Efficacy of transdiagnostic cognitive­-behavioral therapy for anxiety and depression in adults, children and adolescentsA meta­-analysis

  1. Julia García-Escalera 1
  2. Paloma Chorot 1
  3. Rosa M. Valiente 1
  4. José M. Reales 1
  5. Bonifacio Sandín 1
  1. 1 Universidad Nacional de Educación a Distancia
    info

    Universidad Nacional de Educación a Distancia

    Madrid, España

    ROR https://ror.org/02msb5n36

Zeitschrift:
Revista de psicopatología y psicología clínica

ISSN: 1136-5420

Datum der Publikation: 2016

Ausgabe: 21

Nummer: 3

Seiten: 147-175

Art: Artikel

DOI: 10.5944/RPPC.VOL.21.NUM.3.2016.17811 DIALNET GOOGLE SCHOLAR lock_openOpen Access editor

Andere Publikationen in: Revista de psicopatología y psicología clínica

Zusammenfassung

This meta-­analysis examined the effect of transdiagnostic cognitive­-behavioral therapy (T­-CBT) in adults, children, and adolescents with emotional disorders, exploring the effects of possible moderator variables on efficacy. In contrast with previous reviews, only studies employing transdiagnostic theory­-based protocols were included. A total of 48 studies reporting on 6291 participants were identified. Treatment efficacy was examined using a random effects model and taking into account pre­- and post­-treatment data. Results within the adult population showed large overall effect sizes on anxiety (randomized con­trolled trials [RCTs]: g = 0.80; Uncontrolled studies: g = 1.02) and depression (RCTs: g = 0.72; Uncontrolled studies: g = 1.08) that were stable at follow up. Preliminary analysis with children and adolescents showed medium effect sizes on anxiety (g = 0.45) and depression (g = 0.50). No significant differences between T­-CBT and disorder­-specific CBT were found. Overall, results support the efficacy of T­-CBT for emotional disorders.

