Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: a feasibility study

BMC Psychiatry. 2017 Dec 28;17(1):411. doi: 10.1186/s12888-017-1527-4.

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).

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

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior / physiology
  • Adolescent Behavior / psychology*
  • Emotions* / physiology
  • Feasibility Studies
  • Female
  • Humans
  • Psychotherapy / methods*
  • Retrospective Studies
  • Self Report
  • Self-Injurious Behavior / diagnosis
  • Self-Injurious Behavior / psychology*
  • Self-Injurious Behavior / therapy*

Associated data

  • ClinicalTrials.gov/NCT02326012
  • ClinicalTrials.gov/NCT02326012