Transdiagnostic Treatment Research Articles

Exploring cutoff points and measurement invariance of the Brunnsviken brief quality of life inventory.

Quality of life (QoL) can be defined as the goodness of life, beyond simply absence of disease or functional impairments, self-rating scales of which capture valuable information beyond change in primary outcomes. This study (n = 3,384) validated the Brunnsviken Brief Quality of Life Inventory (BBQ) across divergent groups by evaluating its measurement invariance (MI). We hypothesized measurement invariance for the BBQ across age groups, genders, depression, and anxiety severity. Potential cutoff points for the BBQ were also explored. Confirmatory factor analysis (CFA) models were fit to sample data obtained from an ongoing study on transdiagnostic internet-based treatment modules. Parameters were successively constrained to assess configural, metric, scalar, and residual invariance factor structures across different groups. The BBQ demonstrated MI at the metric level and partial MI at the scalar level across all these groups, which remained stable at the strict-residual level for all groups except for genders. These results remained stable after correcting for unbalanced group sizes for gender, clinical-subclinical levels of depression, and clinical-subclinical levels of anxiety. A cutoff point analysis revealed that a BBQ total scores below 39 was associated with notable psychopathology. The BBQ is a reliable measure of QoL that is applicable for various divergent groups (e.g., vulnerable persons), and thus a viable instrument for use in healthcare and research with minimal aversive impact.Clinical trial registration: NCT05016843.

Effectiveness of the Unified Protocol on symptoms of anxiety and depression in Mexican adults.

Emotional disorders, such as anxiety and depression, represent a public health problem worldwide due to the impact they have on the quality of life of the people who suffer from it. Clinical psychology began to develop various interventions for the specific treatment of each of them. However, research and clinical practice have shown the practical limitations that this entails. Due to this, various research groups began to develop transdiagnostic interventions such as the Unified Protocol (UP) to overcome these limitations. Objective: This article reports the effectiveness of the PU in face-to-face mode in users of a civil association (n=3) who presented symptoms of anxiety and depression. Method: An intrasubject design was carried out with pre and post treatment measurements and visual inspection. The instruments used were the PHQ-9, GAD-7, DERS-E, ODIS and OASIS. An analysis was performed through the objective clinical change (OCC). Results: a decrease in the scores was observed in the three participants in the PHQ-9, GAD-7, DERS-E, which was compared with the downward trend in the ODSIS and OASIS scores. Conclusion: the intervention was clinically significant for the participants and evidenced the flexibility in the application of the PU, however, the main limitations were the size of the sample, the lack of instruments that measure aspects of personality, a dimension that has been used in other research as an indicator of change and a follow-up evaluation.

Effectiveness of online integrative trans-diagnostic treatment on internet addiction and high-risk behaviors in female adolescents with borderline personality disorder with comorbid depressive disorder.

Based on research, borderline personality disorder is associated with many behavioral and emotional problems, including Internet addiction and high-risk behaviors. On the other hand, integrative trans-diagnostic treatment, by targeting trans-diagnostic factors in emotional pathology, is considered a suitable treatment for comorbid psychological pathologies. Also, since in adolescence, the opinion of others about oneself is more important, online therapy has the advantage of protecting them from the fear of stigma and shame in the face of others' judgments. Therefore, the aim of the current research was to investigate the effectiveness of online integrative trans-diagnostic treatment on the internet addiction and high-risk behaviors in adolescents with borderline personality disorder. The current research was applied and quasi-experimental in a pre-test-post-test manner with a control group. The research sample included 40 female adolescents with borderline personality disorder who were randomly divided into two groups of 20 people, experimental and control groups. The criteria for entering the research included the age range of 12 to 18 years, female, confirmation of the disease by a psychologist, not receiving other psychological treatments in the last 3 months, and having a smartphone to participate in the online group. Substance abuse, any serious mental and physical illness/disorder that interferes with treatment, and failure to attend more than two sessions in therapy sessions were some of the exclusion criteria.The participants were tested on the scales of internet addiction and high-risk behaviors. Then, the treatment plan based on online integrative trans-diagnostic group therapy was presented to the participants of the experimental group online in 9 two-hour sessions. The control group was placed on the waiting list until the completion of the treatment sessions and the post-test implementation, and after the post-test implementation, they received the treatment. Then, their scores were measured, after completing the treatment, and a three-month follow-up period. Descriptive statistics and covariance test were used to analyze the data. Patients showed a clear improvement in the severity of internet addiction and high-risk behavior symptoms. So that the scores of internet addiction and high-risk behaviors in the experimental group after receiving the treatment, as well as after a three-month follow-up period, were significantly reduced (p < 0.001). These results show that online integrative trans-diagnostic therapy can be an effective treatment option for reducing some symptoms of risky behaviors and internet addiction in adolescents with borderline personality disorder and should be studied further. It is noteworthy that the limitations of this study were the available sampling method, the use of a unisex sample of female patients, and the short-term follow-up period, which makes it difficult to generalize the results.

Effectiveness of Transdiagnostic Child Therapy Combined with Maternal Acceptance and Commitment Intervention on Anxiety and Depression in Anxious Children and Obsessive Thoughts Related to COVID-19 in Mothers with Corona Anxiety

Objective: The aim of the present study was to compare the effectiveness of transdiagnostic child therapy with and without maternal acceptance and commitment intervention on anxiety and depression in anxious children and obsessive thoughts related to COVID-19 in mothers with corona anxiety. Methods and Materials: The method of this research was a quasi-experimental design with a pre-test-post-test (two experimental groups and one control group) along with a two-month follow-up period. The population included all anxious elementary school students in the second half of the year 2021-2022 in districts 1 and 2 of Sari city whose mothers also had corona anxiety. Transdiagnostic child-parent centered intervention combined with acceptance and commitment therapy for the parent was applied in the first group, and transdiagnostic child-parent centered intervention without acceptance and commitment therapy for the parent in the second experimental group, while the control group received no intervention. Sixty participants were selected through purposive sampling. They were then randomly assigned into 3 groups (Group 1; transdiagnostic child-parent centered intervention with parental acceptance and commitment intervention (20 participants), Group 2; transdiagnostic child-centered intervention without parental acceptance and commitment intervention (20 participants), and Group 3; as the control group (20 participants)). For data collection, depression and anxiety questionnaires were used for children, and a practical obsessive-compulsive questionnaire with COVID-19 was used for mothers. For the implementation of interventions, Ehrenreich-May et al.'s (2019) transdiagnostic intervention (12 90-minute group sessions twice a week), and Eifert et al.'s (2017) acceptance and commitment therapy (12 90-minute group sessions twice a week) were utilized. For data analysis, repeated measures ANOVA with SPSS software, version 26 was used. Findings: The results of the repeated measures ANOVA regarding the children showed that the effectiveness of transdiagnostic child therapy combined with maternal acceptance and commitment intervention was significantly greater than transdiagnostic child therapy without acceptance and commitment intervention for the mother, in terms of anxiety and depression. Although anxiety and depression decreased in both experimental groups and were stable over time. The results of the repeated measures ANOVA regarding mothers showed that there was no significant difference in the effectiveness of transdiagnostic child therapy combined with maternal acceptance and commitment intervention with transdiagnostic child therapy without acceptance and commitment intervention for the mother regarding obsessive thoughts, although both interventions showed significant effectiveness over time. Conclusion: Therefore, it is recommended that therapists and counselors use this treatment in conjunction with other therapeutic interventions to improve the interaction between children and parents.

