The Effect of Training Emotion Regulation Skills on the Resiliency of Patients with Generalized Anxiety Disorder


1 Associate Professor, Department of Psychology, Faculty of Literature and Humanities, Shahid Bahonar University of Kerman, Kerman, Iran

2 M.Sc. of Psychology, Consulting Expert, The Education of 2 Erea, Kerman, Iran

3 M.Sc. of Psychology, Kerman, Iran


Background & Aims: Anxiety is an emotion-based disorder resulting from resiliency and it is expected that the ability of individuals to regulate their emotions can be a key factor in determining the amount of their resiliency. The present study aimed to examine the effects of training emotion regulation skills on the resiliency of patients with generalized anxiety disorder (GAD). Methods: Using multi-stage clustered random sampling method in this quasi-experimental study, participants were selected from three high schools and two first-grade classes in each high school, respectively. Following the completion of the Beck anxiety inventory (BAI) and clinical interviews, 30 individuals were selected and placed randomly in two groups of experimental and control. The experimental group exposed to 13-sessions Gratz and Gunderson’s emotion regulation skills training, but the control group received no training. Both the groups were responded to the items of the Connor–Davidson Resilience Scale before and after the intervention. The differences of the scores were calculated between pre- and postintervention data and were analyzed using one-way ANOVA. Results: Training emotion regulation skills was effective on the resiliency of patients with generalized anxiety disorder. Conclusion: It seems that training the emotion regulation skills can be implemented in clinical interventions to promote resiliency among the patients with generalized anxiety disorder.


