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Lindh, Å. U., Dahlin, M., Beckman, K., Strömsten, L. M. J., Jokinen, J., Wiktorsson, S., . . . Runeson, B. (2019). A Comparison of Suicide Risk Scales in Predicting Repeat Suicide Attempt and Suicide: A Clinical Cohort Study. Journal of Clinical Psychiatry, 80(6), Article ID 18m12707.
Open this publication in new window or tab >>A Comparison of Suicide Risk Scales in Predicting Repeat Suicide Attempt and Suicide: A Clinical Cohort Study
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2019 (English)In: Journal of Clinical Psychiatry, ISSN 0160-6689, E-ISSN 1555-2101, Vol. 80, no 6, article id 18m12707Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To compare the predictive accuracy of the Suicide Intent Scale (SIS), the Suicide Assessment Scale (SUAS), the Karolinska Interpersonal Violence Scale (KIVS), and the Columbia-Suicide Severity Rating Scale (C-SSRS) for suicide attempts and suicides within 3 and 12 months of an episode of self-harm.

METHODS: This prospective multicenter cohort study included patients (N = 804) aged 18-95 years with a recent episode of self-harm assessed in psychiatric emergency settings from April 2012 to April 2016. Suicide attempts and suicides were identified in medical records and in the National Cause of Death Register. Receiver operating characteristic curves were constructed, and accuracy statistics were calculated. A sensitivity of at least 80% combined with a specificity of at least 50% were considered minimally acceptable.

RESULTS: At least 1 suicide attempt was recorded for 216 participants during follow-up, and 19 participants died by suicide. The SUAS and C-SSRS were better than chance in classifying the 114 suicide attempts occurring within the first 3 months; a C-SSRS score ≥ 27 yielded a sensitivity/specificity of 79.8%/51.5% (P < .001). During 1-year follow-up, the SUAS and C-SSRS also performed better than chance, but no cutoff on either instrument gave a sensitivity/specificity of ≥ 80%/≥ 50%. The SIS was the only instrument that could classify suicides correctly. At 3 months, the area under the curve (AUC) was 0.94 (95% CI, 0.89-0.99), and a score ≥ 21 predicted suicide with a sensitivity/specificity of 100%/81.9%, based on only 4 suicides. At 1-year follow-up, the AUC was 0.74 (95% CI, 0.61-0.87), and a score ≥ 17 predicted suicide with a sensitivity/specificity of 72.2%/57.9%.

CONCLUSIONS: Instruments that predicted nonfatal repeat suicide attempts did not predict suicide and vice versa. With the possible exception of the prediction of suicide by the SIS in a short time frame, the specificity of these instruments was low, giving them a limited relevance in the prediction of suicidal behaviors.

Place, publisher, year, edition, pages
Physicians Postgraduate Press, 2019
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-165430 (URN)10.4088/JCP.18m12707 (DOI)000517803900011 ()31747488 (PubMedID)
Funder
Swedish Research Council, 521-2011-299
Available from: 2019-11-25 Created: 2019-11-25 Last updated: 2020-04-07Bibliographically approved
Hallberg, J., Kaldo, V., Arver, S., Dhejne, C., Jokinen, J. & Oberg, K. G. (2019). A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men. Journal of Sexual Medicine, 16(5), 733-745
Open this publication in new window or tab >>A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men
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2019 (English)In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 16, no 5, p. 733-745Article in journal (Refereed) Published
Abstract [en]

Background: Hypersexual disorder (HD) is defined as a condition in which the individual loses control over engagement in sexual behaviors, leading to distress and negative effects on key life areas. Cognitive behavioral therapy (CBT) has been proven to reduce symptoms of hypersexual behavior; however, no randomized controlled study of CBT interventions for HD has been reported previously.

Aim: To investigate the efficacy of group-administered CBT for HD.

Methods: Male participants (n = 137) diagnosed with HD, were randomized between 7 weeks of group-administered CBT (n = 70) and a waitlist control receiving the intervention after 8 weeks (n = 67). Measurements were administered at pre-, mid-, and posttreatment, with follow-up after 3 and 6 months.

Outcomes: The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS), and secondary outcomes were the Sexual Compulsivity Scale (SCS) and measures of depression (Montgomery–Åsberg Depression Rating Scale (MADRS-S), psychological distress (Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), and treatment satisfaction (CSQ-8).

Results: A significantly greater decrease in HD symptoms and sexual compulsivity, as well as significantly greater improvements in psychiatric well-being, were found for the treatment condition compared with the waitlist. These effects remained stable at 3 and 6 months after treatment.

Clinical Implications: CBT can ameliorate HD symptoms and psychiatric distress, suggesting that the CBT program may serve as a first-line treatment in clinical settings.

Strengths & Limitations: This is the first randomized controlled study evaluating the efficacy of a CBT program in a rather large sample of HD-specific diagnosed men. The long-term treatment effects are vague due to the low response rate on follow-up measurements, and the efficacy of this program for hypersexual women remains unknown.

Conclusion: This study supports the efficacy of a group-administered CBT program as a treatment option for HD; however, future studies should include women, comprise dismantling analysis of the constituting interventions, and evaluate other treatment formats, for example, administration via the Internet.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Male Sexual Desire Disorders, Basic science male behavioral, Mental Health and Male Sexuality
National Category
Applied Psychology Psychiatry
Identifiers
urn:nbn:se:umu:diva-160310 (URN)10.1016/j.jsxm.2019.03.005 (DOI)000469936400015 ()30956109 (PubMedID)
Available from: 2019-06-17 Created: 2019-06-17 Last updated: 2019-06-17Bibliographically approved
Pahnke, J., Hirvikoski, T., Bjureberg, J., Bölte, S., Jokinen, J., Bohman, B. & Lundgren, T. (2019). Acceptance and commitment therapy for autistic adults: An open pilot study in a psychiatric outpatient context. Journal of Contextual Behavioral Science, 13, 34-41
Open this publication in new window or tab >>Acceptance and commitment therapy for autistic adults: An open pilot study in a psychiatric outpatient context
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2019 (English)In: Journal of Contextual Behavioral Science, ISSN 2212-1447, Vol. 13, p. 34-41Article in journal (Refereed) Published
Abstract [en]

Highlights:

Feasibility and credibility of the NeuroACT protocol was high.

Symptoms of stress and depression were significantly reduced.

Cognitive defusion and psychological flexibility significantly increased.

Quality of life and social functioning were significantly improved.

National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-164547 (URN)10.1016/j.jcbs.2019.04.002 (DOI)000483320600005 ()
Available from: 2019-10-23 Created: 2019-10-23 Last updated: 2019-10-23Bibliographically approved
Stenbacka, M., Moberg, T. & Jokinen, J. (2019). Adolescent criminality: multiple adverse health outcomes and mortality pattern in Swedish men. BMC Public Health, 19, Article ID 400.
Open this publication in new window or tab >>Adolescent criminality: multiple adverse health outcomes and mortality pattern in Swedish men
2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 400Article in journal (Refereed) Published
Abstract [en]

Background: To investigate the impact of adolescent violent and non-violent criminality and subsequent risk of morbidity and mortality in adulthood in a large Swedish cohort of young men conscripted for military service in 1969/70.

Methods: The cohort consisted of 49,398 18-year-old Swedish conscripts followed up for morbidity and mortality up to the age of 55 years in Swedish national registers. Information about convictions for crime before conscription was obtained from national crime registers. Data from a survey at conscription were scrutinized to get information on potential confounders.

Results: Hospitalization due to alcohol and drug related diagnoses and attempted suicide were significantly more evident in the violent group compared to non-violent criminals and non-criminals. More than one fifth (21.13%) of the young violent offenders, 12.90% of the non-violent offenders and 4.96% of the non-criminals had died during the follow-up period. In Cox proportional multivariate analyses, young violent offenders had twice the hazard (HR = 4.29) of all-cause mortality than the non-violent offenders (HR = 2.16) during the follow-up period. Alcohol and drug related mortality, suicide and fatal accidents were most evident in both violent and non-violent offenders.

