Hall Kate, Youssef George, Simpson Angela, Sloan Elise, Graeme Liam, Perry Natasha, Moulding Richard, Baker Amanda L, Beck Alison K, Staiger Petra K
School of Psychology, Deakin University, Geelong, VIC, Australia.
Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, VIC, Australia.
Front Psychol. 2021 Apr 1;12:554100. doi: 10.3389/fpsyg.2021.554100. eCollection 2021.
There is a demonstrated link between the mental health and substance use comorbidities experienced by young adults, however the vast majority of psychological interventions are disorder specific. Novel psychological approaches that adequately acknowledge the psychosocial complexity and transdiagnostic needs of vulnerable young people are urgently needed. A modular skills-based program for emotion regulation and impulse control (ERIC) addresses this gap. The current one armed open trial was designed to evaluate the impact that 12 weeks exposure to ERIC alongside usual care had on young people's ability to regulate emotions, as well as examine potential moderating mechanisms. Seventy nine young people (50.6% male; = 19.30; = 2.94) were enrolled to the 12 week intervention period. Twenty one practitioners from youth and community health services delivered relevant ERIC modules adjunct to usual care. Linear mixed effects regression (with random intercept) was used to examine change over time across the primary outcome of emotion dysregulation and secondary outcomes of depression, anxiety, stress, experiential avoidance and mindfulness. Moderation analyses were conducted to test whether the magnitude of change in emotion dysregulation moderated change over time in secondary outcomes. Analyses revealed significant improvement in the primary outcome of emotion dysregulation with a moderate effect size (Mean Change = -10.24, 95% CI (-14.41, -6.06; Cohen's d = -0.53), in addition to decreases in the secondary outcomes of depression, anxiety, stress and experiential avoidance. No improvements in mindfulness were reported. Moderation analyses revealed that the residualised change over time in emotion dysregulation moderated the change over time in symptoms of distress, depression, anxiety, stress, experiential avoidance, and mindfulness. Reductions in the severity of emotion dysregulation, depression, anxiety, stress and experiential avoidance are promising, and were evident despite the complexity of the participants and the diversity of the service setting. The improvements found in each outcome were only observed for those young people whose emotion regulation also improved, providing preliminary evidence for the role of emotion regulation as a key treatment target in this population.
已证实年轻成年人所经历的心理健康问题与物质使用共病之间存在联系，然而绝大多数心理干预都是针对特定疾病的。迫切需要新的心理方法，以充分认识到脆弱年轻人的心理社会复杂性和跨诊断需求。一个基于技能模块的情绪调节与冲动控制项目（ERIC）填补了这一空白。当前的单臂开放试验旨在评估在接受常规护理的同时，为期12周的ERIC干预对年轻人情绪调节能力的影响，并研究潜在的调节机制。79名年轻人（50.6%为男性；平均年龄=19.30岁；标准差=2.94岁）参加了为期12周的干预期。来自青年和社区卫生服务机构的21名从业者在常规护理的基础上提供了相关的ERIC模块。使用线性混合效应回归（随机截距）来检验情绪失调的主要结果以及抑郁、焦虑、压力、经验性回避和正念的次要结果随时间的变化。进行调节分析以测试情绪失调变化的幅度是否调节次要结果随时间的变化。分析显示，情绪失调的主要结果有显著改善，效应量中等（平均变化=-10.24，95%置信区间（-14.41，-6.06）；科恩d值=-0.53），此外，抑郁、焦虑、压力和经验性回避的次要结果也有所下降。未报告正念方面的改善。调节分析显示，情绪失调随时间的残差变化调节了痛苦、抑郁、焦虑、压力、经验性回避和正念症状随时间的变化。情绪失调、抑郁、焦虑、压力和经验性回避严重程度的降低是有希望的，尽管参与者情况复杂且服务环境多样，但这些改善仍然明显。仅在情绪调节也得到改善的年轻人中观察到每个结果的改善，这为情绪调节作为该人群关键治疗靶点的作用提供了初步证据。
