Supplemental Material for Dimensions of Skill Use in the Unified Protocol: Exploring Unique Effects on Anxiety and Depression

2021 ◽  
Keyword(s):  
Anxiety And Depression ◽  
Unified Protocol

scholarly journals Transdiagnostic CBT Treatment of Co-morbid Anxiety and Depression in an Older Adult: Single Case Experimental Design

2014 ◽  
Vol 43 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Ben Hague ◽  
Shonagh Scott ◽  
Stephen Kellett
Keyword(s):  
Older Adults ◽  
Experimental Design ◽  
Treatment Approach ◽  
Single Case ◽  
Anxiety And Depression ◽  
Unified Protocol ◽  
End Of Treatment ◽  
Routine Clinical Setting ◽  
Clinical Models

Background: Despite the prevalence of co-morbid anxiety and depression in older adults, evaluation of suitable clinical models is rare. Aims: This study tested the acceptability and effectiveness of a transdiagnostic approach to treating co-morbid anxiety and depression in an older adults in a routine clinical setting. Method: In an A/B single case experimental design, a patient completed five daily ideographic measures of anxiety and depression across baseline and treatment and the HADS at five time points over time, including 3-month follow-up. The 8-session treatment was transdiagnostic CBT informed by the Unified Protocol. Results: All sessions were attended. Significant baseline-treatment improvements were found for daily structure, mood, confidence and worry, with large associated effect sizes. The HADS showed that the patient met recovery criteria by the end of treatment, with some evidence of anxious relapse at follow-up. Conclusion: Transdiagnostic CBT offers promise as a treatment approach to mixed anxiety and depression in older adults. The model needs to be further tested using more rigorous and suitably powered methodologies.

The unified protocol for anxiety and depression with comorbid borderline personality disorder: a single case design clinical series

2019 ◽  
Vol 12 ◽  
Author(s):  
Michelle E. Lopez ◽  
Steven R. Thorp ◽  
Matthew Dekker ◽  
Andrew Noorollah ◽  
Giovanna Zerbi ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotional Disorders ◽  
Single Case ◽  
Borderline Personality ◽  
Anxiety And Depression ◽  
Individual Treatment ◽  
List Type ◽  
Unified Protocol ◽  
Clinical Series

AbstractThis study used a single case experimental design to investigate the use of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) among a sample of individuals with depression and anxiety who also presented with borderline personality disorder (BPD). Eight women received individual treatment with the UP over the course of 14–16 treatment sessions, and were assessed for anxiety and depression severity on a weekly basis over a 2–6 week baseline period and throughout treatment. Three of the eight participants demonstrated reliable pre- to post-treatment clinical improvements on depression and stress scales, and one participant demonstrated a reliable reduction on an anxiety scale. Two participants demonstrated a reliable improvement in overall anxiety. The results indicate that the UP applied to individuals diagnosed with primary BPD may lead to clinical improvement in depression, stress and anxiety for some individuals. However, the majority of individuals with BPD in our sample did not show strong improvement, and this suggests the need for additional sessions of UP or an intervention that focuses on the symptoms of BPD specifically for some women.Key learning aims (1)To describe the applicability of the Unified Protocol in the treatment of individuals with borderline personality and co-occurring anxiety or depression.(2)To understand the value of utilizing a transdiagnostic approach as an alternative to diagnosis-specific approaches to treatment.(3)To identify the four core modules of the Unified Protocol and describe the general format for individual treatment.

scholarly journals Emotion regulation as the mediator of reductions in anxiety and depression in the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders: double-blind randomized clinical trial

2019 ◽  
Vol 41 (3) ◽  
pp. 227-236
Author(s):  
Sahel Khakpoor ◽  
Omid Saed ◽  
Alireza Armani Kian
Keyword(s):  
Clinical Trial ◽  
Emotion Regulation ◽  
Randomized Clinical Trial ◽  
Emotional Disorders ◽  
Beck Anxiety Inventory ◽  
Anxiety And Depression ◽  
Double Blind ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Goal Directed Behavior