Transdiagnostic Psychological Interventions for Symptoms of Common Mental Disorders Delivered by Non‐Specialist Providers in Low‐ and Middle‐Income Countries: A Systematic Review and Meta‐Analysis

There is a treatment gap for Common Mental Disorders (CMDs) such as anxiety, depression, and post‐traumatic stress disorder (PTSD), as well as non‐specific psychological distress (NPD) in low‐ and middle‐income countries (LAMIC), due to the lack of available clinicians and locally appropriate interventions. Task‐shifting using non‐specialist providers (NSP) and transdiagnostic approaches may address this. Transdiagnostic approaches can be effective at treating CMDs and NPD in high‐income countries (HIC), but currently, there is no comprehensive synthesis of evidence regarding their effectiveness in LAMICs. This review addressed this gap by examining the effectiveness of transdiagnostic psychological interventions for symptoms of CMDs and NPD delivered by NSPs in LAMICs. Three databases were searched (Embase, PsycInfo, and PubMed). Hedge’s g’s were calculated using random‐effect models to correct for small sample bias. Twenty‐one transdiagnostic interventions across 20 studies were included. Moderate reductions at posttreatment were found in psychological distress (g = −0.64; 95% CI: −0.81 to −0.46), symptoms of anxiety (g = −0.61; 95% CI: −0.80 to −0.42), depression (g = −0.59; 95% CI: −0.75 to −0.44), and PTSD/trauma (g = −0.38; 95% CI: −0.59 to −0.16), with significant small reductions maintained at follow‐up ranging from 13 to 26 weeks for NPD (SMD = − 0.37; 95% CI: −0.57 to −0.17), anxiety (g = − 0.41; 95% CI: −0.91 to 0.09), depression (g = −0.38; 95% CI: −0.59 to −0.16), and trauma symptoms (g = −0.23; 95% CI: −0.42 to −0.05). These findings are important and suggest that transdiagnostic approaches delivered by NSPs are effective at treating symptoms of CMDs and NPD in LAMICs. Future research should consider comparing task‐shifting approaches with disorder‐specific interventions and explore the effectiveness of longer sessions across various mental health conditions.

Mental health treatment for first responders: An assessment of mental health provider needs.

First responders experience mental health conditions at a higher rate than the general population. To improve treatment and enhance quality of care, it is important to understand the needs of those who provide mental health treatment to this population. The purpose of this study was to explore the needs of mental health providers with experience working with first responders to better understand how first responders differ from community patients, and what training and supports providers need to enhance treatment. Semistructured qualitative interviews were conducted via videocalls with 12 mental health providers who provide mental health care to Australian first responders. The interviews were transcribed verbatim and interpretative phenomenological analysis was performed. The findings highlighted the importance of identity and culture among first responders, and the need for cultural awareness and understanding among mental health providers working with this population. Various training opportunities which could enhance treatment capacities were identified, including training in accurate assessment and differential diagnosis, evidence-based trauma-focused treatments, transdiagnostic treatments, and working with specific first responder treatment characteristics (e.g., emotional detachment, rigid cognitive styles, and preferences toward structure and order). Ways in which mental health providers can be supported included facilitating professional networks between providers and connection with first responder organizations. The insights gathered from this study provide a foundation from which to consider training and support development for mental health providers working with first responders. Service level implications and directions are outlined to assist future decision making on this topic. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cognitive-behavioral statuses in depression and internet gaming disorder of adolescents: A transdiagnostic approach.

To investigate the comorbidity of adolescent depression and Internet gaming disorder (IGD) and their shared and unique cognitive-behavioral factors (i.e., self-esteem, dysfunctional attitudes, hopelessness, and coping), a large-scale school-based survey was conducted among 3147 Chinese secondary school students in Hong Kong. Probable depression and IGD were screened using the Centre for Epidemiological Studies-Depression Scale and DSM-5 IGD checklist, respectively. Multinomial logistic regression was performed to identify the associations between different condition statuses and cognitive-behavioral factors. Four groups were identified, including comorbidity group (having probable depression and IGD), IGD group (having probable IGD alone), depression group (probable depression alone), and healthy group (neither condition). Comorbidity group showed the worst cognitive-behavioral statuses, followed by depression group and then IGD group. Compared with healthy group, those with lower self-esteem and higher hopelessness and dysfunctional attitudes were more likely to be classified into depression group and comorbidity group, while maladaptive coping was positively associated with all three disorder groups. The results suggest that depression and IGD may share common cognitive-behavioral mechanisms (e.g., maladaptive coping) but also own their uniqueness regarding specific factors (e.g., hopelessness and self-esteem). A transdiagnostic intervention approach targeting the common factors may effectively address the comorbidity.

