Comparison of the Effectiveness of Biofeedback Therapy, Cognitive Behavioral Therapy, and Their Combination Therapy on Dimensions of Cognitive Avoidance of Women with Generalized Anxiety Disorder

Emotional disorders are the most common spectrum of psychiatric disorders and one of its important types is generalized anxiety. Cognitive avoidance is also a meta-diagnostic construct that plays an important role in the symptoms of generalized anxiety disorder.

The aim of this study was to comparison of cognitive-behavioral therapy, biofeedback therapy and their combination therapy on cognitive avoidance in women with generalized anxiety disorder.

The research method was semi-experimental with pre-test, post-test, and two-month follow-up with the control group. In this study, the statistical population comprised all women with generalized anxiety disorder referred to the New Psychiatric Clinic of Boroujerd City in the year 2021. Using the available sampling method, 60 of them were selected and divided into four equal groups. The experimental groups underwent cognitive-behavioral therapy (8 sessions), biofeedback therapy (8 sessions), and combination therapy (8 sessions), while the control group received no training and remained on the waiting list. Spitzer’s generalized anxiety disorder scale and Sexton and Dugas cognitive avoidance questionnaire were used for data collection. The analysis of the data was conducted using analysis of variance with repeated measurements and Bonferroni’s post hoc test in SPSS-24 software, with a significance level of less than 0.05.

The results indicated that all three treatments significantly impacted cognitive avoidance in women with generalized anxiety during the post-test and follow-up phases compared to the control group (P<0.05). The combined treatment showed a larger average difference from the control group (-14.822) than cognitive  behavioral therapy (-9.956) and biofeedback (-9.911), indicating greater effectiveness in reducing cognitive avoidance (P<0.05).

It is suggested that combined therapy be used as a therapeutic method to reduce cognitive avoidance in women with generalized anxiety disorder in psychological counseling and service centers.