Rosendahl-Santillo Alexandra, Lantto Reid, Nylander Lena, Thylander Christina, Schultz Pernilla, Brown Julie, Wallinius Märta, Westling Sofie
Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.
Gillberg Neuropsychiatry Centre, Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Int J Dev Disabil. 2021 Sep 1;69(4):533-545. doi: 10.1080/20473869.2021.1965825. eCollection 2023.
Dialectical behavior therapy (DBT) is an evidence-based treatment for self-harm and emotion regulation difficulties. A modified version, DBT-Skills System (DBT-SS), has been developed in the USA for individuals with cognitive difficulties. The present study is a pilot study, testing the DBT-SS in a Swedish context. Six participants were treated with individual therapy and group skills training for 48 sessions each. A case series design was used to follow individual development over time. The primary outcome measure was reduction in challenging behaviors. Secondary outcomes were level of functioning in daily life, hospital admissions, and resilience and vulnerabilities in different risk domains. Data was analyzed using time-series diagrams. Effect sizes of changes were calculated using Cohen's d. Challenging behaviors decreased over time and participants' global level of functioning increased. There was a reduction in number of hospital admissions over time. As for resilience and vulnerabilities, participants' overall level of risk in various areas remained unchanged or decreased after treatment. The results indicate that DBT-SS might be a promising treatment for cognitively challenged individuals with emotion regulation difficulties and challenging behaviors in a Swedish context. The study provides suggestions for a future randomized controlled trial. Supplemental data for this article is available online at here.
辩证行为疗法（DBT）是一种针对自我伤害和情绪调节困难的循证治疗方法。美国针对认知困难个体开发了一种改良版的辩证行为疗法技能系统（DBT-SS）。本研究是一项试点研究，在瑞典背景下对DBT-SS进行测试。六名参与者分别接受了48节个体治疗和团体技能培训。采用病例系列设计来跟踪个体随时间的发展。主要结局指标是挑战性行为的减少。次要结局包括日常生活功能水平、住院次数以及不同风险领域的复原力和脆弱性。使用时间序列图对数据进行分析。使用科恩d值计算变化的效应量。随着时间的推移，挑战性行为减少，参与者的整体功能水平提高。随着时间的推移，住院次数减少。至于复原力和脆弱性，治疗后参与者在各个领域的总体风险水平保持不变或下降。结果表明，在瑞典背景下，DBT-SS可能是一种有前景的治疗方法，适用于有情绪调节困难和挑战性行为的认知障碍个体。该研究为未来的随机对照试验提供了建议。本文的补充数据可在网上此处获取。