Conclusions: Men with adolescent criminality received more inpatient care due to alcohol and drug related diagnoses and attempted suicide as adults. Mortality due to unnatural causes, alcohol, and drug related diagnoses, suicide and accidents was most evident in violent offenders, while these causes of death were much lower in non-criminals. Men with adolescent criminality are a high-risk group for multiple adverse health outcomes and for early death. Efforts for detection of substance use and psychiatric disorders in this group is important for the prevention work in both local- and community levels as well as national prevention programs.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Alcohol, Criminality, Violence, Substance use, Mortality
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychiatry
Identifiers
urn:nbn:se:umu:diva-158573 (URN)10.1186/s12889-019-6662-z (DOI)000464880000011 ()30975117 (PubMedID)
Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-05-27Bibliographically approved
Bjureberg, J., Ohlis, A., Ljotsson, B., D'Onofrio, B. M., Hedman-Lagerlöf, E., Jokinen, J., . . . Hellner, C. (2019). Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register. Journal of Child Psychology and Psychiatry and Allied Disciplines, 60(3), 295-304
Open this publication in new window or tab >>Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register
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2019 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 60, no 3, p. 295-304Article in journal (Refereed) Published
Abstract [en]

Background: Self-harm is common and there is a need for studies that investigate the relevance of this behavior in clinical samples to inform risk assessment and treatment. The objectives in the current studies were to compare clinical and psychosocial correlates and subsequent adverse outcomes in youth who present to child and adolescent mental health services (CAMHS) with self-harm only (SH), self-harm with suicidality (SH+SU), with those without any indication of SH or SH+SU.

Methods: We conducted a case-control study and a longitudinal cohort study using data from a regional clinical care register, and Swedish national registers. The case-control study included all patients (5-17 years) between 2011 and 2015 (N = 25,161). SH and SH+SU cases were compared with controls (patients without SH) regarding a range of correlates. The longitudinal study included former CAMHS patients (N = 6,120) who were followed for a median time of 2.8 years after termination of CAMHS contact regarding outcomes such as clinical care consumption, social welfare recipiency, and crime conviction.

Results: In the case-control study, both the SH and SH+SU groups received more clinical care, had lower global functioning, and higher odds of having mental disorders compared to controls. In most comparisons, the SH+SU group had more problems than the SH group. In the longitudinal study, the same pattern emerged for most outcomes; for example, the adjusted hazard ratio for recurrent care due to self-harm was 23.1 (95% confidence interval [CI], 17.0-31.4) in the SH+SU group compared to 3.9 (95% CI, 2.3-6.7) in the SH group.

Conclusions: Adolescent patients presenting with self-harm have higher risks for adverse outcomes than patients without self-harm. Suicidality in addition to self-harm is associated with more severe outcomes, importantly recurrent episodes of care for self-harm.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Self-harm, self-injurious behavior, suicidal ideation, epidemiology, cohort study
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-157201 (URN)10.1111/jcpp.12967 (DOI)000459224900008 ()30207392 (PubMedID)
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2020-04-14Bibliographically approved
Bendix, M., Bixo, M., Wihlbäck, A.-C., Ahokas, A. & Jokinen, J. (2019). Allopregnanolone and progesterone in estradiol treated severe postpartum depression and psychosis: Preliminary findings. Neurology, psychiatry and brain research, 34, 50-57
Open this publication in new window or tab >>Allopregnanolone and progesterone in estradiol treated severe postpartum depression and psychosis: Preliminary findings
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2019 (English)In: Neurology, psychiatry and brain research, ISSN 0941-9500, Vol. 34, p. 50-57Article in journal (Refereed) Published
Abstract [en]

Background: Postpartum affective disorders may be associated with dysregulation of gonadal steroids. We investigated peripheral levels of allopregnanolone and progesterone in a combined group of women with postpartum onset of severe depression and/or psychosis who, as previously reported, responded with rapid symptom remission during sublingual estradiol treatment. The aim was to assess differences in allopregnanolone and progesterone between patients and healthy controls at baseline, and hormonal changes during estradiol treatment and symptom remission in patients.

Methods: Allopregnanolone and progesterone in serum were analyzed with radioimmunoassay before and four weeks after initiation of sublingual estradiol treatment in ten women with postpartum depression and four women with postpartum psychosis (ICD-10). Twenty-eight healthy postpartum controls were included for baseline comparison.

