{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:09:23Z","timestamp":1788883763611,"version":"build-2803163510"},"reference-count":61,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["PI17\/00320"],"award-info":[{"award-number":["PI17\/00320"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010067","name":"Gobierno de Arag\u00f3n","doi-asserted-by":"publisher","award":["S31_23R"],"award-info":[{"award-number":["S31_23R"]}],"id":[{"id":"10.13039\/501100010067","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Psychology and Psychoth"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Dropout, defined as the unilateral discontinuation of treatment before achieving goals or completing a set number of sessions, affects a large number of individuals. Additionally, many individuals do not experience an improvement of symptoms after treatment. This study has explored the profile of individuals who drop out or do not respond favourably to the Unified Protocol (UP) applied in group format. This is a secondary analysis of a RCT that involved 277 participants (78.3% women) diagnosed with emotional disorders who received 12\u2010weekly group sessions at specialized mental health units. Socio\u2010demographic variables, personality, anxiety and depression symptoms and emotional regulation were analysed at baseline, post\u2010treatment and 12\u2010month follow\u2010up. Fewer emotional regulation difficulties at baseline predict higher dropout rates at post\u2010treatment, with 28.9% of participants (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200980) receiving fewer than six sessions. Additionally, 46.0% of participants showed no change in the severity of depressive symptoms, and 56.8% showed no change in anxiety symptoms post\u2010treatment. At the 12\u2010month follow\u2010up, 31.1% of participants maintained the same severity level for depressive symptoms and 49.5% for anxiety symptoms. Higher baseline anxiety and emotional dysregulation and lower extraversion predicted higher depressive symptoms at post\u2010treatment, and higher baseline anxiety predicted higher depressive symptomatology at the 12\u2010month follow\u2010up. Higher baseline depression and emotional dysregulation predicted higher post\u2010treatment anxiety, and depression also predicted higher anxiety at the 12\u2010month follow\u2010up. Additionally, high baseline depression predicted higher neuroticism and emotional dysregulation and lower extraversion after treatment and at the 12\u2010month follow\u2010up (for neuroticism and extraversion). Finally, high baseline emotional dysregulation predicted higher neuroticism post\u2010treatment, whereas high baseline maladjustment predicted lower emotional dysregulation at post\u2010treatment. Emotional dysregulation, neuroticism, extraversion and especially baseline depression and anxiety symptoms are key factors associated with dropouts and treatment response when applying the UP in group format. Considering these variables may improve attendance and treatment outcomes.\n                  <\/jats:p>","DOI":"10.1002\/cpp.70154","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T11:41:27Z","timestamp":1758022887000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Defining the Profile of People With Emotional Disorders That Drop Out or Do Not Respond to Treatment After Receiving the Unified Protocol in Group Format"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2437-1207","authenticated-orcid":false,"given":"\u00d3.","family":"Peris\u2010Baquero","sequence":"first","affiliation":[{"name":"Universidad de Zaragoza  Zaragoza Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria de Arag\u00f3n  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u00a0D.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Universidad Aut\u00f3noma de Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Mart\u00ednez\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Universidad de Zaragoza  Zaragoza Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria de Arag\u00f3n  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"P\u00e9rez\u00a0Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Universidad de Zaragoza  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7293-318X","authenticated-orcid":false,"given":"J.","family":"Osma","sequence":"additional","affiliation":[{"name":"Universidad de Zaragoza  Zaragoza Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria de Arag\u00f3n  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders (DSM\u2010IV)","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5944\/ap.19.2.37000"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11469\u2010024\u201001330\u2010z"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/09637214211030253"},{"key":"e_1_2_9_6_1","volume-title":"Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide","author":"Barlow D. H.","year":"2018"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2167702613505532"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033\u20103204.45.2.247"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"e_1_2_9_10_1","volume-title":"Beck Anxiety Inventory Manual","author":"Beck A. T.","year":"1993"},{"key":"e_1_2_9_11_1","volume-title":"BDI\u2010II, Beck Depression Inventory: Manual Second Edition","author":"Beck A. T.","year":"1996"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2021.03.007"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/gmh.2024.94"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0016608"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20539"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/cpsp.12278"},{"key":"e_1_2_9_17_1","volume-title":"Revised NEO Personality Inventory (NEO\u2010PI\u2010R) and NEO Five\u2010Factor Inventory (NEO\u2010FFI)","author":"Costa