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Trial registered on ANZCTR
Registration number
ACTRN12617000529347
Ethics application status
Approved
Date submitted
27/02/2017
Date registered
11/04/2017
Date last updated
14/08/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised control trial – the efficacy of dialectical behaviour therapy in young adult prisoners who engage in self-harm
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Scientific title
Will prisoners who self-harm reduce their frequency of self-harming after going through the Dialectical Behaviour Therapy intervention?
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Secondary ID [1]
291284
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
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Linked study record
Nil
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Health condition
Health condition(s) or problem(s) studied:
self-harm
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borderline personality disorder
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well-being
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Condition category
Condition code
Mental Health
301832
301832
0
0
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Psychosis and personality disorders
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Mental Health
301833
301833
0
0
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Suicide
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Mental Health
301834
301834
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention for young prisoners who self-harm will be the modified dialectical behaviour therapy by Mission Australia’s Triple Care Farm. The group intervention is a 12-week, biweekly group-skills session conducted by two clinical psychologists who are DBT-trained. The modules included will be on mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. 1. Sessions will be in a group therapy format with up to 10 participants per group (Triple Care Farm, 2015). DBT is a structured, skills-based program which will teach participants skills such as mindfulness (i.e. to encourage teaching in the 'here and now' and focus on the present), distress tolerance (i.e. coping skills whenever participants are in a crisis), interpersonal effectiveness (i.e. how to behave in relationships and to maintain respect at the same time) and emotion regulation (i.e. how to identify emotions and manage emotions that are unhelpful or unjustified). Besides teaching skills, participants will also be given a treatment workbook where they can fill in their own notes during sessions.
2. Duration of sessions will be 2-hours
3. Strategies to monitor adherence: Register of attendance at the beginning of each session and a diary-card, where participants will need to tick which skill they used outside therapy times and any reasons why some skills are difficult than others and this will be reviewed at the beginning of every session
4. Biweekly means two sessions a week.
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Intervention code [1]
297299
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Early detection / Screening
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Intervention code [2]
297300
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Treatment: Other
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Intervention code [3]
297303
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Behaviour
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Comparator / control treatment
Treatment as Usual: Participants in this group will receive leaflets on self-harm and alternative coping strategies and will be required to meet with the prison doctor for further monitoring. No other therapy will be provided to this group of participants throughout the 12-week period.
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Control group
Active
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Outcomes
Primary outcome [1]
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Self-harm behaviours assessed using the Inventory of Statements about Self-Injury (ISAS)
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Assessment method [1]
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Timepoint [1]
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Follow-up at Week 16 and 20 post-intervention here means:
3 weeks of screening, plus 12 weeks of intervention.
Week 16 is the week immediately after intervention just ended (follow-up 1) and week 20 is 4 weeks after the intervention (follow-up 2).
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Primary outcome [2]
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Borderline Personality Disorder symptoms as assessed by the Structured Clinical Interview for Borderline Personality Disorder (SCID-BPD)
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Assessment method [2]
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Timepoint [2]
301256
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Follow-up at Week 16 and 20 post-intervention here means:
3 weeks of screening, plus 12 weeks of intervention.
Week 16 is the week immediately after intervention just ended (follow-up 1) and week 20 is 4 weeks after the intervention (follow-up 2).
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Secondary outcome [1]
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General well-being (as observed from the Well-being Survey)
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Assessment method [1]
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Timepoint [1]
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Follow-up at Week 16 and 20 post-intervention here means:
3 weeks of screening, plus 12 weeks of intervention.
Week 16 is the week immediately after intervention just ended (follow-up 1) and week 20 is 4 weeks after the intervention (follow-up 2).
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Secondary outcome [2]
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Emotion regulation (as observed from the Difficulties in Emotion Regulation, DERS questionnaire)
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Assessment method [2]
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Timepoint [2]
332113
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Follow-up at Week 16 and 20 post-intervention here means:
3 weeks of screening, plus 12 weeks of intervention.
