Elsevier

Behavior Therapy

Volume 37, Issue 1, March 2006, Pages 25-35
Behavior Therapy

Preliminary Data on an Acceptance-Based Emotion Regulation Group Intervention for Deliberate Self-Harm Among Women With Borderline Personality Disorder

https://doi.org/10.1016/j.beth.2005.03.002Get rights and content

Abstract

Borderline personality disorder (BPD) and deliberate self-harm are clinically important conditions for which additional economically and clinically feasible interventions are needed. Literature on both the emotion regulating and experientially avoidant function of self-harm and the role of emotional dysfunction in BPD provided the rationale for developing a group intervention targeting emotion dysregulation among self-harming women with BPD. This study provides preliminary data on the efficacy of this new, 14-week, emotion regulation group intervention, designed to teach self-harming women with BPD more adaptive ways of responding to their emotions so as to reduce the frequency of their self-harm behavior. Participants were matched on level of emotion dysregulation and lifetime frequency of self-harm and randomly assigned to receive this group in addition to their current outpatient therapy (N = 12), or to continue with their current outpatient therapy alone for 14 weeks (N = 10). Results indicate that the group intervention had positive effects on self-harm, emotion dysregulation, experiential avoidance, and BPD-specific symptoms, as well as symptoms of depression, anxiety, and stress. Participants in the group treatment condition evidenced significant changes over time on all measures, and reached normative levels of functioning on most. While these preliminary results are promising, the study’s limitations require their replication in a larger-scale randomized controlled trial.

Section snippets

Participants

Participants were obtained through referrals by clinicians at McLean Hospital and in private practice in the greater Boston area, as well as self-referrals by potential clients in response to advertisements for an “emotion regulation skills group for women with self-harm” posted at McLean Hospital and on two Web sites. All provided written informed consent. Potential participants were screened by a doctoral-level trainee or postdoctoral fellow trained in the administration of the assessment

Results

Before conducting analyses, a square root transformation was used to transform the positively skewed and kurtotic DSHI frequency scores.

A series of t-tests and chi-square analyses were conducted on demographic and clinical characteristic variables to determine equivalence across conditions. Results indicate no significant between-group differences on any of these variables. Furthermore, a series of one-way (group treatment + TAU vs. TAU waitlist) ANOVAs were conducted on pretreatment scores on

Discussion

Results suggest that this emotion regulation group intervention has positive effects on emotion dysregulation, experiential avoidance, and self-harm behavior, as well as BPD-specific symptoms and symptoms of depression, anxiety, and stress. Not only were the observed treatment effects statistically significant, many were clinically significant as well. Moreover, the treatment group reached normative levels of functioning on measures of emotion dysregulation, experiential avoidance, and

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    This research was previously presented at the annual meeting of the Association for Advancement of Behavior Therapy in November, 2004. This research was supported by the Psychosocial Fellowship of McLean Hospital, awarded to the first author. The first author wishes to thank Matthew Tull and Melanie Harned for their help in conducting the assessment interviews, as well as Matthew Tull and Liz Roemer for their helpful comments on previous drafts of this manuscript.

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