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

Abstract

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.

Emotion Regulation Difficulties and Academic Procrastination

“…On the other hand, emotion dysregulation defined as “maladaptive emotional responsiveness reflected in dysfunctional understanding, reactivity, and management” ( Mennin et al, 2007 ). Emotion regulation difficulties have been reported across a wide range of emotional problems ( Berking and Wupperman, 2012 ; Naragon-Gainey et al, 2017 ; Khakpoor et al, 2019 ). Steel (2007a) considers procrastination as a kind of dysfunctional, emotional driven self-regulation.…”

The efficacy of transdiagnostic cognitive behavioural therapy on reducing negative affect, anxiety sensitivity and improving perceived control in children with emotional disorders - a randomized controlled trial

“…The triple vulnerability model and previous research have shown that UPs can effectively treat a range of emotional disorders based on providing flexibility and convenience (Ehrenreich-May et al ., 2017 ; Ehrenreich et al ., 2009 ; Farchione et al ., 2012 ; Kennedy et al ., 2019 ; Leonardo, Aristide, & Michela, 2021 ; O’donnell et al ., 2021 ; Sakiris & Berle, 2019 ; Steele et al ., 2018 ). Previously, the studies on the effectiveness of the UP on transdiagnostic factors have yielded promising results in adolescents and adults (Khakpoor, Bytamar, & Saed, 2019 ). In the present study, we aimed to evaluate UP effectiveness specifically in the paediatric population, by selecting three key transdiagnostic constructs (NA, AS, PC).…”

Cannabis use among early adolescents and transdiagnostic mental health risk factors

“…Given the association found between adolescent cannabis use and the severity of concurrent psychopathology, such as suicidal behavior (Gobbi et al, 2019), further development of prevention programs is needed. Subgroups of the most vulnerable adolescents could be identified using markers of increased cannabis use identified here, namely, hopelessness, rumination, or anomalous perception of reality (Khakpoor et al, 2019). These programs may incorporate individualized interventions focused on learning emotional management and regulation skills.…”

“…These variables increase the vulnerability to mental disorder and are factors in their maintenance. Early intervention of these variables can play a fundamental role in preventing and treating psychopathology (Khakpoor et al, 2019). Further, intervention of trandiagnostic variables could be a method of reducing risk of cannabis dependence.…”