P. T.","year":"1999"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2008.07091422"},{"issue":"74","key":"e_1_2_9_19_1","first-page":"561","article-title":"Abandono Terap\u00eautico na Terapia Cognitivo\u2010Comportamental","volume":"31","author":"Rosa Pureza J.","year":"2013","journal-title":"Psicologia em Argumento"},{"key":"e_1_2_9_20_1","volume-title":"Anxiety Disorders Interview Schedule for DSM\u2010IV: Lifetime Version (ADIS\u2010IV\u2010L)","author":"Di Nardo P. A.","year":"1994"},{"issue":"107","key":"e_1_2_9_21_1","first-page":"325","article-title":"Escala de Inadaptaci\u00f3n: Propiedades Psicom\u00e9tricas en Contextos Cl\u00ednicos","volume":"26","author":"Echebur\u00faa E.","year":"2000","journal-title":"An\u00e1lisis y Modificaci\u00f3n de Conducta"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10608\u2010020\u201010116\u20101"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000044"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:JOBA.0000007455.08539.94"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.3109\/01612840.2012.713082"},{"issue":"2","key":"e_1_2_9_26_1","first-page":"139","article-title":"Adaptaci\u00f3n al Castellano de la Escala de Dificultades en la Regulaci\u00f3n Emocional","volume":"19","author":"Herv\u00e1s G.","year":"2008","journal-title":"Cl\u00ednica y Salud"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10608\u2010012\u20109476\u20101"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1109\/MCSE.2007.55"},{"key":"e_1_2_9_29_1","unstructured":"IHME (Institute for Health Metrics and Evaluation).2023. \u201cGlobal Health Data Exchange (GHDx).\u201dhttps:\/\/www.healthdata.org\/spain?language=149."},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000111"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.1899"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000059"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010clinpsy\u2010032210\u2010104540"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1037\/12141-000"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40479\u2010016\u20100043\u20103"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.08.004"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-200005000-00008"},{"key":"e_1_2_9_38_1","unstructured":"National Collaborating Centre for Mental Health.2020. \u201cThe Improving Access to Psychological Therapies Manual.\u201dhttps:\/\/www.england.nhs.uk\/wp\u2010content\/uploads\/2018\/06\/nhs\u2010talking\u2010therapies\u2010manual\u2010v7.1\u2010updated.pdf."},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2694"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40359\u2010024\u201002133\u20106"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010018\u20100866\u20102"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.57.102904.190127"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12144\u2010022\u201003365\u20108"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2023.03.079"},{"key":"e_1_2_9_45_1","volume-title":"R: A Language and Environment for Statistical Computing. Version 4.4.0","author":"R Core Team","year":"2024"},{"key":"e_1_2_9_46_1","first-page":"31","volume-title":"Aplicaciones del Protocolo Unificado Para el Tratamiento Transdiagn\u00f3stico de la Disregulaci\u00f3n Emocional","author":"Rosellini A. J.","year":"2019"},{"key":"e_1_2_9_47_1","volume-title":"Adherence to Long\u2010Term Therapies: Evidence for Action","author":"Sabat\u00e9 E.","year":"2003"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.23113"},{"issue":"1","key":"e_1_2_9_49_1","first-page":"37","article-title":"Escalas PANAS de Afecto Positivo y Negativo: Validaci\u00f3n Factorial y Convergencia Transcultural","volume":"11","author":"Sand\u00edn B.","year":"1999","journal-title":"Psicothema"},{"issue":"3","key":"e_1_2_9_50_1","first-page":"563","article-title":"The Beck Anxiety Inventory (BAI): Psychometric Properties of the Spanish Version in Patients With Psychological Disorders","volume":"20","author":"Sanz J.","year":"2012","journal-title":"Behavioral Psychology\/Psicologia Conductual"},{"issue":"124","key":"e_1_2_9_51_1","first-page":"239","article-title":"Adaptaci\u00f3n Espa\u00f1ola del Inventario Para la Depresi\u00f3n de Beck\u2010II (BDI\u2010II): 1. Propiedades Psicom\u00e9tricas en Estudiantes Universitarios","volume":"29","author":"Sanz J.","year":"2003","journal-title":"An\u00e1lisis y Modificaci\u00f3n de Conducta"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2013.04.007"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145445518774914"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2016.09.004"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10608\u2010018\u20109979\u20105"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2010.541294"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0028226"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0037512"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2018.00756"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.54.6.1063"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1037\/0735\u20107028.24.2.190"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2018.05.004"}],"container-title":["Clinical Psychology &amp; Psychotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cpp.70154","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T06:43:55Z","timestamp":1762929835000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cpp.70154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":61,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/cpp.70154"],"URL":"https:\/\/doi.org\/10.1002\/cpp.70154","archive":["Portico"],"relation":{},"ISSN":["1063-3995","1099-0879"],"issn-type":[{"value":"1063-3995","type":"print"},{"value":"1099-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70154"}}