Mentalization-based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial / Emma BECK in Journal of Child Psychology and Psychiatry, 61-5 (May 2020)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 61-5 (May 2020) . - p.594-604 Titre : Mentalization-based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial Type de document : Texte imprimé et/ou numérique Auteurs : Emma BECK, Auteur ; Sune BO, Auteur ; Mie Sedoc JORGENSEN, Auteur ; Matthias GONDAN, Auteur ; Stig POULSEN, Auteur ; Ole Jakob STOREBO, Auteur ; Christian FJELLERAD ANDERSEN, Auteur ; Espen FOLMO, Auteur ; Carla SHARP, Auteur ; Jesper PEDERSEN, Auteur ; Erik SIMONSEN, Auteur Article en page(s) : p.594-604 Langues : Anglais (eng) Mots-clés : Mentalization-based treatment  adolescence  borderline personality disorder  group psychotherapy  mentalizing Index. décimale : PER Périodiques Résumé : BACKGROUND: Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence-based psychotherapeutic programs, including mentalization-based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD has mainly been tested with adults, and no RCT has examined the effectiveness of MBT in groups (MBT-G) for adolescent BPD. METHOD: A total of 112 adolescents (111 females) with BPD (106) or BPD symptoms >/=4 DSM-5 criteria (5) referred to child and adolescent psychiatric outpatient clinics were randomized to a 1-year MBT-G, consisting of three introductory, psychoeducative sessions, 37 weekly group sessions, five individual case formulation sessions, and six group sessions for caregivers, or treatment as usual (TAU) with at least 12 monthly individual sessions. The primary outcome was the score on the borderline personality features scale for children (BPFS-C); secondary outcomes included self-harm, depression, externalizing and internalizing symptoms (all self-report), caregiver reports, social functioning, and borderline symptoms rated by blinded clinicians. Outcome assessments were made at baseline, after 10, 20, and 30 weeks, and at end of treatment (EOT). The ClinicalTrials.gov identifier is NCT02068326. RESULTS: At EOT, the primary outcome was 71.3 (SD = 15.0) in the MBT-G group and 71.3 (SD = 15.2) in the TAU group (adjusted mean difference 0.4 BPFS-C units in favor of MBT-G, 95% confidence interval -6.3 to 7.1, p = .91). No significant group differences were found in the secondary outcomes. 29% in both groups remitted. 29% of the MBT group completed less than half of the sessions compared with 7% of the control group. CONCLUSIONS: There is no indication for superiority of either therapy method. The low remission rate points to the importance of continued research into early intervention. Specifically, retention problems need to be addressed. En ligne : http://dx.doi.org/10.1111/jcpp.13152 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422 [article] Mentalization-based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial [Texte imprimé et/ou numérique] / Emma BECK, Auteur ; Sune BO, Auteur ; Mie Sedoc JORGENSEN, Auteur ; Matthias GONDAN, Auteur ; Stig POULSEN, Auteur ; Ole Jakob STOREBO, Auteur ; Christian FJELLERAD ANDERSEN, Auteur ; Espen FOLMO, Auteur ; Carla SHARP, Auteur ; Jesper PEDERSEN, Auteur ; Erik SIMONSEN, Auteur . - p.594-604. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 61-5 (May 2020) . - p.594-604 Mots-clés : Mentalization-based treatment  adolescence  borderline personality disorder  group psychotherapy  mentalizing Index. décimale : PER Périodiques Résumé : BACKGROUND: Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence-based psychotherapeutic programs, including mentalization-based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD has mainly been tested with adults, and no RCT has examined the effectiveness of MBT in groups (MBT-G) for adolescent BPD. METHOD: A total of 112 adolescents (111 females) with BPD (106) or BPD symptoms >/=4 DSM-5 criteria (5) referred to child and adolescent psychiatric outpatient clinics were randomized to a 1-year MBT-G, consisting of three introductory, psychoeducative sessions, 37 weekly group sessions, five individual case formulation sessions, and six group sessions for caregivers, or treatment as usual (TAU) with at least 12 monthly individual sessions. The primary outcome was the score on the borderline personality features scale for children (BPFS-C); secondary outcomes included self-harm, depression, externalizing and internalizing symptoms (all self-report), caregiver reports, social functioning, and borderline symptoms rated by blinded clinicians. Outcome assessments were made at baseline, after 10, 20, and 30 weeks, and at end of treatment (EOT). The ClinicalTrials.gov identifier is NCT02068326. RESULTS: At EOT, the primary outcome was 71.3 (SD = 15.0) in the MBT-G group and 71.3 (SD = 15.2) in the TAU group (adjusted mean difference 0.4 BPFS-C units in favor of MBT-G, 95% confidence interval -6.3 to 7.1, p = .91). No significant group differences were found in the secondary outcomes. 29% in both groups remitted. 29% of the MBT group completed less than half of the sessions compared with 7% of the control group. CONCLUSIONS: There is no indication for superiority of either therapy method. The low remission rate points to the importance of continued research into early intervention. Specifically, retention problems need to be addressed. En ligne : http://dx.doi.org/10.1111/jcpp.13152 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422

