scholarly journals Transdiagnostic treatment of emotional disorders for women with multiple sclerosis: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nabi Nazari ◽  
Akram Aligholipour ◽  
Masoud Sadeghi
Keyword(s):  
Multiple Sclerosis ◽  
Negative Affect ◽  
Emotional Disorders ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Repeated Measure ◽  
Treatment As Usual ◽  
Transdiagnostic Treatment ◽  
Assessment Protocol ◽  
Scale Scores

Abstract Background Multiple sclerosis (MS) is a chronic, unpredictable, neurodegenerative disease, significantly associated with psychological, behavioral, cognitive, and emotional consequences. MS is more common in females than males and frequently affects women during their reproductive years. Despite the frequent mental disorders, comorbidities, and emotional problems in People with MS (PwMS), these conditions are too often underdiagnosed and undertreated. Objective This study aimed to examine the efficacy of a group format of the Unified Protocol (UP) for the Transdiagnostic treatment of depression and anxiety disorders in females with MS. Methods In the present study, Sixty-four adult females diagnosed with MS were randomized to either the UP (n = 32) or treatment-as-usual conditions. The assessment protocol included semi-structured clinical interviews and self-reports evaluating diagnostic criteria, depression, anxiety and worry symptoms, emotional regulation, and affectivity. Results Repeated measure analysis of variance (ANOVA) revealed that the UP significantly improved depression scores [Cohen’s d = − 2.11, 95% CI (− 2.72, − 1.50)], anxiety scores [Cohen’s d = − 3.34, 95% CI (− 4.01, − 2.58)], positive and negative affect scale (PANAS)-positive affect scores [Cohen’s d = 1.46, 95% CI (1.46, 2.01)], PANAS-negative affect scores [Coen’s d = − 2.21, 95% CI (− 2.84, − 1.60)], difficulties emotion regulation scale scores [Cohen’s d = 1.40, 95% CI (− 0.87, − 0.03)], and Worry scale scores [Cohen’s d = − 0.45, 95% CI (− 0.95, − 0.04)] at the end of treatment relative to compared to the control condition. Also, treatment gains were maintained at the three-month follow-up (p < 0.001). Conclusion The findings provide the support that the UP could be an additional efficient psychological treatment for females with MS. ISRCTN Number: ISRCTN95459505.

scholarly journals Transdiagnostic treatment of emotional disorders in people with multiple sclerosis: randomized controlled trial

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Nabi Nazari ◽  
Masood Sadeghi ◽  
Ezatolah Ghadampour ◽  
Davod Mirzaeefar
Keyword(s):  
Multiple Sclerosis ◽  
Emotional Disorders ◽  
Analysis Of Covariance ◽  
High Rate ◽  
Control Group ◽  
Depression Symptoms ◽  
Usual Condition ◽  
Transdiagnostic Treatment ◽  
Assessment Protocol ◽  
Unified Protocol

Abstract Background Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system. MS is significantly associated with a high rate of psychological, behavioral, and emotional consequences. Despite the frequent mental disorders, high rate of psychological comorbidities, and emotional problems in people with MS (PwMS), these conditions are often underdiagnosed and undertreated. This study aimed to examine the efficacy of a group format of the unified protocol for the transdiagnostic treatment of emotional disorders in adult PwMS associated with an emotional disorder. Methods Seventy adult PwMS were randomized using an internet-based computer system to either the unified protocol (n = 35) or treatment as usual condition. The assessment protocol included semi-structured clinical interviews and self-reports evaluating diagnostic criteria, depression, anxiety and worry symptoms, emotional dysregulation, and affectivity. Results The parametric test of analysis of covariance, followed the intent to treat analyses, revealed the unified protocol significantly changed depression symptoms (Cohen’s d = 1.9), anxiety symptoms (Cohen’s d = 2.16), worry symptoms (Cohen’s d = 1.27), emotion dysregulation (Cohen’s d = 0.44), positive affect (Cohen’s d = 1.51), and negative affect (Cohen’s d = 1.89) compared with the control group. The unified protocol also significantly improved outcome scores at the end of treatment relative to baseline (p < .001). Conclusion The findings support that the unified protocol could be an additional efficient psychological treatment for PwMS. Trial registration IRCT, number: IRCT20190711044173N1. Registered 31october 2019, https://en.irct.ir/user/trial/40779/view.

