Barlow David

Barlow David
Boston University | BU · Department of Psychology

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882
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Publications

Publications (882)
Book
Um dos problemas mais difíceis com que se confrontam os pais de crianças com alguma perturbação psicológica é em encontrar a melhor ajuda disponível. Certamente conhece algum amigo ou familiar que procurou a ajuda de um determinado profissional e que, mais tarde, acabou por descobrir, através de outro profissional, que o diagnóstico original estava...
Book
Um dos problemas mais difíceis com que se confrontam os pais de crianças com alguma perturbação psicológica é em encontrar a melhor ajuda disponível. Certamente conhece algum amigo ou familiar que procurou a ajuda de um determinado profissional e que, mais tarde, acabou por descobrir, através de outro profissional, que o diagnóstico original estava...
Chapter
This chapter introduces the Unified Protocol (UP) concerned with the Transdiagnostic Treatment of Emotional Disorders. Commonalities between emotional disorders are expressed in high rates of comorbidity, similar rates of treatment response, and shared neurobiological vulnerabilities. The chapter elaborates on how neuroticism significantly contribu...
Article
Importance: A transdiagnostic treatment, the Unified Protocol, is as effective as single diagnostic protocols in comorbid emotional disorders in clinical populations. However, its effects on posttraumatic stress disorder and other emotional disorders in individuals living in war and armed conflict contexts have not been studied. Objective: To ev...
Article
Background: Anxiety disorders are highly prevalent and debilitating conditions that show high comorbidity rates in adolescence. The present article illustrates how Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) was adapted for Iranian adolescents with anxiety disorders. Methods: A total of 54 adolesce...
Article
Although evidence-based psychological treatments such as cognitive behavioral therapy (CBT) have strong empirical support for reducing anxiety and depression symptoms, CBT outcome research often does not report race and ethnicity variables, or assess how well CBT works for people from historically excluded racial and ethnic groups. This study prese...
Chapter
Modern systems for classifying psychopathology yielded the first diagnostic guidelines in the mid-twentieth century and have been debated ever since. Despite a recognition that classification and diagnosis may improve understanding and treatment, authors have criticized the many limitations of a categorical approach. In recent years, a return to co...
Book
O Protocolo Unificado (PU) para o Tratamento Transdiagnóstico de Perturbações Emocionais: Manual do Doente, foi desenvolvido para ajudar pessoas que estão a lidar com emoções intensas como ansiedade, tristeza, raiva ou culpa. Uma pessoa pode ter uma perturbação emocional quando as suas emoções são tao intensas que condicionam a forma como a pessoa...
Book
O Protocolo Unificado (PU) para o Tratamento Transdiagnóstico de Perturbações Emocionais: Manual do Doente, foi desenvolvido para ajudar pessoas que estão a lidar com emoções intensas como ansiedade, tristeza, raiva ou culpa. Uma pessoa pode ter uma perturbação emocional quando as suas emoções são tao intensas que condicionam a forma como a pessoa...
Article
Full-text available
Background The general aim of the study was to examine potential mediators and moderators in an adaptation of the Unified Protocol for Homeless Women (UPHW).Methods We conducted a secondary analysis in a sample of 80 homeless women participated in the study: 37 in the UPHW and 43 in the waitlist control condition. The assessment before and after th...
Article
Full-text available
Objective The therapeutic alliance is related to treatment outcome but less is known about the agreement on alliance between patients and therapists and its relationship to outcomes. We examined the association of patient-therapist congruence of alliance perceptions, early and late in cognitive behavioral therapy for panic disorder in relation to s...
Article
Full-text available
Background: Research has shown that internet-based cognitive behavioral therapy (iCBT) can be a very promising solution to increase access to and the dissemination of evidence-based treatments to all of the population in need. However, iCBT is still underutilized in clinical contexts, such as primary care. In order to achieve the effective implemen...
