The efficacy of transdiagnostic cognitive behavioural therapy on reducing negative affect, anxiety sensitivity and improving perceived control in children with emotional disorders - a randomized controlled trial

Submitted: September 22, 2021
Accepted: March 8, 2022
Published: May 9, 2022
Abstract Views: 2068
PDF: 657
HTML: 79
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

In response to the high rate of comorbidity among different types of emotional disorders in children, Transdiagnostic Unified Protocol of Emotional disorder in children (UP-C) was developed to address common underlying mechanisms in the development and maintenance of emotional disorders using empirically supported cognitive and behavioural strategies. Although, studies supported the effectiveness of this protocol in the treatment of wide range of emotional disorders, further studies are needed to examine its effect on transdiagnostic factors. The present study aimed to investigate the efficacy of the UP-C on negative affect, anxiety sensitivity and perceived control in children with emotional disorders. During this randomized controlled trial, 34 children aged 7 to 13 with emotional disorders were randomly assigned to treatment (n=18) and control (n=16) groups. The treatment group and their parents received 15 sessions of UP-C. Negative Affect Schedule for Children (PANASNA- C), Children’s Anxiety Sensitivity Index (CASI), Anxiety Control Questionnaire-Children (ACQ-C) were carried out in all phases (pre-treatment, post-treatment, 3 and 8 months follow- up). The results showed that following UP-C, negative affect (hedges’g=2.01) and anxiety sensitivity (hedges’g=1.05) were significantly reduced, and perceived control (hedges’g= –2.36) was significantly improved. The results remained relatively constant during the follow-ups. Findings provide evidence that the UP-C has significant effect on negative affect, anxiety sensitivity and perceived control as roots of emotional disorders.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Abramson, L. Y., Seligman, M. E., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87(1), 49. DOI: https://doi.org/10.1037/0021-843X.87.1.49
Allan, N. P., Felton, J. W., Lejuez, C. W., MacPherson, L., & Schmidt, N. B. (2016). Longitudinal investigation of anxiety sensitivity growth trajectories and relations with anxiety and depression symptoms in adolescence. Development and Psychopathology, 28(2), 459-469. DOI: https://doi.org/10.1017/S0954579415000590
Allen, L. B., Ehrenreich, J. T., & Barlow, D. H. (2005). A Unified Treatment for Emotional Disorders: Applications With Adults and Adolescents (Invited Article). Japanese Journal of Behavior Therapy, 31(1), 3-30.
Allen, L. B., White, K. S., Barlow, D. H., Shear, M. K., Gorman, J. M., & Woods, S. W. (2010). Cognitive-behavior therapy (CBT) for panic disorder: Relationship of anxiety and depression comorbidity with treatment outcome. Journal of Psychopathology and Behavioral Assessment, 32(2), 185-192. DOI: https://doi.org/10.1007/s10862-009-9151-3
Andrews, G. (1996). Comorbidity and the general neurotic syndrome. The British Journal of Psychiatry, 168(S30), 76-84. DOI: https://doi.org/10.1192/S0007125000298449
Andrews, G., Stewart, G., Morris-Yates, A., Holt, P., & Henderson, S. (1990). Evidence for a general neurotic syndrome. The British Journal of Psychiatry, 157(1), 6-12. DOI: https://doi.org/10.1192/bjp.157.1.6
Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological review, 84(2), 191. DOI: https://doi.org/10.1037/0033-295X.84.2.191
Bandura, A. (1982). Self-efficacy mechanism in human agency. American psychologist, 37(2), 122. DOI: https://doi.org/10.1037/0003-066X.37.2.122
Barlow, D., Allen, L., & Choate, M. (2008). Unified protocol for the treatment of emotional disorders. Unpublished treatment manual.
Barlow, D., & Durand, V. (2011). Abnormal Psychology: An Integrative Approach: Cengage Learning.
Barlow, D. H. (2000). Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. American Psychologist, 55(11), 1247. DOI: https://doi.org/10.1037/0003-066X.55.11.1247
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a Unified Treatment for Emotional Disorders. Behavior Therapy, 35(2), 205-230. DOI: https://doi.org/10.1016/S0005-7894(04)80036-4
Barlow, D. H., Allen, L. B., & Choate, M. L. (2016). Toward a unified treatment for emotional disorders–republished article. Behavior Therapy, 47(6), 838-853. DOI: https://doi.org/10.1016/j.beth.2016.11.005
Barlow, D. H., Ellard, K. K., Fairholme, C. P., Farchione, T. J., Boisseau, C. L., & Allen, L. (2011). The unified protocol for transdiagnostic treatment of emotional disorders: Client workbook: Oxford University Press. DOI: https://doi.org/10.1093/med:psych/9780199772674.001.0001
Barlow, D. H., Sauer-Zavala, S., Carl, J. R., Bullis, J. R., & Ellard, K. K. (2014). The nature, diagnosis, and treatment of neuroticism: Back to the future. Clinical Psychological Science, 2(3), 344-365. DOI: https://doi.org/10.1177/2167702613505532
Barrett, L. F., Lewis, M., & Haviland-Jones, J. M. (2018). Handbook of Emotions, Fourth Edition: Guilford Publications.
