Group Application of Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders In A University Sample
DOI:
https://doi.org/10.5944/ap.19.2.37006Abstract
There are currently few studies that support the efficacy of the Unified Protocol (UP) for the transdiagnostic treatment of emotional disorders in university samples. The aim of this study was to evaluate the validity of the PU in a group format, in online and face-to-face modalities, in university students. The sample consisted of 35 participants who requested assistance at the Psychological Attention Service (SAP) of the University of Cadiz. The following assessment instruments were administered: NEO-FFI; STAI; CORE-OM; SCL-90-R; PANAS and BEAQ; as well as an ad hoc questionnaire. The intervention consisted of the application of 12 sessions of the PU in groups of 8-10 participants, for 90 minutes. The results showed an improvement in the emotional management of the participants. Anxiety and depressive symptoms were reduced. The subjective well-being and functioning of the students improved. In addition, the PU was effective as a coping strategy for experiencing negative emotions, reducing experiential avoidance. In relation to the application format, both the online and face-to-face formats proved to be effective in improving the present symptomatology. Therefore, the PU seems to show its clinical usefulness in addressing emotional disorders in this population both online and face-to-face.
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Aldao, A., Nolen-Hoeksema, S., y Schweizer, S. (2010). Emotion-regulation Strategies across Psychopathology: A Meta-Analytic Review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5ª ed., rev.). Autor.
Bullis, J. R., Boettcher, H., Sauer‐Zavala, S., Farchione, T. J. y Barlow, D. H. (2019). What is an Emotional Disorder? A Transdiagnostic Mechanistic Definition with Implications for Assessment, Treatment, and Prevention. Clinical Psychology: Science and Practice, 26(2), Artículo e12278. https://doi.org/10.1037/h0101755
Arrigoni, Flavia, Marchena-Consejero, E. y Navarro-Guzmán, José I. (2021). Aplicación y evaluación de la eficacia del protocolo unificado transdiagnóstico con estudiantes universitarios españoles [Application and Evaluation of the Efficacy of the Unified Transdiagnostic Protocol with Spanish College Students]. Revista Costarricense de Psicología, 40(2), 149–169.
Barlow, D. H., Ellard, K. K., Sauer-Zavala, S., Bullis, J. R. y Carl, J. R. (2014). The Origins of Neuroticism. Perspectives on Psychological Science, 9(5), 481–496. https://doi.org/10.1177/1745691614544528
Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Murray Latin, H., Ellard, K., Bullis, J., Bentley, K., Boettcher, H. y Cassiello-Robbins, C. (2019b). Protocolo unificado para el tratamiento transdiagnóstico de los trastornos emocionales: Manual del terapeuta [Unified Protocol for Transdiagnostic Treatment of Emotional Disorder: Workbook] (Trad. J. J. Osma López y E. Crespo Delgado; 2ª ed. rev y act.). Alianza.
Belloch, A. (2012). Propuestas para un enfoque transdiagnóstico de los trastornos mentales y del comportamiento: evidencia, utilidad y limitaciones [Proposals for a Transdiagnostic Perspective of Mental and Behavioural Disorders: Evidence, usefulness, and Limitations]. Revista de Psicopatología y Psicología Clínica, 17(3), 295–311. https://doi.org/10.5944/rppc.vol.17.num.3.2012.11845
Bermudez, M. B., Costanzi, M., Macedo, M. J. A., Tatton-Ramos, T., Xavier, A. C. M., Ferrão, Y.A., Bentley, K. H., Manfro, G. G. y Dreher, C.B. (2020). Improved Quality of Life and Reduced Depressive Symptoms in Medical Students after a Single-Session Intervention. Brazilian Journal of Psychiatry, 42(2), 145–152. https://doi.org/10.1590/1516-4446-2019-0526
Botella-Arbona, C., García Palacios, A., Días García, A., González Robles, A. y Castilla López, D. (2019) protocolo de tratamiento transdiagnóstico online para los trastornos emocionales. En J. Osma (coord.), Aplicaciones del Protocolo Unificado para el tratamiento transdiagnóstico de la disregulación emocional (pp. 297–318). Alianza.
