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.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
34
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.
Affektiva, ångest och traumaprogrammet, Psykiatri Sydväst
Stockholm, Sweden
Patients experience of, and satisfaction with, the treatment assessed through qualitative interviews
Patients experience of, and satisfaction with, the treatment assessed through qualitative interviews
Time frame: Immediately after treatment completion
Depression symtoms
Depression symtoms will be measured with Patient Health Questionnaire (PHQ-9; (Kroenke et al., 2001)
Time frame: 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)
Time frame: Immediately after treatment completion (25 weeks)
Adverse events related to the treatment
Adverse events related to the treatment
Time frame: 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
Time frame: Throughout the treatment period, up to 25 weeks
Number of group sessions attended during the treatment
Number of group sessions attended during the treatment
Time frame: Throughout the treatment period, up to 25 weeks
Number of dropouts
Number of dropouts
Time frame: Throughout the treatment period, up to 25 weeks
Total number of sessions attended during the treatment
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Total number of sessions attended during the treatment
Time frame: Throughout the treatment period, up to 25 weeks
Fear of negative emotions
Fear of negative emotion scale (Gilbert et al., 2014) for assessing fear and avoidance of negative feelings.
Time frame: Change from baseline to post-treatment (25 weeks) and follow up 6 months after treatment.
Anxiety symtoms
Generalized Anxiety Disorder-7 (GAD-7; Spitzer et al., 2006) for assessing anxiety symtoms.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: 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
Time frame: 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.
Time frame: Weekly throughout treatment, up to 25 weeks