Treating Suicidal Thoughts and Behaviors Within an Emotional Disorders Framework: Acceptability and Feasibility of the Unified Protocol in an Inpatient Setting

2017 ◽  
Vol 41 (4) ◽  
pp. 529-557 ◽  
Author(s):  
Kate H. Bentley ◽  
Shannon Sauer-Zavala ◽  
Clair F. Cassiello-Robbins ◽  
Laren R. Conklin ◽  
Stephanie Vento ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Inpatient Setting ◽  
Suicidal Thoughts ◽  
Treatment As Usual ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Adjunctive Intervention ◽  
And Behaviors ◽  
Suicidal Thoughts And Behaviors

We provide a theoretical rationale for applying a transdiagnostic, shared mechanism treatment (the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders [UP]) to suicidal thoughts and behaviors. We also present results from a proof of concept study examining the feasibility and acceptability of adding a modified UP to treatment as usual (TAU) in an inpatient setting for individuals reporting a recent suicide attempt or active suicidal ideation. Participants ( N = 12) were randomly assigned to receive UP + TAU or TAU alone. Findings indicate good feasibility and acceptability of the adjunctive intervention. Among participants who were responsive to contact attempts postdischarge ( n = 6), there were no observable differences in suicidal thoughts or behaviors during a 6-month follow-up. This application represents a promising initial extension of a cognitive-behavioral, emotion-focused treatment to suicidal individuals within an inpatient setting. Future studies adequately powered to speak to efficacy of the modified UP intervention are warranted.

scholarly journals The Unified Protocol for Transdiagnostic Treatment of Perinatal Depression: A Case Study

2020 ◽  
Vol 19 (6) ◽  
pp. 491-508 ◽  
Author(s):  
Elena Crespo-Delgado ◽  
Verónica Martínez-Borba ◽  
Jorge Osma
Keyword(s):  
Emotional Disorders ◽  
Individual Treatment ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Group Format ◽  
Regulation Strategies ◽  
Anxiety Depression ◽  
Perinatal Women

This case study aims to present the application of the Unified Protocol (UP) for the Transdiagnostic Treatment of Emotional Disorders in the case of a 38-year-old pregnant woman with a peripartum onset of major depressive disorder and anxiety symptoms. The UP is a cognitive-behavioral intervention based on the shared etiological and maintenance mechanisms of emotional disorders (i.e., mood, anxiety, and related disorders). The UP helps to modify maladaptive emotion-regulation strategies and enhance tolerance of unpleasant and intense emotions (sadness, anxiety, anger, etc.). Whereas previous studies demonstrate the efficacy of the UP in different emotional disorders, to our knowledge, none of them have used the UP to treat perinatal emotional disorders. After the eight UP modules of individual treatment, a significant decrease in anxiety, depression, negative affect, and anxiety sensitivity, and also an increase in positive affect were observed. These results were maintained at the 12-month follow-up. In addition to its clinical utility and acceptance, these results indicate that the UP can be adapted and personalized for the treatment of perinatal emotional disorders. Future studies with larger samples and controlled experimental designs should be developed to demonstrate its efficacy. Furthermore, as the UP seems to be useful in a group format, future efforts should be focused on the UP with perinatal women in a group format.

scholarly journals Implementation, efficacy and cost effectiveness of the unified protocol in a blended format for the transdiagnostic treatment of emotional disorders: a study protocol for a multicentre, randomised, superiority controlled trial in the Spanish National Health System

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054286
Author(s):  
J Osma ◽  
Laura Martínez-García ◽  
Óscar Peris-Baquero ◽  
María Vicenta Navarro-Haro ◽  
Alberto González-Pérez ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Controlled Trial ◽  
National Health System ◽  
Research Committee ◽  
Treatment As Usual ◽  
Adequate Treatment ◽  
Transdiagnostic Treatment ◽  
Face To Face ◽  
Unified Protocol ◽  
Ethics Research