Results: Allopregnanolone declined significantly during estradiol treatment while there was a trend for lower baseline allopregnanolone levels in patients compared with healthy postpartum controls. The ratio between allopregnanolone and progesterone was significantly lower in patients compared with controls and it remained unchanged after clinical recovery.

Limitations: This study is a secondary analysis of two estradiol treatment studies based on availability of samples for the analysis of allopregnanolone. Healthy controls were assessed earlier after delivery. Data on potential confounders (somatic health, breastfeeding, other medication) were not available.

Conclusions: These preliminary findings suggest that clinical recovery of severe postpartum depression and psychosis during estradiol treatment does not seem to depend on increasing levels of allopregnanolone. Differences in progesterone metabolism may constitute a risk factor for severe postnatal affective dysregulation.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Postpartum depression, Postpartum psychosis, Allopregnanolone, Progesterone, Estradiol, Estradiol treatment
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-156823 (URN)10.1016/j.npbr.2019.10.003 (DOI)2-s2.0-85074335144 (Scopus ID)
Note

Originally included in thesis in manuscript form with title: "Allopregnanolone and progesterone in estradiol treated severe postpartum depression and psychosis".

Available from: 2019-02-28 Created: 2019-02-28 Last updated: 2020-04-16Bibliographically approved
Budhiraja, M., Pereira, J. B., Lindner, P., Westman, E., Jokinen, J., Savic, I., . . . Hodgins, S. (2019). Cortical structure abnormalities in females with conduct disorder prior to age 15. Psychiatry Research: Neuroimaging, 289, 37-44
Open this publication in new window or tab >>Cortical structure abnormalities in females with conduct disorder prior to age 15
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2019 (English)In: Psychiatry Research: Neuroimaging, ISSN 0925-4927, E-ISSN 1872-7506, Vol. 289, p. 37-44Article in journal (Refereed) Published
Abstract [en]

Among females, conduct disorder (CD) before age 15 is associated with multiple adverse outcomes in adulthood. The few existing structural neuroimaging studies of females with CD report abnormalities of gray matter volumes. The present study compared cortical thickness and surface area of young women with childhood/adolescent CD and healthy women to determine whether cortical abnormalities were present in adulthood and whether they were related to prior CD. Structural brain images from 31 women with CD and 25 healthy women were analyzed using FreeSurfer. Group differences between cortical thickness and surface area were assessed using cluster-wise corrections with Monte Carlo simulations. Women with prior CD, relative to healthy women, showed: (1) reduced cortical thickness in left fusiform gyrus extending up to entorhinal cortex and lingual gyrus; (2) reduced surface area in right superior parietal cortex; (3) increased surface area in left superior temporal gyrus, and right precentral gyrus. These differences remained significant after adjusting for past comorbid disorders, current symptoms of anxiety and depression, current substance use as well as maltreatment. The study suggests that among females, CD prior to age 15 is associated with cortical structure abnormalities in brain regions involved in emotion processing and social interaction.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Conduct disorder, Structural MRI, Freesurfer, Cortical thickness, Surface area, Fusiform gyms
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-160596 (URN)10.1016/j.pscychresns.2018.12.004 (DOI)000470122700006 ()31101397 (PubMedID)
Funder
Stockholm County CouncilSwedish Foundation for Strategic Research VinnovaSwedish Research Council
Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-06-24Bibliographically approved
Jokinen, J., Flanagan, J., Chatzittofis, A., Öberg, K. & Arver, S. (2019). High Plasma Oxytocin Levels in Men With Hypersexual Disorder. Paper presented at 58th Annual Meeting of the American-College-of-Neuropsychopharmacology (ACNP), DEC 08-11, 2019, Orlando, FL. Neuropsychopharmacology, 44, 114-114
Open this publication in new window or tab >>High Plasma Oxytocin Levels in Men With Hypersexual Disorder
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2019 (English)In: Neuropsychopharmacology, ISSN 0893-133X, E-ISSN 1740-634X, Vol. 44, p. 114-114Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Hypersexual disorder (HD) integrating pathophysiological aspects such as sexual desire deregulation, sexual addiction, impulsivity and compulsivity was suggested as a diagnosis for the DSM-5. "Compulsive Sexual Behavior Disorder" is now presented as an impulse-control disorder in ICD-11. Recent studies showed dysregulated HPA axis in men with HD. Oxytocin (OXT) affects the function of the HPA axis; no studies have assessed OXT levels in patients with HD. Whether a CBT treatment for HD symptoms has an effect on OXT levels has not been investigated.

