Maria Neizvestnaya, Psy.D., is a 2022 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England

Dissertation Committee:

  • Theodore Ellenhorn, PhD, ABPP, Committee Chair
  • Jennifer McLean, PsyD, Committee Member
  • Barbara Belcher-Timme, PsyD, Committee Member


anxiety, digital therapeutics, emotion regulation, attachment security, attachment anxiety, self-esteem, mindfulness-based interventions, population health

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The COVID-19 pandemic exacerbated the prevalence of anxiety disorders, making it a population health concern in the United States and worldwide. The growing need for effective prevention and treatment of anxiety coincides with a deficit of mental health providers and physicians. With the healthcare system currently overwhelmed and the slow training pipeline of new providers, the gap between patient demand and treatment providers will not be closed in the next decade. There is a growing need for evidence-based treatments for anxiety disorders that can increase access to care while addressing the underlying mechanisms of anxiety. Digital therapeutics is a fast-developing field that can be one such solutions provided in “one-to-many” format. It can be used in conjunction with individual therapy, as well as independently, depending on the severity of patients’ symptoms. This quantitative dissertation study aimed to investigate the mechanism of reducing anxiety in the digital application (app) Unwinding Anxiety Program and its impact on emotion regulation, self-representation (self-esteem), and the degree of attachment security in adults. The study used a single-case experimental design to assess the effect size of the intervention in these domains. Five study participants completed the program. The results of the study demonstrated the efficacy of the intervention for reducing anxiety among participants with medium to large effect size and decrease of attachment-related anxiety for all participants with small effect size. All study participants demonstrated improved emotion regulation with moderate effect size for the sample. Self-esteem scores improved for some participants, while decreased for others. These findings support the existing evidence for the efficacy of mindfulness-based interventions for anxiety demonstrating the key role of emotion regulation in the mechanism of change. This study brings the novelty of examining the impact of digital therapeutic intervention on attachment security.


Maria Neizvestnaya

ORCID Scholar ID# 0000-0003-2356-8961