Comparing the Effectiveness of Modular Cognitive-‎Behavioral Therapy, ‎‏‏Pharmacotherapy (Paroxetine), and Their Combination in Intolerance of Uncertainty and Meta-Worry‎ among Female University Students with Generalized Anxiety Disorder

Background: This study aimed to compare the effectiveness of pharmacotherapy and modular cognitive-behavioral therapy, ‎‏‏as well as their combination, in intolerance of uncertainty and meta-worry‎ among female university students with generalized anxiety disorder. Objectives: Paying attention to psychological, cognitive-behavioral and biological dimensions in patients with generalization anxiety disorder causes continuity of therapeutic effects. Methods: The present study was a ‎semi-experimental ‎research. The statistical population comprised all female students of the Islamic Azad University of Mashhad, of which 60 people were selected by a convenience sampling method and were randomly assigned to three experimental groups and one control group. All groups were initially pretested; afterward, the first experimental group received modular cognitive-behavioral therapy during ten 90-minute sessions; the second experimental group received pharmacotherapy and one daily dose of paroxetine; and the third experimental group received combination therapy; however, the control group was placed on the waiting list. At the end of the treatment period and three months thereafter, the participants were given a post-test and a follow-up test. The required data were collected through questionnaires, namely Freeston Intolerance of Uncertainty Scale and Wells Anxious Thoughts Inventory. The data were analyzed in SPSS-24 software using the repeated measures analysis of variance. Results: The results demonstrated that all three therapeutic approaches compared to the control group were effective in reducing intolerance of uncertainty and meta-worry. However, the combination therapy was significantly superior to any of the two treatment approaches alone (P 0.05). Conclusion: Considering the biological and psychological underpinnings of generalized anxiety disorder, the combination of psychological and drug therapies seems to be a more effective approach to improving anxiety states.