A Contextual Adaptation of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Victims of the Armed Conflict in Colombia

Castro-Camacho, Leonidas; Rattner, Michel; Quant, Diana Melisa; González, Laura; Moreno, Julián David; Ametaj, Amantia

doi:10.1016/j.cbpra.2018.08.002

Cited by 14 publications

(13 citation statements)

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“…The authors did not find any difference in emotion suppression from pre‐ to post‐treatment, which they state is consistent with existing literature showing a lack of association between suppression and psychopathology in Japan, and may represent an important cultural difference to consider when delivering the UP. In another example, the UP has been adapted to fit the uniquely broad spectrum of cultures, education levels and backgrounds of victims of Colombia's armed conflict 9 .…”

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confidence: 99%

The unified protocol for transdiagnostic treatment of emotional disorders

et al. 2020

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confidence: 99%

The unified protocol for transdiagnostic treatment of emotional disorders

et al. 2020

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“…Lo anterior es fundamental en tanto el conflicto se ha caracterizado por diversos tipos de violencia en regiones con particularidades culturales, educativas y socioeconómicas. La contextualización permite partir de estas condiciones sociales para tener un entendimiento más acertado del impacto del conflicto según estas condiciones sociales y tipos de violencia, para la aplicación de metodologías más acertadas y para futuras intervenciones más efectivas (Castro-Camacho et al, 2019).…”

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Medición de indicadores de salud mental de población en contexto de conflicto armado en Colombia: revisión de alcance

et al. 2022

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El conflicto armado ha marcado las diferentes dimensiones de vida de la población colombiana por lo que ha sido objeto de diversos estudios, generando la necesidad de evaluar el abordaje e instrumentos utilizados para medir indicadores de salud mental de población en contexto de conflicto armado. Esta investigación pretende analizar artículos científicos que aborden dichos indicadores y que utilicen instrumentos psicométricos para tal fin. Se realizó una revisión de alcance siguiendo la metodología PRISMA y utilizando el software CADIMA. La búsqueda bibliográfica se hizo en las bases de datos Web of Science, Scielo y Scopus, usando términos claves en inglés y español. Se analizaron 21 artículos en los que se identifica el uso de 53 instrumentos, siendo los más aplicados el AUDIT y la CIDI-CAPI. La mayoría de los artículos reportaron afectaciones relacionadas con estrés postraumático, ansiedad, depresión y consumo de sustancias. Se encontraron pocos estudios de validación o construcción de instrumentos. Es necesario fortalecer el trabajo en el desarrollo y validación de pruebas para evaluar indicadores de salud mental en poblaciones víctimas del conflicto armado colombiano, con las que se posibilite una mejor valoración de las afectaciones.

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“…Examples of participants' own emotional experiences were used to illustrate concepts within their cultural context and assignments adapted to their daily activities; text was replaced with graphic material in the workbook while core elements and order of modules of the original protocol were preserved as described in a previous publication. 24 Treatment was delivered individually through 12 to 14 face-to-face sessions once to twice per week, with each session lasting for about 90 minutes over 6 to 12 weeks. For cultural reasons, an initial session was also added to allow participants to talk freely about their unique experiences, foster trust, and promote a collaborative relationship with the therapist.…”

Section: Interventionmentioning

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Effects of a Contextual Adaptation of the Unified Protocol in Multiple Emotional Disorders in Individuals Exposed to Armed Conflict in Colombia

et al. 2023

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ImportanceA transdiagnostic treatment, the Unified Protocol, is as effective as single diagnostic protocols in comorbid emotional disorders in clinical populations. However, its effects on posttraumatic stress disorder and other emotional disorders in individuals living in war and armed conflict contexts have not been studied.ObjectiveTo evaluate the efficacy of a cultural and contextual adaptation of the Unified Protocol (CXA-UP) on posttraumatic stress disorder, anxiety, and depression compared to waitlist control in individuals exposed to armed conflict in Colombia.Design, Setting, and ParticipantsFrom April 2017 to March 2020, 200 participants 18 years and older were randomly assigned to the CXA-UP or to a waitlist condition. CXA-UP consisted of 12 to 14 twice-a-week or weekly individual 90-minute face-to-face sessions. Outcomes were assessed at baseline, posttreatment, and 3 months following treatment. Analyses were performed and compared for all randomly allocated participants (intent-to-treat [ITT]) and for participants who completed all sessions and posttreatment measures (per protocol [PP]). The study took place at an outpatient university center and included individuals who were registered in the Colombian Victims Unit meeting DSM-5 diagnostic criteria for posttraumatic stress disorder, anxiety, or depression or were severely impaired by anxiety or depression. Individuals who were receiving psychological therapy, were dependent on alcohol or drugs, were actively suicidal or had attempted suicide in the previous 2 months, had psychosis or bipolar disorder, or were cognitively impaired were excluded.InterventionCXA-UP or waitlist.Main Outcomes and MeasuresPrimary outcomes were changes in anxiety, depression, and somatic scores on the Patient Health Questionnaire and Posttraumatic Stress Disorder Checklist for DSM-5.ResultsAmong the 200 participants (160 women [80.0%]; 40 men [20.0%]; mean [SD] age, 43.1 [11.9] years), 120 were randomized to treatment and 80 to waitlist. Results for primary outcomes in the ITT analysis showed a significant pretreatment-to-posttreatment reduction when comparing treatment and waitlist on the posttraumatic stress disorder checklist for DSM-5 scores (slope [SE], −31.12 [3.00]; P &lt; .001; Cohen d, 0.90; 90% CI, 0.63-1.19), 9-item Patient Health Questionnaire (PHQ-9) (slope [SE],−11.94 [1.30]; P &lt; .001; Cohen d, 0.77; 90% CI, 0.52-1.06), PHQ-anxiety (slope [SE], −6.52 [0.67]; P &lt; .001; Cohen d, 0.82; 90% CI, 0.49-1.15), and PHQ-somatic (slope [SE], −8.31 [0.92]; P &lt; .001; Cohen d, 0.75; 90% CI, 0.47-1.04).Conclusions and RelevanceIn this study, significant reductions and large effect sizes in all measures of different emotional disorders showed efficacy of a single transdiagnostic intervention in individuals exposed to armed conflicts.Trial RegistrationClinicalTrials.gov Identifier: NCT03127982

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A Contextual Adaptation of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Victims of the Armed Conflict in Colombia

Cited by 14 publications

References 83 publications

The unified protocol for transdiagnostic treatment of emotional disorders

The unified protocol for transdiagnostic treatment of emotional disorders

Medición de indicadores de salud mental de población en contexto de conflicto armado en Colombia: revisión de alcance

Effects of a Contextual Adaptation of the Unified Protocol in Multiple Emotional Disorders in Individuals Exposed to Armed Conflict in Colombia

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