The purpose of this study was to evaluate whether the Unified Protocol (UP)—a mechanistically transdiagnostic psychological treatment—provides benefit to individuals with a range of trauma histories, psychological difficulties, and diagnostic comorbidity. Using data from a sequential multiple-assignment randomized trial (SMART), this exploratory analysis included a sample of 69 community-recruited adults seeking outpatient mental health treatment. We examined reductions in anxiety and depressive symptoms and changes in aversive and avoidant reactions to intense emotions—the UP’s putative mechanism—first by comparing individuals with and without trauma histories and then specifically among participants with PTSD. Findings suggest that the UP may lead to similar improvements in clinical diagnostic severity, anxiety, and depression among patients with trauma exposure as those without trauma exposure. Roughly half of participants with PTSD demonstrated reductions in PTSD clinical severity, anxiety, depression, and distress aversion, suggesting the UP may be an efficacious treatment for people with PTSD and comorbid conditions.

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Published in International Journal of Environmental Research and Public Health, v. 18, issue 21, 11729.

© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Effort on this project was supported by the National Institute on Drug Abuse (T32 DA035200) through the National Institutes of Health (NIH). This publication’s contents are solely the responsibility of the authors and do not necessarily represent the official views of NIH.

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Raw data are available upon request. Syntax files for the primary outcomes are located on Open Science Framework (https://osf.io/xrv8k/) (accessed on 8 November 2021).

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