IntroductionEmotional disorders (EDs) have become the most prevalent psychological disorders in the general population, which has boosted the economic burden associated with their management. Approximately half of the individuals do not receive adequate treatment. Consequently, finding solutions to deliver cost-effective treatments for EDs has become a key goal of today’s clinical psychology. Blended treatments, a combination of face-to-face and online interventions, have emerged as a potential solution to the previous. The Unified Protocol for the Transdiagnostic Treatment of EDs (UP) might serve this purpose, as it can be applied to a variety of disorders simultaneously and its manualised format makes it suitable for blended interventions.Methods and analysisThe study is a multicentre, randomised, superiority, clinical trial. Participants will be 310 individuals with a diagnosis of an ED. They will be randomised to a treatment as usual (individual cognitive behavioural therapy) or a UP condition in a blended format (face-to-face individual UP +online, app-based UP). Primary outcomes will be ED diagnostic criteria and depression and anxiety symptoms. Cost efficiency of the intervention, app usability, as well as opinion and confidence in the treatment will also be evaluated. Assessment points will include baseline and 3 months, 6 months and 12 months after UP treatment.Ethics and disseminationThe study has received approvals by the Ethics Research Committee of Navarra, Castellón, Euskadi, Castilla y León, Extremadura, Lleida and Aragón. The study is currently under an approval process by the Ethics Research Committees of all the remaining collaborating centres. Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conference meetings.Trial registration numberNCT04304911.

Understanding Your Emotions—What Is an Emotion?

2017 ◽  
pp. 41-52
Author(s):  
David H. Barlow ◽  
Shannon Sauer-Zavala ◽  
Todd J. Farchione ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Positive Emotions ◽  
Negative Emotions ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
And Behaviors

Chapter 5 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Workbook teaches that emotions are necessary and helpful in our day-to-day lives and explains why we wouldn’t actually want to get rid of all “bad” feelings. Instead of getting rid of negative emotions, the goal of this treatment is to help people respond differently when these emotions come up. The chapter looks at how emotions (such as fear, sadness, anxiety, and anger, as well as positive emotions, like happiness, excitement, and pride) can go from providing useful input to feeling totally overwhelming. Emotional experiences are made less overwhelming by breaking them down into more manageable parts—thoughts, physical sensations, and behaviors.

Module 2: Understanding Emotions

2017 ◽  
pp. 63-80
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Shannon Sauer-Zavala ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Emotional Disorders ◽  
Emotional Experiences ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Emotional Responding ◽  
Core Components ◽  
And Behaviors ◽  
Understanding Emotions ◽  
Adaptive Nature

Chapter 7 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide provides psychoeducation on the functional, adaptive nature of emotions and assists patients in developing greater awareness of patterns of emotional responding, including potential maintaining factors (e.g., common triggers, environmental contingencies, and/or the maintaining role of avoidance). Patients also learn how to monitor and track their emotions by focusing on three core components of their emotional experiences (thoughts, physical feelings, and behaviors).

The Unified Protocol for Nonsuicidal and Suicidal Self-Injurious Thoughts and Behaviors

2017 ◽  
pp. 179-199
Author(s):  
Kate H. Bentley ◽  
Shannon Sauer-Zavala ◽  
Clair Cassiello-Robbins ◽  
Stephanie Vento
Keyword(s):  
Mood Disorders ◽  
Emotional Disorders ◽  
Clinical Case ◽  
Full Range ◽  
Cognitive Behavioral Intervention ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Self Injury ◽  
And Behaviors ◽  
Case Presentations

Nonsuicidal self-injury (NSSI) and suicidal behavior are extremely common phenomena, with devastating consequences for individuals, families, and communities. Although interventions for NSSI and suicidal self-injurious thoughts and behaviors exist, there remains an urgent need to establish the most highly effective, efficient, and easily disseminable treatments for the full range of self-injuring individuals. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is a cognitive-behavioral intervention recently developed to be applicable across the range of anxiety and mood disorders, as well as other disorders with strong emotional components. The aim of this chapter is to provide a rationale for using the UP, or its components, to address nonsuicidal and suicidal self-injurious thoughts and behaviors, as well as to discuss recent applications of the UP treatment to two self-injuring individuals through clinical case presentations.

