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In this pilot study, the effect of a group intervention targeting self-criticism in adolescents in a clinical child- and adolescent psychiatric outpatient setting will be examined using a single-case experimental design (AB). Participants will be randomized to multiple baseline with weekly measures. Our primary outcomes, measured weekly, are self-criticism, nonsuicidal self-injury and symptoms of depression and anxiety, as well as an individually chosen behavior driven by self-criticism. Secondary outcomes are self-compassion, psychological flexibility, quality of life and functioning. In addition to the weekly administered questionnaires, before and after measures, and 3- and 6-month follow-up will be collected. After the treatment, participants will also be interviewed about their experiences of targeting self-criticism.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treating self-criticism | Experimental | 8-session group intervention targeting self-criticism given 2-hrs/week with booster session after 3-months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Treating self-criticism | Behavioral | A psychological treatment given i a group format targeting self-criticism. The treatment is based on treatment principles from Cognitive behavior therapy, Self-compassion, Acceptance and Commitment Therapy and also contains psychoeducation. The group treatment consists of 8 sessions delivered once a week for 2 hrs during 8 weeks in a child- and adolescent psychiatric outpatient setting. |
| Measure | Description | Time Frame |
|---|---|---|
| Self-criticism | Forms of Self-Criticism and Self-Reassuring Scale (FSCRS; Gilbert et al., 2004) | Change from baseline (phase A) at intervention (phase B) 8 weeks, and at 3- and 6- months |
| Measure | Description | Time Frame |
|---|---|---|
| Self-Compassion | Self-Compassion Scale, short form (SCS; Raes et al., 2011) | Change from before to after intervention, and at 3- and 6- month follow-up |
| Psychological flexibility | Avoidance and Fusion Questionnaire for Youth (AFQ-Y8; Greco et al., 2008). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Maria Zetterqvist, PhD | Region Östergötland and Linköping university | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Region Ostergotland BUP-kliniken | Linköping | 581 85 | Sweden |
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| ID | Term |
|---|---|
| D016728 | Self-Injurious Behavior |
| D003863 | Depression |
| D001008 | Anxiety Disorders |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D001523 | Mental Disorders |
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Single-case experimental design
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| Change from before to after intervention, and at 3- and 6- month follow-up |
| Quality of life and functioning | The Work and Social Adjustment Scale, youth version (WSAS-Y; Mundt et al., 2002). | Change from before to after intervention, and at 3- and 6- month follow-up |
| Symptoms of depression | Montgomery Åsberg Depression Rating Scale, self-report version (MADRS-S; Montgomery et al., 1979). | Change from baseline (phase A) at intervention (phase B) 8 weeks, and at 3- and 6- months |
| Symptoms of anxiety | Liebowitz Social Anxiety Scale, self-report (LSAS; Liebowitz, 1987) | Change from baseline (phase A) at intervention (phase B) 8 weeks, and at 3- and 6- months |
| Nonsuicidal self-injury | Selected items from Self-Injurious Thoughts and Behaviors interview (SITBI; Nock et al., 2007), Deliberate self-harm inventory (DSHI; Gratz et al., 2001) och Clinician Administered Nonsuicidal self-injury Disorder Interview (CANDI; Gratz et al., 2015) | Change from baseline (phase A) at intervention (phase B) 8 weeks, and at 3- and 6- months |
| Individually chosen behavior | A behavior driven by self-criticism | Change from baseline (phase A) at intervention (phase B) 8 weeks, and at 3- and 6- months |