Emotion Regulation and Anxiety

2017 ◽  
pp. 154-170
Author(s):  
Dagmar Kr. Hannesdóttir ◽  
Thomas H. Ollendick
Keyword(s):  
Emotion Regulation ◽  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Behavioral Therapy ◽  
Future Research ◽  
Childhood And Adolescence ◽  
Success Rates ◽  
Treatment As Usual ◽  
Unified Protocol ◽  
Clinically Significant

Chapter 8 reviews anxiety disorders of childhood and adolescence, investigating the role of emotion regulation in onset, maintenance and propagation. Based on DSM-5 criteria anxiety disorders have the following core features: Excessive, persisting anxious arousal and clinically significant symptoms causing distress or dysfunction in social, academic or other domains of functioning. Currently, CBT interventions have been created for school-aged children with anxiety including the Coping Cat and the Cool Kids programs. Despite relatively high success rates, children remaining symptomatic after treatment may benefit from emotion-focused approaches, such as Emotion-Focused Cognitive-Behavioral Therapy and the Unified Protocol for the Treatment of Emotional Disorders in Youth. In addition, novel therapies have been devised targeting parents and their emotion regulation deficits like the Supportive Parenting for Anxious Childhood Emotions (SPACE) program. Future research should employ randomized control trials comparing the novel treatment approaches, treatment as usual, and standard CBT determining best practice protocols.

scholarly journals Enhancing In Vivo Exposure in the Treatment of Panic Disorder and Agoraphobia Using Location-Based Technologies: A Case Study

2019 ◽  
Vol 19 (2) ◽  
pp. 145-159 ◽  
Author(s):  
Ignacio Miralles ◽  
Carlos Granell ◽  
Azucena García-Palacios ◽  
Diana Castilla ◽  
Alberto González-Pérez ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Emotional Disorders ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Unified Protocol ◽  
High Satisfaction ◽  
Patient Reported ◽  
Underlying Mechanisms

Panic disorder (PD) is quite prevalent and often appears along with agoraphobia (PD/A). The treatment of choice is cognitive behavioral therapy (CBT). Transdiagnostic intervention, an emotion-focused, cognitive behavioral intervention that has led to the Unified Protocol (UP), emphasizes the common underlying mechanisms that contribute to the development and maintenance of emotional disorders such as PD/A. A core feature of this treatment approach is in vivo exposure (IVE) to feared situations, which aims to prevent avoidance behaviors and encourages the patient to confront feared situations gradually. It is a difficult component for patients, especially when implementing the exposure on their own. Different feedback formats can be used to increase adequate IVE and reduce overt or subtle avoidance. The use of smartphones is a very useful option to initiate and sustain exposure behavior. The purpose of this study is to describe the use of location-based technologies (LBTs) during the IVE component of the UP treatment of a 47-year-old patient with PD/A. The acceptability and usability of the system were assessed. The Symptoms platform was employed during the exposure module, using LBT with a smartphone app. The patient reported positive expectations, high satisfaction scores, and an overall satisfactory experience. Enhancing key therapeutic components during treatment through the development of media-based tools is a very promising future research aim, and the possibility of using advanced smartphone features should be explored.

scholarly journals Efficacy of the unified protocol for transdiagnostic cognitive-behavioral treatment for depressive and anxiety disorders: a randomized controlled trial

2022 ◽  
pp. 1-12
Author(s):  
Masaya Ito ◽  
Masaru Horikoshi ◽  
Noriko Kato ◽  
Yuki Oe ◽  
Hiroko Fujisato ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Behavioral Treatment ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Controlled Trial ◽  
Principal Diagnosis ◽  
Treatment As Usual ◽  
Unified Protocol

Abstract Background The efficacy of the unified protocol of the transdiagnostic treatment for emotional disorders (UP) has been poorly studied in patients with depressive disorders. This study aimed to examine the efficacy of UP for improving depressive symptoms in patients with depressive and/or anxiety-related disorders. Methods This assessor-blinded, randomized, 20-week, parallel-group, superiority study compared the efficacy of the UP with treatment-as-usual (UP-TAU) v. wait-list with treatment-as-usual (WL-TAU). Patients diagnosed with depressive and/or anxiety disorders and with depressive symptoms participated. The primary outcome was depressive symptoms assessed by GRID-Hamilton depression rating scale (GRID-HAMD) at 21 weeks. The secondary outcomes included assessor-rated anxiety symptoms, severity and improvement of clinical global impression, responder and remission status, and loss of principal diagnosis. Results In total, 104 patients participated and were subjected to intention-to-treat analysis [mean age = 37.4, s.d. = 11.5, 63 female (61%), 54 (51.9%) with a principal diagnosis of depressive disorders]. The mean GRID-HAMD scores in the UP-TAU and WL-TAU groups were 16.15 (s.d. = 4.90) and 17.06 (s.d. = 6.46) at baseline and 12.14 (s.d. = 5.47) and 17.34 (s.d. = 5.78) at 21 weeks, with a significant adjusted mean change difference of −3.99 (95% CI −6.10 to −1.87). Patients in the UP-TAU group showed significant superiority in anxiety and clinical global impressions. The improvement in the UP-TAU group was maintained in all outcomes at 43 weeks. No serious adverse events were observed in the UP-TAU group. Conclusions The UP is an effective approach for patients with depressive and/or anxiety disorders.

Effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Among Veterans With Posttraumatic Stress Disorder: A Pilot Study

2017 ◽  
Vol 42 (2) ◽  
pp. 210-230 ◽  
Author(s):  
Ruth L. Varkovitzky ◽  
Andrew M. Sherrill ◽  
Greg M. Reger
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Emotion Regulation ◽  
Depressive Symptoms ◽  
Pilot Study ◽  
Posttraumatic Stress ◽  
Emotional Disorders ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

Effective treatment options are needed for veterans who do not participate in trauma-focused psychotherapy. Research has yet to examine the effectiveness of transdiagnostic psychotherapy in veterans with posttraumatic stress disorder (PTSD) and co-occurring psychological disorders. This pilot study examined the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a 16-week group format. We examined treatment outcomes in male and female veterans ( n = 52) in an outpatient specialty PTSD clinic at a large Veterans Affairs (VA) medical center. We hypothesized significant decreases in emotion regulation difficulty (Difficulties in Emotion Regulation Scale), PTSD symptom severity (PTSD Checklist for DSM-5), and depressive symptom severity (Patient Health Questionnaire–9). In addition, we hypothesized that reductions in emotion regulation difficulty across treatment would negatively predict PTSD and depressive symptoms at posttreatment. PTSD symptoms, depressive symptoms, and emotion regulation difficulty all evidenced significant improvements at the end of treatment relative to baseline ( ps < .001). In addition, reductions in emotion regulation across treatment were associated with lower PTSD and depressive symptoms at posttreatment ( ps < .001). This pilot study provides preliminary evidence supporting use of UP among veterans with PTSD and co-occurring disorders. Well-designed clinical trials evaluating efficacy of UP among veterans are needed.

Cognitive Behavioral Therapy for Insomnia for Caregivers

2019 ◽  
pp. 201-218
Author(s):  
Kelly M. Shaffer ◽  
Patricia Carter ◽  
Sheila N. Garland ◽  
Allison J. Applebaum
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Contributing Factors ◽  
Compensatory Behaviors ◽  
Wide Range ◽  
Cancer Caregivers ◽  
Clinically Significant ◽  
Mental And Physical Health

Between 40% and 76% of cancer caregivers report clinically significant symptoms of insomnia, likely due in part to the unique responsibilities, stressors, and compensatory behaviors endemic to the role. Insomnia negatively affects one’s mental and physical health, is frequently chronic, and may impair the normal grieving process among bereaved caregivers. Cognitive behavioral therapy for insomnia (CBT-I) is a first-line treatment for insomnia and is well suited to address the multifaceted contributing factors unique to caregivers’ sleep disturbance. This chapter addresses the distinct presentation of insomnia among cancer caregivers and describes key modifications to standard CBT-I that address these specific needs to enhance sensitivity and feasibility. A case example demonstrates the implementation of CBT-I tailored to one caregiver’s presentation. Future research must demonstrate effectiveness and acceptability of CBT-I among active caregivers, as well as develop a wide range of effective CBT-I delivery modalities to best serve this vulnerable population.

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

2010 ◽  
Author(s):  
David H. Barlow ◽  
Kristen K. Ellard ◽  
Christopher P. Fairholme ◽  
Todd J. Farchione ◽  
Christina L. Boisseau ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Emotional Disorders ◽  
Emotional Experience ◽  
Dissociative Disorders ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Situational Cues ◽  
Unified Protocol ◽  
The Common ◽  
Evidenced Based

This online patient workbook is a radical departure from disorder-specific treatments of various emotional disorders, and is designed to be applicable to all anxiety and unipolar mood disorders, as well as other disorders with strong emotional components, such as many somatoform and dissociative disorders. It covers the Unified Protocol (UP), which capitalizes on the contributions made by cognitive-behavioral theorists by distilling and incorporating the common principles of CBT present in all evidenced based protocols for specific emotional disorders, as well as drawing on the field of emotion science for insights into deficits in emotion regulation. It discusses the seven modules of UP, and focuses on four core strategies: becoming mindfully aware of emotional experience; reappraising rigid emotion laden attributions; identifying and preventing behavioral and emotional avoidance; and facilitating exposure to both interoceptive and situational cues associated with emotional experiences.

