A Comparison of the Effectiveness of Unified Protocol (UP) Transdiagnostic Treatment and Cognitive Behavioral Therapy (CBT) on Emotional Dysregulation and Distress Tolerance in Patients with Generalized Anxiety Disorder (GAD)
TL;DR
The findings indicate that both UP and CBT are effective interventions for improving emotional dysregulation and distress tolerance in patients with GAD; however, the Unified Protocol appears to be more effective, likely due to its transdiagnostic focus on core emotional processes.
Abstract
Purpose: The present study aimed to compare the effectiveness of Unified Protocol (UP) transdiagnostic treatment and Cognitive Behavioral Therapy (CBT) on emotional dysregulation and distress tolerance in patients with Generalized Anxiety Disorder (GAD). Methods and Materials: This study employed a quasi-experimental design with a pretest–posttest and follow-up structure, including two experimental groups and one control group. The statistical population consisted of individuals diagnosed with GAD in Tehran, from which sixty participants were selected through purposive sampling and randomly assigned to UP, CBT, and control groups. Data were collected using the Difficulties in Emotion Regulation Scale (DERS) and the Distress Tolerance Scale (DTS). The UP and CBT interventions were administered in twelve 90-minute group sessions, while the control group received no intervention. Data analysis was conducted using repeated measures ANOVA and Bonferroni post hoc tests in SPSS-27. Findings: The results revealed significant effects of time, group, and the interaction between time and group on emotional dysregulation and distress tolerance (p < 0.001). Both UP and CBT interventions significantly reduced emotional dysregulation and increased distress tolerance compared to the control group. Furthermore, the UP intervention demonstrated significantly greater effectiveness than CBT in improving both variables at posttest and follow-up stages, with large effect sizes indicating substantial intervention impact. Conclusion: The findings indicate that both UP and CBT are effective interventions for improving emotional dysregulation and distress tolerance in patients with GAD; however, the Unified Protocol appears to be more effective, likely due to its transdiagnostic focus on core emotional processes. These results support the application of UP as a comprehensive and flexible treatment approach for anxiety disorders.