Effectiveness of Spirituality-based Schema Therapy on Worry, Quality of Life, and Mental Well-being of Women with Generalized Anxiety Disorder

Document Type : Original Article

Authors

1 Department of Psychology, Faculty of Psychology, Islamic Azad University, Gachsaran Branch. Gachsaran, Iran

2 Associate Professor, Department of Psychology, Faculty of Psychology, Islamic Azad University, Gachsaran Branch. Gachsaran, Iran

3 Department of Clinical Psychology, Faculty of Psychology and Educational Science, Kharazmi University, Tehran, Iran

4 PhD student in Psychology and Education of Exceptional Children, Faculty of Psychology and Educational Sciences, Tehran University, Tehran, Iran

5 Department of Psychology, Faculty of Psychology, Payame Noor University, Islamshahr Branch, Islamshahr, Iran

Abstract

Background: Chronic generalized anxiety disorder is challenging to manage and often presents itself with a variety of psychological and physical symptoms.
 
Objectives: This study aimed to explore how spirituality-based schema therapy impacts worry, quality of life, and mental well-being in women dealing with generalized anxiety disorder.
 
Methods: This study was carried out with a semi-experimental design, consisting of a pre-test, post-test, and a follow-up period of three months. The statistical population for this study was women with generalized anxiety disorder who referred to psychology and counseling clinics in Tehran, Iran, between July and November 2023. This study involved 26 participants who were selected through purposive sampling. The intervention group participated in ten 90-minute sessions twice a week, whereas the control group did not undergo any interventions. The used assessment tools were the World Health Organization Quality-of-Life Scale, Ryff's Psychological Well-Being Scales, and the State Worry Questionnaire. Statistical analysis of data was conducted using repeated measure ANOVA and MANCOVA tests in SPSS software (version 27).
 
Results: Based on the findings, self-acceptance, relationship with others, and autonomy underwent significant changes at the post-test and follow-up stages, compared to the pre-test stage (P<0.05). However, a significant contrast was noted in the psychological health component between the pre-test and the follow-up stages (P<0.001).
 
Conclusion: Based on the findings, spirituality-based schema therapy had a notable impact on the decrease of anxiety and improvement of mental well-being in women with disorders, as well as enhancement of self-acceptance, positive relationships with others, and autonomy in the short run. 

Keywords

Acknowledgments: The authors express their gratitude to the staff at psychological clinics in Tehran and the participants in the study. The research received approval from the Islamic Azad University, Science and Research Branch, with the Ethics Code: IR.IAU.SRB.REC.1402.132. 

 

Availability of data and materials: The corresponding author can provide the information upon request either during the submission process or after the article has been published.

 

Conflicts of interests: Researchers verify that the research was conducted without any conflicts of interest related to commercial or financial matters.

 

Consent for publication: The Authors give permission to the Publisher to publish the Work by signing the Consent to Publish form and sending it to the Publisher.

 

Ethics approval and consent to participate: The research received approval from the

Islamic Azad University, Science and Research Branch, with the Ethics Code: IR.IAU.SRB.REC.1402.132. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.

 

Financial disclosure: The research project did not receive any funding from any institution.

 

Author contributions: M. H. T: Contributed to the conception of the work, revising the draft; S.A.: Approving the final version of the manuscript, M. H. T: Agreeing on all aspects of the work; F.R. B.: Contributed to the data analysis and interpretation, critical revision, and approval of the final version of the manuscript; F. N.: Contributed to acquiring data, drafting the manuscript, and approving the final version; M. H. T. and M. KH.: Contributed to the conception and design of the study, critical revision, and approval of the manuscript's final version; F. N.: Contributed to the conception and design of the study, data interpretation, drafting of the manuscript and critical revision, and approval of final version.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

References

1. Xiong, Z., X. Weng, and Y. Wei, SandplayAR: Evaluation of psychometric game for people with generalized anxiety disorder. The Arts in Psychotherapy, 2022. 80: p. 101934.
https://doi.org/10.1016/j.aip.2022.101934
 
2. Dursun, P., P. Alyagut, and I. Yılmaz, Meaning in life, psychological hardiness and death anxiety: individuals with or without generalized anxiety disorder (GAD). Current psychology, 2022. 41(6): p. 3299-3317.
https://doi.org/10.1007/s12144-021-02695-3
PMid:35035188 PMCid:PMC8742667  
 
3. Peimanpak, F., M. Pourshahriari, and A. Abdollahi, Comparison of the Effectiveness of Paradoxical Timetable Therapy and Cognitive Behavioral Therapy on Reducing Symptoms in Women with Generalized Anxiety Disorder. Women and Family Studies, 2023. 16(59).  
 
