The Effectiveness of ACT Matrix with compassion on self-injury behaviors and quality of life of Students with symptoms of Borderline Personality Disorders

Peymannia, Bahram; Hamid, Najmeh; Mhmudalilu, Majid

doi:10.22055/psy.2018.23581.1905

Document Type : Research Article

Authors

¹ PhD student in Psychology, Member of the National Elite Foundation of the Ministry of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran.

² Associate professor, Shahid Chamran University of Ahvaz, Ahvaz. Iran.

³ University of Tabriz, Iran.

https://doi.org/10.22055/psy.2018.23581.1905

Abstract

Intoduction
Researches has recently provided convincing evidence about diagnosing borderline personality disorder in youth. Therefore National Institute for Clinical Excellence (NICE) acknowledged the diagnosis of borderline personality in individuals under 18 years old and if necessary supports treatment and early intervention in this age group. ACT matrix is an approach based on route selection and upgrading the ability of individuals to approach valuable goals, despite the problems in life. Therefore, in the matrix model getting viewpoints of clients considered as the basis of treatment and by examining actions of getting away and getting close to values and compassion in commitment and change strategies helps them achieve a live, purposeful and meaningful life. In fact mindfulness due to taking viewpoints provides context for getting compassion and mindfulness. Mindfulness and compassion are two wings of a bird that both play effective role in inspiring for man, their transition and also individual evolution to fly. Overall, on the one hand according to evidence-based researches about effectiveness of ACT with compassion treatment on a wide range of borderline personality disorder symptoms and on the other hand lack of this kind of researches in Iran, this question arises that whether ACT with compassion is effective on self-injury behaviors and quality of life of female students with symptoms of borderline personality disorder.

Method
Present study is an experimental design by using pre and posttest with a control group. Therapeutic intervention in experimental group implemented 16 sixty minute sessions weekly for female students between 15-17 years old who have Borderline personality symptoms. During this time participants in experimental and control group responded to Self-Injury behavior Scale of Klonsky and Glenn (2009) and Quality of Life Index of Cummins (2002), before and after intervention and in follow-up (8 weeks after the end of intervention).

Results
The findings of covariance analysis showed that ACT matrix with
Compassion has significantly reduced symptoms of self-injury and improved quality of life. Eta coefficient shows that ACT with Compassion therapy explain 47% of self-injury behaviors and 46% of life quality and these results has been maintained in follow-up stage.

Discussion
The results of this study showed that despite the cultural and social differences between the present research group and the groups studied in other societies and cultures, ACT matrix with Compassion therapy has significantly reduced symptoms of self- injury and improved quality of life in teenagers with symptoms of borderline personality disorder. This approach seeks to teach teens how to break up from thought content by taking viewpoints, instead of stuck the past and conceptualizing on future live sort their life story, recognizing values and important individuals of their lives and ultimately taking step to achieve these goals and values without getting stuck in trap of their attention and with compassion for themselves and others.

Keywords

20.1001.1.22286144.1397.25.1.2.0

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth Ed). Arlington, VA: American Psychiatric Publishing.

Begley, S. (2007). Train your mind, change your brain. New York: Ballantine Books.

Bernstein, D. P., Cohen, P., & Velez, C. N. (1993). Prevalence and stability of the DSM III-R personality disorders in a community-based survey of adolescents. American Journal of Psychiatry. 1 (50), 1237–1243.

Bakas, T., McLennon, S. M., Carpenter, J. S., Buelow, J. M., Otte, J. L., & Hanna, K. M. (2012). Systematic review of health-related quality of life models. Health and Quality of Life Outcomes, 10 (1), 134-138.

Bakhtiari, M. (2000). Mental disorders in patients with body dysmorphic disorder. MA thesis, clinical psychology, Tehran University of Medical Sciences, Tehran Psychiatric Institute, Tehran, Iran. [Persian].

Benzo, R., Kirsch, J., Abascal-Bolado, B., & Dulohery, M., M. (2015). impact of self-compassion on quality of life, emotions and self-management abilities in COPD. American Journal of Respiratory and Critical Care Medicine, 191, A61-84.

Chabrol, H., Montovany, A., & Chouicha, K. (2001). Frequency of borderline personality disorder in a sample of French high school students. Canadian Journal of Psychiatry. 4(6): 847–849.

Chanen, A., M. Jackson, H., J., & McGorry, P., D. (2004). Two-year stability of personality disorder in older adolescent outpatients. Journal of Personality Disorders. 1 (8), 526–541.

Cozolino, L. (2007). The neuroscience of human relationships: atechment and the developing brain. New York: Norton.

Cozolino, L. (2008). The healthy acing brain: sustaining attachment, attaining Wisdom. New York: Norton.

Crick, N., R. Murray-Close, D., & Woods, K. (2005). Borderline personality features in childhood: a short-term longitudinal study. Dev Psychopathol. 17 (4), 1051–70.

Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44 (3), 371–394.

Chapman, A. L., Specht, M. W., & Cellucci, T. (2005). Borderline personality disorder and deliberate self-harm: Does experiential avoidance play a role? Suicide and Life-Threatening Behavior, 35(4), 388–399.

