Effectiveness of Emotion Regulation Group Therapy on symptom reduction and quality of life in individuals with Illness Anxiety Disorder

Document Type : Research Paper

Authors

1 student / university of Tabriz

2 Professor of psychology, Department of clinical psychology, Faculty of Educational science and psychology, Shiraz University, Shiraz, Iran.

3 Assistant Professor of psychology, Department of clinical psychology, Faculty of Educational science and psychology, Shiraz University, Shiraz, Iran.

Abstract

Introduction: People with Illness Anxiety Disorder experience excessive worry and poor quality of life. The aim of the present study is to examine Effectiveness of Emotion Regulation Group Therapy on symptom reduction and quality of life in individuals with Illness Anxiety Disorder. This is an experimental study with pre-test and post-test design and control group. Population of the of the present study was All people with panic disorder in Shiraz city in 1398 who went to the psychiatric clinics of Shiraz University of Medical Sciences. The sample was 18 people with Illness Anxiety Disorder who were randomly assigned to the experimental group and the control group.
Method: The subjects in the experimental group and the control group were assessed in both pre-test and post-test periods using Structured Clinical Interview for DSM-5, Anxiety and Related Disorders Interview Schedule for DSM-5 and The World Health Organization Quality of Life questionnaire.
Results: results showed that Group format of Emotion Regulation Therapy significantly Improve Symptoms of anxiety and quality of life of individuals with Illness Anxiety Disorder.
Conclusion: Emotion Regulation Therapy throughout using Body scan mindfulness technique, Awareness of physical senses and breathe technique, and also intervention in worry and emotion regulation construct which Known as mediators in the treatment of many disorders, significantly Improve symptoms and quality of life of people with Illness Anxiety Disorder.