Abstract Objective: An important subject in evaluation of the efficacy of treatments is to examine how the intervention is effective and to identify the consequences of that treatment. In this regard, the current study investigates the role of emotion regulation as the mediator of the treatment outcomes of therapy using the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders. Method: This article describes a double-blind randomized clinical trial. A sample of 26 individuals was selected based on cut-off scores for the Beck Depression Inventory and Beck Anxiety Inventory and their final diagnoses were confirmed with the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV). The sample was randomly divided into two groups: control and treatment (13 patients each). The treatment group received 20 one-hour UP sessions. The Beck Depression Inventory, the Beck Anxiety Inventory, and the Difficulties in Emotion Regulation Scale were administered at two stages, pre-treatment and post-treatment. Results: The UP reduced anxiety and depression in patients through improvement in emotion regulation. Furthermore, the results showed that the difficulty engaging in goal-directed behavior and non-acceptance of emotional response subscales were capable of predicting 62% of variance in anxiety scores. In turn, two subscales, difficulty engaging in goal-directed behavior and lack of emotional clarity, predicted 72% of variance in depression scores. Conclusion: Emotion regulation can be considered as a potential mediating factor and as predictive of outcomes of transdiagnostic treatment based on the UP. Clinical trial registration: Iranian Registry of Clinical Trials, IRCT2017072335245N1.

scholarly journals Dimensions of Skill Use in the Unified Protocol: Exploring Unique Effects on Anxiety and Depression

2021 ◽  
Author(s):  
Matthew W. Southward ◽  
Shannon Sauer-Zavala
Keyword(s):  
Randomized Trial ◽  
Skill Training ◽  
Test Session ◽  
Anxiety And Depression ◽  
Symptom Change ◽  
Unified Protocol ◽  
Multiple Assignment ◽  
Specific Skill ◽  
Using Data ◽  
Anxiety Depression

Objective: Although the Unified Protocol contains multiple distinct skills to target anxiety, depression, and related conditions, researchers have yet to establish if patients' use of these skills contributes to symptom change. Using data from the first-stage randomization of a sequential multiple assignment randomized trial, we tested whether general skillfulness, defined by skill knowledge, frequency, quality, and effectiveness, predicted within- or between-person changes in anxiety and depression. We further tested whether use of particular UP skills (e.g., mindfulness, behavior change) predicted changes in these outcomes. Method: Participants (N = 70; Mage = 33.74, 67% female, 74% white) completed six sessions of core UP modules and reported on their skillfulness and specific skill use using two novel measures, along with their symptoms of anxiety (OASIS) and depression (ODSIS) before each session, and their alliance (WAI) after each session. We disaggregated between- from within-person effects to test session- to-session effects of skillfulness, skill use, and the alliance on symptom change. Results: Greater within-person skillfulness predicted decreases in anxiety and depression. More frequent within- person use of all UP skills predicted decreases in anxiety, whereas more frequent within-person use of alternative actions specifically predicted decreases in depression. Conclusions: This pattern of results provides guidance on the specific aspects of skill training to prioritize in transdiagnostic treatments depending on whether therapists are targeting anxiety or depression.

scholarly journals Effectiveness of the unified protocol for treating co-morbid health anxiety and depression: an empirical case study

2021 ◽  
pp. 1-11
Author(s):  
Chris Gaskell ◽  
Ben Hague ◽  
Stephen Kellett
Keyword(s):  
Food Intake ◽  
Single Case ◽  
Health Anxiety ◽  
Baseline Period ◽  
Anxiety And Depression ◽  
Single Case Design ◽  
Unified Protocol ◽  
Co Morbidity ◽  
Clinically Significant

Abstract Aims: The unified protocol (UP) is indicated when patients present with co-morbidity, but no studies have previously investigated the effectiveness of the UP with co-morbid health anxiety and depression. Method: An A/B single case design evaluated outcomes for a 27-year-old male presenting with health anxiety and co-morbid depression. Following a 21-day assessment-baseline period containing three sessions, the manualised UP was delivered across a 42-day period containing seven intervention sessions. Four idiographic measures (occurrence and duration of health checking, sleep duration and food intake satisfaction) were collected daily throughout, and two nomothetic measures were collected at four time points. Results: All sessions were attended. Number of health checking episodes reduced from four per day to two per day. A 59 minute per day reduction in time spent health checking occurred, and sleep increased by 100 minutes per night. There was little apparent change in terms of food intake satisfaction. There was a reliable and clinically significant reduction in depression. Discussion: Further testing of the effectiveness of the UP with co-morbid health anxiety and depression in true single case experimental designs is now indicated.

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