Bauer, I., Wilansky-Traynor, P., & Rector, N. A. (2012). Cognitive-behavioral therapy for anxiety disorders with comorbid depression: a review. International Journal of Cognitive Therapy, 5(2), 118-156. DOI: https://doi.org/10.1521/ijct.2012.5.2.118
Berman, S. L., Weems, C. F., Silverman, W. K., & Kurtines, W. M. (2000). Predictors of outcome in exposure-based cognitive and behavioral treatments for phobic and anxiety disorders in children. Behavior Therapy, 31(4), 713-731. DOI: https://doi.org/10.1016/S0005-7894(00)80040-4
Bilek, E. L., & Ehrenreich-May, J. (2012). An open trial investigation of a transdiagnostic group treatment for children with anxiety and depressive symptoms. Behavior Therapy, 43(4), 887-897. DOI: https://doi.org/10.1016/j.beth.2012.04.007
Bosman, R. C., Ten Have, M., de Graaf, R., Muntingh, A. D., van Balkom, A. J., & Batelaan, N. M. (2019). Prevalence and course of subthreshold anxiety disorder in the general population: a three-year follow-up study. Journal of Affective Disorders, 247, 105-113. DOI: https://doi.org/10.1016/j.jad.2019.01.018
Boswell, J. F., Farchione, T. J., Sauer-Zavala, S., Murray, H. W., Fortune, M. R., & Barlow, D. H. (2013). Anxiety sensitivity and interoceptive exposure: A transdiagnostic construct and change strategy. Behavior Therapy, 44(3), 417-431. DOI: https://doi.org/10.1016/j.beth.2013.03.006
Brown, H. M., Meiser-Stedman, R., Woods, H., & Lester, K. J. (2016). Cognitive vulnerabilities for depression and anxiety in childhood: Specificity of anxiety sensitivity and rumination. Behavioural and Cognitive Psychotherapy, 44(1), 30-42. DOI: https://doi.org/10.1017/S1352465814000472
Brown, T. A. (2007). Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs. Journal of Abnormal Psychology, 116(2), 313. DOI: https://doi.org/10.1037/0021-843X.116.2.313
Brown, T. A., & Barlow, D. H. (2009). A proposal for a dimensional classification system based on the shared features of the DSM-IV anxiety and mood disorders: Implications for assessment and treatment. Psychological Assessment, 21(3), 256. DOI: https://doi.org/10.1037/a0016608
Brozina, K., & Abela, J. R. (2006). Symptoms of depression and anxiety in children: Specificity of the hopelessness theory. Journal of Clinical Child and Adolescent Psychology, 35(4), 515-527. DOI: https://doi.org/10.1207/s15374424jccp3504_3
Carl, J. R., Gallagher, M. W., Sauer-Zavala, S. E., Bentley, K. H., & Barlow, D. H. (2014). A preliminary investigation of the effects of the unified protocol on temperament. Comprehensive Psychiatry, 55(6), 1426-1434. DOI: https://doi.org/10.1016/j.comppsych.2014.04.015
Chorpita, B. F., Moffitt, C. E., & Gray, J. (2005). Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behaviour Research and Therapy, 43(3), 309-322. DOI: https://doi.org/10.1016/j.brat.2004.02.004
Chu, B. C. (2012). Translating transdiagnostic approaches to children and adolescents. Elsevier. DOI: https://doi.org/10.1016/j.cbpra.2011.06.003
Chu, B. C., Colognori, D., Weissman, A. S., & Bannon, K. (2009). An initial description and pilot of group behavioral activation therapy for anxious and depressed youth. Cognitive and Behavioral Practice, 16(4), 408-419. DOI: https://doi.org/10.1016/j.cbpra.2009.04.003
Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100(3), 316. DOI: https://doi.org/10.1037/0021-843X.100.3.316
Compton, S. N., March, J. S., Brent, D., Albano, A. M., Weersing, V. R., & Curry, J. (2004). Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review. Journal of the American Academy of Child & Adolescent Psychiatry, 43(8), 930-959. DOI: https://doi.org/10.1097/01.chi.0000127589.57468.bf
Copeland, W. E., Angold, A., Shanahan, L., & Costello, E. J. (2014). Longitudinal patterns of anxiety from childhood to adulthood: the Great Smoky Mountains Study. Journal of the American Academy of Child & Adolescent Psychiatry, 53(1), 21-33. DOI: https://doi.org/10.1016/j.jaac.2013.09.017
Crowe, K., & McKay, D. (2017). Efficacy of cognitive-behavioral therapy for childhood anxiety and depression. Journal of Anxiety Disorders, 49, 76-87. DOI: https://doi.org/10.1016/j.janxdis.2017.04.001
Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. The Canadian Journal of Psychiatry, 58(7), 376-385. DOI: https://doi.org/10.1177/070674371305800702
Doos Ali Vand, H., Gharraee, B., Asgharnejad Farid, A.-A., Ghaleh Bandi, M. F., & Habibi, M. (2018). Investigating the effects of the unified protocol on common and specific factors in a comorbid insomniac sample: a single-case experimental design. Iranian Journal of Psychiatry and Behavioral Sciences, 12(3). DOI: https://doi.org/10.5812/ijpbs.14452
Ebesutani, C., Regan, J., Smith, A., Reise, S., Higa-McMillan, C., & Chorpita, B. F. (2012). The 10-item positive and negative affect schedule for children, child and parent shortened versions: application of item response theory for more efficient assessment. Journal of Psychopathology and Behavioral Assessment, 34(2), 191-203. DOI: https://doi.org/10.1007/s10862-011-9273-2
Eckhardt, S., Martell, C., Duncombe Lowe, K., Le Grange, D., & Ehrenreich-May, J. (2019). An ARFID case report combining family-based treatment with the unified protocol for Transdiagnostic treatment of emotional disorders in children. Journal of Eating Disorders, 7(1), 1-7. DOI: https://doi.org/10.1186/s40337-019-0267-x
Ehrenreich-May, J., & Bilek, E. L. (2012). The development of a transdiagnostic, cognitive behavioral group intervention for childhood anxiety disorders and co-occurring depression symptoms. Cognitive and Behavioral Practice, 19(1), 41-55. DOI: https://doi.org/10.1016/j.cbpra.2011.02.003
Ehrenreich-May, J., Bilek, E. L., Queen, A. H., & Hernandez Rodriguez, J. (2012). A unified protocol for the group treatment of childhood anxiety and depression = Protocolo unificado de grupo para el tratamiento de la ansiedad y la depresión en la infancia. DOI: https://doi.org/10.5944/rppc.vol.17.num.3.2012.11841
Ehrenreich-May, J., Kennedy, S. M., Sherman, J. A., & Barlow, D. H. (2018). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents: Workbook. Oxford University Press. DOI: https://doi.org/10.1093/med-psych/9780190855536.001.0001
Ehrenreich-May, J., Kennedy, S. M., Sherman, J. A., Barlow, D. H., & Bilek, E. L. (2018). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children: Workbook. Oxford University Press. DOI: https://doi.org/10.1093/med-psych/9780190642952.001.0001
Ehrenreich-May, J., Kennedy, S. M., Sherman, J. A., & Buzzella, B. A. (2018). Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents: Therapist Guide: Oxford University Press. DOI: https://doi.org/10.1093/med-psych/9780199340989.001.0001
Ehrenreich-May, J., Rosenfield, D., Queen, A. H., Kennedy, S. M., Remmes, C. S., & 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. DOI: https://doi.org/10.1016/j.janxdis.2016.10.006
Ehrenreich, J. T., Goldstein, C. R., Wright, L. R., & Barlow, D. H. (2009). Development of a unified protocol for the treatment of emotional disorders in youth. Child & Family Behavior Therapy, 31(1), 20-37. DOI: https://doi.org/10.1080/07317100802701228
Ellard, K. K., Bernstein, E. E., Hearing, C., Baek, J. H., Sylvia, L. G., Nierenberg, A. A., & Deckersbach, T. (2017). Transdiagnostic treatment of bipolar disorder and comorbid anxiety using the Unified Protocol for Emotional Disorders: A pilot feasibility and acceptability trial. Journal of Affective Disorders, 219, 209-221. DOI: https://doi.org/10.1016/j.jad.2017.05.011
Essau, C. A., Lewinsohn, P. M., Lim, J. X., Moon-ho, R. H., & Rohde, P. (2018). Incidence, recurrence and comorbidity of anxiety disorders in four major developmental stages. Journal of Affective Disorders, 228, 248-253. DOI: https://doi.org/10.1016/j.jad.2017.12.014
Etkin, A., & Wager, T. D. (2007). Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. American journal of Psychiatry, 164(10), 1476-1488. DOI: https://doi.org/10.1176/appi.ajp.2007.07030504
Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., & Barlow, D. H. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior Therapy, 43(3), 666-678. DOI: https://doi.org/10.1016/j.beth.2012.01.001
Flessner, C. A., & Piacentini, J. C. (2017). Clinical Handbook of Psychological Disorders in Children and Adolescents: A Step-by-Step Treatment Manual: Guilford Publications.
Franco, X., Saavedra, L. M., & Silverman, W. K. (2007). External validation of comorbid patterns of anxiety disorders in children and adolescents. Journal of Anxiety Disorders, 21(5), 717-729. DOI: https://doi.org/10.1016/j.janxdis.2006.10.002
Franz, L., Angold, A., Copeland, W., Costello, E. J., Towe-Goodman, N., & Egger, H. (2013). Preschool anxiety disorders in pediatric primary care: prevalence and comorbidity. Journal of the American Academy of Child & Adolescent Psychiatry, 52(12), 1294-1303.e1291. DOI: https://doi.org/10.1016/j.jaac.2013.09.008
Friedberg, R. D., & Paternostro, J. K. (2019). Handbook of cognitive behavioral therapy for pediatric medical conditions. Springer. DOI: https://doi.org/10.1007/978-3-030-21683-2
Gallagher, M. W., Bentley, K. H., & Barlow, D. H. (2014). Perceived control and vulnerability to anxiety disorders: A meta-analytic review. Cognitive Therapy and Research, 38(6), 571-584. DOI: https://doi.org/10.1007/s10608-014-9624-x
García-Escalera, J., Valiente, R. M., Chorot, P., Ehrenreich-May, J., Kennedy, S. M., & Sandín, B. (2017). The Spanish version of the unified protocol for transdiagnostic treatment of emotional disorders in adolescents (UP-A) adapted as a school-based anxiety and depression prevention program: Study protocol for a cluster randomized controlled trial. JMIR Research Protocols, 6(8), e7934. DOI: https://doi.org/10.2196/resprot.7934
Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: Conceptual foundations.
Grossman, R. A., & Ehrenreich-May, J. (2020). Using the unified protocol for Transdiagnostic treatment of emotional disorders with youth exhibiting anger and irritability. Cognitive and Behavioral Practice, 27(2), 184-201. DOI: https://doi.org/10.1016/j.cbpra.2019.05.004
Hankin, B. L., Davis, E. P., Snyder, H., Young, J. F., Glynn, L. M., & Sandman, C. A. (2017). Temperament factors and dimensional, latent bifactor models of child psychopathology: Transdiagnostic and specific associations in two youth samples. Psychiatry Research, 252, 139-146. DOI: https://doi.org/10.1016/j.psychres.2017.02.061
Harvey, A. G., Watkins, E., & Mansell, W. (2004). Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment: OUP Oxford. DOI: https://doi.org/10.1093/med:psych/9780198528883.001.0001
Hawks, J. L., Kennedy, S. M., Holzman, J. B., & Ehrenreich-May, J. (2020). Development and application of an innovative transdiagnostic treatment approach for pediatric irritability. Behavior Therapy, 51(2), 334-349. DOI: https://doi.org/10.1016/j.beth.2019.07.004
Hernandez Rodriguez, J. (2015). Individual Differences in Anxiety Sensitivity and Emotional Avoidance: Potential Links in the Association between Internalizing Problems and Peer Victimization.
Hettema, J. M., Neale, M. C., & Kendler, K. S. (2001). A review and meta-analysis of the genetic epidemiology of anxiety disorders. American journal of Psychiatry, 158(10), 1568-1578. DOI: https://doi.org/10.1176/appi.ajp.158.10.1568
Higa-McMillan, C. K., Francis, S. E., Rith-Najarian, L., & Chorpita, B. F. (2016). Evidence base update: 50 years of research on treatment for child and adolescent anxiety. Journal of Clinical Child & Adolescent Psychology, 45(2), 91-113. DOI: https://doi.org/10.1080/15374416.2015.1046177
Ho, S. M., Dai, D. W. T., Mak, C., & Liu, K. W. K. (2018). Cognitive factors associated with depression and anxiety in adolescents: A two-year longitudinal study. International Journal of Clinical and Health Psychology, 18(3), 227-234. DOI: https://doi.org/10.1016/j.ijchp.2018.04.001
Hovenkamp-Hermelink, J. H., Voshaar, R. C. O., Batelaan, N. M., Penninx, B. W., Jeronimus, B. F., Schoevers, R. A., & Riese, H. (2019). Anxiety sensitivity, its stability and longitudinal association with severity of anxiety symptoms. Scientific Reports, 9(1), 1-7. DOI: https://doi.org/10.1038/s41598-019-39931-7
Jacobson, N. C., & 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. DOI: https://doi.org/10.1037/bul0000111
Kennedy, S. M., Bilek, E. L., & 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. DOI: https://doi.org/10.1177/0145445517753940
Kennedy, S. M., Halliday, E., & Ehrenreich-May, J. (2021). Trajectories of change and intermediate indicators of non-response to transdiagnostic treatment for children and adolescents. Journal of Clinical Child & Adolescent Psychology, 50(6), 904-918. DOI: https://doi.org/10.1080/15374416.2020.1716363
Kennedy, S. M., Tonarely, N. A., Sherman, J. A., & Ehrenreich-May, J. (2018). Predictors of treatment outcome for the unified protocol for transdiagnostic treatment of emotional disorders in children (UP-C). Journal of Anxiety Disorders, 57, 66-75. DOI: https://doi.org/10.1016/j.janxdis.2018.05.004
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617-627. DOI: https://doi.org/10.1001/archpsyc.62.6.617
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve‐month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21(3), 169-184. DOI: https://doi.org/10.1002/mpr.1359
Khakpoor, S., Bytamar, J. M., & Saed, O. (2019). Reductions in transdiagnostic factors as the potential mechanisms of change in treatment outcomes in the Unified Protocol: a randomized clinical trial. Research in Psychotherapy: Psychopathology, Process, and Outcome, 22(3). DOI: https://doi.org/10.4081/ripppo.2019.379
Khakpour, S., Yousefi, F., & Saed, O. (2018). Anxiety Sensitivity and Obsessive-Compulsive Disorder: A Mini Review. Journal In Psychology, Psychiatry & Mental Health, 5(5), 69-80. DOI: https://doi.org/10.29252/shenakht.5.5.69
Kim, J., & Cicchetti, D. (2010). Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. Journal of Child Psychology and Psychiatry, 51(6), 706-716. DOI: https://doi.org/10.1111/j.1469-7610.2009.02202.x
Knapp, A. A., Blumenthal, H., Mischel, E. R., Badour, C. L., & Leen-Feldner, E. W. (2016). Anxiety sensitivity and its factors in relation to generalized anxiety disorder among adolescents. Journal of Abnormal Child Psychology, 44(2), 233-244. DOI: https://doi.org/10.1007/s10802-015-9991-0
Koch, E. I., Eye, B. D., Ellison, G., & Gourley, B. (2017). Targeting anxiety sensitivity to prevent the development of psychopathology.
