Cognitive Behavior Therapy for Generalized Anxiety Disorder: A Case Study of Arrhythmia Patient

Putri Dewinta; Adhityawarman Menaldi

doi:10.21512/humaniora.v9i2.4715

Authors

Putri Dewinta University of Indonesia
Adhityawarman Menaldi University of Indonesia

DOI:

https://doi.org/10.21512/humaniora.v9i2.4715

Keywords:

anxiety, GAD, arrhythmia, CBT, psychoeducation

Abstract

This research aimed to test the efficacy of Cognitive Behavior Therapy (CBT) and psychoeducation methods to decrease anxiety level in arrhythmia patient. Besides that, it was also to discuss how CBT could reduce anxiety level on a subject who had Generalized Anxiety Disorder (GAD) and also had the medical disease. This research used the qualitative method. The subject in this research was a 22-years-old single female, called S (initials), who came to community health center (Puskesmas) to get help regarding her uncomfortable feelings about her thoughts and concerns. The subject was given a pre-post test using Hamilton Anxiety Rating Scale (HARS) to see the differences in the anxiety level before, during, and after the treatment. Results of the research show that the level of anxiety in the subject is decreased. The categorization score goes from “very severe anxiety” to “moderate anxiety”. The subject also conveys on the last session that she feels less anxious and that she can control her negative thought.

Dimensions

Plum Analytics

Author Biographies

Putri Dewinta, University of Indonesia

Department of Clinical Psychology, University of Indonesia

Adhityawarman Menaldi, University of Indonesia

Department of Clinical Psychology, University of Indonesia

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th Ed). doi: https://doi.org/10.1002/jps.3080051129

Ansari, S., & Arbabi, M. (2014). Cognitive Behavioral Therapy (CBT) in a patient with Implantable Cardioverter Defibrillator (ICD) and Posttraumatic Stress Disorder (PTSD). Iranian Journal of Psychiatry, 9(3), 181–183. Retrieved from http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L600023654%5Cnhttp://sfx.library.uu.nl/utrecht?sid=EMBASE&issn=20082215&id=doi:&atitle=Cognitive+behavioral+therapy+(CBT)+in+a+patient+with+implantable+cardioverter+defibrillator+%252.

Asmadi. (2008). Kebutuhan dasar manusia. Jakarta: Salemba Medika.

Badrya, L. (2015). Perbedaan tingkat kecemasan antara mahasiswa kedokteran laki-laki dan perempuan angkatan 2011 FKIK UIN Syarif Hidayatullah Jakarta dalam menghadapi ujian OSCE. Jakarta: UIN Syarif Hidayatullah.

Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd Ed). American Journal of Psychiatry, 159 (8), 1453. doi: https://doi.org/10.1176/appi.ajp.159.8.1453.

Bashiri, Z., Aghajani, M., & Alavi, N. M. (2016). Effects of psychoeducation on mental health in patients with coronary heart disease. Iranian Red Crescent Medical Journal, 18(5), 1-8. doi:

https://doi.org/http://dx.doi.org/10.5812/ircmj.25089.

Cohen, B. E., Edmondson, D., & Kronish, I. M. (2015). State of the art review: Depression, stress, anxiety, and cardiovascular disease. American Journal of Hypertension, 28(11), 1295-1302. https://doi.org/10.1093/ajh/hpv047.

Dekker, R. L., Lennie, T. A., Doering, L. V., Chung, M. L., Wu, J. R., & Moser, D. K. (2014). Coexisting anxiety and depressive symptoms in patients with heart failure. European Journal of Cardiovascular Nursing: Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 13(2), 168–176. doi:

https://doi.org/10.1177/1474515113519520.

Donker, T., Griffiths, K. M., Cuijpers, P., & Christensen, H. (2009). Psychoeducation for depression, anxiety, and psychological distress: A meta-analysis. BMC Medicine, 7(79), 1-9. doi: https://doi.org/10.1186/1741-7015-7-79.

Dorland. (2011). Dorland’s illustrated medical dictionary (32nd ed) Philadephia: Saunders. doi: https://doi.org/10.2105/AJPH.55.9.1451.

Dunbar, S. B., Dougherty, C. M., Sears, S. F., Carroll, D. L., Goldstein, N. E., Mark, D. B., McDaniel, G., Pressler, S. J., Schron, E., Wang, P., & Zeigler, V. L. (2012). Educational and psychological interventions to improve outcomes for recipients of implantable cardioverter defibrillators and their families: A scientific statement from the American heart association. Circulation, 126(17), 2146-2173. doi: https://doi.org/10.1161/CIR.0b013e31825d59fd.

Greer, J. A., Park, E. R., Prigerson, H. G., & Safren, S. A. (2010). Tailoring cognitive-behavioral therapy to treat anxiety comorbid with advanced cancer. Journal of Cognitive Psychotherapy, 24(4), 294–313. doi: https://doi.org/10.1891/0889-8391.24.4.294.

Halm, M. A. (2009). Relaxation: A self-care healing modality reduces harmful effects of anxiety. American Journal of Critical Care, 18(2), 169–172. doi: https://doi.org/10.4037/ajcc2009867.

Hanafi, B. T. (2001). Buku ajar ilmu penyakit dalam, jilid I edisi 3. Jakarta: Balai Penerbit FKUI.

Hawari, D. (2011). Manajemen stress, cemas, dan depresi. Jakarta: FKUI.

