Adaptation and investigation of the effect of the unified protocol for transdiagnostic treatment of anxiety and depressive symptoms

Depressive and anxiety disorders are the most common emotional disorders; at the same time, both have high rates of current and lifetime comorbidity. The high rate of comorbidity, similarities in treatment outcomes, and commonalities in the etiology of emotion-related disorders has encouraged a transdiagnostic intervention approach applicable to a range of problems.One of thesesprogramscalled Unified Protocol in shortterm (i.e., UnifiedProcotolforEmotionalDisorders) is based on thetraditionalCognitiveBehavioralTherapy, but itsdistinguishingcharacteristic is thefocusparticularly on somecommonmechanismsfunctioning background andsomestrategies on change of thesefactors. Relevantliteraturefindingsandinferencespointedoutsomeadvantagesthatthis program maybringaboutpositivechanges in commonfactors, success of treatment of comorbidpsychologicalproblems, motivationandaccessforintervention as well as decrease in therapistburden; thus, thepresentstudyaimedto investigate the feasibility and effectiveness of the Unified Protocol on anxiety and depressive symptomsin Turkish university students with a pretest-posttest control group research design. In addition, because of their strong sensitivity to the change in anxiety and depressive symptoms, the adaptation, validity and reliability study of two measurement tools frequently used in the original protocol manual and related studies were carried out with 281 university students: Overall Anxiety Severity and Impairment Scale (OASIS) and Overall Depression Severity and Impairment Scale (ODSIS). The results of relevant analyses showed that both measurements were valid and reliabletools. The main study included 34 undergraduate students with high levels of depressive and/or anxiety complaints in DokuzEylulUniversity. They were randomly assigned to one of two conditions, namely, intervention group based on the intervention (n=17) or a waitlist control group (n=17). In order to determine the effectiveness of the Unified Protocol, 2 (intervention-control group) x 2 (pre-post test) mixed measures variance analysis was applied for the outcome measures; degree of depressive and anxiety symptoms as well as positive and negative affect, and psychological well-being. The group comparison analyses revealed a significant difference between pre-post-test scores on outcome measures in intervention group, and between internetion and control groups in these measures in posttest scores;whereas, in the beginning,there was no difference in pretest measures of both groups. In other words, it seems that the participants who took Unified Protocol reported lower levels of anxiety, depressive complaints and negative affect, while they had higher degree of positive affect and psychological well-being as compared to their beginning position and control group. The findings of this study initially imply that Unified Protocolintervention resulted in significantly greater improvement in conditions of intervention group in a different cultural context. Thus, these findings provide the first preliminary support for the potential utility of this treatment approach targeting a range of emotional disorders in Turkey.The research findings were evaluated in the light of the relevant literature and within the scope of the limitations of the study, and suggestions for academic and clinical applications were presented.