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Espinosa V, Valiente RM, García-Escalera J, Chorot P, Arnáez S, Schmitt JC, Sandín B. Efficacy of a transdiagnostic internet-based program for adolescents with emotional disorders: A randomized controlled trial. Behav Res Ther 2024; 179:104560. [PMID: 38744141 DOI: 10.1016/j.brat.2024.104560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 04/23/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is a well-established transdiagnostic cognitive-behavioral therapy (T-CBT) intervention. The aim of the present study was to examine the efficacy of the program Learn to Manage your Emotions [Aprende a Manejar tus Emociones] (AMtE), a self-applied transdiagnostic internet-delivered program based on the Spanish version of the UP-A. This is the first transdiagnostic internet-based program designed for the treatment of emotional disorders in adolescents. METHOD A sample of Spanish adolescents with a primary diagnosis of an anxiety and/or depressive disorder (n = 58; age range = 12-18 years; 78.3% girls; 90% Caucasian) were randomly allocated to receive AMtE (n = 28) or the UP-A via videocall (n = 30). Pre-treatment, post-treatment and 3-month follow-up data were collected using self-reports and clinician-rated measures of anxiety, depression, positive and negative affect, anxiety sensitivity and emotional avoidance. RESULTS Based on generalized estimating equations (GEE) models, both intervention programs were effective in significantly reducing self-reported anxiety and depressive disorder symptoms and clinician-rated severity of anxiety and depression, as well as self-reported transdiagnostic outcome variables. CONCLUSIONS Data provide empirical support for the efficacy of AMtE as a transdiagnostic online CBT treatment for anxiety and depressive disorders in adolescents. No marked nor consistent differences were observed between the UP-A and AMtE, highlighting the potential usefulness of the online self-administered AMtE program.
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Affiliation(s)
- Victoria Espinosa
- Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040, Madrid, Spain
| | - Rosa M Valiente
- Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040, Madrid, Spain
| | - Julia García-Escalera
- Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040, Madrid, Spain
| | - Paloma Chorot
- Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040, Madrid, Spain.
| | - Sandra Arnáez
- Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040, Madrid, Spain
| | - Julia C Schmitt
- Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040, Madrid, Spain
| | - Bonifacio Sandín
- Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040, Madrid, Spain
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Rozental A, Shafran R, Johansson F, Forsström D, Jovicic F, Gelberg O, Molin K, Carlbring P, Andersson G, Buhrman M. Treating perfectionism via the Internet: a randomized controlled trial comparing cognitive behavior therapy to unified protocol. Cogn Behav Ther 2024; 53:324-350. [PMID: 38483057 DOI: 10.1080/16506073.2024.2327339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/28/2024] [Indexed: 03/20/2024]
Abstract
Perfectionism can be problematic when your self-worth is dependent on achievements and leads to inflexible standards, cognitive biases, and rigid behaviors. Cognitive behavior therapy for perfectionism is shown to be effective, including for targeting psychiatric symptoms and when delivered via the Internet (iCBT-P). However, few studies have compared it to an active comparator. The current study randomly assigned 138 participants seeking help for perfectionism to iCBT-P or Internet-based Unified Protocol (iUP). Both treatments provided guidance on demand from a therapist and were eight weeks in duration. The results indicated large within-group effects of Cohen's d 2.03 (iCBT) and 2.51 (iUP) on the Clinical Perfectionism Questionnaire at post-treatment, and maintained effects at 6- and 12-month follow-up, but no between-group difference (β = 0.02, SE = 1.04, p = .98). Secondary outcomes of depression, anxiety, quality of life, self-compassion, procrastination, and stress ranged from small to large, with no differences between the conditions. Both treatments were deemed credible, relevant, of high quality, and well-adhered by the participants. Further research needs to be conducted, but the findings could indicate a lack of specificity, perhaps suggesting there is no need to differentiate between different treatments that are transdiagnostic in nature.
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Affiliation(s)
- Alexander Rozental
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Roz Shafran
- Great Ormond Street Hospital Institute of Child Health, UCL, London, UK
| | - Fred Johansson
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
| | - David Forsström
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Filip Jovicic
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Olle Gelberg
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Katarina Molin
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Monica Buhrman
- Department of Psychology, Uppsala University, Uppsala, Sweden
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Martínez-Borba V, Martínez-García L, Peris-Baquero Ó, Osma J, del Corral-Beamonte E. Guiding future research on psychological interventions in people with COVID-19 and post COVID syndrome and comorbid emotional disorders based on a systematic review. Front Public Health 2024; 11:1305463. [PMID: 38274511 PMCID: PMC10808326 DOI: 10.3389/fpubh.2023.1305463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Objective The COVID-19 pandemic has been emotionally challenging for the entire population and especially for people who contracted the illness. This systematic review summarizes psychological interventions implemented in COVID-19 and long COVID-19 patients who presented comorbid emotional disorders. Methods and measures 3,839 articles were identified in 6 databases and 43 of them were included in this work. Two independent researchers selected the articles and assessed their quality. Results 2,359 adults were included in this review. Severity of COVID-19 symptoms ranged from asymptomatic to hospitalized patients; only 3 studies included long COVID-19 populations. Similar number of randomized controlled studies (n = 15) and case studies (n = 14) were found. Emotional disorders were anxiety and/or depressive symptoms (n = 39) and the psychological intervention most represented had a cognitive behavioral approach (n = 10). Length of psychological programs ranged from 1-5 sessions (n = 6) to 16 appointments (n = 2). Some programs were distributed on a daily (n = 4) or weekly basis (n = 2), but other proposed several sessions a week (n = 4). Short (5-10 min, n = 4) and long sessions (60-90 min, n = 3) are proposed. Most interventions were supported by the use of technologies (n = 18). Important risk of bias was present in several studies. Conclusion Promising results in the reduction of depressive, anxiety and related disorders have been found. However, important limitations in current psychological interventions were detected (i.e., duration, format, length, and efficacy of interventions were not consistently established across investigations). The results derived from our work may help to understand clinical practices in the context of pandemics and could guide future efforts to manage emotional suffering in COVID-19 patients. A stepped model of care could help to determine the dosage, length and format of delivery for each patient.Systematic review registration: PROSPERO 2022 CRD42022367227. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022367227.
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Affiliation(s)
- Verónica Martínez-Borba
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Laura Martínez-García
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Óscar Peris-Baquero
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Jorge Osma
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
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