Personality Disorder
Conditions
Keywords
Personality disorder, ISTDP, Intensive Short-Term Dynamic Psychotherapy
Brief summary
The primary objective of this study is to evaluate the feasibility and acceptability of a 25-week combined group and individual therapy program using Intensive Short-Term Dynamic Psychotherapy (ISTDP) for patients diagnosed with personality disorders. The secondary objective is to investigate preliminary effects of the treatment in terms of reducing symtoms of depression, anxiety and emotion regulation difficulties.
Detailed description
The investigators vill investigate a 25-week treatment with ISTDP that consists of both weekly group- and individual therapy for patients diagnosed with personality disorder in a psychiatric clinic specialized on depression, anxiety and PTSD. The feasibility and acceptability and preliminary effects will be evaluated using a within-group design with repeated measures and qualitative interviews. Patients will be recruited from the clinic and the main inclusion criteria is that the patient have a personality disorder diagnosis.
Interventions
BEHAVIORALISTDP
Both the individual therapy and the group therapy is based on ISTDP (Intensive Short-Term Dynamic Psychotherapy), an affect-focused psychodynamic therapy method. The therapy focus on the relationship between feelings, anxiety and dysfunctional emotion regulation (i.e. defenses). The purpose is to increase the capacity of anxiety regulation in the patient and to help the patient identify the dysfunctional patterns developed to avoid internal stress and then gradually approach previously warded of feelings. The individual therapy consists of 25 weekly sessions. The group treatment consists of 18 weekly sessions and is structured in three phases. Phase one: Psychoeducation about anxiety and exercises in anxiety regulation. Phase two: patients takes turn to observe their own anxiety and defenses together with a therapist. Phase three: Every session two patients will work with a chosen problem and identify defenses, anxiety and feelings together with a therapist in front of the group.
Sponsors
Region Stockholm
Stockholm University
Karolinska Institutet
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Personality disorder diagnosis (Clinical assessment using STIP-5) Speaks Swedish fluently
Exclusion criteria
Autism or intellectual disability Borderline, antisocial or narcissistic personality disorder diagnosis Need for interpreter Urgent social misery Psychotic disorder High suicidality
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total number of sessions attended during the treatment | Throughout the treatment period, up to 25 weeks | Total number of sessions attended during the treatment |
| Patients experience of, and satisfaction with, the treatment assessed through qualitative interviews | Immediately after treatment completion | Patients experience of, and satisfaction with, the treatment assessed through qualitative interviews |
| Depression symtoms | Baseline, weekly throughout treatment, immediately after treatment completion and 6-month follow-up | Depression symtoms will be measured with Patient Health Questionnaire (PHQ-9; (Kroenke et al., 2001) |
| Participants satisfaction with treatment assessed with the Client Satisfaction Questionnaire (CSQ-8) | Immediately after treatment completion (25 weeks) | Participants satisfaction with treatment assessed with the Client Satisfaction Questionnaire (CSQ-8) |
| Adverse events related to the treatment | From start of treatment up to. 6 month follow up. | Adverse events related to the treatment |
| Number of individual sessions attended during the treatment | Throughout the treatment period, up to 25 weeks | Number of individual sessions attended during the treatment |
| Number of group sessions attended during the treatment | Throughout the treatment period, up to 25 weeks | Number of group sessions attended during the treatment |
| Number of dropouts | Throughout the treatment period, up to 25 weeks | Number of dropouts |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fear of negative emotions | Change from baseline to post-treatment (25 weeks) and follow up 6 months after treatment. | Fear of negative emotion scale (Gilbert et al., 2014) for assessing fear and avoidance of negative feelings. |
| Anxiety symtoms | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. | Generalized Anxiety Disorder-7 (GAD-7; Spitzer et al., 2006) for assessing anxiety symtoms. |
| Emotions regulation difficulties | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. | Difficulties in Emotion Regulation Scale (DERS-16; Bjureberg et al., 2016) for assessing difficulties with emotions regulation. |
| Severity of personality disorder | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. | The Standardized Assessment of Severity of Personality Disorders (SASPD; Olajide et al., 2018) for assessing degree of personality disorder. |
| Symtoms of Borderline Personality disorder | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. | Borderline Symtom List (BLS-23; Bohus et al., 2008) for assessing symtoms of Borderline personality disorder. |
| Quality of life | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. | Brunnsviken Brief Quality of life (Lindner et al., 2016) for assessing quality of life. |
| Working alliance | Weekly throughout treatment , up to 25 weeks | Session Alliance Inventory (SAI; Falkenström et al., 2015) for assessing the working alliance with the therapist |
| Emotional activation during therapy | Weekly throughout treatment, up to 25 weeks | Emotional Experience Self Report (Fisher et al., 2016) for assessing the degree of emotional activation during the session. |
Countries
Sweden
Outcome results
None listed