Strengths use and emotional disorder symptom reduction during a transdiagnostic cognitive behavioral therapy: A random-intercept cross-lagged panel model study.

Abstract

Strengths use, the engagement of positive character traits in everyday contexts, is associated with both positive functioning and symptom reduction. The present study examined longitudinal relationships between strengths use and emotional disorder symptoms (anxiety, stress, and depression) during a randomized clinical trial of the Digital Unified Protocol, a transdiagnostic cognitive behavioral therapy. Participants (N = 120) completed assessments at four major time points during treatment and at 3-month follow-up. We specified three random-intercept cross-lagged panel model to capture within-person, bidirectional, time-lagged relationships between strengths use and anxiety, stress, and depression, respectively. Prospective increases in strengths use were associated with significant decreases in anxiety at all time points (β = -0.26 to -0.49), while prospective decreases in anxiety were associated with significant increases in strengths use at most time points (β = -0.25 to -0.36). Prospective increases in strengths use were associated with significant decreases in stress at most time points (β = -0.23 to -0.54), while prospective decreases in stress were associated with significant increases in strengths use at Week 4 (β = -0.21) and at follow-up (β = -0.41). Prospective increases in strengths use were associated with significant decreases in depression at Week 8 (β = -0.63) and at posttreatment (β = -0.67), while prospective decreases in depression were associated with significant increases in strengths use at most time points (β = -0.34 to -0.47). Clinical implications of findings are discussed, including the potential role of strengths use as a treatment target. (PsycInfo Database Record (c) 2024 APA, all rights reserved).