Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children with Comorbid Anxiety and Depressive Disorders: A Case Study
Subject Areas :Firouzeh Zarghami 1 , Mohammad Reza Shaeiri 2 * , Zahra Shahrivar 3
1 -
2 -
3 -
Keywords: unified protocol, transdiagnostic treatment anxiety depressioncomorbidity ,
Abstract :
The purpose of the present study was to evaluate the initial efficacy of the new unified protocol of transdiagnostic treatment for children with emotional disorders (UP-C) on reducing symptoms of anxiety disorders and comorbid depression in Iranian children aged 8 to 11 years. In this study, a 15-session UP-C within a single-case experimental design with pre-test, post-test, and one-month follow-up was conducted on a 9-year-old child with separation anxiety disorder, social anxiety disorder, and major depressive disorder (as comorbid disorder). To collect data, Kiddie Schedule for Affective Disorder and Schizo-phrenia- Present and Lifetime Version (K SADS-PL), Child Behavior Checklist (CBCL), Screen for Child Anxiety Related Disorders (SCARED) and, Children Depression Invento-ry (CDI) were used. Results of graph-chart analysis and percentage change index showed that at the end of treatment and one-month follow-up period, there were significant statistical and clinical changes in both anxiety disorders and depression disorder (as comorbid disorder).
اکبری، مهدی؛ روشن، رسول؛ شعبانی، امیر؛ فتی، لادن؛ شعیری، محمدرضا؛ و ضرغامی، فیروزه (1393). مقایسه اثربخشی درمان فراتشخیصی مبتنی بر افکار تکرارشونده منفی با درمان فراتشخیصی یکپارچه در درمان بیماران مبتلا به اختلالهای اضطرابی و افسردگی همایند: کارآزمایی بالینی تصادفی. مجله روانپزشکی و روانشناسی بالینی ایران، 21 (2)، 107-88.
اِهِرنریچ¬ ـ¬ می، جیل؛ کندی، سارا؛ شرمن، جامی؛ بیلک، امیلی؛ بازلا، برایان؛ بِنِت، شنون؛ و بارلو، دیوید (1398). پروتکل درمان یکپارچه اختلالات هیجانی کودکان و نوجوانان (راهنمای درمانگر، (ترجمه فیروزه ضرغامی، مهدی اکبری و فاطمه سروری). تهران: ارجمند، (تاریخ انتشار به زبان اصلی، 2017).
اِهِرنریچ ¬ـ¬ می. جیل؛ کندی، سارا؛ شرمن، جامی؛ بیلک، امیلی؛ و بارلو، دیوید (1398). پروتکل درمان یکپارچه اختلالات هیجانی کودکان؛ کتاب تمرین کودکان، (ترجمه فیروزه ضرغامی). تهران: ارجمند، (تاریخ انتشار به زبان اصلی، 2017).
بخشی¬پور، عباس؛ محمودعلیلو، مجید؛ فرنام، علیرضا؛ و عبدی، رضا (1392). ارزیابی کارایی درمان فراتشخیصی در کاهش شدت نشانه¬های افراد مبتلا به اختلال اضطراب فراگیر همراه با اختلال هیجانی همایند. فصلنامه پژوهش-های نوین روانشناختی، 8 (32)، 74-41.
دهشیری، غلامرضا؛ نجفی، محمود؛ منصوره، شیخی؛ و حبیبی عسگرآباد، مجتبی (1388). بررسی مقدماتی ویژگی¬های روان¬سنجی پرسشنامه افسردگی کودکان (CDI). خانواده پژوهی، 5 (18)، 177-159.
رجبی، غلامرضا (1386). بررسی اعتبار و روایی پرسشنامه افسردگی (CDI) در نوجوانان 13 تا 15 ساله. مجله روانشناسی و علوم تربیتی (دانشگاه تهران)، (75)، 46-23.
زمستانی، مهدی؛ و ایمانی، مهدی (1395). اثربخشی درمان فراتشخیصی بر نشانه¬های افسردگی، اضطراب، و تنظیم هیجان. روانشناسی معاصر، (1)11، 32-21.
