Within-person changes in aversive reactivity predict session-to-session reductions in anxiety and depression in the unified protocol

Stephen A. Semcho, Matthew W. Southward, Nicole E. Stumpp, Michelle M. Smith, Martina Fruhbauerova, Shannon Sauer-Zavala

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

The Unified Protocol (UP) theoretically leads to reductions in emotional disorder symptoms by reducing aversive reactions to emotions. However, aversive reactions can take many forms (e.g., non-acceptance, behavioral avoidance). We examined if (1) multiple aspects of aversive reactivity predicted session-to-session changes in anxiety and depression in the UP, (2) these aspects reflected a single latent construct, and (3) changes in this latent construct predicted changes in anxiety and depression. Participants (N = 70, M age = 33.74, 67.1% female, 74.3% white) completed six sessions of UP modules and measures of aversive reactivity, anxiety, and depression before each session. We used hierarchical linear modeling and random-intercept cross-lagged panel models to test aspects of aversive reactivity and a latent factor of aversive reactivity, respectively, as predictors of session-to-session changes in anxiety and depression. Within-person improvements in four of five aspects of aversive reactivity predicted decreases in anxiety, and improvements in two aspects predicted decreases in depression. However, within-person improvements in latent aversive reactivity predicted decreases in anxiety at five sessions and in depression across all sessions. These results add to the growing literature highlighting the role of aversive reactivity as a potential transdiagnostic process involved in improvements in emotional disorder symptoms during treatment.

Original languageEnglish
Pages (from-to)760-773
Number of pages14
JournalPsychotherapy Research
Volume34
Issue number6
DOIs
StatePublished - 2024

Bibliographical note

Publisher Copyright:
© 2023 Society for Psychotherapy Research.

Keywords

  • anxiety
  • aversive reactivity
  • depression
  • mechanisms
  • transdiagnostic
  • within-person

ASJC Scopus subject areas

  • Clinical Psychology

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