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Acceptance and Commitment Therapy for Nonsuicidal Self-injury

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ClinicalTrials.gov Identifier: NCT03548402
Recruitment Status : Completed
First Posted : June 7, 2018
Last Update Posted : June 7, 2018
Sponsor:
Information provided by (Responsible Party):
Alicia Meuret, Southern Methodist University

Brief Summary:

The goal of this study is to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) for individuals who engage in nonsuicidal self-injury(NSSI) and have comorbid anxiety.

With the data collected from the study, the investigators will test the following hypotheses:

Acceptance and commitment therapy will lead to reductions in anxiety and self-harm behaviors in non-suicidal self-injury individuals.


Condition or disease Intervention/treatment Phase
Nonsuicidal Self-Injury Anxiety Behavioral: Acceptance and Commitment Therapy (ACT) Not Applicable

Detailed Description:

Non-suicidal self-injury is the direct and purposeful harming of one's bodily tissue outside of social and religious norms and lacking suicidal intent. The most common NSSI behaviors include cutting (70-90%), banging or hitting (21-44%), and burning (15-35%) (Rodham & Hawton, 2009); but many report utilizing multiple methods (50-70%; Klonsky, 2011; Whitlock, Eckenrode, & Silverman, 2006). NSSI has an alarming prevalence among college students, with rates ranging from 17-38% (Whitlock et al., 2006; Gratz, Conrad, & Roemer, 2002). NSSI occurs in the context of many psychological disorders (Nock, 2010), and is associated with anxiety and mood disturbances (Andover et al., 2005). This is a prevalent problem and lacks an efficacious treatment. As a result, this study can shed insight into possible treatments.

The experiential avoidance model of deliberate self-harm posits that a function of self-injury is maintained through negative reinforcement by reducing unpleasant emotional arousal (Chapman et al. 2006). Therefore a treatment that directly targets reducing experiential avoidance is likely to be effective.

ACT is based on the theory that rigid attempts to control internal states, thoughts and feelings, and other forms of experiential avoidance contribute to symptom development and maintenance of anxiety and self-injury. The training includes three components: (a) educating Ps about the exacerbation of anxiety symptoms and problem behaviors through rigid attempts at experiential avoidance, (b) introducing acceptance and the willingness to experience anxiety-related sensations and cognitions as an alternative to experiential control, through the practice of intentional and non-judgmental paying attention to one's thoughts, feelings, images and bodily sensations (including aversive symptoms of anxiety) and learning to see thoughts as an ongoing process distinct from self rather than merely an event with literal meaning (cognitive defusing), and (c) instructing Ps in between-session exercises incorporating awareness of present, internal experiences and cognitive defusion exercises while engaging in exercises that give rise to them.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 10 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Acceptance and Commitment Therapy for Nonsuicidal Self-injury
Actual Study Start Date : March 19, 2012
Actual Primary Completion Date : March 19, 2015
Actual Study Completion Date : May 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anxiety Self-Harm


Intervention Details:
  • Behavioral: Acceptance and Commitment Therapy (ACT)
    ACT is based on the theory that rigid attempts to control internal states, thoughts and feelings, and other forms of experiential avoidance contribute to symptom development and maintenance of anxiety and self-injury.


Primary Outcome Measures :
  1. Urges to Self-Injure [ Time Frame: During treatment (weeks 1-10) and 2 month follow-up ]
    Whether there is a decrease in the participants self-reported urge to self-injure as measured by the Alexian Brothers Urge to Self-Injure Scale (ABUSI)


Secondary Outcome Measures :
  1. Experiential Avoidance [ Time Frame: During treatment (weeks 1-10) and at 2 month follow-up ]
    Whether there are reductions in the participants self-reported experiential avoidance measured by the Acceptance and Action Questionnaire-II (AAQ-II)


Other Outcome Measures:
  1. Anxiety [ Time Frame: During treatment (weeks 1-10) and at 2 month follow-up ]
    Whether there are changes in the participants self-reported anxiety symptoms measured by the Anxiety Sensitivity Index (ASI)



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. If applicable, be stabilized on their current medications for at least two months.
  2. Must report at least one incidence of self-injuring during the past six months.

Exclusion Criteria:

  • Active psychosis, schizophrenia and schizoaffective disorder Current active suicidal ideation Individuals with a history of seizure disorders, angina, myocardial infarction, congestive heart failure, clinically significant arrhythmias, transient ischemic attacks, cerebrovascular accidents, diabetes mellitus, significant asthma, emphysema, chronic obstructive pulmonary disease or a family history of heart disease before age 55 are also excluded.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03548402


Locations
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United States, Texas
Stress, Anxiety, and Chronic Disease Research Program, Southern Methodist University
Dallas, Texas, United States, 75206
Sponsors and Collaborators
Southern Methodist University
Investigators
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Principal Investigator: Alicia Meuret, PhD Southern Methodist University

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Responsible Party: Alicia Meuret, Associate Professor of Psychology, Southern Methodist University
ClinicalTrials.gov Identifier: NCT03548402     History of Changes
Other Study ID Numbers: 2012-029-MEUA
First Posted: June 7, 2018    Key Record Dates
Last Update Posted: June 7, 2018
Last Verified: May 2018

Additional relevant MeSH terms:
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Wounds and Injuries
Self-Injurious Behavior
Behavioral Symptoms