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Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder

Published online by Cambridge University Press:  28 August 2013

K. L. Gratz ,
M. T. Tull  and
R. Levy
K. L. Gratz*
Affiliation:
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
M. T. Tull
Affiliation:
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
R. Levy
Affiliation:
T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
*
*Address for correspondence: Dr K. L. Gratz, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216USA. (Email: KLGratz@aol.com)
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Abstract

Background

Despite the clinical importance of deliberate self-harm (DSH; also referred to as non-suicidal self-injury) within borderline personality disorder (BPD), empirically supported treatments for this behavior among individuals with BPD are difficult to implement in many clinical settings. To address this limitation, a 14-week, adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD was developed. The current study examined the efficacy of this ERGT in a randomized controlled trial (RCT) and the durability of treatment gains over a 9-month uncontrolled follow-up period.

Method

Female out-patients with BPD and recent recurrent DSH were randomly assigned to receive this ERGT in addition to their ongoing out-patient therapy immediately (n = 31) or after 14 weeks (n = 30). Measures of DSH and other self-destructive behaviors, psychiatric symptoms, adaptive functioning and the proposed mechanisms of change (emotion dysregulation/avoidance) were administered pre- and post-treatment or -waitlist (to assess treatment efficacy), and 3 and 9 months post-treatment (to assess durability of treatment gains).

Results

Intent-to-treat (ITT) analyses (n = 61) revealed significant effects of this ERGT on DSH and other self-destructive behaviors, emotion dysregulation, BPD symptoms, depression and stress symptoms, and quality of life. Analyses of all participants who began ERGT (across treatment and waitlist conditions; n = 51) revealed significant improvements from pre- to post-treatment on all outcomes, additional significant improvements from post-treatment to 9-month follow-up for DSH, emotion dysregulation/avoidance, BPD symptoms and quality of life, and no significant changes from post-treatment to 9-month follow-up on the other measures.

Conclusions

The results support the efficacy of this ERGT and the durability of treatment gains.

Keywords

Borderline personalityemotion regulationgroupself-harmself-injurytreatment
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 10 , July 2014 , pp. 2099 - 2112
Copyright
Copyright © Cambridge University Press 2013 

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