scholarly journals Efficacy of the iDBT-Pain skills training intervention to reduce emotional dysregulation and pain intensity in people with chronic pain: protocol for a single-case experimental design with multiple baselines

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041745
Author(s):  
Nell Norman-Nott ◽  
Chelsey Wilks ◽  
Negin Hesam-Shariati ◽  
Jessica Schroeder ◽  
Jina Suh ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Experimental Design ◽  
Pain Intensity ◽  
Emotional Regulation ◽  
Outcome Measure ◽  
Single Case ◽  
Skills Training ◽  
Emotional Dysregulation ◽  
Training Intervention ◽  
Pain Intervention

IntroductionDifficulties in emotional regulation are key to the development and maintenance of chronic pain. Recent evidence shows internet-delivered dialectic behaviour therapy (iDBT) skills training can reduce emotional dysregulation and pain intensity. However, further studies are needed to provide more definitive evidence regarding the efficacy of iDBT skills training in the chronic pain population.Methods and analysisA single-case experimental design (SCED) with multiple baselines will be used to examine the efficacy of a 4-week iDBT-Pain skills training intervention (iDBT-Pain intervention) to reduce emotional dysregulation and pain intensity in individuals with chronic pain. The iDBT-Pain intervention encompasses two components: (1) iDBT-Pain skills training sessions (iDBT-Pain sessions) and (2) the iDBT-Pain skills training web application (iDBT-Pain app). Three individuals with chronic pain will be recruited and randomly allocated to different baseline phases (5, 9 or 12 days). Following the baseline phase, participants will receive six 60–90 min iDBT-Pain sessions approximately 4 or 5 days apart, delivered by a psychologist via Zoom. To reinforce learnings from the iDBT-Pain sessions, participants will have unlimited use of the iDBT-Pain app. A 7-day follow-up phase (maintenance) will follow the intervention, whereby the iDBT-Pain sessions cease but the iDBT-Pain app is accessible. Emotional regulation, as the primary outcome measure, will be assessed using the Difficulties in Emotion Regulation Scale. Pain intensity, as the secondary outcome measure, will be assessed using a visual analogue scale. Generalisation measures will assess psychological state factors (depression, anxiety and coping behaviour), alongside sleep quality, well-being and harm avoidance. SCEDs are increasingly considered effective designs for internet-delivered psychological interventions because SCED enables the investigation of interindividual variability in a heterogeneous population such as chronic pain.Ethics and disseminationThis trial was approved by the University of New South Wales (HC200199). Results will be published in peer-reviewed journals.Trial registration numberACTRN12620000604909.

scholarly journals Role of Spinal Cyclooxygenase in Human Postoperative and Chronic Pain

2010 ◽  
Vol 112 (5) ◽  
pp. 1225-1233 ◽  
Author(s):  
James C. Eisenach ◽  
Regina Curry ◽  
Richard Rauck ◽  
Peter Pan ◽  
Tony L. Yaksh
Keyword(s):  
Chronic Pain ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Intrathecal Morphine ◽  
Intrathecal Injection ◽  
Primary Outcome Measure ◽  
Antiinflammatory Drugs ◽  
Double Blinded

Background Nonsteroidal antiinflammatory drugs are commonly used to treat postoperative and chronic pain. Animal studies suggest that these drugs act, in part, by blocking prostaglandin production in the spinal cord. The authors tested intrathecal ketorolac in patients with chronic or postoperative pain. Methods After approval of the institutional review board and the Food and Drug Administration, three clinical studies were performed. First, 15 patients receiving chronic intrathecal morphine received 0.5-2.0 mg of intrathecal ketorolac. Second, 12 patients receiving chronic intrathecal morphine received, in a double-blinded, randomized, cross-over design, intrathecal saline or 2.0 mg of ketorolac, with pain intensity as the primary outcome measure. Third, 30 patients undergoing total vaginal hysterectomy received, in a double-blinded, randomized, controlled design, intrathecal saline or 2.0 mg of ketorolac, with bupivacaine with time to first morphine dose after surgery as the primary outcome measure. Results Patients with chronic pain had many symptoms before intrathecal injection, without worsening of these symptoms from ketorolac. Pain intensity was reduced by intrathecal ketorolac, but this did not differ from placebo. In the first study, pain was reduced by intrathecal ketorolac in patients with high cerebrospinal fluid prostaglandin E2 concentrations but not in those with normal concentrations. Intrathecal ketorolac did not alter time to first morphine after surgery. Conclusions Intrathecal ketorolac did not relieve chronic pain or extend anesthesia or analgesia from intrathecal bupivacaine administered at the beginning of surgery. Under the conditions of these studies, it seems that spinal cylcooxygenase activity does not contribute to chronic or postoperative pain.

