جستجوی مقالات مرتبط با کلیدواژه « اختلال اضطراب منتشر » در نشریات گروه « پزشکی »

Diabetes is one of the most common diseases in the elderly. Mental health problems, including depression and anxiety disorders, are common in the elderly with diabetes while they are usually not diagnosed. Patients with co-occurrence of diabetes and psychiatric disorders have a worse prognosis. This study aimed to investigate the prevalence of generalized anxiety disorder and depression in patients over 60 years old with type II diabetes.

This cross-sectional and descriptive study included 300 elderly patients with type 2 diabetes referred to the diabetes clinic of Golestan Hospital, Ahvaz, Iran, in 2021. The existence of anxiety and depression was measured using Beck Anxiety and Depression Inventories, Geriatric Depression Scale-Short Form (GDS-SF), Geriatric Anxiety Inventory-Short form-Persian version (GAI-SF-PV), and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). 

Most of the patients were female (56.7%), married (95%), with a diploma or less (86.6%), Arab (57.7%), with average economic status (69%), and living with family (97%). Controlled diabetes was reported in most people using medicines and insulin (94.3%). The rates of generalized anxiety and depression based on the mentioned inventories and the DSM-V were 33.8% and 40.7%, respectively.

The findings of our study showed a high prevalence of depression and anxiety in diabetic patients over 60 years of age. Low level of education, poor economic status, uncontrolled blood sugar, and gender are independent risk factors affecting anxiety and depression. Moreover, life without a family was an independent risk factor for generalized anxiety disorder in diabetic patients over 60 years of age.

* 3
1- . PhD Student, Research Group of Cognitive Sciences , Alborz Branch, Academic Center for Education, Culture and Research
2- PhD in Psychology, Research Group of Cognitive Sciences Alborz Branch, Academic Center for Education, Culture and Research, Alborz Branch
3- PhD in Clinical Psychology, Assistant Professor Research Group of Cognitive Sciences, Alborz Branch, Karaj, Academic Center for Education, Culture and Research, , E-mail:
Abstract: (1158 Views)
Objectives The purpose of this study was to compare the metacognitive factors between individuals with Obsessive Compulsive Disorder (OCD), Generalized Anxiety Disorder (GAD), dysthymic disorder (Dys), and non-clinical disorders (Normals).
Methods Metacognitive Questionnaire - short form (MCQ-30), Thought Control Questionnaire (TCQ), and Anxious Thought Inventory (ATI) were administered to a sample of 120 individuals (OCD-30; GAD-30; Dys-30 and Normals-30).
Results Results of MANOVA and post-hoc comparison revealed significant differences in metacognitive factors between all groups except attention distraction and cognitive confidence. Post-hoc comparisons also showed that OCD patients have significantly higher scores in punishment and reappraisal subscales than GAD and non-clinical groups. Likewise, GAD patients have significantly higher scores in social and health worry than OCD patients and in positive and negative beliefs about worry and need to control subscales than OCD and non-clinical groups. Also Dys group had significantly higher scores in health and social worry than others. In general, nonclinical sample had lower scores in all metacognitive questionnaires, RSQ, and neuroticism.
Conclusion Metacognitive beliefs and strategies could differentiate between diagnostic groups. Also findings support the Self regulatory executive function model of Wells.

Generalized anxiety disorder (GAD) can be affected by different emotional, cognitive, and natural factors. The purpose of this study was to predict GAD based on emotion regulation deficits, thought-action fusion, and behavioral inhibition. This was a correlational study. The study sample was comprised of 135 patients with GAD selected from among patients who were referred to psychiatric clinics and centers in Tabriz, Iran, using convenient sampling method. The data collection tool consisted of cognitive emotion regulation questionnaire (CERQ), thought fusion instrument (TFI), Beck Anxiety Inventory (BDI), retrospective and adults measures of behavioral inhibition (RMBI, AMBI), and the 20-item Toronto Alexithymia Scale (TAS-20). Data were analyzed using Pearson correlation coefficient and stepwise multiple regression analysis method. Difficulty in describing and identifying emotions, maladaptive emotion regulation strategies, thought-action fusion, and childhood behavioral inhibition had significant relationships with GAD (P < 0.010). Moreover, stepwise regression analysis showed that difficulty in identifying emotions, maladaptive emotion regulation, thought-action fusion, and childhood behavioral inhibition were the best predictors for GAD, respectively. Considering the role of emotion regulation deficits, thought-action fusion, and childhood behavioral inhibition in GAD, these variables must be taken into account in the prevention and treatment programs for GAD.

