Exploring Two Emotion-Focused Treatment Modules in Non-Suicidal Self-Injury

探索非自杀性自伤的两种以情绪为中心的治疗模块

• 批准号: 8525989
• 负责人: Kate H. Bentley
• 金额: $ 4.03万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-01 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8525989
• 关键词: Adult; Area; Awareness; Behavior; Borderline Personality Disorder; Bronchopulmonary Dysplasia; Characteristics; Client; Clinical; Cognitive; Complex; Development; Diagnosis; Diagnostic and Statistical Manual; Diagnostic and Statistical Manual of Mental Disorders; Dimensions; Disease; Distress; Effectiveness; Elements; Emotional; Emotional disorder; Emotions; Epidemiologic Studies; Ethics; Evidence based treatment; Experimental Designs; Feeling; Fellowship; Fostering; Frequencies; Goals; Guilt; Impairment; Individual; Intervention; Knowledge; Light; Major Depressive Disorder; Mental Health; Mentorship; Methodology; Methods; Modeling; Monitor; Negative Reinforcements; Participant; Phase; Population; Positive Reinforcements; Post-Traumatic Stress Disorders; Prevalence; Procedures; Process; Protocols documentation; Psychiatric Diagnosis; Regulation; Reporting; Research; Research Design; Research Personnel; Sampling; Scientist; Self-Injurious Behavior; Series; Shame; Telephone; Testing; Thinking; Training; Training Support; United States; base; clinical care; clinically significant; cognitive training; design; effective therapy; emotion regulation; emotional experience; evidence base; falls; follow-up; medical complication; meetings; mindfulness; non-suicidal self injury; phase change; psychologic; public health relevance; research and development; research study; skills; social; suicidal; suicidal behavior; theories; therapy development; treatment program

DESCRIPTION (provided by applicant): The broad aim of this study is to begin establishing an effective treatment for individuals who engage in non- suicidal self-injury (NSSI), as there are currently no evidence-based psychological interventions that directly target this transdiagnostic, maladaptive behavior (1). Epidemiological studies suggest that NSSI occurs in 19 to 25% of adult clinical samples (8), and is present across a range of Axis I and Axis II disorders (3, 15, 16). Extant treatments that have demonstrated initial promise in reducing NSSI incorporate a multitude of skills embedded in complex multi-component treatment programs (e.g., 26, 52, 63); thus, the treatment component(s) responsible for improvements in NSSI are not readily apparent. A growing body of research emphasizes the importance of emotion dysregulation in NSSI (e.g., 27, 28, 36). Emotion-focused psychological procedures, particularly that aim to foster greater emotional awareness and increase engagement in cognitive reappraisal strategies, may be critical in effective NSSI treatment (e.g., 34, 60, 65). The specific goals of te research study proposed for this fellowship are to investigate the effects of two specific emotion-focused treatment elements on parameters of NSSI while simultaneously providing invaluable training in research design and execution, use of ecological momentary assessment (EMA) methods, exploration of transdiagnostic psychopathological processes, and treatment development research. Participants will be ten individuals (N=10) who meet proposed DSM-5 criteria for NSSI disorder (9) and report engaging in NSSI to reduce or escape from negative emotions. The investigator will adapt two core modules of the Unified Protocol Transdiagnostic Treatment of Emotional Disorders (UP; 70) with the aim of reducing participants' non-suicidal self-injurious thoughts and behaviors (SITBs; 2). Each treatment module will consist of four 50-minute individual weekly sessions of emotion awareness training or cognitive reappraisal. The study will use a counterbalanced, combined-series (multiple baseline and phase change) design, which will allow for both between-subjects comparison and clients to serve as their own control (i.e., within-subjects comparison). Phase change will be determined idiosyncratically based on each participant's changes in frequency of non- suicidal SITBs. This single-case experimental design methodology offers the opportunity to flexibly tailor interventions to the individual as needed (115), and is recommended in research of harmful behaviors due to ending on a treatment phase, which can be extended to allow for good clinical care (71). The frequency and characteristics of non-suicidal SITBs will be monitored continuously with EMA on a smart-phone. Coursework, training, and mentorship germane to the proposed research will support the applicant's long-term goal to become an independent scientist-practitioner in this key field of mental health.

描述（由申请人提供）：本研究的主要目的是开始为非自杀性自伤（NSSI）的个体建立一种有效的治疗方法， 目前还没有直接针对这种转化诊断，适应不良行为的循证心理干预措施（1）。流行病学研究表明，NSSI发生在19%至25%的成人临床样本中（8），并且存在于一系列轴I和轴II疾病中（3，15，16）。已经证明在减少NSSI方面具有初步前景的现有治疗方法结合了复杂的多组分治疗方案中嵌入的多种技能（例如，26，52，63）;因此，导致NSSI改善的治疗组分并不明显。越来越多的研究强调了情绪失调在NSSI中的重要性（例如，27、28、36）。以预防为重点的心理程序，特别是旨在培养更大的情感意识和增加对认知重新评价策略的参与的程序，可能对有效的NSSI治疗至关重要（例如，34、60、65）。该研究的具体目标是调查两个特定的情绪集中的治疗元素对NSSI参数的影响，同时在研究设计和执行，使用生态瞬时评估（EMA）方法，探索transdiagnosis精神病理学过程和治疗开发研究方面提供宝贵的培训。参与者将是十个人（N=10），他们符合拟议的DSM-5 NSSI障碍标准（9），并报告参与NSSI以减少或逃避负面情绪。研究人员将调整情绪障碍统一协议跨诊断治疗（UP; 70）的两个核心模块，旨在减少参与者的非自杀性自我伤害想法和行为（SITBs; 2）。每个治疗模块将包括四个50分钟的情绪意识训练或认知重新评估的每周会议。本研究将使用平衡、组合系列（多个基线和相位变化）设计，这将允许受试者之间进行比较，并允许客户作为自己的对照（即，受试者内比较）。将基于每名受试者非自杀性SITB频率的变化特异性地确定阶段变化。这种单一病例实验设计方法提供了根据需要灵活调整个体干预措施的机会（115），并建议在治疗阶段结束时进行有害行为的研究，可以扩展到允许良好的临床护理（71）。将使用智能手机上的EMA持续监测非自杀性SITB的频率和特征。与拟议研究密切相关的课程，培训和指导将支持申请人的长期目标，即成为心理健康这一关键领域的独立科学家实践者。