محمدی، ابوالفضل؛ بهروز، بیرشک؛ و غرایی، بنفشه (1392). مقایسه اثربخشی گروه درمانی فراتشخیصی و گروه درمانی شناختی بر فرایندهای تنظیم هیجان. مجله روانپزشكي و روانشناسي باليني ايران، 19(3)، 194-187.
هومن، فرزانه؛ مهرابی¬زاده هنرمند، مهناز؛ زرگر، یدا...؛ و داوودی، ایران (1394). اثربخشی درمان فراتشخیصی بر علائم اضطراب، افسردگی، راهبردهای شناختی تنظیم هیجان و عملکرد عمومی زنان مبتلا به اضطراب و افسردگی همبود. مجله دانشگاه علوم پزشکی فسا، 5(4)، 563-551.
يزدخواستي، فریبا؛ و عريضي، حمیدرضا (1390). هنجاريابي سه نسخه كودك، پدر مادر، و معلم سياهه رفتار كودك در شهر اصفهان. مجله روانپزشكي و روانشناسي باليني ايران، 17 (1)، 70-60. Achenbach, T. M. (1991). Integrative guide for the 1991 CBCL/4-18, YSR and TRF profiles. Burlington: Department of Psychiatry, University of Vermont.
Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2the ed.). New York: Guilford Press.
Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B., & Ehrenreich-May, J. (2011). The unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. New York, NY: Oxford University Press.
Barlow, D., Allen, L., & Choate, M. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205-230.
Bélanger, L., Harvey, A. G., Fortier-Brochu, É., Beaulieu-Bonneau, S., Eidelman, P., Talbot, L., & Morin, C. M. (2016). Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia. Journal of Consulting and Clinical Psychology, 84(8), 659-667.
Boisseau, C. L., Farchione, T. J., Fairholme, C. P., Ellard, K K., & Barlow, D. H. (2010). The development of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: A case study. Cognitve and Behavioral Practice, 17(1), 102-113.
Brown, T. A., & Barlow, D. H. (2009). A proposal for a dimensional classification system based on the shared features of the DSM-IV anxiety and mood disorders: Implications for assessment and treatment. Psychological Assessment, 21(3), 256-271.
Chorpita, B. F., & Barlow, D. H. (1998). The development of anxiety: The role of control in the early environment. Psychological Bulletin, 124(1), 3-21.
Crawley, S. A., Beidas, R. S., Benjamin, C. L., Martin, E., & Kendall, P. C. (2008). Treating socially phobic youth with CBT: Differential outcomes and treatment considerations. Behavioural and Cognitive Psychotherapy, 36(4), 379-389.
Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. H. (2016). How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry, 15(3), 245-258.
Cummings, C. M., Caporino, N. E., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. American Psychological Association, 140(3), 816-845.
Curry, J., Rohde, P., Simons, A., Silva, S., Vitiello, B., Kratochvil, C., & March, J. (2006). Predictors and moderators of acute outcome in the treatment for adolescents with depression study (TADS). Journal of the American Academy of Child & Adolescent Psychiatry, 45(12), 1427-1439.
Davis, L., Barlow, D., & Smith, L. (2010). Comorbidity and the treatment of principal anxiety disorders in a naturalistic sample. Behavior Therapy, 41(3), 296-305.
Ehrenreich, J. T., Goldstein, C. M., Wright, L. R., & Barlow, D. H. (2009). Development of a unified protocol for the treatment of emotional disorders in youth. Child & Family Behavior Therapy, 31 (1), 20-37.
Ehrenreich-May, J., & Bilek, E. L. (2012). The development of a transdiagnostic cognitive behavioral group intervention for childhood anxiety disorders and co-occurring depression symptoms. Cognitive and Behavioral Practice, 19 (1), 41-55.
Ehrenreich-May, J., Kennedy., S., M., Sherman, J., A. Bilek, E., L. Buzzella, B., A., Bennett, S., M., & Barlow, D., H. (2018). Unified protocol for transdiagnostic treatment of emotional disorders in children and adolescents. New York: Oxford university Press.
Ehrenreich-May, J., Kennedy., Sarah, M., Sherman, J., A. Bilek, E., & L. Barlow, D., H. (2018). Unified protocol for transdiagnostic treatment of emotional disorders in children. New York: Oxford university Press.
