Dialectic Behaviour Therapy (DBT) for People With Autism: A Multiple Baseline Single Case Design

GGZ Friesland6 enrolled

Overview

The goal of this experimental study is to test the effectiveness of Dialectic Behavioural Therapy in patients with Autism Spectrum Disorder. The aim questions are: 1. What is the effect of DBT on maladaptive emotion regulation strategies and emotional well-being in patients with ASD? 2. Is the use of DBT skills associated with a reduction in maladaptive emotion regulation strategies and an increase of emotional well-being over time? 3. What are the dynamics over time between maladaptive emotion regulation strategies, emotional well-being and sensory overload? Participants will: * Follow DBT of 10 months * Keep a diary on their urge of maladaptive emotion regulation strategies and well-being

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Autism Spectrum Disorder

Interventions

Eligibility

Sex: ALLMin age: 16 Years

Medical Language ↔ Plain English

Inclusion Criteria: * DSM-5 diagnosis of ASD * Sufficient understanding, as demonstrated in conversation with intake therapist; * Explicit behavioural problems, which, according to patient and therapist, lead to functional problems (like suicidal ideation, auto mutilation, emotional outburst and interpersonal conflicts); * BMI \> 17; * Commitment to the therapy and shared goals as assessed by intake therapist; Exclusion Criteria: * Antisocial behaviour which interrupts the group climate; * Presence of a trauma-related disorder that is likely to interfere with the ability to engage effectively in DBT or that requires specialized trauma-focused treatment prior to or alongside DBT as assessed by intake team; * Excessive dependency on substances for which no parallel appropriate policy can be made; * Diagnosis of psychotic disorder if not stable; * Diagnosed with bipolar disorder.

Outcomes

Primary Outcomes

Maladaptive Emotion Regulation Strategies (MERS) measured assessed by the DBT diary (Linehan, 2016)

MERS is the average of the urge to six maladaptive emotion regulation strategies: 1. suicidal thoughts/behaviours 2. self-harm, 3. eating problems 4. substance abuse 5. anger outburst 6. other All emotion regulation strategies are measured on a scale from 0 - 100. MERS will be created by adding scores of the six strategies together and divide it by 6.

Time frame: From enrollment to end of treatment at 10 months

Emotional well-being as assessed by the DBT diary (Linehan, 2016)

The daily diary measures emotional suffering and happiness on a scale from 0 - 100. Emotional suffering is inverted, following the logic that higher emotional suffering means lower emotional well-being. The variable well-being is created by averaging the invert of emotional suffering and happiness.

Time frame: From enrollment to end of treatment at 10 months

Secondary Outcomes

Social behaviour

As measured by the Vragenlijst Inventarisatie van Sociaal gedrag bij Volwassenen (VIS-V) (Horwitz et al. 2013). The VIS-V is a 44-item questionnaire that assess social behaviour, with answers ranging from 0 (= not applicable) to 2 (=cleary applicable). Higher scores mean lower social behaviour.

Time frame: At start of baseline (T1), at end of treatment phase at 10 months (T2)

Emotion regulation

As measured with the Difficulties in Emotion Regulation Scale (DERS) (Gratz \& Roemer, 2004). The DERS is a 36-item questionnaire with 5-point Likert answers, ranging from "almost never" to "almost always".

Time frame: At the start of the baseline phase (T1), at the end of the treatment phase at 10 months (T2)

Generic psychopathology and functioning

As measured with the Outcome Questionnaire-45 (OQ-45) (De Jong et al., 2008). The OQ-45 is a 45-item questionnaire, with answers ranging from never (0) to almost always (4). Some items are mirrored.