故意自残行为的早期缓解预示着成年后的情绪调节能力:对具有反复自残和边缘化特征的青少年进行的随机对照试验的 12.4 年随访。

IF 6 2区 医学 Q1 PEDIATRICS European Child & Adolescent Psychiatry Pub Date : 2024-10-29 DOI:10.1007/s00787-024-02602-8
Iselin Solerød Dibaj, Anita Johanna Tørmoen, Ole Klungsøyr, Katharina Teresa Enehaug Morken, Egil Haga, Kine Johansen Dymbe, Lars Mehlum
{"title":"故意自残行为的早期缓解预示着成年后的情绪调节能力:对具有反复自残和边缘化特征的青少年进行的随机对照试验的 12.4 年随访。","authors":"Iselin Solerød Dibaj, Anita Johanna Tørmoen, Ole Klungsøyr, Katharina Teresa Enehaug Morken, Egil Haga, Kine Johansen Dymbe, Lars Mehlum","doi":"10.1007/s00787-024-02602-8","DOIUrl":null,"url":null,"abstract":"<p><p>Emotion regulation capacity, critical for adult functioning and mental health, develops strongly during adolescence in healthy individuals. Deficits in emotion regulation is often referred to as emotion dysregulation [ED] and is associated with various mental health problems, including repeated deliberate self-harm [DSH] which peaks in adolescence. Dialectical Behaviour Therapy for adolescents [DBT-A] systematically targets ED through strategies such as changing coping behaviours and has previously been shown to effectively induce DSH remission in adolescents. However, whether such remission is associated with improved emotion regulation capacity in adulthood, and whether this effect is mediated by changes in use of coping strategies has not been previously studied. Prospective long-term follow-up study of an RCT comparing DBT-A with enhanced usual care [EUC] for adolescents presenting to community child and adolescent psychiatric outpatient clinics with borderline personality features and repeated self-harm. Assessments included both structured interviews and self-report at baseline and 1.6, 3.1 and 12.4 years follow-up. In the final follow-up, adult ED was measured and data were collected for 61 (80%) of the original 77 participants. DSH remission was assessed at 1.6 years follow-up, and use of coping strategies at 3.1 and 12.4 years follow-ups. A mediation analysis was conducted within a causal inference framework. Both treatment groups increased their use of functional coping skills from adolescence to adulthood, while only DBT-A was associated with decreases in dysfunctional coping. There was a direct effect of DSH remission 1 year after treatment on adult ED, particularly for participants who did not receive DBT-A. There was a negative association between reductions in dysfunctional coping and adult ED, however this did not mediate the effect of DSH remission. This is the first study to report that early DSH remission in adolescence predicted lower ED in adulthood. These results highlight the importance of early DSH remission and provides new insight into the long-term relationship between DSH and ED. Clinical trial registration information: \"Treatment for Adolescents with Deliberate Self-harm\"; http://ClinicalTrials.gov/;NCT00675129.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.0000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early remission of deliberate self-harm predicts emotion regulation capacity in adulthood: 12.4 years follow-up of a randomized controlled trial of adolescents with repeated self-harm and borderline features.\",\"authors\":\"Iselin Solerød Dibaj, Anita Johanna Tørmoen, Ole Klungsøyr, Katharina Teresa Enehaug Morken, Egil Haga, Kine Johansen Dymbe, Lars Mehlum\",\"doi\":\"10.1007/s00787-024-02602-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Emotion regulation capacity, critical for adult functioning and mental health, develops strongly during adolescence in healthy individuals. Deficits in emotion regulation is often referred to as emotion dysregulation [ED] and is associated with various mental health problems, including repeated deliberate self-harm [DSH] which peaks in adolescence. Dialectical Behaviour Therapy for adolescents [DBT-A] systematically targets ED through strategies such as changing coping behaviours and has previously been shown to effectively induce DSH remission in adolescents. However, whether such remission is associated with improved emotion regulation capacity in adulthood, and whether this effect is mediated by changes in use of coping strategies has not been previously studied. Prospective long-term follow-up study of an RCT comparing DBT-A with enhanced usual care [EUC] for adolescents presenting to community child and adolescent psychiatric outpatient clinics with borderline personality features and repeated self-harm. Assessments included both structured interviews and self-report at baseline and 1.6, 3.1 and 12.4 years follow-up. In the final follow-up, adult ED was measured and data were collected for 61 (80%) of the original 77 participants. DSH remission was assessed at 1.6 years follow-up, and use of coping strategies at 3.1 and 12.4 years follow-ups. A mediation analysis was conducted within a causal inference framework. Both treatment groups increased their use of functional coping skills from adolescence to adulthood, while only DBT-A was associated with decreases in dysfunctional coping. There was a direct effect of DSH remission 1 year after treatment on adult ED, particularly for participants who did not receive DBT-A. There was a negative association between reductions in dysfunctional coping and adult ED, however this did not mediate the effect of DSH remission. This is the first study to report that early DSH remission in adolescence predicted lower ED in adulthood. These results highlight the importance of early DSH remission and provides new insight into the long-term relationship between DSH and ED. Clinical trial registration information: \\\"Treatment for Adolescents with Deliberate Self-harm\\\"; http://ClinicalTrials.gov/;NCT00675129.</p>\",\"PeriodicalId\":11856,\"journal\":{\"name\":\"European Child & Adolescent Psychiatry\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2024-10-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Child & Adolescent Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00787-024-02602-8\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Child & Adolescent Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00787-024-02602-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