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.

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.

Introduction

2021 ◽  
pp. 3-36
Author(s):  
Heather Thompson-Brenner ◽  
Melanie Smith ◽  
Gayle Brooks ◽  
Rebecca Berman ◽  
Angela Kaloudis ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Negative Affect ◽  
Emotional Disorders ◽  
Emotional Functioning ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

The Renfrew Unified Treatment for Eating Disorders and Co-occurring Emotional Disorders (UT) is an integrative, transdiagnostic, principle-based approach to address patterns of emotion avoidance, emotion sensitivity, and negative affect that produce and maintain the symptoms of eating disorders and co-occurring emotional disorders. The UT model was developed through an extensive process of adapting the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) for use with patients with severe and diverse eating disorders. The modules of the UT are distinct from other approaches due to their cohesive (internal and collective) focus on how each module addresses these shared maintaining mechanisms. There is extensive evidence that eating disorders typically co-occur with other emotional disorders. There is also extensive evidence that eating disorders and other emotional disorders share common maintaining mechanisms, reflecting aspects of emotional functioning.

Sensor-based technology for upper limb rehabilitation in patients with multiple sclerosis: A randomized controlled trial

2020 ◽  
Vol 38 (4) ◽  
pp. 333-341
Author(s):  
Marco Tramontano ◽  
Giovanni Morone ◽  
Sara De Angelis ◽  
Laura Casagrande Conti ◽  
Giovanni Galeoto ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Upper Limb ◽  
Controlled Trial ◽  
Control Group ◽  
Hand Rehabilitation ◽  
Upper Limb Rehabilitation ◽  
Rehabilitation Programs ◽  
Scale Scores ◽  
Limb Rehabilitation ◽  
Experimental Group

Background: Sensor-based technological therapy devices may be good candidates for neuromotor rehabilitation of people with Multiple Sclerosis (MS), especially for treating upper extremities function limitations. The sensor-based device rehabilitation is characterized by interactive therapy games with audio-visual feedback that allows training the movement of shoulders, elbows, and wrist, measuring the strength and the active range of motion of upper limb, registering data in an electronic database to quantitatively monitoring measures and therapy progress. Objective: This study aimed to investigate the effects of sensor-based motor rehabilitation in add-on to the conventional neurorehabilitation, on increasing the upper limb functions of patients with MS. Methods: Thirty patients were enrolled in the study and randomly assigned to the experimental group and the control group. The training consisting of twelve sessions of upper limb training was compared with twelve sessions of upper limb sensory-motor training, without robotic support. Both rehabilitation programs were performed for 40 minutes three times a week, for 4 weeks, in addition to conventional therapy. All patients were evaluated at the baseline (T0) and after 4 weeks of training (T1). Results: The within-subject analysis showed a statistically significant improvement in both groups, in the Modified Barthel Index and in the Rivermead Mobility Index scores and a significant improvement in Multiple Sclerosis Quality of Life-54 in the experimental. The analysis of effectiveness revealed that, compared with baseline (T0), the improvement percentage in all clinical scale scores was greater in the experimental group than the control group. Conclusions: Proposed training provides an intensive and functional-oriented rehabilitation that objectively evaluates achieved progress through exercises. Therefore, it can represent a good complementary strategy for hand rehabilitation in MS patients.

