The Effectiveness of Schema Therapy and Cognitive-Behavioral Intolerance of Uncertainty Interventions on Worry States, Thought-Action Fusion, and Cognitive Avoidance in Adolescents with Generalized Anxiety Disorder
Keywords:
Schema therapy, cognitive-behavioral therapy, intolerance of uncertainty, worry states, thought-action fusion, generalized anxiety disorderAbstract
Objective: The aim of this study was to investigate the effectiveness of schema therapy and cognitive-behavioral interventions focused on intolerance of uncertainty in reducing worry states, thought-action fusion, and cognitive avoidance among adolescents diagnosed with GAD.
Methods and Materials: This study employed a quasi-experimental, pretest-posttest control group design. The statistical population consisted of all adolescents diagnosed with GAD who referred to 30 psychological counseling centers in District 17 of Tehran in 2025. A total of 36 participants were selected through convenience sampling and were randomly assigned to one of three groups: schema therapy, cognitive-behavioral therapy (CBT) targeting intolerance of uncertainty, and a control group. Measurement tools included the 7-item Generalized Anxiety Disorder Scale (Spitzer et al., 2006), the Intolerance of Uncertainty Scale (Freeston et al., 1994), the Penn State Worry Questionnaire (Meyer et al., 1990), the Thought-Action Fusion Questionnaire (Shafran et al., 1996), and the Cognitive Avoidance Questionnaire (Sexton & Dugas, 2009). The schema therapy intervention (Young, 1990) was delivered in 8 sessions of 90 minutes each. The CBT intervention was based on the Dugas model (Dugas & Chavot, 2007; Chavot et al., 2019) and was delivered over 12 sessions of 90 minutes each. The control group was placed on a waitlist. Following the intervention, a posttest was administered to all groups. Data were analyzed using multivariate analysis of covariance (MANCOVA) in SPSS version 24, including both descriptive and inferential statistics.
Findings: The results indicated that, based on the posttest mean scores of the experimental groups, both schema therapy and cognitive-behavioral therapy focused on intolerance of uncertainty had a significant effect on reducing worry states, thought-action fusion, and cognitive avoidance in adolescents with GAD.
Conclusion: Based on the findings of this study, both cognitive-behavioral therapy focused on intolerance of uncertainty and schema therapy can be considered effective interventions and may be utilized in clinical and healthcare settings to improve worry states, thought-action fusion, and cognitive avoidance.
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Copyright (c) 2025 Sanaz Pourgoli, Mohammad Talaei kahjugh, Elham Sargolzaei, Giti Shahbazi, Somaye Nazari (Author); Zeinab Baharestani (Corresponding Author); Kamran Pourmohammad Ghouchani (Author)
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