Introduction and purpose: Self-harming behaviors in adolescents pose a serious threat to their mental health; beyond intensifying negative emotions, these behaviors can establish a vicious cycle of maladaptive emotion regulation. This process impairs self-esteem, problem-solving abilities, and concentration, while also increasing vulnerability to suicidal ideation. According to this the present study was conducted to investigate the effectiveness of unified protocol for transdiagnostic treatment on Psychological Tolerance and Cognitive-Attentional Syndrome in Adolescent Girls with Self- Harm Behaviors.
Methodology: The current study was a semi-experimental application with a pre-test-post-test design with a control group and a two-month follow-up period. The statistical population consisted of adolescent girls with self-harming behaviors who visited the counseling center of the General Directorate of Education in Isfahan Province during the 2024–2025 academic year. In this study, 32 adolescent girls with self-harming behaviors were selected using purposive sampling and randomly assigned to either an experimental group or a control group (16 participants in the experimental group and 16 in the control group). The adolescents in the experimental group received the unified protocol for transdiagnostic treatment during five weeks in ten 75-minute sessions. In this study, the Self-Harm Behavior Questionnaire (SHBQ), the Psychological Tolerance Questionnaire (PTQ), and the Cognitive-Attentional Syndrome Questionnaire (CASQ) were used. were used in the present study. The data were analyzed through mixed ANOVA and Bonferroni post hoc test via SPSS23 software.
Findings: The results showed that unified protocol for transdiagnostic treatment has significant effect on psychological tolerance (P < 0.0001) and the cognitive-attentional syndrome (P < 0.0001) in adolescent girls with self-harming behaviors. These results remained stable during the two-month follow-up period.
Conclusion: Based on the research findings, an unified protocol for transdiagnostic treatment by targeting the shared mechanisms underlying emotional disorders has helped adolescents with self-harming behaviors to increase their psychological tolerance for negative emotions. Consequently, instead of resorting to self-harm, they have adopted more adaptive emotion regulation strategies. Furthermore, the reduction in the Cognitive-Attentional Syndrome indicates that this intervention has successfully decreased self-focused attention and negative rumination in these adolescents. The persistence of these results at the two-month follow-up suggests that the effects of the unified protocol for transdiagnostic treatment extend beyond temporary improvement, leading to enduring changes in cognitive-emotional structures.