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Primary Outcomes for Adults Receiving the Unified Protocol after Hurricane Harvey in an Integrated Healthcare Setting

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Abstract

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated efficacy for treating anxiety and depression. However, there are limited effectiveness data when conducted in real-world settings with diverse populations, including those with trauma. We evaluated treatment outcomes in a naturalistic, community setting among 279 adults who received UP following Hurricane Harvey. We examined change in overall clinical severity, depression and anxiety symptoms, functional impairment, and baseline outcome predictors (i.e., demographic characteristics, impact from Hurricane Harvey, co-occurrence of depression and anxiety symptoms). Global clinical severity, depression and anxiety symptoms, and functional impairment decreased by end-of-treatment. Participants experienced global symptom improvement to a lesser degree than demonstrated in efficacy trials. Participants who experienced greater storm impact reported larger reductions in anxiety symptoms than those less impacted by Harvey. Further studies evaluating the effectiveness of the UP post-disaster and with diverse samples are needed.

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Notes

  1. Number of patients who received intervention in Spanish was not recorded.

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Acknowledgements

The views expressed are those of the authors alone and do not necessarily reflect views of the Greater Houston Community Foundation, Hurricane Harvey Relief Fund, National Institutes of Health, or Baylor College of Medicine. We acknowledge the contributions of Ms. Maryam Anis, Ms. Stacy Baynham, Ms. Jamie Campos, Dr. Lawrence Chiu, Ms. Cynthia Connor, Dr. Michelle Davis, Ms. Roxanne Deams, Dr. Syed Iqbal, Dr. Natalia Kazakevich, Ms. Margaret Kenney, Ms. Mayra Perez, Ms. Alana Stanley, Dr. Beenish Syed, Mr. Frank Velasquez, and Dr. Lorna Wilks.

Funding

Research reported in this publication was supported by the Greater Houston Community Foundation and the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number P50HD103555 for use of the Clinical and Translational Core facilities. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA

    Saira A. Weinzimmer, Amy R. Goetz, Andrew G. Guzick, Lynn M. Hana, Sandra L. Cepeda, Sophie C. Schneider, Gifty N. Amos Nwankwo, Catherine C. Christian, Asim A. Shah, Wayne K. Goodman & Eric A. Storch

  2. Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL, 33124, USA

    Sandra L. Cepeda & Jill Ehrenreich-May

  3. School of Medicine, University of Colorado, 1635 Aurora Ct, Aurora, CO, 80045, USA

    Sarah M. Kennedy

  4. Center for Children and Families, Florida International University, 11200 Southwest 8th Street, AHC1 140, Miami, FL, 33199, USA

    Ashley M. Shaw

  5. College of Behavioral and Community Sciences, University of South Florida, 13301 Bruce B Downs Blvd, Tampa, FL, 33612, USA

    Alison Salloum

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  1. Saira A. Weinzimmer
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Correspondence to Eric A. Storch.

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Confilct of interest

Dr. Storch receives research support from NIH, International OCD Foundation, Greater Houston Community Foundation, Texas Higher Education Coordinating Board, and the Misophonia Research Fund. He has received royalties from Elsevier Publications, Springer Publications, American Psychological Association, Wiley, Inc., Jessica Kingsley, and Lawrence Erlbaum. Dr. Storch is on the Speaker’s Bureau and Scientific Advisory Board for the International OCD Foundation. He owns stock in NView. He is a consultant for Biohaven. Dr. Ehrenreich-May receives financial support for research from NIH, PCORI, the U.S. Department of Defense, the Children’s Trust, the Misophonia Research Fund, and Northwell Health. Dr. Schneider receives grant funding from the Texas Higher Education Coordinating Board, NIH, the American Red Cross, and the Misophonia Research Fund. All other authors report no financial disclosures. We report no other potential conflicts of interest.

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This research was approved by the Baylor College of Medicine and Harris Health System institutional review boards with a waiver of consent to collect de-identified data. All authors certify responsibility for this manuscript.

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Weinzimmer, S.A., Goetz, A.R., Guzick, A.G. et al. Primary Outcomes for Adults Receiving the Unified Protocol after Hurricane Harvey in an Integrated Healthcare Setting. Community Ment Health J 58, 1522–1534 (2022). https://doi.org/10.1007/s10597-022-00967-1

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