Authenticity as a Mediator of Change in Anxiety Disorders Treatment

Strategic Insights -

Research conducted at the National Center of Neurology and Psychiatry in Tokyo, Japan, has shed light on the significance of authenticity in treating anxiety disorders. The study, which was a secondary analysis of a randomized controlled trial, found that the Unified Protocol (UP), a transdiagnostic cognitive-behavioural treatment, improved patients' subjective sense of authenticity. The researchers also discovered that changes in authenticity mediated the treatment effect on depression, suggesting that authenticity is a viable candidate for future research examining the mechanisms of psychotherapy.

Key Takeaways:

  • The study involved 104 patients with depressive (n = 52) and anxiety disorders (n = 52) and used multilevel models to assess the effect of the Unified Protocol (UP) on authenticity and depression.
  • Patients who received the UP showed significantly higher levels of self-reported sense of authenticity compared to waitlist controls (d = 0.97, 95% CI [0.28, 1.65]).
  • The effect of the UP on authenticity was maintained at the six-month follow-up.
  • Authenticity mediated the treatment effect on depression (indirect effect: b = -6.51, SE = 2.89, 95% CI [-14.04, -1.88]), accounting for 22.90% of the total effect.
  • The mediation remained significant when controlling for therapeutic alliance.
  • The study provides empirical evidence that changes in authenticity can mediate outcomes in the UP, suggesting that authenticity is a viable candidate for future research examining the mechanisms of psychotherapy.

Statistics:

  • 104 patients participated in the study, with 52 patients diagnosed with depressive disorders and 52 patients diagnosed with anxiety disorders.
  • The Unified Protocol (UP) showed a significant improvement in patients' self-reported sense of authenticity, with a Cohen's d of 0.97.
  • A 95% confidence interval for the effect size ranges from 0.28 to 1.65.
  • The indirect effect of authenticity on depression was -6.51 (SE = 2.89), with a 95% confidence interval ranging from -14.04 to -1.88.
  • Authenticity accounted for 22.90% of the total effect on depression.

Sources:

  • NewsRx. Researchers at National Center of Neurology and Psychiatry Report Findings in Anxiety Disorders (Authenticity as a Mediator of Change in the Unified Protocol for Transdiagnostic Treatment of Depressive and Anxiety Disorders). Psychology & Psychiatry Journal. November 1, 2025; p 907.
  • Masaya Ito, So Sugita, Hiroko Fujisato, Ayako Kanie, Shun Nakajima, Todd J. Farchione, and Hironori Kuga. Authenticity as a Mediator of Change in the Unified Protocol for Transdiagnostic Treatment of Depressive and Anxiety Disorders. Clinical Psychology & Psychotherapy, 2025;32(5).