Specialized treatment of personality disorders (PD) in youth has been neglected for a long time, because these disorders were not diagnosed before the age of 18. Since 2013 the age threshold has been dropped in the Diagnostic and Statistical Manual (DSM)-5, and such change is also announced for the International Classification of Diseases (ICD)-11. There is broad consensus from both scientific evidence and clinical experience that specialized early interventions in adolescents with PD are urgently needed. In the last decades a number of specialized psychotherapeutic treatment programs have been developed. Despite their conceptual differences, many of the treatment models have shown significant effects in the treatment of PD in adults. However, the treatment of adolescents with PD remains difficult and further enhancement and development of treatments is needed. Given the different therapeutic approaches available, the present project aims to go beyond the comparison of integral therapeutic models in the classical outcome study design. While outcome research is important to build on the evidence of the effectiveness of an intervention, it contributes little to its understanding and refinement. The aim of the present multi-center project is to compare two therapeutic methods used in routine care: * Adolescent Identity Treatment (AIT) * Dialectic Behavioral Treatment for Adolescents (DBT-A) Treatments will be performed at different study centers and compared using the same measures of outcome. The main outcome will be psychosocial functioning. Additionally, the psychotherapy process will be investigated to explore specific and unspecific mechanisms of the therapeutic process, its outcome and mediators.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Integrative Approach for the treatment of adolescents with Personality Disorder. Manual was published in 2013.
Dialectic Behavioral Treatment for Adolescents is the most commonly used Approach for the Treatment of adolescents with Boderline Personality Disorder
Millennium Institute for Research in Depression and Personality - Pontificia Universidad Católica de Chile
Santiago, Chile
Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg
Heidelberg, Germany
Psychiatric Universitiy Hospital Basel
Basel, Switzerland
Change in Children's Global Assessment Scale (CGAS)
Psychosocial functioning. Rated considering the results of the Columbia Impairment Scale - parent and patient versions
Time frame: Baseline, 12 months after Baseline
Psychosocial functioning
Columbia Impairment Scale (CIS) (Patient and Parent versions)
Time frame: Baseline, 12 months after Baseline
School functioning
School Functioning Rating (SFR)
Time frame: Baseline, 12 months after Baseline
Change in Psychopathology
Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)
Time frame: Baseline, 12 months after Baseline (only Basel and Heidelberg)
Change in Severity of Psychopathology
Clinical Global Impression Scale
Time frame: Baseline, 12 months after Baseline
Change in Depression
Beck Depression Inventory (BDI)
Time frame: Baseline, 12 months after Baseline
Change in Psychopathological Symptoms
Strengths \& Difficulties Questionnaires (SDQ)
Time frame: Baseline, 12 months after Baseline
Change in Personality Functioning
Levels of Personality Functioning - Questionnaire for Adolescents (LoPF-QA)
Time frame: Baseline, 12 months after Baseline (only Basel and Heidelberg)
Change in Identity
Assessment of Identity Development in Adolescence (AIDA)
Time frame: Baseline, 12 months after Baseline
Change in Personality Disorder Symptoms
Structured Clinical Interview of Diagnostic and Statistical Manual of Mental Disorders (DSM) (SCID)-II
Time frame: Baseline, 12 months after Baseline (only Basel and Heidelberg)
Change in Interpersonal Problems
Inventory of Interpersonal Problems (IIP-64)
Time frame: Baseline, 12 months after Baseline (only Santiago)
Change in Mentalizing Capacity
Movie for the Assessment of Social Cognition (MASC)
Time frame: Baseline, 12 months after Baseline
Change in Quality of Life
Health-related Quality of Life Screening Instrument for Children and Adolescents (KIDSCREEN)
Time frame: Baseline, 12 months after Baseline
Change in Parental Stress
Eltern-Belastungs-Inventar (EBI)
Time frame: Baseline, 12 months after Baseline (only Basel and Heidelberg)
Self-injurious Behavior
Self- Injurious Thoughts and Behaviors Interview
Time frame: Baseline, 12 months after Baseline (only Basel and Heidelberg)
Borderline-specific Personality Pathology
Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD)
Time frame: Baseline, 12 months after Baseline (only Basel and Heidelberg)
Borderline-specific Symptoms
Borderline Symptom List 23 (BSL-23)
Time frame: Baseline, 12 months after Baseline (only Basel and Santiago)
Change in Psychophysiological Measures (Only Basel and Heidelberg)
Regression analysis will be used to evaluate change; Parameters: Heart Rate Variability and Electrodermal Activity (Basel only)
Time frame: Baseline, 12 months after Baseline
Change in Hair Cortisol Level (only Basel and Heidelberg)
Time frame: Baseline, 12 months after Baseline
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