The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders
Open accessAbstract
The present study aimed to understand the contributions of both the trait tendency to experience negative emotions and how one relates to such experience in predicting symptom change during participation in the Unified Protocol (UP), a transdiagnostic treatment for emotional disorders. Data were derived from a randomized controlled trial comparing the UP to a waitlist control/delayed-treatment condition. First, effect sizes of pre- to post-treatment change for frequency of negative emotions and several variables measuring reactivity to emotional experience (emotional awareness and acceptance, fear of emotions, and anxiety sensitivity) were examined. Second, the relative contributions of change in negative emotions and emotional reactivity in predicting symptom (clinician-rated anxiety, depression, and severity of principal diagnosis) reductions were investigated. Results suggested that decreases in the frequency of negative emotions and reactivity to emotions following participation in the UP were both large in magnitude. Further, two emotional reactivity variables (fear of emotions and anxiety sensitivity) remained significantly related to symptom outcomes when controlling for negative emotions, and accounted for significant incremental variance in their prediction. These findings lend support to the notion that psychological health depends less on the frequency of negative emotions and more on how one relates to these emotions when they occur. © 2012 Elsevier Ltd.
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Claims the paper makes
4 of 42 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured
- Premisecitation
The Unified Protocol targets heightened negative reactivity to emotions by identifying maladaptive responses and teaching better management strategies.
“The UP addresses heightened negative reactivity to emotions by identifying maladaptive responses to emotions and developing more effective strategies to manage these experiences (Ellard et al., 2010).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Ellard et al., 2010 source
- Findingown data
Following participation in the Unified Protocol, decreases in the frequency of negative emotions were large.
“Results suggested that decreases in the frequency of negative emotions and reactivity to emotions following participation in the UP were both large in magnitude.”
Quote in the paperNot a substantial claim - Findingown data
Following participation in the Unified Protocol, decreases in reactivity to emotions were large.
“Results suggested that decreases in the frequency of negative emotions and reactivity to emotions following participation in the UP were both large in magnitude.”
Quote in the paperSubstantial claim - Findingown data
Changes in the emotional reactivity variables targeted by the UP all had large effect sizes.
“Change in the emotional reactivity variables targeted by the UP all represented large effects, as did change in negative affect”
Quote in the paperNot a substantial claim - Findingown data
In the hierarchical regression predicting change in depression, change in negative affect accounted for 22% of the variance.
“While change in negative affect accounted for a significant amount of variance in predicting change in depression (22%)”
Quote in the paperSubstantial claim
- Findingown data
Participants in the UP showed a decrease in the frequency of negative affect (PANAS-NA) from pre- to post-treatment.
“participants in the UP experienced decreased frequency of negative affect (PANAS-NA), fear of emotions (ACS), and sensitivity to anxiety symptoms (ASI) and increased awareness and acceptance of emotions (ERSQ).”
Quote in the paperNot a substantial claim - Findingown data
In the same regression, adding change in fear of emotions and anxiety sensitivity accounted for an additional 42% of the variance.
“the addition of change in fear of emotions and assigned at step 2 accounted for an additional 42% of the variance”
Quote in the paperSubstantial claim - Findingown data
Participants in the UP showed an increase in awareness and acceptance of emotions (ERSQ) from pre- to post-treatment.
“participants in the UP experienced decreased frequency of negative affect (PANAS-NA), fear of emotions (ACS), and sensitivity to anxiety symptoms (ASI) and increased awareness and acceptance of emotions (ERSQ).”
Quote in the paperNot a substantial claim - Findingown data
In that regression, change in fear of emotions and sensitivity to anxiety together accounted for an additional 25% of the variance in clinical severity.
“Together, change in fear of emotions and sensitivity to anxiety accounted for an additional 25% of the variance in change in clinical severity”
Quote in the paperSubstantial claim - Findingown data
Participants in the UP showed a decrease in fear of emotions (ACS) from pre- to post-treatment.
“participants in the UP experienced decreased frequency of negative affect (PANAS-NA), fear of emotions (ACS), and sensitivity to anxiety symptoms (ASI) and increased awareness and acceptance of emotions (ERSQ).”
Quote in the paperNot a substantial claim - Findingown data
Participants in the UP showed a decrease in sensitivity to anxiety symptoms (ASI) from pre- to post-treatment.
“participants in the UP experienced decreased frequency of negative affect (PANAS-NA), fear of emotions (ACS), and sensitivity to anxiety symptoms (ASI) and increased awareness and acceptance of emotions (ERSQ).”
Quote in the paperNot a substantial claim - Findingown data
After controlling for decreases in negative affect, increased awareness and acceptance of emotions was no longer significantly related to any outcome variable.
“Unexpectedly, increased awareness and acceptance of emotions was no longer significantly related to any outcome variable when controlling for decreases negative affect.”
Quote in the paperSubstantial claim - Findingown data
The decrease in fear of emotions was significantly larger than the decrease in negative affect.
“decreases in fear of emotions were significantly larger than decreases in negative affect.”
Quote in the paperNot a substantial claim - Findingown data
Partial correlations between emotional awareness/acceptance and symptom change were moderate, ranging from -.25 to -.35.
“partial correlations between emotional awareness/acceptance and symptom change were moderate, ranging between -.25 and -.35”
Quote in the paperNot a substantial claim - Findingown data
Decreases in sensitivity to anxiety (ASI) were associated with decreases in depression, anxiety, and clinical severity scores.
“decreases in fear of emotions (ACS) and sensitivity to anxiety (ASI) were associated with decreases on depression, anxiety, and clinical severity scores.”
Quote in the paperSubstantial claim - Findingown data
A comparison of effect sizes suggested that the magnitude of change on negative affect and emotional reactivity variables was comparable for all treatment completers and for delayed treatment participants.
“a comparison of the effect sizes suggests that the magnitude of change on both frequency of negative affect and the emotional reactivity variables was comparable for all treatment completers and for delayed treatment participants”
Quote in the paperNot a substantial claim - Findingown data
Change in negative affect also had a large effect size.
“Change in the emotional reactivity variables targeted by the UP all represented large effects, as did change in negative affect”
Quote in the paperNot a substantial claim - Findingown data
Decreases in negative affect were positively correlated with decreases in clinician-rated depression (HAM-D) and anxiety (HAM-A).
“decreases in level of negative affect (PANAS-NA) were positively correlated with decreases in level of clinician-rated depression (HAM-D) and anxiety (HAM-A)”
Quote in the paperSubstantial claim - Findingown data
In that regression, fear of emotions was not a significant predictor of change in clinical severity.
“however, fear of emotions was not a significant predictor of change in clinical severity.”
Quote in the paperSubstantial claim - Findingown data
Decreases in fear of emotions (ACS) were associated with decreases in depression, anxiety, and clinical severity scores.
“decreases in fear of emotions (ACS) and sensitivity to anxiety (ASI) were associated with decreases on depression, anxiety, and clinical severity scores.”
Quote in the paperSubstantial claim - Findingown data
Decreases in negative affect were not significantly associated with change in clinician-rated symptom severity for the principal diagnosis (CSR).
“decreases in negative affect were not significantly associated with change in clinician-rated symptom severity on the participant's principal diagnosis (CSR).”
Quote in the paperSubstantial claim - Findingown data
After controlling for decreases in negative affect, decreases in sensitivity to anxiety remained related to depression and clinical severity, but not to anxiety.
“Decreases in fear of emotions remained significantly associated with decreases in depression and anxiety (but not to clinical severity), while decreases in sensitivity to anxiety remained related to depression and clinical severity (but not to anxiety), after controlling for decreases in negative affect.”
Quote in the paperSubstantial claim - Findingown data
In the hierarchical regression predicting change in anxiety, change in negative affect accounted for 26% of the variance.
“Change in negative affect accounted for 26% of the variance in predicting change in anxiety”
Quote in the paperSubstantial claim - Premisecitation
The Unified Protocol was developed because emotional disorders frequently co-occur.
“Development of the UP was initiated in response to high rates of comorbidity amongst emotional disorders (Wilamowska et al., 2010)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wilamowska et al., 2010 source
- Premisecitation
Cross-sectional research indicates that how people respond to negative emotions predicts psychological symptoms beyond the contribution of having those experiences.
“Cross-sectional research has revealed that how individuals respond to negative emotions predicts psychological symptoms over and above the contributions of having such experiences (Sauer & Baer, 2009)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Sauer & Baer, 2009 source
- Premisecitation
People who view their emotional responses as unacceptable or inappropriate are more likely to have emotional disorders.
“For example, individuals who deem their emotional responses as unacceptable or inappropriate are more likely to suffer from emotional disorders (Campbell-Sills et al., 2006; Mennin, Heimberg, Turk, & Fresco, 2005).”
Quote in the paperSubstantial claim0 of 2 sources checked - Study design and conductreasoning
Excluding participants with recent prior cognitive-behavioral therapy was intended to make responses more clearly attributable to the therapy dose in this trial.
“Similar to methods used in pharmacotherapy efficacy trials, this was done to further ensure that an individual's response could be more clearly attributed to the dose of therapy received in this course of treatment.”
Quote in the paperSubstantial claim - Interpretationown data
Psychological health depends less on how often negative emotions occur and more on how a person relates to those emotions when they occur.
“These findings lend support to the notion that psychological health depends less on the frequency of negative emotions and more on how one relates to these emotions when they occur.”
Quote in the paperSubstantial claim - Premisecitation
Suppressing emotion-eliciting thoughts leads to rebound effects, where the suppressed thoughts return more frequently or intensely.
“suppression of emotion-eliciting thoughts has demonstrated paradoxical consequences known as rebound effects, in which the suppressed thoughts return with greater frequency or intensity (Abramowitz, Tolin, & Street, 2001; Wegner, Schneider, Carter, & White, 1987).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Premisecitation
The Unified Protocol was developed because treatments aimed at one emotional disorder often improve co-occurring disorders.
“and evidence that psychological treatments targeting a specific emotional disorder often lead to improvements in comorbid disorders (Brown, Antony, & Barlow, 1995; Tsao, Lewin, & Craske, 1998; Tsao, Mystkowski, & Zucker, 2002).”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationnone given
This is one of the first studies to show that reductions in psychological symptoms are more a function of how emotions are managed than of the frequency or intensity of experience in a treatment outcome study.
“This is one of the first studies to show that reductions in psychological symptoms are more a function of how emotions are managed, rather than the frequency/intensity of experience, in the context of a treatment outcome study”
Quote in the paperSubstantial claim - Premisecitation
Cognitive and emotional avoidance and control strategies can lead to significant increases in subsequent distress.
“cognitive and emotional avoidance and control strategies (e.g., suppression, worry, rumination) can lead to significant increases in subsequent distress (e.g., Butler, Wells, & Dewick, 1995; Stewart, Zvolensky, & Eifert, 2002).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Study design and conductcitation
The data came from a randomized controlled trial that compared the UP with a wait-list control or delayed-treatment condition.
“Data were derived from a randomized controlled trial comparing the UP to a wait-list control / delayed-treatment condition (Farchione et al. in press).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Farchione et al. in press
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data
Reductions in fear about losing control over one's emotions and about the consequences of the somatic component of an emotional response strongly predicted symptom decrease.
“Specifically, reductions in fear about losing control over one's emotions and the consequences of the somatic component of an emotional response strongly predicted symptom decrease.”
Quote in the paperSubstantial claim- The authors state this as an assumption: The tendency to experience negative emotions is a trait construct that temporally precedes learning skills to reduce reactivity.
- The authors state this as an assumption: Strong reactions to emotions cause symptoms of depression and anxiety.
- Study design and conductnone given
The sample size was small.
“the sample size was small”
Quote in the paperSubstantial claim - Interpretationown data
Decreased emotional reactivity is more important than decreased frequency of negative emotions for predicting decreases in anxiety in the UP.
“These results suggest that decreased emotional reactivity is more important in predicting decreases in anxiety in the UP than decreases in the frequency of negative emotions experienced.”
Quote in the paperSubstantial claim- The authors state this as an assumption: The tendency to experience negative emotions is a trait construct that temporally precedes learning skills to reduce reactivity.
- The authors state this as an assumption: Strong reactions to emotions cause symptoms of depression and anxiety.
- Interpretationown data
Decreasing negative reactivity to the experience of emotions is important for symptom reduction in the treatment of emotional disorders, even when accounting for decreases in the frequency of negative emotions.
“These results suggest that decreasing negative reactivity to the experience of emotions is important for symptom reduction in the treatment of emotional disorders, even when accounting for decreases in the frequency of experiencing negative emotions.”
Quote in the paperSubstantial claim - Study design and conductreasoning
Because all measures were not given at multiple intervals during treatment, it is impossible to assess the precise directionality of change.
“Given that all measures were not given at multiple intervals during the course of treatment, it is impossible to assess the precise directionality of change.”
Quote in the paperSubstantial claim - Interpretationown data
How one relates to negative emotion is a more important factor than the frequency of negative emotions in predicting change in the treatment of emotional disorders.
“Overall, these findings suggest that how one relates to negative emotion is a more important factor in predicting change in the treatment of emotional disorders than the frequency with which negative emotions occur.”
Quote in the paperSubstantial claim- The authors state this as an assumption: The tendency to experience negative emotions is a trait construct that temporally precedes learning skills to reduce reactivity.
- The authors state this as an assumption: Strong reactions to emotions cause symptoms of depression and anxiety.
- Premisecitation
Recent research indicates that change scores can be reliable measures of intraindividual change.
“recent research has demonstrated that change scores can be reliable measures of intraindividual change (King, King, McArdle, et al., 2006).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites King, King, McArdle, et al., 2006 source
- Study design and conductown data
The reliability of the change scores was calculated for the present study and was adequate for each variable.
