Efficacy of a modified digital unified protocol targeting both positive and negative emotion regulation: A randomized clinical trial.

IF 6 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2026-06-01 DOI:10.1037/ccp0001010

Laura J Long,Daniella Spencer-Laitt,Audrey J Hey,Madison R Boschulte,Daniel A Teplow,Julián D Moreno-Villamizar,Alexander L Williams,Elizabeth H Eustis,Claudia Trudel-Fitzgerald,Todd J Farchione

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引用次数: 0

Abstract

OBJECTIVE The Unified Protocol (UP) has proven effective for treating emotional disorders; however, its standard format primarily focuses on regulating negative emotions. While difficulties with negative emotion regulation are common across these disorders, difficulties with positive emotion regulation are often overlooked. This study evaluated the efficacy of a digitally adapted UP incorporating positive emotion regulation strategies (internet-delivered unified protocol+). METHOD In a randomized clinical trial, 120 adults (Mage = 34.0, SD = 12.0; 73% female; 75% White) with principal anxiety, depressive, or obsessive-compulsive disorders were assigned to the internet-delivered unified protocol+ (n = 80) or standard internet-delivered unified protocol (n = 40). Both 12-week programs occurred via an online platform with asynchronous clinical support through weekly messaging. Outcomes included anxiety, depression, and stress; positive/negative affect; functional impairment; savoring; positive mental health; and flourishing. Analyses included between- and within-group effect sizes, remission comparisons, and latent growth modeling. RESULTS Both groups demonstrated statistically significant reductions in anxiety, depression, stress, negative affect, and functional impairment (standardized mean gain effect size ≈ -0.28 to -1.13) that were maintained across a 3-month follow-up. Statistically significant, small-to-moderate gains in positive mental health and flourishing (standardized mean gain effect size ≈ 0.31-0.37) were also observed and maintained. Positive affect and savoring significantly increased by Week 8 but diminished and were no longer significant at follow-up. No group differences emerged for any outcome. CONCLUSIONS Digital UP interventions were associated with symptom reduction and improvements in flourishing, but adding positive emotion regulation content did not yield incremental benefits. Future research should explore whether increased intensity or duration of these strategies improves outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

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针对积极和消极情绪调节的改进数字统一协议的有效性：一项随机临床试验。

目的：统一协议（UP）已被证明是治疗情绪障碍的有效方法；然而，其标准格式主要侧重于调节负面情绪。虽然负面情绪调节的困难在这些疾病中很常见，但积极情绪调节的困难往往被忽视。本研究评估了结合积极情绪调节策略（互联网提供的统一协议+）的数字适应性UP的疗效。方法在一项随机临床试验中，120名主要患有焦虑、抑郁或强迫症的成年人（Mage = 34.0, SD = 12.0, 73%女性，75%白人）被分配到互联网提供的统一方案+ (n = 80)或标准互联网提供的统一方案（n = 40）。这两个为期12周的项目都是通过在线平台进行的，通过每周的消息传递提供异步临床支持。结果包括焦虑、抑郁和压力；积极/消极的影响;功能障碍;品味;积极的心理健康；和繁荣。分析包括组间和组内效应大小、缓解比较和潜在增长模型。结果两组患者在焦虑、抑郁、压力、负面情绪和功能障碍方面均有统计学意义上的显著降低（标准化平均增益效应大小≈-0.28至-1.13），并在3个月的随访中得以维持。具有统计学意义的是，在积极心理健康和繁荣方面也观察到小到中度的增长（标准化平均增长效应大小≈0.31-0.37）。积极情绪和品味在第8周显著增加，但在随访中减弱，不再显著。任何结果都没有出现组间差异。结论数字UP干预与症状减轻和繁荣的改善有关，但增加积极情绪调节内容并没有产生增量效益。未来的研究应该探索是否增加这些策略的强度或持续时间可以改善结果。（PsycInfo数据库记录(c) 2026 APA，版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.