Effective Common Emotional Schemas in Iranian Adults with Generalized Anxiety Disorder: A Qualitative Study

There is evidence that emotion plays a role in explaining generalized anxiety disorder, and on the other hand, dysfunctional emotional schemas are different in various psychopathological disorders, but few studies have addressed this issue. Therefore, the purpose of this study was to qualitatively investigate emotional schemas in Iranian patients with generalized anxiety disorder.

For this purpose, 16 patients with generalized anxiety disorder in Mashhad, Iran were interviewed and their responses were qualitatively clustered to extract their emotional schemas and subthemes related to each emotional schema. A semi-structured interview was conducted to investigate patients' perspectives on emotion and their 14 emotional schemas. Patients' statements were transcribed and analyzed through comparative-inductive thematic analysis and coding. They were then categorized into main themes and subtheme naming was done in consultation with experts.

The findings showed that four emotional schemas of validation, duration, uncontrollability, and extreme rationalization are more involved in patients with generalized anxiety disorder and 12 subthemes including mentalized emotional insecurity, desocialization, somatization, significance, uncertainty intolerance, unpredictability threat, extreme emotional perfectionism, continuity of catastrophic thinking, trait anxiety, superiority of others, emotional avoidance, emotional inflexibility, and extreme approval led to the creation and continuation of generalized anxiety disorder symptoms.

Therefore, addressing these 4 emotional schemas in patients with generalized anxiety disorder with a greater focus on the validation schema, which is more pervasive, can increase treatment efficacy. In addition, we can focus on them in educational and preventive protocols, not just intervention protocols.