Keywords


Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review30(2), 217-237.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
American Psychiatric Association. (2015). Structured clinical interview for DSM-5 (SCID-5). Washington, DC: American Psychiatric Association.
Asmundson, G. J., & Fergus, T. A. (2019). The Concept of Health Anxiety. In The Clinician's Guide to Treating Health Anxiety (pp. 1-18). Academic Press.
Bailer, J., Witthöft, M., Erkic, M., & Mier, D. (2017). Emotion dysregulation in hypochondriasis and depression. Clinical psychology & psychotherapy24(6), 1254-1262.
Bardeen, J. R., & Fergus, T. A. (2014). An examination of the incremental contribution of emotion regulation difficulties to health anxiety beyond specific emotion regulation strategies. Journal of anxiety disorders, 28(4), 394-401.
Brown, T. A., & Barlow, D. H. (2014). Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5L).: Lifetime Version. Client Interview Schedule. Oxford University Press.
Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of abnormal psychology110(4), 585 –599.
Cuijpers, P., Sijbrandij, M., Koole, S., Huibers, M., Berking, M., & Andersson, G. (2014). Psychological treatment of generalized anxiety disorder: a meta-analysis. Clinical psychology review34(2), 130-140.
Dryman, M. T., & Heimberg, R. G. (2018). Emotion regulation in social anxiety and depression: A systematic review of expressive suppression and cognitive reappraisal. Clinical psychology review65, 17-42.
Eilenberg, T., Fink, P., Jensen, J. S., Rief, W., & Frostholm, L. (2016). Acceptance and commitment group therapy (ACT-G) for health anxiety: a randomized controlled trial. Psychological medicine46(1), 103-115.
Eilenberg, T., Hoffmann, D., Jensen, J. S., & Frostholm, L. (2017). Intervening variables in group-based acceptance & commitment therapy for severe health anxiety. Behaviour research and therapy92, 24-31.
Eilenberg, T., Kronstrand, L., Fink, P., & Frostholm, L. (2013). Acceptance and commitment group therapy for health anxiety–Results from a pilot study. Journal of Anxiety Disorders27(5), 461-468.
Fink, P., Ørnbøl, E., & Christensen, K. S. (2010). The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health. PloS one5(3), 73-98.
Fink, P., Ørnbøl, E., Toft, T., Sparle, K. C., Frostholm, L., & Olesen, F. (2004). A new, empirically established hypochondriasis diagnosis. American Journal of Psychiatry161(9), 1680-1691.
Fresco, D. M., Mennin, D. S., Heimberg, R. G., & Ritter, M. (2013). Emotion regulation therapy for generalized anxiety disorder. Cognitive and Behavioral Practice20(3), 282-300.
Golden, J., Conroy, R. M., Bruce, I., Denihan, A., Greene, E., Kirby, M., & Lawlor, B. A. (2011). The spectrum of worry in the community-dwelling elderly. Aging & mental health15(8), 985-994.
Grabe, H. J., Baumeister, S. E., John, U., Freyberger, H. J., & Völzke, H. (2009). Association of mental distress with health care utilization and costs: a 5-year observation in a general population. Social psychiatry and psychiatric epidemiology44(10), 835-844.
Hartmann, A. S., Cordes, M., Hirschfeld, G., & Vocks, S. (2019). Affect and worry during a checking episode: a comparison of individuals with symptoms of obsessive-compulsive disorder, anorexia nervosa, bulimia nervosa, body dysmorphic disorder, illness anxiety disorder, and panic disorder. Psychiatry research272, 349-358.
Himle, J., A., Van-Etten, M., Fischer, D., J. (2003). Group cognitive behavioral therapy for obsessive-compulsive disorder: a review. Bri Treat & Cris Intervent. 2003; (3): 217-229.
Hofmann, S. G., Sawyer, A. T., Fang, A., & Asnaani, A. (2012). Emotion dysregulation model of mood and anxiety disorders. Depression and anxiety29(5), 409-416.
Jasper, F., & Witthöft, M. (2013). Automatic evaluative processes in health anxiety and their relations to emotion regulation. Cognitive therapy and research37(3), 521-533.
Lovas, D. A., & Barsky, A. J. (2010). Mindfulness-based cognitive therapy for hypochondriasis, or severe health anxiety: A pilot study. Journal of anxiety disorders24(8), 931-935.
McManus, F., Surawy, C., Muse, K., Vazquez-Montes, M., & Williams, J. M. G. (2012). A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). Journal of consulting and clinical psychology80(5), 817 -828.
Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2002). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice9(1), 85-90.
Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behaviour research and therapy43(10), 1281-1310.
Mennin, D. S., Holaway, R. M., Fresco, D. M., Moore, M. T., & Heimberg, R. G. (2007). Delineating components of emotion and its dysregulation in anxiety and mood psychopathology. Behavior therapy38(3), 284-302.
Mennin, D. S., McLaughlin, K. A., & Flanagan, T. J. (2009). Emotion regulation deficits in generalized anxiety disorder, social anxiety disorder, and their co-occurrence. Journal of anxiety disorders23(7), 866-871.
Miloyan, B., & Pachana, N. A. (2015). Clinical significance of worry and physical symptoms in lateā€life generalized anxiety disorder. International journal of geriatric psychiatry30(12), 1186-1194.
Mykletun, A., Heradstveit, O., Eriksen, K., Glozier, N., Øverland, S., Mæland, J. G., & Wilhelmsen, I. (2009). Health anxiety and disability pension award: The HUSK Study. Psychosomatic medicine71(3), 353-360.
Nejat, S., Montazeri, A., Holakouie Naieni, K., Mohammad, K., Majdzadeh, S. (2006). The World Health Organization quality of Life (WHOQOL-BREF) questionnaire: Translation and validation study of the Iranian version. Journal of School of Public Health and Institute of Public Health Research, 4(4), 1-12.
O’Toole, M. S., Renna, M. E., Mennin, D. S., & Fresco, D. M. (2019). Changes in decentering and reappraisal temporally precede symptom reduction during Emotion Regulation Therapy for generalized anxiety disorder with and without co-occurring depression. Behavior therapy50(6), 1042-1052.
Olatunji, B. O., Deacon, B. J., & Abramowitz, J. S. (2009). The cruelest cure? Ethical issues in the implementation of exposure-based treatments. Cognitive and Behavioral Practice16(2), 172-180.
Olatunji, B. O., Kauffman, B. Y., Meltzer, S., Davis, M. L., Smits, J. A., & Powers, M. B. (2014). Cognitive-behavioral therapy for hypochondriasis/health anxiety: a meta-analysis of treatment outcome and moderators. Behaviour research and therapy58, 65-74.
olde Hartman, T. C., Borghuis, M. S., Lucassen, P. L., van de Laar, F. A., Speckens, A. E., & van Weel, C. (2009). Medically unexplained symptoms, somatisation disorder and hypochondriasis: course and prognosis. A systematic review. Journal of psychosomatic research66(5), 363-377.
Renna, M. E., Quintero, J. M., Fresco, D. M., & Mennin, D. S. (2017). Emotion regulation therapy: a mechanism-targeted treatment for disorders of distress. Frontiers in psychology8, 98.
Rief, W., Glaesmer, H., Baehr, V., Broadbent, E., Brähler, E., & Petrie, K. J. (2012). The relationship of modern health worries to depression, symptom reporting and quality of life in a general population survey. Journal of psychosomatic research72(4), 318-320.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Synopsis of psychiatry: behavioral sciences, clinical psychiatry. Wolters Kluwer.
Samimi, R., Imani, M. Rahimi Taghanaki, C. (2016). Examination of validity and reliability of Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5)® - Adult Version. M.A. thesis in clinical psychology. Department of clinical psychology, Faculty of Educational science and psychology, Shiraz University, Shiraz, Iran.
Sempértegui, G. A., Karreman, A., van Hout, G. C., & Bekker, M. H. (2017). Functional status in patients with medically unexplained physical symptoms: Coping styles and their relationship with depression and anxiety. Journal of health psychology22(13), 1743-1754.
Sharifi, V., Asadi, S. M., Mohammadi, M. R., Amini, H., Kaviani, H., Semnani, Y., ... & Sedigh, A. (2004). Reliability and feasibility of the Persian version of the structured diagnostic interview for DSM-IV (SCID). Advances in cognitive science6(1), 10-22.
Sheppes, G., Suri, G., & Gross, J. J. (2015). Emotion regulation and psychopathology. Annual review of clinical psychology11, 379-405.
Shooshtari, M. H., Davari-Ashtiani, R., Shahrivar, Z., Shabani, A., Semnani, Y., Kaviani, H., ... & Seddigh, A. (2007). Structured clinical interview for DSM-IV (SCID Persian translation and cultural adaptation). Iranian journal of psychiatry, 46-48.
Taylor, S., Asmundson, G., & Coons, M. (2005). Current directions in the treatment of hypochondriasis. Journal of Cognitive Psychotherapy: An International Quarterly, 19, 285e304.
Weck, F., Gropalis, M., Hiller, W., & Bleichhardt, G. (2015). Effectiveness of cognitive-behavioral group therapy for patients with hypochondriasis (health anxiety). Journal of anxiety disorders30, 1-7.
Wolgensinger, L. (2015). Cognitive behavioral group therapy for anxiety: recent developments. Dialogues in clinical neuroscience17(3), 347.
World Health Organization. The world health organization quality of life (WHOQOL)-BREF. World Health Organization; 2004.