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Evaluation of AIT Study

Not Applicable
Completed
Conditions
Personality Disorders
Borderline Personality Disorder
Interventions
Behavioral: Adolescent Identity Treatment
Behavioral: DBT-A
Registration Number
NCT02518906
Lead Sponsor
Klaus Schmeck
Brief Summary

Specialized treatment of personality disorders (PD) in youth has been neglected for a long time, because these disorders were not diagnosed before the age of 18. Since 2013 the age threshold has been dropped in the Diagnostic and Statistical Manual (DSM)-5, and such change is also announced for the International Classification of Diseases (ICD)-11. There is broad consensus from both scientific evidence and clinical experience that specialized early interventions in adolescents with PD are urgently needed.

In the last decades a number of specialized psychotherapeutic treatment programs have been developed. Despite their conceptual differences, many of the treatment models have shown significant effects in the treatment of PD in adults. However, the treatment of adolescents with PD remains difficult and further enhancement and development of treatments is needed.

Given the different therapeutic approaches available, the present project aims to go beyond the comparison of integral therapeutic models in the classical outcome study design. While outcome research is important to build on the evidence of the effectiveness of an intervention, it contributes little to its understanding and refinement. The aim of the present multi-center project is to compare two therapeutic methods used in routine care:

* Adolescent Identity Treatment (AIT)

* Dialectic Behavioral Treatment for Adolescents (DBT-A)

Treatments will be performed at different study centers and compared using the same measures of outcome. The main outcome will be psychosocial functioning.

Additionally, the psychotherapy process will be investigated to explore specific and unspecific mechanisms of the therapeutic process, its outcome and mediators.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Identity Diffusion (AIDA T-score > 60)
  • borderline Criteria (SKID-II)
Exclusion Criteria
  • intelligence quotient (IQ) < 80
  • psychotic disorder
  • pervasive developmental disorders
  • heavy and persistent substance abuse
  • major somatic or neurological disease
  • hospital treatment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Adolescent Identity TreatmentAdolescent Identity TreatmentPsychotherapeutic treatment performed routinely at the centres in Basel and Santiago de Chile
DBT-ADBT-APsychotherapeutic treatment performed routinely at the centre in Heidelberg
Primary Outcome Measures
NameTimeMethod
Change in Children's Global Assessment Scale (CGAS)Baseline, 12 months after Baseline

Psychosocial functioning. Rated considering the results of the Columbia Impairment Scale - parent and patient versions

Secondary Outcome Measures
NameTimeMethod
Change in Interpersonal ProblemsBaseline, 12 months after Baseline (only Santiago)

Inventory of Interpersonal Problems (IIP-64)

Change in PsychopathologyBaseline, 12 months after Baseline (only Basel and Heidelberg)

Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)

Change in IdentityBaseline, 12 months after Baseline

Assessment of Identity Development in Adolescence (AIDA)

Change in Mentalizing CapacityBaseline, 12 months after Baseline

Movie for the Assessment of Social Cognition (MASC)

Borderline-specific SymptomsBaseline, 12 months after Baseline (only Basel and Santiago)

Borderline Symptom List 23 (BSL-23)

School functioningBaseline, 12 months after Baseline

School Functioning Rating (SFR)

Change in Personality Disorder SymptomsBaseline, 12 months after Baseline (only Basel and Heidelberg)

Structured Clinical Interview of Diagnostic and Statistical Manual of Mental Disorders (DSM) (SCID)-II

Self-injurious BehaviorBaseline, 12 months after Baseline (only Basel and Heidelberg)

Self- Injurious Thoughts and Behaviors Interview

Borderline-specific Personality PathologyBaseline, 12 months after Baseline (only Basel and Heidelberg)

Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD)

Change in Personality FunctioningBaseline, 12 months after Baseline (only Basel and Heidelberg)

Levels of Personality Functioning - Questionnaire for Adolescents (LoPF-QA)

Psychosocial functioningBaseline, 12 months after Baseline

Columbia Impairment Scale (CIS) (Patient and Parent versions)

Change in Severity of PsychopathologyBaseline, 12 months after Baseline

Clinical Global Impression Scale

Change in DepressionBaseline, 12 months after Baseline

Beck Depression Inventory (BDI)

Change in Psychopathological SymptomsBaseline, 12 months after Baseline

Strengths \& Difficulties Questionnaires (SDQ)

Change in Quality of LifeBaseline, 12 months after Baseline

Health-related Quality of Life Screening Instrument for Children and Adolescents (KIDSCREEN)

Change in Parental StressBaseline, 12 months after Baseline (only Basel and Heidelberg)

Eltern-Belastungs-Inventar (EBI)

Change in Hair Cortisol Level (only Basel and Heidelberg)Baseline, 12 months after Baseline
Change in Psychophysiological Measures (Only Basel and Heidelberg)Baseline, 12 months after Baseline

Regression analysis will be used to evaluate change; Parameters: Heart Rate Variability and Electrodermal Activity (Basel only)

Trial Locations

Locations (3)

Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg

🇩🇪

Heidelberg, Germany

Millennium Institute for Research in Depression and Personality - Pontificia Universidad Católica de Chile

🇨🇱

Santiago de Chile, Chile

Psychiatric Universitiy Hospital Basel

🇨🇭

Basel, Switzerland

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