.10.1092. PubMed PMID: 16717171. ##
  21. Omani-Samani R, Ghaheri A, Navid B, Sepidarkish M, Maroufizadeh S. Prevalence of generalized anxiety disorder and its related factors among infertile patients in Iran: a cross-sectional study. Health Qual Life Outcomes. 2018;16(1):129. doi: 1186/s12955-018-0956-1. PubMed PMID: 29914527; PubMed Central PMCID: PMC6006936. ##
  22. Meyer TJ, Miller ML, Metzger RL, Borkovec TD. Development and validation of the Penn State Worry Questionnaire. Behav Res Ther. 1990;28(6):487-95. doi: 10.1016/0005-7967(90)90135-6. PubMed PMID: 2076086. ##
  23. Dehshiri GR, Golzari M, Borjali A, Sohrabi F Psychometrics particularity of farsi version of Pennsylvania state worry questionnaire for college students. Journal of Clinical Psychology. 2010;1:67-75. doi: 22075/JCP.2017.1988. Persian. ##
  24. World Health Organization. WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment: field trial version; 1996. Available from: https://apps.who.int/iris/handle/10665/63529. ##
  25. Nejat S, Montazeri A, Holakouie Naieni K, Mohammad K, Majdzadeh S. The World Health Organization quality of Life (WHOQOL-BREF) questionnaire: Translation and validation study of the Iranian version. sjsph. 2006;4(4):1-12. Persian. ##
  26. Mohagheghi H, Dousti P, Jafari D. The effectiveness of acceptance and commitment therapy on reduction, generalized anxiety disorder, social phobia and health anxiety in students. Clinical Psychology Studies. 2016;6(23):81-94. doi: 10.22054/jcps.2016.4559. ##
  27. Petersen JM, Davis CH, Renshaw TL, Levin ME, Twohig MP. School-based acceptance and commitment therapy for adolescents with anxiety: A pilot trial. Cognitive and Behavioral Practice. 2023;30(3):436-452. doi: 10.1016/j.cbpra.2022.02.021. ##
  28. Kelson J, Rollin A, Ridout B, Campbell A. Internet-Delivered Acceptance and Commitment Therapy for Anxiety Treatment: Systematic Review. J Med Internet Res. 2019;21(1):e12530. doi: 10.2196/12530. PubMed PMID: 30694201; PubMed Central PMCID: PMC6371070. ##
  29. Barreto M, Gaynor ST. A single-session of acceptance and commitment therapy for health-related behavior change: Protocol description and initial case examples. Behavior Analysis: Research and Practice. 2019;19(1):47-59.  doi: 10.1037/bar0000093. ##
  30. Mansouri A, Korozhde N, Miri S. The Effectiveness of Acceptance and Commitment Therapy (ACT) on the Symptoms of Generalized Anxiety Disorder (GAD) in Mothers of Children with Autism Spectrum Disorder. Clinical Psychology Achievements. 2017;2(4):1-20. doi: 10.22055/jacp.2018.23820.1055. Persian. ##
  31. Fledderus M, Bohlmeijer ET, Pieterse ME, Schreurs KM. Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: a randomized controlled trial. Psychol Med. 2012;42(3):485-95. doi: 10.1017/S0033291711001206. PubMed PMID: 21740624. ##
  32. Nordahl HM, Borkovec TD, Hagen R, Kennair LEO, Hjemdal O, Solem S, et al. Metacognitive therapy versus cognitive-behavioural therapy in adults with generalised anxiety disorder. BJPsych Open. 2018;4(5):393-400. doi: 10.1192/bjo.2018.54. PubMed PMID: 30294448; PubMed Central PMCID: PMC6171331. ##
  33. van der Heiden C, Muris P, van der Molen HT. Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder. Behav Res Ther. 2012;50(2):100-9. doi: 10.1016/j.brat.2011.12.005. PubMed PMID: 22222208. ##
  34. Javandel Someesaraee R, Zare S, Zare S. The Effectiveness of Teaching Metacognitive Strategies on the Emotional Processing in Patients with Generalized Anxiety Disorder. Iranian Journal of Learning and Memory. 2019;2(6):19-25. doi: 22034/iepa.2019.198119.1121. Persian. ##
  35. Naderi Lordegani M, Chorami M. The Effectiveness of Meta-Cognitive Training on Quality of Life and Psychological Hardiness of Red Crescent Relief Rescuer Workers. Positive Psychology Research. 2021;6(4):81-92. doi: 22108/ppls.2021.117405.1754. ##
  36. Sandin K, Gjengedal RGH, Osnes K, Hannisdal M, Berge T, Leversen JSR, et al. Metacognitive therapy and work-focused interventions for patients on sick leave due to anxiety and depression: study protocol for a randomised controlled wait-list trial. Trials. 2021;22(1):854. doi: 10.1186/s13063-021-05822-4. PubMed PMID: 34838125; PubMed Central PMCID: PMC8626756. ##
  37. Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017;19(2):93-107. doi: 10.31887/DCNS.2017.19.2/bbandelow. PubMed PMID: 28867934; PubMed Central PMCID: PMC5573566. ##
  38. Nayinian MR, Shairi M, Sharifi 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. ##
Women’s Health Bulletin
Volume 10, Issue 4 - Serial Number 40
October 2023
Pages 255-265
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