title: Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder.
abstract: BACKGROUND
  Despite the clinical importance of deliberate self-harm (DSH; also referred to as non-suicidal self-injury) within borderline personality disorder (BPD), empirically supported treatments for this behavior among individuals with BPD are difficult to implement in many clinical settings. To address this limitation, a 14-week, adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD was developed. The current study examined the efficacy of this ERGT in a randomized controlled trial (RCT) and the durability of treatment gains over a 9-month uncontrolled follow-up period.
  
  
  METHODS
  Female out-patients with BPD and recent recurrent DSH were randomly assigned to receive this ERGT in addition to their ongoing out-patient therapy immediately (n = 31) or after 14 weeks (n = 30). Measures of DSH and other self-destructive behaviors, psychiatric symptoms, adaptive functioning and the proposed mechanisms of change (emotion dysregulation/avoidance) were administered pre- and post-treatment or -waitlist (to assess treatment efficacy), and 3 and 9 months post-treatment (to assess durability of treatment gains).
  
  
  RESULTS
  Intent-to-treat (ITT) analyses (n = 61) revealed significant effects of this ERGT on DSH and other self-destructive behaviors, emotion dysregulation, BPD symptoms, depression and stress symptoms, and quality of life. Analyses of all participants who began ERGT (across treatment and waitlist conditions; n = 51) revealed significant improvements from pre- to post-treatment on all outcomes, additional significant improvements from post-treatment to 9-month follow-up for DSH, emotion dysregulation/avoidance, BPD symptoms and quality of life, and no significant changes from post-treatment to 9-month follow-up on the other measures.
  
  
  CONCLUSIONS
  The results support the efficacy of this ERGT and the durability of treatment gains.
authors.affiliation: Department of Psychiatry and Human Behavior,University of Mississippi Medical Center,Jackson, MS,USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Gratz
authors.affiliation: Department of Psychiatry and Human Behavior,University of Mississippi Medical Center,Jackson, MS,USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Tull
authors.affiliation: T. Denny Sanford School of Social and Family Dynamics,Arizona State University,Tempe, AZ,USA.
authors.forename: R
authors.initials: R
authors.lastname: Levy
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000150:complications / Q000628:therapy*; D004644:Emotions / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods*; D016728:Self-Injurious Behavior / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome