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1. Systems Training for Emotional Predictability and Problem Solving Program and Emotion Dysregulation: A Pilot Study.

Author

Boccalon S, Alesiani R, Giarolli L, and Fossati A

Subjects
Adult, Female, Follow-Up Studies, Goals, Humans, Male, Middle Aged, Pilot Projects, Behavior Therapy methods, Borderline Personality Disorder therapy, Emotions physiology, Hospitalization statistics & numerical data, Impulsive Behavior physiology, Outcome Assessment, Health Care, Problem Solving physiology, Self-Control, Suicide, Attempted statistics & numerical data
Abstract

The aim of this study was to assess the observed changes on emotion dysregulation obtained through the Systems Training for Emotional Predictability and Problem Solving (STEPPS) program. The sample is composed of 24 subjects with a personality disorder with borderline features. All participants filled out the Difficulties in Emotion Regulation Scale (DERS). There was a significant decrease in the DERS total score at the end of the treatment and at 6-month follow-up. Friedman test showed a significant decrease in suicide attempts and hospitalizations over time. The analysis of the DERS subscales showed that "goals" and "impulse" were the two dimensions on which the treatment acted and the changes were stable over time. STEPPS is associated with an improvement in emotion regulation and a reduction in the number of hospitalizations and suicide attempts. The treatment seems to act on the behavioral dimensions of emotion dysregulation like the ability to control impulsive behaviors and to achieve goals.

Published
2017
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2. Systems Training for Emotional Predictability and Problem Solving (STEPPS): Program efficacy and personality features as predictors of drop-out — An Italian study

Author

Silvia Boccalon, Nancee Blum, Roberta Alesiani, L. Giarolli, Andrea Fossati, Alesiani, R, Boccalon, S, Giarolli, L, Blum, N, and Fossati, Andrea

Subjects
Adult, Hospitals, Psychiatric, Male, medicine.medical_specialty, Bipolar Disorder, Patient Dropouts, lcsh:RC435-571, media_common.quotation_subject, Emotions, Population, Systems Theory, Poison control, Suicide, Attempted, Comorbidity, Personality Disorders, Borderline Personality Disorder, lcsh:Psychiatry, medicine, Humans, Personality, education, Psychiatry, Borderline personality disorder, Problem Solving, media_common, education.field_of_study, Cognitive Behavioral Therapy, Middle Aged, medicine.disease, Psychiatry and Mental health, Clinical Psychology, Mood, Mood disorders, Psychotherapy, Group, Marital status, Female, Psychology, Self-Injurious Behavior, Clinical psychology
Abstract

In this study we present a clinical application of the STEPPS model in an Italian sample of severely affected patients with borderline personality disorder (BPD) or personality disorder (PD) with prominent borderline features in comorbidity with a mood disorder. The aims of this work are: 1) to confirm our preliminary results in a larger sample and at a 12-month follow-up, and 2) to identify predictors of drop-out vs completion of STEPPS in order to understand which characteristics of patients make them suitable or not for this treatment. The sample is composed of 32 subjects recruited from a population of inpatients of the Mood Disorders Center, Department of Clinical Neurosciences, Hospital San Raffaele-Turro, Milan. To confirm STEPPS efficacy at 12-month follow-up, we selected the following outcome criteria: reduction in the number of hospitalizations related to self-harm acts; reduction in the number of suicidal attempts; reduction of perceived emotional intensity levels; changes in cognitive filter scores; changes in the scores on self-report questionnaires. To identify predictors of drop-out vs completion, we analysed the following variables: demographic features (sex, marital status, school level achieved, and job status); Axis-I diagnosis; Axis-II categorical and dimensional diagnosis; and personality features. Seventeen (53%) subjects completed the treatment successfully. The drop-out rate was 47%. Patients who completed the program show a significant decrease in the number of hospitalizations, both at the end of the treatment and at 12-month follow-up. Friedman ANOVA test shows a significant decrease in suicidal attempts during and after STEPPS, and at 12-month follow-up. Analysis of drop-outs showed no significant differences with regard to sex, marital status, school level and job status between the two groups. Axis-I and Axis-II categorical diagnoses did not discriminate between the two groups. Those patients who dropped differ significantly from completers in histrionic personality traits and magical thinking index, given by the interaction between low scores in Self-Directedness and high scores in Self-Transcendence.

Published
2014

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