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A culturally adapted unified protocol for transdiagnostic treatment of anxiety disorders in adolescents (UP-A): a randomized waitlist-controlled trial

Published online by Cambridge University Press:  17 July 2023

Mehdi Zemestani Open the ORCID record for Mehdi Zemestani [Opens in a new window] ,
Saman Ezzati ,
Farzad Nasiri ,
Matthew W. Gallagher ,
David H. Barlow  and
Philip C. Kendall
Mehdi Zemestani*
Affiliation:
Department of Psychology, University of Kurdistan, Sanandaj, Iran
Saman Ezzati
Affiliation:
Department of Psychology, University of Kurdistan, Sanandaj, Iran
Farzad Nasiri
Affiliation:
Department of Psychology, University of Kurdistan, Sanandaj, Iran
Matthew W. Gallagher
Affiliation:
Department of Psychology, University of Houston, Houston, TX, USA
David H. Barlow
Affiliation:
Department of Psychology, Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA
Philip C. Kendall
Affiliation:
Department of Psychology, Temple University, Philadelphia, USA
*
Corresponding author: Mehdi Zemestani; Email: m.zemestani@uok.ac.ir; m.zemestan@gmail.com
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Abstract

Background

Anxiety disorders are highly prevalent and debilitating conditions that show high comorbidity rates in adolescence. The present article illustrates how Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) was adapted for Iranian adolescents with anxiety disorders.

Methods

A total of 54 adolescents with comorbid anxiety disorders participated in a randomized, waitlist-controlled trial of group weekly sessions of either UP-A or waitlist control (WLC). Primary and process of change outcomes were assessed at baseline, posttreatment, and 1-month follow-up.

Results

Significant changes were observed over time on major DSM-5 anxiety disorder symptoms (F(2, 51) = 117.09, p < 0.001), phobia type symptoms (F(2, 51) = 100.67, p < 0.001), and overall anxiety symptoms (F(2, 51) = 196.29, p < 0.001), as well as on emotion regulation strategies of reappraisal (F(2, 51) = 17.03, p < 0.001), and suppression (F(2, 51) = 21.13, p < 0.001), as well as on intolerance of uncertainty dimensions including prospective (F(2, 51) = 74.49, p < 0.001), inhibitory (F(2, 51) = 45.94, p < 0.001), and total intolerance of uncertainty (F(2, 51) = 84.42, p < 0.001), in favor of UP-A over WLC.

Conclusion

Overall, results provide a cultural application of the UP-A and support the protocol as useful for improving anxiety disorders as well as modifying of emotion regulation strategies and intolerance of uncertainty dimensions in Iranian adolescents. Future directions and study limitations are discussed.

Keywords

Adolescentsanxietycultural adaptationLMICstransdiagnosticunified protocol
Type
Original Article
Information
Psychological Medicine , Volume 54 , Issue 2 , January 2024 , pp. 385 - 398
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Copyright
Copyright © Mehdi Zemestani, 2023. Published by Cambridge University Press

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