Psychopathological symptoms associated with psychosocial functioning in children and adolescents with autism spectrum disorders and their typically developing peers / Jonathan LASSEN in Research in Autism Spectrum Disorders, 98 (October 2022)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 98 (October 2022) . - 102040 Titre : Psychopathological symptoms associated with psychosocial functioning in children and adolescents with autism spectrum disorders and their typically developing peers Type de document : Texte imprimé et/ou numérique Auteurs : Jonathan LASSEN, Auteur ; Bodil AGGERNAES, Auteur ; Malene FOLDAGER, Auteur ; Jesper PEDERSEN, Auteur ; Bob ORANJE, Auteur ; Troels W. KJAER, Auteur ; Sidse ARNFRED, Auteur ; Martin VESTERGAARD, Auteur Article en page(s) : 102040 Langues : Anglais (eng) Mots-clés : ASD  Autism  School attendance  Adaptive behavior  Special education  Internalizing Index. décimale : PER Périodiques Résumé : Children and adolescents with autism have increased prevalence of psychosocial disabilities. Studies in autism indicate that key psychosocial factors including adaptive functioning, school absence, special needs education, frequency of peer socialization and participation in organized leisure activities may differ in their relationship with autistic, internalizing and externalizing symptoms, but the findings are so far mixed. Therefore, we examined if these measures of psychosocial functioning displayed specific associations with autistic, internalizing and/or externalizing symptoms in 61 children with autism aged 7-14 years compared to 61 typically developing controls. Multiple linear regression analyses across all participants showed that lower adaptive functioning, frequency of peer socialization and participation in leisure activities were driven by more social communication problems and not internalizing, externalizing or autistic-like symptoms including rigidity, stereotypy and sensory sensitivity. Notably, increased school absence was specifically driven by more internalizing symptoms and not autistic or externalizing symptoms. These associations were observed across all participants, both children with autism and their typically developing peers, and therefore appear to be dimensional and general in nature. Within the autism group, children who received special needs education displayed fewer social communication problems compared to those who attended regular education, while a developmental history of social interaction problems was related to lower adaptive functioning. Our findings suggest that social communication problems are more critical for psychosocial functioning than other autistic-like behaviors, internalizing or externalizing symptoms but that efforts to reduce school absence specifically need to target internalizing symptoms and not autistic-like or externalizing symptoms. En ligne : https://doi.org/10.1016/j.rasd.2022.102040 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490 [article] Psychopathological symptoms associated with psychosocial functioning in children and adolescents with autism spectrum disorders and their typically developing peers [Texte imprimé et/ou numérique] / Jonathan LASSEN, Auteur ; Bodil AGGERNAES, Auteur ; Malene FOLDAGER, Auteur ; Jesper PEDERSEN, Auteur ; Bob ORANJE, Auteur ; Troels W. KJAER, Auteur ; Sidse ARNFRED, Auteur ; Martin VESTERGAARD, Auteur . - 102040. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 98 (October 2022) . - 102040 Mots-clés : ASD  Autism  School attendance  Adaptive behavior  Special education  Internalizing Index. décimale : PER Périodiques Résumé : Children and adolescents with autism have increased prevalence of psychosocial disabilities. Studies in autism indicate that key psychosocial factors including adaptive functioning, school absence, special needs education, frequency of peer socialization and participation in organized leisure activities may differ in their relationship with autistic, internalizing and externalizing symptoms, but the findings are so far mixed. Therefore, we examined if these measures of psychosocial functioning displayed specific associations with autistic, internalizing and/or externalizing symptoms in 61 children with autism aged 7-14 years compared to 61 typically developing controls. Multiple linear regression analyses across all participants showed that lower adaptive functioning, frequency of peer socialization and participation in leisure activities were driven by more social communication problems and not internalizing, externalizing or autistic-like symptoms including rigidity, stereotypy and sensory sensitivity. Notably, increased school absence was specifically driven by more internalizing symptoms and not autistic or externalizing symptoms. These associations were observed across all participants, both children with autism and their typically developing peers, and therefore appear to be dimensional and general in nature. Within the autism group, children who received special needs education displayed fewer social communication problems compared to those who attended regular education, while a developmental history of social interaction problems was related to lower adaptive functioning. Our findings suggest that social communication problems are more critical for psychosocial functioning than other autistic-like behaviors, internalizing or externalizing symptoms but that efforts to reduce school absence specifically need to target internalizing symptoms and not autistic-like or externalizing symptoms. En ligne : https://doi.org/10.1016/j.rasd.2022.102040 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490

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