Bullis, J. R., Boettcher, H., Sauer‐Zavala, S., Farchione, T. J. y Barlow, D. H. (2019). What is an Emotional Disorder? A Transdiagnostic Mechanistic Definition with Implications for Assessment, Treatment, and Prevention. Clinical Psychology: Science and Practice, 26(2), Artículo e12278. https://doi.org/10.1111/CPSP.12278
Bullis, J. R., Sauer-Zavala, S., Bentley, K. H., Thompson-Hollands, J., Carl, J. R. y Barlow, D. H. (2015). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Behavior Modification, 39(2), 295–321. https://doi.org/10.1177/0145445514553094
Caiado, B., Góis, A., Pereira, B., Canavarro, M. C. y Moreira, H. (2022). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) in Portugal: Feasibility Study Results. International Journal of Environmental Research and Public Health, 19(3), Artículo 1782. https://doi.org/10.3390/ijerph19031782
Caparrós-Caparrós, B., Villar-Hoz, E., Juan-Ferrer, J., y Viñas-Poch, F. (2007). Symptom Check-List-90-R: Fiabilidad, datos normativos y estructura factorial en estudiantes universitarios [Symptom Checklist-90-R: Psychometric Properties in a Representative Sample of University Students]. International Journal of Clinical and Health Psychology, 7(3), 781–794.
Carlucci, L., Saggino, A. y Balsamo, M. (2021). On the Efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A systematic Review and Meta-analysis. Clinical Psychology Review, 87, Artículo 101999. https://doi.org/10.1016/j.cpr.2021.101999
Castro-Camacho, L., Díaz, M. M. y Barbosa, S. (2022). Effect of a Group Prevention Program Based on the Unified Protocol for College Students in Colombia: A Quasi-experimental Study. Journal of Behavioral and Cognitive Therapy, 32(2), 111–123. https://doi.org/10.1016/j.jbct.2021.04.001
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2ª ed.). LEA.
De Paul, N. F. y Caver, K. A. (2021). A Pilot Study of a Brief Group Adaptation of the Unified Protocol in Integrated Primary Care. Psychological Services, 18(3), 416–425. https://doi.org/10.1037/ser0000406
Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J. y Barlow, D. H. (2010). Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: Protocol Development and Initial Outcome Data. Cognitive and Behavioral Practice, 17(1), 88–101. https://doi.org/10.1016/j.cbpra.2009.06.002
Ehrenreich-May, J., Kennedy, S. M., Sherman, J. A., Bilek, E. L., Buzzella, B. A., Bennett, S. M. y Barlow, D. H. (2017). Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in children and adolescents: Therapist Guide. Oxford University Press.
Ehrenreich-May, J., Rosenfield, D., Queen, A. H., Kennedy, S. M., Remmes, C. S. y Barlow, D. H. (2017). An Initial Waitlist-Controlled Trial of the Unified Protocol for the Treatment of Emotional Disorders in Adolescents. Journal of Anxiety Disorders, 46, 46–55. https://doi.org/10.1016/j.janxdis.2016.10.006
Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., Gallagher, M. W. y Barlow, D. H. (2012). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A Randomized Controlled Trial. Behavior Therapy, 43(3), 666–678. https://doi.org/10.1016/j.beth.2012.01.001
Fernández-Ballesteros, R. (1994). El proceso de evaluación psicológica. UNED.
Ferreres-Galán, V., Quilez-Orden, A. B. y Osma, J. (2022). Application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Post-Bariatric Surgery Patients: An Effectiveness and Feasibility Study in Group Format. Anales de Psicologia, 38(1), 219–231. https://doi.org/10.6018/analesps.482301
Fonseca-Pedrero, E., Paino, M., Sierra-Baigrie, S., Lennos-Girald, S. y Muniz, J. (2012). Propiedades psicométricas del "Cuestionario de ansiedad estado-rasgo" (STAI) en universitarios [Psychometric properties of the State-Trait Anxiety Inventory (STAI) in college students]. Behavioral Psychology / Psicología Conductual: Revista Internacional Clínica y de la Salud, 20(3), 547–561.