“To ensure that the changes scores were reliable in the present study, the reliability of the change scores was calculated (rDD) using the formula specified in King et al., (2006), and was found to be adequate for each variable.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites King et al., (2006) source
- Interpretationown data
The UP appears to effectively target one of the key processes it was designed to address: decreased negative reactivity to emotional experiences.
“These results show that the UP appears to be effectively targeting one of the key processes it was designed to address – decreased negative reactivity to emotional experiences.”
Quote in the paperSubstantial claim - Study design and conductown data
The small number of delayed treatment participants limited the ability to compare relationships between treatment completers and delayed treatment samples.
“the small number of delayed treatment participants limited our ability to compare relationships between these variables in the treatment completers and delayed treatment samples.”
Quote in the paperNot a substantial claim - Interpretationown data
Decreased reactivity to emotions, especially decreased beliefs about the dangerousness of anxiety symptoms, is more important than decreased frequency of negative affect for predicting decreased clinical severity ratings in the UP.
“These results suggest that decreased reactivity to the experience emotions, particularly decreased beliefs about the dangerousness of anxiety symptoms, is more important in predicting decreased clinical severity ratings in the UP than decreases in the frequency of negative affect experienced.”
Quote in the paperSubstantial claim- The authors state this as an assumption: The tendency to experience negative emotions is a trait construct that temporally precedes learning skills to reduce reactivity.
- The authors state this as an assumption: Strong reactions to emotions cause symptoms of depression and anxiety.
- Classified as probably not a substantial claim. 22
- May combine two claims. 23
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe Affective Control Scale has acceptable internal consistency and convergent validity.
“The ACS has demonstrated acceptable internal consistency and convergent validity (Williams et al., 1997).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Williams et al., 1997 source
The passages from “Latent Structure of Emotional Disorders” discuss affective dimensions, and “Preliminary Data” reports treatment outcomes; neither addresses the Affective Control Scale’s psychometric properties. Searches for the scale, internal consistency, convergent validity, and Williams et al. (1997) found no relevant passage in our copy. Page numbers were not available. (LLM, conf=0.72)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationEmotional disorders involve sharp increases in affect in response to environmental triggers and interpreting those experiences as harmful.
“Emotional disorders are characterized by a tendency to experience steep increases in affect in response to environmental stimuli and, subsequently, interpret these emotional experiences as harmful (Andrews, 1990; Andrews, 1996; Brown & Barlow, 2009).”
Quote in the paperSubstantial claim1 of 3 sources checked- cites Andrews, 1990 source
- cites Andrews, 1996
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Brown & Barlow, 2009 source
In “A New Proposal for a Dimensional Classification System” (page unavailable), the paper describes discrete eruptions of emotion, including fear triggered by internal or external cues, and apprehension about anxiety or panic symptoms. These examples support parts of the claim, but the paper does not characterize emotional disorders generally as a sequence of sharp affective increases in response to environmental stimuli followed by interpreting those experiences as harmful. (LLM, conf=0.83)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe HAM-A showed good reliability between raters and across time, and it correlated well with comparable clinician-rated and self-report measures of depression.
“This commonly used measure has demonstrated good levels of interrater and test-retest reliability, as well as convergent validity with similar clinician rated and self-report measures of depression symptoms (Shear et al., 2001).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Shear et al., 2001 source
The Reliability section reports good HAM-A test–retest reliability (ICC 0.86) and interrater reliability (ICC 0.98). The Validity of SIGH-A as a Measure of Hamilton Anxiety Score section reports correlations with the clinician-rated SIGH-A and the self-report Beck Anxiety Inventory, but these measure anxiety, not depression symptoms. (LLM, conf=0.90)
Experimental — accuracy not yet measured
May combine two claims.
Findingown dataAnxiety sensitivity remained significantly related to symptom outcomes after controlling for negative emotions and contributed significant incremental variance to their prediction.
“Further, two emotional reactivity variables (fear of emotions and anxiety sensitivity) remained significantly related to symptom outcomes when controlling for negative emotions, and accounted for significant incremental variance in their prediction.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFear of emotions remained significantly related to symptom outcomes after controlling for negative emotions and contributed significant incremental variance to their prediction.
“Further, two emotional reactivity variables (fear of emotions and anxiety sensitivity) remained significantly related to symptom outcomes when controlling for negative emotions, and accounted for significant incremental variance in their prediction.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIncreased awareness and acceptance of emotions (ERSQ) was associated with decreases in depression and anxiety scores, but not with clinical severity scores.
“Increased awareness and acceptance of emotions (ERSQ) was associated with decreases on depression and anxiety scores, but not on clinical severity scores.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataNegative emotions and fear of emotions accounted for 10% and 7% of the variance in principal diagnosis severity ratings, respectively, but these predictors were not statistically significant.
“negative emotions and fear of emotions accounted for 10% and 7% of the variance in principal diagnosis severity rating, respectively, yet these predictors were not statistically significant.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataIn that regression, change in fear of emotions and sensitivity to anxiety accounted for significant additional variance (42%) and made negative affect no longer significant.
“when entered into the model change in fear of emotions and sensitivity to anxiety accounted for significant additional variance (42%) and rendered negative affect no longer significant in the prediction of change in anxiety.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAfter controlling for decreases in negative affect, decreases in fear of emotions remained significantly associated with decreases in depression and anxiety, but not with clinical severity.
“Decreases in fear of emotions remained significantly associated with decreases in depression and anxiety (but not to clinical severity), while decreases in sensitivity to anxiety remained related to depression and clinical severity (but not to anxiety), after controlling for decreases in negative affect.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn the hierarchical regression predicting clinical severity, change in negative affect predicted 10% of the variance but was not statistically significant.
“Change in negative affect predicted 10% of the variance in clinical severity ratings but was not a statistically significant predictor.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationSymptoms of emotional disorders reflect shared underlying factors, especially neuroticism, a stable tendency to experience negative affect.
“Findings from recent research suggest that the various symptoms of emotional disorders are in fact manifestations of common underlying factors. Such underlying factors include prominently the core temperamental dimension of neuroticism, an enduring tendency to experience negative affect (Brown, Chorpita, & Barlow, 1998; Gershuny & Sher, 1998; Kasch, Rottenberg, Arnow, & Gotlib, 2002; Watson, Clark”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataAll medicated participants had been on the same dose for at least three months before enrollment and agreed to keep their medications and doses unchanged during the study.
“All individuals were stable on the same dose for at least 3 months prior to enrolling in the study as a condition for participation in the study, and all agreed to maintain these dosages and medications for the duration of the study (for a description of medication stability compliance, see Farchione et al., in press).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Farchione et al., in press
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
PremisecitationDecreased emotional avoidance is a hypothesized mechanism by which reduced negative reactivity improves psychological functioning.
“A hypothesized mechanism through which decreased negative reactivity may lead to improvements in psychological functioning is decreased emotional avoidance.”
Quote in the paperSubstantial claim0 of 3 sources checkedClassified as probably not a substantial claim.
PremisecitationAccepting and understanding the full range of internal experience without trying to change or reduce it is considered important for symptom reduction.
“In contrast, acknowledging, understanding, and accepting the full range of internal experience (without attempts to change or reduce it) is thought to be important for symptom reduction (Hayes, Follette, & Linehan, 2004).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Hayes, Follette, & Linehan, 2004
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe Anxiety Sensitivity Index has good internal consistency and convergent validity.
“The ASI has demonstrated good internal consistency and convergent validity (Peterson & Reiss, 1987; Vujanovic, Arrindell, Bernstein, Norton, & Zvolensky, 2007).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Peterson & Reiss, 1987
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Vujanovic, Arrindell, Bernstein, Norton, & Zvolensky, 2007 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationNo differences between groups were found for age or gender.
“As reported by Farchione et al. (in press), no group differences were observed for age or gender.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Farchione et al. (in press)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Unified Protocol is a cognitive-behavioral treatment created for anxiety, depression, and related emotional disorders.
“The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional disorders is a cognitive-behavioral intervention recently developed to address anxiety, depression and related disorders (somatoform and dissociative disorders), or “emotional disorders” (Barlow et al., 2011).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Barlow et al., 2011
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe Emotion Regulation Strategies Questionnaire has high internal consistency, adequate test-retest reliability, and construct validity.
“The ERSQ has demonstrated high internal consistency (α = .90) and adequate test-retest reliability (rtt = .75). Additionally, positive associations with well-being and negative associations with psychopathology and emotion-regulation deficits have provided construct validity for this measure (Berking, Wupperman, Reichard, et al. 2008; Berking & Znoj, 2008).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Berking, Wupperman, Reichard, et al. 2008 source
- cites Berking & Znoj, 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThought suppression is associated with depression, generalized anxiety disorder, obsessive compulsive disorder, and post-traumatic stress disorder.
“In fact, thought suppression has been associated with depression, generalized anxiety disorder, obsessive compulsive disorder, and post-traumatic stress disorder (Purdon, 1999).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Purdon, 1999 source
Classified as probably not a substantial claim.
PremisecitationResponses to daily mood shifts, rather than the moods themselves, significantly affect the occurrence of depressive symptoms.
“and that responses to mood shifts in daily life (rather than the moods themselves) have significant impact on the occurrence of depressive symptoms (Segal et al., 2002).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Segal et al., 2002
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe PANAS negative affect scale had high internal consistency and test-retest reliability in its validation sample.
“In the validation sample, internal consistency and test-retest reliability were high (α = .90; r = .71).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Watson, Clark & Tellegen, 1988 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationDeliberately hiding emotions from others is linked to poorer adaptive functioning and lower well-being.
“For example, deliberately trying to conceal emotions from others has been associated with less adaptive functioning and reduced well-being (Gross & John, 2003)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gross & John, 2003 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataSixteen participants were taking psychotropic medications when they enrolled and were randomized.
“Sixteen individuals were taking psychotropic medications at the time of enrollment and randomization.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThirty-two of 37 patients were treatment completers.
“Thirty-two out of 37 patients were considered treatment completers (see Procedure section for treatment completer criteria).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe ADIS-IV-L has excellent to acceptable interrater reliability for anxiety and mood disorders.
“This measure has demonstrated excellent to acceptable interrater reliability for the anxiety and mood disorders (Brown, Di Nardo, Lehman, & Campbell, 2001).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Brown, Di Nardo, Lehman, & Campbell, 2001 source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationSelf-harm, substance abuse, and binge eating have been described as maladaptive reactions to emotions aimed at pushing away emotional experience.
“Further, behaviors such as self-harm, substance abuse, and binge eating, have also been conceptualized as maladaptive negative reactions to emotions with the goal of pushing away this experience (Hayes, Wilson, Gifford, Follette & Strosahl, 1996).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hayes, Wilson, Gifford, Follette & Strosahl, 1996 source
May combine two claims.
Study design and conductown dataData were collected only at pre- and post-treatment, which limits temporal interpretation.
“data were only collected at pre- and post-treatment, so temporal interpretation is limited.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenAll therapists received extensive training and certification before treating study patients.
“All therapists underwent extensive training and certification prior to treating study patients”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductreasoningAll treatment completers, including immediate treatment and post-waitlist delayed treatment participants, were combined into a single sample.
“all treatment completers (immediate treatment and post-waitlist delayed treatment participants) were combined into a single sample”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenTreatment adherence was checked in weekly supervision meetings.
“treatment adherence was monitored during weekly supervision meetings.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataDecreased levels of negative emotions and decreased reactivity to them both contribute to symptom change.
“Overall, these results indicate that decreased levels of negative emotions as well as decreased reactivity to them both contribute to symptom change.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataBoth the frequency of negative emotions and the extent of strong reactions to them changed to a large degree as a function of UP treatment.
“Overall, these results suggest that both frequency of negative emotions and the extent to which one reacts strongly to them change to a large degree as a function of treatment with the UP.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
Study design and conductnone givenIndependent evaluators were trained to a reliability criterion and were unaware of participants' randomized condition.
“Independent evaluators who were trained to criterion reliability and blind to randomized condition, conducted semi-structured diagnostic clinical interviews and provided clinical ratings.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationThe Hamilton Depression Rating Scale has good interrater and test-retest reliability and concurrent validity with similar depression measures.
“This commonly used measure has demonstrated good levels of interrater and test-retest reliability (Williams, 1988), as well as concurrent validity with similar clinician rated and self-report measures of depression symptoms (Bech et al., 1992).”
Quote in the paperNot a substantial claim0 of 2 sources checked
The paper relies on this without support.
The question of whether symptom reductions depend on the frequency of negative emotions or on how they are managed has not been examined in a treatment outcome study.
“Despite being a central tenet of cognitive-behavioral therapy, the extent to which reductions in psychological symptoms are a function of the frequency of negative emotions or how they are managed has not been studied in the context of a treatment outcome study.”
The paper relies on this without support.
The Unified Protocol is thought to address neuroticism by reducing reactivity to emotional experience.
“Given that the UP is posited to address neuroticism, thought to be a stable dimension of personality (Costa & McCrae, 1992), by decreasing reactivity to emotional experience, it is important to clarify what is changing as a function of treatment: the frequency with which patients experience negative emotions, or how they relate to negative emotions when these experiences occur.”
The paper relies on this without support.
Fear of emotions, anxiety sensitivity, and emotional awareness/acceptance are related but distinct indicators of reactivity to emotion.
“It is important to emphasize that the constructs of fear of emotions, anxiety sensitivity, and emotional awareness/acceptance are related, yet distinct markers of reactivity to emotion.”
The paper relies on this without support.
Trait neuroticism is marked by frequent and intense negative emotions.
“High frequency and intensity of negative emotions characterize trait neuroticism.”
The authors state this as an assumption.
The tendency to experience negative emotions is a trait construct that temporally precedes learning skills to reduce reactivity.
“based on the a priori conception that the tendency to experience negative emotions is a trait construct with temporal precedence over learning new skills to decrease reactivity.”
The authors state this as an assumption.
Strong reactions to emotions cause symptoms of depression and anxiety.
“A priori assumptions that the tendency to experience negative emotions is a trait-level construct and that strong reactions to emotions leads to symptoms of depression and anxiety shaped the formulation of analyses in this study.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Various studies have identified the role of recognition and acceptance of emotions in reducing symptoms of disorders.
“Various studies have identified the role of recognition and acceptance of emotions in reducing the symptoms of disorders.”
From Emotion regulation as the mediator of reductions in anxiety and depression in the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders: double-blind randomized clinical trial (2019) · cites this paper as [22]
The Results report that increased emotional awareness and acceptance was associated with reduced depression and anxiety symptoms during treatment. However, that association was no longer significant after controlling for changes in negative affect, so the paper does not establish a distinct symptom-reducing role for awareness and acceptance. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSauer Zavala et al. found that improvement in how one reacts to one's emotions, more than reduction of negative emotions, can predict symptom severity after treatment.
“Their results showed that improvement in how one reacts to one's emotions, more than reduction of negative emotions, can predict the severity of symptoms after treatment.”
How people interact with negative emotions can better predict treatment outcomes than the frequency of these emotions.
“Their results suggested that how people interact with negative emotions can better predict the treatment outcomes than the frequency of these emotions.”
Reductions in reactions to negative emotions, including fear of emotions and anxiety sensitivity, were significantly related to symptom change in the UP, above and beyond trait negative emotionality.
“Reductions in reactions to negative emotions (including fear of emotions and anxiety sensitivity) were significantly related to symptom change in the UP, above and beyond trait negative emotionality (Sauer-Zavala et al., 2012).”
From Within-person changes in aversive reactivity predict session-to-session reductions in anxiety and depression in the unified protocol. (2024) · cites this paper as Sauer-Zavala et al., 2012
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“The UP targets psychological mechanisms that have been shown to maintain negative affect across disorders, such as emotion avoidance and anxiety sensitivity (e.g., Boswell, Farchione, et al., 2013; Sauer-Zavala et al., 2012).”
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“In addition, several studies have demonstrated that the UP is also associated with reductions in its putative target—aversive reactions to emotional experiences (Boswell et al., 2013; Sauer-Zavala et al., 2012).”
BackgroundSelf-citationCognitive Hypnotherapy as a Transdiagnostic Protocol for Emotional Disorders
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“A person with an emotional disorder is characterized by a tendency to experience precipitous increases in negative affect in response to environmental stimuli and to interpret the subsequent experience as being harmful (Andrews, 1990, 1996; Brown & Barlow, 2009; Payne, Ellard, Farchione, Fairholme, & Barlow, 2014; Sau…”
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“Data also suggest improvement in comorbid conditions (Davis, Barlow, & Smith, 2010) and temperamental changes in regard to neuroticism (Carl, Gallagher, Sauer-Zavala, Bentley, & Barlow, 2014; Sauer-Zavala et al., 2012).”
BackgroundIntegrating and differentiating personality and psychopathology in cognitive behavioral therapy
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Self-citationVarkovitzky, R. L., Sherrill, A. M., & Reger, G. M. (2018) · Behavior Modification · doi:10.1177/0145445517724539 · Cited by 55 · see citing works
“In accordance with the UP theoretical model (Barlow et al., 2011), evidence suggests that UP may improve emotion regulation (Mohammadi et al., 2014; Sauer-Zavala et al., 2016) as well as the related constructs of emotional reactivity (Sauer-Zavala et al., 2012) and temperament (Carl et al., 2014).”
BackgroundKhakpoor, S., Saed, O., & Armani Kian, A. (2019) · Trends in Psychiatry and Psychotherapy · doi:10.1590/2237-6089-2018-0074 · Cited by 53 · see citing works
Mindfulness:<i>A Transtherapeutic Approach for Transdiagnostic Mental Processes</i>
Greeson, J., Garland, E. L., & Black, D. (2014) · The Wiley Blackwell Handbook of Mindfulness · doi:10.1002/9781118294895.ch28 · Cited by 50 · see citing works
“…eating disorders, and self-harm, transdiagnostic treatments including mindfulness training offer promising avenues of further research attention and clinical translation (Barlow et al., 2011; Farchione et al., 2012; Garland, 2013; McKay, Fanning, & Zurita Ona, 2011; Sauer-Zavala et al., 2012).”
BackgroundTransdiagnostic processes linking anxiety symptoms and substance use problems among adolescents
Wolitzky-Taylor, K. B., McBeth, J., Guillot, C. R., Stone, M. D., Kirkpatrick, M. G., Zvolensky, M. J., Buckner, J. D., & Leventhal, A. M. (2016) · Journal of Addictive Diseases · doi:10.1080/10550887.2016.1207969 · Cited by 47 · see citing works
“Indeed, individuals with anxiety disorders experience stronger reactions to negative emotions when they attempt to suppress or avoid them,(6,7) and negative interpretations of anxiety increase the duration and intensity of the emotions.(8) Thus, both the experience of negative affect and the adverse reaction to negati…”
BackgroundCarleton, R. N., Krätzig, G. P., Sauer-Zavala, S., Neary, J. P., Lix, L. M., Fletcher, A. J., Afifi, T. O., Brunet, A., Martin, R., Hamelin, K. S., et al. (2022) · Health Promotion and Chronic Disease Prevention in Canada · doi:10.24095/hpcdp.42.8.02 · Cited by 45 · see citing works
Self-citationMindfulness and acceptance-based behavioral therapies for anxiety disorders.
Roemer, L., Williston, S. K., Eustis, E. H., & Orsillo, S. M. (2013) · Current Psychiatry Reports · doi:10.1007/s11920-013-0410-3 · Cited by 46 · see citing works
“ders) over and above changes in reports of negative affect [14].”
BackgroundMohajerin, B., Bakhtiyar, M., Olesnycky, O. S., Dolatshahi, B., & Motabi, F. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.058 · Cited by 45 · see citing works
Gender-based differential item function for the difficulties in emotion regulation scale
Anderson, L. M., Reilly, E. E., Gorrell, S., Schaumberg, K., & Anderson, D. A. (2015) · Personality and Individual Differences · doi:10.1016/j.paid.2015.12.016 · Cited by 41 · see citing works
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents
Halliday, E. R., & Ehrenreich, J. T. (2020) · Neuromethods · doi:10.1007/978-1-0716-0700-8_13 · Cited by 41 · see citing works
Effects of stress on eating behaviours in adolescents: a daily diary investigation
Hsu, T., & Raposa, E. B. (2020) · Psychology and Health · doi:10.1080/08870446.2020.1766041 · Cited by 43 · see citing works
Sherman, J. A., & Ehrenreich-May, J. (2020) · Behavior Therapy · doi:10.1016/j.beth.2019.12.002 · Cited by 37 · see citing works
Khakpoor, S., Mohammadi Bytamar, J., & Saed, O. (2019) · Research in Psychotherapy: Psychopathology, Process and Outcome · doi:10.4081/ripppo.2019.379 · Cited by 34 · see citing works
Bernstein, E. E., LeBlanc, N. J., Bentley, K. H., Barreira, P. J., & McNally, R. J. (2020) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2020.09.008 · Cited by 35 · see citing works
Self-citationIntervention strategies and clinical process in transdiagnostic cognitive–behavioral therapy.
Boswell, J. F. (2013) · Psychotherapy · doi:10.1037/a0032157 · Cited by 33 · see citing works
Self-citationArnfred, S. M., Aharoni, R., Hvenegaard, M., Poulsen, S., Bach, B., Arendt, M., Rosenberg, N. K., & Reinholt, N. (2017) · BMC Psychiatry · doi:10.1186/s12888-016-1175-0 · Cited by 31 · see citing works
“UP targets neuroticism itself and preliminary findings suggest that negative affectivity is reduced following treatment with the UP [28, 29].”
BackgroundSauer-Zavala, S. E., Southward, M. W., Stumpp, N. E., Semcho, S., Hood, C. O., Garlock, A., & Urs, A. (2022) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2022.2053571 · Cited by 33 · see citing works
“Additionally, the UP is associated with reductions in aversive reactivity to emotions (Boswell et al., 2013; Eustis et al., 2019; Sauer-Zavala et al., 2012).”
BackgroundSelf-citationReed, R. G., Weihs, K. L., Sbarra, D. A., Breen, E. C., Irwin, M. R., & Butler, E. A. (2016) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2016.02.018 · Cited by 32 · see citing works
Espejo, E. P., Gorlick, A., & Castriotta, N. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.06.006 · Cited by 29 · see citing works
Rector, N. A., Man, V., & Lerman, B. (2014) · The Canadian Journal of Psychiatry · doi:10.1177/070674371405900603 · Cited by 28 · see citing works
Emotion Ideology Mediates Effects of Risk Factors on Alexithymia Development
Edwards, E. R., Micek, A., Mottarella, K. E., & Wupperman, P. (2016) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-016-0254-y · Cited by 26 · see citing works
Rogers, A. H., Bakhshaie, J., Ditre, J. W., Manning, K. F., Mayorga, N. A., Viana, A. G., & Zvolensky, M. J. (2018) · Journal of American College Health · doi:10.1080/07448481.2018.1481071 · Cited by 25 · see citing works
“identify transdiagnostic factors that underlie complex clinical conditions.(16) This work suggests that the underlying cause of many forms of anxiety and depressive symptoms and disorders, as well as their comorbidity with other conditions (eg, pain), may be underpinned by a smaller set of transdiagnostic vulnerabilit…”
BackgroundEskildsen, A., Reinholt, N., van Bronswijk, S. C., Brund, R. B. K., Christensen, A. B., Hvenegaard, M., Arendt, M. C. B. B., Alrø, A. J., Poulsen, S., Rosenberg, N., et al. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10116-1 · Cited by 25 · see citing works
Your presence soothes me: a neural process model of aversive emotion regulation via social buffering
Bratec, S. M., Bertram, T., Starke, G., Brandl, F., Xie, X., & Sorg, C. (2020) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsaa068 · Cited by 23 · see citing works
“Especially for affective disorders, such as depression or anxiety, one of the goals of psychotherapy is to reduce the occurrence of negative emotions and the enhanced negative emotional reactions, to improve the patient’s symptoms and long-term mental health (Sauer-Zavala et al., 2012; Boumparis et al., 2016).”
BackgroundZvolensky, M. J., Kauffman, B. Y., Garey, L., Viana, A. G., & Matoska, C. T. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104141 · Cited by 24 · see citing works
Chasson, G. S., Bello, M. S., Luxon, A. M., Graham, T. A. A., & Leventhal, A. M. (2017) · Depression and Anxiety · doi:10.1002/da.22669 · Cited by 22 · see citing works
“Recent perspectives in psychopathological science propose that crosscutting dimensions and biological pathways underlie and account for the presentation and co-presentation of various mental disorders (Cuthbert & Insel, 2013; Dozois, Seeds, & Collins, 2009; Sauer-Zavala et al., 2012).”
BackgroundRogers, A. H., Bakhshaie, J., Garey, L., Piasecki, T. M., Gallagher, M. W., Schmidt, N. B., & Zvolensky, M. J. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.10.007 · Cited by 22 · see citing works
Self-citationWolitzky-Taylor, K. B., Glasner, S. V., Tanner, A. S., Ghahremani, D. G., & London, E. D. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104032 · Cited by 21 · see citing works
Distress tolerance and pain experience among young adults
Rogers, A. H., Bakhshaie, J., Mayorga, N. A., Ditre, J. W., & Zvolensky, M. J. (2018) · Psychology Health & Medicine · doi:10.1080/13548506.2018.1454598 · Cited by 22 · see citing works
“related conditions may be underpinned by a smaller set of transdiagnostic vulnerability processes (Sauer-Zavala et al., 2012).”
BackgroundA Review of Transdiagnostic Mechanisms in Cognitive Behavior Therapy
Southward, M. W., Kushner, M. L., Terrill, D. R., & Sauer-Zavala, S. E. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.02.003 · Cited by 21 · see citing works
Self-citationCognitive Hypnotherapy for Accessing and Healing Emotional Injuries for Anxiety Disorders
Alladin, A. (2016) · American Journal of Clinical Hypnosis · doi:10.1080/00029157.2016.1163662 · Cited by 23 · see citing works
“This was supported by a recent study, which demonstrated that emotional well-being depended less on frequency of negative emotions, but more on how one related to these emotions as they occurred (Sauer-Zavala et al., 2012).”
ResultMindfulness and avoidance mediate the relationship between yoga practice and anxiety
Boni, M., Schütze, R., Kane, R. T., Morgan-Lowes, K. L., Byrne, J., & Egan, S. J. (2018) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2018.08.002 · Cited by 21 · see citing works
Kraemer, K. M., Luberto, C. M., Hall, D. L., Ngo, L. H., & Yeh, G. Y. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103746 · Cited by 21 · see citing works
“, Olatunji & McKay, 2007), have also been shown to be associated with various forms of psychopathology (e.g., Cisler, Olatunji, & Lohr, 2009; Sauer-Zavala et al., 2012).”
BackgroundRogers, A. H., Garey, L., Allan, N. P., & Zvolensky, M. J. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103786 · Cited by 21 · see citing works
Mechler, J., Lindqvist, K., Falkenström, F., Carlbring, P., Andersson, G., & Philips, B. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00671 · Cited by 19 · see citing works
“Our results are in agreement with prior studies conducted on CBT (29, 30), suggesting that larger deficits in emotion regulation predict better treatment responses.”
