The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) has been shown to be effective for reducing symptoms of anxiety and depression in adolescents with emotional disorders. Internet-delivered psychological treatments have great potential to improve access to evidence-based psychological therapy since they are associated with reduced human and economic costs and less social stigma. Recently, our group developed an online version of the UP-A (the iUP-A) for the treatment of emotional disorders in adolescents. The aim of this pilot trial was to test the clinical utility of the iUP-A in a small sample (n = 12) of adolescents with elevated anxiety and/or depressive symptoms. Intention-to-treat and completer analyses revealed pre- to post-intervention self-reported decreases of anxiety and depressive symptoms, anxiety sensitivity, emotional avoidance, panic disorder symptoms, panic disorder severity, generalized anxiety disorder symptoms, pathological worry, and major depressive disorder symptoms. We found high feasibility and acceptability of the program with all participants and responsible parents reporting an improvement in the adolescents’ ability to cope with emotions. Results suggest that the iUP-A may provide a new approach to improve access to treatment for anxious and depressive adolescents in Spain; however, further research must be conducted before firm conclusions can be drawn.

Anxiety and depressive symptoms are common problems in adolescence that could be addressed by means of preventive interventions. Even though transdiagnostic cognitive behavior therapy (T-CBT) is potentially an ideal strategy to deal with anxiety and depression, it has rarely been used for preventive purposes. In addition, so far, no study has used internet-delivered T-CBT to prevent anxiety and depression in adolescents. This study aimed to examine the utility of AMTE, an internet-delivered T-CBT program, for the indicated prevention of anxiety and depression in adolescents. AMTE was applied to 30 adolescents (56.7% females, age range = 12–18 years, M_age = 14.00, SD_age = 1.89) who showed subclinical symptoms of anxiety and/or depression. Participants were assessed at pre- and post-treatment and follow-up (3 months). We found that after the program, the symptoms of self-reported anxiety and depression, clinician-rated symptom severity, and self-reported and parent-reported severity of the main problems had significantly improved. In addition, there were significant improvements in anxiety sensitivity and emotional avoidance. Finally, we found high feasibility and acceptability of the program. AMTE is feasible and potentially effective for the indicated prevention of anxiety and depression as well as of clinical transdiagnostic factors, in adolescents.

Fears related to COVID-19 (“coronavirus fears”) have emerged as a new psychological effect of the current COVID-19 pandemic and have been associated with psychological distress and impairment. Other adverse effects include an increase in anxiety and depression symptoms and the respective disorders. The purpose of the current study was to examine the incremental validity of coronavirus fears and transdiagnostic factors in the prediction of the severity of anxiety and depressive disorder symptoms. A sample of 144 adolescents [aged 12–18 years, 55 boys (38.2%) and 89 girls (61.8%)] most of whom showed elevated levels of anxiety and depressive disorder symptoms completed several self-report measures online assessing coronavirus fears, transdiagnostic vulnerability and protective factors, and emotion regulation strategies. Results based on a series of hierarchical multiple regression analyses revealed that coronavirus fears, negative affect, intolerance of uncertainty, acceptance/tolerance, rumination and suppression explained unique variance in the severity of anxiety and depressive disorder symptoms. Path analysis demonstrated that acceptance/tolerance, rumination and suppression mediated the association between higher level transdiagnostic factors and the severity of major depressive disorder symptoms. Findings provide support for the hierarchical transdiagnostic model of emotional disorders and suggest that clinicians should be aware of coronavirus fears. Also, the results warrant the need to consider transdiagnostic vulnerability and protective processes in the new protocols for the treatment of emotional disorders.

Internet-delivered unified protocol for transdiagnostic treatment of emotional disorders in adolescents (iUP-A): Web application and study protocol for a randomized controlled trial. A characteristic of transdiagnostic treatment is that it targets simultaneously the core symptoms and underlying vulnerabilities of several disorders. The UP-A is a new empirically supported cognitive-behavioral therapy (CBT) protocol developed by Ehrenreich-May’s group for the transdiagnostic treatment approach of emotional disorders (i.e., depression, anxiety and related disorders) in adolescents (Ehrenreich-May et al., 2018), to be applied in a face-to-face format. Internet-delivered psychological treatments represent an emerging model to improve access to evidence-based CBT. A first aim of this study is to describe the development of a web application named Aprende a Manejar Tus Emociones (AMTE; Learn to Manage Your Emotions), designed to implement the UP-A in order to be delivered via internet (iUP-A). A second objective is to test the efficacy of the iUP-A for the treatment of depression and anxiety disorders compared to waiting list, in a randomized controlled trial. We investigated changes in a broad range of primary, secondary and transdiagnostic outcome measures.Keywords: Transdiagnostic; UP-A; iUP-A; internet-delivered CBT; AMTE; anxiety; depression.Resumen: Una característica del tratamiento transdiagnóstico consiste en que aborda simultáneamente los síntomas principales y las vulnerabilidades que subyacen a varios trastornos. El UP-A es un nuevo protocolo de terapia cognitivo-conductual (TCC) basada en la evidencia desarrollado por el grupo de Ehrenreich-May para un tratamiento transdiagnóstico de los trastornos emocionales (i.e., depresión, ansiedad y trastornos relacionados) en adolescentes (Ehrenreich-May et al., 2018), para ser aplicado en un formato cara-a-cara. Los tratamientos psicológicos dispensados a través de internet representan un modelo emergente para mejorar el acceso a la TCC basada en la evidencia. Un primer objetivo del presente estudio consiste en describir el desarrollo de una aplicación web denominada Aprende a Manejar Tus Emociones (AMTE), diseñada para implementar el UP-A con objeto de ser dispensado a través de internet (iUP-A). Un segundo objetivo es probar la eficacia del iUP-A para el tratamiento de la depresión y los trastornos de ansiedad en comparación con una lista de espera, en un ensayo controlado aleatorizado. Se investigan los cambios en un amplio rango de medidas de resultado primarias, secundarias y transdiagnósticas.Palabras clave: Transdiagnóstico; UP-A; iUP-A; TCC por internet; AMTE; ansiedad; depresión.

Impaired metacognition, the capacity to understand one's own and others' mental states, has gained increasing attention in psychosis research. Different conceptualizations, psychological treatments and assessment methods have emerged; however, there is a lack of consensus regarding the appropriate tools for clinical and research use. This systematic review had two aims: (1) to compile and organize available assessment tools and (2) to propose an index of metacognitive domains and processes. Instruments were categorized according to authorship, year of use in psychosis, outcomes assessed, language/version, administration time and type of Clinical Outcome Assessment (ClinRO, PRO or PerfO). We identified 42 studies that used 31 instruments. The tools were classified into four domains: Metacognitive Awareness, Metacognitive Capacity, Neurometacognition and Social Metacognition. Our findings highlight the diversity of the available measures and propose a framework for aligning instruments with specific reflective processes. This work represents a practical and theoretical first step toward building consensus and facilitating both the use of available tools according to practical needs and the development of an agreed‐upon definition and components of metacognition.