The Effectiveness of Acceptance and Commitment Therapy (ACT) on Emotional Expression, Interpersonal Relationships, and Self-Efficacy in People with Generalized Anxiety Disorder

Mahdi Rajabian Noghondar; Sogand Rahimi; Fatemeh Khalilfam; Elham Mohamadi; Sogand Asgharzadeh Rafsanjani

doi:10.63053/ijhes.193

Authors

Mahdi Rajabian Noghondar Mahdi Rajabian Noghondar, M.A. in Clinical Psychology, Faculty of Humanities, Islamic Azad University of Neyshabur, Neyshabur, Iran
Sogand Rahimi Sogand Rahimi, M.A. in General Psychology, Islamic Azad University of Gorgan, Gorgan, Iran.
Fatemeh Khalilfam Fatemeh Khalilfam, M.A. in General Psychology, Bonab Branch, Payame Noor University, East Azerbaijan, Iran.
Elham Mohamadi M.A. in General Psychology, Islamic Azad University of Birjand Branch, Birjand, Iran.
Sogand Asgharzadeh Rafsanjani M.A. in Clinical Psychology of Child and Adolescent, Faculty of Humanities, University of Science and Art, Yazd, Iran.

DOI:

https://doi.org/10.63053/ijhes.193

Keywords:

Generalized Anxiety Disorder, Acceptance and Commitment Therapy, Emotional Expression, Interpersonal Relationships, Self Efficacy

Abstract

Background: Generalized Anxiety Disorder (GAD) is associated with significant deficits in emotional expression, interpersonal functioning, and self-efficacy. Acceptance and Commitment Therapy (ACT), which targets psychological inflexibility, may address these specific difficulties. This study aimed to investigate the effectiveness of ACT on emotional expression, interpersonal relationships, and self-efficacy in individuals with GAD.

Methods: This quasi-experimental study employed a pretest posttest follow up design with a waitlist control group. The statistical population included all adults aged 18–50 years diagnosed with GAD attending psychology and psychiatry clinics in Tehran during 2024–2025. A total of 40 participants were selected using convenience sampling and randomly assigned to an ACT group (n = 20) or a waitlist control group (n = 20). The ACT group received ten 90-minute weekly group sessions. Data collection instruments included the Generalized Anxiety Disorder Scale (GAD 7), Emotional Expressiveness Questionnaire (EEQ), Inventory of Interpersonal Problems (IIP 32), Self-Efficacy Scale (SE 12), and Acceptance and Action Questionnaire II (AAQ II). Data were analyzed using repeated measures analysis of variance (ANOVA) and Bonferroni post hoc tests with SPSS 26.

Results: The ACT group demonstrated significant improvements compared to the control group. Significant effects were found for GAD 7 (F = 34.52, P < 0.001, η² = 0.52), EEQ total score (F = 28.14, P < 0.001, η² = 0.46), IIP 32 total score (F = 31.45, P < 0.001, η² = 0.48), SE 12 (F = 26.73, P < 0.001, η² = 0.44), and AAQ II (F = 35.28, P < 0.001, η² = 0.53). Improvements were maintained at two month follow up (P < 0.001).

Conclusion: ACT is an effective intervention for improving emotional expression, interpersonal relationships, and self efficacy in individuals with GAD, with large effect sizes and sustained gains. Increased psychological flexibility appears to mediate these improvements

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