Crocker, J., & Canevello, A. (2008). Creating and undermining social support in communal relationships: The role of compassionate and self-image goals. Journal of Personality and Social Psychology. 95, 555-575.

Cummins, A. R. (2002). Personal Wellbeing Index-Comprehensive quality of life questionnaire. New York. Guillford press.

Cummins, R. A., Eckersley, R., Pallant, J., Misajon, R., & Davern, M. (2004). Australian Unity Wellbeing Index: Survey 10, Report 10. Australian Centre on Quality of Life, School of Psychology, Deakin University, Melbourne.

Fehr, C., Sprecher S., & Underwood, L. G. (2009). The Science compassionate Love: theory, research and application. Chichester, UK: Wily.

Felie-Soler, A., Pascual, J. C., Elices, M., Martin-Blanco, A., Carmona, C., Cebolla, A., Simon, V., & Soler, J. (2016). Fostering self-compassion and loving-kindness in patients with borderline personality disorder: A ranomized pilot study. Clinical Psychology & Psychotherapy, 24, 278- 286. doi: 10.1002/cpp.2000.

First, M., B, Gibbon, M., Spitzer, R., L, Williams, J., B., W. & Benjamin, L. (1997). Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). Washington, DC: American Psychiatric Association.

Fonagy, P., Speranza, M., Luyten, P., Kaess, M., Hessels, C., & Bohus, M. (2015). ESCAP expert article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice. European Child & Adolescent Psychiatry. 1–14.

Gunderson, J., G. & Waldinger, A., C. (2008). The rate of droupourt in borderline personality disorder. Am J Psychiatry. 2 (8), 212-219.

Ghasemiharandi, A., &Froozandeh E. )2016). The effectiveness of Acceptance and Commitment Therapy on self-efficacy and quality of life in derelict and bad guardian adolescents in Isfahan city. International conference on modern approach in humanities. Tehran, Iran, December.

Gilbert, P., & Choden, S. (2013). Mindful compassion. London: Constable and Robinson.

Gilbert, P. (2009). The compassionate mind: A new approach to life’s challenges. London: Constable and Robinson.

Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behavior Therapy, 37 (1), 25-35.

Gunderson, J. G. (2009). Borderline Personality Disorder: A Clinical Guid. Arlington: American Psychiatric Press.

Hawes, D., J. (2014). Does the concept of borderline personality features have clinical utility in childhood? Current Opinion in Psychiatry, 2 (7), 87–93.

Hayes, S. C., & Strosahl K. D (2010). A practical Guide to Acceptance and Commitment Therapy. New York: Springer Science and Business Media Inc.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change, second edition. New York: Guilford.

Hutcherson, C. A., Seppala, E. M., & Gross, J. J. (2008). Loving-kindness meditation increases social connectedness. Emotion, 8, 720.

Iverson, K. M., Follette, V. M., Pistorello, J., & Fruzzetti, A. E. (2012). An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms. Personality Disorders: Theory, Research, and Treatment, 3 (4), 415-425.

Kaess, M., Brunner, R., & Chanen, A. (2014). Borderline personality disorder in adolescence. Pediatrics, 13 (4), 782–793.

Kaess, M., Resch, F., Parzer, P., von Ceumern-Lindenstjerna, I., A., Henze, R., & Brunner, R. (2013). Temperamental patterns in female adolescents with borderline personality disorder. The Journal of Nervous and Mental Disease. 20 (1), 109–115.

Klein, D. A., & Miller, A. L. (2011). Dialectical behavior therapy for suicidal adolescents with borderline personality disorder. Child Adolesc Psychiatric, 20, 205–216.

Klonsky, E. D., & Glenn, C. G. (2009). Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements about Self-injury (ISAS). Journal of Psychopathology and Behavioral Assessment, 3 (1), 215-219.

Leichsenring, F., Leibing, E. Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 37 (7), 74–84.

Lloyd-Richardson, E. E., Perrine, N., Dierker, L., & Kelley, M. L. (2007). Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychological Medicine, 37, 1183-1192.

Mahmoud-alilou, M., Hashemi, T., Beyrami, M., Bakhshipour, A., & Sharifi, M. A. (2014). relationship between childhood abuse, loss and initial separation and emotional dysregulation with borderline personality disorder. Journal of Psychological Achievements, 21 (2), 88-65. [Persian].

Miller, A. L., Muehlenkamp, J. J., & Jacobson, C. M. (2008). Fact or fiction: Diagnosing borderline personality disorder in adolescents. Clinical Psychology Review. 2 (8), 969–981.

Morton, J., Snowdon, S., Gopold, M., & Guymer, E. (2012). Acceptance and commitment therapy group treatment for symptoms of borderline personality disorder: A public sector pilot study. Cognitive and Behavioral Practice, 19(4), 527–544.

Nainian, M. R., Gohari, Z, Motabi, S., & Baluchan, M. (2013). Basic Evaluation of Validity and Relia-bility of Personal Welfare (Life Qual-ity) Index, Student Copy (PWI-SC). CPAP, 2 (9), 119-128. [Persian].

