Do Unified Protocol modules exert general or unique effects on anxiety, depression, and transdiagnostic targets?
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Abstract
Several transdiagnostic cognitive-behavior therapies include multiple treatment components. However, it is unclear whether some components are more efficacious than others at reducing symptoms or whether these components uniquely influence their putative mechanism of change. Participants (N = 70; Mage = 33.7; 67.1% female, 74.3% White) with a primary anxiety or depressive disorder were randomized to one of three standard or personalized sequences of core UP modules. Using hierarchical linear modeling, we tested (a) whether the average session-to-session change in anxiety and depression differed between modules and (b) whether the average session-to-session change in the putative mechanism of each module differed between modules. All modules led to similar changes in anxiety, but Confronting Physical Sensations led to significantly less change in depression than other modules. There were no significant differences among modules predicting putative mechanisms of change, although there was a trend for Mindful Emotion Awareness to predict greater improvements in mindfulness than Understanding Emotions. Consistent with its transdiagnostic nature, UP modules may exert similar effects on anxiety and putative mechanisms of change, although interoceptive exposures may be less impactful for changing depressive symptoms and the mindfulness module may promote relatively specific improvements in mindfulness.
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These evidence-based psychotherapies include "active elements" such as therapy concepts, emotion regulation skills, and behavior change skills that impart unique therapeutic benefits.
“These evidence-based psychotherapies include “active elements” such as therapy concepts, emotion regulation skills, and behavior change skills that impart unique therapeutic benefits [4,5].”
From Clinical Effects of Asynchronous Provider-Guided Practice Sessions During Blended Care Therapy for Anxiety and Depression: Pragmatic Retrospective Cohort Study (2024) · cites this paper as [4]
The paper describes Unified Protocol modules containing psychoeducation, emotion-awareness, cognitive, and behavior-change skills, and reports some module-specific effects. But its Discussion (page not provided) says it found little evidence that the modules had differential effects overall. The claim overstates the evidence by presenting unique therapeutic benefits as a general feature of these elements. (LLM, conf=0.87)
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- Authors
- Southward, M. W., Lane, S. P., Shroyer, S. E., & Sauer-Zavala, S.
- Affiliations
- University of Kentucky (US)
- University of Missouri (US)
- Corresponding author
- Southward, Matthew W.
- Venue
- Journal of Mood & Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2023-10
- Volume
- 3
- Pages
- 100022
- ISSN
- 2950-0044 (ISSN-L)
- PMC
- PMC10621804
- OpenAlex
- W4386142847
- Cited by
- 6
- References
- 60
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Mood and Anxiety Disorders (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion, cc-by-nc-nd)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- Funders
- National Institute of Mental Health (K23MH126211)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- Unified Protocol, anxiety disorders, depression, treatment modules, mechanisms of change, interoceptive exposure, emotional understanding, mindfulness, emotional awareness
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