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: 8654263
• 负责人: Kate H. Bentley
• 金额: $ 3.05万
• 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/8654263
• 关键词: Adult; Area; Awareness; Behavior; Borderline Personality Disorder; Characteristics; Client; Clinical; Cognitive; Complex; Development; Diagnosis; 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）：本研究的广泛目的是开始为从事非自杀自我伤害（NSSI）的个人建立有效的治疗方法，因为有 目前，没有直接针对这种转诊性，适应不良行为的基于证据的心理干预措施（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Axis II疾病中（3、15、16）。现有的治疗方法在减少NSSI方面表现出了最初的承诺，其中包括嵌入了复杂多组分治疗计划中的多种技能（例如26，52，63）；因此，负责改善NSSI的治疗部分并不容易显而易见。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）。以情绪为重点的心理程序，尤其是旨在增强情感意识并增加认知重新评估策略的参与，这对于有效的NSSI治疗可能至关重要（例如34、60、65）。 TE研究的特定目标是为该团契提出的研究，以研究两个具体的以情绪为中心的治疗元素对NSSI参数的影响，同时在研究设计和执行中提供了宝贵的培训，生态瞬时评估（EMA）方法的使用，探索经诊断的精神病理学病理学过程和治疗发展研究。参与者将是十个人（n = 10），他们符合拟议的NSSI疾病（9）标准，并报告参与NSSI以减少或摆脱负面情绪。研究人员将适应情绪障碍的统一方案转诊治疗的两个核心模块（UP; 70），目的是减少参与者的非自杀的自我伤害思想和行为（SITBS; 2）。每个治疗模块将由四个50分钟的个人情绪意识训练或认知重新评估组成。该研究将使用平衡，组合的串行（多个基线和相变）设计，这将允许受试者间比较和客户作为自己的控制（即受试者内部比较）。基于每个参与者的非自杀位置频率的变化，将相变的相关确定。这种单例实验设计方法提供了机会，可以根据需要灵活地量身定制干预措施（115），并建议由于在治疗阶段结束而进行有害行为的研究，这可以扩展以进行良好的临床护理（71）。智能手机上的EMA将连续监视非杀伤性Sitb的频率和特征。对拟议研究的课程，培训和指导性将支持申请人的长期目标，以成为这一心理健康关键领域的独立科学家实践者。