scholarly journals Transdiagnostic Treatment of Bipolar Disorder and Comorbid Anxiety With the Unified Protocol: A Clinical Replication Series

2012 ◽  
Vol 36 (4) ◽  
pp. 482-508 ◽  
Author(s):  
K. K. Ellard ◽  
T. Deckersbach ◽  
L. G. Sylvia ◽  
A. A. Nierenberg ◽  
D. H. Barlow
Keyword(s):  
Bipolar Disorder ◽  
Transdiagnostic Treatment ◽  
Comorbid Anxiety ◽  
Unified Protocol

The Unified Protocol for Bipolar and Comorbid Disorders

2017 ◽  
pp. 86-110
Author(s):  
Kristen K. Ellard ◽  
Emily E. Bernstein ◽  
Andrew A. Nierenberg ◽  
Thilo Deckersbach
Keyword(s):  
Bipolar Disorder ◽  
Anxiety Disorder ◽  
Emotional Disorders ◽  
Emotion Dysregulation ◽  
Transdiagnostic Treatment ◽  
Comorbid Anxiety ◽  
Unified Protocol ◽  
Target Emotion ◽  
Bipolar Patients ◽  
Affective Lability

Bipolar disorder is a chronic and severe mental disorder characterized by affective lability and emotion dysregulation. In addition, it is associated with high rates of comorbidity, particularly with anxiety disorders. Approximately 90% of bipolar patients have been diagnosed with at least one comorbid anxiety disorder across the lifespan, with as many as two-thirds of patients meeting criteria for comorbid anxiety disorder at any given time. As such, transdiagnostic treatments that directly target emotion dysregulation in bipolar disorder are needed. In this chapter, we discuss evidence supporting an emotion dysregulation model of bipolar disorder and its roots in neuroticism. We then present a recent case of a patient with bipolar disorder with comorbid anxiety who received 18 sessions of treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP).

Skill Acquisition During Transdiagnostic Treatment With the Unified Protocol

2021 ◽  
Author(s):  
Shannon Sauer-Zavala ◽  
Anthony J. Rosellini ◽  
Kate H. Bentley ◽  
Amantia A. Ametaj ◽  
James F. Boswell ◽  
...  
Keyword(s):  
Skill Acquisition ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

scholarly journals Treatment of bipolar depression with supraphysiologic doses of levothyroxine: a randomized, placebo-controlled study of comorbid anxiety symptoms

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Maximilian Pilhatsch ◽  
Thomas J Stamm ◽  
Petra Stahl ◽  
Ute Lewitzka ◽  
Anne Berghöfer ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Phenotypic Expression ◽  
Anxiety Symptoms ◽  
Controlled Study ◽  
Double Blind ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Depressive Episodes

Abstract Background Symptoms of anxiety co-occur in a variety of disorders including in depressive episodes of bipolar disorder and in patients with thyrotoxicosis. Treatment of refractory bipolar disorder with supraphysiologic doses of levothyroxine (L-T4) has been shown to improve the phenotypic expression of the disorder and is associated with an increase of circulating thyroid hormones. However, it might be associated with somatic and mental adverse effects. Here we report the investigation of the influence of treatment with supraphysiologic doses of L-T4 on symptoms of anxiety in patients with refractory bipolar depression. Methods Post-hoc analysis from a 6-week, multi-center, randomized, double-blind, placebo-controlled study of the effects of supraphysiologic L-T4 treatment on anxiety symptoms in bipolar depression. Anxiety symptoms were measured weekly with the Hamilton anxiety/somatization factor (HASF) score of the Hamilton Depression Rating Scale (HAMD) and the State- and Trait Anxiety Inventory (STAI). Results Treatment of both groups was associated with a significant reduction in anxiety symptoms (p < 0.001) with no statistical difference between groups (LT-4: from 5.9 (SD = 2.0) at baseline to 3.7 (SD = 2.4) at study end; placebo: from 6.1 (SD = 2.4) at baseline to 4.4 (SD = 2.8) at study end; p = 0.717). Severity of anxiety at baseline did not show a statistically significant correlation to the antidepressive effect of treatment with supraphysiologic doses of L-T4 (p = 0.811). Gender did not show an influence on the reduction of anxiety symptoms (females: from 5.6 (SD = 1.7) at baseline to 3.5 (SD = 2.4) at study end; males: from 6.1 (SD = 2.3) at baseline to 4.0 (SD = 2.4) at study end; p = 0.877). Conclusions This study failed to detect a difference in change of anxiety between bipolar depressed patients treated with supraphysiologic doses of L-T4 or placebo. Comorbid anxiety symptoms should not be considered a limitation for the administration of supraphysiologic doses of L-T4 refractory bipolar depressed patients. Trial registration ClinicalTrials, ClinicalTrials.gov identifier: NCT01528839. Registered 2 June 2012—Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT01528839