Bibliographische Referenzen

  • Aldao, A. (2012). Emotion regulation strategies as transdiagnostic processes: A closer look at the invariance of their form and function. Revista de Psicopatología y Psicología Clínica, 17(3), 261­277.
  • Andersson, G., Nordgren, L. B., Buhrman, M., & Carlbring, P. (2014). Psychological treatments for depression delivered via the internet and supported by a clinician: An update. Revista de Psicopatología y Psicología Clínica, 19(3), 217­225.
  • Barajas, S. (2015). Evitación y psicopatología: Un estudio a través de una tarea experimental y su relación con medidas de autoinforme. Revista de Psicopatología y Psicología Clínica, 20(1), 63­73.
  • Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35(2), 205­230.
  • Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B., ... Ehrenreich­May, J. (2011). Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide. New York, NY, US: Oxford University Press.
  • Bell, A. C., & D’Zurilla, T. J. (2009). Problem­-solving therapy for depression: A meta­analysis. Clinical Psychology Review, 29(4), 348­353.
  • Belloch, A. (2012). Propuestas para un enfoque transdiagnóstico de los trastornos mentales y del comportamiento: Evidencia, utilidad y limitaciones. Revista de Psicopatología y Psicología Clínica, 17(3), 295­311.
  • Bilek, E. L., & Ehrenreich­-May, J. (2012). An open trial investi­gation of a transdiagnostic group treatment for children with anxiety and depressive symptoms. Behavior Therapy, 43(4), 887­897.
  • Birmaher, B., Ryan, N. D., Williamson, D. E., Brent, D. A., Kaufman, J., Dahl, R. E., ...Nelson, B. (1996). Childhood and adolescent depression: A review of the past 10 years. Part I. Journal of the American Academy of Child & Adolescent Psychiatry, 35(11), 1427­1439.
  • Bolton, P., Lee, C., Haroz, E. E., Murray, L., Dorsey, S., Robin­ son, C., ... Bass, J. (2014). A transdiagnostic community­-based mental health treatment for comorbid disorders: Development and outcomes of a randomized controlled trial among bur­ mese refugees in thailand. PLoS Med, 11(11), e1001757.
  • Botella, J., & Sánchez-­Meca, J. (2015). Meta­análisis en ciencias sociales y de la salud [Meta­analysis in social and health sciences]. Madrid, Spain: Sintesis.
  • Brown, T., Antony, M., & Barlow, D. (1995). Diagnostic comor­bidity in panic disorder: Effect on treatment outcome and course of comorbid diagnoses following treatment. Journal of Consulting and Clinical Psychology, 63(3), 408.
  • Brown, T., & Barlow, D. (2002). Classification of anxiety and mood disorders. Anxiety and its Disorders: The Nature and Treatment of Anxiety and Panic, 2, 292­327.
  • Bullis, J. R., Sauer­-Zavala, S., Bentley, K. H., Thompson­-Hol­lands, J., Carl, J. R., & Barlow, D. H. (2015). The unified protocol for transdiagnostic treatment of emotional disorders: Preliminary exploration of effectiveness for group delivery. Behavior Modification, 39(2), 295­321.
  • Chartier, I. S., & Provencher, M. D. (2013). Behavioural activa­tion for depression: Efficacy, effectiveness and dissemination. Journal of Affective Disorders, 145(3), 292­299.
  • Chu, B. C., Colognori, D., Weissman, A. S., & Bannon, K. (2009). An initial description and pilot of group behavioral activation therapy for anxious and depressed youth. Cognitive and Behavioral Practice, 16(4), 408­419.
  • Chu, B. C., Crocco, S. T., Esseling, P., Areizaga, M. J., Lindner, A. M., & Skriner, L. C. (2016). Transdiagnostic group behav­ioral activation and exposure therapy for youth anxiety and depression: Initial randomized controlled trial. Behaviour Research and Therapy, 76, 65­75.
  • Chu, B. C., Johns, A., & Hoffman, L. (2015). Transdiagnostic be­ havioral therapy for anxiety and depression in schools. In Cognitive and behavioral interventions in the schools (pp. 101­118). New York: Springer.
  • Chu, B. C., Hoffman, L., Johns, A., Reyes-­Portillo, J., & Hansford, A. (2014). Transdiagnostic behavior therapy for bullying­re­ lated anxiety and depression: Initial development and pilot study. Cognitive and Behavioral Practice, 22(4), 415­429.