Evaluating the Effectiveness of a Dialectical Behaviour Therapy (DBT) Informed Programme in a Community Perinatal Team

2018 ◽  
Vol 46 (5) ◽  
pp. 541-553 ◽  
Author(s):  
Hannah Wilson ◽  
Alexandra L. Donachie
Keyword(s):  
Mental Health ◽  
Emotional Regulation ◽  
Emotion Dysregulation ◽  
Distress Tolerance ◽  
Training Group ◽  
Skills Training ◽  
Perinatal Period ◽  
Emotional Dysregulation ◽  
Intervention Period ◽  
Behaviour Therapy

Background:Adapted DBT programmes have been well documented but little has been published on such programmes in the perinatal period.Aim:To assess the effectiveness of a stand-alone DBT skills group for perinatal women with emotion dysregulation.Method:A stand-alone DBT-informed skills training group was offered to 21 women with emotional dysregulation under the care of a perinatal community mental health team; 14 completed the programme. Staff received support via a consultation group. Modules included mindfulness, emotional regulation, distress tolerance and interpersonal effectiveness adapted to the specific demands of parenting infants. Outcome measures were collected at three time points: assessment, start of the group and at the end.Results:Statistical analysis showed significant reduction in CORE scores over the intervention period (t(13) = 5.32,p< .001; Cohen'sd= 0.83), with similar effects on the Mental Health Confidence Scale (t(13) = ‒8.03,p< .001, Cohen'sd= 0.83) and Living with Emotions Scale (t(13) = ‒9.42,p< .001, Cohen'sd= 0.93). There were no significant changes on these three measures from assessment to start of the group.Conclusions:In this uncontrolled study, the intervention period was associated with reduced distress, increased confidence and ability to regulate emotion. Recommendations for continuing this model of service delivery are made. Further research is needed.

scholarly journals Emotional Regulation in Teens and Improvement of Constructive Skills (EmoTIConS): study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Laura Pedrini ◽  
Roberta Rossi ◽  
Laura Rosa Magni ◽  
Mariangela Lanfredi ◽  
Serena Meloni ◽  
...  
Keyword(s):  
Mental Health ◽  
Emotional Regulation ◽  
Skills Training ◽  
Emotional Dysregulation ◽  
Control Group ◽  
Post Intervention ◽  
Adolescent Students ◽  
Biological Features ◽  
Biological Variables ◽  
The Impact

Abstract Background Emotional dysregulation (ED) constitutes a relevant factor involved in the onset and maintenance of many mental disorders. Targeting ED during adolescence could be a determinant both to identify high-risk individuals and to promote preventive interventions. This study will aim to evaluate the impact of a brief Dialectical Behavioral Therapy (DBT)-based intervention for adolescent students by measuring changes in emotional regulation skills and impulsive behaviors. Moreover, alterations in biological features related to stress response and inflammation will be assessed as potential biological variables associated with ED. Methods This is a randomized trial. A total of 20 classes of adolescent students will be recruited among high schools in Brescia, a city in northern Italy. They will be randomized to the psychoeducational intervention (experimental group) or to a control condition (control group). The intervention will be based on DBT Skills Training for Emotional Problem Solving for Adolescents, and will consist of four monthly, 2-h sessions (for a total of 8 h) scheduled during regular school time. Participants will be assessed at baseline, post-intervention, and at 3 and 6 months of follow-up. The primary outcome measures will be represented by changes in the use of emotional regulation skills and by changes in the frequency of impulsive behaviors. Salivary samples will be collected at baseline and post-intervention to explore possible biological features underlying ED. Discussion Data from the present project will offer the opportunity to better understand the complex phenomenon of ED. Repeated assessment will cover several domains (emotional, behavioral, social, biological) as potential factors associated with ED. Moreover, it will be possible to establish the effect of the proposed intervention, thus helping to improve knowledge on the impact of school-based universal preventive programs. Finally, the current trial will propose an integrated screening and intervention-based model. Ultimately, this could reduce barriers to youths’ mental health care by fostering collaboration between schools and mental health services. Trial registration ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT04349709?cond=emotional+dysregulation&cntry=IT&draw=2&rank=1. Registered on April 16, 2020.

