A functional analysis of two transdiagnostic, emotion-focused interventions on nonsuicidal self-injury.

Abstract

Objective Nonsuicidal self-injury (NSSI) is prevalent and associated with clinically significant consequences. Developing time-efficient and cost-effective interventions for NSSI has proven difficult given that the critical components for NSSI treatment remain largely unknown. The aim of this study was to examine the specific effects of mindful emotion awareness training and cognitive reappraisal, two transdiagnostic treatment strategies that purportedly address the functional processes thought to maintain self-injurious behavior, on NSSI urges and acts. Method Using a counterbalanced, combined series (multiple baseline and data-driven phase change) aggregated single-case experimental design, the unique and combined impact of these two four-week interventions was evaluated among ten diagnostically heterogeneous self-injuring adults. Ecological momentary assessment was used to provide daily ratings of NSSI urges and acts during all study phases. Results Eight of 10 participants demonstrated clinically meaningful reductions in NSSI; six participants responded to one intervention alone, whereas two participants responded after the addition of the alternative intervention. Group analyses indicated statistically significant overall effects of study phase on NSSI, with fewer NSSI urges and acts occurring after the interventions were introduced. The interventions were also associated with moderate to large reductions in self-reported levels of anxiety and depression, and large improvements in mindful emotion awareness and cognitive reappraisal skills. Conclusions Findings suggest that brief mindful emotion awareness and cognitive reappraisal interventions can lead to reductions in NSSI urges and acts. Transdiagnostic, emotion-focused therapeutic strategies delivered in time-limited formats may serve as practical yet powerful treatment approaches, especially for lower-risk self-injuring individuals.

Applying the Unified Protocol Transdiagnostic Treatment to Nonsuicidal Self‐Injury and Co‐Occurring Emotional Disorders: A Case Illustration

“…Laura initially entered the aforementioned research study testing the effects of two UP modules on NSSI (Bentley et al., submitted for publication). Thus, the first part of her treatment consisted of four sessions of UP Module 3.…”

“…There are also initial findings to support use of the UP in unipolar and bipolar depression (Boswell, Anderson, & Barlow, ; Ellard, Deckersbach, Sylvia, Nierenberg, & Barlow, 2012), borderline personality disorder (BPD; Lopez et al., 2015; Sauer‐Zavala, Bentley, & Wilner, ), posttraumatic stress disorder (PTSD; Gallagher, 2015), and alcohol use disorders (Ciraulo et al., 2013). Recent findings from a small study also indicate that two modules of the UP can effectively reduce NSSI urges and acts (Bentley, Nock, Sauer‐Zavala, Gorman, & Barlow, submitted for publication). Although promising, research on using the UP to treat NSSI is still in early stages.…”

Nonsuicidal Self‐Injury and Attachment to God or a Higher Power

“…In this section, we will focus on counseling implications relevant to clients' spiritual attachment styles. Although numerous recommendations exist in the research for treatment approaches for NSSI, such as cognitive‐behavioral techniques (Bentley, Nock, Sauer‐Zavala, Gorman, & Barlow, ), our present investigation specifically examined the relevance of spiritual attachment styles in relation to NSSI behaviors, and our implications will thus highlight counseling techniques related to client faith. We do acknowledge that spiritual beliefs may not be salient for certain clients and some clients may be best assisted by additional or alternate treatment methods that do not address spirituality.…”

Work Stress and Depressive Symptoms in Fishermen With a Smoking Habit: A Mediator Role of Nicotine Dependence and Possible Moderator Role of Expressive Suppression and Cognitive Reappraisal

“…The present findings suggest the possibility that cognitive reappraisal training might have a direct positive impact on the relationship between work stress and depressive symptoms in fishermen. Prior research have proved the efficiency of intervention on cognitive reappraisal, for example, the cognitive behavioral therapy (enhancing cognitive reappraisal) could reduce the negative emotion problem by modifying cognitive reappraisal-related prefrontal cortex neural signal magnitude ( Goldin et al, 2013 ); the body-mind relaxation meditation induction could help depression patients construct reappraisal strategies ( Chen et al, 2015 ); and the brief mindful emotion awareness and cognitive reappraisal interventions could lead to large reductions in self-reported levels of negative emotion problems ( Bentley et al, 2017 ). Thus, improvements in cognitive reappraisal can be an effective way to mitigate the impact of work stress on depressive symptoms.…”