Gallagher, M. W., Sauer-Zavala, S. E., Boswell, J. F., Carl, J. R., Bullis, J., Farchione, T. J. y Barlow, D. H. (2013). The Impact of the Unified Protocol for Emotional Disorders on Quality of Life. International Journal of Cognitive Therapy, 6(1), 57–72. https://doi.org/10.1521/ijct.2013.6.1.57
Gámez, W., Chmielewski, M., Kotov, R., Ruggero, C., Suzuki, N. y Watson, D. (2014). The Brief Experiential Avoidance Questionnaire: Development and Initial Validation. Psychological Assessment, 26(1), 35-45. https://doi.org/10.1037/a0034473
García-Escalera, J., Valiente, R. M., Sandín, B., Ehrenreich-May, J., Prieto, A. y Chorot, P. (2020). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Anxiety and Depression Prevention Program: An Initial Cluster Randomized Wait-List-Controlled Trial. Behavior Therapy, 51(3), 461–473. https://doi.org/10.1016/j.beth.2019.08.003
González de Rivera, J. L., De las Cuevas, C., Rodríguez-Abuín, M. J. y Rodríguez-Pulido, F. (2002). El cuestionario de 90 síntomas (adaptación española del SCL-90R de L. R. Derogatis). TEA.
González-Robles, A., García-Palacios, A., Baños, R., Riera, A., Llorca, G., Traver, F., Haro, G., Palop, V., Lera, G., Romeu, J. E. y Botella, C. (2015). Effectiveness of a Transdiagnostic Internet-Based Protocol for the Treatment of Emotional Disorders versus Treatment as Usual in Specialized Care: Study Protocol for a Randomized Controlled Trial. Trials, 16(1), 1–13. https://doi.org/10.1186/s13063-015-1024-3
Hawks, J. L., Kennedy, S. M., Holzman, J. B. W. y Ehrenreich-May, J. (2020). Development and Application of an Innovative Transdiagnostic Treatment Approach for Pediatric Irritability. Behavior Therapy, 51(2), 334–349. https://doi.org/10.1016/j.beth.2019.07.004
Hidaka, Y., Imamura, K., Sekiya, Y., Watanabe, K. y Kawakami, N. (2020). Effects of a Transdiagnostic Preventive Intervention on Anxiety and Depression Among Workers in Japan. Journal of Occupational & Environmental Medicine, 62(2), e52-e58. https://doi.org/10.1097/JOM.0000000000001796
Jacobson, N. C. y Newman, M. G. (2017). Anxiety and Depression as Bidirectional Risk Factors for one Another: A Meta-analysis of Longitudinal Studies. Psychological Bulletin, 143(11), 1155–1200. https://doi.org/10.1037/bul0000111
Kendler, K. S. (2009). An Historical Framework for Psychiatric Nosology. Psychological Medicine, 39(12), 1935–1941. https://doi.org/10.1017/S0033291709005753
Kennedy, S. M., Bilek, E. L. y Ehrenreich-May, J. (2019). A Randomized Controlled Pilot Trial of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children. Behavior Modification, 43(3), 330–360. https://doi.org/10.1177/0145445517753940
Kessler, R. C., Sampson, N. A., Berglund, P., Gruber, M. J., Al-Hamzawi, A., Andrade, L., Bunting, B., Demyttenaere, K., Florescu, S., de Girolamo, G., Gureje, O., He, Y., Hu, C., Huang, Y., Karam, E., Kovess-Masfety, V., Lee, S., Levinson, D., Medina Mora, M.E., … Wilcox, M.A. (2015). Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys. Epidemiology and Psychiatric Sciences, 24(3), 210–226. https://doi.org/10.1017/S2045796015000189
Khakpoor, S., Saed, O. y Armani Kian, A. (2019). 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. Trends in Psychiatry and Psychotherapy, 41(3), 227–236. https://doi.org/10.1590/2237-6089-2018-0074
Kivity, Y., Sela, M. S., Yariv, A., Koubi, M., Saad, A., Fennig, S. y Bloch, Y. (2020). Transdiagnostic Treatment of Anxiety Disorders in a Group Format Based on the Principles of the Unified Protocol: A Preliminary Intensive Measurement Examination of Process and Outcome. International Journal of Cognitive Therapy, 13(2), 127–145. https://doi.org/10.1007/s41811-019-00059-1
Marchena Consejero, E., Rapp García, C., Hervías Ortega, F., Navarro Guzmán, J. I., Alcalde Cuevas, C., Aguilar Villagrán, M., y Menchano Jiménez, I. (2012). Counseling and Psychological Services (CAPS) at the Cádiz University. Acción Psicológica, 6(1), 73–85. https://doi.org/10.5944/ap.6.1.445
Marín, C., Guillén, A. I., Rodriguez-Moreno, S., Diéguez, S., Panadero, S. y Farchione, T. (2021). Application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders among Homeless Women: A Feasibility Study. Psychotherapy, 58(2), 242–247. https://doi.org/10.1037/pst0000357
Martínez-Borba, V., Osma, J., Crespo-Delgado, E., Andreu-Pejó, L. y Monferrer-Serrano, A. (2022). Prevention of Emotional Disorders and Symptoms Under Health Conditions: A Pilot Study using the Unified Protocol in a Fertility Unit. Anales de Psicología/Annals of Psychology, 38(1), 25–35.
Micin, S. y Bagladi, V. (2011). Salud Mental en Estudiantes Universitarios: Incidencia de Psicopatología y Antecedentes de Conducta Suicida en Población que Acude a un Servicio de Salud Estudiantil [Mental Health in University Students: Incidence of Psychopathology and Suicidal Behavior Data in The Student Health Service Users]. Terapia Psicológica, 29(1), 53–64. https://doi.org/10.4067/S0718-48082011000100006
Mohammadi, F., Bakhtiari, M., Masjedi Arani, A., Dolatshahi, B. y Habibi, M. (2018). The Applicability and Efficacy of Transdiagnostic Cognitive Behavior Therapy on Reducing Signs and Symptoms of Borderline Personality Disorder with co-Occurring Emotional Disorders: A Pilot Study. Iranian Journal of Psychiatry and Behavioural Science, 12(1), Artículo e9697. https://doi.org/10.5812/ijpbs.9697
O'Donnell, M. L., Lau, W., Chisholm, K., Agathos, J., Little, J., Terhaag, S., Brand, R., Putica, A., Holmes, A., Katona, L., Felmingham, K. L., Murray, K., Hosseiny. F. y Gallagher, M. W. (2021). A Pilot Study of the Efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Treating Posttraumatic Psychopathology: A Randomized Controlled Trial. Journal of Traumatic Stress, 34(3), 563–574. https://doi.org/10.1002/jts.22650
Osma, J. (2019). Aplicaciones del Protocolo Unificado para el tratamiento transdiagnóstico de la desregulación emocional. Alianza.
Osma, J., Castellano, C., Crespo, E. y García-Palacios, A. (2015). The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Group Format in a Spanish Public Mental Health Setting. Psicología Conductual, 23(3), 447–466.
Ruiz Sánchez, J. J., Trillo Padilla, F. J. y Ruiz Miñarro, I. (2019). Reducción de la evitación experiencial con terapias de grupo ACT y FAP en grupos transdiagnósticos [Reduction of Experiential Avoidance with ACT and FAP Group Therapies in Transdiagnostic Groups]. Revista de Investigación en Psicología, 22(1), 139–156. https://doi.org/10.15381/rinvp.v22i1.16587
Sakiris, N. y Berle, D. (2019). A Systematic Review and Meta-Analysis of the Unified Protocol as a Transdiagnostic Emotion Regulation based Intervention. Clinical Psychology Review, 72, Artículo 101751. https://doi.org/10.1016/J.CPR.2019.101751
Sandín, B., Chorot, P., Lostao, L., Joiner, T. E., Santed, M. Á. y Valiente, R. M. (1999). Escalas PANAS de afecto positivo y negativo: Validación factorial y convergencia transcultural [The PANAS Scales of Positive and Negative Affect: Factor Analytic Validation and Cross-cultural Convergence]. Psicothema, 11, 37–51. https://doi.org/10.5944/rppc.vol.12.num.2.2007.4036
Sandín, B. (2012). Transdiagnóstico y psicología clínica: Introducción al número monográfico. Revista de Psicopatología y Psicología Clínica, 17(3), 181–184. https://doi.org/10.5944/rppc.vol.17.num.3.2012.11838
Sanz, J. y García-Vera, M. P. (2009). Nuevos baremos para la adaptación española del Inventario de Personalidad NEO Revisado (NEO PI-R): fiabilidad y datos normativos en voluntarios de la población general [New Norms for the Spanish Adaptation of the NEO Personality Inventory-Revised (NEO PI-R): Reliability and Normative Data in Volunteers From the General Population]. Clínica y Salud, 20(2), 131–144.
Sauer-Zavala S., Fournier J. C., Jarvi Steele S., Woods B. K., Wang M., Farchione T. J. y Barlow D. H. (2020). Does the Unified Protocol Really Change Neuroticism? Results from a Randomized Trial. Psychological Medicine, 51, 1–10. https://doi.org/10.1017/S0033291720000975
Spielberger, C. D., Gorsuch, R. L. y Lushene, R. E. (1982). Cuestionario de ansiedad estado-rasgo. TEA.
Toro Tobar, R. A., Barrera, S. M., Ramos Rodríguez, B. R. y Velásquez Gordillo, A. I. (2019). Sensitividad Ansiosa y Afecto Negativo: Modelo transdiagnóstico para síntomas ansiosos y depresivos. Revista de Psicología, 37(2), 583–602. https://doi.org/10.18800/psico.201902.009
Trujillo, A., Feixas, G., Bados, A., García-Grau, E., Salla, M., Medina, J. C., Montesano, A., Soriano, J., Medeiros-Ferreira, L., Cañete, J., Corbella, S., Grau, A., Lana F. y Evans, C. (2016). Psychometric Properties of the Spanish Version of the Clinical Outcomes in Routine Evaluation - Outcome Measure. Neuropsychiatr Dis Treat. 21(12), 1457–1466. https://doi.org/10.2147/NDT.S103079
Vázquez-Morejón, R., León Rubio, J. M., Martín Rodríguez, A. y Vázquez Morejón, A. J. (2019). Validation of a Spanish Version of the Brief Experiential Avoidance Questionnaire (BEAQ) in clinical population. Psicothema, 31(3), 335–340. https://doi.org/10.7334/psicothema2019.60
Watkins, E. (2015). An Alternative Transdiagnostic Mechanistic Approach to Affective Disorders Illustrated with Research from Clinical Psychology. Emotion Review, 7(3), 250–255. https://doi.org/10.1177/1754073915575400
Watson, D., Clark, L. A. y Tellegen, A. (1988). Development and Validation of Brief Measures of Positive and Negative Affect: The PANAS Scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063
Weintraub, M. J., Zinberg, J., Bearden, C. E. y Miklowitz, D. J. (2020). Applying a Transdiagnostic Cognitive-Behavioral Treatment to Adolescents at High Risk for Serious Mental Illness: Rationale and Preliminary Findings. Cognitive and Behavioral Practice, 27(2), 202–214. https://doi.org/10.1016/j.cbpra.2019.07.007
Zemestani, M., Ommati, P., Rezaei, F. y Gallagher, M. W. (2021). Changes in Neuroticism-related Constructs over the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in patients on an optimal dose of SSRI. Personality Disorders: Theory, Research, and Treatment, 13(2), 171–181.https://doi.org/10.1037/per0000482
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