Article
Full-text available
The COVID-19 pandemic, and the social distancing practices that followed, have been associated with increased prevalence of emotional disorders. However, not all individuals affected by COVID-19-related social distancing experienced elevations in emotional disorder symptoms. Understanding this phenomenon is of crucial public health significance giv...
Article
Methodology in the behavioral sciences is heterogeneous, and this is particularly true in the application of methodologies in the study of the nature and treatment of psychopathology and related areas of applied behavior change. For this reason, the very thoughtful and thorough report on strategies and tactics of contextual behavioral science (CBS)...
Chapter
This chapter covers medications that are prescribed for anxiety and panic. Many people with anxiety and panic attacks have had their doctors prescribe medications. Many of these medications, however, are not effective in the long term unless one continues to take them. Even then, they may lose some of their effectiveness unless one learns some new,...
Chapter
This chapter explores the value of facing agoraphobia situations. In many ways, direct experience is the most powerful way of learning. It is essential that one eventually repeatedly face and deal with all the situations on one’s agoraphobia hierarchy. Sometimes people believe that they have already tried to face agoraphobia situations, without any...
Chapter
This chapter explores thinking skills. The main goals of the first section are (1) to help clients recognize that the way they think is critical to their level of fear or anxiety at any given moment and (2) that recognizing negative thinking at a specific and detailed level is necessary before developing different, less negative ways of thinking. I...
Book
This edition of the Mastery of Your Anxiety and Panic: Therapist Guide provides therapists with all the tools necessary to deliver effective treatment for panic disorder and agoraphobia. It provides step-by-step instructions for teaching clients the skills to overcome their fear of panic and panic attacks. The book also presents case vignettes as w...
Chapter
This chapter presents a therapist guide to the Mastery of Your Anxiety and Panic: Workbook for Brief Six-Session Version for Primary Care and Related Settings . It begins by tracing the evolution of this brief treatment program. This treatment entails the same components as the full version of panic control treatment, including psychoeducation and...
Chapter
This chapter covers the process of learning how to structure continued practice, ways of maintaining progress, and how to approach high-risk times and manage setbacks. One can use the Your Practice Plan form to list all of the things to be practiced over the next few weeks in terms of breathing skills, thinking skills, facing agoraphobia situations...
Chapter
This chapter addresses breathing skills. The main goals are to introduce the physiology of overbreathing as something that may contribute to the physiological sensations during panic attacks and to recognize that hyperventilatory sensations are not harmful. It is important that the client not misconstrue the discussion of overbreathing as an indica...
Chapter
This chapter provides an overview of the nature of panic disorder and agoraphobia. The key features of panic disorder are (1) one or more episodes of abrupt, intense fear or discomfort (i.e., a panic attack) and (2) persistent anxiety or worry about the recurrence of panic attacks, their consequences, or life changes as a result of the attacks. Ano...
Chapter
This chapter assesses the process of establishing an individualized hierarchy of agoraphobia situations for the client, in preparation for in vivo exposure. A hierarchy composed of situations that range in anxiety level from mild to moderate, and all the way up to extremely anxious, will form the basis of a graduated approach to in vivo exposure. A...
Chapter
This chapter outlines the treatment procedures and looks at the basic principles underlying treatment. There are four main sections to the Mastery of Your Anxiety and Panic: Workbook , Fifth Edition (MAP–5): Basics, Coping Skills, Exposure to Feared Symptoms and Situations, and Planning for the Future. The treatment begins with education about the...
Chapter
This chapter highlights the importance of objective recordkeeping of panic and anxiety. Keeping records offsets the anxiety-inducing effects of avoidance, subjective monitoring, and recall biases. The goal is for clients to begin to become observers rather than victims of their anxiety. The chapter then looks at the two forms of recording panic and...
Chapter
This chapter focuses on the importance of understanding the negative cycles that contribute to panic attacks and agoraphobia. There are three major parts to the emotions of anxiety and panic: physical symptoms, thoughts, and behaviors. Physical symptoms, thoughts, and behaviors contribute to each other in what is called a negative cycle. Negative t...
