Comparison of the Effect of Unified Transdiagnostic Treatment from Emotional Disorders and Emotion Efficacy Therapy on Emotion Regulation among Adults with Stuttering

Document Type : Research Paper

Authors

1 Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran.

2 Department of Psychology, Karaj branch, Islamic Azad University, Karaj, Iran.

3 Department of Psychology, Alzahra University, Tehran, Iran.

4 Department of Speech and Language Pathology . Rehabilitation Sciences Faculty, Iran University of Medical Sciences. Tehran, Iran.

Abstract

The main aim of the present study is to compare the effectiveness of unified transdiagnostic treatment of emotional disorders and emotion efficacy therapy on emotion regulation in adults with stuttering and anxiety disorder. The research method is applied purposively and the research design is a quasi-experimental with pre-test-post-test design and control group with a follow-up period. The statistical population include all stuttering adults who visited speech therapy clinics in Tehran and the Iranian Stuttering Association in 2018–2019. 36 individuals (27 males and 9 females) who stutter were selected using an available sample and based on inclusion criteria such as a structured clinical interview. They were then randomly assigned to the experimental groups and the control group. For the treatment groups, each intervention was based on two-hour sessions, and for the control group, no intervention was conducted. The tools used in the present study included the Gratz and Roemer’sDifficulties in Emotion Regulation Scale (DERS). According to the nature of the study and measurement in three stages, repeated measures analysis was used to analyze the data using SPSS 18. From the remarkable results, we can mention the effectiveness of EET on reducing all six components of emotion regulation difficulties (P <0.01) and the effectiveness of UP on reducing the four components of emotion regulation difficulties (P <0.01). In general, stuttering therapists can use these two methods for better emotion regulation.

