Objective: An important subject in evaluation of the efficacy of treatments is to examine how the intervention is effective and to identify the consequences of that treatment. In this regard, the current study investigates the role of emotion regulation as the mediator of the treatment outcomes of therapy using the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders. Method: This article describes a double-blind randomized clinical trial. A sample of 26 individuals was selected based on cut-off scores for the Beck Depression Inventory and Beck Anxiety Inventory and their final diagnoses were confirmed with the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV). The sample was randomly divided into two groups: control and treatment (13 patients each). The treatment group received 20 one-hour UP sessions. The Beck Depression Inventory, the Beck Anxiety Inventory, and the Difficulties in Emotion Regulation Scale were administered at two stages, pre-treatment and post-treatment. Results: The UP reduced anxiety and depression in patients through improvement in emotion regulation. Furthermore, the results showed that the difficulty engaging in goal-directed behavior and non-acceptance of emotional response subscales were capable of predicting 62% of variance in anxiety scores. In turn, two subscales, difficulty engaging in goal-directed behavior and lack of emotional clarity, predicted 72% of variance in depression scores. Conclusion: Emotion regulation can be considered as a potential mediating factor and as predictive of outcomes of transdiagnostic treatment based on the UP. Clinical trial registration: Iranian Registry of Clinical Trials, IRCT2017072335245N1.

Transdiagnostic approaches emphasize on the share underlying features of emotional disorders. In their view, these transdiagnostic factors play an important role in the etiology, maintenance, and treatment of emotional disorders. This study aimed to investigate the transdiagnostic factors as the potential mechanisms of change in the Unified Protocol (UP) for the transdiagnostic treatment of emotional disorders outcomes. The present study is a randomized clinical trial. Twenty-six individuals were selected based on the Beck anxiety inventory and Beck depression inventory and randomly assigned into two groups of control and treatment (n=13). The treatment group received 20 one-hour individual UP sessions. Beck Depression Inventory, Beck Anxiety Inventory, Difficulty in emotion regulation scale, Intolerance of Uncertainty scale and Acceptance and Action questionnaire were carried out in all three phases. UP enhances the difficulty in emotion regulation (large effect size, SEsg=1.81), intolerance of uncertainty (SEsg=1.91), and experiential avoidance (SEsg=1.78). In addition, the results of linear regression show the association between changes in anxiety and depression with changes in transdiagnostic factors. The difficulty in emotion regulation, intolerance of uncertainty and experiential avoidance can be considered as the potential mechanism of change in improving UP outcomes.

Background: Midwives' stress can have negative consequences on their emotional state, burnout, and poor quality of midwifery care. This study aimed to determine the effectiveness of an adapted mindfulness-based stress management program on perceived stress and the emotional regulation of midwives.Methods: The study was a parallel randomized clinical trial on the midwives working in general hospitals of Zanjan, Iran. In this study, 121 midwives registered to participate based on the census sampling method were screened using a cut point of ≥ 28 in the Perceived Stress Scale (PSS). From the initial sample, 42 subjects had inclusion criteria assigned to two groups of control (n = 21) and intervention (n = 21) using online random allocation. The intervention group received an 8-week adapted mindfulness-based stress management program. This program emanates from the Kabat-Zinn's MBSR program, which has been adjusted according to the Iranian culture. The ANCOVA and repeated measure analysis of variance test were used to compare groups over time.Results: The results showed that the group intervention effectively affected perceived stress (P = 0.001) and difficulty in emotion regulation during the post-intervention period (P = 0.001). Moreover, the interventions were effective in emotion regulation (P = 0.003), but it was not effective on perceived stress (P = 0.125) at the 3-month follow-up.Conclusions: This adapted mindfulness-based program successfully reduced stress and increased emotion regulation strategies in midwives; however, the long-term outcomes of this treatment program need further consideration.

The Contrast avoidance model (CAM) suggests that individuals with generalized anxiety disorder (GAD) avoid negative emotional contrasts (shifts) by creating and sustaining negative emotions through worry, and the main fear in these individuals is negative emotional contrasts. The purpose of the present study is to review studies on the CAM and its underlying assumptions, studies supporting and criticizing the model, and emotional factors related to the development of contrast avoidance (CA) tendencies with a focus on the transdiagnostic nature of the CAM and respective principles. Moreover, we reviewed a two-pronged treatment method based on the CAM. Finally, we proposed several research suggestions and emphasized on the importance of studying different aspects of the CAM in order to support its applicability to emotional disorders other than GAD.

Social Anxiety Disorder (SAD) is considered as prevalent, chronic, and debilitating, with complex symptomatology. Various theories and psychopathological models have been purposed to explain SAD. This article will try to focus and emphasis on the concept of Anxiety Sensitivity (AS) and its role in perceiving anxiety and its treatment. The AS refers to the fear of “somatic sensations” related to anxiety and seems to play an important role in the onset and maintenance of anxiety disorders, including SAD. It seems that AS can play a role in various ways, such as fear of showing anxiety related somatic symptoms, fear of cognitive dyscontrol, and fear of losing control of mental abilities. Considering the SAD etiological models, they generally emphasize on the role of cognitive processing and underlying vulnerabilities in the development of this disorder. However, these models have not considered the role of AS directly, but the precise investigation of etiological models showed that the core elements of these models have implicitly regarded this construct. Altogether, incorporating Anxiety Sensitivity into the treatment model could further enhance the understanding of the symptomatology, as well as its dynamic and treatment modality.

Problematic social media use can be characterized as compulsive or excessive engagement with social media applications that have addictive qualities. Research has highlighted a strong link between self-control and academic procrastination. Therefore, the primary aim of this study is to explore the connection between problematic social media use and academic procrastination, with self-control acting as a mediator. This study is cross-sectional and aims to describe and analyze simple and multiple-variable relationships within the framework of structural equation modeling. The participants of this study comprised 665 students (female 50.8% M-age 21.72). The survey was conducted online, and the respondents consented to participate in the study. Hierarchical regression revealed that problematic social media use (β = .238, p < .001) and self-control (β = −.691, p < .001) were independent factors of academic procrastination; the SEM results demonstrated that self-control fully mediated the relationship between problematic social media use and academic procrastination; the bootstrap method revealed that the bounds of the CI did not contain 0, confirming the significance of this mediating effect. Problematic social media use can positively predict academic procrastination, and this relationship is fully mediated by self-control.