Adjunctive Deep Touch Pressure for Comorbid Anxiety in Bipolar Disorder

2014 ◽  
Vol 20 (1) ◽  
pp. 71-77 ◽  
Author(s):  
LOUISA GRANDIN SYLVIA ◽  
LEAH W. SHESLER ◽  
ANDREW D. PECKHAM ◽  
TEMPLE GRANDIN ◽  
DAVID A. KAHN
Keyword(s):  
Bipolar Disorder ◽  
Comorbid Anxiety

scholarly journals Initial Effectiveness Evaluation of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders for Homeless Women

2020 ◽  
pp. 014544552098256
Author(s):  
Sara Rodriguez-Moreno ◽  
Todd J. Farchione ◽  
Pablo Roca ◽  
Carolina Marín ◽  
Ana I. Guillén ◽  
...  
Keyword(s):  
Negative Affect ◽  
Emotional Disorders ◽  
Group Treatment ◽  
Linear Trend ◽  
Control Period ◽  
Well Being ◽  
Homeless Women ◽  
Depression And Anxiety ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

The purpose of this study is to evaluate the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders adapted for homeless women (UPHW). Eighty-one homeless women participated in this single-blinded quasi-experimental clinical trial, involving up to 12 sessions of group treatment, and 3-and 6-month follow-ups. The participants received either immediate treatment with the UPHW ( n = 46) or delayed treatment, following a 12-week wait-list control period (WLC; n = 35). Primary outcomes included depression and anxiety. Secondary measures comprised positive and negative affect, psychological well-being, health perception, and social support. The UPHW resulted in significant improvement on measures of anxiety, depression and negative affect. Improvements in anxiety and depression were maintained over a 3-month follow-up period, but not at 6-month. The reliability of the clinical changes showed significant differences between UPHW and WLC for depression. Moreover, the inter-session assessment in the UPHW group showed a linear trend reduction for depression and anxiety scores along the 12 sessions. The clinical implications on the UPHW in social settings are also discussed.

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.

Culturally and Linguistically Sensitive Applications in Other Countries

2021 ◽  
pp. 180-194
Author(s):  
Hiroko Fujisato ◽  
Noriko Kato ◽  
Dominique Phillips ◽  
Estefany Sáez-Clarke
Keyword(s):  
Children And Adolescents ◽  
Emotional Disorders ◽  
Cultural Context ◽  
Japanese Culture ◽  
Cultural Groups ◽  
Cultural Adaptations ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Intervention Protocol

Cultural adaptation can help maintain a balance between scientifically rigorous interventions and culturally sensitive, effective practice. When introducing the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A) into a new cultural context, translating the treatment may be sufficient in some countries and regions, while others may require more systematic modification. This chapter discusses specific steps that were taken for adapting the UP-C/A in the context of Japanese culture and presents a case study in Japan. When introducing the UP-C/A into the Japanese context, modifications were made to increase the treatment’s acceptability and comprehension, but there were no significant modifications in the content of the intervention protocol. In the future, as the UP-C/A is introduced into other cultures, its effectiveness will be further evaluated and the cultural adaptations needed to accommodate new cultural groups will become increasingly apparent.

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