Refractory depression: mechanisms and evaluation of radically open dialectical behaviour therapy (RO-DBT) [REFRAMED]: protocol for randomised trial

Lynch, Thomas R.; Whalley, Ben; Hempel, Roelie; Byford, Sarah; Clarke, Paul; Clarke, Susan E.; Kingdon, David; O’Mahen, Heather; Russell, Ian; Shearer, James; Stanton, Maggie; Swales, Michaela; Watkins, Alan; Remington, Bob

doi:10.1136/bmjopen-2015-008857

Cited by 27 publications

(21 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This qualitative study explored interviewees’ responses to receiving an invitation to participate in the REFRAMED trial (REFRActory depression - Mechanisms and Efficacy of Dialectical Behaviour Therapy) [ 28 ]. REFRAMED evaluated the effectiveness of Radically Open Dialectical Behavioural Therapy (RO-DBT) [ 29 ] for treatment-resistant depression.…”

Section: Methodsmentioning

confidence: 99%

What can we learn from trial decliners about improving recruitment? Qualitative study

Hughes-Morley

Young

Hempel

et al. 2016

Trials

View full text Add to dashboard Cite

BackgroundTrials increasingly experience problems in recruiting participants. Understanding the causes of poor recruitment is critical to developing solutions. We interviewed people who had declined a trial of an innovative psychological therapy for depression (REFRAMED) about their response to the trial invitation, in order to understand their decision and identify ways to improve recruitment.MethodsOf 214 people who declined the trial, 35 (16 %) gave permission to be contacted about a qualitative study to explore their decision. Analysis of transcripts of semi-structured interviews was informed by grounded theory.ResultsWe interviewed 20 informants: 14 women and six men, aged 18 to 77 years. Many interviewees had prior experience of research participation and positive views of the trial. Interviewees’ decision making resembled a four-stage sequential process; in each stage they either decided not to participate in the trial or progressed to the next stage. In stage 1, interviewees assessed the invitation in the context of their experiences and attitudes; we term those who opted out at this stage ‘prior decliners’ as they had an established position of declining trials. In stage 2, interviewees assessed their own eligibility; those who judged themselves ineligible and opted out at this stage are termed ‘self-excluders’. In stage 3, interviewees assessed their need for the trial therapy and potential to benefit; we term those who decided they did not need the trial therapy and opted out at this stage ‘treatment decliners’. In stage 4, interviewees deliberated the benefits and costs of trial participation; those who opted out after judging that disadvantages outweighed advantages are termed ‘trial decliners’. Across all stages, most individuals declined because they judged themselves ineligible or not in need of the trial therapy. While ‘prior decliners’ are unlikely to respond to any trial recruitment initiative, the factors leading others to decline are amenable to amelioration as they do not arise from a rejection of trials or a personal stance.ConclusionsTo improve recruitment in similar trials, the most successful interventions are likely to address patients’ assessments of their eligibility and their potential to benefit from the trial treatment, rather than reducing trial burden.Trial registrationInternational Standard Randomised Controlled Trial Number: ISRCTN85784627. Registration date 10 August 2011.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1626-4) contains supplementary material, which is available to authorized users.

show abstract

Section: Methodsmentioning

confidence: 99%

What can we learn from trial decliners about improving recruitment? Qualitative study

Hughes-Morley

Young

Hempel

et al. 2016

Trials

View full text Add to dashboard Cite

show abstract

“…When factoring in the non-clinical population, approval seeking behaviour may be seen as a motivated by social responsibility, whereas in clinical populations this behaviour may be a function of difficulties associated with Impaired Autonomy/Underdeveloped Self. The Excessive Responsibility/Overcontrol HOF is clinically meaningful as there are now treatment models such as Radically Open Dialectical Behaviour Therapy (RO-DBT), which recognise overcontrol as a problematic transdiagnostic coping style (Lynch et al, 2015;Lynch, Hempel, & Dunkley, 2018).…”

Section: Hof Analysismentioning

confidence: 99%

Factor Structure of the Young Schema Questionnaire (Long Form‐3)

Yalcin

Lee

Correia

2020

Australian Psychologist

View full text Add to dashboard Cite

Objective The aim of this study was to assess the factor structure of the English version of the Young Schema Questionnaire Long Form‐3 (YSQ‐L3) using a large clinical sample and smaller non‐clinical population. The items in the YSQ‐L3 were evaluated as to how well they assess the underlying theoretical constructs of schema and schema domains. Method A primary and a higher order factor (HOF) analysis was undertaken on a large heterogeneous clinical sample (N = 574) and the total sample (N = 838) that included a small non‐clinical population (N = 264). Results The primary factor analysis revealed 20 early maladaptive schemas (EMS). Of the 232 items, 182 loaded above .4 and were retained for the final analysis. The original Emotional Inhibition schema separated into Emotional Constriction and Fear of Losing Control, and Punitiveness likewise separated into Punitiveness (Self) and Punitiveness (Other). The HOF analysis indicated four domains: Emotional Dysregulation, Disconnection, Impaired Autonomy/Underdeveloped Self, and Excessive Responsibility/Overcontrol. These overlap with the domains proposed by Young et al. (2003) but with some differences. The Emotion Dysregulation domain was unique to the current study. The mean item loading for each factor ranged from .52 to .82. The revised scale showed excellent overall internal consistency (a = .91). Conclusion This is the first study that investigated the psychometric properties of the English version of the YSQ‐L3. The resultant domains fitted with existing literature of meaningful clinical phenomenon such as attachment and emotion dysregulation and their role in maintaining chronic psychological disorders.

show abstract

“…Our initial literature searches, not included in this scoping review, highlighted a growing body of non‐RCT literature in the field. Such studies included investigations into the effect of CBT focusing on early core beliefs emotional intelligence training, mentalization‐based therapy and radically open dialectical behaviour therapy . Indeed, pilot studies for radically open dialectical behaviour therapy indicate that this treatment is a feasible option for the treatment of depression and anxiety in patients with specific types of personality disorder, notably paranoid, avoidant and obsessive–compulsive personality types .…”

Section: Discussionmentioning

confidence: 99%

“…Such studies included investigations into the effect of CBT focusing on early core beliefs emotional intelligence training, mentalization‐based therapy and radically open dialectical behaviour therapy . Indeed, pilot studies for radically open dialectical behaviour therapy indicate that this treatment is a feasible option for the treatment of depression and anxiety in patients with specific types of personality disorder, notably paranoid, avoidant and obsessive–compulsive personality types . This emerging research highlights the importance of considering the patient's underlying personality disorder when treating depression and/or anxiety and suggests that the treatment of depression and anxiety in those with personality disorder might potentially be optimized by stratifying treatment on the basis of personality disorder symptom profile.…”

Section: Discussionmentioning

confidence: 99%

Psychological treatment of depression and anxiety in patients with co‐morbid personality disorder: A scoping study of trial evidence

French

Turner

Dawson

et al. 2017

Personality & Mental Health

View full text Add to dashboard Cite

It is unclear what the best psychological treatment is for depression and anxiety in people with co-morbid personality disorder. Trials of different psychological treatment options for this patient group have been conducted, but this evidence has not previously been systematically reviewed or critically appraised. We set out to conduct a scoping review in order to describe which psychological therapies appear most effective in treating depression and/or anxiety in patients with co-morbid personality disorder. PsycINFO, Cochrane library trials, Medline and Embase databases were searched for studies involving randomized, controlled, experimental, parallel-arm comparisons, examining any well-defined, psychotherapeutic intervention for adults, in an outpatient setting, with a clearly defined diagnosis of depression and/or anxiety, and co-morbid personality disorder. A total of 1662 papers were identified. Fifteen met criteria for inclusion and were reviewed. There was weak evidence to support the use of cognitive behavioural therapy as a psychological treatment for depression in patients with co-morbid personality disorder. However, the literature is characterized by considerable methodological heterogeneity, and further research is needed before there is sufficient evidence to indicate which psychological treatment would be most effective in treating anxiety and/or depression in this patient group. Copyright © 2017 John Wiley & Sons, Ltd.

show abstract

Refractory depression: mechanisms and evaluation of radically open dialectical behaviour therapy (RO-DBT) [REFRAMED]: protocol for randomised trial

Cited by 27 publications

References 86 publications

What can we learn from trial decliners about improving recruitment? Qualitative study

What can we learn from trial decliners about improving recruitment? Qualitative study

Factor Structure of the Young Schema Questionnaire (Long Form‐3)

Psychological treatment of depression and anxiety in patients with co‐morbid personality disorder: A scoping study of trial evidence

Contact Info

Product

Resources

About