Kranzler, A., Young, J. F., Hankin, B. L., Abela, J. R., Elias, M. J., & Selby, E. A. (2016). Emotional awareness: A transdiagnostic predictor of depression and anxiety for children and adolescents. Journal of Clinical Child & Adolescent Psychology, 45(3), 262-269. DOI: https://doi.org/10.1080/15374416.2014.987379
Lambert, L. (2019). Longitudinal associations between childhood self-worth, perceived control, and peer victimization experiences.
Leonardo, C., Aristide, S., & Michela, B. (2021). On the efficacy of the Barlow Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A systematic review and meta-analysis. Clinical Psychology Review, 101999. DOI: https://doi.org/10.1016/j.cpr.2021.101999
Lonigan, C. J., Carey, M. P., & Finch, A. (1994). Anxiety and depression in children and adolescents: negative affectivity and the utility of self-reports. Journal of Consulting and Clinical Psychology, 62(5), 1000. DOI: https://doi.org/10.1037/0022-006X.62.5.1000
Lonigan, C. J., Hooe, E. S., David, C. F., & Kistner, J. A. (1999). Positive and negative affectivity in children: Confirmatory factor analysis of a two-factor model and its relation to symptoms of anxiety and depression. Journal of Consulting and Clinical Psychology, 67(3), 374. DOI: https://doi.org/10.1037/0022-006X.67.3.374
Lotfi, M., Bahrampoori, L., Amini, M., Fatemitabar, R., Birashk, B., & Shiasi, Y. (2020). Developing the Persian version of positive and negative affect scale for children (Original and short form) and assessing its psychometric properties. Iranian Journal of Psychiatry and Clinical Psychology, 25(4), 440-453. DOI: https://doi.org/10.32598/ijpcp.25.4.7
Lyneham, H. J., Abbott, M. J., & Rapee, R. M. (2007). Interrater reliability of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent version. Journal of the American Academy of Child & Adolescent Psychiatry, 46(6), 731-736. DOI: https://doi.org/10.1097/chi.0b013e3180465a09
Manley, S. M. (2017). Parental Overprotection and Child Anxiety Symptoms: The Mediating Role of Perceived Control of Anxiety. University of Toledo.
Mariotti, E. C., Bolden, J., & Finn, M. (2021). Unifying treatment for mild anxiety and depression in preadolescence. Psychotherapy, 58(1), 121. DOI: https://doi.org/10.1037/pst0000350
Martinsen, K. D., Kendall, P. C., Stark, K., & Neumer, S.-P. (2016). Prevention of anxiety and depression in children: acceptability and feasibility of the transdiagnostic EMOTION program. Cognitive and Behavioral Practice, 23(1), 1-13. DOI: https://doi.org/10.1016/j.cbpra.2014.06.005
McLaughlin, K. A., Aldao, A., Wisco, B. E., & Hilt, L. M. (2014). Rumination as a transdiagnostic factor underlying transitions between internalizing symptoms and aggressive behavior in early adolescents. Journal of Abnormal Psychology, 123(1), 13. DOI: https://doi.org/10.1037/a0035358
McLaughlin, K. A., & Nolen-Hoeksema, S. (2011). Rumination as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy, 49(3), 186-193. DOI: https://doi.org/10.1016/j.brat.2010.12.006
Mohammad, E. E. (2007). Adaptation and standardization of child symptom inventory-4 (CSI-4).