scholarly journals Improving chronic pain management with eHealth and mHealth: study protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033586 ◽  
Author(s):  
Irene Jaén ◽  
Carlos Suso-Ribera ◽  
Diana Castilla ◽  
Irene Zaragoza ◽  
Azucena García-Palacios ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Web Application ◽  
Controlled Trial ◽  
Repeated Measure ◽  
Health Concern ◽  
Randomised Control Trial ◽  
Treatment As Usual ◽  
Use Of Technology ◽  
Public Costs ◽  
Randomised Controlled

IntroductionChronic pain has become a matter of public health concern due to its high prevalence and because public costs associated with treatment and disability increase each year. Research suggests that limitations in the traditional assessment of chronic pain patients limit the effectiveness of current medical treatments. The use of technology might serve change patient traditional monitoring into ecological momentary assessments, which might be visualised by physicians live. This study describes a randomised control trial designed to test the utility of a technology-based solution for pain telemonitoring consisting of a smartphone app for patients and a web application for physicians. The goal of this study will be to explore whether this combination of eHealth and mHealth improves the effectiveness of existing pain treatments.Methods and analysisParticipants will be 250 patients randomly assigned to one of these two conditions: treatment-as-usual (TAU) and TAU +app+ web. All participants will receive the usual treatment for their pain. Only the TAU +app+ web group use Pain Monitor app, which generates alarms that are sent to the physicians in the face of previously established undesired events. Physicians will be able to monitor app reports using a web application, which might result in an adjustment of treatment. We anticipate that the use of Pain Monitor plus the therapist web will result in a reduction of pain intensity and side effects of the medication. Improvements on secondary outcomes, namely fatigue, mood, pain interference, rescue medication use and quality of life, are also expected. Mixed repeated-measure multivariate analyses of variances will be conducted to investigate whether there are differences between preassessment and postassessment scores as a function of the experimental condition.Ethics and disseminationEthical approval from the Hospital General Universitari de Castellon was obtained. The findings will be published in peer-reviewed journals.Trial registration numberNCT03606265

Current Evidence Base for the UP-C and UP-A

2021 ◽  
pp. 31-38
Author(s):  
Niza Tonarely ◽  
Dominique Phillips
Keyword(s):  
Randomized Controlled Trial ◽  
Children And Adolescents ◽  
Emotional Disorders ◽  
Controlled Trial ◽  
Evidence Base ◽  
Current Evidence ◽  
Controlled Trials ◽  
Transdiagnostic Treatment ◽  
Randomized Controlled ◽  
Current Evidence Base

This chapter summarizes current research support for Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C and UP-A), which have been found to be efficacious for children and adolescents with a range of emotional concerns. The UP-A has been investigated in randomized controlled trials and has demonstrated efficacy in treating anxiety and depressive symptoms, with significant decreases in symptoms during treatment and maintenance of gains following treatment. The UP-C has been investigated using open and randomized controlled trial designs and was found to be as efficacious as an established anxiety protocol. This chapter also presents research on patterns of change across symptoms and individuals in response to the UP-C and UP-A, including response trajectories, the timing of change, and comparisons of rates of change by symptom and reporter.

Module 5: Countering Emotional Behaviors

2017 ◽  
pp. 113-130
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Shannon Sauer-Zavala ◽  
Heather Murray Latin ◽  
Kristen K. Ellard ◽  
...  
Keyword(s):  
Negative Affect ◽  
Emotional Disorders ◽  
Emotional Response ◽  
Behavioral Patterns ◽  
Behavioral Component ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Emotional Responding ◽  
Over Time

Chapter 10 of Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide focuses on the behavioral component of the emotional response and begins by reviewing the role of emotional behaviors (i.e., behaviors that are used to control strong emotions) in the development and maintenance of maladaptive emotional responding. In this module, therapists help patients to identify relevant emotional behaviors and then work with them to develop and engage in Alternative Actions. Over time, it is expected that these Alternative Actions will help remediate cognitive and behavioral patterns contributing to the frequent occurrence of strong negative affect and maintaining patient distress in response to experience of strong emotions.

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