  • Clark, D. A. (2009). Cognitive behavioral therapy for anxiety and depression: possibilities and limitations of a transdiagnostic perspective. Cognitive Behaviour Therapy, 38(S1), 29­34.
  • Cohen, J. (1992). Statistical power analysis. Current directions in psychological science, 1(3), 98­101.
  • Craske, M. G. (2012). Transdiagnostic treatment for anxiety and depression. Depression and Anxiety, 29(9), 749­753.
  • Craske, M. G., Farchione, T. J., Allen, L. B., Barrios, V., Stoyano­ va, M., & Rose, R. (2007). Cognitive behavioral therapy for panic disorder and comorbidity: More of the same or less of more? Behaviour Research and Therapy, 45(6), 1095­1109.
  • Cuijpers, P., & Riper, H. (2014). Internet interventions for depres­sive disorders: An overview. Revista de Psicopatología y Psicología Clínica, 19(3), 209­216.
  • Davis, L., Barlow, D. H., & Smith, L. (2010). Comorbidity and the treatment of principal anxiety disorders in a naturalistic sample. Behavior Therapy, 41(3), 296­305.
  • De Ornelas Maia, A., Braga, A., Nunes, C., Nardi, A., & Silva, A. (2013). Transdiagnostic treatment using a unified protocol: Application for patients with a range of comorbid mood and anxiety disorders. Trends in Psychiatry and Psychotherapy, 35(2), 134­140.
  • Dear, B. F., Staples, L. G., Terides, M. D., Karin, E., Zou, J., Johnston, L., ... & Titov, N. (2015). Transdiagnostic versus disorder ­specific and clinician­ guided versus self­guided in­ ternet­delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial. Journal of anxiety disorders, 36, 63­77.
  • Dear, B. F., Titov, N., Schwencke, G., Andrews, G., Johnston, L., Craske, M. G., & McEvoy, P. (2011). An open trial of a brief transdiagnostic internet treatment for anxiety and depres­ sion. Behaviour Research and Therapy, 49(12), 830­837.
  • Dugas, M. J., Brillon, P., Savard, P., Turcotte, J., Gaudet, A., Ladouce­ ur, R., ... Gervais, N. J. (2010). A randomized clinical trial of cog­ nitive­behavioral therapy and applied relaxation for adults with generalized anxiety disorder. Behavior Therapy, 41(1), 46­58.
  • Duval, S., & Tweedie, R. (2000). Trim and fill: A simple fun­ nel­plot–based method of testing and adjusting for publication bias in meta­analysis. Biometrics, 56(2), 455­463.
  • Egan, S. J., Wade, T. D., & Shafran, R. (2012). The transdiagnostic process of perfectionism. Revista de Psicopatología y Psicología Clínica, 17(3), 279­-294.
  • Ehrenreich­-May, J., Bilek, E. L., Buzzella, B., Kennedy, S. M., Mash, J. A., & LBennett, S. (2016). Unified protocols for the treatment of anxiety disorders in adolescents and children. New York: Oxford University Press [in press].
  • Ehrenreich­-May, J., Bilek, E. L., Queen, A. H., & Hernandez Rod­riguez, J. (2012). A unified protocol for the group treatment of childhood anxiety and depression. Revista de Psicopatología y Psicología Clínica, 17(3), 219­236.
  • Ehrenreich­-May, J., & Chu, B. C. (2014). In Ehrenreich­-May J., Chu B. C. (Eds.), Transdiagnostic treatments for children and adolescents: Principles and practice. New York, NY, US: Guilford Press.
  • Ejeby, K., Savitskij, R., Öst, L., Ekbom, A., Brandt, L., Ramnerö, J., ... Backlund, L. G. (2014). Randomized controlled trial of transdiagnostic group treatments for primary care patients with common mental disorders. Family Practice, 31(3), 273­ 280.
  • Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J., & Barlow, D. H. (2010). Unified protocol for the transdiagnos­ tic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17(1), 88­101.
  • Espejo, E. P., Castriotta, N., Bessonov, D., Kawamura, M., Werdowatz, E. A., & Ayers, C. R. (2016). A pilot study of transdi­ agnostic group cognitive–behavioral therapy for anxiety in a veteran sample. Psychological services,13(2), 162.
  • Essau, C., Lewinsohn, P., Olaya, B., & Seeley, J. (2014). Anxiety disorders in adolescents and psychosocial outcomes at age 30. Journal of Affective Disorders, 163, 125­132.
  • Essau, C., Olaya, B., Sasagawa, S., Pithia, J., Bray, D., & Ollen­dick, T. (2014). Integrating video­feedback and cognitive preparation, social skills training and behavioural activation in a cognitive behavioural therapy in the treatment of child­ hood anxiety. Journal of Affective Disorders, 167, 261­267.
