Borderline Personality Disorder Clinical Trial
Official title:
Dialectic Behavior Treatment Skills System (DBT-SS) as Treatment for Cognitively Challenged Individuals With Deliberate Self-harm
The study evaluates the effect of Dialectic Behavior Therapy Skills System (DBT-SS) in individuals with Intelligence Quotient 65-85 and recurrent self-harm. The study is primarily descriptive with 6 cases followed by repeated measurements (weekly; time series analysis). Primary outcome measure is frequency and severity of self-harming behavior, reported weekly 4 weeks before the start of the intervention, throughout the intervention and 12 weeks after the intervention has stopped.
Not many psychotherapies are adapted to suit individuals with Intelligence Quotient(IQ) in
the lower normal range. For individuals diagnosed with cognitive disability and self-harm,
psychiatric treatment as usual often consists of only supportive meetings and sometimes heavy
medication.
Dialectical Behavior therapy (DBT) is one of the evidence based treatments for individuals
with self-harm and Borderline Personality Disorder. It is a comprehensive, multi component
treatment, usually lasting a year or more. When offering DBT to individuals with cognitive
disabilities or IQ in the lower normal range, it is necessary to alter the individual therapy
procedures and skills group materials, while remaining adherent to DBT principles.
The Skills System is an adaptation of the standard DBT skills for individuals with cognitive
challenges, well suited for IQ 65-85. When adapted DBT individual therapy integrates the
Skills System as the skill group curriculum the treatment is called DBT-Skills System
(DBT-SS). DBT-SS comprises weekly individual sessions, weekly group education and separate
education for caregivers and/or near standing persons. The method is tested with positive
effects on problem behaviors, however results need to be reproduced, and further tested in a
randomized controlled trial. The handouts from Skills System has recently been translated to
Swedish.
The current study aims to investigate the effect of Skills system on individuals with
self-harm, IQ 65-85 and three or more symptoms of borderline personality disorder. A
single-case time series design will be used with repeated, weekly measurements before, during
and after the intervention is provided. 6 participants will be recruited in a pilot study, to
investigate the feasibility of the method in a Swedish setting. Main outcome measures are
frequency and severity of self-harming and aggressive behaviors, number of days with hospital
admission and coercive care, number of medications, and self-rated level of daily
functioning. Participation will last 64-70 weeks depending on when the group therapy starts
in relation to enrollment.
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