Bjureberg, Johan, Sahlin, Hanna, Hellner, Clara, Hedman-Lagerlöf, Erik, Gratz, Kim L., Bjärehed, Jonas, Jokinen, Jussi, Tull, Matthew T., and Ljótsson, Brjánn
Background: Nonsuicidal self-injury (NSSI) is a serious health risk behavior that forms the basis of a tentative diagnosis in DSM-5, NSSI Disorder (NSSID). To date, established treatments specific to NSSI or NSSID are scarce. As a first step in evaluating the feasibility, acceptability, and utility of a novel treatment for adolescents with NSSID, we conducted an open trial of emotion regulation individual therapy for adolescents (ERITA): a 12-week, behavioral treatment aimed at directly targeting both NSSI and its proposed underlying mechanism of emotion regulation difficulties. Methods: Seventeen girls (aged 13-17; mean = 15.31) with NSSID were enrolled in a study adopting an uncontrolled open trial design with self-report and clinician-rated assessments of NSSI and other self-destructive behaviors, emotion regulation difficulties, borderline personality features, and global functioning administered at pre-treatment, post-treatment, and 6- month follow-up. Measures of NSSI and emotion regulation difficulties were also administered weekly during treatment. Results: Ratings of treatment credibility and expectancy and the treatment completion rate (88%) were satisfactory, and both therapeutic alliance and treatment attendance were strong. Intent-to-treat analyses revealed significant improvements associated with large effect sizes in past-month NSSI frequency, emotion regulation difficulties, selfdestructive behaviors, and global functioning, as well as a medium effect size in past-month NSSI versatility, from pre- to post-treatment. Further, all of these improvements were either maintained or further improved upon at 6-month followup. Finally, change in emotion regulation difficulties mediated improvements in NSSI over the course of treatment. Conclusions: Results suggest the acceptability, feasibility, and utility of this treatment for adolescents with NSSID. [ABSTRACT FROM AUTHOR]