Generalized Anxiety Disorder (GAD) is affected by different emotional, cognitive and natural factors. The purpose of this study was to investigate the role of emotional regulation deficits, thought-action fusion and behavioral inhibition in Generalized Anxiety Disorder. This research is a correlational study and the sample included 120 patients with GAD selected from patients referring to four psychiatry centers in Shiraz using availability sampling. Instruments used for data collection included Cognitive emotion regulation questionnaire (CERQ), Thought Fusion Instrument (TFI), Beck Anxiety Inventory (BDI), retrospective and adults Measures of Behavioral Inhibition (RMBI, AMBI), and the 20-item Toronto alexithymia Scale (TAS-20). Data was analyzed using Pearson Correlation Coefficient and stepwise multiple regression analysis method. Results showed that there was a significant relationship between difficulty in describing and identifying emotions, mal-adaptive emotion regulation strategies, thought-action fusion and childhood behavioral inhibition with GAD (p<0.01). Also, stepwise regression analysis showed that difficulty in identifying emotions, ma-ladaptive emotion regulation, thought-action fusion and childhood behavioral inhibition were the best predictors for GAD respectively. Discussion & Given the role of emotion regulation deficits, thought-action fusion and childhood behavioral inhibition in GAD, the prevention and treatment programs for GAD should take these variables into account.

Intolerance of uncertainty can be defined as a cognitive bias that affects how a person perceives، interprets، and responds to uncertain situations. Although intolerance of uncertainty has been reported mainly in literature relating to worry and anxiety symptoms، it may be also important to investigate the relationship between Intolerance of uncertainty، rumination، and depression. The aim of the present study was to compare the intolerance of uncertainty in patients with generalized anxiety disorder، major depressive disorder and normal individuals and that relate with worry and rumination in a clinical sample. The present study was a cross-sectional and ex-post facto investigation. Statistical universe constituted all patients had been referred the first to the Bozorgmehr clinic in Tabriz in 2011. In this study، 32 client with generalized anxiety disorder، 32 client with major depressive disorder and 32 normal individuals were selected as a convenience sample. The groups were matched in demographic characteristics with each other. The subjects completed intolerance of uncertainty scale، Penn State worry questionnaire، and ruminative response scale. The gathered data was analyzed using SPSS-17 and descriptive statistic index and multivariate analysis of variance (MANOVA) and Pearson correlation analysis. The result showed that there weren’t any significant differences in intolerance of uncertainty between two groups with generalized anxiety disorder and major depressive disorder (P=0. 77). But، there were significant differences in worry in the people with generalized anxiety compared with major depressive disorder (P=0. 012). Also، there were significant differences in rumination in the people with major depressive compared with generalized anxiety disorder (P=0. 025). Also، intolerance of uncertainty is related to worry and rumination. Intolerance of uncertainty is not a special factor for generalized anxiety disorder and this cognitive construct also plays a role in onset and maintenance of major depressive disorder، and maybe what separate these two disorders are different strategies (worry and rumination) which patients with generalized anxiety and major depressive disorders use to cope with intolerance of uncertainty

Cognitive-affective factors and demographical characteristics have an important role in prediction of symptoms severity and quality of life in generalized anxiety disorder. The purpose of this study was to investigate the role of cognitive-affective system and demographic characteristics in the severity of symptoms for generalized anxiety disorder. In a cross-sectional descriptive study، 128 outpatients with generalized anxiety disorder who attended three psychiatric outpatient''s clinics of Tehran were selected by convenience sampling. Data were collected by The structured clinical interview، The Brief Core Schema Scales، The Cognitive-Behavioral Avoidance Scale، the Intolerance of Uncertainty Scale، Penn State Worry Questionnaire، Anxiety Sensitivity Index-revised، and demographical questionnaire and then analyzed by multiple regression analysis in stepwise method with PASW software. Feeling worried، anxiety sensitivity and socio-economic status have important predictive role in severity of symptoms for generalized anxiety disorder (F(3،124) =60. 85، p<0. 001). These three variables were predicted 0. 58 variation in symptoms of generalized anxiety disorder (R2=0. 58). Age، gender، literacy، intolerance of uncertainty، emotional schema and cognitive-behavioral avoidance didn’t have significant predictive role in prediction of severity of symptoms in generalized anxiety disorder (P>0. 05). Regarding the important role of feeling worried، anxiety sensitivity، and socio-economic status in prediction of symptoms severity for generalized anxiety disorder، it is necessity to pay attention to tailored interventions in these symptoms for basic quality of life promotion in these patients.

