Authenticity as a Mediator of Change in the Unified Protocol for Transdiagnostic Treatment of Depressive and Anxiety Disorders

IF 2.7 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2025-10-15 DOI:10.1002/cpp.70161

So Sugita, Masaya Ito, Hiroko Fujisato, Ayako Kanie, Shun Nakajima, Todd J. Farchione, Hironori Kuga

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引用次数: 0

Abstract

Objectives

Authenticity is defined as awareness of one's internal states and actions that align with personal values, preferences and goals. Research has linked authenticity to wellbeing and lower depression and anxiety symptoms. Although authenticity has been proposed as an important process of change, there is limited empirical research examining the effect of psychotherapy on authenticity and whether changes in authenticity mediate improved mental health outcomes. This study investigated the mediating role of authenticity in psychotherapy.

Methods

This study is a secondary analysis of a randomized controlled trial including patients with depressive (n = 52) and anxiety disorders (n = 52). Multilevel models were used to assess (1) whether the Unified Protocol (UP), a transdiagnostic cognitive-behavioural treatment, improved subjective sense of authenticity as measured by the Sense of Authenticity Scale, and (2) whether changes in authenticity mediated the treatment effect on depression.

Results

At post-treatment, patients who received the UP showed significantly higher levels of self-reported sense of authenticity compared to waitlist controls (d = 0.97, 95% CI [0.28, 1.65]). This effect was maintained at the six-month follow-up. Additionally, authenticity mediated the treatment effect on depression (indirect effect: b = −6.51, SE = 2.89, 95% CI [−14.04, −1.88]), accounting for 22.90% of the total effect. This mediation remained significant when controlling for therapeutic alliance.

Conclusions

This study provides the first empirical evidence that changes in authenticity mediate outcomes in the UP. These findings suggest that authenticity represents a viable candidate for future research examining the mechanisms of psychotherapy.

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真实性在抑郁和焦虑障碍跨诊断治疗统一方案中的中介作用。

目标：真实性被定义为意识到一个人的内在状态和行为与个人价值观、偏好和目标相一致。研究表明，真实性与幸福感、抑郁和焦虑症状的减少有关。虽然真实性被认为是一个重要的变化过程，但关于心理治疗对真实性的影响以及真实性的变化是否会改善心理健康结果的实证研究有限。本研究探讨了真实性在心理治疗中的中介作用。方法：本研究是对一项随机对照试验的二次分析，该试验包括抑郁症（n = 52）和焦虑症（n = 52）。采用多水平模型来评估(1)统一方案（UP），一种跨诊断的认知行为治疗方法，是否提高了主观真实性感（通过真实性量表测量），以及(2)真实性的改变是否介导了抑郁症的治疗效果。结果：在治疗后，接受UP治疗的患者自我报告的真实性水平明显高于等候名单对照组（d = 0.97, 95% CI[0.28, 1.65]）。这种效果在六个月的随访中保持不变。此外，真实性介导了抑郁症的治疗效果（间接效应：b = -6.51, SE = 2.89, 95% CI[-14.04, -1.88]），占总效应的22.90%。当控制治疗联盟时，这种调解仍然是显著的。结论：本研究首次提供了真实性变化介导UP结果的实证证据。这些发现表明，真实性代表了未来研究心理治疗机制的可行候选。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.