Newton-Howes, G., Clark, L. A., & Chanen, A. (2015). Personality disorder across the life course. The Lancet, 3 (85), 727–734.

Peymannia, B., Poursarifi, H., Mahmoud-alilou, M. (2013). The effect of group therapy based on the relation of child- parent- (CPRT) on Improvement of Conduct Disorder symptoms at school children in Ahvaz. Journal of Psychological Achievements, 20 (2), 141-160. [Persian].

Polk, K. L., Schoendorff, B., Webster, M., & Olaz, F. (2016). The Essential Guide to the ACT Matrix. Context Press, An imprint of New Harbinger Publications, Inc. Oakland, CA.

Razzaque, R. (2013). An acceptance and commitment therapy based protocol for the management of acute self-harm and violence in severe mental illness. Journal of Psychiatric Intensive Care, 9 (02), 72–76.

Rahimi, M., & Khayyer, M. (2007). The relationship between family communication patterns and quality of life in Shiraz high school. Educational Studies and Psychology Ferdowsi University of Mashhad, 1, 5-25. [Persian].

Reyes, M., Vargas, N., & Miranda, E. (2015). Comparison of 4 brief contextual behavioral interventions for borderline personality disorder: The process of building an empirically supported treatment as usual. In K. Strosahl (Chair), Brief ACT interventions: Understanding their benefit and processes of change. Symposium conducted at the Association for Contextual Behavioral Science World Conference 13, Berlin, Germany.

Robin, M., Scottez, A. P., Curt, F., Bigre. C. P. L., Spranza, M., Sapinho, D., Coros, M., Berthoz, S., & Kedia, G. (2012). Decreased sensitivity to facial emotion in adolescent with borderline personality disorder. Psychiatry Research, 200, 417-421.

Ryff, C. D., & Singer, B. (1998). The contours of positive human health. Psychology Inguriy, 19, 91-28.

Saffarinia, M., Nikoogoftar, M., & Damavandian, A. (2014). The Effectiveness of Dialectical Behavior Therapy (DBT) on Reducing Self-Harming Behaviors in Juvenile Offenders in Tehran's Juvenile Correction and Rehabilitation Centre. Journal of Clinical Psychology. 4 (15), 141-158. [Persian].

Schanche, E., Stiles, T. C., McCullough, L., Svartberg, M., & Nielsen, G. H. (2011). The relationship between activating affects, inhibitory affects, and self-compassion in patients with Cluster C personality disorders. Psychotherapy, 48, 293.

Sharp, C., Pane, H., Ha, C., Venta, A., Patel, A., B, & Sturek, J. (2011). Theory of mind and emotion regulation difficulties in adolescents with borderline traits. J Am Acad Child Adolesc Psychiatry, 50 (6), 563–73.

Sharp, C., Ha, C., Michonski, J., Venta, A., & Carbone, C. (2012). Borderline personality Borderline Personality Disorder in a sample of adolescent inpatients. Compr Psychiatry. 53 (disorder in adolescents: evidence in support of the Childhood Interview for DSM-IV 6, 765–74.

Strosahl, K. D. (2004). ACT with the multi-problem patient. In S.C. Hayes & K.D. Strosahl (Eds.) a practical guide to acceptance and commitment therapy (209–245). New York: Springer US.

Suymoto, K. L. (1998). The functions of self-mutilation. Clinical Psychology Review, 18, 531-554.

Tapolaa, V., Lappalainen, R., & Wahlström, J. (2010). Brief intervention for deliberate self-harm: An exploratory study. Suicidology Online, 1, 95-108.

Testa, M. A., & Simonson, D. C. (1996). Assessment of Quality of Life Outcomes. N Eng J Med, 334, 835- 40.

Tirch, D., Schoendorff, B., & Silberstein, R. L. (2014). The ACT Practitioner's Guide to the Science of Compassion: Tools for Fostering Psychological Flexibility. New Harbinger Publications.

VanVliet, K., J., & Kalnins, G., R. C. (2011). A compassion-focused approach to nonsuicidal self-injury. Journal of Mental Health Counseling, 33 (4), 295-311.

Winsper, C., Marwaha, S., Lereya, S., Thompson, A., Eyden, J., & Singh, S. (2015). Clinical and psychosocial outcomes of borderline personality disorder in childhood and adolescence: A Systematic Review. Psychological Medicine, 45, 2237–2251.

Zargar, Y., Sajjadi, F., Mehrabizadeh, H. M., & Arshadi, N. (2014). Validation of the Borderlin Personality Features Scale for children on students in Shiraz. The Journal of Urmia University of Medical Sciences, 25 (4), 338-352.

The Effectiveness of ACT Matrix with compassion on self-injury behaviors and quality of life of Students with symptoms of Borderline Personality Disorders

References

References

Volume 25, Issue 1 - Serial Number 19June 2018Pages 23-44

Volume 25, Issue 1 - Serial Number 19
June 2018
Pages 23-44