Emotional schema، cognitive-behavioral avoidance and cognitive-affective system have important role in generalized anxiety disorder and obsessive-compulsive disorder. This study was aimed to compare emotional schema، cognitive-behavioral avoidance and cognitive-affective system among patients with generalized anxiety disorder، obsessive-compulsive disorder and healthy people. In an analytic retrospective study، 38 outpatients with generalized anxiety disorder and 35 outpatients with obsessive-compulsive disorder who attended to psychiatric clinic of Ebne-Sina hospital and four private psychiatric centers of Mashhad city and 58 healthy persons among staffs and students of these centers were selected for convenience sampling. Data were collected by the Brief Core Schema Scales (BCSS)، the Cognitive-Behavioral Avoidance Scale (CBAS)، the Intolerance of Uncertainty Scale (IUS)، Penn State Worry Questionnaire (PSWQ) and Anxiety Sensitivity Index-revised (ASI-R)، and then were statistically judged by appropriate tests. According to self-schema، all kinds of cognitive-behavioral avoidance، intolerance of uncertainty، pathological worry and anxiety sensitivity، there was significantly difference among three groups (P<0. 001). There wasn’t significantly difference among three groups in terms of other-schema and wasn’t significantly difference between obsessive-compulsive group and healthy persons based upon fear of respiratory symptoms (P>0. 05). In regards to higher negative self-schema، cognitive-behavioral avoidance، and deficient cognitive-affective system (intolerance of uncertainty، worry and anxiety sensitivity) in patients with generalized anxiety disorder and obsessive-compulsive disorder than healthy group. Therefore، it is necessity to pay attention for tailored interventions in these specific symptoms of such disorders.

The intolerance of uncertainty model was initially developed as an explanation for worry within the context of generalized anxiety disorder. However، recent research has identified intolerance of uncertainty (IU) as a transdiagnostic maintaining factor across the anxiety disorders. The aim of the present study was to compare the intolerance of uncertainty in patients with generalized anxiety disorder (GAD)، obsessive compulsive disorder (OCD)، panic disorder (PD) and control group. The present study was a cross-sectional and ex-post facto investigation (causal comparative method). Statistical universe constituted all patients had been referred the first to the Bozorgmehr clinic in Tabriz in the 1389_1390. In this study، 30 client with Generalized anxiety disorder (GAD)، 30 client with Obsessive-Compulsive disorder (OCD)، panic disorder (PD) and 30 control group were selected accessibility. The groups were matched in demographic characteristics with other. Data were collected through a structured clinical interview and the Intolerance of Uncertainty Scale (IUS). The gathered data is analyzed by SPSS-17 and descriptive statistic indexs and Multivariate Analysis of Variance (MANOVA). The present study has found that people with GAD، OCD، and PD disorders compared with controls، according to the f=89/6 significance levels of /0001 had higher intolerance of uncertainty، but people with GAD، OCD، and PD disorders were not significantly different in the intolerance of uncertainty. The results showe differences between the (GAD، OCD، and PD) disorders and control groups in the (F=1/7)، significance level0/0001، F=23/5، and significance level 0/002،in the two factors the intolerance of uncertainty questionnaire. In tolerance of uncertainty is not just for generalized anxiety disorder، It construct seen in the obsessive compulsive disorder and panic disorder. It seems cognitive factor of intolerance of uncertainty plays a pivotal role in causing in this disorders. A potential application of these results for the treatment of anxiety disorders are treatable.

Generalized Anxiety Disorder leads to high level of disability in patients. The present study Compared efficacy of metacognitive therapy with cognitive behavior therapy in treatment of gene-ralized anxiety disorder. This research is based on Multiple-base-line experimental single case studies. Six subjects were selected by sampling based on target and divided randomly in two three-member experiment (MCT) and control (CBT) groups. Subjects were analyzed for two months. The data were collected using Trait An-xiety Inventory (STAI) and anxious touts inventory (AnTI) and subjective unit distress (SUD)، in pre-treatment (base line)، during treatment (four)، post treatment (eight) and follow up (two mounts after the treatment). They were analyzed by descriptive statistics (such as mean،median،…) and demonstrated in some charts. in MCT group there were healings for STAI scale up to 54%، AnTI up to 55% and SUD up to 89%. While in control group، they were 33% for STAI، 37% for AnTI and 56% r SUD، respectively. Metacognitive therapy and cognitive behavior therapy were both effective in decreasing generalized anxiety disorder symptoms. However، findings showed the superiority of metacognitive ther-apy over cognitive behavior therapy in treatment of generalized anxiety disorder symptoms.