Muris, P., de Jong, P. J., & Engelen, S. (2004). Relationships between neuroticism, attentional control, and anxiety disorders symptoms in non-clinical children. Personality and Individual Differences, 37(4), 789-797. DOI: https://doi.org/10.1016/j.paid.2003.10.007
Mychailyszyn, M. P., Brodman, D. M., Read, K. L., & Kendall, P. C. (2012). Cognitive‐behavioral school‐based interventions for anxious and depressed youth: A meta‐analysis of outcomes. Clinical Psychology: Science and Practice, 19(2), 129. DOI: https://doi.org/10.1111/j.1468-2850.2012.01279.x
Norton, P. J., Barrera, T. L., Mathew, A. R., Chamberlain, L. D., Szafranski, D. D., Reddy, R., & Smith, A. H. (2013). Effect of transdiagnostic CBT for anxiety disorders on comorbid diagnoses. Depression and Anxiety, 30(2), 168-173. DOI: https://doi.org/10.1002/da.22018
Norton, P. J., & Mehta, P. D. (2007). Hierarchical model of vulnerabilities for emotional disorders. Cognitive Behaviour Therapy, 36(4), 240-254. DOI: https://doi.org/10.1080/16506070701628065
Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice, Training, 45(2), 214. DOI: https://doi.org/10.1037/0033-3204.45.2.214
O’donnell, M. L., Lau, W., Chisholm, K., Agathos, J., Little, J., Terhaag, S., & Katona, L. (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. DOI: https://doi.org/10.1002/jts.22650
O’Neil, K. A., Podell, J. L., Benjamin, C. L., & Kendall, P. C. (2010). Comorbid depressive disorders in anxiety-disordered youth: Demographic, clinical, and family characteristics. Child Psychiatry & Human Development, 41(3), 330-341. DOI: https://doi.org/10.1007/s10578-009-0170-9
Olatunji, B. O., Cisler, J. M., & Deacon, B. J. (2010). Efficacy of cognitive behavioral therapy for anxiety disorders: a review of meta-analytic findings. Psychiatric Clinics, 33(3), 557-577. DOI: https://doi.org/10.1016/j.psc.2010.04.002
Pereira, A. I., Muris, P., Roberto, M. S., Marques, T., Goes, R., & Barros, L. (2018). Examining the mechanisms of therapeutic change in a cognitive-behavioral intervention for anxious children: The role of interpretation bias, perceived control, and coping strategies. Child Psychiatry & Human Development, 49(1), 73-85. DOI: https://doi.org/10.1007/s10578-017-0731-2
Piqueras, J. A., Martín-Vivar, M., Sandin, B., San Luis, C., & Pineda, D. (2017). The Revised Child Anxiety and Depression Scale: A systematic review and reliability generalization meta-analysis. Journal of Affective Disorders, 218, 153-169. DOI: https://doi.org/10.1016/j.jad.2017.04.022
Poursharifi, H., Babapour, J., Aliloo, M. M., Khanjani, Z., & Zeinali, S. (2021). Designing and testing a child anxiety model based on child and parent variables. Journal of Family Psychology, 4(1), 17-28.
Pozza, A., Meneghelli, A., Meliante, M., Amato, L., & Dèttore, D. (2020). Anxiety sensitivity dimensions in young individuals with at-risk-mental states. Research in Psychotherapy: Psychopathology, Process, and Outcome, 23(1). DOI: https://doi.org/10.4081/ripppo.2020.431
Queen, A. H., & Ehrenreich-May, J. (2014). Anxiety-disordered adolescents with and without a comorbid depressive disorder: Variations in clinical presentation and emotion regulation. Journal of Emotional and Behavioral Disorders, 22(3), 160-170. DOI: https://doi.org/10.1177/1063426613478175
Racer, K. H., & Dishion, T. J. (2012). Disordered attention: Implications for understanding and treating internalizing and externalizing disorders in childhood. Cognitive and Behavioral Practice, 19(1), 31-40. DOI: https://doi.org/10.1016/j.cbpra.2010.06.005
Raines, E. M., Viana, A. G., Trent, E. S., Conroy, H. E., Woodward, E. C., Zvolensky, M. J., & Storch, E. A. (2020). The explanatory role of anxiety sensitivity in the association between effortful control and child anxiety and depressive symptoms. Cognitive Behaviour Therapy, 49(6), 501-517. DOI: https://doi.org/10.1080/16506073.2020.1790644
Rapee, R. M., Craske, M. G., Brown, T. A., & Barlow, D. H. (1996). Measurement of perceived control over anxiety-related events. Behavior Therapy, 27(2), 279-293. DOI: https://doi.org/10.1016/S0005-7894(96)80018-9
Rasouli, H., & Minaee, A. ( 2017). Standardization and standardization of the Child Anxiety and Depression Scale (RCADS) in the community of high school students in Tehran. 8th International Conference on Psychology and Social Sciences.
