Cited by 133Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPersonality Disorders and PsychopathologyPsychotherapy Techniques and Applications

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Does the unified protocol really change neuroticism? Results from a randomized trial

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Sauer-Zavala, Shannon, Fournier, Jay C., Jarvi Steele, Stephanie, Woods, Brittany K., Wang, Mengxing, Farchione, Todd J., Barlow, David H.·2021·Psychological Medicine

DOI 10.1017/s0033291720000975PMC PMC7678331

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Abstract

BACKGROUND: Neuroticism is associated with the onset and maintenance of a number of mental health conditions, as well as a number of deleterious outcomes (e.g. physical health problems, higher divorce rates, lost productivity, and increased treatment seeking); thus, the consideration of whether this trait can be addressed in treatment is warranted. To date, outcome research has yielded mixed results regarding neuroticism's responsiveness to treatment, perhaps due to the fact that study interventions are typically designed to target disorder symptoms rather than neuroticism itself. The purpose of the current study was to explore whether a course of treatment with the unified protocol (UP), a transdiagnostic intervention that was explicitly developed to target neuroticism, results in greater reductions in neuroticism compared to gold-standard, symptom focused cognitive behavioral therapy (CBT) protocols and a waitlist (WL) control condition. METHOD: Patients with principal anxiety disorders (N = 223) were included in this study. They completed a validated self-report measure of neuroticism, as well as clinician-rated measures of psychological symptoms. RESULTS: At week 16, participants in the UP condition exhibited significantly lower levels of neuroticism than participants in the symptom-focused CBT (t(218) = -2.17, p = 0.03, d = -0.32) and WL conditions(t(207) = -2.33, p = 0.02, d = -0.43), and these group differences remained after controlling for simultaneous fluctuations in depression and anxiety symptoms. CONCLUSIONS: Treatment effects on neuroticism may be most robust when this trait is explicitly targeted.

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Authors: Sauer-Zavala, S., Fournier, J. C., Jarvi Steele, S., Woods, B. K., Wang, M., Farchione, T. J., & Barlow, D. H.
Affiliations: University of Kentucky (US)
University of Pittsburgh (US)
Boston University (US)
Corresponding author: Sauer-Zavala, Shannon
ORCID: Sauer-Zavala, Shannon
Fournier, Jay C.
Jarvi Steele, Stephanie
Woods, Brittany K.
Wang, Mengxing
Farchione, Todd J.
Barlow, David H.
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2020-04-21
Volume: 51
Issue: 14
Pages: 2378-2387
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291720000975
PMC: PMC7678331
OpenAlex: W3016695856
Cited by: 133
References: 63
Citations by year: 2026: 13 · 2025: 21 · 2024: 24 · 2023: 31 · 2022: 25 · 2021: 15 · 2020: 4
FWCI: 18.13
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Smith ScholarWorks (Smith College) (submittedVersion)
Funders: National Institute of Mental Health (R01MH090053)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: neuroticism, Unified Protocol, transdiagnostic treatment, anxiety disorders, cognitive behavioral therapy, trait change, treatment response, waitlist control, depression, anxiety symptoms
MeSH terms: Neuroticism, Adult, Anxiety Disorders, Female, Humans, Male, Brief Psychiatric Rating Scale, Phenotype, Waiting Lists, Cognitive Behavioral Therapy, Treatment Outcome, Self Report

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Does the unified protocol really change neuroticism? Results from a randomized trial

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