Keywords

References

امامی میبدی، آ.، بنی جمالی، ش.، یزدی، س.، شفیعی، م.، و مؤذن، ع. (1394). اثربخشی آموزش روش ذهن‌آگاهی مبتنی بر کاهش استرس بر بهبود واکنش‌های شناختی، عاطفی، رفتاری در افراد دارای لکنت زبان. مجلة مطالعات ناتوانی. 11(5)، 118-109.
انصاری، ه. (1397). اثربخشی درمان پذیرش و تعهد بر انعطاف‌پذیری روانی و تنظیم هیجان و سازگاری روان در افراد دارای لکنت زبان. مجلة پیشرفت‌های نوین در علوم رفتاری. 26(3)، 98-83.
بشارت، م. ع.، و بزازیان، س. (1393). بررسی ویژگی‌های روان‌سنجی پرسش‌نامة تنظیم شناختی هیجان در نمونه‌ای از جامعة ایرانی. مجلة دانشکدة پرستاری و مامایی. 84(24)، 70-61.
سعیدمنش، م.، و بابایی، ز. (1396). اثربخشی درمان گروهی مبتنی بر پذیرش و تعهد بر اضطراب و عزت‌نفس نوجوانان 14 تا 18 سال دارای لکنت. مجلة مطالعات ناتوانی. 6(3)، 7-1.
عبدی، ر.، بخشی، ع.، و محمود علیلو، م. (1392). بررسی کارایی درمان فراتشخیصی یکپارچه در کاهش شدت عوامل فراتشخیصی و نشانه‌های اختلالات هیجانی. مجلة روش‌ها و مدل‌های روان‌شناختی. 13(3)، 27-21.
عزیزی، ع.، میرزایی، آ.، و شمس، ج. (1389). بررسی رابطة تحمل آشفتگی و تنظیم هیجانی با میزان وابستگی دانشجویان به سیگار. مجلة پژوهشی حکیم. 13(1)، 18-11.
 علیپور، ف.، حسنی، ج.، بداقی، ا.، محتشمی‌راد، ف.، و سعیدپور، ص. (1395). مقایسة راهبردهای تنظیم شناختی هیجان، باورهای فراشناختی، و روان‌بنه‌های سازش‌نایافتة اولیة دانش‌آموزان مبتلا و غیرمبتلا به لکنت‌زبان. مجلة سلامت روان کودک. 3(2)، 55-42.
فرست، م.، ویلیامز، ج.، کرگ، ر.، و اسپیتزر، ر. (1396). مصاحبة بالینی ساختاریافته برای اختلال‌های روانی دی اس ام فایو (راهنمای نسخة بالینگر). ترجمة تینا شادلو، سمانه کریمان و بهرنگ شادلو. تهران: انتشارات ابن‌سینا.
نصری، م.، احدی، ح.، و درتاج، ف. (1396). اثربخشی درمان فراتشخیصی بر انعطاف‌پذیری شناختی، تنظیم هیجان و عامل hb در بیماران دیابتی. مجلة دستاوردهای روان‌شناختی (علوم تربیتی و روان‌شناسی) دانشگاه شهید چمران اهواز. 24(2)، 100-81.
Amester, J., & Klein, R. (2018). More than fluency: The social, emotional, and cognitive dimensions of stuttering. San Diego: Plural Publishing.
Barlow, D. H., Todd, J. F., Bullis, J. R., Gallagher, M. W., Murray, H., Bentley, K. H., …, & Robbins, C. (2017). The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders a randomized clinical trial. JAMA Psychiatry. 74(9), 875–884.
 Barlow, D. H., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B., & Ehrenreich-May, J. (2011). Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. Oxford: New York.
Beilby, J. M., Byrnes, M. L., & Yuruss, J. S. (2012). Acceptance and commitment therapy for adults who stutter: Psychosocial adjustment and speech fluency. Journal of Fluency Disorders. 37(4), 289-299.
Boyle, M. P. (2017). Personal perceptions and perceived public opinion about stuttering in the United States: Implications for anti-stigma campaigns. The American Journal of Speech-Language Pathology. 26(3), 921-938.
Boyle, M. P., & Fearon, AN. (2018). Self-stigma and its associations with stress, physical health, and health care satisfaction in adults who stutter. Journal of Fluency Disorders. 56(14), 112-121.
Boyle, M. P. (2011). Mindfulness training in stuttering therapy: Atutorial for speech-language pathologists. Jornal of fluency Disorders. 36(9), 122-129.
Brignell, A., Krahe, M., Downes, M., Kefalianos, E., Reilly, S., & Morgan, A. T. (2020). A systematic review of interventions for adults who stutter. Journal of Fluency Disorders. 64(16), 18-35.‌
Bullis, J. R., Suaer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Carl, J. R., & Barlow, D. H. (2015). The unified protocol for transdiagnostic treatment of emotional disorders. Behavior Modification. 39(2), 295-321.
Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006). Acceptability and suppression of negative emotion in anxiety and mood disorders. Emotion. 6(4), 587-595.
Colombo, D., Fernández-Álvarez, J., García Palacios, A., Cipresso, P., Botella, C., & Riva. G, (2019), New technologies for the understanding, assessment, and intervention of emotion regulation. Frontiers in Psychology. 10(2), 1261-1273.
Coto-Lesmes, R., Fernández-Rodríguez, C., & González-Fernández, S. (2020). Acceptance and commitment therapy in group format for anxiety and depression. A systematic review. Journal of Affective Disorders. 263(15), 107–120.