An adapted transdiagnostic sleep and circadian intervention for adults with excess weight and suboptimal sleep health: pilot study results.

This single-arm, mixed-methods, pilot study examined the feasibility and preliminary efficacy of an adapted version of the transdiagnostic intervention for sleep and circadian dysfunction (TranS-C) on multidimensional sleep health (MDSH) in a sample of adults with excess weight and suboptimal sleep health. Participants received up to eight, weekly, remotely delivered, tailored TranS-C sessions. At pre- and post-intervention, the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and 7 days of Fitbit data were used to evaluate changes in sleep dimensions (regularity, alertness, timing, satisfaction, duration, and efficiency) and the composite MDSH score. Study feasibility examined recruitment, data collection, and intervention engagement (completion of core TranS-C sessions). Acceptability of the intervention was assessed with semi-structured interviews, which were analyzed using thematic analysis. From 85 referrals, 11 individuals were eligible, and 10 completed the study. All intervention participants completed the measures needed to calculate their composite MDSH score and completed the core intervention sessions. Themes from interviews support the intervention's remote delivery approach, applicability of the information provided, and impact on self-reported health. The intervention resulted in a large improvement in the mean composite MDSH score (Cohen's d = 1.17). Small-to-large effects were also observed for individual sleep health dimensions except for timing. Adapted TranS-C is acceptable for adults with excess weight and suboptimal sleep health and may be effective at improving short-term MDSH. With changes to recruitment methods, a larger study is feasible. Limitations include the small sample size and the lack of a control condition.

Comparison of the Effectiveness of Emotion Regulation-Based Therapy and Unified Transdiagnostic Treatment on Cognitive Insight in Women Engaged in Emotional Divorce with Early Marriage

Objective: The objective of this study was to compare the effectiveness of emotion regulation-based therapy and unified transdiagnostic therapy on cognitive insight in women engaged in emotional divorce with early marriage. Methods and Materials: This quasi-experimental research employed a pre-test and post-test control group design. The sample consisted of 45 women involved in emotional divorce, diagnosed by psychologists at counseling centers in Shiraz, and were selected through convenience sampling. Participants were randomly assigned to three groups: one control group (n=15) and two experimental groups (n=30). The experimental groups received either emotion regulation-based therapy or unified transdiagnostic therapy. Data were collected using Beck's Cognitive Insight Questionnaire (BCIS) and analyzed using SPSS (version 26) through descriptive statistics and Multivariate Analysis of Covariance (MANCOVA). Findings: The results indicated that both unified transdiagnostic therapy and emotion regulation-based therapy were effective in increasing cognitive insight in women engaged in emotional divorce with early marriage. The post-test scores showed significant improvement compared to the pre-test scores in the experimental groups, while the control group showed little change. The analysis revealed significant differences in cognitive insight components (self-reflectiveness and self-certainty) between the experimental and control groups. However, there was no significant difference in the effectiveness between the two therapeutic methods. Conclusion: This study highlights the importance of employing these therapeutic approaches in counseling centers to improve cognitive insight and other psychological variables in women with early marriages.

