Prevention of Emotional Disorders and Symptoms Under Health Conditions: A Pilot Study using the Unified Protocol in a Fertility Unit

Abstract

Emotional Disorders (EDs) are common in women who undergo fertility treatments. The Unified Protocol (UP) is a transdiagnostic intervention that has demonstrated efficacy in preventing EDs under different health conditions. The aim of this pilot study is to: 1) improve emotional dysregulation for the prevention of anxiety and depressive symptoms in women undergoing intrauterine inseminations (IUI); 2) assess their acceptability (e.g., satisfaction and adherence rates). Method: Five women undergoing IUI, with no clinical diagnoses, responded to measures of mood (anxiety and depression), affect, quality of life and emotional dysregulation in the pre- and post-assessments, and at the 1-, 3- and 6-month follow-ups. The UP was adapted to be applied during six face-to-face group sessions lasting 2 h. The COVID-19 pandemic situation implied changing to an online format to end the program. Results: The results showed that women did not develop EDs, and no statistically significant pre-post and pre-follow-up differences were found for anxiety, depression, quality of life and emotional dysregulation (all p > .050). A tendency towards improvement in the post-assessment evaluation was noted. Satisfaction with the format and UP program was high. Conclusions: It would seem that programs focusing on therapeutic common factors like the UP could have an emotional preventive effect during IUI. Los trastornos emocionales (TE) son frecuentes durante los tratamientos de fertilidad. El Protocolo Unificado (PU) es una intervención transdiagnóstica que ha demostrado su eficacia en la prevención de TE en condiciones médicas. El objetivo de este estudio piloto es: 1) mejorar la disregulación emocional para prevenir síntomas ansiosos y depresivos en mujeres en tratamiento de inseminación artificial (IA); 2) evaluar la aceptabilidad (satisfacción y adherencia). Método: 5 mujeres en tratamiento de IA, sin diagnóstico clínico, respondieron a medidas de estado de ánimo (ansiedad y depresión), afecto, calidad de vida y regulación emocional en el pre- y post-evaluación, y en los seguimientos a los 1, 3 y 6 meses. La adaptación preventiva del PU se basó en la aplicación de 6 sesiones presenciales grupales de 2 horas de duración. La situación generada por la COVID-19 provocó el cambio al formato online para finalizar el programa. Resultados: las mujeres no desarrollaron TE, no se encontraron diferencias pre-post y pre-seguimientos estadísticamente significativas en ansiedad, depresión, calidad de vida y disregulación emocional (p > .050). Se observa una tendencia a la mejoría en la evaluación post-programa. Conclusiones: Parece que programas como el PU, centrado en factores terapéuticos compartidos, ha tenido un efecto emocional preventivo durante IA.

Assessment of Acceptability and Initial Effectiveness of a Unified Protocol Prevention Program to Train Emotional Regulation Skills in Female Nursing Professionals during the COVID-19 Pandemic

“…The UP is one of the most effective treatments to address EDs by reducing emotional symptomatology and increasing quality of life in different clinical and nonclinical populations [24][25][26][27]. Recent studies have shown preliminary evidence of the UP as a preventive program of EDs in the general population [28,29]. However, to our knowledge, this is the first study to evaluate the UP in professionals of a nursing department exposure to COVID-19.…”

“…In addition to the effectiveness in emotional symptoms, the UP enhances overall functioning and quality of life [26,27]. Furthermore, preliminary research shows promising results of the effectiveness of preventive applications of the UP for nonclinical populations, such as students [28][29][30]. With respect to other psychological programs in Spain during the COVID-19 crisis for healthcare workers, a study showed that the most common component of these interventions in 36 hospitals was emotional regulation, which was implemented by psychoeducational and cognitive-behavioral techniques in individual interventions.…”

Aplicación del protocolo unificado para el tratamiento transdiagnóstico de los trastornos emocionales en pacientes post-cirugía bariátrica: estudio de efectividad y viabilidad en formato grupal

“…Indeed, data from a systematic review explicitly explore preliminary data about the effectiveness and feasibility of UP for treating EDs in people with other comorbid medical conditions (Osma et al, 2021). On a prevention level, UP has recently been applied in Spain in a group of women with fertility problems (Martínez-Borba et al, 2022).…”

Developing a smartphone App based on the Unified Protocol for the transdiagnostic treatment of emotional disorders: A qualitative analysis of users and professionals' perspectives

“…Moreover, by focusing on common mechanisms in different EDs, the UP offers numerous advantages over protocols designed for the treatment of specific disorders, such as allowing treatment of people presenting comorbidity ( Brown et al, 2001 ) and the reduction of costs associated with the training of mental health professionals in each of the specific treatments for each EDs Evidence-Based Psychological Treatments ( Steele et al, 2018 ). In turn, different studies have demonstrated the versatility, flexibility and adaptability of the UP to different problems ( Sauer-Zavala et al, 2021 ; Martínez-Borba et al, 2022 ) and formats ( Reinholt et al, 2017 ; Sandín et al, 2020 ). Regarding its efficacy, several systematic reviews and meta-analysis have shown that UP is a highly effective treatment for EDs, with improvements in anxious and depressive symptoms with moderate to large effect sizes that appear to be maintained over time ( Carlucci et al, 2021 ; Cassiello-Robbins et al, 2020 ; Sakiris and Berle, 2019 ).…”