DeNardoa, T., Gabelb, R. M., Tetnowskic, J. A., & Swartzd, E. R. (2016). Self-acceptance of stuttering: A preliminary study. Journal of Communication Disorders. 60(13), 27-38.
Eggers, K., De Nil, L. F., & Van den Bergh, B. R. (2012). The efficiency of attentional networks in children who stutter. Journal of Speech, Language, and Hearing Research. 55(3), 946–959.
Everard, R. A., & Howell, P. (2018). We have a voice: Exploring participants’experiences of stuttering modification therapy. American Journal of Speech-Language Pathology. 27(3), 1273–1286.
Fassbinder, E., Schweiger, U., Martius, D., Brand-de Wilde, O., & Arntz, A. (2016). Emotion regulation in schema therapy and dialectical behavior therapy. Frontiers in Psychology. 7(2), 1373-1386.
Fitzpatrick, S., Bailey, K., & Rizvi, S. L. (2019). Changes in emotions over the course of dialectical behavior therapy and the moderating role of depression, anxiety, and posttraumatic stress disorder. Behavior Therapy. 51(6), 946-957.
Feldner, M. T., Hekmat, H., Zvolensky, M. J., Vowles, K. E., Secrist, Z., & Leen-Feldner, E. W. (2006). The role of experiential avoidance in acute pain tolerance: A laboratory test. Journal of Behavior Therapy and Experimental Psychiatry. 37(2), 146-158.
Garnett, E. O., Chow, H. M., Choo, A. L., & Chang, S. E. (2019). Stuttering severity modulates effects of non-invasive brain stimulation in adults who stutter. Frontiers in Human Neuroscience. 13(2), 411-425.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment. 26(1), 41-55.
Gratz, K. L., & Tull, M. T. (2010). Emotion regulation as a mechanism of change in acceptance- and mindfulness-based treatments. In R. Baer (Ed.), Assessing mindfulness and acceptance processes in clients: Illuminating the theory and process of change (pp. 107-133). Oakland, CA: New Harbinger Publications.
Gavric, D., Moscovitch, D. A., Rowa, K., & McCabe, R. E. (2017). Post-event processingin social anxiety disorder: Examining the mediating roles of positive metacognitive beliefs and perceptions of performance. Behaviour. Research and Therapy. 44(8), 1177–1185.
Gallegoa, A., McHughb, L., Villattec, M., & Lappalainena, R. (2020). Examining the relationship between public speaking anxiety, distress tolerance and psychological flexibility. Journal of Contextual Behavioral Science. 16(4), 128–133.
Guitar, B. (2019). Stuttering an integrated approach to its nature and treatment. Baltimore: Wolters Kluwer.
Hayes, S. C., Bissett, R. T., Strosahl, K., Follette, W. C., Polusney, M. A., Pistorello, J., Toarmino, D.,Batten, S.V., Dykstra, T. A., Stewart, S. H., Zvolensky, M. J., Eifert, G. H., Bond, F. W., & Bergan, J. (2002). Psychometric properties of the Acceptance and Action Questionnaire (AAQ). Manuscript submitted for publication.
Hayes, S. C., Strosahl, K. D., Bunting, K., Twohing, M., & Wilson, K. G. (2010). What is acceptance and commitment therapy? In S. C. Hayes, & K. D. Strosahl (Eds.), A practical guide to acceptance and commitment therapy. New York, NY: Springer Science-Business Media.
Herbert, J. D., Forman, E. M., Kaye, J. L., Gershkovich, M., Goetter, E., Yuen, E. K., Glassman, L., Goldstein, S., Hitchcock, P., Tronieri, J. S., Berkowitz, S., & Marando-Blanck, S. (2018). Randomized controlled trial of acceptance and commitment therapy versus traditional cognitive behavior therapy for social anxiety disorder: Symptomatic and behavioral outcomes. Journal of Contextual Behavioral Science. 9(2), 88-96.
Lazarus, R. (1991). Cognition and motivation in emotion. American Psychologist. 46(4), 352–367.
Lehner, T., Miller, B. L., & State, M. W. (2016). Genomics, circuits, and pathways in clinical neuropsychiatry. New York: Elsevier Science.
Llewellyn-Bennett, R., Bowman, L., & Bulbulia, R. (2016). Post-trial follow-up methodology in large randomized controlled trials: A systematic review protocol. Systematic Reviews, 5(1), 214-220.
Manning, W. H., & DiLollo, A. (2017). Clinical decision making influency disorders (4th ed.). San Diego, CA: Plural.
McKay, M., & West, A. (2016). Emotion efficacy therapy: A brief, exposure-based treatment for emotion regulation integrating ACT & DBT. Oakland: New Harbinger.