Reinholt, N., & Krogh, J. (2014). Efficacy of transdiagnostic cognitive behaviour therapy for anxiety disorders: a systematic review and meta-analysis of published outcome studies. Cognitive Behaviour Therapy, 43(3), 171-184. DOI: https://doi.org/10.1080/16506073.2014.897367
Reiss, S. (1980). Pavlovian conditioning and human fear: An expectancy model. Behavior Therapy, 11(3), 380-396. DOI: https://doi.org/10.1016/S0005-7894(80)80054-2
Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11(2), 141-153. DOI: https://doi.org/10.1016/0272-7358(91)90092-9
Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcement. Psychological monographs: General and Applied, 80(1), 1. DOI: https://doi.org/10.1037/h0092976
Rouquette, A., Pingault, J.-B., Fried, E. I., Orri, M., Falissard, B., Kossakowski, J. J., & Borsboom, D. (2018). Emotional and behavioral symptom network structure in elementary school girls and association with anxiety disorders and depression in adolescence and early adulthood: a network analysis. JAMA Psychiatry, 75(11), 1173-1181. DOI: https://doi.org/10.1001/jamapsychiatry.2018.2119
Sakiris, N., & Berle, D. (2019). A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clinical Psychology Review, 72, 101751. DOI: https://doi.org/10.1016/j.cpr.2019.101751
Sandín, B., García-Escalera, J., Valiente, R. M., Espinosa, V., & Chorot, P. (2020). Clinical Utility of an Internet-Delivered Version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (iUP-A): A Pilot Open Trial. International Journal of Environmental Research and Public Health, 17(22), 8306. DOI: https://doi.org/10.3390/ijerph17228306
Sauer-Zavala, S., Boswell, J. F., Gallagher, M. W., Bentley, K. H., Ametaj, A., & Barlow, D. H. (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. Behaviour Research and Therapy, 50(9), 551-557. DOI: https://doi.org/10.1016/j.brat.2012.05.005
Sauer-Zavala, S., Gutner, C. A., Farchione, T. J., Boettcher, H. T., Bullis, J. R., & Barlow, D. H. (2017). Current definitions of ‘transdiagnostic’ in treatment development: A search for consensus. Behavior Therapy, 48(1), 128-138. DOI: https://doi.org/10.1016/j.beth.2016.09.004
Schaffer, A., McIntosh, D., Goldstein, B. I., Rector, N. A., McIntyre, R. S., Beaulieu, S., & Yatham, L. (2012). The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid anxiety disorders. Annals of Clinical Psychiatry, 24(1), 6-22.
Schmidt, N. B., Mitchell, M. A., & Richey, J. A. (2008). Anxiety sensitivity as an incremental predictor of later anxiety symptoms and syndromes. Comprehensive Psychiatry, 49(4), 407-412. DOI: https://doi.org/10.1016/j.comppsych.2007.12.004
Seligman, M. E. P. (1975). Helplessness: On Depression, Development, and Death: W. H. Freeman.
Seligman, M. E. P. (1992). Helplessness: On Depression, Development, and Death: W. H. Freeman.
Sherman, J. A., & Ehrenreich-May, J. (2020). Changes in risk factors during the unified protocol for transdiagnostic treatment of emotional disorders in adolescents. Behavior Therapy, 51(6), 869-881. DOI: https://doi.org/10.1016/j.beth.2019.12.002
Sherman, J. A., Tonarely, N. A., & Ehrenreich-May, J. (2018). Targeting comorbid anxiety and depression using the unified protocol for transdiagnostic treatment of emotional disorders in adolescents. Clinical Case Studies, 17(2), 59-76. DOI: https://doi.org/10.1177/1534650117753671
Shin, L. M., & Liberzon, I. (2010). The neurocircuitry of fear, stress, and anxiety disorders. Neuropsychopharmacology, 35(1), 169-191. DOI: https://doi.org/10.1038/npp.2009.83
Silverman, W. K., Fleisig, W., Rabian, B., & Peterson, R. A. (1991). Childhood anxiety sensitivity index. Journal of Clinical Child and Adolescent Psychology, 20(2), 162-168. DOI: https://doi.org/10.1207/s15374424jccp2002_7
Snyder, J., Bullard, L., Wagener, A., Leong, P. K., Snyder, J., & Jenkins, M. (2009). Childhood anxiety and depressive symptoms: Trajectories, relationship, and association with subsequent depression. Journal of Clinical Child & Adolescent Psychology, 38(6), 837-849. DOI: https://doi.org/10.1080/15374410903258959
Starcevic, V., & Berle, D. (2006). Cognitive specificity of anxiety disorders: a review of selected key constructs. Depression and Anxiety, 23(2), 51-61. DOI: https://doi.org/10.1002/da.20145
Steele, S. J., Farchione, T. J., Cassiello-Robbins, C., Ametaj, A., Sbi, S., Sauer-Zavala, S., & Barlow, D. H. (2018). Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. Journal of Psychiatric Research, 104, 211-216. DOI: https://doi.org/10.1016/j.jpsychires.2018.08.005