4. Böhlen, F., et al., Gender-specific predictors of generalized anxiety disorder symptoms in older adults. 2020.
https://doi.org/10.1016/j.jad.2019.10.025
PMid:31668601  
 
5. Hirsch, C.R., et al., Internet-delivered interpretation training reduces worry and anxiety in individuals with generalized anxiety disorder: A randomized controlled experiment. Journal of Consulting and Clinical Psychology, 2021. 89(7): p. 575.
https://doi.org/10.1037/ccp0000660
PMid:34383532  
 
6. Kim, H. and M.G. Newman, Worry and rumination enhance a positive emotional contrast based on the framework of the Contrast Avoidance Model. Journal of anxiety disorders, 2023. 94: p. 102671. (PubMed: 36681058).
https://doi.org/10.1016/j.janxdis.2023.102671
PMid:36681058 PMCid:PMC10071830  
 
7. Krahé, C., et al., Are different forms of repetitive negative thinking associated with interpretation bias in generalized anxiety disorder and depression? Clinical Psychological Science, 2019. 7(5): p. 969-981
https://doi.org/10.1177/2167702619851808  
 
8. Parkinson, S., What maintains generalized anxiety disorder? Examining intolerance of uncertainty and negative beliefs about worry. 2022.  
 
9. Budikayanti, A., et al., Screening of generalized anxiety disorder in patients with epilepsy: Using a valid and reliable Indonesian version of generalized anxiety disorder-7 (GAD-7). Neurology research international, 2019. 2019.
https://doi.org/10.1155/2019/5902610
PMid:31275648 PMCid:PMC6582805  
 
10. Sierżantowicz, R., J.R. Ładny, and J. Lewko, Quality of life after bariatric surgery-a systematic review. International Journal of Environmental Research and Public Health, 2022. 19(15): p. 9078.
https://doi.org/10.3390/ijerph19159078
PMid:35897447 PMCid:PMC9330722  
 
11. Huang, C.W., et al., Prevalence and risk factors for elevated anxiety symptoms and anxiety disorders in chronic kidney disease: a systematic review and meta-analysis. General hospital psychiatry, 2021. 69: p. 27-40..(PubMed: 33516963).
https://doi.org/10.1016/j.genhosppsych.2020.12.003
PMid:33516963  
 
12. Wilmer, M.T., K. Anderson, and M. Reynolds, Correlates of quality of life in anxiety disorders: review of recent research. Current psychiatry reports, 2021. 23: p. 1-9.(PubMed: 34613508).
https://doi.org/10.1007/s11920-021-01290-4
PMid:34613508 PMCid:PMC8493947  
 
13. Sarabadani, A., R. Hassanzadeh, and S.O. Emadian, Comparison of the Effectiveness of Cognitive Therapy Based on Mindfulness and Life Therapy on Mental Well-Being and Psychological Security in Women with Generalized Anxiety Disorder: A Quasi-Experimental Study. Journal of Rafsanjan University of Medical Sciences, 2023. 21(12): p. 1249-1266.
https://doi.org/10.52547/jrums.21.12.1249  
 
14. Zhang, Y., et al., The association between green space and adolescents' mental well-being: a systematic review. International journal of environmental research and public health, 2020. 17(18): p. 6640..(PubMed: 32932996).
https://doi.org/10.3390/ijerph17186640
PMid:32932996 PMCid:PMC7557737  
 
15. Jalali M, M.A., Aghae H. , Effectiveness of Cognitive-Behavioral Therapy with and without Neurofeedback, Neurofeedback on Treatment and Increasing Women's Psychological  
 
Wellbeing with Generalized Anxiety Disorder. . Clinical Psychology and Personality, 2022. 20(1): p. 1-5.  
 
16. Viftrup, D.T., N.C. Hvidt, and N. Buus, Spiritually and religiously integrated group psychotherapy: A systematic literature review. Evidence-Based Complementary and Alternative Medicine, 2013. 2013.(PubMed: 24288557).
https://doi.org/10.1155/2013/274625
PMid:24288557 PMCid:PMC3833113  
 
17. Talaeezadeh, M., A. Heydarie, and R. Joharifard, Comparing the effectiveness of" hypnosis therapy" and" schema therapy" on the dimensions of mental health in the prevention of divorce of men and women who have been betrayed. Journal of Health Promotion Management, 2023. 12(3): p. 63-81. 10.22034/JHPM.12.3.63  
 
18. Sheivandi, K. and F. Hasanvand, Developing a model for the psychological consequences of corona epidemic anxiety and studying the mediating role of spiritual health. Counseling Culture and Psycotherapy, 2020. 11(42): p. 1-36.  
 