Moses, E. B., & Barlow, D. H. (2006).A new unified treatment approach for emotional disorders based on emotion science. Current Directions in Psychological Science. 15(3), 146-150
Neumann, A., van Lier, P. A., Gratz, K. L., & Koot, H. M. (2010). Multidimensional assessment of emotion regulation difficulties in adolescents using the Difficulties in Emotion Regulation Scale. Assessment. 17(1), 138-149.
Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T., & Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behaviour Research and Therapy. 59(12), 40–51.
Plexico, L. W., Erath, S., Shores, H., & Burrus, E. (2019). Self-acceptance, resilience, coping and satisfaction of life in people who stutter. Journal of Fluency Disorders. 59(13), 52-63.
Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013). Acceptance and commitment therapy in the treatment of anxiety: A systematic review. Clinical Psychology Review. 33(8), 965-978.
Steele, S. J., Farchione, T. J., Cassiello-Robbins, C., Ametaj, A., Sbi, S., Sauer-Zavala, S., & Barlow, D. H. (2018). Efficacy of the unified protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. Journal of Psychiatric Research. 104(36), 211-216.
 Smith, A., & Weber, C. (2017). How stuttering develops: The multifactorial dynamic pathways theory. Journal of Speech, Language, and Hearing Research. 60(9), 2483–2505.
Tamir, M., Vishkin, A., & Gutentag T. (2020). Emotion regulation is motivated. Emotion. 20(1), 115-119.
Treleaven, S., Buhr, A., Kucharski, B., & Coalson, G. (2018). Daily emotions and stuttering: What is the relation? Clinical Archives of Communication Disorders. 3(3), 246-252.
Sakiris, N., & Berle, D. (2019). A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clinical Psychology Review, 72, 101751.‌
Scheuricha, J. A., Beidela, D. C., & Vanryckeghemb, M. (2019). Exposure therapy for social anxiety disorder in people who stutter: An exploratory multiple baseline design. Journal of Fluency Disorders. 59(8), 21–32.
St. Louis, K. O., Irani, F., Gabel, R. M., Hughes, S., Langevin, M., & Rodriguez, M. (2017). Evidence-based guidelines for being supportive of people who stutter in North America. Journal of Fluency Disorders. 53(6), 1–13.
Sønsterud, H., Feragen, K. B., Kirmess, M., Halvorsen, M. S., & Ward, D. (2019). What do people search for in stuttering therapy: Personal goal-setting as a gold standard? Journal of Communication Disorders. 85(24), 1-8.
VanVoorhis, C. R. W., & Morgan, B. L. (2007). Understanding  power and rules of thumb for determining sample sizes. Tutor Quantitative Methods for Psychology. 3(2), 43–50.
Webster, W. G. (1989). Sequence initiation performance by stutterers under conditions of response competition. Brain and Language. 36(4), 286–300.
 Webb, C. H. A., Beard, C., Kertz, S. J.,  Hsu, K., & Björgvinsson, T. H. (2016). Differential role of CBT skills, DBT skills and psychological flexibility in predicting depressive versus anxiety symptom improvement. Behaviour Research and Therapy. 81(2), 12-20.
Walden, T. A., Frankel, C. B., Buhr, A. P., Johnson, K. N., Conture, E. G., & Karrass, J. M. (2011). Dual diathesis-stressor model of emotional and linguistic contributions to developmental stuttering. Journal of Abnormal Child Psychology. 40(4), 33-644.
Williams, A. D. (2012). Distress tolerance and experiential avoidance in compulsive acquisition behaviours. Australian Journal of Psychology. 64(4), 217-224.
Zettle, R. D., Hocker, T. R., Mick, K. A., Scofield, B. E., Petersen, C. L., Song, H., & Sudarijanto, R. P. (2005). Differential strategies in coping with pain as a function of level of experiential avoidance. The Psychological Record. 55, 511-524.
 
Journal of Applied Psychological Research
Volume 12, Issue 2
September 2021
Pages 185-209

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History

  • Receive Date: 20 October 2020
  • Revise Date: 10 December 2020
  • Accept Date: 02 August 2021
  • First Publish Date: 02 August 2021
  • Publish Date: 23 August 2021

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