Methods: We examined plasma OXT levels in 64 male patients with HD and 38 male age-matched healthy volunteers. Further, we examined correlations between plasma OXT levels and dimensional symptoms of HD using the rating scales measuring hypersexual behaviour: Hypersexual disorder screening inventory (HDSI) and the Sexual Compulsive scale (SCS). A part of the patients (N = 30) completed the manual-based group-administered CBT program for HD and had a secondary measurement of OXT at post-treatment. OXT was measured with Radioimmunoassay (RIA).

Results: Patients with HD had significantly higher OXT (Mean 31.0 ± SD 9.9 pM) levels compared to healthy volunteers (Mean 16.9 ± SD 3.9 pM) (p < 0.001). There were significant positive correlations between OXT levels and the rating scales measuring hypersexual behaviour (Spearman rhos between HDSI r = 0.649, p < 0.001 and SCS r = 0.629, p < 0.001) in the study participants combined. Patients who completed CBT treatment had significant reduction of OXT levels from pre-treatment (30.5 ± 10.1pM) to post-treatment (20.2 ± 8.0pM) (p < 0.001). Patients with HD had a significant positive correlation of their changes in HD:CAS with plasma oxytocin level before and after CBT(r = 0.388, p value= 0.0344).

Conclusions: The results suggest hyperactive oxytonergic system in male patients with hypersexual disorder which may be a compensatory mechanism to attenuate hyperactive stress system. A successful CBT group therapy may have effect on hyperactive oxytonergic system.

Place, publisher, year, edition, pages
Nature Publishing Group, 2019
Keywords
Oxytocin and Addiction, Hypersexual Disorder, Cognitive Behavior Therapy
National Category
Pharmacology and Toxicology Neurosciences Psychiatry
Identifiers
urn:nbn:se:umu:diva-168967 (URN)000509665600228 ()
Conference
58th Annual Meeting of the American-College-of-Neuropsychopharmacology (ACNP), DEC 08-11, 2019, Orlando, FL
Note

Supplement: 1

Meeting Abstract: M71

Available from: 2020-04-01 Created: 2020-04-01 Last updated: 2020-04-01Bibliographically approved
Bostrom, A. E., Chatzittofis, A., Ciuculete, D.-M., Flanagan, J. N., Krattinger, R., Bandstein, M., . . . Jokinen, J. (2019). Hypermethylation-associated downregulation of microRNA-4456 in hypersexual disorder with putative influence on oxytocin signalling: A DNA methylation analysis of miRNA genes. Epigenetics
Open this publication in new window or tab >>Hypermethylation-associated downregulation of microRNA-4456 in hypersexual disorder with putative influence on oxytocin signalling: A DNA methylation analysis of miRNA genes
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2019 (English)In: Epigenetics, ISSN 1559-2294, E-ISSN 1559-2308Article in journal (Refereed) Epub ahead of print
Abstract [en]

