Emotional disorders, particularly anxiety disorders and depression are common, chronic, costly, and can be severely impairing. We have developed increased understanding of the nature and causes of these emotional disorders during the past decade with evidence pointing to very similar biological and psychological vulnerabilities that interact with specific learning and, often, stressful life events to cause emotional disorders. Treatments, both drug and psychological, have been proven effective in the short term, but leave plenty of room for improvement in terms of outcome. Effective psychological treatments, many of which have been developed only in the past five to ten years, have been targeted very specifically to each IDSM-IV emotional disorder. This has resulted in a plethora of protocols, that has retarded training and dissemination of these efficacious treatments. The purpose of this application is to create a unified psychological approach to emotional disorders. To develop this unified protocol (UP) we will distill the major ingredients of current efficacious approaches in light of our advancing knowledge of modern learning theory and cognitive neuroscience and emotion regulation. This has led us to a focus on antecedent cognitive reappraisal, emotional avoidance, and modifying emotion driven action tendencies as basic approaches in the treatment of any emotional disorder. Thus, the first phase of the study will focus on treatment development and protocol writing. In the second phase of the study twenty-four patients will be treated and the manual will be refined through patient, therapist, investigator and consultant feedback. Adherence and competency ratings will also be developed and raters will be trained to reliably administer them. In the third phase, the pilot study, forty patients with a principal diagnosis of the major emotional disorders (panic disorder with or without agoraphobia, social phobia, obsessive compulsive disorder, generalized anxiety disorder, and major depressive disorder, as well as other emotional disorders if they are available, such as post-traumatic stress disorder and dysthymia) will be randomly assigned to receive the newly developed intervention or to a twelve-week wait list condition. Therapeutic gains will be assessed in several domains, including emotional symptomatology, and quality of life. If successful, this will be the first step towards a large scale treatment study validating a unified psychosocial approach to the emotional disorders.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
5R34MH070693-02
Application #
7125990
Study Section
Interventions Research Review Committee (ITV)
Program Officer
Kozak, Michael J
Project Start
2005-09-26
Project End
2008-11-30
Budget Start
2006-06-01
Budget End
2007-11-30
Support Year
2
Fiscal Year
2006
Total Cost
$189,246
Indirect Cost
Name
Boston University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
049435266
City
Boston
State
MA
Country
United States
Zip Code
02215
Carl, Jenna R; Gallagher, Matthew W; Sauer-Zavala, Shannon E et al. (2014) A preliminary investigation of the effects of the unified protocol on temperament. Compr Psychiatry 55:1426-34
Bullis, Jacqueline R; Fortune, Meghan R; Farchione, Todd J et al. (2014) A preliminary investigation of the long-term outcome of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Compr Psychiatry 55:1920-7
Thompson-Hollands, Johanna; Farchione, Todd J; Barlow, David H (2013) Thought-action fusion across anxiety disorder diagnoses: specificity and treatment effects. J Nerv Ment Dis 201:407-13
Boswell, James F; Gallagher, Matthew W; Sauer-Zavala, Shannon E et al. (2013) Patient characteristics and variability in adherence and competence in cognitive-behavioral therapy for panic disorder. J Consult Clin Psychol 81:443-54
Boswell, James F; Thompson-Hollands, Johanna; Farchione, Todd J et al. (2013) Intolerance of uncertainty: a common factor in the treatment of emotional disorders. J Clin Psychol 69:630-45
Boswell, James F; Farchione, Todd J; Sauer-Zavala, Shannon et al. (2013) Anxiety sensitivity and interoceptive exposure: a transdiagnostic construct and change strategy. Behav Ther 44:417-31
Gallagher, Matthew W; Sauer-Zavala, Shannon E; Boswell, James F et al. (2013) The Impact of the Unified Protocol for Emotional Disorders on Quality of Life. Int J Cogn Ther 6:
Boswell, James F; Sauer-Zavala, Shannon E; Gallagher, Matthew W et al. (2012) Readiness to change as a moderator of outcome in transdiagnostic treatment. Psychother Res 22:570-8
Sauer-Zavala, Shannon; Boswell, James F; Gallagher, Matthew W et al. (2012) The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders. Behav Res Ther 50:551-7
Farchione, Todd J; Fairholme, Christopher P; Ellard, Kristen K et al. (2012) Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behav Ther 43:666-78

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