Effectiveness of Unified Transdiagnostic Treatment on Behavioral Problems in Children with Internalizing Behavioral Problems

This study aimed to investigate the effectiveness of unified transdiagnostic treatment on behavioral problems in children with internalizing behavioral problems. This quasi-experimental study utilized a pre-test, post-test design with a control group and a two-month follow-up. The statistical population included 8- to 10-year-old children with internalizing behavioral problems in Najafabad during the first half of 2022. Thirty children were selected based on inclusion criteria using convenience sampling and were randomly assigned to two groups of 15 (experimental and control). The experimental group received the unified transdiagnostic treatment (child version) for 15 weekly sessions of 120 minutes each, while the control group received no intervention. The Child Behavior Checklist (Achenbach &amp; Rescorla, 2001) was used as the research instrument. The obtained data were analyzed using repeated measures analysis of variance. The results showed that the unified transdiagnostic treatment had a significant impact on behavioral problems and their components, with the effects of the intervention being sustained over time. Based on the findings, it can be concluded that this therapeutic intervention can reduce behavioral problems in children with internalizing behavioral problems.

Comparison of the Effectiveness of Unified Transdiagnostic Treatment and Short-Term Psychodynamic Therapy on the Spiritual Health of Women Affected by Marital Infidelity

Comparison of the Effectiveness of Unified Transdiagnostic Treatment and Short-Term Psychodynamic Therapy on the Spiritual Health of Women Affected by Marital Infidelity

Further Evidence for a Dimensional Latent Structure of Health Anxiety: Taxometric Analyses of the Whiteley Index Based on Two German Representative Samples.

Health anxiety is an intricate part of illness anxiety and somatic symptom disorder. Based on convenience samples, two out of three available studies indicate that it is a dimensional rather than a categorical construct. Using two representative datasets, this study investigates whether previous results can be clarified. Conventional taxometric analyses as well as comparison curve fit indices (CCFI) profile analyses (MAMBAC and MAXSLOPE procedures) were calculated with two datasets of the German adult population assessing the Whiteley Index (WI-14, N = 2,072; WI-7, N = 2,498). Mean CCFIs indicated a dimensional structure for both the WI-7 (mean CCFI = 0.42, mean CCFI profile = 0.40) and the WI-14 (mean CCFI = 0.44, mean CCFI profile = 0.32). The results support and extend previous findings by strongly suggesting a dimensional distribution of health anxiety in the general population. Implications for research and practice comprise the adoption of a dimensional description of psychopathology as well as transdiagnostic treatment approaches.

A 12-Month Follow-Up of PROCARE+,a Transdiagnostic,Selective, Preventive Intervention for Adolescents At-Risk for Emotional Disorders.

Few studies have reported long-term follow-up data on selective preventive interventions for adolescents. No follow-up selective preventive transdiagnostic studies for adolescents at-risk for emotional disorders, such as anxiety and depression, have been reported. To fill this gap, this study aims to provide the first follow-up assessment of a randomized controlled trial (RCT) studying selective transdiagnostic prevention in at-risk adolescents. A 12-month follow-up assessment was conducted with subjects who originally received either PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), PROCARE+, which includes the PROCARE protocol along with personalized add-on modules or an active control condition (ACC) based on emotional psychoeducation, and their respective booster session for each experimental condition. 80 subjects (47.5% girls) aged between 12 and 18years (M = 14.62; SD 1.43) who completed these treatment conditions were available for the 12-month follow-up. The results demonstrate the superior long-termefficacy of the PROCARE+ intervention in mitigating emotional symptoms and obsessive-compulsive symptomatology compared to the PROCARE and ACC conditions, with effect sizes notably exceeding those commonly observed in preventive programs. While the three treatments demonstrated beneficial impacts, the pronounced results associated with PROCARE+ at the 12-month follow-up emphasized the importance of personalized treatment modules and the sustained benefits of booster sessions in the realm of preventive psychological interventions. The findings also highlight the potential role of add-on modules in enhancing the effects of the PROCARE+ condition.

