Citation

Bjureberg J, Sahlin H, Hellner C, Hedman-Lagerlöf E, Gratz KL, Bjärehed J, Jokinen J, Tull MT, Ljótsson B. BMC Psychiatry 2017; 17(1): e411.

Affiliation

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

Copyright

(Copyright © 2017, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12888-017-1527-4

PMID

29282024

Abstract

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).

Language: en

Keywords

Emotion regulation; Emotion regulation individual therapy; Mediation; Nonsuicidal self-injury disorder; Self-harm