The Theoretical Rationale for Barlow’s Unified Protocol
A 550 word paper on the theoretical rational that led to the development of Barlow's unified protocol.
the core message: The development of the Unified Protocol was born from decades of clinical experience and corresponding research evidence. Clinically, it is evident that there is a high degree of comorbidity amongst anxiety and depressive disorders. Research findings suggest that this cormorbidity is due to core deficits present across the range of these diagnoses. These deficits include a biologically-based propensity for strong emotions, coupled with aversive reactions to these emotional experiences that lead to reliance on emotionally-avoidant coping strategies. Due to the role of strong emotions in the development and maintenance of all anxiety and depressive disorders, we refer to them as emotional disorders.
The Unified Protocol was developed to explicitly address the core deficits shared across emotional disorders. We believe that targeting processes common across diverse disorders is a more efficient way of addressing comorbid conditions simultaneously than targeting the symptoms of each diagnosis individually.
Elaborated version of this core message with resources and studies to prove.
The Theoretical Rationale for Barlow’s Unified Protocol
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The Theoretical Rationale for Barlow’s Unified Protocol
There is an established consensus in scholarly contexts that the DSM-III prompted a paradigm shift in classifying psychiatric illnesses and conditions. DSM-III employed the operationalized diagnostic framework to define different mental health disorders based on a variety of clinical manifestations and client-reported symptoms. It also eradicated the influence of unproven etiological constructs from its organizational architecture in favor of an increasingly theoretical approach. It shifted the biopsychosocial framework with respect to the multiaxial diagnosis approach (First, 2012). Despite its usefulness, the DSM-III approach failed to account for the relative significance of the different clinical manifestations and included overly broad descriptions of the manifestation criteria. This implied that the clients found to be having the same disorder equally presented dissimilar subthreshold clinical presentations. The other shortcoming of the DSM-III is that it presented a high degree of concurrence or overlap of personality disorders with each other, as well as other psychiatric conditions (Ghaemi, 2018).
Temperament can be understood as a biologically driven inclination to experience a given cluster of emotions and particular emotional reactivity and intensity thresholds to specific stimuli. Research indicates that there is an overlap between temperament and higher-order personality constructs (extraversion and neuroticism). In addition, “emotionality/negative affectivity,” harm avoidance,” “trait anxiety,” or “behavioral inhibition” for neuroticism and “behavioral activation,” “surgency,” or “emotionality/positive affectivity” for extraversion. Whereas these dimensions span a continuum of maladaptive to adaptive functioning, they differ in the extent to which they are inclined to appraise positive affect versus interpersonal surgency features personality or temperament. They also have barely different relationships with clinical psychological manifestations (Sauer-Zavala & Barlow, 2021). The close empirical and conceptual overlap between the aforementioned temperamental constructs prompts researchers to perceive them by evaluating increasingly common temperament processes.
The triple vulnerability framework suggests that uncontrollability and unpredictability over one’s emotional states and life events correspond to a psychiatric vulnerability to wide-ranging mood and anxiety disorders. Neuroticism is based on triple vulnerability because it is conceived as the inclin...