情绪调节个体治疗对非自杀性自伤障碍青少年的可行性研究。
Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: a feasibility study.
机构信息
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69, SE-11364, Stockholm, Sweden.
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
出版信息
BMC Psychiatry. 2017 Dec 28;17(1):411. doi: 10.1186/s12888-017-1527-4.
BACKGROUND
Nonsuicidal self-injury (NSSI) is a serious health risk behavior that forms the basis of a tentative diagnosis in DSM-5, NSSI Disorder (NSSID). To date, established treatments specific to NSSI or NSSID are scarce. As a first step in evaluating the feasibility, acceptability, and utility of a novel treatment for adolescents with NSSID, we conducted an open trial of emotion regulation individual therapy for adolescents (ERITA): a 12-week, behavioral treatment aimed at directly targeting both NSSI and its proposed underlying mechanism of emotion regulation difficulties.
METHODS
Seventeen girls (aged 13-17; mean = 15.31) with NSSID were enrolled in a study adopting an uncontrolled open trial design with self-report and clinician-rated assessments of NSSI and other self-destructive behaviors, emotion regulation difficulties, borderline personality features, and global functioning administered at pre-treatment, post-treatment, and 6-month follow-up. Measures of NSSI and emotion regulation difficulties were also administered weekly during treatment.
RESULTS
Ratings of treatment credibility and expectancy and the treatment completion rate (88%) were satisfactory, and both therapeutic alliance and treatment attendance were strong. Intent-to-treat analyses revealed significant improvements associated with large effect sizes in past-month NSSI frequency, emotion regulation difficulties, self-destructive behaviors, and global functioning, as well as a medium effect size in past-month NSSI versatility, from pre- to post-treatment. Further, all of these improvements were either maintained or further improved upon at 6-month follow-up. Finally, change in emotion regulation difficulties mediated improvements in NSSI over the course of treatment.
CONCLUSIONS
Results suggest the acceptability, feasibility, and utility of this treatment for adolescents with NSSID.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT02326012, December 22, 2014, retrospectively registered).
背景
非自杀性自伤（NSSI）是一种严重的健康风险行为，构成了 DSM-5 中暂定诊断的基础，即非自杀性自伤障碍（NSSID）。迄今为止，针对 NSSI 或 NSSID 的既定治疗方法还很少。作为评估针对 NSSID 青少年的新型治疗方法的可行性、可接受性和实用性的第一步，我们对青少年情绪调节个体治疗（ERITA）进行了开放性试验：这是一种为期 12 周的行为治疗方法，旨在直接针对 NSSI 及其提出的情绪调节困难的潜在机制。
方法
17 名患有 NSSID 的女孩（年龄 13-17 岁；平均年龄=15.31 岁）参加了一项研究，该研究采用了无对照开放性试验设计，使用自我报告和临床医生评定的 NSSI 和其他自我伤害行为、情绪调节困难、边缘型人格特征和总体功能的评估，在治疗前、治疗后和 6 个月随访时进行评估。在治疗期间还每周评估 NSSI 和情绪调节困难的测量。
结果
治疗可信度、期望和治疗完成率（88%）的评定令人满意，治疗联盟和治疗出勤率都很强。意向治疗分析显示，过去一个月 NSSI 频率、情绪调节困难、自我伤害行为和总体功能显著改善，具有大的效应量，过去一个月 NSSI 多样性也有中等的效应量，从治疗前到治疗后。此外，所有这些改善在 6 个月随访时都得到了维持或进一步改善。最后，情绪调节困难的变化中介了治疗过程中 NSSI 的改善。
结论
结果表明，该治疗方法对患有 NSSID 的青少年是可接受、可行和有效的。
试验注册
ClinicalTrials.gov（NCT02326012，2014 年 12 月 22 日，回顾性注册）。
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