scholarly journals Preventing Emotional Dysregulation: Acceptability and Preliminary Effectiveness of a DBT Skills Training Program for Adolescents in the Spanish School System

2022 ◽  
Vol 19 (1) ◽  
pp. 494
Author(s):  
Xavier Gasol ◽  
María Vicenta Navarro-Haro ◽  
Isabel Fernández-Felipe ◽  
Azucena García-Palacios ◽  
Carlos Suso-Ribera ◽  
...  
Keyword(s):  
Mental Health ◽  
Life Satisfaction ◽  
Secondary School ◽  
Training Program ◽  
Dialectical Behavior Therapy ◽  
Emotional Regulation ◽  
Emotional Problem ◽  
Skills Training ◽  
Emotional Dysregulation ◽  
Positive Trend

Emotional dysregulation is a key factor in the development and maintenance of multiple disabling mental disorders through a person’s lifespan. Therefore, there is an urgent need to prevent emotional dysregulation as early as possible. The main aim of this study was to evaluate the acceptability and preliminary effectiveness of an adapted Dialectical Behavior Therapy Skills Training program for Emotional Problem Solving in Adolescents (DBT STEPS-A) during secondary school. The sample included 93 adolescents (mean age = 12.78; SD = 0.54; and 53% female) studying in their 2nd year of secondary school in a public center in Catalonia (Spain). Measures of acceptability, difficulties of emotional regulation, mental health problems, and life satisfaction were completed before and after participation in the DBT STEPS-A program during one academic year. The majority of students rated the program as useful (64%) and enjoyed the classes (62%) and 48% of them reported practicing the newly learned skills. Statistically significant improvements were revealed in some emotional regulation-related variables, namely the number of peer problems (p = 0.003; d = 0.52) and prosocial behaviors (p < 0.001; d = −0.82). Although non-significant, the scores in the remaining outcomes indicated a general positive trend in emotional dysregulation, mental health, and life satisfaction. The adapted DBT STEPS-A was very well-accepted and helped overcome some emotional regulation difficulties in Spanish adolescents.

Comparing the transfer effects of three nonpharmacological interventions in children with AD/HD: a single-case experimental design

2020 ◽  
Author(s):  
Da-Wei Zhang ◽  
Stuart J. Johnstone ◽  
Hui Li ◽  
Xiangsheng Li ◽  
Li Sun
Keyword(s):  
Experimental Design ◽  
Visual Analysis ◽  
Single Case ◽  
Multiple Baseline ◽  
Neurofeedback Training ◽  
Transfer Effects ◽  
Baseline Phase ◽  
Intervention Phase ◽  
Inhibitory Function ◽  
Home Training

The current study used behavioral and electroencephalograph measures to compare the transferability of cognitive training (CT), neurofeedback training (NFT), and CT combined with NFT in children with AD/HD. Following a multiple-baseline single-case experimental design, twelve children were randomized to a training condition. Each child completed a baseline phase, followed by an intervention phase. The intervention phase consisted of 20 sessions of at-home training. Tau-U analysis and standardized visual analysis were adopted to detect effects. CT improved inhibitory function, and NFT showed improved alpha activity and working memory. The combined condition, who was a reduced 'dose' of CT and NFT, did not show any improvements. The three conditions did not alleviate AD/HD symptoms. While CT and NFT may have near transfer effects, considering the lack of improvement in symptoms, this study does not support CT and NFT on their own as a treatment for children with AD/HD.

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