Experimental Manipulations to Test Theory-Driven Mechanisms of Cognitive Behavior Therapy

Southward, Matthew W.; Sauer‐Zavala, Shannon

doi:10.3389/fpsyt.2020.603009

Cited by 18 publications

(7 citation statements)

References 30 publications

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“…Findings from the data collection have been reported in two separate manuscripts. MS1 (Southward & Sauer-Zavala, 2020) includes measures of anxiety symptoms (OASIS) from three participants at nonoverlapping timepoints with the current manuscript. MS2 (Sauer-Zavala et al, 2021) reports on changes in anxiety (OASIS) and depression (ODSIS) between the three arms of the randomized clinical trial but does not include an overall test of changes in these measures collapsing across arms.…”

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confidence: 99%

Dimensions of skill use in the unified protocol: Exploring unique effects on anxiety and depression.

Southward¹,

Sauer‐Zavala²

2022

Journal of Consulting and Clinical Psychology

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Objective: Although the Unified Protocol contains multiple distinct skills to target anxiety, depression, and related conditions, researchers have yet to establish if patients' use of these skills contributes to symptom change. Using data from the first-stage randomization of a sequential multiple assignment randomized trial, we tested whether general skillfulness, defined by skill knowledge, frequency, quality, and effectiveness, predicted within-or between-person changes in anxiety and depression. We further tested whether use of particular UP skills (e.g., mindfulness and behavior change) predicted changes in these outcomes. Method: Participants (N = 70; M age = 33.74, 67% female, 74% white) completed six sessions of core UP modules and reported on their skillfulness and specific skill use using two novel measures, along with their symptoms of anxiety (Overall Anxiety Severity and Impairment Scale) and depression (Overall Depression Severity and Impairment Scale) before each session, and their alliance (Working Alliance Inventory) after each session. We disaggregated between-from within-person effects to test the effects of skillfulness, skill use, and the alliance on session-to-session symptom change. Results: Greater within-person skillfulness predicted decreases in anxiety and depression. More frequent within-person use of all UP skills predicted decreases in anxiety, whereas more frequent within-person use of alternative actions specifically predicted decreases in depression. Conclusions: This pattern of results provides guidance on the specific aspects of skill training to prioritize in transdiagnostic treatments depending on whether therapists are targeting anxiety or depression.What is the public health significance of this article? For people with anxiety and depressive disorders being treated with the Unified Protocol, using therapy skills more skillfully and more frequently than normal predicts decreases in anxiety. Using therapy skills more skillfully and specifically using alternative actions to avoidant urges more frequently than normal predicts decreases in depression.

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confidence: 99%

Dimensions of skill use in the unified protocol: Exploring unique effects on anxiety and depression.

Southward¹,

Sauer‐Zavala²

2022

Journal of Consulting and Clinical Psychology

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“…We included a dummy-coded UP module indicator variable to test our primary hypotheses regarding differences in residualized change in our outcomes of interest by module. Because UP modules were delivered at different points in treatment for different participants and changes in symptoms [ 38 ] and processes of change [ 55 ] tend to occur relatively early in treatment, we also entered session number at time t as a predictor. Finally, we included a dummy-coded therapist indicator variable to account for therapist effects 8 and a dummy-coded sequencing condition indicator variable to account for any effects of participants’ randomly assigned sequencing condition.…”

Section: Methodsmentioning

confidence: 99%

Do Unified Protocol modules exert general or unique effects on anxiety, depression, and transdiagnostic targets?

Southward,

Lane,

Shroyer

et al. 2023

Journal of Mood & Anxiety Disorders

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“…Maladaptive patterns of thinking and behavior trigger symptoms and impede recovery. Although the specific mechanisms of change during psychotherapy are not well understood [7][8][9], the premise that these maladaptive patterns can be modified or changed underlies the teaching of psychological skills within several treatment approaches, including cognitive therapy [10], behavior therapy [11,12], mindfulness [13], and interpersonal therapy [14].…”

Section: Introductionmentioning

confidence: 99%

Measures of Daily Activities Associated With Mental Health (Things You Do Questionnaire): Development of a Preliminary Psychometric Study and Replication Study

Titov¹,

Dear²,

Bisby³

et al. 2022

JMIR Form Res

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Background A large body of research has identified modifiable cognitions and behaviors (actions) associated with psychological health. However, little is known regarding the actions that are most strongly associated with psychological health or the frequency with which they should be performed. Objective This paper described 2 studies that used survey methodology to create the Things You Do Questionnaire (TYDQ), which aims to identify and rank actions (items) and domains of actions (factors) most strongly associated with psychological health. Methods We used digital marketing strategies to recruit Australian adult participants, who were asked to complete 2 web-based surveys comprising versions of the TYDQ; validated measures of depression, anxiety, and satisfaction with life; and demographic questions. In study 1, a total of 3040 participants rated how often they performed each of the 96 items comprising the TYDQ. This design was replicated in study 2, in which a 59-item version of the TYDQ was completed by 3160 participants. In both studies, the factor structure and validity were examined, as were the associations between individual TYDQ items and 3 mental health outcomes: depression, anxiety, and satisfaction with life. Results In study 1, factor analyses revealed that a 5-factor model comprising 27 items achieved an optimum balance between brevity and variance and accounted for 38.1%, 31.4%, and 33.2% of the variance in scores on measures of depression, anxiety, and satisfaction with life, respectively. The factors were interpreted as realistic thinking, meaningful activities, goals and plans, healthy habits, and social connections. These 5 factors were more strongly associated with psychological health than those such as practicing kindness, exercising gratitude, and practicing spirituality. This pattern of results was replicated across gender, age groups, and depression severity. The 5-factor solution found in study 1 was replicated in study 2. Analyses revealed that a 21-item version accounted for 46.8%, 38.2%, and 38.1% of the variance in scores on measures of depression, anxiety, and satisfaction with life, respectively. Conclusions These findings indicate that some actions are more strongly associated with psychological health than others and that these activities fall within 5 broad domains, which represent skills often taught in psychological treatments. Subsequent studies are planned to explore the reliability of these items and results in other samples and to examine patterns of change in scores during treatment for anxiety and depression. If replicated, these efforts will assist in the development of new psychological interventions and provide an evidence base for public mental health campaigns designed to promote good mental health and prevent the emergence of common mental disorders.

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Experimental Manipulations to Test Theory-Driven Mechanisms of Cognitive Behavior Therapy

Cited by 18 publications

References 30 publications

Dimensions of skill use in the unified protocol: Exploring unique effects on anxiety and depression.

Dimensions of skill use in the unified protocol: Exploring unique effects on anxiety and depression.

Do Unified Protocol modules exert general or unique effects on anxiety, depression, and transdiagnostic targets?

Measures of Daily Activities Associated With Mental Health (Things You Do Questionnaire): Development of a Preliminary Psychometric Study and Replication Study

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