Abstract
The present study aimed to investigate the effectiveness of schema therapy on the symptoms of Anxiety Disorder in mothers with Intellectual Developmental Disorder children in Quds city. This research was conducted as a semi-experimental design with a pre-test and post-test, also featuring a control group. The statistical population of this research included all mothers with Intellectual Developmental Disorder Children residing in Quds city attending the academic year of 2022-2023, from which 30 participants were selected through convenience sampling and subsequently divided randomly into 2 groups consisting of 15 individuals: experimental and control. To assess anxiety levels, both groups initially completed the Beck's Anxiety Inventory (1998) as a pre-test. The experimental group subsequently received 12 sessions of schema therapy, while the control group followed their regular daily routine. Following both group's completion of the post-test, inferential (covariance analysis) and descriptive statistics (central tendency and dispersion indices) were employed to analyze the research data. The findings revealed a significant and positive effect of schema therapy on reducing Anxiety Disorder symptoms (η=0/290,P<0/005). The results clearly indicate that implementing schema therapy as an effective treatment option can significantly reduce the symptoms of Anxiety Disorder in mothers with Intellectual Developmental Disorder children, thereby enhancing their overall mental status and daily functioning.
Keywords: Anxiety Disorder, Intellectual Developmental Disorder, Mothers, Schema Therapy.
 
 
 
Extended Abstract

Introduction

Intellectual Developmental Disorder, which affects around 2-3% of the general population, has a significant societal impact (Jansen et al., 2023). This developmental disorder, recognized by a defect in the development of intelligence, reflects deficits that arise during a person's formative years. To clarify, the term "Intellectual Developmental Disorder" has a specific meaning in the field of mental health. It refers to a condition that affects an individual's ability to adapt to different situations, understand and use various concepts, engage in effective social communication, and perform practical and practical tasks. This condition, as defined by the American Psychiatric Association (2023), reduces a person's capacity to communicate and benefit from life resources. The birth of a child with Intellectual Developmental Disorder can be a sudden and overwhelming experience for families. It often triggers strong reactions and a sense of shock among family members. This shock can lead to deep worries and stress, as well as the emergence of unexpected challenges. The presence of a child with Intellectual Developmental Disorder can significantly impact the daily life of the family and disrupt their routines. This situation may involve significant changes in the family's daily routines and necessitates appropriate support for the child. (Qasemipour & Roshan, 2019; Bahadori Khosroshahi, 2017).
Mothers often fulfill the traditional role of primary caregiver, taking on the responsibility of providing care and nurturing to their children. This role extends beyond just fulfilling their physical needs and encompasses their psychological and social development as well. Therefore, due to their crucial role, mothers encounter the challenges and psychological problems of their children head-on. As the primary caregivers, they play a critical role in influencing and shaping the development of their children's personalities(Halstead, Ekas, et al., 2018; Kraaij et al., 2010; Ogston et al., 2011). Proven effective, Schema therapy addresses chronic psychopathology(Voshaar et al., 2024). This type of treatment aims to improve individuals' performance and mental wellbeing through the combination of cognitive and behavioral concepts, resulting in reduced mental and behavioral issues (Cox & Root, 2020). Schema therapy is a combination of therapies used to alleviate challenging symptoms. It effectively addresses moderate to severe manifestations of personality disorders and complex trauma (Bernstein et al., 2023; Edwards, 2022; Simpson & Smith, 2019; Yakın et al., 2020). Over recent years, this treatment approach has gained popularity and become a prominent diagnostic method (Salicru, 2024). This study found that approximately 61% of mothers with children diagnosed with Intellectual Developmental Disorder experienced anxiety, while around half dealt with depression. These findings indicate that this population of women face a high level of mental pressure. Indeed, this situation has detrimental effects on individuals' personal lives, but also imposes social and financial costs on families and society as a whole (Sharma et al., 2023). This highlights the significance of conducting research in this area, as it can contribute to enhancing the mental health and overall well-being of mothers affected by IDD.
Research Question
Does schema therapy have an effect on symptoms of Anxiety Disorder in mothers with children diagnosed with Intellectual Developmental Disorder?

Literature Review

Based on extant research, there is evidence suggesting that schema therapy can effectively reduce psychological issues in mothers with children with special needs. For example, Hasanvand et al (2023) found that schema therapy significantly reduced initial maladaptive schemas. Utilizing schema therapy as an effective treatment approach can contribute to reducing and reconciling the initial maladaptive schemas of mothers with Intellectual Developmental Disorder children, ultimately leading to an improvement in their mental well-being and daily functioning. The research conducted by Rahat Dehmardeh et al (2021) suggests that schema therapy can be an effective method to enhance distress tolerance and resilience in mothers with children diagnosed with Intellectual Developmental Disorder. Similarly, Kivanlu et al (2022) highlight the effectiveness of group therapy based on Emotional Schema Therapy in addressing difficulties with emotional regulation faced by mothers with Intellectual Developmental Disorder children. These findings highlight the potential benefits of schema therapy-based interventions on mothers' emotional well-being.The study by Choubforush Zadeh and Mohammad Panah Ardakan (2018) revealed that schema therapy can be an effective intervention for improving mental health in mothers. The findings demonstrated that schema therapy can indeed have positive effects on maternal well-being. The study conducted by Ghale Nui (2018) examined the efficacy of schema therapy in minimizing marital conflicts and anxiety among mothers with children with down syndrome. Notably, the findings indicated that schema therapy effectively reduced both marital conflicts and anxiety levels in this specific group of mothers. In line with the findings of Shaham et al (2021), this research aligns with the notion that schema therapy training can significantly reduce parenting stress, enhance psychological toughness, and improve overall mental health in mothers with children with special needs.

