Examining the Efficacy of the Unified Transdiagnostic Treatment on Social Anxiety and Positive and Negative Affect in Students

Authors

1 Department of Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran

2 Department of Psychology, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran

3 Department of Psychiatric, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Abstract

Abstract Background: Social anxiety is anextremely harmful disorder affectingmany aspects of life and causes limited capability of encoun- tering social situations among individuals. Objectives: The purpose of this study was to examine the efficacy of the unified transdiagnostic treatment on social anxiety and positive and negative affect in students. Methods: The statistical population of this study included all female undergraduate studentswith social anxiety in Ahvaz Jundisha- pur University of Medical Sciences. 32 female undergraduate students of medical sciences university of Ahvazwere selected among thosewith social anxiety score of 19 ormore (cut-offscore) throughmultistage randomsamplingmethodandwere randomly placed in experimental and control groups. Social phobia inventory (SPIN) and positive and negative affect schedule (PANAS) were imple- mented on subjects of both groups before and after conducting the intervention. Unified transdiagnostic treatmentwas performed on the experimental group within 8 sessions of 90minutes, but the control group received no intervention. Data were analyzed by multivariate covariance analysis. Results: Results showed a significant difference between experimental and control groups in terms of social anxiety and negative and positive affect, and unified transdiagnostic treatmenthas reduced social anxiety and negative affect and also has increased pos- itive affect in experimental group. Conclusions: Itmay be concluded based on the results of this study that unified transdiagnostic treatment is effective on recovery of social anxiety and negative and positive affects among the students. Therefore, clinical therapists are advised to use this interven- tion.

Keywords


  1. 1.Hofmann SG, Di Bartolo PM. Social anxiety: Clinical, developmental, and social perspectives. 2 ed. Amsterdam: Elsevier-Academic Press.; 2010.

