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| Name | Class |
|---|---|
| Region Stockholm | OTHER_GOV |
| Stockholm University | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ISTDP | Experimental | ISTDP combined group- and individual therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ISTDP | Behavioral | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Patients experience of, and satisfaction with, the treatment assessed through qualitative interviews | Patients experience of, and satisfaction with, the treatment assessed through qualitative interviews | Immediately after treatment completion |
| Depression symtoms | Depression symtoms will be measured with Patient Health Questionnaire (PHQ-9; (Kroenke et al., 2001) | Baseline, weekly throughout treatment, immediately after treatment completion and 6-month follow-up |
| Participants satisfaction with treatment assessed with the Client Satisfaction Questionnaire (CSQ-8) | Participants satisfaction with treatment assessed with the Client Satisfaction Questionnaire (CSQ-8) | Immediately after treatment completion (25 weeks) |
| Adverse events related to the treatment | Adverse events related to the treatment | From start of treatment up to. 6 month follow up. |
| Number of individual sessions attended during the treatment | Number of individual sessions attended during the treatment | Throughout the treatment period, up to 25 weeks |
| Number of group sessions attended during the treatment | Number of group sessions attended during the treatment | Throughout the treatment period, up to 25 weeks |
| Number of dropouts |
| Measure | Description | Time Frame |
|---|---|---|
| Fear of negative emotions | Fear of negative emotion scale (Gilbert et al., 2014) for assessing fear and avoidance of negative feelings. | Change from baseline to post-treatment (25 weeks) and follow up 6 months after treatment. |
| Anxiety symtoms |
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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
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Affektiva, ångest och traumaprogrammet, Psykiatri Sydväst | Stockholm | 14157 | Sweden |
The raw data collected in the study can be made available on a group level given that the request comply with Swedish and EU laws regulating protection of identifiable data.
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| ID | Term |
|---|---|
| D010554 | Personality Disorders |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
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Number of dropouts
| Throughout the treatment period, up to 25 weeks |
| Total number of sessions attended during the treatment | Total number of sessions attended during the treatment | Throughout the treatment period, up to 25 weeks |
Generalized Anxiety Disorder-7 (GAD-7; Spitzer et al., 2006) for assessing anxiety symtoms.
| Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. |
| Emotions regulation difficulties | Difficulties in Emotion Regulation Scale (DERS-16; Bjureberg et al., 2016) for assessing difficulties with emotions regulation. | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. |
| Severity of personality disorder | The Standardized Assessment of Severity of Personality Disorders (SASPD; Olajide et al., 2018) for assessing degree of personality disorder. | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. |
| Symtoms of Borderline Personality disorder | Borderline Symtom List (BLS-23; Bohus et al., 2008) for assessing symtoms of Borderline personality disorder. | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. |
| Severity of personality disorder | Levels of Personality Functioning Brief Form (LPFS-BF; Weekers et al., 2019) for assessing degree of personality disorder. | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. |
| Quality of life | Brunnsviken Brief Quality of life (Lindner et al., 2016) for assessing quality of life. | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. |
| Quality of life | EuroQol-5D (EQ5D; Balestroni, Gianluigi, & Bertolotti, 2015) for assessing quality of life. | Change from baseline to immediately after treatment completion (25 weeks) and follow up 6 months after treatment. |
| Working alliance | Session Alliance Inventory (SAI; Falkenström et al., 2015) for assessing the working alliance with the therapist | Weekly throughout treatment , up to 25 weeks |
| Emotional activation during therapy | Emotional Experience Self Report (Fisher et al., 2016) for assessing the degree of emotional activation during the session. | Weekly throughout treatment, up to 25 weeks |