Transdiagnostic treatment of emotional disorders for women with multiple sclerosis: a randomized controlled trial

Abstract

Background Multiple sclerosis (MS) is a chronic, unpredictable, neurodegenerative disease, significantly associated with psychological, behavioral, cognitive, and emotional consequences. MS is more common in females than males and frequently affects women during their reproductive years. Despite the frequent mental disorders, comorbidities, and emotional problems in People with MS (PwMS), these conditions are too often underdiagnosed and undertreated. Objective This study aimed to examine the efficacy of a group format of the Unified Protocol (UP) for the Transdiagnostic treatment of depression and anxiety disorders in females with MS. Methods In the present study, Sixty-four adult females diagnosed with MS were randomized to either the UP (n = 32) or treatment-as-usual conditions. The assessment protocol included semi-structured clinical interviews and self-reports evaluating diagnostic criteria, depression, anxiety and worry symptoms, emotional regulation, and affectivity. Results Repeated measure analysis of variance (ANOVA) revealed that the UP significantly improved depression scores [Cohen’s d = − 2.11, 95% CI (− 2.72, − 1.50)], anxiety scores [Cohen’s d = − 3.34, 95% CI (− 4.01, − 2.58)], positive and negative affect scale (PANAS)-positive affect scores [Cohen’s d = 1.46, 95% CI (1.46, 2.01)], PANAS-negative affect scores [Coen’s d = − 2.21, 95% CI (− 2.84, − 1.60)], difficulties emotion regulation scale scores [Cohen’s d = 1.40, 95% CI (− 0.87, − 0.03)], and Worry scale scores [Cohen’s d = − 0.45, 95% CI (− 0.95, − 0.04)] at the end of treatment relative to compared to the control condition. Also, treatment gains were maintained at the three-month follow-up (p < 0.001). Conclusion The findings provide the support that the UP could be an additional efficient psychological treatment for females with MS. ISRCTN Number: ISRCTN95459505.

Psychometric validation of the Persian version of the Emotional Style Questionnaire

“…Facilitating psychological resilience for vulnerable groups (e.g., healthcare staff, individuals with a mental disorder), particularly those assigned to the front lines of the COVID-19 crisis, is arguably one of the highest priorities during the pandemic (Santarone, McKenney, & Elkbuli, 2020). Note: CFI = comparative fit index; TLI = Tucker-Lewis index; RMSEA = root mean square error of approximation (RMSEA); CI = confidence interval Self-awareness can facilitate treatment from trauma and find productive solutions in event-based traumatic situations (Nazari, Aligholipour & Sadeghi, 2020). Clinical research has suggested health benefits of body awareness for patients with a variety of diagnoses.…”

Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Medical Conditions: A Systematic Review

“…Of the nine research studies included in the systematic review, only one was a prevention study [ 43 ], while the rest were treatment studies. Most were published in the USA ( n = 4) [ 43 , 44 , 45 , 46 ] and Iran ( n = 4) [ 40 , 47 , 48 , 49 ], while the remaining study was published in Sweden [ 50 ], between 2012 and 2020. The sample size of the different research works ranged from 2 to 70 participants.…”

“…Only in one of the included articles were the participants aged under 18 years [ 46 ]. In relation to the sample’s genders, three studies included only women [ 43 , 47 , 48 ] and one included an exclusively male sample [ 45 ]. Of the remaining five [ 40 , 44 , 46 , 49 , 50 ], the proportion of participants was mostly women, 60% versus 40%.…”

“…The included research studies targeted different medical conditions, specifically: breast cancer [ 46 ]; irritable bowel syndrome [ 50 ]; HIV [ 44 ]; chronic pain [ 44 , 50 ]; idiopathic Parkinson’s disease [ 46 ]; multiple sclerosis [ 48 , 49 ]; and infertility problems [ 47 ]. The most frequent EDs were anxiety disorders and depression.…”

“…In design terms, two were pilot studies done with a single group [ 43 , 45 ], two were a single-case experimental design [ 46 , 50 ], one was a case study [ 44 ], and four were RCTs [ 40 , 47 , 48 , 49 ]. In the RCTs, the control condition was a waiting list in one [ 40 ], in which they received usual pharmacological treatment, as well as information about the medical condition, and an active condition in the remaining three research studies.…”