scholarly journals The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Among Japanese Children: A Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Hiroko Fujisato ◽  
Noriko Kato ◽  
Hikari Namatame ◽  
Masaya Ito ◽  
Masahide Usami ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Functional Status ◽  
Emotional Disorders ◽  
Depressive Disorders ◽  
Anxiety Symptoms ◽  
Japanese Children ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Pre Treatment

At present, there is no established cognitive behavioral therapy (CBT) for treating emotional disorders in Japanese children. Therefore, we introduced the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) in Japan and adapted it to the Japanese context. We then examined its feasibility and preliminary efficacy using a single-arm pretest, posttest, follow-up design. Seventeen Japanese children aged between 8 and 12 years (female n = 11; male n = 6; M = 10.06 ± 0.97 years) with a principal diagnosis of anxiety, obsessive-compulsive, or depressive disorders, and their parents were enrolled in the study. The primary outcome was the overall severity of emotional disorders as assessed by psychiatrists using the Clinical Global Impression-Severity Scale. Secondary outcomes included child- and parent-reported anxiety symptoms, depressive symptoms, and functional status. No severe adverse events were observed. The feasibility was confirmed by the low dropout proportion (11.76%), high attendance proportion (children: 95.6%; parents: 94.6%), and sufficient participant satisfaction. Linear mixed models (LMMs) showed that the overall severity of emotional disorders and child- and parent-reported anxiety symptoms improved from pre-treatment to post-treatment, and that these treatment effects were maintained during the 3-month follow-up period. Additionally, child- and parent-reported functional status improved from pre-treatment to the 3-month follow-up. In contrast, child-reported depressive symptoms improved from pre-treatment to follow-up, but there was no significant change in parent-reported depressive symptoms between pre-treatment and other time points. These findings demonstrate the feasibility and preliminary efficacy of the Japanese version of the UP-C, suggesting that future randomized controlled trials (RCTs) are warranted (Clinical trial registration: UMIN000026911).

scholarly journals Predicting suicidal thoughts and behaviors among college students: a machine learning approach

2021 ◽  
Author(s):  
Melissa Macalli ◽  
Marie Navarro ◽  
Massimiliano Orri ◽  
Marie Tournier ◽  
Rodolphe Thiébaut ◽  
...  
Keyword(s):  
Mental Health ◽  
College Students ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Receiver Operating Curve ◽  
Suicidal Thoughts ◽  
And Behaviors ◽  
One Year ◽  
Suicidal Thoughts And Behaviors

Abstract Suicidal thoughts and behaviors are prevalent among college students. Yet little is known about screening tools to identify students at higher risk. We aimed to develop a risk algorithm to identify the main predictors of suicidal thoughts and behaviors among college students within one-year of baseline assessment. We used data collected in 2013–2019 from the French i-Share cohort, a longitudinal population-based study including 5066 volunteer students. To predict suicidal thoughts and behaviours at follow-up, we used random forests models with 70 potential predictors measured at baseline, including sociodemographic and familial characteristics, mental health and substance use. Model performance was measured using the area under the receiver operating curve (AUC), sensitivity, and positive predictive value. At follow-up, 17.4% of girls and 16.8% of boys reported suicidal thoughts and behaviors. The models achieved good predictive performance: AUC, 0.8; sensitivity, 79% for girls, 81% for boys; and positive predictive value, 40% for girls and 36% for boys. Among the 70 potential predictors, four showed the highest predictive power: 12-month suicidal thoughts, trait anxiety, depression symptoms, and self-esteem. We identified a parsimonious set of mental health indicators that accurately predicted one-year suicidal thoughts and behaviors in a community sample of college students.

scholarly journals Recurrence of suicidal thoughts and behaviors during one year of follow-up: An exploratory study.

2020 ◽  
Vol 288 ◽  
pp. 112988
Author(s):  
Paula Suárez-Pinilla ◽  
Marina Pérez-Herrera ◽  
Marta Suárez-Pinilla ◽  
Raquel Medina-Blanco ◽  
Enrique López-García ◽  
...  
Keyword(s):  
Exploratory Study ◽  
Suicidal Thoughts ◽  
And Behaviors ◽  
One Year ◽  
Suicidal Thoughts And Behaviors
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