2 - (SYM 12) Examining Changes in Negative Affectivity, Stress, Depression, and Anxiety in Response to an Augmented Digital Application of the Unified Protocol

         Over the last decade, transdiagnostic interventions have become popular due to their time-efficient, cost-effective method of addressing comorbid psychiatric disorders simultaneously. Digital technologies have the potential to maximize these benefits while reducing therapist burden and promoting greater access to empirically supported treatments. The Unified Protocol (UP) is a transdiagnostic intervention that targets deficits in emotion regulation associated with neuroticism, thought to be a core underlying mechanism of anxiety and related disorders (Barlow et al., 2017). Meta-analysis of studies examining the efficacy of the UP has shown that it leads to large effect size (ES) improvements in symptoms of internalizing disorders when delivered face-to-face (Carlucci et al., 2021; Sakiris & Berle, 2019). Recently, an internet-based application of the UP (iUP) was developed, including an augmented version that targets positive affect regulation and psychological flourishing more directly (iUP+). The present research aimed to examine the efficacy of these novel digital UP applications in reducing negative affect, anxiety, depression, and stress. We hypothesized that the iUP and the iUP+ would lead to comparable improvement in these outcomes.
         The sample included participants who completed either the original iUP or iUP+ and the Positive and Negative Affect Schedule - Expanded Form (Watson & Clark, 1994) or the 21-item Depression, Anxiety, and Stress Scale (DASS; Lovibond, & Lovibond, 1995) at both baseline and post-treatment. Mixed ANOVAs were used to compare the effects of the iUP and UP+ on these main outcomes. As expected, there were main effects of time but no significant effects of treatment condition. Thus, paired samples t-tests and Cohen’s d were used to quantify change in study outcomes for the full sample. Treatment completers showed large reductions in anxiety (t(43) = 6.35, p < .001; d = .96) and stress (t(43) = 6.50, p < .001; d = .97), which reflected reliable and clinically significant change based on established benchmarks for the DASS. Moderate reductions in depression and (t(43) = 2.35, p = .02; d = .38) negative affect (t(45) = 2.62, p = .01; d = .39) were also observed. Overall, these findings suggest that digital versions of the UP lead to broad improvements in distress and symptoms of emotional disorders in a treatment-seeking sample. Treatment effects were strongest for anxiety and stress, given their large ES, though reductions in depression and negative affect were also notable.