scholarly journals The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders

2017 ◽  
Vol 74 (9) ◽  
pp. 875 ◽  
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Jacqueline R. Bullis ◽  
Matthew W. Gallagher ◽  
Heather Murray-Latin ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

scholarly journals Parental Involvement in CBT for Anxiety-Disordered Youth Revisited: Family CBT Outperforms Child CBT in the Long Term for Children With Comorbid ADHD Symptoms

2015 ◽  
Vol 22 (5) ◽  
pp. 506-514 ◽  
Author(s):  
Marija Maric ◽  
Francisca J. A. van Steensel ◽  
Susan M. Bögels
Keyword(s):  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Child Behavior Checklist ◽  
Behavioral Therapy ◽  
Attention Problems ◽  
Anxiety Symptoms ◽  
Clinical Severity ◽  
Adhd Symptoms ◽  
Comorbid Adhd

Objective: The objective of this study was to examine the efficacy of child cognitive-behavioral therapy (CCBT) versus family CBT (FCBT) in anxiety-disordered youth with high and low comorbid ADHD symptoms. Method: Youth with anxiety disorders ( n = 123, aged 8-18) were classified in four groups according to (a) the type of CBT received (child vs. family) and (b) their comorbid ADHD symptoms, measured with the Child Behavior Checklist (CBCL) Attention Problems syndrome scale level (normal vs. [sub]clinical). Severity of anxiety disorders was assessed with Anxiety Disorders Interview Schedule–Child and Parent (ADIS-C/P) version and anxiety symptoms via a 71-item anxiety symptom questionnaire, the Screen for Child Anxiety and Related Emotional Disorders (SCARED-71), before and after CBT, and at 3 months and 1-year follow-ups. Results: Based on the severity of anxiety disorders, children with high ADHD symptoms profit more from FCBT than CCBT in the long term. For children low on ADHD symptoms, and for anxiety symptoms and attention problems, no differences between CCBT and FCBT occurred. Conclusion: Family involvement seems a valuable addition to CBT for children with comorbid anxiety and ADHD symptoms.

Group Treatment Applications of the Unified Protocol

2017 ◽  
pp. 252-267
Author(s):  
Jacqueline R. Bullis ◽  
Kate H. Bentley ◽  
Katherine A. Kennedy
Keyword(s):  
Cost Effectiveness ◽  
Emotional Disorders ◽  
Group Treatment ◽  
Depressive Disorders ◽  
Research Priorities ◽  
Future Research ◽  
Recent Application ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Group Format

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated promising results among patients with heterogeneous anxiety and comorbid depressive disorders when delivered on an individual basis, but greater efficiencies may be achieved with group-based applications. This chapter will provide a rationale for utilizing a transdiagnostic approach in a group format, including cost-effectiveness and efficiency for patients and practitioners alike. It will illustrate a recent application of the UP with patients who completed 12 sessions in a group, offer guidelines on how to successfully implement the UP in a group of patients with a range of anxiety, depressive, and related disorders, and discuss the challenges that arose during treatment. We will then present data on the treatment response for each patient, as well as patients’ perceptions of the acceptability and feasibility of the UP in a group format, and conclude with our thoughts on future research priorities.

The Unified Protocol for Anxiety Disorders

2017 ◽  
pp. 38-52 ◽  
Author(s):  
Laren R. Conklin ◽  
Todd J. Farchione ◽  
Steven Dufour
Keyword(s):  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Clinical Case ◽  
The United States ◽  
Transdiagnostic Treatment ◽  
Diagnostic And Statistical Manual ◽  
Unified Protocol ◽  
Clinical Case Studies ◽  
Individual Module ◽  
Manualized Protocol

Of any cluster of illnesses outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), none is more prevalent, likely to serve as a comorbid diagnosis, or costly in the United States than anxiety disorders. This chapter outlines the applications of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) for the treatment of such disorders. First, we briefly review the background research that provides context for the use of transdiagnostic treatment for anxiety disorders. The UP, with its intent to target comorbidity, is an approach that can be especially helpful for therapists who want to use an evidence-based treatment, prefer the structure of a manualized protocol, and value the benefits that a workbook can bring to patients. We then present two clinical case studies to demonstrate how each individual module of the UP maps onto typical cases of principal and comorbid anxiety. Recommendations for specific methods of protocol implementation are also described.

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