  • Essau, C., Ollendick, T. (2013). The super skills for life programme. London, UK: University of Roehampton.
  • Ewing, D. L., Monsen, J. J., Thompson, E. J., Cartwright­-Hatton, S., & Field, A. (2015). A meta­analysis of transdiagnostic cog­ nitive behavioural therapy in the treatment of child and young person anxiety disorders. Behavioural and Cognitive Psychotherapy, 43(5), 562­577.
  • Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive be­ haviour therapy for eating disorders: A “transdiagnostic” the­ ory and treatment. Behaviour Research and Therapy, 41(5), 509­528.
  • Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-­Hollands, J., Carl, J. R., ... Barlow, D. H. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: A randomized controlled trial. Behavior Therapy, 43(3), 666­678.
  • Fogliati, V., Dear, B., Staples, L., Terides, M., Sheehan, J., Johnston, L., ... Titov, N. (2016). Disorder­-specific versus transdi­ agnostic and clinician­guided versus self­guided internet­de­ livered treatment for panic disorder and comorbid disorders: A randomized controlled trial. Journal of Anxiety Disorders, 39, 88­102.
  • Forti­-Buratti, M. A., Saikia, R., Wilkinson, E. L., & Ramchandani, P. G. (2016). Psychological treatments for depression in pre­adolescent children (12 years and younger): Systematic review and meta­analysis of randomised controlled trials. European Child & Adolescent Psychiatry, 1­10.
  • González-­Robles, A., García-­Palacios, A., Baños, R., Riera, A., Llorca, G., Traver, F., ... & Botella, C. (2015). Effectiveness of a transdiagnostic internet­-based protocol for the treatment of emotional disorders versus treatment as usual in specialized care: study protocol for a randomized controlled trial. Trials, 16(1), 488.
  • Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland­-Seymour, A., Sharma, R., ... Shihab, H. M. (2014). Meditation programs for psychological stress and well­being: A systemat­ ic review and meta­analysis. JAMA Internal Medicine, 174(3), 357­368.
  • Gros, D. F. (2014). Development and initial evaluation of trans­ diagnostic behavior therapy (TBT) for veterans with affective disorders. Psychiatry Research, 220(1­2), 275­282.
  • Harvey, A. G. (2004). Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment. Oxford University Press, USA.
  • Hedges, L., & Olkin, I. (1985). Statistical models for meta­analy­sis. New York: Academic Press.Hedges, LV, & Pigott, TD (2001). The Power of Statistical Tests in Meta-Analysis.Psychological Methods, 6, 203­217.
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane­handbook.org.
  • Higgins, J. P., & Thompson, S. G. (2002). Quantifying heteroge­ neity in a meta-­analysis. Statistics in Medicine, 21(11), 1539­ 1558.
  • Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-­analyses. BMJ, 327(7414), 557­560.
  • Hopko, D. R., Lejuez, C., Ruggiero, K. J., & Eifert, G. H. (2003). Contemporary behavioral activation treatments for depression: Procedures, principles, and progress. Clinical Psychology Review, 23(5), 699­717.
  • Ito, M., Horikoshi, M., Kato, N., Oe, Y., Fujisato, H., Nakajima, S., ... & Usuki, M. (2016). Transdiagnostic and transcultural: Pilot study of unified protocol for depressive and anxiety dis­ orders in Japan. Behavior therapy, 47(3), 416­430.
  • Johnston, L., Dear, B. F., Gandy, M., Fogliati, V. J., Kayrouz, R., Sheehan, J., ... Titov, N. (2014). Exploring the efficacy and acceptability of internet­-delivered cognitive behavioural ther­ apy for young adults with anxiety and depression: An open trial. The Australian and New Zealand Journal of Psychiatry, 48(9), 819­827.
  • Johnston, L., Titov, N., Andrews, G., Spence, J., & Dear, B. F. (2011). A RCT of a transdiagnostic internet­-delivered treat­ ment for three anxiety disorders: Examination of support roles and disorder­specific outcomes. PLoS ONE, 6(11), e28079