MethodResultInfluentialGallagher, M. W., Thompson‐Hollands, J., Bourgeois, M. L., & Bentley, K. H. (2015) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-015-9303-6 · Cited by 19 · see citing works
Self-citationSkill Acquisition During Transdiagnostic Treatment With the Unified Protocol
Sauer-Zavala, S., Rosellini, A. J., Bentley, K. H., Ametaj, A. A., Boswell, J. F., Cassiello-Robbins, C., Wilner Tirpak, J., Farchione, T. J., & Barlow, D. H. (2021) · Behavior Therapy · doi:10.1016/j.beth.2021.03.001 · Cited by 22 · see citing works
Self-citationPéris-Baquero, Ó., & Osma, J. (2023) · Depression and Anxiety · doi:10.1155/2023/1981377 · Cited by 20 · see citing works
Experimental Manipulations to Test Theory-Driven Mechanisms of Cognitive Behavior Therapy
Southward, M. W., & Sauer-Zavala, S. E. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.603009 · Cited by 17 · see citing works
Self-citationWoods, B. K., Sauer-Zavala, S. E., Farchione, T. J., & Barlow, D. H. (2020) · Behavior Therapy · doi:10.1016/j.beth.2020.01.001 · Cited by 16 · see citing works
“By fostering an approachoriented stance toward emotions, the UP reduces these rebound effects, thereby decreasing the frequency of negative emotions (Sauer-Zavala et al., 2012; Sauer-Zavala et al., under review).”
BackgroundSelf-citationTully, P. J., Turnbull, D. A., Horowitz, J. D., Beltrame, J. F., Selkow, T., Baune, B. T., Markwick, E., Sauer-Zavala, S. E., Baumeister, H., Cosh, S., et al. (2016) · Trials · doi:10.1186/s13063-015-1109-z · Cited by 16 · see citing works
“Moreover, with increasing recognition of the necessity to formulate interventions matching the complexity of CVD populations [37, 41] and the requirement for mental health interventions to match transdiagnostic developments in clinical psychology [42–47], the use of depression disorder-only treatments may become incre…”
BackgroundSelf-citationFive-factor model in bereaved adults with and without complicated grief
Goetter, E. M., Bui, É., Horenstein, A., Baker, A. W., Hoeppner, S. S., Charney, M. E., & Simon, N. M. (2018) · Death Studies · doi:10.1080/07481187.2018.1446059 · Cited by 16 · see citing works
“Recently, there has been a shift away from focusing on binary (e.g., present or absent) disorder-specific symptoms with a movement aimed at better understanding common factors that underlie a range of related emotional disorders (Sauer-Zavala et al., 2012).”
BackgroundInfluentialExploring Recovery Perspectives in Individuals Diagnosed with Mental Illness
Clarke, L. M. A., & Warner, B. (2016) · Occupational Therapy in Mental Health · doi:10.1080/0164212x.2016.1201450 · Cited by 15 · see citing works
“…supports that feeling, acknowledging, and expressing emotions is essential for recovery from mental illness (Garland, Boettiger, Gaylord, Chanon, & Howard, 2012; Sauer-Zavala et al., 2012), and the therapeutic benefits of positive emotions are abundant in the literature (Sin & Lyubomirsky, 2009).”
BackgroundShaw, A. M., Halliday, E. R., Tonarely, N. A., & Ehrenreich-May, J. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.10.048 · Cited by 14 · see citing works
Wolitzky-Taylor, K. B., Niles, A. N., Ries, R. K., Krull, J. L., Rawson, R. A., Roy‐Byrne, P., & Craske, M. G. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.05.005 · Cited by 14 · see citing works
Emotion dysregulation in the experience of pain among persons living with HIV/AIDS
Rogers, A. H., Bakhshaie, J., Horenstein, A., Brandt, C. P., Heimberg, R. G., & Zvolensky, M. J. (2019) · AIDS Care · doi:10.1080/09540121.2019.1612024 · Cited by 14 · see citing works
“that contribute to and maintain emotional and psychological disorders as well as physical health disorders, such as pain (Sauer-Zavala et al., 2012).”
BackgroundGeiger, P. J., Peters, J. R., Sauer-Zavala, S. E., & Baer, R. A. (2013) · Journal of Personality Disorders · doi:10.1521/pedi_2013_27_097 · Cited by 14 · see citing works
“Recent studies in student and clinical samples have demonstrated that depression and anxiety symptoms are more strongly related to how one manages negative internal experiences when they occur than to the frequency of such experiences (Sauer & Baer, 2009; Sauer-Zavala et al., 2012).”
BackgroundSelf-citationRisk of recurrent cardiovascular events in coronary artery disease patients with Type D personality
Torgersen, K. S., Sverre, E., Weedon‐Fekjær, H., Andreassen, O. A., Munkhaugen, J., & Dammen, T. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1119146 · Cited by 13 · see citing works
“Recently, a psychological intervention targeting personality traits such as neuroticisms rather than psychological disorders has been developed showing effects on the score of NA (Sauer-Zavala et al., 2012; Barlow et al., 2017; Sauer-Zavala et al., 2017).”
BackgroundBrandt, C. P., Bakhshaie, J., Jardin, C., Lemaire, C. M., Kauffman, B. Y., Sharp, C., & Zvolensky, M. J. (2016) · International Journal of Behavioral Medicine · doi:10.1007/s12529-016-9568-5 · Cited by 13 · see citing works
“The recent work in affective science proposes that many forms of emotional symptoms and disorders may be underpinned by a smaller set of transdiagnostic vulnerability processes [1, 2].”
Kleiman, E. M., Bentley, K. H., Wacha-Montes, A., Taylor, M. E., Lozy, O., Conti, K., & Reese Mayer, W. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.04.008 · Cited by 12 · see citing works
Self-citationTalaei‐Khoei, M., Mohamadi, A., Fischerauer, S., Ring, D., & Vranceanu, A. (2017) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2017.09.005 · Cited by 12 · see citing works
Alaee, E. Q., Saed, O., Khakpoor, S., Ahmadi, R., Mohammadi, M. A., Afrashteh, M. Y., & Morovati, Z. (2022) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2022.588 · Cited by 12 · see citing works
“…Gharraee, Asgharnejad Farid, Ghaleh Bandi, & Habibi, 2018; Ellard et al., 2017; García-Escalera et al., 2017; Sandín, García-Escalera, Valiente, Espinosa, & Chorot, 2020; Sauer-Zavala et al., 2012; Sherman & Ehrenreich-May, 2020), it was hypothesized that UP-C can reduce NA and AS, and improve PC.”
Wurm, M., Strandberg, E. K., Lorenz, C., Tillfors, M., Buhrman, M., Holländare, F., & Boersma, K. (2017) · Internet Interventions · doi:10.1016/j.invent.2017.10.004 · Cited by 11 · see citing works
Ito, M., Okumura, Y., Horikoshi, M., Kato, N., Oe, Y., Miyamae, M., Hirabayashi, N., Kanie, A., Nakagawa, A., & Ono, Y. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0779-8 · Cited by 11 · see citing works
“Neuroticism here refers to the shared aspects of temperament commonly observed between depressive and anxiety disorders [44, 45].”