Hazlett-Stevens, H. (2008). Psychological approaches to generalized anxiety disorder: A clinician’s guide to assessment and treatment. New York: Springer-V.

Hursepuny, S. A., Sriati, A., & Fitria, N. (2015). Gambaran tingkat kecemasan pada pegawai yang bekerja di Lembaga Pemasyarakatan Wanita Klas IIA Bandung. Jatinangor: Fakultas Ilmu Keperawatan Universitas Padjadjaran.

Keliat, B. A., Wiyono, A. P., & Susanti, H. (2012). Manajemen kasus gangguan jiwa: CMHN (intermediate course). Jakarta: EGC.

Kornerup, H., Zwisler, A. D. O., & Prescott, E. (2011). No association between anxiety and depression and adverse clinical outcome among patients with cardiovascular disease: Findings from the DANREHAB trial. Journal of Psychosomatic Research, 71(4), 207–214. doi:

https://doi.org/10.1016/j.jpsychores.2011.04.006.

Lipschutz, R. S., Gray, S. A. O., Weems, C. F., & Scheeringa, M. S. (2017). Respiratory sinus arrhythmia in Cognitive Behavioral Therapy for Posttraumatic Stress Symptoms in children: Preliminary treatment and gender effects. Applied Psychophysiol Biofeedback, 42(4), 309–321.

Luscher, T. F. (2016). Managing arrhythmias: Diagnosis and modern treatment. European Heart Journal, 37(7), 577–579. doi: https://doi.org/10.1093/eurheartj/ehw030.

Maia, A. C. C. O., Braga, A. A., Soares-Filho, G., Pereira, V., Nardi, A. E., & Silva, A. C. (2014). Efficacy of cognitive behavioral therapy in reducing psychiatric symptoms in patients with implantable cardioverter defibrillator: An integrative review. Br azilian Journal of Medical and Biological Research, 47(4), 265–272. doi: https://doi.org/10.1590/1414-431X20133418.

Mann, D. L., Zipes, D. P., Libby, P., Bonow, R. O., & Braunwald, E. (2015). Braunwald’s heart disease: A textbook of cardiovascular medicine. Philadelphia: Saunders. doi: https://doi.org/10.1001/jama.294.3.376-a.

Martens, E. J., de Jonge, P., Na, B., Cohen, B. E., Lett, H., & Whooley, M. A. (2010). Scared to death? Generalized anxiety disorder and cardiovascular events in patients with stable coronary

heart disease: The heart and soul study. Archives of General Psychiatry, 67(7), 750–758. doi: https://doi.org/10.1001/archgenpsychiatry.2010.74.

Mawandha, H. G., & Ekowarni, E. (2009). Terapi kognitif perilaku dan kecemasan menghadapi prosedur medis pada anak penderita leukimia. Jurnal Intervensi Psikologi, 1(1), 75-92.

Megawati. (2014). Rancangan dan uji coba cognitive behavioral therapy terhadap penurunan frekuensi merokok pada perokok wanita dewasa awal yang ingin berhenti merokok di kota Bandung. Bandung: Universitas Kristen Maranatha.

Moser, D. K. (2007). The rust of life: Impact of anxiety on cardiac patients. American Journal of Critical Care, 16(4), 361–369. doi: https://doi.org/10.1016/j.biotechadv.2011.08.021.Secreted.

Muliawati, D. (2015). Perbedaan efektivitas terapi murotal dan aromaterapi lavender terhadap penuruan gejala kecemasan pada pasien pre operasi di RSUD Dr. R. Goeteng Taroenadibrata Purbalingga. Purwokerto: Universitas Muhammadiyah Purwokerto.

Nurlindayanti, E., Susetyowati., Probosuseno., & Pangastuti, R. (2015). Kecemasan dan status gizi berhubungan dengan lama rawat inap pada pasien jantung di RSUD Jenderal Ahmad Yani, Metro, Lampung. Jurnal Gizi dan Dietetik Indonesia, 3(2), 98–104. doi:

http://dx.doi.org/10.21927/ijnd.2015.3(2).98-104.

Oemarjoedi, A. K. (2003). Pendekatan cognitive behavior dalam psikoterapi. Jakarta: Kreativ Media.

Sabhan, H. (2015). Treatment of cardiac arrhythmias in the emergency department. Zagreb: University of Zagreb.

Stuart, G. W. (2007). Buku saku keperawatan jiwa. Jakarta: EGC.

Thaler, M. S. (2013). Satu-satunya buku EKG yang Anda perlukan, edisi 7. Jakarta: EGC.

Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills and applications (2nd edition). London: SAGE.

Young, D. J. (1991). Creating a low-anxiety classroom environment: What does language anxiety research suggest? The Modern Language Journal, 75(4), 426–439.

Yousefy, A., Khayyam-Nekouei, Z., Sadeghi, M., Ahmadi, S. A., Ruhafza, H., Rabiei, K., & Khayyam-Nekouei, S. A. (2010). The effect of cognitive-behavioral therapy in reducing anxiety in heart disease patients. Arya Journal, 2(2), 84-88.

Zakiyah. (2014). Pengaruh dan efektifitas Cognitive Behavioral Therapy (CBT) berbasis komputer terhadap klien cemas dan depresi. E-Journal WIDYA Kesehatan Dan Lingkungan, 1(1), 75-80.