The Efficiency of Emotional Schema Therapy on level of anxiety and depression, symptom and signs of patients suffering from Post-Traumatic Stress Disorder (PTSD)

Authors

1 MA in Clinical Psychology, Psychiatry and Behavioral Sciences Research Center, Addiction I

2 Professor of Psychiatry, Department of Psychiatry and Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran

3 Candidate in health psychology, MA in Clinical Psychology, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran

Abstract

Background: Comprehensive studies in Iran showed that Post-Traumatic Stress Disorder is highly common among the survivors of the imposed war and most of them are in a vicious therapeutic cycle, frequently under long therapies which mostly have low effects.Objectives: This study aims to examine the efficiency of Emotional Schema Therapy on The Emotional Schema & Cognitive Emotion Regulation Strategies of patients suffering from Post-Traumatic Stress Disorder (PTSD). Materials & Methods: 6 patients from the clients of psychiatric clinic of Baqiyatallah hospital in Tehran Iran (2015), were selected through available sampling, matched together and then divided into 3 groups (Emotional Schema Therapy (EST) combined with Medications, Cognitive Behavioral Therapy combined with Medications & Medications) Patients were examined 5 & 3 times by Beck anxiety Inventory (BAI), Beck depression Inventory (BDI) and The Persian versions of the Impact of Event Scale-Revise (IES-R). To analyze the data, indexes of effect size, cohen’s d, process changes, slope and interpretation of ups & downs in charts were employed. Results:  EST and CBT (in post-treatment and follow-up phases) significantly decreased the anxiety and depression in the patients received EST and CBT and also could help to control the patients' signs and symptoms of PTSD. Moreover, pharmacotherapy had only effect on the control of anxiety and depressive signs and symptoms in post-treatment, but after the termination of pharmacotherapy, the patients to some degrees experienced a recurrence of the signs and symptoms.Conclusions: Emotional Schema Therapy via targeting directly mechanisms of pathological Emotional Schemas & Maladaptive Cognitive Emotion Regulation strategies can be appropriate choice for treatment of PTSD.  

Keywords


References
Association AP. American Psychiatric Association DSM-5 Development. Proposed Revisions/Somatic Symptom Disorders/J. 2010;2.
Foa EB, Rothbaum BO. Treating the trauma of rape: Cognitive-behavioral therapy for PTSD: Guilford Press; 2001.
Mohaghegh-Motlagh SJ MS, Musavi-Nasab SN, Arab A, Saburi E. Post-traumatic Stress Disorder in Male Chemical Injured War Veterans Compared to non-chemical War Veterans. Medical Journal of Mashhad University of Medical Sciences. 2014;56(6):361-8.
Shafiee-Kamalabadi MMA, Bigdeli, I. Ph, .D. A, K. Ph.D., Kianersi, F. Ph.D. . Prevalence of Post Traumatic Stress Disorder and Comorbid Personality Disorders in the Groups Veterans Tehran City. Journal of Clinical Psychology 2014;6(1):65-76.
K Y. barresie asar bakhshie darmane shenakhti raftari bar ekhtelale stresse pas az sanehe. payanname karshenasie arshade ravanshenasie balini, anistitue ravanpezeshkie tehran 1380.
Davidson J. Pharmacologic treatment of acute and chronic stress following trauma: 2006. J Clin Psychiatry. 2006;67(Suppl 2):34-9.
Friedman MJ, Keane TM, Resick PA. Handbook of PTSD: Science and practice: Guilford Press; 2007.
Taylor S. Clinician's guide to PTSD: A cognitive-behavioral approach: Guilford Press; 2006.
Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behaviour research and therapy. 2000;38(4):319-45.
Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: The process and practice of mindful change: Guilford Press; 2011.
Leahy RL. Roadblocks in cognitive-behavioral therapy: Transforming challenges into opportunities for change: Cambridge Univ Press; 2003.
Maredpour A NF, Mehrabizade Honarmand M. The Effectiveness of Eye Movement Desensitization and Reprocessing Technique on Chronic Post-traumatic Stress Disorder (PTSD) In Soldiers Knowledge & Research in Applied Psychology. 2015;16(1):22-32.
Bisson J, Andrew M, Collaboration C. Psychological Treatment of Post-traumatic Stress Disorder (PTSD)(Review): Wiley Online Library; 2007.
Bradley R, Greene J, Russ E, Dutra L, Westen D. A multidimensional meta-analysis of psychotherapy for PTSD. American journal of Psychiatry. 2005.
Leahy RL. A model of emotional schemas. Cognitive and behavioral practice. 2002;9(3):177-90.
Leahy RL, Tirch D, Napolitano LA. Emotion regulation in psychotherapy: A practitioner's guide: Guilford Press; 2011.
Vogel PA, Stiles TC, Götestam KG. Adding cognitive therapy elements to exposure therapy for obsessive compulsive disorder: a controlled study. Behavioural and Cognitive Psychotherapy. 2004;32(03):275-90.
Foa EB, Kozak MJ. Emotional processing of fear: exposure to corrective information. Psychological bulletin. 1986;99(1):20.
Leahy RL. Emotional schemas and resistance to change in anxiety disorders. Cognitive and Behavioral practice. 2007;14(1):36-45.
Durmaz DA. Emotional Regulation and Posttraumatic Stress Disorder. 2013.
Wells A. Metacognitive therapy for anxiety and depression: Guilford press; 2011.
Clark DA, Beck AT. Cognitive therapy of anxiety disorders: Science and practice: Guilford Press; 2011.
First MB, Spitzer RL, Gibbon M, Williams JB. User's guide for the Structured clinical interview for DSM-IV axis I disorders SCID-I: clinician version: American Psychiatric Pub; 1997.
sharifi V AM, Mohamadi M, Amini H, Kavyani H et al. payaei va ghabeliate ejraye noskhe farsie mosahebe balinie sakhtar yafte tashkhisi baraye DSM IV (SCID). tazehaye olume shenakhti. 1383;6(1):10-23.
Beck AT, Steer RA, Brown GK. Beck depression inventory-II. San Antonio, TX: Psychological Corporation. 1996:b9.
Fata L, Birashk B, Atif Waheed M, Dobson K. By means of this scheme, the state of emotional and cognitive processing of emotional information. Thought and Behavior in Clinical Psychology. 2005;2:20-5.
Kaviani H, Mousavi A. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran University Medical Journal (TUMJ). 2008;66(2):136-40.
Marmar CR, Weiss DS, Metzler TJ. The peritraumatic dissociative experiences questionnaire. Assessing psychological trauma and PTSD. 1997;2:144-68.
Moradi AR, Herlihy J, Yasseri G, Shahraray M, Turner S, Dalgleish T. Specificity of episodic and semantic aspects of autobiographical memory in relation to symptoms of posttraumatic stress disorder (PTSD). Acta psychologica. 2008;127(3):645-53.
Wegner DM, Zanakos S. Chronic thought suppression. Journal of personality. 1994;62(4):615-40.
Gilbert DT, Pinel EC, Wilson TD, Blumberg SJ, Wheatley TP. Immune neglect: a source of durability bias in affective forecasting. Journal of personality and social psychology. 1998;75(3):617.
Leahy RL. Resistance: An emotional schema therapy (EST) approach. Cognitive behaviour therapy: A guide for the practising clinician. 2008;2:187.