Chapter
This chapter studies the process of conducting symptom exercises with the client. Facing fear of physical symptoms means to deliberately expose oneself to the feared sensations that trigger panic attacks. Typically, these types of sensations are avoided. Subtle avoidance includes distracting oneself from thoughts about physical sensations, while ob...
Chapter
This chapter examines the introduction to the treatment program. The information presented in this initial stage of treatment is intended to clarify the purposes of the workbook and provide corrective information that assures clients that they are neither insane nor atypical and that there is a good chance of successful treatment. By describing the...
Chapter
This chapter addresses the value of facing physical symptoms of panic and anxiety. Fear of physical symptoms is central to panic disorder. Indeed, being afraid of physical symptoms leads to more physical symptoms, since the symptoms are the natural result of anxiety and fear. This is part of the panic cycle. It is thus important to face the physica...
Chapter
This chapter evaluates the process of learning to face one’s fear. The final step of breathing skills training is to use it at times when one feels anxious or panicky, or when one notices panic symptoms. The goal is not to immediately eliminate fear and anxiety; rather, the goal of breathing skills is to regulate breathing so that one can continue...
Chapter
This chapter assesses the process of building thinking skills for changing one’s mistaken beliefs and negative thoughts. Years of research have shown that when we become anxious or panicky, we make two mistakes in our thinking. The mistakes are (1) to jump to conclusions about negative events and (2) to blow things out of proportion. These mistakes...
Chapter
This chapter presents ways for incorporating significant others to help one confront one’s fears of agoraphobia situations. Research suggests that involving spouses, life partners, family, or friends in the therapy process can lead to continued improvement, especially after formal therapy is over. Helpers can learn about panic and agoraphobia by re...
Chapter
This chapter examines the importance of learning about the causes of the physical symptoms of panic. The physical changes that underlie the physical symptoms of panic and anxiety are protective in that they are designed to help us escape from or fight off danger. The symptoms are real, but they are not harmful. Interestingly, physical symptoms are...
Chapter
This chapter provides an overview of the nature of panic disorder and agoraphobia. The key features of panic disorder are (1) one or more episodes of abrupt, intense fear or discomfort (i.e., a panic attack) and (2) persistent anxiety or worry about the recurrence of panic attacks, their consequences, or life changes as a result of the attacks. Ind...
Chapter
This chapter focuses on the importance of understanding how breathing patterns contribute to panic and anxiety. Many people overbreathe/hyperventilate when they panic—in other words, they breathe too quickly. Technically, to overbreathe or to hyperventilate means to breathe in more oxygen than is needed by the body. The chapter then explains the me...
Chapter
This chapter highlights the importance of providing the client with information about panic attacks. Overall, the informational model of panic attacks builds on the previous chapters in providing an alternative conceptual framework that is nonthreatening and contributes to a personal scientist perspective, whereby clients can gain an objective unde...
Chapter
This chapter evaluates the importance of reviewing the client’s progress, encouraging the client to continue to face fear and anxiety, and discussing ways of maintaining progress and relapse prevention. Instead of focusing on feelings in general, an assessment that is likely to be biased, progress is best evaluated by examining objective data. Prog...
Book
This edition of the Mastery of Your Anxiety and Panic Workbook has been updated to include strategies and techniques for dealing with both panic disorder and agoraphobia. The program outlined is based on the principles of cognitive behavioral therapy (CBT) and is organized by skill, with each chapter building on the one before it. It covers the imp...
Chapter
This chapter examines the importance of developing more breathing skills and thinking skills, looking at ways of replacing negative thoughts with evidence-based thinking. Two errors characterize anxious thinking: (1) jumping to conclusions and (2) blowing things out of proportion. The first step toward change is to treat thoughts as guesses rather...
Chapter
This chapter discusses medications for anxiety and panic. In the workbook, medication is not described as a more or less effective form of treatment in comparison to cognitive behavioral therapy (CBT) but as a more or less appropriate treatment dependent on different beliefs and life circumstances. Medications are described, so that clients may und...
Chapter
This chapter discusses the mistaken beliefs about panic as well as the importance of understanding one’s negative thoughts and learning breathing skills. Common myths and mistaken beliefs about the physical symptoms of fear include sensations of going insane, losing control, suffering a nervous collapse, suffering a heart attack, and fainting. Such...
Chapter
This chapter focuses on the importance of helping clients understand the negative cycles that contribute to panic attacks and agoraphobia. In addition to being informative, the therapist should give corrective feedback and facilitate the client’s discovery of the pattern of influences across thoughts, behaviors, and physiology, as well as the seque...
Chapter
This chapter reviews the process of conducting in vivo exposure practices to guide clients in facing agoraphobia situations. Essential throughout all aspects of in vivo exposure is for the therapist to be directive and confident and to encourage clients to continue despite high levels of anxiety. The goal of exposure therapy is not immediate reduct...
Chapter
This chapter examines the process of discussing and planning ways for clients to involve significant others in their treatment. Significant others frequently have a big impact on panic disorder and particularly agoraphobia. Indeed, these individuals can play both positive and negative roles in the development and maintenance of agoraphobia and also...
Chapter
This chapter discusses the importance and method of recordkeeping, looking at ways to objectively record panic, anxiety, and other moods. Learning to be an observer as opposed to a victim of one’s own anxiety is a first step toward gaining control. Through recordkeeping, one will learn to observe when, where, and under what circumstances one’s pani...
Chapter
This chapter highlights the process of evaluating one’s progress, maintaining progress, and relapse prevention. One can use the Your Practice Plan form to list all of the things to be practiced over the next few weeks in terms of breathing skills, thinking skills, facing agoraphobia situations, and facing symptoms. The chapter then looks at several...
Chapter
This chapter provides introductory information for therapists regarding the treatment for panic disorder and agoraphobia. Developments in the conceptualization of panic attacks and panic disorder in the 1980s and 1990s made possible significant improvements in the psychological treatment of panic disorder and the development of panic control treatm...
Chapter
This chapter evaluates the process of establishing a hierarchy of agoraphobia situations. Too much anxiety leads to too much avoidance, and avoidance prevents corrective learning. Thus, approaching rather than avoiding situations or experiences is critical to overcoming fear and anxiety. But first, it is necessary to identify the specific situation...
Chapter
This chapter focuses on the process of continuing to face one’s fear of physical symptoms, and learning to face fear of activities that produce physical symptoms as well as feared agoraphobia situations. Avoidance (both direct and indirect) is to be prevented. Usually, avoidance happens because of the continued mistaken belief that the symptoms are...
Chapter
This chapter discusses the nature of panic disorder (PD) and agoraphobia. The hallmark symptom of PD is a history of unexpected panic attacks that are experienced by the patient as occurring from out of the blue, without any obvious trigger or cue. However, some patients may be quite adept at predicting their panic attacks, and upon initial screeni...
Book
This edition of the Mastery of Your Anxiety and Panic: Workbook for Brief Six-Session Version for Primary Care and Related Settings outlines a time-limited treatment for those dealing with panic disorder and agoraphobia. If a patient primarily seeks treatment from a family doctor, this guide will be useful. The program described is based on the pri...
Chapter
This edition of the Mastery of Your Anxiety and Panic Workbook has been updated to include strategies and techniques for dealing with both panic disorder and agoraphobia. The program outlined is based on the principles of cognitive behavioral therapy (CBT) and is organized by skill, with each chapter building on the one before it. It covers the imp...
Chapter
This edition of the Mastery of Your Anxiety and Panic Workbook has been updated to include strategies and techniques for dealing with both panic disorder and agoraphobia. The program outlined is based on the principles of cognitive behavioral therapy (CBT) and is organized by skill, with each chapter building on the one before it. It covers the imp...
Chapter
This edition of the Mastery of Your Anxiety and Panic: Workbook for Brief Six-Session Version for Primary Care and Related Settings outlines a time-limited treatment for those dealing with panic disorder and agoraphobia. If a patient primarily seeks treatment from a family doctor, this guide will be useful. The program described is based on the pri...
Chapter
This edition of the Mastery of Your Anxiety and Panic: Therapist Guide provides therapists with all the tools necessary to deliver effective treatment for panic disorder and agoraphobia. It provides step-by-step instructions for teaching clients the skills to overcome their fear of panic and panic attacks. The book also presents case vignettes as w...
Chapter
This edition of the Mastery of Your Anxiety and Panic: Therapist Guide provides therapists with all the tools necessary to deliver effective treatment for panic disorder and agoraphobia. It provides step-by-step instructions for teaching clients the skills to overcome their fear of panic and panic attacks. The book also presents case vignettes as w...
Article
We describe an approach to anxiety, depressive, trauma-related, and other disorders, which we conceptualize as “emotional disorders” because of shared underlying dimensions uncovered by the study of traits or temperaments. We then explicate a functional model of emotional disorders based largely, but not exclusively, on the temperament of neurotici...
Article
Full-text available
Background Neuroticism (N), extraversion (E), and negative/positive affect (NA/PA) are personality/affective characteristics highly related to the etiology and maintenance of emotional disorders (EDs). This study aims at exploring the moderating role of baseline personality/ and affectivity profiles in the response to a transdiagnostic psychologica...
Article
Alcohol Use Disorder (AUD) and anxiety disorders (ANX) are each highly prevalent and frequently co-occur, resulting in a complex clinical presentation. The existing literature to date has not yet identified how to best treat comorbid AUD/ANX, partially due to limitations in understanding what factors and mechanisms are implicated in their co-occurr...
Article
Background The present study aims to investigate the effectiveness of the Unified Protocol (UP), a transdiagnostic treatment of emotional disorders (EDs), when applied in a group format in the public mental health system in Spain. Methods 488 participants with a primary diagnosis of ED were randomized to the UP group or to the treatment as usual (...
Article
The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders is an emotion-focused, cognitive-behavioral intervention developed to address the full range of anxiety, depressive, and related disorders. The UP consists of core therapeutic skills that, though unique in focus, are each designed to promote an approach-oriented stance t...
Article
Dropout from psychotherapy is common and can have negative effects for patients, providers, and researchers. Better understanding when and why patients stop treatment early, as well as actionable factors contributing to dropout, has the potential to prevent it. Here, we examine dropout from a large randomized controlled trial of transdiagnostic ver...
Article
Homework assignments are an integral part of cognitive behavioral therapy, providing patients with opportunities to practice skills between sessions. Generally, greater homework compliance is associated with better treatment outcomes. However, fewer studies have examined the effect of homework quality on treatment outcomes. This study examined home...
Article
There has been increasing interest in transdiagnostic cognitive-behavioral therapy (CBT), which is more cost efficient yet yields similar effect sizes when compared to disorder-specific CBT. The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders was adapted for Hong Kong Chinese adults with common mental disorders, such as d...
Article
Full-text available
Objective To examine whether the Unified Protocol (UP) remains equivalent to single-disorder protocols (SDPs) in the treatment of anxiety disorders at 12-month follow-up. Method We report results from the 12-month follow-up of a recent randomized equivalence trial [1]. Data are from 179 participants (55.31% female sex, 83.24% White, average age 30...
Article
Exposure therapy works through inhibitory learning, whereby patients are exposed to stimuli that elicit anxiety in order to establish safety associations. Mindful emotion awareness, or nonjudgmental and present-focused attention toward emotions, may facilitate engagement in exposures, which may in turn enhance therapeutic outcome. This study utiliz...
