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多中心开放试验中情绪调节团体治疗疗效改善的预测因素。

Predictors of improvement in an open-trial multisite evaluation of emotion regulation group therapy.

机构信息

a Centre for Psychiatry Research, Department of Clinical Neuroscience , Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden.

b Department of Psychology, Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden.

出版信息

Cogn Behav Ther. 2019 Jul;48(4):322-336. doi: 10.1080/16506073.2018.1509119. Epub 2018 Sep 19.

Abstract

Emotion regulation group therapy (ERGT) is a novel treatment specifically targeting deliberate non-suicidal self-harm (DSH) in individuals with borderline personality disorder (BPD). Identifying robust predictors of positive response to ERGT could aid clinicians in treatment selection; however, to date, only one such study has been conducted. Thus, we aimed to replicate previously identified predictors of treatment response to ERGT by investigating demographic, clinical, and diagnostic predictors in 95 women with BPD or subclinical BPD who had participated in an open-trial evaluation of ERGT. Outcomes evaluated were frequency of DSH and emotion dysregulation. Assessments were conducted at pretreatment, post-treatment, and 6-month follow-up. Multilevel mixed linear models and multilevel negative binomial generalized estimated equations were used to identify significant interactions between the predictors and outcomes. We found that greater pretreatment DSH frequency was associated with greater improvements in DSH during treatment ( = 0.998, SE = 0.00,  = 0.03) and follow-up ( = 0.997, SE = 0.00,  < 0.01) and that greater BPD severity was associated with greater improvements in DSH during treatment ( = 0.84, SE = 0.06,  = 0.02) and in emotion dysregulation at follow-up ( = -3.05, SE = 1.47,  = 0.04). Co-occurring disorders were associated with poorer treatment response during follow-up. Results were generally consistent with a previous study of the predictors of response to ERGT. The findings provide further support for the utility of this treatment across a range of BPD patients, including patients with severe DSH and BPD.

摘要

情绪调节团体治疗(ERGT)是一种针对边缘型人格障碍(BPD)患者蓄意非自杀性自伤(DSH)的新型治疗方法。确定对 ERGT 治疗反应的有力预测因素可以帮助临床医生选择治疗方法;然而,迄今为止,只有一项这样的研究。因此,我们旨在通过调查 95 名患有 BPD 或亚临床 BPD 的女性在 ERGT 开放试验中的人口统计学、临床和诊断预测因素,复制先前确定的 ERGT 治疗反应预测因素。评估的结果是 DSH 的频率和情绪失调。评估在治疗前、治疗后和 6 个月随访时进行。使用多层次混合线性模型和多层次负二项式广义估计方程来识别预测因素与结果之间的显著相互作用。我们发现,治疗前 DSH 频率越高,治疗期间(β=0.998,SE=0.00,β=0.03)和随访期间(β=0.997,SE=0.00,β<0.01)的 DSH 改善越大,BPD 严重程度越高,治疗期间(β=0.84,SE=0.06,β=0.02)和随访期间(β=-3.05,SE=1.47,β=0.04)的 DSH 和情绪失调改善越大。共病与随访期间的治疗反应较差有关。结果与之前关于 ERGT 反应预测因素的研究基本一致。这些发现为该治疗方法在一系列 BPD 患者中的应用提供了进一步的支持,包括有严重 DSH 和 BPD 的患者。

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