Transdiagnostic Processes as Mediators of Change in an Internet-Delivered Intervention Based on the Unified Protocol

Abstract Background Transdiagnostic treatments target shared mechanisms between disorders to facilitate change across diagnoses. The Unified Protocol (UP) aims at changing dysfunctional reactions towards emotions by increasing mindful emotion awareness and cognitive flexibility, as well decreasing anxiety sensitivity avoidance. Method We investigated whether these transdiagnostic processes were malleable treatment mediated the relationship outcome in an internet-delivered adaptation of UP. N = 129 participants with mixed anxiety, depressive, somatic symptom randomized or waitlist. Results yielded significant changes all over time comparison a waitlist condition. In separate mediator models, mediating effects found for mindfulness, behavioral activation, experiential When mediators combined multiple model, indirect through mindfulness flexibility emerged significant. Conclusion These findings add growing body research on emphasize target. However, results should be interpreted cautiously, temporal precedence could not established.