The Effectiveness of Unified Transdiagnostic Treatment on Difficulties in Emotion Regulation, Quality of Life, and Fasting Blood Glucose among Patients with Type 2 Diabetes
Keywords:
Integrated transdiagnostic treatment, emotion regulation, quality of life, fasting blood glucose, type 2 diabetesAbstract
This study aimed to examine the effectiveness of unified transdiagnostic treatment on difficulties in emotion regulation, quality of life, and fasting blood glucose among patients with type 2 diabetes in Tehran. This applied quasi-experimental study used a pretest–posttest–follow-up design with a control group. The statistical population included patients with type 2 diabetes who referred to diabetes clinics and medical centers in Tehran in 2024. Thirty eligible patients were selected through convenience and voluntary sampling and randomly assigned to an unified transdiagnostic treatment group (n = 15) and a control group (n = 15). The experimental group received eight weekly 60-minute sessions of unified transdiagnostic treatment, while the control group received no psychological intervention. Data were collected using the Difficulties in Emotion Regulation Scale, the World Health Organization Quality of Life Questionnaire, and fasting blood glucose laboratory testing. Data were analyzed using repeated-measures analysis of variance and Bonferroni post hoc tests. Unified transdiagnostic treatment significantly reduced difficulties in emotion regulation, improved quality of life, and decreased fasting blood glucose compared with the control group. The time × group interaction was significant for difficulties in emotion regulation, F(3.52, 74.00) = 4.80, p = .004, η² = .21; quality of life, Wilks’ Λ = .47, F(4, 66) = 2.14, p < .001, η² = .39; and fasting blood glucose, F(4, 84) = 4.50, p = .002, η² = .18. Bonferroni comparisons confirmed significant improvements at posttest and follow-up. Unified transdiagnostic treatment was effective in improving emotion regulation, quality of life, and fasting blood glucose among patients with type 2 diabetes and can be used as a complementary psychological intervention in diabetes care.
Downloads
References
1. Kalra S, Jena BN, Yeravdekar R. Emotional and Psychological Needs of People with Diabetes. Indian Journal of Endocrinology and Metabolism. 2018;22(5):696-704. doi: 10.4103/ijem.IJEM_579_17.
2. Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial Factors in Medication Adherence and Diabetes Self-Management: Implications for Research and Practice. American Psychologist. 2016;71(7):539-51. doi: 10.1037/a0040388.
3. Gross JJ. Emotion Regulation: Current Status and Future Prospects. Psychological Inquiry. 2015;26(1):1-26. doi: 10.1080/1047840X.2014.940781.
4. Gratz KL, Roemer L. Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment. 2004;26(1):41-54. doi: 10.1023/B:JOBA.0000007455.08539.94.
5. Joseph JJ, Golden SH. Cortisol Dysregulation: The Bidirectional Link between Stress, Depression, and Type 2 Diabetes Mellitus. Annals of the New York Academy of Sciences. 2017;1391(1):20-34. doi: 10.1111/nyas.13217.
6. Rubin RR, Peyrot M. Quality of Life and Diabetes. Diabetes/Metabolism Research and Reviews. 1999;15(3):205-18. doi: 10.1002/(SICI)1520-7560(199905/06)15:3<205::AID-DMRR29>3.0.CO;2-O.
7. Sauer-Zavala S, Gutner CA, Farchione TJ, Boettcher HT, Bullis JR, Barlow DH. Current Definitions of "Transdiagnostic" in Treatment Development: A Search for Consensus. Behavior Therapy. 2017;48(1):128-38. doi: 10.1016/j.beth.2016.09.004.
8. Barlow DH, Allen LB, Choate ML. Toward a Unified Treatment for Emotional Disorders. Behavior Therapy. 2011;42(4):732-42.
9. Barlow DH, Farchione TJ, Sauer-Zavala S, Latin HM, Ellard KK, Bullis JR, et al. Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. 2nd ed: Oxford University Press; 2018.
10. Cassiello-Robbins C, Southward MW, Tirpak JW, Sauer-Zavala S. A Systematic Review of Unified Protocol Applications with Adult Populations: Facilitating Widespread Dissemination via Adaptability. Clinical Psychology Review. 2020;78:101852. doi: 10.1016/j.cpr.2020.101852.
11. Cassiello-Robbins C, Barlow DH. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. In: Barlow DH, editor. Clinical Handbook of Psychological Disorders. 6th ed: Guilford Press; 2021.
12. Pearl SB, Norton PJ. Transdiagnostic versus Diagnosis-Specific Cognitive Behavioural Therapies for Anxiety: A Meta-Analysis. Journal of Anxiety Disorders. 2017;46:11-24. doi: 10.1016/j.janxdis.2016.07.004.
13. Sakiris N, Berle D. A Systematic Review and Meta-Analysis of the Unified Protocol as a Transdiagnostic Emotion Regulation Based Intervention. Clinical Psychology Review. 2019;72:101751. doi: 10.1016/j.cpr.2019.101751.
14. Beyranvand N, Rezaei M. The Effectiveness of Unified Transdiagnostic Treatment on Depressive Symptoms and Alexithymia in Adolescents with Social Anxiety Disorder. Clinical Psychology. 2025;2:85-98.
15. Rahimi M, Bahramipour M. The effectiveness of unified transdiagnostic treatment on emotional awareness, cognitive emotion regulation, and positive and negative affect in anxious children. Clinical Psychology and Personality. 2024;22(1). doi: 10.22070/cpap.2024.16501.1252.
16. Ranjbar S. The Effectiveness of Unified Protocol Transdiagnostic Treatment on Emotion Regulation and Parent-Child Relationship of Parents of Children With Learning Disabilities. Journal of Learning Disabilities. 2024;13(4):12-23. doi: 10.22098/jld.2024.15431.2177.
17. Soleimani E, Chitsaz M. The effectiveness of unified transdiagnostic treatment on intolerance of uncertainty and self-control in adolescent boys with addiction vulnerability. Scientific Quarterly of Addiction Research. 2025;19(77):31-50.
18. Larki T. Comparison of the Impact of Mentalization-Based Therapy and Unified Transdiagnostic Treatment on Intimacy and Marital Satisfaction of Women With Experience of Marital Infidelity. Injoeacs. 2025;6(1):137-47. doi: 10.61838/kman.ijecs.6.1.14.
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2026 Rahim Basaeri (Author); Neda Alibeigi; Marzieh Poursalehi (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
