Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Trials
Published in: Trials 1/2013

Open Access 01-12-2013 | Study protocol

Short-term psychotherapeutic treatment in adolescents engaging in non-suicidal self-injury: a randomized controlled trial

Authors: Gloria Fischer, Romuald Brunner, Peter Parzer, Franz Resch, Michael Kaess

Published in: Trials | Issue 1/2013

Login to get access

Abstract

Background

Worldwide, prevalence rates of adolescent non-suicidal self-injury (NSSI) range between 13 and 45%. In Germany, lifetime prevalence of NSSI is around 25% in non-clinical samples, and the one-year prevalence for repetitive NSSI is 4%. NSSI is present in the context of several axis I and II disorders (for example, affective disorders or borderline personality disorder); however, preliminary evidence suggests that it would be justified to consider NSSI as its own diagnostic category. Despite the large impact of this behavior, there is still a lack of evidence-based, specific, and effective manualized treatment approaches for adolescents with NSSI.

Methods/Design

The study is designed as a randomized controlled trial (RCT) to test the effectiveness of a new cognitive-behavioral treatment manual for self-harming adolescents - the ‘Cutting-Down-Programme’ (CDP). A total of 80 adolescents aged between 12 and 17 years from a region in Southern Germany who have engaged in repetitive NSSI (≥5 incidents) in the last 6 months will be randomized into a treatment group (CDP) or a control group that will receive treatment as usual (TAU). The adolescents will be assessed by means of structured interviews and questionnaires at three time points (before treatment, directly after treatment and six months after treatment). Primary outcome criterion is a significant reduction (or remission) in the frequency of NSSI. Secondary outcome criteria are depressivity as well as general well-being and self-worth. Additionally, comorbid psychiatric disorders and childhood adversity will be evaluated as predictors of therapeutic outcome.

Discussion

Recently, a pilot study in the United Kingdom showed significant reductions in self-harming behavior, depressive symptoms and trait anxiety. This is the first RCT to test the effectiveness of a short-term psychotherapeutic intervention in outpatients engaging in NSSI.