Effectiveness of a transdiagnostic indicated preventive intervention for adolescents at high risk for anxiety and depressive disorders

Despite ample evidence for transdiagnostic interventions in clinical populations and in universal prevention approaches, there are only a few controlled trials examining their role for indicated prevention. This study is the first randomized controlled trial to assess the effectiveness of a brief, 8-session group version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), called PROCARE-I (Preventive Transdiagnostic Intervention for Adolescents at Risk for Emotional Disorders-Indicated), delivered online, and including a booster session, in reducing symptoms of anxiety and depression in adolescents compared to an active control condition. Sixty-four adolescents (53% identifying as female) with elevated levels of anxiety and/or depression were randomly assigned to either the 8-week PROCARE-I or the active control condition. Self-report, parent, and clinician measures were collected before and after the interventions, at the 6-month follow-up, and 1 month after the booster session. After the intervention, participants in the PROCARE-I group showed improved scores on 9 of the 13 primary and secondary outcome measures, including reduction of anxiety and mood symptomatology, level of risk of developing emotional disorders, resilience, as well as increase of psychological flexibility, and emotional regulation. In contrast, those in the control group showed improvements in only 2 of the 13 outcome measures. After the booster session, significant differences were found between the PROCARE-I and control condition on measures of overall anxiety and depression symptoms, emotional risk, resilience, and quality of life. Low dropout rates and limited incidence of emotional disorders were observed at follow-ups. The interventions were well-accepted, with high satisfaction rates.

Interpersonal Trauma and Substance Use Severity: The Serial Mediation of Emotional Intolerance and Emotional Dysregulation

ABSTRACT Substance use is highly prevalent in those with trauma histories, especially in women, which may be in part explained by high rates of interpersonal trauma in this population. Research examining the potential mechanisms underlying the relationship between co-occurring interpersonal trauma histories and substance use disorders (SUDs) is in its infancy. The current study examined whether the relationship between interpersonal trauma and SUD severity could be understood via the sequential ordering of two transdiagnostic emotional vulnerability factors: 1) emotional intolerance (anxiety sensitivity, distress intolerance), and 2) emotional dysregulation (negative urgency, lack of clarity, nonacceptance, limited strategies, difficulties with goal-directed behavior). A sample of 130 adult community-based women self-identifying as experiencing substance use problems completed the online survey. Mediation analyses suggest that as women’s lifetime interpersonal trauma increases, so does their SUD severity by way of emotional intolerance and subsequent difficulties regulating their emotions. The findings suggests that transdiagnostic interventions targeting tolerance of aversive emotions may facilitate the ability to learn and employ healthy emotion regulation strategies among women with interpersonal trauma histories and SUDs.

The Effects of a Digital, Transdiagnostic, Clinically and Peer-Moderated Treatment Platform for Young People With Emerging Mental Health Complaints: Repeated Measures Within-Subjects Study.

To address the growing prevalence of youth mental health problems, early intervention is crucial to minimize individual, societal, and economic impacts. Indicative prevention aims to target emerging mental health complaints before the onset of a full-blown disorder. When intervening at this early stage, individuals are more responsive to treatment, resulting in cost-effective outcomes. The Moderated Online Social Therapy platform, which was successfully implemented and proven effective in Australia, is a digital, peer- and clinically moderated treatment platform designed for young people. The Netherlands was the first country outside Australia to implement this platform, under the name Engage Young People Early (ENYOY). It has the potential to reduce the likelihood of young people developing serious mental health disorders. This study aims to investigate the effects on young people using the ENYOY-platform in relation to psychological distress, psychosocial functioning, and positive health parameters. Dutch-speaking young people with emerging mental health complaints (N=131) participated in the ENYOY-platform for 6 months in a repeated measures within-subjects study. Psychological distress, psychosocial functioning, and positive health parameters were assessed at baseline and 3, 6, and 12 months. Repeated measures ANOVA was conducted and adjusted for age, sex, therapy, and community activity. The Reliable Change Index and Clinically Significant Index were computed to compare the baseline with the 6- and 12-month measurements. The missing data rate was 22.54% and the dropout rate 62.6% (82/131). The primary analysis (77/131, 58.8%) showed that psychological distress decreased and psychosocial functioning improved over time with large effect sizes (P<.001 in both cases; ηp2=0.239 and 0.318, respectively) independent of age (P=.76 for psychological distress and P=.48 for psychosocial functioning), sex (P=.24 and P=.88, respectively), therapy activity (P=.49 and P=.80, respectively), or community activity (P=.59 and P=.48, respectively). Similarly, secondary analyses (51/131, 38.9%) showed significant effects of time on the quality of life, well-being, and meaningfulness positive health parameters (P<.05; ηp2=0.062, 0.140, and 0.121, respectively). Improvements in all outcome measures were found between baseline and 3 and 6 months (P≤.001-.01; d=0.23-0.62) and sustained at follow-up (P=.18-.97; d=0.01-0.16). The Reliable Change Index indicated psychological distress improvements in 38% (39/102) of cases, no change in 54.9% (56/102) of cases, and worsening in 5.9% (6/102) of cases. Regarding psychosocial functioning, the percentages were 50% (51/102), 43.1% (44/102), and 6.9% (7/102), respectively. The Clinically Significant Index demonstrated clinically significant changes in 75.5% (77/102) of cases for distress and 89.2% (91/102) for functioning. This trial demonstrated that the ENYOY-platform holds promise as a transdiagnostic intervention for addressing emerging mental health complaints among young people in the Netherlands and laid the groundwork for further clinical research. It would be of great relevance to expand the population on and service delivery of the platform. RR2-10.1186/s12888-021-03315-x.