摘要

情绪调节能力对成年人的功能发挥和心理健康至关重要,而健康人的情绪调节能力在青春期发育得很强。情绪调节能力的缺陷通常被称为情绪失调(ED),与各种心理健康问题有关,包括在青春期达到高峰的反复故意自残(DSH)。针对青少年的 "辩证行为疗法"(DBT-A)通过改变应对行为等策略,系统性地解决情绪失调问题。然而,这种缓解是否与成年后情绪调节能力的提高有关,以及这种效果是否由应对策略的使用变化所介导,以前还没有研究过。一项RCT前瞻性长期随访研究比较了DBT-A与增强型常规护理[EUC],研究对象为前往社区儿童与青少年精神科门诊就诊的具有边缘型人格特征且反复自残的青少年。评估包括基线时的结构化访谈和自我报告,以及 1.6 年、3.1 年和 12.4 年的随访。在最后一次随访中,对成人 ED 进行了测量,并收集了最初 77 名参与者中 61 人(80%)的数据。在 1.6 年的随访中评估了 DSH 缓解情况,在 3.1 年和 12.4 年的随访中评估了应对策略的使用情况。在因果推论框架内进行了中介分析。从青春期到成年期,两个治疗组都增加了功能性应对技能的使用,而只有 DBT-A 与功能失调应对的减少有关。治疗一年后,DSH缓解对成人ED有直接影响,尤其是对未接受DBT-A治疗的参与者。功能失调应对的减少与成人 ED 之间存在负相关,但这并不影响 DSH 缓解的效果。这是第一项报告青春期早期 DSH 缓解预示着成年后 ED 会降低的研究。这些结果凸显了早期DSH缓解的重要性,并为DSH和ED之间的长期关系提供了新的视角。临床试验注册信息:"青少年故意自残治疗"; http://ClinicalTrials.gov/;NCT00675129.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Early remission of deliberate self-harm predicts emotion regulation capacity in adulthood: 12.4 years follow-up of a randomized controlled trial of adolescents with repeated self-harm and borderline features.

Emotion regulation capacity, critical for adult functioning and mental health, develops strongly during adolescence in healthy individuals. Deficits in emotion regulation is often referred to as emotion dysregulation [ED] and is associated with various mental health problems, including repeated deliberate self-harm [DSH] which peaks in adolescence. Dialectical Behaviour Therapy for adolescents [DBT-A] systematically targets ED through strategies such as changing coping behaviours and has previously been shown to effectively induce DSH remission in adolescents. However, whether such remission is associated with improved emotion regulation capacity in adulthood, and whether this effect is mediated by changes in use of coping strategies has not been previously studied. Prospective long-term follow-up study of an RCT comparing DBT-A with enhanced usual care [EUC] for adolescents presenting to community child and adolescent psychiatric outpatient clinics with borderline personality features and repeated self-harm. Assessments included both structured interviews and self-report at baseline and 1.6, 3.1 and 12.4 years follow-up. In the final follow-up, adult ED was measured and data were collected for 61 (80%) of the original 77 participants. DSH remission was assessed at 1.6 years follow-up, and use of coping strategies at 3.1 and 12.4 years follow-ups. A mediation analysis was conducted within a causal inference framework. Both treatment groups increased their use of functional coping skills from adolescence to adulthood, while only DBT-A was associated with decreases in dysfunctional coping. There was a direct effect of DSH remission 1 year after treatment on adult ED, particularly for participants who did not receive DBT-A. There was a negative association between reductions in dysfunctional coping and adult ED, however this did not mediate the effect of DSH remission. This is the first study to report that early DSH remission in adolescence predicted lower ED in adulthood. These results highlight the importance of early DSH remission and provides new insight into the long-term relationship between DSH and ED. Clinical trial registration information: "Treatment for Adolescents with Deliberate Self-harm"; http://ClinicalTrials.gov/;NCT00675129.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
12.80
自引率
4.70%
发文量
186
审稿时长
6-12 weeks
期刊介绍: European Child and Adolescent Psychiatry is Europe''s only peer-reviewed journal entirely devoted to child and adolescent psychiatry. It aims to further a broad understanding of psychopathology in children and adolescents. Empirical research is its foundation, and clinical relevance is its hallmark. European Child and Adolescent Psychiatry welcomes in particular papers covering neuropsychiatry, cognitive neuroscience, genetics, neuroimaging, pharmacology, and related fields of interest. Contributions are encouraged from all around the world.
期刊最新文献
Neurocognitive dysfunction in adolescents with recent onset major depressive disorder: a cross-sectional comparative study. Early psychopathology: a persistently misunderstood and overlooked issue? Mediation of DNA methylation (cg04622888 and cg05037505) in the association between childhood maltreatment and non-suicidal self-injury in early adolescents. Adult mental health outcomes of adolescent depression and co-occurring alcohol use disorder: a longitudinal cohort study. Associations between academic achievement and internalizing disorders in Swedish students aged 16 years between 1990 and 2018.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1