Assessing Theories of State and Trait Change in Neuroticism and Symptom Improvement in the Unified Protocol

Nicole E. Stumpp, Matthew W. Southward, Shannon Sauer-Zavala

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Researchers have shown neuroticism decreases with treatment (Roberts et al., 2017), although it is unclear if this reflects fleeting state-level changes (state-artifact position) or trait-level change (cause-correction hypothesis). These theories further propose that changes in neuroticism predict symptom change (cause-correction hypothesis) or are predicted by symptom change (state-artifact position). We compared these theories in a clinical trial of the Unified Protocol (UP). Participants (N = 38; Mage = 34.55, 71.1% female, 78.9% Caucasian) meeting DSM-5 criteria for a primary emotional disorder completed up to 12 weekly sessions of the UP. Neuroticism exhibited state-level changes by Session 6 but trait-level changes by Session 12. Within-person reductions in neuroticism exhibited bidirectional relations with anxiety symptom change but predicted unidirectional session-to-session reductions in depression. These findings provide relatively more nuanced support for the cause-correction hypothesis that the UP leads to trait changes in neuroticism that tend to precede symptom change.

Original languageEnglish
Pages (from-to)93-105
Number of pages13
JournalBehavior Therapy
Volume55
Issue number1
DOIs
StatePublished - Jan 2024

Bibliographical note

Publisher Copyright:
© 2023 Association for Behavioral and Cognitive Therapies

Keywords

  • Unified Protocol
  • anxiety
  • change mechanisms
  • depression
  • neuroticism

ASJC Scopus subject areas

  • Clinical Psychology

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