Effectiveness of Short-Term Dynamic Psychotherapy on Distress Tolerance, Emotion Regulation, and Compulsive Avoidance in Generalized Anxiety Disorder

Objective: This study aimed to evaluate the effectiveness of Short-Term Dynamic Psychotherapy (STDP) on distress tolerance, emotion regulation, and compulsive avoidant behaviors in adults with generalized anxiety disorder.

Methods and Materials: A randomized controlled trial with a pretest–posttest and follow-up design was conducted. Sixty adults meeting DSM-5 criteria for generalized anxiety disorder were randomly assigned to an STDP group (n = 30) or a wait-list control group (n = 30). The intervention group received 16 weekly individual STDP sessions, each lasting 60 minutes, while the control group received treatment as usual without structured psychotherapy. Outcomes were assessed at baseline, post-treatment, and eight-week follow-up using the Distress Tolerance Scale, Difficulties in Emotion Regulation Scale, Cognitive Behavioral Avoidance Scale, and Generalized Anxiety Disorder-7. Data were analyzed using mixed-effects repeated-measures models.

Findings: Significant group × time interactions were found for distress tolerance, F(2, 110) = 24.56, p < .001, ηp² = .31; emotion regulation difficulties, F(2, 110) = 19.84, p < .001, ηp² = .27; and compulsive avoidant behaviors, F(2, 110) = 15.61, p < .001, ηp² = .22. At post-treatment, the STDP group showed significantly higher distress tolerance than controls, t(58) = 6.01, p < .001, d = 1.55, lower emotion regulation difficulties, t(58) = 4.52, p < .001, d = 1.16, and lower compulsive avoidance, t(58) = 4.03, p < .001, d = 1.04. Effects remained significant at follow-up.

Conclusion: STDP significantly improved distress tolerance and emotion regulation and reduced compulsive avoidant behaviors in adults with generalized anxiety disorder. The findings support STDP as a time-limited intervention targeting affective and avoidant mechanisms in GAD.