Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A Randomized Controlled Trial

Abstract

This study further evaluates the efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP). A diagnostically heterogeneous clinical sample of 37 patients with a principal anxiety disorder diagnosis was enrolled in a randomized controlled trial (RCT) involving up to 18 sessions of treatment and a 6-month follow-up period. Patients were randomly assigned to receive either immediate treatment with the UP (n=26) or delayed treatment, following a 16-week wait-list control period (WLC; n= 11). The UP resulted in significant improvement on measures of clinical severity, general symptoms of depression and anxiety, levels of negative and positive affect, and a measure of symptom interference in daily functioning across diagnoses. In comparison, participants in the WLC condition exhibited little to no change following the 16-week wait-list period. The effects of UP treatment were maintained over the 6-month follow-up period. Results from this RCT provide additional evidence for the efficacy of the UP in the treatment of anxiety and comorbid depressive disorders, and provide additional support for a transdiagnostic approach to the treatment of emotional disorders.

The Hierarchical Taxonomy of Psychopathology (HiTOP): A Dimensional Alternative to Traditional Nosologies

“…For example, selective serotonin reuptake inhibitors originally were regarded as antidepressants but subsequently were found to be efficacious in treating anxiety disorders and are increasingly used in eating disorders (Martinez, Marangell, & Martinez, 2008). Transdiagnostic cognitive behavioral therapy and even disorder-specific psychotherapies have been found to reduce symptoms of various internalizing conditions (Farchione et al, 2012;Newby et al, 2013;. Thus, response to selective serotonin reuptake inhibitors and cognitive behavioral therapy appears to be a shared feature of internalizing disorders.…”

Aplicación grupal del Protocolo Unificado para el tratamiento transdiagnóstico de los trastornos emocionales en población argentina

“…Entre ellos se destaca la aplicación de programas basados en abordajes transdiagnósticos (Bullis et al, 2015;Chu et al, 2016;Espejo et al, 2016;Farchione et al, 2012;García-Escalera, Chorot, Valiente, Reales y Sandín, 2016;Mullin et al, 2015). La terapia cognitivo conductual transdiagnóstica (TCC-T) sostiene que existen procesos cognitivos y conductuales diferentes responsables de ciertos síntomas compartidos por diversos trastornos psicológicos que comparten aspectos comunes en las áreas cognitivas, conductuales y/o emocionales (García-Escalera et al, 2016;Sandín et al, 2012) y que podrían explicar su mantenimiento (Egan, Wade, y Shafran, 2012;Mansell, Harvey, Watkins y Shafran, 2008).…”

“…El UP fue diseñado para intervenir sobre la elevada afectividad negativa presente en el espectro clínico ansioso-depresivo. Se basa en los principios del tratamiento cognitivo-conductual (TCC) que han aportado más evidencia sobre una mayor efectividad comparada con otros abordajes clínicos (García-Escalera et al, 2016;McHugh y Barlow, 2012;Sandín et al, 2012), y esto lo convierte en un programa breve de alcance poblacional que cuenta con evidencia de efi cacia en estudios controlados en un formato individual (Ellard, Fairholme, Boisseau, Farchione y Barlow, 2010;Farchione et al, 2012), así como, más recientemente en formato grupal (Bullis et al, 2015;Castellano Badenas, Osma, Crespo Delgado y Fermoselle Esclapez, 2015;Ito et al, 2016). El UP incluye intervenciones dirigidas a modifi car dimensiones comunes que se encuentran afectadas en distinto grado en el denominado Síndrome de afectividad negativa.…”

Panic Disorder and Agoraphobia Across the Lifespan

“…Two open clinical trials of a transdiagnostic treatment suggest that this approach can distil common strategies and enhance the effectiveness by targeting core affective 'higher order' components, which results in substantial clinical improvement in primary and secondary disorders (Ellard et al, 2010). These findings were extended by Farchione and colleagues (Farchione et al, 2012), who treated 38 patients with a unified protocol consisting of 5 modules, which targeted key aspects of emotional processing and regulation of emotional experiences: (1) increasing present-focused emotion awareness, (2) increasing cognitive flexibility, (3) identifying and preventing patterns of emotion avoidance, (4) increasing awareness and tolerance of emotion-related physical sensations, and (5) interoceptive and situation-based emotion focused exposure (Farchione et al, 2012).…”