{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T17:07:43Z","timestamp":1773162463009,"version":"3.50.1"},"reference-count":46,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Japanese Society for the Promotion of Science","award":["25705018; 17H04788; 18K13337"],"award-info":[{"award-number":["25705018; 17H04788; 18K13337"]}]},{"name":"NCNP Intramural Research Grant","award":["24-4, 27-3, 30-2"],"award-info":[{"award-number":["24-4, 27-3, 30-2"]}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP20dk0307084"],"award-info":[{"award-number":["JP20dk0307084"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: The efficacy of the Unified Protocol (UP), a transdiagnostic cognitive-behavioral therapy, with trauma-focused exposure has not been sufficiently demonstrated for post-traumatic stress disorder (PTSD) with multiple comorbidities. This study examined the effects of UP treatment with trauma-focused exposure on symptoms of PTSD and comorbidities in a client who was hesitant about exposure. (2) Methods: The client, who had comorbid dysthymia, social anxiety disorder, agoraphobia, and bulimia nervosa, participated in the UP for 20 sessions over 6 months. The principal diagnosis and symptoms of the comorbid disorders were assessed at baseline, post-intervention, and at the 3-month follow-up. This treatment was conducted as part of a clinical study (UMIN000008322). (3) Results: The client showed improvement in the principal diagnosis and symptoms of the comorbid disorders post-intervention compared with baseline and no longer met the diagnostic criteria for any of the disorders. Considerable symptom improvement was observed with imaginal exposure to trauma memories. (4) Conclusions: The UP was an effective alternative treatment for PTSD and symptoms of comorbidities in this client who was hesitant about exposure to traumatic memories, and that the inclusion of trauma-focused exposure provided sufficient therapeutic effects. Further research is needed to examine the generalizability of our findings.<\/jats:p>","DOI":"10.3390\/ijerph182111644","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T10:33:09Z","timestamp":1636108389000},"page":"11644","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Application of the Unified Protocol for a Japanese Patient with Post-Traumatic Stress Disorder and Multiple Comorbidities: A Single-Case Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Noriko","family":"Kato","sequence":"first","affiliation":[{"name":"Department of Neuropsychiatry, Keio University School of Medicine, Tokyo 160-8582, Japan"},{"name":"National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2295-9733","authenticated-orcid":false,"given":"Masaya","family":"Ito","sequence":"additional","affiliation":[{"name":"National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8690-8129","authenticated-orcid":false,"given":"Yutaka J.","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"National Hospital Organization Disaster Medical Center, Department of Psychiatry, Tokyo 190-0014, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaru","family":"Horikoshi","sequence":"additional","affiliation":[{"name":"National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Ono","sequence":"additional","affiliation":[{"name":"Ono Institute for Cognitive Behavior Therapy, Tokyo 102-0072, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.cpr.2015.10.003","article-title":"Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis","volume":"43","author":"Cusack","year":"2016","journal-title":"Clin. 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