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 Reductions in transdiagnostic factors as the potential mechanisms of change in treatment outcomes in the Unified Protocol: a randomized clinical trial

2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Sahel Khakpoor ◽  
Jahangir Mohammadi Bytamar ◽  
Omid Saed
Keyword(s):  
Clinical Trial ◽  
Emotion Regulation ◽  
Randomized Clinical Trial ◽  
Emotional Disorders ◽  
Experiential Avoidance ◽  
Intolerance Of Uncertainty ◽  
Beck Anxiety Inventory ◽  
Mechanisms Of Change ◽  
Unified Protocol ◽  
Transdiagnostic Factors

Transdiagnostic approaches emphasize on the share underlying features of emotional disorders. In their view, these transdiagnostic factors play an important role in the etiology, maintenance, and treatment of emotional disorders. This study aimed to investigate the transdiagnostic factors as the potential mechanisms of change in the Unified Protocol (UP) for the transdiagnostic treatment of emotional disorders outcomes. The present study is a randomized clinical trial. Twenty-six individuals were selected based on the Beck anxiety inventory and Beck depression inventory and randomly assigned into two groups of control and treatment (n=13). The treatment group received 20 one-hour individual UP sessions. Beck Depression Inventory, Beck Anxiety Inventory, Difficulty in emotion regulation scale, Intolerance of Uncertainty scale and Acceptance and Action questionnaire were carried out in all three phases. UP enhances the difficulty in emotion regulation (large effect size, SEsg=1.81), intolerance of uncertainty (SEsg=1.91), and experiential avoidance (SEsg=1.78). In addition, the results of linear regression show the association between changes in anxiety and depression with changes in transdiagnostic factors. The difficulty in emotion regulation, intolerance of uncertainty and experiential avoidance can be considered as the potential mechanism of change in improving UP outcomes.

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.

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.

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

2017 ◽  
pp. 1-16 ◽  
Author(s):  
Katherine A. Kennedy ◽  
David H. Barlow
Keyword(s):  
Clinical Trial ◽  
Emotional Disorders ◽  
Anxiety Sensitivity ◽  
Experiential Avoidance ◽  
Large Clinical Trial ◽  
Transdiagnostic Treatment ◽  
The Core ◽  
Unified Protocol ◽  
Core Elements ◽  
Negative Appraisals

This chapter recounts the origins of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) as it developed over a period of several decades. The rationale for developing it was derived from research emerging over this period of time that highlighted commonalities among anxiety, depressive, and related disorders, focusing on emotional disruption and dysregulation, as well as research highlighting common underlying temperamental factors associated with all these disorders. With a particular emphasis on the temperament of neuroticism, transdiagnostic constructs in emotional disorders that are fundamental aspects of neuroticism, such as increased anxiety sensitivity, decreased mindfulness, experiential avoidance, and negative appraisals and attributions, were identified and became targets for treatment. After presentation of the core elements comprising the UP, research supporting its efficacy, including a recently completed large clinical trial, is presented.

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

2010 ◽  
Author(s):  
David H. Barlow ◽  
Todd J. Farchione ◽  
Christopher P. Fairholme ◽  
Kristen K. Ellard ◽  
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 therapist guide 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 covers the seven modules of UP, and focuses on four core strategies to help patients: 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 A randomized clinical trial of metacognitive therapy and nortriptyline for anxiety, depression, and difficulties in emotion regulation of patients with functional dyspepsia

2020 ◽  
Vol 23 (2) ◽  
Author(s):  
Sepideh Batebi ◽  
Abbas Masjedi Arani ◽  
Mahdi Jafari ◽  
Amir Sadeghi ◽  
Mohsen Saberi Isfeedvajani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Emotion Regulation ◽  
Randomized Clinical Trial ◽  
Functional Dyspepsia ◽  
Rating Scale ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Metacognitive Therapy ◽  
Difficulties In Emotion Regulation ◽  
Anxiety Depression

Functional Dyspepsia (FD) as a psychosomatic disorder is an upper gastrointestinal tract disease without organic pathogenesis causes. The psychopathological nature of this disease and its high correlation with anxiety and depression implies the need for psychological interventions. The purpose of the present study is to compare the efficacy of Metacognitive Therapy (MCT) and medication for the symptoms of anxiety, depression, and difficulties in emotion regulation in patients with FD. In a randomized clinical trial, 65 patients with FD were recruited during their visit to gastroenterology clinics. These patients were randomly assigned to three groups to receive MCT, nortriptyline treatment, and controls. They were treated for 10 weeks and followed up three months later. The instruments used in this study were Hamilton anxiety and Depression Rating Scale (HAM-A and HDRS) and difficulties in emotion regulation scale. The results were analyzed using repeated measure analysis by SPSS (19- IBM). Data analysis showed statistically significant differences in the variables of depression, anxiety among MCT, nortriptyline treatment, and controls at pre-test, post-test and follow-up phases. Moreover, MCT had a better and more persistent effect on anxiety compared to nortriptyline treatment, as well as a better efficacy in treating anxiety and depression symptoms compared to the controls. MCT demonstrated better efficacy in treating anxiety symptoms compared to nortriptyline treatment and controls.

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