Effectiveness of Unified Protocols for Transdiagnostic Treatment in Emotion Regulation of Mothers and Anxiety of Children with Type I Diabetes

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Keywords

Anxiety
Diabetes
Emotion regulation
Integrated transdiagnostic treatment program

How to Cite

Ghasemzadeh, sogand, & naghsh, zahra. (2020). Effectiveness of Unified Protocols for Transdiagnostic Treatment in Emotion Regulation of Mothers and Anxiety of Children with Type I Diabetes. Iranian Red Crescent Medical Journal, 22(11). https://doi.org/10.32592/ircmj.2020.22.11.145

Abstract

Background: Type I diabetes (T1DT1D) is recognized as one of the most prevalent chronic diseases in children. It is accompanied by potentially  life-threatening complications which affect the mood, personality, and emotions of children and their families.

Objectives: The present study aimed to  assess the effectiveness of the unified protocols for transdiagnostic  treatment program in emotion regulation of mothers and anxiety of children with T1D.

Methods: The present experimental ‎study was conducted using the pretest-posttest follow-up control group design. The statistical population included all children with T1D within the age range of 9-11 years T1Dand their mothers who were referred to Iran Diabetes Association in Tehran in 2019-2020. The statistical sample was selected via the convenience (purposive) sampling method from among children with T1D and their mothers, and the subjects were randomly assigned to two experimental and control groups. The Cognitive Emotion Regulation Questionnaire (CERQ) developed by Garnefski et al. and Spence Children’s Anxiety Scale (SCAS) were completed in the pretest, posttest, and follow-up. Diabetic children and their mothers received 15 sessions of the unified protocols for transdiagnostic treatment, while no special training was provided to the control group.

Results: The results of the present study indicated that the three measurements performed in pretest, posttest, and follow-up significantly differed regarding children's anxiety and mothers' emotion regulation strategies (e.g., catastrophizing, coping and acceptance, positive thinking, and blaming others) pointing to the effectiveness of transdiagnostic treatment (P= 0.000).

Conclusion: The obtained results suggested the effectiveness of the unified protocols for transdiagnostic treatment program in reducing the anxiety of children with type 1 diabetes and improving the emotion regulation of their mothers.

https://doi.org/10.32592/ircmj.2020.22.11.145
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References

  1. American Diabetes Association Standards of medical care in diabetes-2017 abridged for primary care providers. Clin. Diabetes. 2017;35:5–26. doi: 10.2337/cd16-0067. [ PubMed: 28144042].
  2. Butwicka A, Fendler W, Zalepa A, Szadkowska A, Zawodniak-Szalapska M, Gmitrowicz A, et al. Psychiatric disorders and health-related quality of life in children with type 1 diabetes mellitus. Psychosomatics. 2016;57(2):185-93. doi: 10.1016/j.psym.2015.11.001. [PubMed: 26774893].
  3. Ellison JK, Kouros CD, Papp LM, Cummings EM. Interplay between marital attributions and conflict behavior in predicting depressive symptoms. J Fam Psychol. 2016;30(2):286-95. doi: 10.1037/fam0000181. [PubMed: 26751758].
  4. Hou Y, Jiang F, Wang X. Marital commitment, communication and marital satisfaction: An analysis based on actor-partner interdependence model. Int J Psychol.. 2019;54(3):369-76. doi: 10.1002/ijop.12473. [PubMed: 29318606].
  5. Aggarwal S, Kataria D, Prasad S. A comparative study of quality of life and marital satisfaction in patients with depression and their spouses. Asian J Psychiatr. 2017;30:65-70. doi: 10.1016/j.ajp.2017.08.003.  [PubMed: 28802799].
  6. Bloch L, Haase CM, Levenson RW. Emotion regulation predicts marital satisfaction: more than a wives' tale. Emotion. 2014;14(1):130-44. doi: 10.1037/a0034272. [PubMed: 24188061].
  7. Golfenshtein N, Srulovici E, Medoff-Cooper B. Investigating parenting stress across pediatric health conditions - a systematic review. Issues Compr Pediatr Nursi. 2015:1-49. doi: 10.3109/01460862.2015.1078423. [PubMed: 26367769].
  8. Jones A, Olsen MZ, Perrild HJ, Willaing I. The psychological impact of living with diabetes: Descriptive findings from the DAWN2 study in Denmark. Prim Care Diabetes. 2016;10(1):83-6. doi: 10.1016/j.pcd.2015.03.008. [PubMed: 25890864].
  9. Curtis K, Foster K, Mitchell R, Van C. Models of care delivery for families of critically Ill children: an integrative review of international literature. J Pediatr Nurs. 2016;31(3):330-41. doi: 10.1016/j.pedn.2015.11.009. [PubMed: 26699441].
  10. Nieuwesteeg AM, Hartman EE, Aanstoot HJ, van Bakel HJ, Emons WH, van Mil E, et al. The relationship between parenting stress and parent-child interaction with health outcomes in the youngest patients with type 1 diabetes (0-7 years). Eur J Pediatr. 2016;175(3):329-38. doi: 10.1007/s00431-015-2631-4. [PubMed: 26438336].
  11. Özgüç S, Tanrıverdi D. Relations between depression level and conflict resolution styles, marital adjustments of patients with major depression and their spouses. Arch Psychiatr Nurs. 2018;32(3):337-42. Epub 2018/05/23. doi: 10.1016/j.apnu.2017.11.022. [PubMed: 29784211].
  12. Duong MT, Kelly BM, Haaland WL, Matsumiya B, Huey SJ, McCarty CA.. Mediators and moderators of a school-based cognitive-behavioral depression prevention program. Cognit Ther Res. 2016;40(5):705-16. doi: 10.1007/s10608-016-9780-2. [PubMed: 27795599].
  13. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345-65. doi: 10.1111/jcpp.12381. [PubMed: 25649325].
  14. Sloan E, Hall K, Moulding R, Bryce S, Mildred H, Staiger PK. Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clin Psychol Rev. 2017;57:141-63. doi: 10.1016/j.cpr.2017.09.002. [PubMed: 28941927].
  15. Kiecolt-Glaser JK, Jaremka L, Andridge R, Peng J, Habash D, Fagundes CP, et al. Marital discord, past depression, and metabolic responses to high-fat meals: Interpersonal pathways to obesity. Psychoneuroendocrinology. 2015;52:239-50. doi: 10.1016/j.psyneuen.2014.11.018. [PubMed: 25506778].
  16. Bentley KH. Applying the unified protocol transdiagnostic treatment to nonsuicidal self-injury and co-occurring emotional disorders: A case illustration. J clin psychol. 2017;73(5):547-58. doi: 10.1002/jclp.22452. [PubMed: 28221666].
  17. Laposa JM, Mancuso E, Abraham G, Loli-Dano L. Unified protocol transdiagnostic treatment in group format. Behav Modif. 2017;41(2):253-68. doi: 10.1177/0145445516667664. [PubMed: 27591430].
  18. Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, et al. The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA psychiatry. 2017;74(9):875-84. doi: 10.1001/jamapsychiatry.2017.2164. [PubMed: 28768327].
  19. Talkovsky AM, Green KL, Osegueda A, Norton PJ. Secondary depression in transdiagnostic group cognitive behavioral therapy among individuals diagnosed with anxiety disorders. J Anxiety Disord. 2017;46:56-64. doi: 10.1016/j.janxdis.2016.09.008. [PubMed: 27707524].
  20. Bullis JR, Fortune MR, Farchione TJ, Barlow DH. A preliminary investigation of the long-term outcome of the unified protocol for transdiagnostic treatment of emotional disorders. Compr Psychiatry. 2014;55(8):1920-7. doi: 10.1016/j.comppsych.2014.07.016. [PubMed: 25113056].
  21. Ito M, Horikoshi M, Kato N, Oe Y, Fujisato H, Nakajima S, et al. Transdiagnostic and transcultural: pilot study of unified protocol for depressive and anxiety disorders in japan. Behav Ther. 2016;47(3):416-30. doi: 10.1016/j.beth.2016.02.005. [PubMed: 27157034].
  22. Kennedy SM, Bilek EL, Ehrenreich-May J. A randomized controlled pilot trial of the unified protocol for transdiagnostic treatment of emotional disorders in children. Behav Modif. 2019;43(3):330-60. doi: 10.1177/0145445517753940. [PubMed: 29374963].
  23. Chu BC, Crocco ST, Esseling P, Areizaga MJ, Lindner AM, Skriner LC. Transdiagnostic group behavioral activation and exposure therapy for youth anxiety and depression: Initial randomized controlled trial. Behav Res Ther. 2016;76:65-75. doi: 10.1016/j.brat.2015.11.005. [PubMed: 26655958].
  24. Blake MJ, Trinder JA, Allen NB. Mechanisms underlying the association between insomnia, anxiety, and depression in adolescence: Implications for behavioral sleep interventions. Clin Psychol Rev. 2018;63:25-40. doi: 10.1016/j.cpr.2018.05.006.  [PubMed: 29879564].
  25. García-Escalera J, Valiente RM, Chorot P, Ehrenreich-May J, Kennedy SM, Sandín B. The spanish version of the unified protocol for transdiagnostic treatment of emotional disorders in adolescents (up-a) adapted as a school-based anxiety and depression prevention program: study protocol for a cluster randomized controlled trial. JMIR Res Protoc. 2017;6(8):e149. doi: 10.2196/resprot.7934. [PubMed: 28827212].
  26. Garnefski N, Kraaij V, Spinhoven P. Negative life events, cognitive emotion regulation and emotional problems. Pers Individ Dif. 2001;30(8):1311-27.
  27. Samani S, Jokar B. Check the credentials and reliability is a short form of psychological pressure and anxiety depression scale. J Soc Sci Hum Univ Shiraz. 2007;26(3):65-77. doi: 10.1007/s11948-017-9989-9. [PubMed: 29127671].
  28. Spence SH, Barrett PM, Turner CM. Psychometric properties of the spence children's anxiety scale with young adolescents. J Anxiety Disord. 2003;17(6):605-25. doi: 10.1016/s0887-6185(02)00236-0. [PubMed: 14624814].
  29. Mousavi R, Moradi AR, Farzad V, Mahdavi S. Psychometric properties of the spence children’s anxiety scale with an Iranian sample. Int J Psychol. 2007;1(1):17-26.
  30. Jakubovski E, Bloch MH. Anxiety disorder-specific predictors of treatment outcome in the coordinated anxiety learning and management (CALM) trial. Psychiatr Q. 2016;87(3):445-64. doi: 10.1007/s11126-015-9399-6. [PubMed: 26563229].
  31. Fernández-Martínez I, Morales A, Espada JP, Essau CA, Orgilés M. Effectiveness of the program Super Skills For Life in reducing symptoms of anxiety and depression in young Spanish children. Psicothema