Trial registration

The study is registered in the German Clinical Trials Register DRKS00003605.
Appendix
Available only for authorised users
Literature
1.
Lloyd-Richardson EE, Perrine N, Dierker L, Kelley ML: Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychol Med. 2007, 37: 1183-1192. 10.1017/S003329170700027X.CrossRefPubMedPubMedCentral
2.
Whitlock J, Knox KL: The relationship between self-injurious behavior and suicide in a young adult population. Arch Pediatr Adolesc Med. 2007, 161: 634-640. 10.1001/archpedi.161.7.634.CrossRefPubMed
3.
Ross S, Heath N: A Study of the Frequency of Self-Mutilation in a Community Sample of Adolescents. J Youth Adolesc. 2002, 31: 67-77. 10.1023/A:1014089117419.CrossRef
4.
Plener PL, Libal G, Keller F, Fegert JM, Muehlenkamp JJ: An international comparison of adolescent non-suicidal self-injury (NSSI) and suicide attempts: Germany and the USA. Psychol Med. 2009, 39: 1549-1558. 10.1017/S0033291708005114.CrossRefPubMed
5.
Brunner R, Parzer P, Haffner J, Steen R, Roos J, Klett M, Resch F: Prevalence and psychological correlates of occasional and repetitive deliberate self-harm in adolescents. Arch Pediatr Adolesc Med. 2007, 161: 641-649. 10.1001/archpedi.161.7.641.CrossRefPubMed
6.
Fischer G, Göbelbecker L, Schneider S: Seyle Ergebnisbericht. 2011, Heidelberg: Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg
7.
Nock MK, Joiner TE, Gordon KH, Lloyd-Richardson E, Prinstein MJ: Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Res. 2006, 144: 65-72. 10.1016/j.psychres.2006.05.010.CrossRefPubMed
8.
Jacobson CM, Muehlenkamp JJ, Miller AL, Turner JB: Psychiatric impairment among adolescents engaging in different types of deliberate self-harm. J Clin Child Adolesc Psychol. 2008, 37: 363-375. 10.1080/15374410801955771.CrossRefPubMed
9.
Hawton K, Harriss L: Deliberate self-harm in young people: characteristics and subsequent mortality in a 20-year cohort of patients presenting to hospital. J Clin Psychiatry. 2007, 68: 1574-1583. 10.4088/JCP.v68n1017.CrossRefPubMed
10.
Plener PL, Kapusta ND, Kölch MG, Kaess M, Brunner R: Nicht-suizidale Selbstverletzung als eigenständige Diagnose. Implikationen des DSM-5 Vorschlages für Forschung und Klinik selbstverletzenden Verhaltens bei Jugendlichen. Z Für Kinder Jugendpsychiatrie Psychother. 2012, 40: 113-120. 10.1024/1422-4917/a000158.CrossRef
11.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (Dsm-5). 2013, Arlington, VA, US: American Psychiatric Publishing
12.
Plener PL, Fegert JM: Non-suicidal self-injury: state of the art perspective of a proposed new syndrome for DSM V. Child Adolesc Psychiatry Ment Health. 2012, 6: 9-10.1186/1753-2000-6-9.CrossRefPubMedPubMedCentral
13.
Bohme R, Fleischhaker C, Mayer-Bruns F, Schulz E: Arbeitsbuch. Dialektisch- Behaviorale Therapie für Jugendliche (DBT-A) – Therapiemanual. 2007, Hauptstr. 8, 79104 Freiburg, Germany: University of Freiburg, Department for Child and Adolescent Psychiatry and Psychotherapy
14.
Foelsch PA, Odom AE, Schmeck K, Schlüter-Müller S, Kernberg OF: Behandlung von Adoleszenten mit Identitätsdiffusion - Eine Modifikation der Übertragungsfokussierten Psychotherapie (TFP). Persönlichkeitsstörungen Theor Ther. 2008, 12: 153-162.
15.
Rathus JH, Miller AL: Dialectical behavior therapy adapted for suicidal adolescents. Suicide Life Threat Behav. 2002, 32: 146-157. 10.1521/suli.32.2.146.24399.CrossRefPubMed
16.
Wilkinson P, Goodyer I: Non-suicidal self-inj. Eur Child Adolesc Psychiatry. 2011, 20: 103-108. 10.1007/s00787-010-0156-y.CrossRefPubMed
17.
Rossouw TI, Fonagy P: Mentalization-based treatment for self-harm in adolescents: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2012, 51: 1304-1313. 10.1016/j.jaac.2012.09.018.CrossRefPubMed
18.
Kaess M: Selbstverletzendes Verhalten: Entwicklungsrisiken erkennen und behandeln. 2012, Beltz Psychologie Verlags Union: Weinheim
19.
Evans K, Tyrer P, Catalan J, Schmidt U, Davidson K, Dent J, Tata P, Thornton S, Barber J, Thompson S: Manual-assisted cognitive-behaviour therapy (MACT): a randomized controlled trial of a brief intervention with bibliotherapy in the treatment of recurrent deliberate self-harm. Psychol Med. 1999, 29: 19-25. 10.1017/S003329179800765X.CrossRefPubMed
20.
Taylor LMW, Oldershaw A, Richards C, Davidson K, Schmidt U, Simic M: Development and pilot evaluation of a manualized cognitive-behavioural treatment package for adolescent self-harm. Behav Cogn Psychother. 2011, 39: 619-625. 10.1017/S1352465811000075.CrossRefPubMed
21.
Nock MK, Holmberg EB, Photos VI, Michel BD: Self-Injurious Thoughts and Behaviors Interview: development, reliability, and validity in an adolescent sample. Psychol Assess. 2007, 19: 309-317.CrossRefPubMed
22.
Plener PL, Fischer G, Groschwitz RC, Kaess M: Das Self-Injurious Thoughts and Behaviors Interview- German. 2012, Steinhövelstrasse 5, 89075 Ulm, Germany: Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm
23.
Beck AT, Steer RA, Brown GK: Beck-Depressions-Inventar (2. Auflage). 2006, Frankfurt/M: Harcourt Test Service GmbH
24.
Ravens-Sieberer U, Gosch A, Erhart M, von Rueden U: The KIDSCREEN Group Europe: The KIDSCREEN Questionnaires. 2006, Lengerich: Pabst Science Publisher, 1
25.
Rosenberg M: Society and the adolescent self-image. 1989, Princeton, NJ: Princeton University Press
26.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC: The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998, 59 (20): 22-33.PubMed
27.
Fydrich T, Renneberg B, Schmitz B, Wittchen H-U: SKID-II - Strukturiertes Klinisches Interview Für DSM-IV, Achse II: Persönlichkeitsstörungen. 1997, Göttingen: Hogrefe
28.
Bifulco A, Brown GW, Harris TO: Childhood Experience of Care and Abuse (CECA): a retrospective interview measure. J Child Psychol Psychiatry. 1994, 35: 1419-1435. 10.1111/j.1469-7610.1994.tb01284.x.CrossRefPubMed
29.
Kaess M, Parzer P, Mattern M, Resch F, Bifulco A, Brunner R: Childhood Experiences of Care and Abuse (CECA): Validierung der deutschen Version von Fragebogen und korrespondierendem Interview sowie Ergebnisse einer Untersuchung von Zusammenhängen belastender Kindheitserlebnisse mit suizidalen Verhaltensweisen. Z Für Kinder Jugendpsychiatr Psychother. 2011, 39: 243-252. 10.1024/1422-4917/a000115.CrossRef
30.
Schmidt J, Lamprecht F, Wittmann WW: Zufriedenheit mit der stationären Versorgung. Entwicklung eines Fragebogens und erste Validitätsuntersuchungen. Psychother Psychosom Med Psychol. 1989, 39: 248-255.PubMed
31.
Metadata
Title
Short-term psychotherapeutic treatment in adolescents engaging in non-suicidal self-injury: a randomized controlled trial
Authors
Gloria Fischer
Romuald Brunner
Peter Parzer
Franz Resch
Michael Kaess
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Trials / Issue 1/2013
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-14-294

Other articles of this Issue 1/2013

Trials 1/2013 Go to the issue

Study protocol

Evaluation of the effectiveness and cost-effectiveness of Families for Health V2 for the treatment of childhood obesity: study protocol for a randomized controlled trial

Methodology

Hospital-admitted COPD patients treated at home using telemedicine technology in The Virtual Hospital Trial: methods of a randomized effectiveness trial

Study protocol

Evaluation of the impact of immediate versus WHO recommendations-guided antiretroviral therapy initiation on HIV incidence: the ANRS 12249 TasP (Treatment as Prevention) trial in Hlabisa sub-district, KwaZulu-Natal, South Africa: study protocol for a cluster randomised controlled trial

Study protocol

Comparing specialist medical care with specialist medical care plus the Lightning Process® for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME): study protocol for a randomised controlled trial (SMILE Trial)

Study protocol

SWIVIT - Swiss video-intubation trial evaluating video-laryngoscopes in a simulated difficult airway scenario: study protocol for a multicenter prospective randomized controlled trial in Switzerland

Study protocol

Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial