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Transdiagnostic Approach in Clinical and Health Psychology: Psychopathology, Assessment and Intervention Outcomes

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (16 May 2022) | Viewed by 56076

Special Issue Editors

Department of Psychology and Sociology, University of Zaragoza, 44003 Teruel, Spain
Interests: reproductive and perinatal mental health, prevention; evidence-based psychological interventions; transdiagnostic; emotion regulation; emotional disorders; e-health; m-health
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Guest Editor
Universidad de Zaragoza and Health Research Institute of Aragon
Interests: Personality disorders; Emotional Disorders; Evidence-Based Psychological Interventions; Dialectical Behavior Therapy; Transdiagnostic interventions; Information and Communication Technologies; Virtual Reality

E-Mail Website
Guest Editor
Universidad de Zaragoza and Health Research Institute of Aragon
Interests: Psychopathology; Psychotherapy; Psychotherapeutic Processes; Psychological resilience; Clinical Psychology; Cognitive Behavioral Therapy; Emotional Disorders; Psychological Assessment; Information and Communication Technologies; Evidence-Based Psychological Interventions

Special Issue Information

Dear Colleagues,

In the last decade, we have witnessed an increased interest in transdiagnostic approach studies by researchers and clinicians all over the world. Psychopathology studies based on the transdiagnostic perspective aim to find common etiological and maintenance features of distinct mental disorders, for example, eating disorders (Fairburn et al., 2003), anxiety disorders (Norton & Paulus, 2017), or emotional disorders (Brown & Barlow, 2009; Suárez et al., 2009). With this knowledge, different transdiagnostic psychological interventions have been designed and tested with treatment and preventive purposes, and promising results on their efficacy and feasibility have been found (e.g., Garcia-Escalera et al., 2016; Newby et al., 2015; Sakiris y Berle, 2019). In addition, new transdiagnostic measures have also been developed (i.e., MEDI; Rosellini & Brown, 2019).

Transdiagnostic psychological interventions have been applied in child, adolescent and adult samples, in a variety of mental disorders, contexts (e.g., research settings, public mental health settings, community settings or social services), and formats (e.g. individual vs. group, face-to-face vs. Internet-delivered treatments or blended). Some relevant advantages associated with transdiagnostic interventions are focused on their cost-effectiveness, implementation and dissemination. For example, clinicians are able to treat different disorders with a single protocol (including comorbid disorders). Furthermore, by using online or group formats clinicians can reduce costs and increase the potential for dissemination and availability of evidence-based psychological interventions. Despite of the positive advances that transdiagnostic interventions are providing to Clinical and Health Psychology fields, more studies are needed in order to increase their empirical support.

Most recently, due the high comorbidity between mental disorders (e.g., anxiety and depressive disorders) and health conditions, most of these transdiagnostic interventions have been adapted and implemented for people with health conditions (cancer, HIV or chronic pain). Preliminary outcomes of these studies are encouraging (e.g., Cassiello-Robbins et al., 2020).

The aim of this Special Issue, “Transdiagnostic Approach in Clinical and Health Psychology: Psychopathology, Assessment and Intervention outcomes”, is to publish studies concerning the most recent advances in psychopathology (e.g., transdiagnostic shared dimensions), assessment (e.g., transdiagnostic measures), and psychological interventions (promotion, prevention and treatment intervention outcomes) from a transdiagnostic approach throughout the life cycle.

Dr. Jorge Osma
Dr. María Vicenta Navarro-Haro
Dr. Amanda Díaz-García
Guest Editors

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Keywords

  • Transdiagnostic approach
  • Transdiagnostic assessment
  • Transdiagnostic interventions
  • Transdiagnostic dimensions
  • Psychopathology
  • Mental health
  • Health conditions
  • Emotional disorders
  • Implementation
  • Dissemination
  • Cost-effectiveness
  • Prevention
  • Evidence-based psychological interventions

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Published Papers (13 papers)

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Research

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18 pages, 391 KiB  
Article
The Strengths and Difficulties Questionnaire as a Valuable Screening Tool for Identifying Core Symptoms and Behavioural and Emotional Problems in Children with Neuropsychiatric Disorders
by Melissa Grasso, Giulia Lazzaro, Francesco Demaria, Deny Menghini and Stefano Vicari
Int. J. Environ. Res. Public Health 2022, 19(13), 7731; https://doi.org/10.3390/ijerph19137731 - 23 Jun 2022
Cited by 10 | Viewed by 3572
Abstract
The Strengths and Difficulties Questionnaire (SDQ) is a worldwide questionnaire used for the early identification of behavioural/emotional symptoms in children and adolescents with neuropsychiatric disorders. Although its prognostic power has been studied, it has not yet been tested whether SDQ: (i) can identify [...] Read more.
The Strengths and Difficulties Questionnaire (SDQ) is a worldwide questionnaire used for the early identification of behavioural/emotional symptoms in children and adolescents with neuropsychiatric disorders. Although its prognostic power has been studied, it has not yet been tested whether SDQ: (i) can identify pathognomonic symptoms across a variety of neurodevelopmental and neuropsychiatric disorders, (ii) can capture emotional and behavioural problems associated with the main diagnosis, as well as shared transdiagnostic dimensions, and (iii) can detect changes in symptomatology with age. The present study evaluated nearly 1000 children and adolescents overall with Global Developmental Delay (GDD), Intellectual Disability (ID), Language Disorder (LD), Specific Learning Disorder (SLD), Autism Spectrum Disorder (ASD), Attention Deficit/Hyperactivity Disorder (ADHD), Mood Disorder (MD), Anxiety Disorder (AD), and Eating Disorders (ED). We found that SDQ: (i) can identify the core symptoms in children with ASD, ADHD, MD, and AD via specific subscales; (ii) can capture the associated emotional and behavioural symptoms in children with LD, GDD, ID, SLD, and ED; and (iii) can detect changes in the symptomatology, especially for GDD, LD, ASD, ADHD, and AD. SDQ is also able to recognise the transdiagnostic dimensions across disorders. Our results underscore the potential of SDQ to specifically differentiate and identify behavioural/emotional profiles associated with clinical diagnosis. Full article
14 pages, 599 KiB  
Article
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
by Vanesa Ferreres-Galán, María Vicenta Navarro-Haro, Óscar Peris-Baquero, Silvia Guillén-Marín, Jordi de Luna-Hermoso and Jorge Osma
Int. J. Environ. Res. Public Health 2022, 19(9), 5715; https://doi.org/10.3390/ijerph19095715 - 7 May 2022
Cited by 11 | Viewed by 2887
Abstract
Healthcare professionals, especially women, have shown increases in anxious-depressive symptoms as a consequence of the COVID-19 pandemic. The aim of this pilot study was to evaluate the acceptability and preliminary effectiveness of a Unified Protocol (UP) prevention program to provide emotional regulation skills [...] Read more.
Healthcare professionals, especially women, have shown increases in anxious-depressive symptoms as a consequence of the COVID-19 pandemic. The aim of this pilot study was to evaluate the acceptability and preliminary effectiveness of a Unified Protocol (UP) prevention program to provide emotional regulation skills to cope with stressful situations. The sample consisted of 27 nursing professionals (100% women; mean age: 45.67; SD = 7.71) working in a Spanish public hospital during COVID-19, who were randomized to an immediate treatment group (ITG, n = 13) or to a delayed treatment group (DTG, n = 14, which served as the waiting list control group and received the program 5 weeks after the ITG had received it). The program consisted of five-weekly, two-hour, UP-based group sessions. Variables related to emotional symptomatology, emotional regulation, personality, burnout, and perceived quality of life were evaluated at the following time points: pre- and post-intervention and at 1-, 3-, and 6-month follow-ups. Statistically significant between-group differences showed lower emotional exhaustion and personal accomplishment in favor of the ITG after the intervention. Regarding the effect over time for all participants who received the UP (n = 27), statistically significant reductions were observed in neuroticism, personal accomplishment, and subjective distress caused by traumatic events (−0.23 ≤ d ≤ −0.73). A statistically significant interaction “Time*Condition” was found in anxiety, with increases in the DTG. Participants showed high satisfaction with the UP. These findings show good acceptability and preliminary effectiveness of the UP to reduce the emotional impact of the pandemic in female nursing workers. Full article
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21 pages, 577 KiB  
Article
Prevention of Depression and Anxiety in Subclinical Adolescents: Effects of a Transdiagnostic Internet-Delivered CBT Program
by Julia C. Schmitt, Rosa M. Valiente, Julia García-Escalera, Sandra Arnáez, Victoria Espinosa, Bonifacio Sandín and Paloma Chorot
Int. J. Environ. Res. Public Health 2022, 19(9), 5365; https://doi.org/10.3390/ijerph19095365 - 28 Apr 2022
Cited by 21 | Viewed by 5479
Abstract
Anxiety and depressive symptoms are common problems in adolescence that could be addressed by means of preventive interventions. Even though transdiagnostic cognitive behavior therapy (T-CBT) is potentially an ideal strategy to deal with anxiety and depression, it has rarely been used for preventive [...] Read more.
Anxiety and depressive symptoms are common problems in adolescence that could be addressed by means of preventive interventions. Even though transdiagnostic cognitive behavior therapy (T-CBT) is potentially an ideal strategy to deal with anxiety and depression, it has rarely been used for preventive purposes. In addition, so far, no study has used internet-delivered T-CBT to prevent anxiety and depression in adolescents. This study aimed to examine the utility of AMTE, an internet-delivered T-CBT program, for the indicated prevention of anxiety and depression in adolescents. AMTE was applied to 30 adolescents (56.7% females, age range = 12–18 years, Mage = 14.00, SDage = 1.89) who showed subclinical symptoms of anxiety and/or depression. Participants were assessed at pre- and post-treatment and follow-up (3 months). We found that after the program, the symptoms of self-reported anxiety and depression, clinician-rated symptom severity, and self-reported and parent-reported severity of the main problems had significantly improved. In addition, there were significant improvements in anxiety sensitivity and emotional avoidance. Finally, we found high feasibility and acceptability of the program. AMTE is feasible and potentially effective for the indicated prevention of anxiety and depression as well as of clinical transdiagnostic factors, in adolescents. Full article
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24 pages, 4834 KiB  
Article
The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) in Portugal: Feasibility Study Results
by Brígida Caiado, Ana Góis, Bárbara Pereira, Maria Cristina Canavarro and Helena Moreira
Int. J. Environ. Res. Public Health 2022, 19(3), 1782; https://doi.org/10.3390/ijerph19031782 - 4 Feb 2022
Cited by 8 | Viewed by 5294
Abstract
The Unified Protocol for Children (UP-C) is a transdiagnostic Cognitive-Behavioral Therapy group intervention for children and caregivers targeting the treatment of children’s emotional disorders (EDs). The present study aims to assess the feasibility and acceptability of the UP-C in the Portuguese population using [...] Read more.
The Unified Protocol for Children (UP-C) is a transdiagnostic Cognitive-Behavioral Therapy group intervention for children and caregivers targeting the treatment of children’s emotional disorders (EDs). The present study aims to assess the feasibility and acceptability of the UP-C in the Portuguese population using a single-armed design. The participants were 32 children (6–12 years of age) with an ED (anxiety and/or depressive disorder) as a main diagnosis and their parents. All participants received the UP-C intervention and were assessed at pretreatment, midtreatment, posttreatment, and 3 months posttreatment. Children, parents, the clinicians, and an external observer completed questionnaires to assess the feasibility and acceptability of the UP-C (e.g., satisfaction, motivation, and adherence). Children and parents also completed self-report measures assessing the children’s anxiety and depression and its interference and severity. The results of the present study support the feasibility and acceptability of the UP-C in Portugal; low dropout rates, high adherence rates, and high levels of child and parent satisfaction and motivation were observed. Moreover, significant reductions over time in children’s levels of anxiety and/or depression and of its interference and severity were found and were maintained after 3 months of follow-up. These results are promising and warrant a subsequent randomized controlled trial (RCT). Full article
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14 pages, 377 KiB  
Article
Preventing Emotional Dysregulation: Acceptability and Preliminary Effectiveness of a DBT Skills Training Program for Adolescents in the Spanish School System
by Xavier Gasol, María Vicenta Navarro-Haro, Isabel Fernández-Felipe, Azucena García-Palacios, Carlos Suso-Ribera and Miquel Gasol-Colomina
Int. J. Environ. Res. Public Health 2022, 19(1), 494; https://doi.org/10.3390/ijerph19010494 - 3 Jan 2022
Cited by 7 | Viewed by 4716
Abstract
Emotional dysregulation is a key factor in the development and maintenance of multiple disabling mental disorders through a person’s lifespan. Therefore, there is an urgent need to prevent emotional dysregulation as early as possible. The main aim of this study was to evaluate [...] Read more.
Emotional dysregulation is a key factor in the development and maintenance of multiple disabling mental disorders through a person’s lifespan. Therefore, there is an urgent need to prevent emotional dysregulation as early as possible. The main aim of this study was to evaluate the acceptability and preliminary effectiveness of an adapted Dialectical Behavior Therapy Skills Training program for Emotional Problem Solving in Adolescents (DBT STEPS-A) during secondary school. The sample included 93 adolescents (mean age = 12.78; SD = 0.54; and 53% female) studying in their 2nd year of secondary school in a public center in Catalonia (Spain). Measures of acceptability, difficulties of emotional regulation, mental health problems, and life satisfaction were completed before and after participation in the DBT STEPS-A program during one academic year. The majority of students rated the program as useful (64%) and enjoyed the classes (62%) and 48% of them reported practicing the newly learned skills. Statistically significant improvements were revealed in some emotional regulation-related variables, namely the number of peer problems (p = 0.003; d = 0.52) and prosocial behaviors (p < 0.001; d = −0.82). Although non-significant, the scores in the remaining outcomes indicated a general positive trend in emotional dysregulation, mental health, and life satisfaction. The adapted DBT STEPS-A was very well-accepted and helped overcome some emotional regulation difficulties in Spanish adolescents. Full article
12 pages, 1691 KiB  
Article
Spanish Adaptation of the Overall Anxiety and Depression Severity and Impairment Scales in University Students
by Jorge Osma, Víctor Martínez-Loredo, Amanda Díaz-García, Alba Quilez-Orden and Óscar Peris-Baquero
Int. J. Environ. Res. Public Health 2022, 19(1), 345; https://doi.org/10.3390/ijerph19010345 - 29 Dec 2021
Cited by 7 | Viewed by 2431
Abstract
The lifetime prevalence of emotional disorders in Spain is 4.1% for anxiety and 5.2% for depression, increasing among university students. Considering the scarcity of screenings with adequate psychometric properties, this study aims to explore the validity evidence of the Overall Anxiety/Depression Severity and [...] Read more.
The lifetime prevalence of emotional disorders in Spain is 4.1% for anxiety and 5.2% for depression, increasing among university students. Considering the scarcity of screenings with adequate psychometric properties, this study aims to explore the validity evidence of the Overall Anxiety/Depression Severity and Impairment Scales (OASIS and ODSIS). A total of 382 university students from the general population were assessed on anxiety and depressive symptoms, as well as quality of life. The one-dimensional structure of both the OASIS and ODSIS explained 87.53% and 90.60% of variance, with excellent internal consistency (α = 0.94 and 0.95, respectively) and optimal cut-offs of 4 and 5, respectively. Both scales show a significant moderate association with other measures of anxiety, depression and quality of life. The OASIS and ODSIS have shown good reliability and sound validity evidence that recommend their use for the assessment and early detection of anxiety and depressive symptoms, and associated quality of life impairment in Spanish youth. Full article
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12 pages, 346 KiB  
Article
A Preliminary Evaluation of the Unified Protocol among Trauma-Exposed Adults with and without PTSD
by Caitlyn O. Hood, Matthew W. Southward, Christian Bugher and Shannon Sauer-Zavala
Int. J. Environ. Res. Public Health 2021, 18(21), 11729; https://doi.org/10.3390/ijerph182111729 - 8 Nov 2021
Cited by 9 | Viewed by 3540
Abstract
The purpose of this study was to evaluate whether the Unified Protocol (UP)—a mechanistically transdiagnostic psychological treatment—provides benefit to individuals with a range of trauma histories, psychological difficulties, and diagnostic comorbidity. Using data from a sequential multiple-assignment randomized trial (SMART), this exploratory analysis [...] Read more.
The purpose of this study was to evaluate whether the Unified Protocol (UP)—a mechanistically transdiagnostic psychological treatment—provides benefit to individuals with a range of trauma histories, psychological difficulties, and diagnostic comorbidity. Using data from a sequential multiple-assignment randomized trial (SMART), this exploratory analysis included a sample of 69 community-recruited adults seeking outpatient mental health treatment. We examined reductions in anxiety and depressive symptoms and changes in aversive and avoidant reactions to intense emotions—the UP’s putative mechanism—first by comparing individuals with and without trauma histories and then specifically among participants with PTSD. Findings suggest that the UP may lead to similar improvements in clinical diagnostic severity, anxiety, and depression among patients with trauma exposure as those without trauma exposure. Roughly half of participants with PTSD demonstrated reductions in PTSD clinical severity, anxiety, depression, and distress aversion, suggesting the UP may be an efficacious treatment for people with PTSD and comorbid conditions. Full article
17 pages, 676 KiB  
Article
Validity Evidence of the Multidimensional Emotional Disorders Inventory among Non-Clinical Spanish University Students
by Jorge Osma, Víctor Martínez-Loredo, Alba Quilez-Orden, Óscar Peris-Baquero and Carlos Suso-Ribera
Int. J. Environ. Res. Public Health 2021, 18(16), 8251; https://doi.org/10.3390/ijerph18168251 - 4 Aug 2021
Cited by 8 | Viewed by 2642
Abstract
The current diagnostic systems for mental health disorders are categorical, which, it has been argued, poorly reflect the reality of mental health problems. This is especially relevant in emotional disorders (EDs), especially due to the existing comorbidity between supposedly different disorders. To address [...] Read more.
The current diagnostic systems for mental health disorders are categorical, which, it has been argued, poorly reflect the reality of mental health problems. This is especially relevant in emotional disorders (EDs), especially due to the existing comorbidity between supposedly different disorders. To address this, Brown and Barlow developed a hybrid dimensional−categorical approach to EDs that can be evaluated with the Multidimensional Emotional Disorder Inventory (MEDI), a transdiagnostic self-report questionnaire. This study aims to adapt and explore the sources of validity evidence of the MEDI in a non-clinical sample of Spanish university students (n = 455). Two confirmatory analyses were performed: one with a four-dimensional structure obtained with an exploratory analysis and another with the original nine-dimensional structure of the MEDI. The latter obtained a better fit. The descriptive data, including percentiles, T-scores, and sex differences in total scores are also provided, together with sources of validity evidence. These revealed significant moderate interrelations between factors and with related measures (e.g., personality, depression, and anxiety). This study adapted the MEDI for use in Spanish, provides further support about its factor structure, and offers novel data about its validity sources. The MEDI makes the evaluation of dimensional and transdiagnostic models easier, which might be fundamental in present and future research and clinical practice. Full article
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16 pages, 7853 KiB  
Article
A Mental Health Drop-In Centre Offering Brief Transdiagnostic Psychological Assessment and Treatment in a Paediatric Hospital Setting: A One-Year Descriptive Study
by Matteo Catanzano, Sophie D Bennett, Marc S Tibber, Anna E Coughtrey, Holan Liang, Isobel Heyman, The Lucy Project Team and Roz Shafran
Int. J. Environ. Res. Public Health 2021, 18(10), 5369; https://doi.org/10.3390/ijerph18105369 - 18 May 2021
Cited by 6 | Viewed by 4474
Abstract
Aim: This study was part of a broader project to examine the acceptability, feasibility and impact of a transdiagnostic mental health drop-in centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the [...] Read more.
Aim: This study was part of a broader project to examine the acceptability, feasibility and impact of a transdiagnostic mental health drop-in centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long-term physical health conditions (LTCs). The aims of this investigation were to characterise: (i) the use of such a centre, (ii) the demographics and symptoms of those presenting to the centre, and (iii) the types of support that are requested and/or indicated. Methods: A mental health “booth” was located in reception of a national paediatric hospital over one year. Characteristics of young people with LTCs and their siblings/parents attending the booth were defined. Emotional/behavioural symptoms were measured using standardised questionnaires including the Strengths and Difficulties Questionnaire (SDQ). Participants subsequently received one of four categories of intervention: brief transdiagnostic cognitive behaviour therapy (CBT), referral to other services, neurodevelopmental assessment or signposting to resources. Results: One hundred and twenty-eight participants were recruited. The mean age of young people was 9.14 years (standard deviation: 4.28); 61% identified as white and 45% were male. Over half of young people recruited scored in the clinical range with respect to the SDQ. Presenting problems included: anxiety (49%), challenging behaviour (35%), low mood (22%) and other (15%). Conclusions: A considerable proportion of young people with LTC in a paediatric hospital scored in the clinical range for common mental health problems, indicating a potential for psychological interventions. Full article
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14 pages, 501 KiB  
Article
“Despite the Differences, We Were All the Same”. Group Cohesion in Diagnosis-Specific and Transdiagnostic CBT Groups for Anxiety and Depression: A Qualitative Study
by Anne Bryde Christensen, Signe Wahrén, Nina Reinholt, Stig Poulsen, Morten Hvenegaard, Erik Simonsen and Sidse Arnfred
Int. J. Environ. Res. Public Health 2021, 18(10), 5324; https://doi.org/10.3390/ijerph18105324 - 17 May 2021
Cited by 12 | Viewed by 6026
Abstract
Group cohesion refers to a sense of belonging, mutual support and identification with other group members. Group cohesion has been associated with better outcomes, lower drop-out rates, more interpersonal support and better participation in psychotherapy. Nevertheless, the role of group cohesion in CBT [...] Read more.
Group cohesion refers to a sense of belonging, mutual support and identification with other group members. Group cohesion has been associated with better outcomes, lower drop-out rates, more interpersonal support and better participation in psychotherapy. Nevertheless, the role of group cohesion in CBT has not yet received much attention. The rationale for delivering CBT in groups is that patients can model themselves through each other due to their similarities in symptoms. However, there has recently been a shift towards transdiagnostic CBT protocols, in which patients with varied diagnoses participate in the same groups. This shift challenges the rationale of delivering CBT in groups, and it is therefore highly important to understand if and how group cohesion develops in mixed diagnoses CBT groups. The current study used a qualitative comparative framework to investigate the patients’ experiences of group cohesion in diagnosis-specific versus transdiagnostic CBT groups. Twenty-three patients were interviewed with semi-structured interviews upon completion of the treatment. Participants had a primary diagnosis of MDD, panic disorder, agoraphobia or social anxiety disorder. A comparative thematic analysis was carried out. Three themes were found: the move from differences to similarities, the role of group cohesion in group CBT and factors helpful and hindering to group cohesion. Group cohesion developed across groups and was considered highly important in both diagnosis-specific and transdiagnostic CBT groups. Full article
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Review

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15 pages, 724 KiB  
Review
The Impact of COVID-19 Related Social Distancing on Mental Health Outcomes: A Transdiagnostic Account
by Daniella Spencer-Laitt, Elizabeth H. Eustis, David H. Barlow and Todd J. Farchione
Int. J. Environ. Res. Public Health 2022, 19(11), 6596; https://doi.org/10.3390/ijerph19116596 - 28 May 2022
Cited by 10 | Viewed by 3213
Abstract
The COVID-19 pandemic, and the social distancing practices that followed, have been associated with increased prevalence of emotional disorders. However, not all individuals affected by COVID-19-related social distancing experienced elevations in emotional disorder symptoms. Understanding this phenomenon is of crucial public health significance [...] Read more.
The COVID-19 pandemic, and the social distancing practices that followed, have been associated with increased prevalence of emotional disorders. However, not all individuals affected by COVID-19-related social distancing experienced elevations in emotional disorder symptoms. Understanding this phenomenon is of crucial public health significance given the burden of emotional disorders on individuals and systems. In this narrative review, we consider the differential impact of COVID-19-related social distancing on mental health outcomes from a transdiagnostic perspective. We argue that individuals high in negative affect and aversive reactivity to emotion, that is, neuroticism, and who respond to such emotional experiences with emotion-motivated avoidant coping, are most likely to experience emotional disorders in the context of COVID-19 social distancing. We acknowledge the pro-social and adaptive function of some types of avoidance during the pandemic, which may have initially buffered against negative mental health outcomes. Implications of this conceptualization for treatment of emotional disorders in the present sociocultural context are discussed. Full article
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19 pages, 680 KiB  
Review
Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Medical Conditions: A Systematic Review
by Jorge Osma, Laura Martínez-García, Alba Quilez-Orden and Óscar Peris-Baquero
Int. J. Environ. Res. Public Health 2021, 18(10), 5077; https://doi.org/10.3390/ijerph18105077 - 11 May 2021
Cited by 18 | Viewed by 5981
Abstract
Emotional disorders are those that most commonly present comorbidly with medical conditions. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP), a cognitive-behavioral emotion-based intervention, has proven efficacy and versatility. The aim of this systematic review is to know the current [...] Read more.
Emotional disorders are those that most commonly present comorbidly with medical conditions. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP), a cognitive-behavioral emotion-based intervention, has proven efficacy and versatility. The aim of this systematic review is to know the current (research studies) and future research interest (study protocols) in using the UP for the transdiagnostic treatment of emotional symptoms or disorders (EDs) in people with a medical condition. Using the PRISMA guidelines, a literature search was conducted in Web of Science, PubMed, Medline, and Dialnet. The nine research studies included in this review indicated that the UP is effective in treating emotional symptomatology in a population with a medical condition (effect sizes ranging from d = −3.34 to d = 2.16). The three included study protocols suggest interest in the future UP application to different medical conditions, and also in distinct application formats. Our review results are encouraging, and conducting more controlled studies is advised to recommend the UP to treat and/or prevent EDs in medical conditions, especially in children and youths. Full article
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Other

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14 pages, 1064 KiB  
Case Report
Application of the Unified Protocol for a Japanese Patient with Post-Traumatic Stress Disorder and Multiple Comorbidities: A Single-Case Study
by Noriko Kato, Masaya Ito, Yutaka J. Matsuoka, Masaru Horikoshi and Yutaka Ono
Int. J. Environ. Res. Public Health 2021, 18(21), 11644; https://doi.org/10.3390/ijerph182111644 - 5 Nov 2021
Cited by 1 | Viewed by 2688
Abstract
(1) Background: The efficacy of the Unified Protocol (UP), a transdiagnostic cognitive-behavioral therapy, with trauma-focused exposure has not been sufficiently demonstrated for post-traumatic stress disorder (PTSD) with multiple comorbidities. This study examined the effects of UP treatment with trauma-focused exposure on symptoms of [...] Read more.
(1) Background: The efficacy of the Unified Protocol (UP), a transdiagnostic cognitive-behavioral therapy, with trauma-focused exposure has not been sufficiently demonstrated for post-traumatic stress disorder (PTSD) with multiple comorbidities. This study examined the effects of UP treatment with trauma-focused exposure on symptoms of PTSD and comorbidities in a client who was hesitant about exposure. (2) Methods: The client, who had comorbid dysthymia, social anxiety disorder, agoraphobia, and bulimia nervosa, participated in the UP for 20 sessions over 6 months. The principal diagnosis and symptoms of the comorbid disorders were assessed at baseline, post-intervention, and at the 3-month follow-up. This treatment was conducted as part of a clinical study (UMIN000008322). (3) Results: The client showed improvement in the principal diagnosis and symptoms of the comorbid disorders post-intervention compared with baseline and no longer met the diagnostic criteria for any of the disorders. Considerable symptom improvement was observed with imaginal exposure to trauma memories. (4) Conclusions: The UP was an effective alternative treatment for PTSD and symptoms of comorbidities in this client who was hesitant about exposure to traumatic memories, and that the inclusion of trauma-focused exposure provided sufficient therapeutic effects. Further research is needed to examine the generalizability of our findings. Full article
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