  1. Naeinian MR, Shaeiri MR, Sharif AM, Hadian BAM. To study reliability and validity for a brief measure for assessing Generalized Anxiety Disorder (GAD-7). Daneshvar Raftar 2011; 3(4): 41-50. [In Persian].
  2. Dadsetan P. Developmental psychopathology: from childhood to adulthood. Tehran, Iran: Samt Publications; 2011. [In Persian].
  3. Hosseinifard SM, Birashk B, Atefvahid MK. Epidemiology of mental disorders in high-school students in Rafsanjan. Iran J Psychiatry Clin Psychol 2005; 11(1): 71-80. [In Persian].
  4. Zarafshan H, Mohammadi M, Salmanian M. Prevalence of anxiety disorders among children and adolescents in Iran: a systematic review. Iran J Psychiatry 2015; 10(1): 1-7.
  5. Wells A, Carter K. Generalized anxiety disorder. In: Carr A, McNulty M, Editors. The handbook of adult clinical psychology: an evidence based practice approach. Abingdon, UK: Routledge; 2006. p. 423-57.
  6. Clark DB, Smith MG, Neighbors BD, Skerlec LM, Randall J. Anxiety disorders in adolescence: Characteristics, prevalence, and comorbidities. Clinical Psychology Review 1994; 14(2): 113-37.
  7. Besharat MA, Salehi M, Shahmohamadi K, Nadali H, Zebardast O. Relations of resilience and hardiness with sport achievement and mental health in a sample of athletes. Contemporary Psychology 2009; 3(2): 38-49. [In Persian].
  8. Newman R. Providing direction on the road to resilience. Behavioral Health Management 2003; 23(4): 42.
  9. Gottesman J. Secondary traumatic stress and resilience among practicum-level psychology trainees [Thesis]. Denver, CO: University of the Rockies; 2008.
  10. Tugade MM, Fredrickson BL. Resilient individuals use positive emotions to bounce back from negative emotional experiences. J Pers Soc Psychol 2004; 86(2): 320-33.
  11. Liu Y, Wang ZH, Li ZG. Affective mediators of the influence of neuroticism and resilience on life satisfaction. Personality and Individual Differences 2012; 52(7): 833-8.
  12. Troy AS, Mauss IB. Resilience in the face of stress: emotion regulation as a protective factor. In: Southwick SM, Litz BT, Charney D, Friedman MJ, Editors. Resilience and mental health challenges across the lifespan. Cambridge, UK: Cambridge University Press; 2011.
  13. Dillon DG, Deveney CM, Pizzagalli DA. From basic processes to real-world problems: how research on emotion and emotion regulation can inform understanding of psychopathology, and vice versa. Emot Rev 2011; 3(1): 74-82.
  14. Reivich K, Shatté A. The resilience factor: 7 essential skills for overcoming life's inevitable obstacles. New York, NY: Broadway Books; 2002.
  15. Roberton T, Daffern M, Bucks RS. Emotion regulation and aggression. Aggression and Violent Behavior 2012; 17(1): 72-82.
  16. Carlson JM, Dikecligil GlN, Greenberg T, Mujica-Parodi LR. Trait reappraisal is associated with resilience to acute psychological stress. Journal of Research in Personality 2012; 46(5): 609-13.
  17. Soleimani E, Habibi Y. The relationship between emotion regulation and resiliency with psychological well-being in students. Journal of School Psychology 2014; 3(4): 51-72. [In Persian].
  18. Gross JJ, John OP. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol 2003; 85(2): 348-62.
  19. Bateni P, Abolghasemi A, Aliakbari Dehkordi M, Hormozi M. The efficacy of emotion-regulation skills training on the anxiety components among female school students. Journal of School Psychology 2013; 2(3): 23-37. [In Persian].
  20. Gratz KL, Gunderson JG. Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behav Ther 2006; 37(1): 25-35.
  21. Graziano PA, Reavis R, Keane S, Calkins SD. The role of emotion regulation and children's early academic success. J Sch Psycho 2007; 45(1): 3-19.
  22. Wu G, Feder A, Cohen H, Kim JJ, Calderon S, Charney DS, et al. Understanding resilience. Front Behav Neurosci 2013; 7: 10.
  23. Graham JR, Calloway A, Roemer L. The buffering effects of emotion regulation in the relationship between experiences of racism and anxiety in a black American sample. Cognitive Therapy and Research 2015; 39(5): 553-63.
  24. Khosravi M, Bigdely I. The relationship between personality factors and test anxiety among university students. Journal of Behavioral Sciences 2008; 2(1): 13-24. [In Persian].
  25. Delavar A. Research methods in psychology. Tehran, Iran: Virayesh Publications; 2006. [In Persian].
  26. Rafiei M, Seifi A. An investigation into the reliability and validity of beck anxiety inventory among the university students. Iran J Psychiatry Clin Psychol 2013; 7(27): 37-46. [In Persian].
  27. Kaviani H, Javaheri F, Bahiraei H. The efficacy mindfulness based cognitive therapy on negative automatic though reduction, dysfunctional attitude, depression, anxiety: A sixty day follow-up. Adv Cogn Sci 2005; 7(1): 49-59. [In Persian].
  28. Kaviani H, Mousavi AS. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J 2008; 66(2): 136-40. [In Persian].
  29. Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 2003; 18(2): 76-82.
  30. Mohammadi M. Study of resilience factors in individuals exposed to drug abuse, Ph.D. thesis, Tehran Well-being University, 2005. [Persian].
  31. Sharifi V, Assadi SM, Mohammadi MR, Amini H, Kaviani H, Semnani Y, et al. A Persian translation of the structured clinical interview for diagnostic and statistical manual of mental disorders, fourth edition: psychometric properties. Compr Psychiatry 2009; 50(1): 86-91.
  32. Martin CS, Pollock NK, Bukstein OG, Lynch KG. Inter-rater reliability of the SCID alcohol and substance use disorders section among adolescents. Drug Alcohol Depend 2000; 59(2): 173-6.
  33. Gratz KL, Dixon-Gordon KL, Tull MT. Predictors of treatment response to an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Personal Disord 2014; 5(1): 97-107.
  34. Gratz KL, Roemer L. 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 2004; 26(1): 41-54.
  35. Andami Khoshk A, Golzari M, Esmaelinasab M. Role of nine strategies of cognitive emotion regulation in the prediction of resilience. Iran J Psychiatry Clin Psychol 2013; 7(27): 57-66. [In Persian].
  36. Feldman Barrett L, Gross J, Christensen TC, Benvenuto M. Knowing what you're feeling and knowing what to do about it: Mapping the relation between emotion differentiation and emotion regulation. Cognition and Emotion 2001; 15(6): 713-24.
  37. Gross JJ. Emotion regulation in adulthood: timing is everything. Current Directions in Psychological Science 2001; 10(6): 214-9.
  38. Babaiee Z, Hasani J, Mohamadkhani SH. The effectiveness of dialectical behavior therapy based emotion regulation skill training in substance abusers craving: a single subject study. Journal of Clinical Psychology 2012; 4(3): 33-41. [In Persian].