The Effectiveness of Cognitive-Behavioral Therapy on Psychological Flexibility and Health Anxiety in Patients with Post-Traumatic Stress Disorder

Sayadi, Ali; Haghighat-Bayan, Nazanin; Bidokhti, Atefeh; Mohseni-Mahani, Amir; Samian, Pooya; Pourmohammad-Ghochani, Kamran

doi:10.47176/rjms.31.138

Volume 31, Issue 1 (3-2024) RJMS 2024, 31(1): 1-10 | Back to browse issues page

‎ 10.47176/rjms.31.138

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Sayadi A, Haghighat-Bayan N, Bidokhti A, Mohseni-Mahani A, Samian P, Pourmohammad-Ghochani K. The Effectiveness of Cognitive-Behavioral Therapy on Psychological Flexibility and Health Anxiety in Patients with Post-Traumatic Stress Disorder. RJMS 2024; 31 (1) :1-10
URL: http://rjms.iums.ac.ir/article-1-8935-en.html

The Effectiveness of Cognitive-Behavioral Therapy on Psychological Flexibility and Health Anxiety in Patients with Post-Traumatic Stress Disorder

Ali Sayadi

, Nazanin Haghighat-Bayan

, Atefeh Bidokhti

, Amir Mohseni-Mahani

, Pooya Samian

, Kamran Pourmohammad-Ghochani

PhD, Department of Psychology, Roudehen Branch, Islamic Azad University, Tehran, Iran , nazanin-_haghighatbayan@yahoo.com

Abstract: (535 Views)

Background & Aims: Post-Traumatic Stress Disorder (PTSD) is a chronic and debilitating psychiatric condition classified under stress-related disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It can develop following exposure to a traumatic event. Although the presence of anxiety in the current state of human life is somewhat favorable and creates positive and beneficial effects in advancing people's life goals. However, increasing the duration and intensity of anxiety may damage the person's normal functioning and threaten the person's mental health. Cognitive flexibility can be seen as the skill and ability to choose between two topics or two different thoughts at the same time, and the meaning of cognitive flexibility is the ability to differentiate and change cognitive strategies based on changes in environmental feedback that require planning. It is an organized search and the ability to use environmental feedback to change cognitive cues. Cognitive flexibility is the ability of people to adjust the cognitive process to face new and unpredictable situations. Cognitive flexibility is also defined as a person's ability to inhibit a dominant but ineffective and inappropriate response and the ability to reach alternative responses that are more distant, so it is thought to include two sub-branches of inhibiting irrelevant items and transferring attention and focus to the assignment or mental intentions are different. Preliminary studies have shown that people with underlying diseases are at a higher risk of developing complications and mortality due to the disease; this can be a cause of anxiety for such people. Stress and anxiety caused by accidents can weaken the body's immune system and make it vulnerable to diseases. Because the inherent function of anxiety is to protect people from life-threatening factors, in the event of the emergence of life-threatening diseases, health-related concerns may appear in the form of anxiety states. This study aimed to compare the effectiveness of cognitive-behavioral therapy (CBT) on psychological flexibility and health anxiety in individuals with PTSD.
Methods: This semi-experimental study involved two experimental groups and one control group, utilizing a pre-test, post-test, and follow-up design. The statistical population included adults aged 18 to 40 years diagnosed with PTSD who referred to psychological centers in Tehran in 2024. A sample of 30 individuals was selected purposively and randomly assigned to two experimental groups and one control group (15 participants in each group). The experimental groups underwent eight 90-minute sessions of CBT, while the control group received no intervention. Data were collected using the Psychological Flexibility Questionnaire and the Health Anxiety Questionnaire. Repeated measures ANOVA was used for data analysis.
Results: Psychological flexibility means a person's ability to accept negative thoughts and emotions and use adaptive strategies to manage stress. This feature is severely impaired in PTSD patients, as they tend to avoid stressful stimuli and use maladaptive mechanisms such as thought suppression. Cognitive-behavioral therapy (CBT) helps to increase psychological flexibility to change negative beliefs and strengthen acceptance. Studies have shown that CBT can significantly reduce PTSD symptoms and replace dysfunctional ones with more flexible thought patterns. Health anxiety is one of the common consequences of PTSD, which can severely reduce the quality of life of patients. Patients with health anxiety often misinterpret minor physical symptoms as signs of serious diseases. CBT helps reduce this anxiety by modifying dysfunctional thoughts and providing stress management skills. In particular, techniques such as cognitive restructuring and confronting anxiety-provoking thoughts in CBT enable patients to have more rational interpretations of physical symptoms. For example, a study conducted by Abramowitz et al. showed that CBT was very effective in reducing health anxiety in patients with PTSD and resulted in stable results. In addition, relaxation training and mindfulness exercises, often included in CBT, help patients better connect with their bodies and reduce hypersensitivity to physical symptoms. These techniques not only reduce health anxiety but also allow patients to have a more positive and balanced approach to their health. Cognitive behavioral therapy is often described as metacognitive monitoring of thoughts, emotions, perceptions, and feelings. This process shows that taking a conscious approach eliminates the need for ego performance in situations. It is thought that thoughts and emotions go up and down with time, and since emotional therapy requires acceptance of the individual's experience, there is no need to actively deal with them. Cognitive-behavioral therapy (CBT) is one of the effective treatment methods for improving PTSD symptoms, increasing psychological flexibility, and reducing health anxiety. Using techniques such as cognitive restructuring, gradual exposure, and coping skills training, this method enables patients to deal with maladaptive thoughts and emotions and improve their quality of life. The findings indicated that cognitive-behavioral therapy significantly improved psychological flexibility and reduced health anxiety in adults with PTSD (P < 0.001).
Conclusion: Based on the results, specialists working with PTSD patients are encouraged to consider using cognitive-behavioral therapy alongside other therapeutic approaches for treating these individuals.

Keywords: Psychological Flexibility, Health Anxiety, Post-Traumatic Stress Disorder, Cognitive-Behavioral Therapy

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Type of Study: Research | Subject: Clinical Psychiatry