  • Kayrouz, R., Dear, B. F., Johnston, L., Gandy, M., Fogliati, V. J., Sheehan, J., & Titov, N. (2015). A feasibility open trial of guided internet­-delivered cognitive behavioural therapy for anxiety and depression amongst arab australians. Internet Interventions, 2(1), 32­38.
  • Kayrouz, R., Dear, B. F., Karin, E., Gandy, M., Fogliati, V. J., Terides, M. D., & Titov, N. (2016). A pilot study of self­guid­ ed internet­-delivered cognitive behavioural therapy for anxi­ ety and depression among arabs. Internet Interventions, 3, 18­24.
  • Kendall, P. C., Stark, K. D., Martinsen, K., O’Neil, K. A., & Aro­ ra, P. (2013). EMOTION: “Coping kids” managing anxiety and depression; group leaders manual. Ardmore, PA: Work­ book Publishing.
  • Kirkpatrick, T., Manoukian, L., Dear, B. F., Johnston, L., & Titov, N. (2013). A feasibility open trial of internet-­delivered cognitive­behavioural therapy (iCBT) among consumers of a non­governmental mental health organisation with anxiety. PeerJ, 1, e210.
  • Kroenke, K., Spitzer, R. L., Williams, J. B., & Löwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32(4), 345­359.
  • Lotfi, M., Bakhtiyari, M., Asgharnezhad­-Farid, A. A., & Amini, M. (2014). Comparison of the effect of transdiagnostic therapy and cognitive­-behavior therapy on patients with emotional disorders: A randomized clinical trial. Zahedan Journal of Research in Medical Sciences, 16(10), 15­18.
  • Mazzucchelli, T., Kane, R., & Rees, C. (2009). Behavioral activation treatments for depression in adults: A meta­analysis and review. Clinical Psychology: Science and Practice, 16(4), 383­411.
  • McEvoy, P. M., & Nathan, P. (2007). Effectiveness of cognitive behavior therapy for diagnostically heterogeneous groups: A benchmarking study. Journal of Consulting and Clinical Psychology, 75(2), 344­350.
  • McEvoy, P. M., Nathan, P., & Norton, P. J. (2009). Efficacy of transdiagnostic treatments: A review of published outcome studies and future research directions. Journal of Cognitive Psychotherapy, 23(1), 20­33.
  • McManus, F., Shafran, R., & Cooper, Z. (2010). What does a ‘transdiagnostic’ approach have to offer the treatment of anxiety disorders?. British Journal of Clinical Psychology, 49(4), 491­505.
  • Mineka, S., Watson, D., & Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49(1), 377­412.
  • Miró, M. T., Perestelo-­Pérez, L., Pérez, J., Rivero, A., González, M., Fuente, J. D. L., & Serrano, P. (2011). Eficacia de los tratamientos basados en Mindfulness para los trastornos de ansiedad y depresión: una revisión sistemática. Revista de Psicopatología y Psicología Clínica, 16(1), 1­14.
  • Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Pre­ferred reporting items for systematic reviews and meta­analy­ses: the PRISMA statement. Annals of internal medicine, 151(4), 264­269.
  • Mullin, A., Dear, B. F., Karin, E., Wootton, B. M., Staples, L. G., Johnston, L., ... Titov, N. (2015). The UniWellbeing course: A randomised controlled trial of a transdiagnostic internet­-delivered cognitive behavioural therapy (CBT) programme for university students with symptoms of anxiety and depression. Internet Interventions, 2(2), 128­136.
  • Nathan, P. E., & Gorman, J. M. (2015). A guide to treatments that work. Oxford University Press.
  • Newby, J. M., McKinnon, A., Kuyken, W., Gilbody, S., & Dalgleish, T. (2015). Systematic review and meta­analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clinical Psychology Review, 40, 91­110.
  • Newby, J. M., Mackenzie, A., Williams, A. D., McIntyre, K., Watts, S., Wong, N., & Andrews, G. (2013). Internet cognitive behavioural therapy for mixed anxiety and depression: A randomized controlled trial and evidence of effectiveness in primary care. Psychological Medicine, 43(12), 2635­ 2648.
  • Newby, J. M., Mewton, L., Williams, A. D., & Andrews, G. (2014). Effectiveness of transdiagnostic internet cognitive be­ havioural treatment for mixed anxiety and depression in pri­ mary care. Journal of Affective Disorders, 165, 45­52.
  • Norton, P. J. (2008). An open trial of a transdiagnostic cognitive-­behavioral group therapy for anxiety disorder. Behavior Therapy, 39(3), 242­250.