The relation between defense mechanisms and anxiety has been shown in scientific texts. Considering epidemiology of generalized anxiety disorder (GAD), this study investigated the correlation between defense styles and trait-state anxiety among university students afflicted with GAD. The participants included 30 university students afflicted with GAD and 30 normal ones with the age range of 19 to 27 years old (15 male and 15 female in each group). The subjects, selected via convenient sampling method, were matched with each other in terms of demographical variables. All subjects met the inclusion criteria by answering to structured clinical interview (SCID-CV) and general health questionnaire (GHQ-28). Information questionnaire groups completed defense style questionnaire (DSQ-40) and Spielberger state-trait anxiety inventory (STAI). To analyze data, descriptive statistics, independent t-test, Pearson’s correlation coefficient, and analysis of variance were employed. An indication of a significant difference in utilization of mature defense mechanism was observed by normal versus GAD students (P<0.032). The normal students used the defense mechanisms of humor (P<0.048), denial (P<0.034), suppression (P<0.035), dissociation (P<0.040), and rationalization (P<0.0005) more significantly; the GAD students used projection (P<0.002) and somatization (P<0.001) more significantly. There were significant negative correlations between the scores of general health level as well as state-trait anxiety with mature defense mechanisms. The results showed a poor support for the correlation between immature defense mechanisms and state-trait anxiety; no correlation was observed between neurotic defense style and state-trait anxiety. People with a good level of general health and a low score on state-trait anxiety tend to use mature defense mechanisms more significantly. Furthermore, using humor and projection defense mechanisms by normal students support the findings of this study.

The comparison of defence mechanisms and coping strategies in individuals with generalized anxiety disorder and major depressive disorder and normal subjects was the aim of the present study. The statistical population of the present study included individuals with generalized anxiety disorder, major depressive disorder and normal subjects who had presented to public and private psychiatric consultation centers in the city of Ardabil (Iran) and had been diagnosed by psy-chiatrists according to DSM-IV criteria. 171 individuals from among the subjects presenting to eight centers were selected using structured sampling. In this retrospective, causal-comparitive and correlational study, Folkman and Lazarus Coping Strategies Questionnaire and Defense Mechanisms Questionnaire were used for gathering data. Data were analyzed through two factor variance analysis, the Least Statistical Difference (LSD) test and Pearson’s correlation test. There was no significant difference in the mean scores of coping strategies between subjects with generalized anxiety disorder and those with major depressive disorder, but the mean score of avoidance coping was higher in the first group than the second (p<0.05). On the other hand, the subjects with the above-mentioned disorders had a lower mean score of social support seeking coping in comparison with normal individuals (p<0.001). The mean score of highly adaptive defensive mechanisms was higher in subjects with generalized anxiety compared to subjects with major depression (p<0.05). Also, the mean scores of negative levels, function, disorganized defense and psychological avoidance were higher in the second group in comparison with the first (p<0.04). Maladaptive defence machanisms have a higher mean in major depressive disorder. However, the mean of avoidance coping is higher in generalized anxiety disorder compared to major depressive disorder. Therefore, attempting to decrease the application of avoidance coping and increasing the use of problem oriented coping instead of emotion oriented coping can cause a reduction in the experience of depression and anxiety in both sexes.

This study was carried out to examine the role of responsibility and metacognitive beliefs in obsessive-compulsive disorder while controlling for worry, and to assess the internal relationship between responsibility and metacognitive beliefs. Twenty-five patients with obsessive-compulsive disorder (OCD), 25 patients with generalized anxiety disorder and 25 normal participants who were selected using convenience sampling method from individuals refered to psychiatric hospitals in the city of Shiraz (Iran), took part in this study. In order to measure metacognitive beliefs, responsibility beliefs and worry the Metacognition Questionnaire-30 (MCQ-30), Responsibility Attitudes Scale (RAS) and Penn State Worry Questionnaire (PSWQ) were used respectively. Data were analyzed using one and multiple way analysis of variance, one way analysis of covariance, and appropriate follow-up tests. Results indicated that when responsibility and worry were controlled the OCD and GAD patients differed from normal participants on metacognitive beliefs (p<0.001), but when metacognitive beliefs were controlled, the OCD, GAD and normal group did not differ on responsibility beliefs. Also, the OCD and GAD group did not differ on all metacognotive subscales except for the need to control thoughts. The present data are consistent with meta-cognitive conceptualizations of obsessive-compulsive disorders.