BackgroundKim, J. H. J., Bright, E. E., Williamson, T. J., Krull, J. L., Weihs, K. L., & Stanton, A. L. (2020) · Journal of Behavioral Medicine · doi:10.1007/s10865-020-00159-w · Cited by 10 · see citing works
Mindfulness and acceptance-based behavioral therapies
Roemer, L., Graham, J. R., Morgan, L., & Orsillo, S. M. (2014) · The Wiley Handbook of Anxiety Disorders · doi:10.1002/9781118775349.ch39 · Cited by 8 · see citing works
Exploring trajectories in transdiagnostic behavior therapy
Grös, D. F., Saulnier, K. G., & Allan, N. P. (2023) · Journal of Traumatic Stress · doi:10.1002/jts.22963 · Cited by 9 · see citing works
The Necessary Rapprochement of Negative Affectivity, Personality Disorder, and Depression
Huprich, S. K., Kuribayashi, S. J., & Voytenko, V. L. (2024) · Current Psychiatry Reports · doi:10.1007/s11920-024-01532-1 · Cited by 8 · see citing works
“As NA remains relatively constant over time [32], it has also been found to predict poor treat-ment outcomes within clinical populations.”
López-Martínez, A. E., Sainero-Tirado, G., Esteve, R., Reyes-Pérez, Á., Ruiz-Párraga, G. T., de la Vega, R., Serrano‐Ibáñez, E. R., & Ramírez‐Maestre, C. (2022) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0001269 · Cited by 8 · see citing works
Vivas-Fernández, M., García-López, L.-J., Muela-Martínez, J., Piqueras, J., Espinosa-Fernández, L., Jiménez-Vázquez, D., & Díaz-Castela, M. D. M. (2024) · European Journal of Psychology Open · doi:10.1024/2673-8627/a000054 · Cited by 8 · see citing works
Dimitrova, L. I., Vissia, E. M., Geugies, H., Hofstetter, H., Chalavi, S., & Reinders, A. A. T. S. (2021) · Journal of Psycholinguistic Research · doi:10.1007/s10936-021-09784-1 · Cited by 8 · see citing works
Lehrbach, K. R., Crane, M. E., Olino, T. M., & Kendall, P. C. (2023) · Cognitive Therapy and Research · doi:10.1007/s10608-023-10408-2 · Cited by 7 · see citing works
“AS has also been identified as a mediator of anxiety and depression treatment outcomes in adults (Arch et al., 2012; Otto et al., 1995; Sauer-Zavala et al., 2012; Smits et al., 2004).”
BackgroundAhmadi, R., Ahmadizadeh, R., Hasani, M., & Saed, O. (2021) · Behaviour Change · doi:10.1017/bec.2021.6 · Cited by 7 · see citing works
Smith, I. S., Bind, M., Weihs, K. L., Bei, B., & Wiley, J. F. (2023) · British Journal of Health Psychology · doi:10.1111/bjhp.12679 · Cited by 9 · see citing works
Peláez, T., López‐Carrilero, R., Espinosa, V., Balsells, S., Ochoa, S., & Osma, J. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.036 · Cited by 9 · see citing works
Mechanism engagement as a potential evidence-based approach to personalized treatment termination
Sauer-Zavala, S. E., Southward, M. W., Terrill, D. R., Semcho, S., & Stumpp, N. E. (2023) · Psychotherapy Research · doi:10.1080/10503307.2023.2168574 · Cited by 6 · see citing works
“…symptoms in CBT generally (Dalrymple & Herbert, 2007; Eustis et al., 2016; 2020; Kocovski et al., 2009; cf. Kocovski et al., 2015), and the UP specifically (Eustis et al., 2020; Sauer-Zavala et al., 2012), however research with more frequent assessment is needed to suggest temporal precedence.”
BackgroundSelf-citationContreras-Valdez, J. A., Hernández‐Guzmán, L., & Freyre, M.-Á. (2017) · Pensamiento Psicológico · doi:10.11144/javerianacali.ppsi16-1.vcvc · Cited by 7 · see citing works
Paucsik, M., Baeyens, C., Tessier, D. P., & Shankland, R. (2024) · Journal of Clinical Psychology · doi:10.1002/jclp.23748 · Cited by 6 · see citing works
von Schrottenberg, V., Kerber, A., Sterner, P., Teusen, C., Beigel, P., Linde, K., Henningsen, P., Herpertz, S. C., Gensichen, J. S., Schneider, A., et al. (2024) · Psychopathology · doi:10.1159/000540161 · Cited by 6 · see citing works
“The uni fi ed protocol therapy aims to promote mindful awareness of emotions, enhance cognitive fl exibility in response to these emotions, and reduce avoidance of emotional experiences [63, 64].”
Wyatt, K. P., Eberle, J. W., Ruork, A. K., & Neacsiu, A. D. (2023) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2879 · Cited by 6 · see citing works
Kivity, Y., Sela, M. S., Yariv, A., Koubi, M., Saad, A., Fennig, S., & Bloch, Y. (2019) · International Journal of Cognitive Therapy · doi:10.1007/s41811-019-00059-1 · Cited by 6 · see citing works
Bounoua, N., & Sadeh, N. (2021) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2021.100284 · Cited by 6 · see citing works
Alladin, A., & Amundson, J. K. (2016) · American Journal of Clinical Hypnosis · doi:10.1080/00029157.2016.1163661 · Cited by 6 · see citing works
“…to experience abrupt increases in negative affect in response to environmental stimuli and to interpret the subsequent experience as harmful (Andrews, 1990, 1996; Barlow, Allen, & Choate, 2004; Brown & Barlow, 2009; Payne, Ellard, Farchione, Fairholme, & Barlow, 2014; Sauer-Zavala et al., 2012).”
BackgroundTransdiagnostic vulnerability factors for behavioral health problems during COVID-19
Rogers, A. H., & Zvolensky, M. J. (2021) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2021.1897667 · Cited by 6 · see citing works
“We highlight the importance and potential of a transdiagnostic framework in efforts to better understand the link between COVID-19 stress and psychopathology (Dalgleish et al., 2020; Krueger & Eaton, 2015; Sauer-Zavala et al., 2012).”
Background
- Authors
- Sauer-Zavala, S., Boswell, J. F., Gallagher, M. W., Bentley, K. H., Ametaj, A., & Barlow, D. H.
- Affiliations
- Boston University (US)
- Corresponding author
- Sauer-Zavala, Shannon
- ORCID
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2012-09
- Volume
- 50
- Issue
- 9
- Pages
- 551-557
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC3408841
- OpenAlex
- W2071566020
- Cited by
- 163
- References
- 61
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 13 · 2023: 16 · 2022: 14 · 2021: 9 · 2020: 21 · 2019: 9 · 2018: 17 · 2017: 11 · 2016: 14 · 2015: 6 · 2014: 8 · 2013: 8
- FWCI
- 6.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (submittedVersion)
- PubMed Central (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- negative affectivity, emotional reactivity, Unified Protocol, transdiagnostic treatment, emotional disorders, fear of emotions, anxiety sensitivity, emotional awareness
- MeSH terms
- Adult, Clinical Protocols, Emotions, Fear, Female, Humans, Male
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Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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