19. Moin, Z.Z., K. Abolmaali, and M. Reza, A comparison of effectiveness of spiritual therapy and acceptance and commitment therapy (ACT) on reducing existential anxiety in women with breast Cancer. Journal of Culture of Counseling and Psychotherapy, 2023. 14: p. 39-66.  
 
20. Ghasemi Nejad Rini, F., M. Golparvar, and A. Aghaei, Comparison of the effectiveness of emotionally-focused therapy based on attachment injuries and spirituality based schema therapy on anxiety and affective capital of women injured by husband's infidelity. Iranian Journal of Rehabilitation Research, 2022. 9(2): p. 88-99. URL: http://ijrn.ir/article-1-705-fa.html  
 
21. Meléndez, M., D.E. Cortés, and H. Amaro, Acceptability and cultural fit of spiritual self-schema therapy for Puerto Rican Women with addiction disorders: Qualitative findings, in Feminist Therapy with Latina Women. 2013, Routledge. p. 105-118.  
 
22. Kang, H., Sample size determination and power analysis using the G* Power software. Journal of educational evaluation for health professions, 2021. 18.(PubMed: 34325496).
https://doi.org/10.3352/jeehp.2021.18.17
PMid:34325496 PMCid:PMC8441096  
 
23. Group, W., Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological medicine, 1998. 28(3): p. 551-558.
https://doi.org/10.1017/S0033291798006667
PMid:9626712  
 
24. Khooshemehri, G., et al., Comparison of quality of life for elderly men and women elderly nursing home resident by Alborz province in 1390. Alborz University Medical Journal, 2013. 2(1): p. 19-24.
https://doi.org/10.18869/acadpub.aums.2.1.19  
 
25. Ryff, C.D., Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of personality and social psychology, 1989. 57(6): p. 1069
https://doi.org/10.1037//0022-3514.57.6.1069  
 
26. Farzan Azar, F. and F. Mehrabi, The Effect of Reality Therapy Counseling on the Psychological Well-Being of Infertile Women. Complementary Medicine Journal, 2023. 13(3): p. 21-29. URL: http://cmja.arakmu.ac.ir/article-1-933-en.html  
 
27. Meyer, T.J., et al., Development and validation of the penn state worry questionnaire. Behaviour research and therapy, 1990. 28(6): p. 487-495.
https://doi.org/10.1016/0005-7967(90)90135-6
PMid:2076086  
 
28. Dehshiri GR, G.M., Borjali A, Sohrabi F., Psychometrics particularity of Farsi version of Pennsylvania state worry questionnaire for college students. Journal of Clinical Psychology, 2009. 1(4): p. 67-75  
 
29. Ramesh, S., M.A. Besharat, and H. Nough, Spiritual well-being and coronary artery diseases severity: Mediating effects of anger rumination and worry. Health education journal, 2021. 80(5): p. 501-512.
https://doi.org/10.1177/0017896920976697  
 
30. Sahour, A., B. Mirzaian, and S. Heydari, Comparing the Effectiveness of schema therapy and Mindfulness-Based Cognitive Therapy on Worry and psychological well-being in infertile women. Shenakht Journal of Psychology and Psychiatry, 2024. 10(6): p. 178-194. 10;10(6):178-94. shenakht.muk.ac.ir/article-1-2195-en.html  
 
31. Pourpashang, M. and S. Mousavi, The effects of group schema therapy on psychological wellbeing and resilience in patients under substance dependence treatment. J Client Center Nurs Care, 2021. 7(2).
https://doi.org/10.32598/JCCNC.7.2.366.1  
 
32. Mohtadijafari S, A.H., Banisi P. , The effectiveness of schema therapy techniques in mental health and quality of life of women with premenstrual dysphoric disorder. Iranian Journal of Psychiatry and Clinical Psychology, 2019. 25(3): p. 278-91.
https://doi.org/10.32598/ijpcp.25.3.278  
 
33. Varmazyar, A., B. Makvandi, and N. Seraj Khorrami, Effectiveness of Schema Therapy in Social Anxiety, Rumination, and Psychological Well-Being among Depressed Patients Referred to Health Centers in Abadan, Iran. Razavi International Journal of Medicine, 2021. 9(1): p. 32-39  
Razavi International Journal of Medicine
Volume 13, Issue 1
special issue(Psychology in health
March 2025
Pages 100-114

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