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

Abstract

BackgroundAnxiety and depression are common, impairing conditions that evidence high comorbidity rates in adolescence. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is one of the few existing resources aimed at applying transdiagnostic treatment principles to target core dysfunctions associated with both anxiety and depression within a single protocol. To our knowledge, this is the first study examining the efficacy of the UP-A adapted as a universal preventive intervention program.ObjectiveThe primary aim of this study is to examine whether the Spanish version of the UP-A is more effective than a waitlist (WL) control group in reducing and preventing symptoms of anxiety and depression when employed as a universal, classroom-based preventive intervention. The secondary aim is to investigate changes in a broad range of secondary outcome measures, including negative and positive affect, anxiety sensitivity, emotional avoidance, top problems ratings, school grades, depression and anxiety-related interference, self-esteem, life satisfaction, quality of life, conduct problems, hyperactivity/inattention symptoms, peer problems, prosocial behavior, school adjustment, and discipline problems. Other aims are to assess a range of possible predictors of intervention effects and to examine the feasibility and the acceptability of implementing UP-A in a prevention group format and in a school setting.MethodsA cluster, randomized, WL, controlled trial design with classroom as the unit of randomization was used in this study. Five classes including a total of 152 adolescents were randomized to the experimental or WL control groups. Participants in the experimental group received 9 55-minute sessions delivered by advanced doctoral and masters students in clinical psychology. The WL control group will receive the intervention once the 3-month follow-up assessment is completed.ResultsWe have recruited participants to the cluster randomized controlled trial (RCT) and have conducted the intervention with the experimental group. We expect the WL control group to complete the intervention in July 2017. Data analysis will take place during the second semester of 2017.ConclusionsWe expect the experimental group to outperform the WL control group at post-intervention and 3-month follow-up. We also expect the WL control group to show improvements in primary and secondary outcome measures after receiving the intervention. Results will have implications for researchers, families, and education providers.Trial RegistrationClinicaltrials.gov NCT03123991; https://clinicaltrials.gov/ct2/show/NCT03123991 (Archived by WebCite at http://www.webcitation.org/6qp7GIzcR)

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

“…The questionnaires EAN [ 31 ], CDN [ 31 ], and the total score on the RCADS-30 [ 32 ] were used as primary outcome measures. To assess transdiagnostic constructs the questionnaires PANASN [ 33 ], CASI [ 34 , 35 ], and EASI-A [ 36 , 37 ] were used. Disorder-specific symptoms of anxiety and depressive disorders were assessed through the RCADS-30 subscales [ 32 ], and the questionnaires PSWQ-11 [ 38 ], SASC-R [ 39 , 40 ], and PDSS-SR [ 39 , 40 , 41 , 42 ].…”

Protocolo unificado para el tratamiento transdiagnóstico de los trastornos emocionales en adolescentes a través de internet (iUP-A): Aplicación web y protocolo de un ensayo controlado aleatorizado

“…Se ha sugerido que posee propiedades psicométricas adecuadas y correlaciones positivas con ansiedad y depresión (Kenney y Ehrenreich-May, 2016). La consistencia interna de la versión española es elevada, con valores del coeficiente α de Cronbach entre .86 y .87 (García-Escalera et al, 2017).…”

“…La persona responde indicando el grado en que se asemeja a su vida lo indicado en cada ítem, con un rango de respuesta de 4 puntos variando entre 1 («No en absoluto») y 4 («Mucho o totalmente»). La consistencia interna de la escala es buena, habiéndose obtenido valores de α entre .81 y .89 (García-Escalera et al, 2017).…”

The Unified Protocol for Transdiagnostic Treatment of Perinatal Depression: A Case Study

“…Within the future lines, taking into account that the UP is effective in the treatment not only of depression but of other EDs, the target population could be expanded to include pregnant women with other diagnoses (e.g., adaptive disorder, eating disorder, obsessive and compulsive disorder, or other anxiety problems such as agoraphobia) that are usually addressed with specific treatment protocols (e.g., Christian & Storch, 2009; Cullinan & Gaynor, 2015). The UP could even be used as a prevention program for women who do not have any diagnosed problem, as has already been proposed in schools with adolescents (García-Escalera et al, 2017). In fact, it would suffice to include it within the birth preparation programs, making the necessary adaptations to focus on emotion-regulation strategies and not so much on specific modules for clinical population.…”