Ehrenreich-May, J., Queen, A.H., Bilek, E., Remmes, C., & Marciel, K. (2012). The unified protocols for the treatment of emotional disorders in youth. In J. Ehrenreich-May & B. Chu (Eds.), Transdiagnostic mechanisms and treatment of youth psychopathology. New York, NY: Guilford Press.
Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010). Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17(1), 88-101.
Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R., Gallagher, M. W., & Barlow, D. H. (2012). The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: A randomized controlled trial. Behavior Therapy, 43(3), 666-678.
Fox, N. A., Nichols, K. E., Henderson, H. A., Rubin, K., Schmidt, L., Hamer, D., & Pine, D. S. (2005). Evidence for a gene-environment interaction in predicting behavioral inhibition in middle childhood. Psychological Science,16(12), 921-926.
Garber, J., & Weersing, V. R. (2010). Comorbidity of anxiety and depression in youth: Implications for treatment and prevention. Clinical Psychology: Science and Practice, 17, 293-306.
Ghanizadeh, A., Mohammadi, M. R., & Yazdanshenas, A. (2006). Psychometric properties of the Farsi translation of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. BMC psychiatry, 6, 10. https://doi.org/10.1186/1471-244X-6-10
Gladstone, G. L., Parker, G. B., Mitchell, P. B., Wilhelm, K. A., & Malhi, G. S. (2005). Relationship between self-reported childhood behavioral inhibition and lifetime anxiety disorders in clinical sample. Depression and Anxiety, 22 (3), 103-113.
Horn, P. J., & Wuyek, L. A. (2010). Anxiety disorders as a risk factor for subsequent depression. International Journal of Psychiatry in Clinical Practice, 14, 244-247.
Kendall, P. C., Compton, S. N., Walkup, J. T., Birmaher, B., Albano, A. M., Sherrill, J., & Piacentini, J. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders, 24, 360-365.
Kendall, P. C., Chu, B. C., Pimentel, S. S., & Choudhury, M. (2000). Treating anxiety disorders in youth. In P Kendall,. (Ed.), Child and adolescent therapy: Cognitive–behavioral procedures (pp. 235-287) (2nd ed.). New York,NY Guilford Press.
Perez-Edgar, K., & Fox, N. A. (2005). Temperament and anxiety disorders. Child & Adolescent Psychiatric Clinics of North America, 14, 681-706.
Rabie, M., Khoramdel, K., Zerehpush, A., Palahang, H., & Hojatkhah. M. (2012). Validity of the Questionnaire for the Revised Version of the Screen for Child Anxiety Related Emotional Disorders (SCARED-41). Zahedan Journal of Research in Medical Sciences, 16(5), 67-63
Shafran, R., Wroe, A., Nagra, S., Pissaridou, E., & Coughtrey, A. (2018). Cognitive behaviour treatment of co-occurring depression and generalised anxiety in routine clinical practice. PLOS ONE, 13(7), 1-13.
Shahrivar, Z., Kousha, M., Moallemi, Sh., Tehrani-Doost, M., & Alaghband-Rad, J. (2008). The reliability and validity of Kiddie Schedule for Affective Disorders and Schizophrenia – Present and Life-time Version – Persian Version. Journal of Child and Adolescent Mental Health, 15(2), 97-102.
Tehrani-Doost, M., Shahrivar, Z., Pakbaz, B., Rezaie, A., & Ahmadi, F. (2011). Normative data and psychometric properties of the Child Behavior Checklist and Teacher Rating Form in an Iranian community sample. Iranian Journal of Pediatrics, 21(3), 331-342.
Twomey, C., O’Reilly, G., & Byrne, M. (2015). Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: a meta-analysis. Family Practice, 32(1), 3-15.
Walkup, J. T., Albano, A. M., Piacentini , J., Birmaher, B., Compton, S.N, Sherrill, J. T., Ginsburg, G. S, Rynn M. A., McCracken. J., Waslick, B., Iyengar, S., March, J.S., & Kendall, P.C. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 368(5),490.
Weems, C. F., Zakem, A. H., Costa, N. M., Cannon, M. F., & Watts, S. E. (2005). Physiological response and child anxiety: Association with symptoms of anxiety disorders and cognitive bias. Journal of Clinical Child & Adolescent Psychology, 34(4), 712-723.