Emotion regulation as mediator of treatment outcome in therapy for deliberate self‐harm

Abstract

This study presents the outcomes of mediator analyses as part of a randomized controlled trial of Cognitive-Behavioural Therapy (CBT) for young people who engage in deliberate self-harm (DSH). The study involved 90 people, aged 15-35 years, who were randomly assigned to CBT in addition to treatment as usual or to treatment as usual only. The fi ndings showed that changes in DSH were partially mediated by changes in emotion-regulation diffi culties, particularly diffi culties with impulse control and goal-directed behaviours. In addition, the potential mediating role of symptoms of depression, anxiety and suicidal cognitions was examined. Although the CBT intervention signifi cantly reduced depression, anxiety and suicidal cognitions, these measures of symptom severity did not play a mediating role. These fi ndings suggest that interventions for DSH should not primarily focus on mental disorders associated with DSH, but should be DSH-specifi c and should target specifi c emotion-regulation diffi culties.

Mentalization and Self-Efficacy as Mediators between Psychological Symptom Severity and Disabilities in Activities and Participation in Psychotherapy Patients

“…The relevance to increase self-efficacy and mentalizing is supported by psychotherapy studies reporting self-efficacy and aspects of mentalization to be mediators of the outcome [38,39]. Yet, a recent review reported that there are specific conditions self-efficacy is not beneficial for and that working on self-efficacy in psychotherapy might not always be necessary [40].…”

Childhood Sexual Abuse Differentially Predicts Outcome of Cognitive-Behavioral Therapy for Deliberate Self-Harm

“…Emotion regulation difficulties have been conceptualized as a relatively distinct feature of the consequences of childhood abuse that are supposed to derive from the abuse's disruptive impact on the achievement of the developmental goals and interpersonal relatedness (Van der Kolk, 1996;Slee et al, 2008b). To influence the vulnerabilities in emotion regulation, the CBT intervention aimed to enhance emotional awareness, distress tolerance and problem solving skills (Slee et al, 2008c). These interventions require a good therapeutic alliance around trust and safety and sufficient time for the internalization of emotional control to develop.…”

Examining the Presence of Anxiety in Aggressive Individuals: The Illuminating Role of Fight-or-Flight Mechanisms

“…Recently a focus has been placed on the importance of emotion regulation in anxiety as well (Hannesdottir and Ollendick 2007;Mennin 2006;Trosper et al 2009). Preliminary research suggests that considering this affective component also aids in therapy (Hinton et al 2009;Slee et al 2008).…”