Methodology

The objective of this study is clear, and its methodology employs a semi-experimental approach, specifically a pre-test and post-test design with a control group. The primary focus is to assess the effectiveness of schema therapy in alleviating symptoms of Anxiety Disorder in mothers who have children diagnosed with Intellectual Developmental Disorder. The research subject pool consisted of all the mothers with children diagnosed with Intellectual Developmental Disorder who attended one of the special education schools in Qods city during the academic year 2022-2023. Utilizing the available sampling method, a total of 30 participants were included in the study out of the overall number of intellectually impaired children. A random allocation process was implemented to divide the chosen sample of 30 participants into two groups consisting of 15 individuals each. The selection of the sample size was based on Cohen's (1986) sample size determination table, with a significance level of 0.05 and an effect size of 0.5, resulting in the required sample size of 30 individuals.
The initial procedures undertaken involved obtaining the necessary approvals and permissions from the appropriate educational authorities. Communication with school administrators was also carried out, and the significance and necessity of the research were emphasized to the members of the Association of Teachers' Parents and Students' Parents. The participants in this study were mothers who were chosen based on the presence of symptoms of Anxiety Disorder and having at least one child diagnosed with Intellectual Developmental Disorder (mild to moderate levels) in all special education schools in the city. A total of 75 women met these criteria and were included in the research. As the study required participant compliance, 45 mothers from two exceptional schools voluntarily expressed their willingness to participate. Utilizing the available sampling technique, 30 participants were chosen, who were then randomly divided into two groups of equal size, an experimental group and a control group, each consisting of 15 individuals. In the initial stage, all participants completed the Beck Anxiety questionnaire. Their pre-test scores were then recorded. Subsequently, the entire group was randomly divided into two groups of 15 participants each, resulting in an experimental and control group. In the following phase of the study, the experimental group underwent a series of 12 group schema therapy sessions held at the Quds exceptional school (Room 1). Conversely, the control group did not receive any training or treatment during this time period. Following the completion of the group therapy sessions, both groups of mothers (experimental and control) were asked to fill out the Beck Anxiety questionnaire for a second time, representing the post-test scores which were subsequently analyzed and recorded for comparison.

Results

The primary goal of this study was to assess the efficacy of schema therapy in alleviating the signs of Anxiety Disorder among mothers with children diagnosed with Intellectual Developmental Disorder. The findings indicated that schema therapy demonstrated a significant and positive impact on reducing anxiety disorder symptoms. Implementing schema therapy as a treatment approach can contribute to reducing anxiety disorder symptoms in mothers with intellectually impaired children and contribute to improved mental well-being and daily functioning.

Discussion

 When examining the significant effect of schema-based therapy on the response to Anxiety Disorder in mothers with Intellectual Developmental Disorder children, the findings illustrate that individuals experiencing widespread anxiety often have a belief that their inability to control their thoughts stems solely from their own false beliefs about managing and regulating emotions. According to Qaseminezhad and Tabatabai (2023), individuals perceive their issues as inherent and beyond their ability to control, attributing their lack of emotional control to their own mental illness rather than external factors. According to the findings, these individuals find themselves trapped in a maladaptive cycle due to ineffective ways of managing emotions. However, schema therapy aims to address this issue by employing various techniques to break the cycle and create healthier coping mechanisms (Erfan et al., 2018). The study highlights the impact of anxiety symptoms and complications on individuals’ quality of life, leading to various disabilities. Therapeutic schemas help identify cognitive errors about the disease by teaching individuals to identify and address self-defeating thoughts, focusing on the relationship between behavioral responses and incorrect or ineffective beliefs about the disease and its treatment. By learning to respond differently, individuals can improve their quality of life (Mahmoudpour et al., 2020).

Conclusion

The findings of the study indicate that schema-based treatment effectively reduces the perception of illness in individuals with widespread anxiety. This is because Anxiety Disorders are developed over time, and this treatment method is fundamentally based on addressing fundamental beliefs and has the ability to alter deep-seated patterns formed over time. As a result, it is proposed to utilize this approach in psychiatric and psychological centers to treat patients with generalized anxiety disorder.
Acknowledgments
We would like to extend our sincere gratitude to all the respected and highly valued mothers who took part in this research, for their support and participation. We acknowledge and appreciate their contribution to this study.