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Emotion regulation group therapy for deliberate self-harm: a multi-site evaluation in routine care using an uncontrolled open trial design.
BMJ Open. 2017 Oct 05; 7(10):e016220
Publication Type
Clinical Trial
Journal Article
Multicenter Study
Hanna Sahlin
Johan Bjureberg
Kim L Gratz
Matthew T Tull
Erik Hedman
Jonas Bjärehed
Jussi Jokinen
Lars-Gunnar Lundh
Brjánn Ljótsson
Clara Hellner
Author Affiliation
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
BMJ Open. 2017 Oct 05; 7(10):e016220
Publication Type
Clinical Trial
Journal Article
Multicenter Study
Behavior Therapy - methods
Borderline Personality Disorder - complications
Middle Aged
Psychiatric Status Rating Scales
Psychotherapy, Group - methods
Regression Analysis
Self-Injurious Behavior - therapy
Treatment Outcome
Young Adult
Emotion regulation group therapy (ERGT) has shown promising results in several efficacy trials. However, it has not been evaluated outside a research setting. In order to increase the availability of empirically supported treatments for individuals with borderline personality disorder and deliberate self-harm, an evaluation of ERGT in routine clinical care was conducted with therapists of different professional backgrounds who had received brief intensive training in ERGT prior to trial onset.
Multi-site evaluation, using an uncontrolled open trial design with assessments at pretreatment, post-treatment and 6-month follow-up.
14 adult outpatient psychiatric clinics across Sweden.
Ninety-five women (mean age=25.1 years) with borderline personality disorder (both threshold and subthreshold) and repeated self-harm were enrolled in the study. Ninety-three per cent of participants completed the post-treatment assessment and 88% completed the follow-up assessment.
Primary outcome was self-harm frequency as measured with the Deliberate Self-Harm Inventory. Secondary outcomes included self-harm versatility, emotion dysregulation, other self-destructive behaviours, depression, anxiety, stress symptoms and interpersonal and vocational difficulties.
ERGT is an adjunctive, 14-week, acceptance-based behavioural group treatment that directly targets both self-harm and its proposed underlying mechanism of emotion dysregulation.
At post-treatment, intent-to-treat analyses revealed a significant improvement associated with a moderate effect size on the primary outcome of self-harm frequency (51%, reduction; Cohen's d=0.52, p
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ErratumIn: BMJ Open. 2017 Nov 3;7(11):e016220corr1 PMID 29101154
PubMed ID
28982814 View in PubMed
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