    1. American Psychiatric Association. . Diagnostic and statistical manual of mental disorders. 5 ed. Arlington, VA: American Psychiatric Publishing; 2013.
    2. Moitra E, Herbert JD, Forman EM. Behavioral avoidance mediates the relationship between anxiety and depressive symptoms among social anxiety disorder patients. J Anxiety Disord. 2008;22(7):1205–13. doi: 10.1016/j.janxdis.2008.01.002. [PubMed: 18282686].
    3. Haller SP, Cohen Kadosh K, Scerif G, Lau JY. Social anxiety disorder in adolescence: How developmental cognitive neuroscience findings may shape understanding and interventions for psychopathology. Dev Cogn Neurosci. 2015;13:11–20. doi: 10.1016/j.dcn.2015.02.002. [PubMed: 25818181].
    4. Talepasand S, Nokani M. Social phobia symptoms: prevalence and sociodemographic correlates. Arch Iran Med. 2010;13(6):522–7. [PubMed: 21039009].
    5. Mohammadi MR, Alavi A, Mahmoodi J, Shahrivar Z, Tehranidoost M, Saadat S. Prevalence of psychiatric disorders amongst adolescents in Tehran. Iran J Psychiatry Behav Sci. 2008;3(3):100–4.
    6. Bella TT, Omigbodun OO. Social phobia in Nigerian university students: prevalence, correlates and co-morbidity. Soc Psychiatry Psychiatr Epidemiol. 2009;44(6):458–63. doi: 10.1007/s00127-008-0457-3. [PubMed: 18979054].
    7. Sumaiyah MN. Social anxiety problem among medical students in universiti malaya medical center (ummc)–a cross-sectional study. Malaysian J Psychiatry. 2008;17(2):17–22.
    8. Rapee RM, Heimberg RG. A cognitive-behavioral model of anxiety in social phobia. Behav Res Ther. 1997;35(8):741–56. [PubMed: 9256517].
    9. Richards JM, Patel N, Daniele-Zegarelli T, MacPherson L, Lejuez CW, Ernst M. Social anxiety, acute social stress, and reward parameters interact to predict risky decision-making among adolescents. J Anxiety Disord. 2015;29:25–34. doi: 10.1016/j.janxdis.2014.10.001. [PubMed: 25465884].
    10. Turk CL, Heimberg RG, Luterek JA, Mennin DS, Fresco DM. Emotion dysregulation in generalized anxiety disorder: A comparison with social anxiety disorder. Cognit Ther Res. 2005;29(1):89–106.
    11. Morrison AS, Heimberg RG. Attentional control mediates the effect of social anxiety on positive affect. J Anxiety Disord. 2013;27(1):56–67. doi: 10.1016/j.janxdis.2012.10.002. [PubMed: 23254261]. 13. Hofmann SG. An introduction to modern CBT: Psychological solutions to mental health problems. John Wiley & Sons; 2011.
    12. Barlow DH, Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Allen LB, et al. The unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. New York: Oxford University Press; 2011.
    13. Mohammadi A. Comparison of the effect of transdiagnostic group therapy with group cognitive therapy on indicated prevention of anxiety and depression. Iran: Tehran University of Medical Sciences; 2011.
    14. Lotfi M, Bakhtiyari M, Farid A, Asghar A, Amini M. The effectiveness of transdiagnostic therapy on emotion regulation strategies of patients with emotional disorders: A randomized clinical trial. Practice clin psychol. 2013;1(4):26–30.
    15. de Ornelas Maia AC, Nardi AE, Cardoso A. The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial. J Affect Disord. 2015;172:179–83. doi: 10.1016/j.jad.2014.09.023. [PubMed: 25451415].
    16. Bullis JR, Fortune MR, Farchione TJ, Barlow DH. A preliminary investigation of the long-term outcome of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Compr Psychiatry. 2014;55(8):1920–7. doi: 10.1016/j.comppsych.2014.07.016. [PubMed: 25113056].
    17. Ellard KK, Fairholme CP, Boisseau CL, Farchione TJ, Barlow DH. Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cogn Behav Pract. 2010;17(1):88–101. doi: 10.1016/j.cbpra.2009.06.002.
    18. Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson Hollands J, Carl JR, et al. Unified protocol for transdiagnostic treatment of emotional disorders: A randomized controlled trial. Behav Ther. 2012;43(3):666–78. doi: 10.1016/j.beth.2012.01.001.
    19. Abdi R, Bakhshi A, Mahmoud Alilou M. Efficacy of unified transdiagnostic treatment on reduction of transdiagnostic factors and symptoms severity in emotional disorders.. J Psychol Mod Meth. 2013;3(13):1– 27.
    20. Sauer-Zavala S, Boswell JF, Gallagher MW, Bentley KH, Ametaj A, Barlow DH. 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. 2012;50(9):551–7. doi: 10.1016/j.brat.2012.05.005. [PubMed: 22738907].
    21. Connor KM, Davidson JR, Churchill LE, Sherwood A, Foa E, Weisler RH. Psychometric properties of the Social Phobia Inventory (SPIN). New self-rating scale. Br J Psychiatry. 2000;176:379–86. [PubMed: 10827888].
    22. Hassanvand Amouzadeh M. The standardization of social phobia inventory (spin)in nonclinical iranian samples. J Urmia Univ Med Sci. 2014;26(1):17–30.
    23. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54(6):1063–70. [PubMed: 3397865]. 6 Razavi Int J Med. 2016; 4(4):e41233. Roushani K et al.
    24. Brown TA, Chorpita BF, Barlow DH. Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. J Abnorm Psychol. 1998;107(2):179–92. [PubMed: 9604548].
    25. Bakhsipour A, Dejkam M. A confirmatory factor analysis of the Positive and Negative Affect schedule. J Psychol. 2005;9(4):351–65.
    26. FirstMB, Spitzer RL. Structured Clinical Interview forDSM-IV Axis IDisorders (SCID-I), Clinician Version. Washington DC: American Psychiatric Association; 1997.
    27. Sharifi V, Asaadi SM, Mohammadi MR, Amini H, kaviani H, Semnani Y. Reliability and feasibility of the persian translation of the structured clinical interview for dsm-iv (scid).. Advan Cogn Sci. 2004;6:10–22.
    28. Zargar F, Asgharnejad Farid AA, Atef-Vahid MK, Afshar H, Maroofi M, Omranifard V. Effect of acceptance-based behavior therapy on severity of symptoms, worry and quality of life in women with generalized anxiety disorder. Iran J Psychiatry Behav Sci. 2012;6(2):23–32. [PubMed: 24644479].
    29. Fava GA, Ruini C, Rafanelli C, Finos L, Salmaso L, Mangelli L, et al. Wellbeing therapy of generalized anxiety disorder. Psychother Psychosom. 2005;74(1):26–30. doi: 10.1159/000082023. [PubMed: 15627853].
    30. Clark DM, Wells A. A cognitive model of social phobia. Social phobia: Diagnosis, assessment, and treatment. 1995;41(68):22–3.
    31. Davison GC, Neale JM, Kring AM. Abnormal psychology. 9 ed. New York: John Wiley and Sons; 2004.
    32. Moscovitch DA.What is the core fear in social phobia? A newmodel to facilitate individualized case conceptualization and treatment.. Cogn Behav Pract. 2009;16(2):123–34. doi: 10.1016/j.cbpra.2008.04.002.
    33. Moscovitch DA, Orr E, Rowa K, Reimer SG, Antony MM. In the absence of rose-colored glasses: ratings of self-attributes and their differential certainty and importance across multiple dimensions in social phobia. Behav Res Ther. 2009;47(1):66–70. doi: 10.1016/j.brat.2008.10.007. [PubMed: 19012879].
    34. Bielak T, Moscovitch DA. How do I measure up? The impact of observable signs of anxiety and confidence on interpersonal evaluations in social anxiety. Cognit Ther Res. 2013;37(2):266–76.
    35. Moscovitch DA, Rodebaugh TL, Hesch BD. How awkward! Social anxiety and the perceived consequences of social blunders. Behav Res Ther. 2012;50(2):142–9. doi: 10.1016/j.brat.2011.11.002. [PubMed: 22137365].
    36. Weisman O, Aderka IM, Marom S, Hermesh H, Gilboa-Schechtman E. Social rank and affiliation in social anxiety disorder. Behav Res Ther. 2011;49(6-7):399–405. doi: 10.1016/j.brat.2011.03.010. [PubMed: 21497793].
    37. Moscovitch DA, Rowa K, Paulitzki JR, Ierullo MD, Chiang B, Antony MM, et al. Self-portrayal concerns and their relation to safety behaviors and negative affect in social anxiety disorder. Behav Res Ther. 2013;51(8):476–86. doi: 10.1016/j.brat.2013.05.002. [PubMed: 23778055].
    38. MoscovitchDA, SuvakMK, Hofmann SG. Emotional response patterns during social threat in individuals with generalized social anxiety disorder and non-anxious controls. J Anxiety Disord. 2010;24(7):785–91. doi: 10.1016/j.janxdis.2010.05.013. [PubMed: 20708493].