Hypersexual disorder (HD) was proposed as a diagnosis in the DSM-5 and the classification ?Compulsive Sexual Behavior Disorder? is now presented as an impulse-control disorder in ICD-11. HD incorporates several pathophysiological mechanisms; including impulsivity, compulsivity, sexual desire dysregulation and sexual addiction. No previous study investigated HD in a methylation analysis limited to microRNA (miRNA) associated CpG-sites. The genome wide methylation pattern was measured in whole blood from 60 subjects with HD and 33 healthy volunteers using the Illumina EPIC BeadChip. 8,852 miRNA associated CpG-sites were investigated in multiple linear regression analyses of methylation M-values to a binary independent variable of disease state (HD or healthy volunteer), adjusting for optimally determined covariates. Expression levels of candidate miRNAs were investigated in the same individuals for differential expression analysis. Candidate methylation loci were further studied for an association with alcohol dependence in an independent cohort of 107 subjects. Two CpG-sites were borderline significant in HD ? cg18222192 (MIR708)(p < 10E-05,p(FDR) = 5.81E-02) and cg01299774 (MIR4456)(p < 10E-06, p(FDR) = 5.81E-02). MIR4456 was significantly lower expressed in HD in both univariate (p < 0.0001) and multivariate (p < 0.05) analyses. Cg01299774 methylation levels were inversely correlated with expression levels of MIR4456 (p < 0.01) and were also differentially methylated in alcohol dependence (p = 0.026). Gene target prediction and pathway analysis revealed that MIR4456 putatively targets genes preferentially expressed in brain and that are involved in major neuronal molecular mechanisms thought to be relevant for HD, e.g., the oxytocin signalling pathway. In summary, our study implicates a potential contribution of MIR4456 in the pathophysiology of HD by putatively influencing oxytocin signalling.

Keywords
Methylome-wide, DNA methylation, hypersexual disorder, MicroRNA, oxytocin signaling, oxytocin, psychiatry, hsa-miR-4456, microRNA-4456, MIR4456, epigenetic dysregulation, differential methylation, microRNA expression, gene target prediction, epigenetics
National Category
Medical Genetics
Identifiers
urn:nbn:se:umu:diva-166588 (URN)10.1080/15592294.2019.1656157 (DOI)000489812500001 ()31542994 (PubMedID)
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2019-12-20
Sahlin, H., Bjureberg, J., Gratz, K. L., Tull, M. T., Hedman-Lagerlöf, E., Bjärehed, J., . . . Ljotsson, B. (2019). Predictors of improvement in an open-trial multisite evaluation of emotion regulation group therapy. Cognitive Behaviour Therapy, 48(4), 322-336
Open this publication in new window or tab >>Predictors of improvement in an open-trial multisite evaluation of emotion regulation group therapy
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2019 (English)In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 48, no 4, p. 322-336Article in journal (Refereed) Published
Abstract [en]

Emotion regulation group therapy (ERGT) is a novel treatment specifically targeting deliberate non-suicidal self-harm (DSH) in individuals with borderline personality disorder (BPD). Identifying robust predictors of positive response to ERGT could aid clinicians in treatment selection; however, to date, only one such study has been conducted. Thus, we aimed to replicate previously identified predictors of treatment response to ERGT by investigating demographic, clinical, and diagnostic predictors in 95 women with BPD or subclinical BPD who had participated in an open-trial evaluation of ERGT. Outcomes evaluated were frequency of DSH and emotion dysregulation. Assessments were conducted at pretreatment, post-treatment, and 6-month follow-up. Multilevel mixed linear models and multilevel negative binomial generalized estimated equations were used to identify significant interactions between the predictors and outcomes.

We found that greater pretreatment DSH frequency was associated with greater improvements in DSH during treatment (b = 0.998, SE = 0.00, p = 0.03) and follow-up (b = 0.997, SE = 0.00, p < 0.01) and that greater BPD severity was associated with greater improvements in DSH during treatment (b = 0.84, SE = 0.06, p = 0.02) and in emotion dysregulation at follow-up (b = −3.05, SE = 1.47, p = 0.04). Co-occurring disorders were associated with poorer treatment response during follow-up. Results were generally consistent with a previous study of the predictors of response to ERGT. The findings provide further support for the utility of this treatment across a range of BPD patients, including patients with severe DSH and BPD.

Place, publisher, year, edition, pages
Routledge, 2019
Keywords
Emotion regulation group therapy, predictors of treatment response, borderline personality disorder, deliberate self-harm, non-suicidal self-injury, emotion regulation
National Category
Psychiatry Applied Psychology
Identifiers
urn:nbn:se:umu:diva-161484 (URN)10.1080/16506073.2018.1509119 (DOI)000470850800005 ()30230412 (PubMedID)
Funder
Stockholm County Council, SLL20140428
Available from: 2019-07-09 Created: 2019-07-09 Last updated: 2019-07-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6766-7983

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