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.

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.

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.

scholarly journals Effects of Coronavirus Fears on Anxiety and Depressive Disorder Symptoms in Clinical and Subclinical Adolescents: The Role of Negative Affect, Intolerance of Uncertainty, and Emotion Regulation Strategies

2021 ◽  
Vol 12 ◽  
Author(s):  
Bonifacio Sandín ◽  
Victoria Espinosa ◽  
Rosa M. Valiente ◽  
Julia García-Escalera ◽  
Julia C. Schmitt ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Negative Affect ◽  
Depressive Disorder ◽  
Emotional Disorders ◽  
Intolerance Of Uncertainty ◽  
Self Report ◽  
Depression Symptoms ◽  
Emotion Regulation Strategies ◽  
Regulation Strategies ◽  
Transdiagnostic Factors

Fears related to COVID-19 (“coronavirus fears”) have emerged as a new psychological effect of the current COVID-19 pandemic and have been associated with psychological distress and impairment. Other adverse effects include an increase in anxiety and depression symptoms and the respective disorders. The purpose of the current study was to examine the incremental validity of coronavirus fears and transdiagnostic factors in the prediction of the severity of anxiety and depressive disorder symptoms. A sample of 144 adolescents [aged 12–18 years, 55 boys (38.2%) and 89 girls (61.8%)] most of whom showed elevated levels of anxiety and depressive disorder symptoms completed several self-report measures online assessing coronavirus fears, transdiagnostic vulnerability and protective factors, and emotion regulation strategies. Results based on a series of hierarchical multiple regression analyses revealed that coronavirus fears, negative affect, intolerance of uncertainty, acceptance/tolerance, rumination and suppression explained unique variance in the severity of anxiety and depressive disorder symptoms. Path analysis demonstrated that acceptance/tolerance, rumination and suppression mediated the association between higher level transdiagnostic factors and the severity of major depressive disorder symptoms. Findings provide support for the hierarchical transdiagnostic model of emotional disorders and suggest that clinicians should be aware of coronavirus fears. Also, the results warrant the need to consider transdiagnostic vulnerability and protective processes in the new protocols for the treatment of emotional 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.

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.

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.

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