A Comparison of a Psychodynamic Emotion-Focused Therapy Package with Dialectical Behavior Therapy: Emphasizing the Reduction of Aggression and Rumination in Women with Comorbid Depression and Social Anxiety

Reza Arab Markadeh; Hadi Farhadi; Seyyed Hamid Atashpour

Authors

Reza Arab Markadeh Department of Psychology, Isf.C., Islamic Azad University, Isfahan, Iran Author https://orcid.org/0000-0002-5640-2186
Hadi Farhadi Department of Psychology, Isf.C., Islamic Azad University, Isfahan, Iran Corresponding Author https://orcid.org/0000-0002-0241-4309
Seyyed Hamid Atashpour Department of Psychology, Isf.C., Islamic Azad University, Isfahan, Iran Author https://orcid.org/0000-0003-2090-7577

Keywords:

Aggression, Comorbid Depression, Dialectical Behavior Therapy, Psychodynamic Emotion-Focused Therapy, Rumination, Social Anxiety

Abstract

Objective: This study aimed to compare the effectiveness of a psychodynamic emotion-focused therapy package and dialectical behavior therapy in reducing aggression and rumination among women with comorbid depression and social anxiety.

Methods and Materials: The study employed a mixed-methods qualitative-quantitative design. In the qualitative phase, the components of the psychodynamic emotion-focused therapy package were developed through deductive thematic analysis. In the quantitative phase, a quasi-experimental pretest-posttest design with a two-month follow-up and a control group was implemented. The statistical population comprised single women aged 20–40 years with comorbid depression and social anxiety who were referred to counseling centers in Isfahan, Iran. A total of 45 eligible participants were selected through purposive sampling and randomly assigned to psychodynamic emotion-focused therapy, dialectical behavior therapy, and control groups. Data were collected using the Beck Depression Inventory, Connor Social Anxiety Inventory, Rumination Response Scale, and Eysenck and Glenn Wilson Aggression Questionnaire. Repeated-measures analysis of variance and Bonferroni post-hoc comparisons were used for inferential analysis.

Findings: Repeated-measures analysis revealed significant time-by-group effects for rumination, indicating that both psychodynamic emotion-focused therapy and dialectical behavior therapy significantly reduced rumination compared with the control condition, with treatment effects maintained at the two-month follow-up (p < .001). For aggression, significant between-group differences were observed, with psychodynamic emotion-focused therapy producing a significantly greater reduction than both dialectical behavior therapy and the control condition (p < .001). Dialectical behavior therapy did not significantly differ from the control group in reducing aggression.

Conclusion: Both psychodynamic emotion-focused therapy and dialectical behavior therapy appear effective for reducing rumination in women with comorbid depression and social anxiety. However, psychodynamic emotion-focused therapy demonstrates superior efficacy for aggression, suggesting that its emphasis on deeper emotional processing and underlying intrapsychic conflicts may provide additional therapeutic benefits when aggression constitutes a prominent clinical symptom.

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