  • Norton, P. J. (2012a). Group cognitive-behavioral therapy of anxiety: A transdiagnostic treatment manual. New York, NY, US: Guilford Press.
  • Norton, P. J. (2012b). A randomized clinical trial of transdiagnostic cognitive­-behavioral treatments for anxiety disorder by compar­ ison to relaxation training. Behavior Therapy, 43(3), 506­517.
  • Norton, P. J., & Barrera, T. L. (2012). Transdiagnostic versus di­ agnosis­specific CBT for anxiety disorders: A preliminary randomized controlled noninferiority trial. Depression and Anxiety, 29(10), 874­882.
  • Norton, P. J., Barrera, T. L., Mathew, A. R., Chamberlain, L. D., Szafranski, D. D., Reddy, R., & Smith, A. H. (2013). Effect of transdiagnostic CBT for anxiety disorders on comorbid diag­noses. Depression and Anxiety, 30(2), 168­173.
  • Norton, P. J., Hayes, S. A., & Hope, D. A. (2004). Effects of a transdiagnostic group treatment for anxiety on secondary de­ pression. Depression and Anxiety, 20(4), 198­202.
  • Norton, P. J., & Hope, D. A. (2005). Preliminary evaluation of a broad­spectrum cognitive­behavioral group therapy for anxie­ ty. Journal of Behavior Therapy and Experimental Psychiatry, 36(2), 79­97.
  • Norton, P. J., & Paulus, D. J. (2015). Toward a unified treatment for emotional disorders: Update on the science and practice. Behavior Therapy, [Article in press].
  • Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice, Training, 45(2), 214­226.
  • Norton, P. J., & Price, E. C. (2007). A meta­analytic review of adult cognitive­-behavioral treatment outcome across the anxiety disorders. The Journal of Nervous and Mental Disease, 195(6), 521­531.
  • Öst, L. (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta­analysis. Behaviour Research and Therapy, 46(3), 296­321.
  • Öst, L., & Westling, B. E. (1995). Applied relaxation vs cognitive behavior therapy in the treatment of panic disorder. Behaviour Research and Therapy, 33(2), 145­158.
  • Paulus, D. J., Talkovsky, A. M., Heggeness, L. F., & Norton, P. J. (2015). Beyond negative affectivity: A hierarchical model of global and transdiagnostic vulnerabilities for emotional disorders. Cognitive Behaviour Therapy, 44(5), 389­405.
  • Pennant, M. E., Loucas, C. E., Whittington, C., Creswell, C., Fonagy, P., Fuggle, P., ... Kendall, T. (2015). Computerised therapies for anxiety and depression in children and young people: A systematic review and meta­analysis. Behaviour Research and Therapy, 67, 1­18.
  • Queen, A. H., Barlow, D. H., & Ehrenreich­May, J. (2014). The trajectories of adolescent anxiety and depressive symptoms over the course of a transdiagnostic treatment. Journal of Anxiety Disorders, 28(6), 511­521.
  • Reinholt, N., & Krogh, J. (2014). Efficacy of transdiagnostic cognitive behaviour therapy for anxiety disorders: A systematic review and meta­analysis of published outcome studies. Cognitive Behaviour Therapy, 43(3), 171­184.
  • Reynolds, S., Wilson, C., Austin, J., & Hooper, L. (2012). Effects of psychotherapy for anxiety in children and adolescents: A meta­analytic review. Clinical Psychology Review, 32(4), 251­262.
  • Sánchez ­Arribas, C., Chorot, P., Valiente, R. M., & Sandín, B. (2015). Evaluación de factores positivos y negativos relacionados con el trastorno de pánico: Validación del CAPT. Revista de Psicopatología y Psicología Clínica, 20(2), 85­100.
  • Sánchez ­Hernández, O., Méndez, F. X., & Garbe, J. (2014). Pre­vención de la depresión en niños y adolescentes: Revisión y reflexión. Revista de Psicopatología y Psicología Clínica, 19(1), 63­76.
  • Sandín, B., Chorot, P., & Valiente, R. M. (2012). Transdiagnóstico: Nueva frontera en psicología clínica. Revista de Psicopatología y Psicología Clínica, 17(3), 185­203.
  • Sandín, B., Chorot, P., & Valiente, R. M. (2016). TCC de los trastornos de ansiedad: Innovaciones en niños y adolescentes. Madrid: Klinik.
  • Sandín, B., Sánchez ­Arribas, C., Chorot, P., & Valiente, R. M. (2015). Anxiety sensitivity, catastrophic misinterpretations and panic self­-efficacy in the prediction of panic disorder se­ verity: Towards a tripartite cognitive model of panic disorder. Behaviour Research and Therapy, 67, 30­40.
