Mentalization-Based Treatment for Self-Harm in Adolescents: A Randomized Controlled Trial - 29/11/12
, Peter Fonagy, Ph.D., F.B.A. b
Correspondence to Trudie I. Rossouw, M.R.C.Psych.,107 A Barley Lane, IG3 8XQ, UKAbstract |
Objective |
We examined whether mentalization-based treatment for adolescents (MBT-A) is more effective than treatment as usual (TAU) for adolescents who self-harm.
Method |
A total of 80 adolescents (85% female) consecutively presenting to mental health services with self-harm and comorbid depression were randomly allocated to either MBT-A or TAU. Adolescents were assessed for self-harm, risk-taking and mood at baseline and at 3-monthly intervals until 12 months. Their attachment style, mentalization ability and borderline personality disorder (BPD) features were also assessed at baseline and at the end of the 12-month treatment.
Results |
MBT-A was more effective than TAU in reducing self-harm and depression. This superiority was explained by improved mentalization and reduced attachment avoidance and reflected improvement in emergent BPD symptoms and traits.
Conclusions |
MBT-A may be an effective intervention to reduce self-harm in adolescents.
Clinical trial registration information |
—The emergence of personality disorder traits in adolescents who deliberately self harm and the potential for using a mentalisation based treatment approach as an early intervention for such individuals: a randomised controlled trial; http://www.controlled-trials.com; ISRCTN95266816.
Le texte complet de cet article est disponible en PDF.Key Words : self-harm, treatment, borderline, RCT
Plan
| This article is discussed in an editorial by Dr. David J. Miklowitz on page 1238. |
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| This article can be used to obtain continuing medical education (CME) category 1 credit at www.jaacap.org. |
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| The research assistants who contributed to the study were employed by NELFT. The authors thank NELFT for employing the research assistants, the research assistants working on the trial, and the clinicians, adolescents, and their families who gave of their time to participate. |
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| Disclosure: Dr. Fonagy is the Chief Executive of the Anna Freud Centre, London, which regularly offers training courses in mentalization based treatment (MBT) and National Clinical Lead for the Department of Health’s Improved Access to Psychological Therapies (IAPT) for Children and Young People Programme. He has received grant income from the National Institute of Clinical Excellence, the UK Mental Health Research Network, the British Academy, the Wellcome Trust, the National Institute of Health Research (Senior Investigator Award and Research for Patient Benefit Programme), the Pulitzer Foundation, the Department for Children, Schools, and Families, the Central and East London Comprehensive Local Research Network (CLRN) Programme, the NHS Health Technology Assessment (HTA) programme, the Department of Health’s IAPT Programme, and the Hope for Depression Foundation. Dr. Rossouw reports no biomedical financial interests or potential conflicts of interest. |
Vol 51 - N° 12
P. 1304 - décembre 2012 Retour au numéro
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