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Bridging Affect Consciousness, Mentalization and Trauma- Exploring an Integrative Treatment Approach for Personality Disorder (PD).

ConditionsPersonality Disorder, BorderlinePersonality TraitPersonality DisorderPersonality TypePersonality Disorder, AvoidantAffect ConsciousnessMentalizationReflective FunctioningPTSDPTSD - Post Traumatic Stress DisorderPTSD and Trauma-related Symptoms
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age20-40
SponsorHelse Stavanger HF

About this trial

Study background: Specialized Group Outpatient Clinic within specialist mental health services, tailoring two year group treatment programmes for severe Avoidant PD (AvPD) and Borderline PD (BPD) with Affect Consciousness (AC) targeting specific areas of emotional dysfunction. Aims: Our main hypothesis, adding AC to Mentalization- based treatment (MBT) to expand the breadth and depth of therapeutically productive work on affect, will aim to examine health indicators, processes and mechanisms of change in depth. The study will extracts preliminary data after 5 years and 10 years to investigate clinical change, variation and outcome during MBT for PD employing AC as add on to MBT. The study has a randomized controlled trail design, with MBT with or without AC as add-on. The RCT is grounded on original literature on Affect Theory, as a framework for understanding patient functioning, and MBT, framing the therapy.Implications: AC methodology as add on can lead to more tailored treatment programmes, service planning, allocation of resources, guidelines, ACI certification and method development for PDs.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

None

Disqualifiers

None

Trial design

Design model

Parallel

Treatments tested in this trial

  • Experimental group: AC-group therapy intervention.

    Behavioral

    The aim is to increase Affect consciousness and Affect integration with 15 two hour group session interventions. Interview for 4 central affect categories to become familiar with the questions/techniques is used pre and post group. Group meeting 1 presents the AC affect theory, 13 affect categories and the group program related to each individual group meeting. Group meetings 2-14 lectures on the current affect category, bodily attentional signals and inner mood/mental content, exploration of impact, handling and the signal function of emotions and non-verbal body language and verbal descriptions related to the desire and ability to express oneself. Group meeting 15 is evaluation, clarification, repetition and closure of the group. "On arrival" focus on disturbances (internal and external) for each participant and performance of four body awareness exercises is used. Therapeutic writings and listening to a piece of music shared by the participants in rotation are methods i

  • Control group 1: Body Awareness Group.

    Behavioral

    The aim is to connect with and become more confident about the body experiences, needs and feelings, to gain an increased understanding of oneself. The Group consists of 15 group sessions. Group meeting 1 Introduces Body Awareness Therapy, group structure and content and focus on experiences and expectations. The practice of slow, simple movements for the whole body in a standing position, introduction of The Autonomous Compass model, giving an opportunity to figure out where to place themselves in the compass in the moment, exercise stimulating the feet and a relaxation exercise. Group meetings 2-14 focuses on a topic as grounding, balance, breathe, play, posture due to habitual positions, body language and emotions, self-compassion and boundaries, explored through experience by using various physical exercises, sharing body experiences and psychoeducation. Session 15 contains summary, evaluation and repetition.Reflection on the previous session and sharing homework is included.

  • Control group 2: Art Psychotherapy group.

    Behavioral

    The aim is to keep an open "non-directive" psychodynamic and analytical approach to explore, discover and feel ownership of creativity as a form of expression. The group consists of 15 group sessions, where session 1-4 is setting the framework by presenting art mediums to be used collectively, creating security, a sense of community and solidarity sharing common challenges. Each individual is free to choose the motive and form of expression, with a high level of sharing and learning. Creative experiences made together on the use of art materials to convey the inner world, become the starting point for further creative exploration on a individual level with their inner selves in a self-developing therapeutic process. Session 1: Introduction to projection and how to read oneself into an object by using figures and sandplay. Sessions 2 - 4: How one can transfer, animate, or create personal expressions using collage, acrylic painting and clay.Groups 5-15 allows freedom to choo

Treatment groups

300 Participants
are divided into 3 treatment groups
Group A: Experimental group: AC-group intervention as Add- on group to MBT group therapyExperimental treatment 1 intervention
Group B: Control group 1: Body Awareness Group as Add on group to MBT group therapyActive comparator 1 intervention
Group C: Control group 2: Art Psychotherapy group as ADD- on to MBT group therapyActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Changes in emotional dysfunction, ACI evaluation

The Affect Consciousness Interview (ACI), scale 1-9. Higher scores indicate more integrated and conscious affective functioning, whereas lower scores suggest difficulties in affect regulation or alexithymic traits.

Time frame
At time of inclusion (baseline), and at 6, 12, 18, and 24 months
2

Changes in emotional dysfunction, All self report

Self-report questionnaire: Affect Integration Inventory (AII), rating 112 items on a 10-point Likert scale (0 = does not fit at all, 9 = fits perfectly), where lower scores indicate lower affect integration across specific emotions.

Time frame
At time of inclusion (baseline), and at 6, 12, 18, and 24 months
3

Changes in emotional dysfunction, TAS-20 self report

Self-report questionnaire: Toronto Alexithymia Scale (TAS-20), rating 20 items on a 5-point Likert scale (1 = strongly disagree, 7 = strongly agree), where total scores: ≥61 = high alexithymia, 52-60 = possible alexithymia, ≤51 = non-alexithymic

Time frame
At time of inclusion (baseline), and at 6, 12, 18, and 24 months
4

Changes in emotional dysfunction, B-MAS self report

Self-report questionnaire: Brief Mentalized Affectivity Scale (B-MAS), rating 12 items on a 5-point Likert scale (1 = strongly disagree, 7 = strongly agree), where lower scores reflect suggest difficulties in affective self- reflection and regulation.

Time frame
At time of inclusion (baseline), and at 6, 12, 18, and 24 months

Secondary outcomes

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Helse Stavanger HF

Lead sponsor

Oslo University Hospital

Collaborator

University of Oslo

Collaborator

University College, London

Collaborator

University of Stavanger

Collaborator

Aalborg University

Collaborator

Source ClinicalTrials.gov

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