Storch, E. A., Ehrenreich May, J., Wood, J. J., Jones, A. M., De Nadai, A. S., Lewin, A. B., & Murphy, T. K. (2012). Multiple informant agreement on the anxiety disorders interview schedule in youth with autism spectrum disorders. Journal of Child and Adolescent Psychopharmacology, 22(4), 292-299. DOI: https://doi.org/10.1089/cap.2011.0114
Suveg, C., Sood, E., Comer, J. S., & Kendall, P. C. (2009). Changes in emotion regulation following cognitive-behavioral therapy for anxious youth. Journal of Clinical Child & Adolescent Psychology, 38(3), 390-401. DOI: https://doi.org/10.1080/15374410902851721
Taylor, S. (2014). Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety: Routledge. DOI: https://doi.org/10.4324/9781410603326
Trosper, S. E., Whitton, S. W., Brown, T. A., & Pincus, D. B. (2012). Understanding the latent structure of the emotional disorders in children and adolescents. Journal of Abnormal Child Psychology, 40(4), 621-632. DOI: https://doi.org/10.1007/s10802-011-9582-7
Tyrer, P., Alexander, J., Remington, M., & Riley, P. (1987). Relationship between neurotic symptoms and neurotic diagnosis: a longitudinal study. Journal of Affective Disorders, 13(1), 13-21. DOI: https://doi.org/10.1016/0165-0327(87)90069-3
Tyrer, P., Murphy, S., Kingdon, D., Brothwell, J., Gregory, S., Seivewright, N., & Johnson, A. (1988). The Nottingham study of neurotic disorder: comparison of drug and psychological treatments. The Lancet, 332(8605), 235-240. DOI: https://doi.org/10.1016/S0140-6736(88)92535-4
Verhulst, F. C., & van der Ende, J. (2006). Assessment scales in child and adolescent psychiatry: CRC Press. DOI: https://doi.org/10.3109/9780203012932
Viana, A. G., Woodward, E. C., Hanna, A. E., Raines, E. M., Alfano, C. A., & Zvolensky, M. J. (2018). The moderating role of anxiety sensitivity in the co-occurrence of anxiety and depression symptoms among clinically anxious children. Journal of Experimental Psychopathology, 9(3), 2043808718791049. DOI: https://doi.org/10.1177/2043808718791049
Voltas, N., Hernández-Martínez, C., Arija, V., & Canals, J. (2017). The natural course of anxiety symptoms in early adolescence: factors related to persistence. Anxiety, Stress, & Coping, 30(6), 671-686. DOI: https://doi.org/10.1080/10615806.2017.1347642
Wauthia, E., Lefebvre, L., Huet, K., Blekic, W., El Bouragui, K., & Rossignol, M. (2019). Examining the hierarchical influences of the Big-Five dimensions and Anxiety Sensitivity on anxiety symptoms in children. Frontiers in Psychology, 10, 1185. DOI: https://doi.org/10.3389/fpsyg.2019.01185
Weems, C. F. (2005). The anxiety control questionnaire for children-Short Form. New Orleans, LA: University of New Orleans.
Weems, C. F., Costa, N. M., Watts, S. E., Taylor, L. K., & Cannon, M. F. (2007). Cognitive errors, anxiety sensitivity, and anxiety control beliefs: Their unique and specific associations with childhood anxiety symptoms. Behavior Modification, 31(2), 174-201. DOI: https://doi.org/10.1177/0145445506297016
Weems, C. F., & Silverman, W. K. (2006). An integrative model of control: Implications for understanding emotion regulation and dysregulation in childhood anxiety. Journal of Affective Disorders, 91(2-3), 113-124. DOI: https://doi.org/10.1016/j.jad.2006.01.009
Weisz, J. R., & Kazdin, A. E. (2017). Evidence-Based Psychotherapies for Children and Adolescents, Third Edition. Guilford Publications.
Wise, J. M., Cepeda, S. L., Ordaz, D. L., McBride, N. M., Cavitt, M. A., Howie, F. R., Lewin, A. B. (2019). Open trial of modular cognitive-behavioral therapy in the treatment of anxiety among late adolescents with autism spectrum disorder. Child Psychiatry & Human Development, 50(1), 27-34. DOI: https://doi.org/10.1007/s10578-018-0817-5
Wood, J. J., Piacentini, J. C., Bergman, R. L., McCracken, J., & Barrios, V. (2002). Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions. Journal of Clinical Child and Adolescent Psychology, 31(3), 335-342. DOI: https://doi.org/10.1207/S15374424JCCP3103_05
Zarrella, I., Russolillo, L. A., Caviglia, G., & Perrella, R. (2017). Continuity and discontinuity between psychopathology of childhood and adulthood: a review on retrospective and prospective studies. Research in Psychotherapy: Psychopathology, Process, and Outcome, 20(2). DOI: https://doi.org/10.4081/ripppo.2017.248

How to Cite

Qanbari Alaee, E., Saed, O., Khakpoor, S., Ahmadi, R., Ali Mohammadi, M. ., Yoosefi Afrashteh, M. ., & Morovati, Z. (2022). The efficacy of transdiagnostic cognitive behavioural therapy on reducing negative affect, anxiety sensitivity and improving perceived control in children with emotional disorders - a randomized controlled trial. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(1). https://doi.org/10.4081/ripppo.2022.588

List of Cited By :

Crossref logo