Efficacy of Internet-based rumination-focused cognitive behavioral therapy and mindfulness-based intervention with guided support in reducing risks of depression and anxiety: A randomized controlled trial.

Rumination and worry are common risk factors of depression and anxiety. Internet-based transdiagnostic interventions targeting individuals with these specific risks may be an effective way to prevent depression and anxiety. This three-arm randomized controlled trial compared the efficacy of Internet-based rumination-focused cognitive behavioral therapy (RFCBT), mindfulness-based intervention (MBI), and psychoeducation (EDU) control among 256 at-risk individuals. Participants' levels of rumination, worry, depressive, and anxiety symptoms were assessed at post-intervention (6weeks), 3-month, and 9-month follow-ups. Linear mixed model analysis results showed similar levels of improvement in all outcomes across the three conditions. Changes in rumination differed comparing RFCBT and MBI, where a significant reduction in rumination was noted at a 3-month follow-up among participants in RFCBT, and no significant long-term effect among participants in MBI was noted at a 9-month follow-up. All three conditions showed similar reductions in risks and symptoms, implying that the two active interventions were not superior to EDU control. The high attrition at follow-ups suggested a need to exercise caution when interpreting the findings. Future studies should tease apart placebo effect and identify ways to improve adherence.

Protocol for a Randomized Controlled Trial Testing the Efficacy of a Transdiagnostic Virtual Reality-Based Intervention for the Reduction of Unhealthy Lifestyles and Behaviors in the General Population

Virtual reality (VR) is a valuable tool for the treatment and prevention of psychiatric disorders and dysfunctional behaviors. Although VR software is mainly developed following a disorder-specific approach, this randomized controlled trial (RCT) will test the efficacy of a new transdiagnostic VR application (H.O.M.E. VR-based psychological intervention) in improving dysfunctional behaviors, three transdiagnostic factors concurrently (emotion regulation, experiential avoidance, and psychological flexibility), and stress. Three groups screened as at-risk for nicotine dependence, alcohol abuse, and eating disorders will be assigned to the H.O.M.E. VR intervention and compared to a waiting-list (WL) condition. Participants will be assessed before and after the H.O.M.E. intervention/WL and at the 3- and 6-month follow-ups in the levels of the displayed dysfunctional behavior, the three transdiagnostic factors, and stress. Changes in dysfunctional behaviors, transdiagnostic factors, and stress in each population VR group and differences in such improvements between each population of the VR and WL groups will be evaluated using mixed-model repeated measure analyses of variance. It is expected that, after the H.O.M.E. intervention and at follow-ups, participants will display improvements in physical and psychological health compared to controls. The H.O.M.E. protocol is expected to result in a cost-effective option to tackle cognitive–behavioral factors shared among several psychopathologies and dysfunctional behaviors.

Comparison of the Effectiveness of Transdiagnostic Treatment and Management of Burnout on Emotional Experience towards Spouse in Married Women

Objective: This research aimed to compare the effectiveness of transdiagnostic treatment and marital burnout management on the emotional experience towards the spouse in married women of Isfahan. Materials and Methods: The present study was a quasi-experimental pre-test, post-test, follow-up design. The statistical population consisted of married women with a minimum of 10 years of marital life. Forty-eight individuals were selected through purposive sampling based on inclusion and exclusion criteria and randomly assigned to two experimental groups and one control group. While the control group received no training, the experimental groups each underwent 10 sessions of 90 minutes according to the respective protocols (Unified transdiagnostic Treatment by Barlow et al., (2010) and the Marital Burnout Management Training Package by the authors. All three groups filled out the Emotional Experience Towards Spouse Questionnaire in three stages: pre-test, post-test, and follow-up. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (repeated measures analysis of variance and Bonferroni post-hoc test) with SPSS-25. Findings: The results indicated that both transdiagnostic treatment and marital burnout management, as compared to the control group, significantly reduced overall negative emotional experience and increased positive emotional experience towards the spouse. However, in reducing negative emotional experience, transdiagnostic treatment was more effective. Conclusion: Both transdiagnostic treatment and marital burnout management are effective in improving the emotional climate in marital relationships of women experiencing long-term marriages. They contribute significantly to reducing negative emotions and fostering positive emotional experiences towards the spouse. Transdiagnostic treatment, in particular, shows greater efficacy in diminishing negative emotional experiences, indicating its potential as a robust approach in marital interventions. These findings underscore the importance of applying targeted therapeutic approaches to enhance marital satisfaction and emotional well-being

Effectiveness and mediators of change of an online CBT intervention for students with adjustment disorder—study protocol for a randomized controlled trial

BackgroundAdjustment problems and disorders are highly prevalent among university students worldwide. These problems can cause significant interference in academic and social functioning and increase vulnerability to other mental health disorders. Unfortunately, only half of students in need receive psychological help. Furthermore, few studies have evaluated psychological interventions for adjustment disorders in students. New, more scalable forms of treatment for students with an adjustment disorder need to be developed, evaluated, and implemented. The study aims to determine the effectiveness of an online transdiagnostic cognitive behavioural intervention for students experiencing adjustment disorder and to assess mediators of change.Method/designIn this three-arm randomized controlled trial, we plan to recruit 214 Polish students diagnosed with an adjustment disorder. Participants who meet initial eligibility criteria will be randomly assigned to one of three 6-week conditions: (1) online cognitive behavioural therapy intervention based on an existing, empirically supported transdiagnostic protocol, the unified protocol; (2) online progressive muscle relaxation training as an active control group; or (3) waiting-list control group. Both interventions are asynchronous, interactive, and include minimal amount of therapist support. Assessments will consist of self-report questionnaires, daily diary measures, and neurocognitive tasks for evaluating cognitive functioning. These will be conducted at baseline, post-treatment, and 1-month follow-up. Daily diary measures will be taken during the first and last week of treatment (or waitlist period). Primary outcome measures will include adjustment disorder severity; secondary outcome measures will consist of other negative (psychopathology: depression, anxiety, and stress) and positive (life satisfaction) indexes of mental health as well as process measures (e.g. mindfulness, experiential avoidance, cognitive fusion).DiscussionTo our knowledge, the current study is the first to evaluate the effectiveness of a psychological intervention for students with adjustment disorder. Therefore, it may have important practical implications for students with this disorder. It can potentially guide the development of a scalable, validated treatment option.Trial registrationClinical Trials, NCT05768308, registered 14 March 2023, https://www.clinicaltrials.gov/ct2/show/NCT05768308