There has recently been increased interest in the study of transdiagnostic
mechanisms and therapies. Targeting transdiagnostic mechanisms rather than using a
single disorder approach should increase efficiency of therapeutic interventions, but only
if the proper mechanisms can be identified. Low distress tolerance and difficulties with
emotion regulation are hypothesized as transdiagnostic mechanisms associated with
anxiety disorders and worry. Due to the high comorbidity and prevalence of anxiety
disorders and their shared symptoms of pathological worry, understanding these
transdiagnostic mechanisms is important to the development of more effective and
efficient treatments. This study used a multiple baseline, single-case experimental design
to evaluate the efficacy of emotion regulation skills training for pathological worry and
low distress tolerance in outpatients with anxiety disorders.
Eight participants (6 women, 2 men) with at least one diagnosed anxiety disorder
were randomized into a 2- or 4-week baseline period. The average age of participants was
29.1 (SD = 8.2; range 19 to 42). Participants completed weekly and daily assessments
throughout the study, attended 7 sessions of treatment, and underwent a final diagnostic
assessment 4 weeks after completing treatment. Emotion regulation skills training was
hypothesized to increase distress tolerance, reduce worry, and lead to a remission in
anxiety disorder diagnoses.
Overall, the hypotheses were partially supported. Six participants displayed a
reliable reduction in worry and 5 experienced an increase in distress tolerance at the
follow-up assessment. Most participants still met criteria for at least one anxiety disorder
after completing the study, indicating continued functional impairment from symptoms.
Only 2 participants experienced complete remission of all clinical diagnoses. The results
failed to show a consistent pattern of improvement, indicating that emotion regulation
skills training alone may not be sufficient for robust, sustained reductions in anxiety
disorder symptoms. However, results do support that worry and emotional distress
tolerance can be changed through emotion regulation skills training. The small sample
size limits the test of hypotheses. Suggestions for future research based on this study
include incorporating interpersonal emotion regulation strategies with this treatment
approach, repeating the treatment module to facilitate mastery of skills, or utilizing a
group format for skills development.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/41965 |
| Date | 28 January 2021 |
| Creators | Correa, Jeannette Kristine |
| Contributors | Brown, Timothy |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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