Article
Background Neuroticism is associated with the onset and maintenance of a number of mental health conditions, as well as a number of deleterious outcomes (e.g. physical health problems, higher divorce rates, lost productivity, and increased treatment seeking); thus, the consideration of whether this trait can be addressed in treatment is warranted....
Article
Full-text available
Despite the substantial evidence that supports the efficacy of cognitive-behavioral therapy for the treatment of anxiety and related disorders, our understanding of mechanisms of change throughout treatment remains limited. The goal of the current study was to examine changes in experiential avoidance across treatment in a sample of participants (N...
Article
Full-text available
Cognitive behavioral therapy (CBT) has been found to be very effective in reducing many forms of mental illness, but much less is known about whether CBT also promotes mental health or well-being. The goals of the present study were to (a) quantify the magnitude and timing of changes in overall well-being and specific facets of well-being during di...
Article
The Unified Protocol for Transdiagnostic Treatment (UP; Barlow et al., 2011) has recently demonstrated statistically equivalent therapeutic effects compared to leading cognitive behavioral therapy (CBT) protocols for anxiety disorders designed to address disorder-specific symptoms (i.e., single-disorder protocols [SDP]); Barlow et al., 2017). Altho...
Article
Current classification systems for mental disorders emphasize categorical assessment. In the domain of emotional disorders, this is inconsistent with a growing consensus that anxiety, depressive, and related disorders are best conceptualized as variations on shared underlying processes, chiefly heightened negative affect, and aversion to unwanted e...
Article
Dysregulated anger in the context of emotional (e.g., mood, anxiety, related) disorders is associated with treatment attrition and a lower likelihood of responding to extant treatments. Therefore, there is a need to identify the most effective skills for targeting this anger and prioritize their delivery in treatment with the hope of producing more...
Article
Objectives: This study aims to examine the efficacy of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) for individuals diagnosed with a depressive disorder. Method: Participants included 44 adults who met criteria for major depressive disorder, persistent depressive disorder, or another specified depressive disorde...
Article
Hope is a trait that represents the capacity to identify strategies or pathways to achieve goals and the motivation or agency to effectively pursue those pathways. Hope has been demonstrated to be a robust source of resilience to anxiety and stress and there is limited evidence that, as has been suggested for decades, hope may function as a core pr...
Article
Objective: This study evaluated changes in positive affect within cognitive-behavioral treatments (CBT) for anxiety disorders. It was hypothesized that there would be significantly greater increases in positive affect in CBT conditions compared to the waitlist, and particularly higher in the Unified Protocol (UP) than the single disorder protocols...
Article
Parkinson’s disease (PD) is characterized by motor symptoms, but nonmotor symptoms also significantly impair daily functioning and reduce quality of life. Anxiety is prevalent and debilitating in PD, but remains understudied and undertreated. Much affective research in PD focuses on depression rather than anxiety, and as such, there are no evidence...
Article
Full-text available
We present a transdiagnostic definition of the commonly used, but poorly defined, term emotional disorder. This definition transcends and possibly complements traditional descriptive diagnostic categories, and candidate dimensional models of psychopathology by focusing on putative mechanisms that contribute to the onset and maintenance of disorders...
Article
Full-text available
We present a transdiagnostic definition of the commonly used, but poorly defined, term emotional disorder. This definition transcends and possibly complements traditional descriptive diagnostic categories, and candidate dimensional models of psychopathology by focusing on putative mechanisms that contribute to the onset and maintenance of disorders...
Article
Quality of life is lower among individuals with anxiety disorders; however, this construct is rarely a focus in treatment research. This study explores changes in quality of life in a randomized, controlled trial of several cognitive-behavioral treatments (CBTs) for anxiety disorders. Adults with heterogeneous anxiety disorders (N = 223) were rando...
Article
Interoceptive exposure (IE; exposure focused on anxiety about somatic sensations) is a well-established component of treatments for panic disorder (PD), but little is known about the specificity of its effects or individual response patterns resulting from this intervention. This study investigated the utility of IE in the treatment of PD with clau...

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