  • Savovic, J., Jones, H. E., Altman, D. G., Harris, R. J., Jüni, P., Pildal, J., ... Gluud, L. L. (2012). Influence of reported study design characteristics on intervention effect estimates from randomized, controlled trials. Annals of Internal Medicine, 157(6), 429­438.
  • Schmidt, N. B., Buckner, J. D., Pusser, A., Woolaway­-Bickel, K., Preston, J. L., & Norr, A. (2012). Randomized controlled trial of false safety behavior elimination therapy: A unified cogni­ tive behavioral treatment for anxiety psychopathology. Behavior Therapy, 43(3), 518­532.
  • Titov, N., Andrews, G., Johnston, L., Robinson, E., & Spence, J. (2010). Transdiagnostic internet treatment for anxiety disor­ders: A randomized controlled trial. Behaviour Research and Therapy, 48(9), 890­899.
  • Titov, N., Dear, B. F., Johnston, L., Lorian, C., Zou, J., Wootton, B., ... Rapee, R. M. (2013). Improving adherence and clinical outcomes in self­guided internet treatment for anxiety and depression: Randomised controlled trial. PLoS One, 8(7), e62873.
  • Titov, N., Dear, B. F., Johnston, L., & Terides, M. (2012). Transdi­agnostic internet treatment for anxiety and depression. Revista de Psicopatología y Psicología Clínica, 17(3), 237­260.
  • Titov, N., Dear, B. F., Staples, L. G., Bennett-­Levy, J., Klein, B., Rapee, R. M., ... Ritterband, L. (2015a). MindSpot clinic: An accessible, efficient, and effective online treatment service for anxiety and depression. Psychiatric Services, 66(10), 1043­1050.
  • Titov, N., Dear, B. F., Staples, L. G., Terides, M. D., Karin, E., Sheehan, J., ... McEvoy, P. M. (2015b). Disorder­specific versus transdiagnostic and clinician­guided versus self­guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial. Journal of Anxiety Disorders, 35, 88­102.
  • Titov, N., Dear, B. F., Schwencke, G., Andrews, G., Johnston, L., Craske, M. G., & McEvoy, P. (2011). Transdiagnostic internet treatment for anxiety and depression: A randomised controlled trial. Behaviour Research and Therapy, 49(8), 441­452.
  • Titov, N., Fogliati, V. J., Staples, L. G., Gandy, M., Johnston, L., Wootton, B., ... Dear, B. F. (2016). Treating anxiety and de­ pression in older adults: Randomised controlled trial comparing guided v. self­guided internet­-delivered cognitive–behav­ioural therapy. British Journal of Psychiatry Open, 2(1), 50­58.
  • Torrents-­Rodas, D., Fullana, M. A., Vervliet, B., Treanor, T., Conway, C., Zbozinek, T., & Craske, M. G. (2015). Maximizar la terapia de exposición: Un enfoque basado en el aprendizaje inhibitorio. Revista de Psicopatología y Psicología Clínica, 20(1), 1­24.
  • Tull, M. T., Stipelman, B. A., Salters­-Pedneault, K., & Gratz, K. L. (2009). An examination of recent non­clinical panic attacks, panic disorder, anxiety sensitivity, and emotion regulation diffi­culties in the prediction of generalized anxiety disorder in an analogue sample. Journal of Anxiety Disorders, 23(2), 275­282.
  • Vázquez, F. L., Blanco, V., Hermida, E., Otero, P., Torres, A., & Díaz­-Fernández, O. (2015). Eficacia de las intervenciones psicológicas breves para reducir los síntomas depresivos en cui­dadores: Revisión sistemática y meta­análisis. Revista de Psicopatología y Psicología Clínica, 20 (3), 173­188.
  • Weersing, V. R., Gonzalez, A., Campo, J. V., & Lucas, A. N. (2008). Brief behavioral therapy for pediatric anxiety and de­ pression: Piloting an integrated treatment approach. Cognitive and Behavioral Practice, 15(2), 126­139.
  • Weersing, V. R., Rozenman, M. S., Maher­Bridge, M., & Campo, J. V. (2012). Anxiety, depression, and somatic distress: Developing a transdiagnostic internalizing toolbox for pediatric practice. Cognitive and Behavioral Practice, 19(1), 68­82.
  • Wuthrich, V., Rapee, R., Kangas, M., & Perini, S. (2016). Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co­morbid anxiety and depression in older adults. Psychological Medicine, 46(4), 785­795.
  • Wuthrich, V., & Rapee, R. (2013). Randomised controlled trial of group cognitive behavioural therapy for comorbid anxiety and depression in older adults. Behaviour Research and Therapy, 51(12), 779­786.