Acceptance and Commitment Therapy for Nonsuicidal Self-injury
Condition: Nonsuicidal Self-Injury; Anxiety
MeSH terms: Wounds and Injuries; Self-Injurious Behavior
Study type: Interventional

Summary: 
      The goal of this study is to evaluate the effectiveness of Acceptance and Commitment Therapy
      (ACT) for individuals who engage in nonsuicidal self-injury(NSSI) and have comorbid anxiety.

      With the data collected from the study, the investigators will test the following hypotheses:

      Acceptance and commitment therapy will lead to reductions in anxiety and self-harm behaviors
      in non-suicidal self-injury individuals.
    

Detailed description: 
      Non-suicidal self-injury is the direct and purposeful harming of one's bodily tissue outside
      of social and religious norms and lacking suicidal intent. The most common NSSI behaviors
      include cutting (70-90%), banging or hitting (21-44%), and burning (15-35%) (Rodham & Hawton,
      2009); but many report utilizing multiple methods (50-70%; Klonsky, 2011; Whitlock,
      Eckenrode, & Silverman, 2006). NSSI has an alarming prevalence among college students, with
      rates ranging from 17-38% (Whitlock et al., 2006; Gratz, Conrad, & Roemer, 2002). NSSI occurs
      in the context of many psychological disorders (Nock, 2010), and is associated with anxiety
      and mood disturbances (Andover et al., 2005). This is a prevalent problem and lacks an
      efficacious treatment. As a result, this study can shed insight into possible treatments.

      The experiential avoidance model of deliberate self-harm posits that a function of
      self-injury is maintained through negative reinforcement by reducing unpleasant emotional
      arousal (Chapman et al. 2006). Therefore a treatment that directly targets reducing
      experiential avoidance is likely to be effective.

      ACT is based on the theory that rigid attempts to control internal states, thoughts and
      feelings, and other forms of experiential avoidance contribute to symptom development and
      maintenance of anxiety and self-injury. The training includes three components: (a) educating
      Ps about the exacerbation of anxiety symptoms and problem behaviors through rigid attempts at
      experiential avoidance, (b) introducing acceptance and the willingness to experience
      anxiety-related sensations and cognitions as an alternative to experiential control, through
      the practice of intentional and non-judgmental paying attention to one's thoughts, feelings,
      images and bodily sensations (including aversive symptoms of anxiety) and learning to see
      thoughts as an ongoing process distinct from self rather than merely an event with literal
      meaning (cognitive defusing), and (c) instructing Ps in between-session exercises
      incorporating awareness of present, internal experiences and cognitive defusion exercises
      while engaging in exercises that give rise to them.
    

Intervention name(s): Acceptance and Commitment Therapy (ACT)
Intervention type(s): Behavioral
Intervention description(s): ACT is based on the theory that rigid attempts to control internal states, thoughts and feelings, and other forms of experiential avoidance contribute to symptom development and maintenance of anxiety and self-injury.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment