Network analysis on the efficacy of the unified protocol for transdiagnostic cognitive behavioral therapy of emotional disorders

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has gained popularity as an alternative to traditional disorder-specific psychotherapies, and its detailed treatment process remains unaddressed empirically. We conducted network analyses using time series data from 123 patients (Mage = 37.9, SD = 11.2; 68.3% female) with emotional disorders who were enrolled in Japanese UP trials to explore the interplay between symptoms and functional impairment of depression and anxiety. The multilevel vector autoregressive (ML-VAR) model revealed functional impairment nodes due to depression and anxiety are central in the temporal network structure. Subsequent network comparisons showed the ML-VAR structures for non-responders were denser than the responders’ structures. On the other hand, network comparisons of the Gaussian graphical models at the beginning, middle, and end of the time series yielded null results. The findings and implications are discussed from a network perspective within the context of transdiagnostic psychotherapies.