Week 16 is the week immediately after intervention just ended (follow-up 1) and week 20 is 4 weeks after the intervention (follow-up 2).
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Eligibility
Key inclusion criteria
- Malaysian nationality
- Young adult prisoner aged between 14 and 21 years of age who self-harm
- Males and Females
- Does not necessarily need to know how to read or write, but must be able to understand English or Malay
- Convicted prisoners only
- Remaining length of sentence should be at least 6 months
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Minimum age
14
Years
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Maximum age
21
Years
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
The participant is Non-Malaysian
The participant is only able to comprehend minimum English or Malay language, and is only able to speak in his mother tongue (i.e. Chinese, Tamil or others)
The participant is over 21 years of age
The participant has significant mental health, physical or drug and alcohol concerns that may get in the way of their involvement or threaten the safety of other participants,
The participant has less than 6 months left of his sentence
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Balanced and blocked randomisation using a randomisation table created by computer software.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Nil
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Using the sample size calculation method via the G*Power program, in order to produce a medium-to-large effect size with the power of approximately 80% for an independent t-test (to see the differences between two groups), one group should have 64 participants. Consequently, two groups would yield 128 participants. However, this number would just be estimates as determining a sample size for a randomised controlled trial is highly unpredictable (i.e. many variables would affect the final sample size).
Similar randomised controlled trials such as cognitive behaviour therapy intervention for self-harm (Slee et al., 2008); DBT for women with borderline personality disorder (Verheul et al., 2003); DBT with suicidal and self-harming adolescents (Tørmoen et al., 2014); DBT for adolescents with repeated suicidal and self-harm behaviour (Mehlum et al., 2016) among other studies included between 27 to 90 participants in their RCTs.
Therefore, 128 participants in our study would be ideal and might just be more than enough.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
18/05/2017
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Actual
26/04/2017
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Date of last participant enrolment
Anticipated
20/12/2017
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Actual
27/07/2017
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Date of last data collection
Anticipated
20/02/2019
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Actual
14/12/2017
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Sample size
Target
128
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Accrual to date
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Final
97
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Recruitment outside Australia
Country [1]
8694
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Malaysia
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State/province [1]
8694
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Malacca
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Funding & Sponsors
Funding source category [1]
295748
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Other Collaborative groups
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Name [1]
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Project Air Strategy for Personality Disorders
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Address [1]
295748
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Project Air Strategy for Personality Disorder, Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, NSW, Australia, 2500
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Country [1]
295748
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
Project Air Strategy for Personality Disorders
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Address
Project Air Strategy for Personality Disorder, Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, NSW, Australia, 2500
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Nil
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Address [1]
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Nil
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Country [1]
294592
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Other collaborator category [1]
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Individual
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Name [1]
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Associate Professor Dr. Muhammad Muhsin Ahmad Zahari
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Address [1]
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Department of Psychological Medicine, Faculty of Medicine, University Malaya, 59100 Kuala Lumpur
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Country [1]
279452
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Malaysia
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Other collaborator category [2]
280297
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Individual
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Name [2]
280297
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Kate Lewis
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Address [2]
280297
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Project AIr Strategy, Northfields Clinic, Building 22.20A, Northfields Avenue, University of Wollongong, NSW 2522
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Country [2]
280297
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297048
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University of Wollongong Human Research Ethics Committee
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Ethics committee address [1]
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Human Research Ethics Committee, University of Wollongong, NSW, Australia, 2500
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Ethics committee country [1]
297048
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Malaysia
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Date submitted for ethics approval [1]
297048
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05/07/2016
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Approval date [1]
297048
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27/09/2016
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Ethics approval number [1]
297048
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HE16/273
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Ethics committee name [2]
297049
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Medical Ethics Committee, University Malaya Medical Center
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Ethics committee address [2]
297049
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Medical Ethics Committee, University Malaya Medical Center, Lembah Pantai, 59100 Kuala Lumpur
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Ethics committee country [2]
297049
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Malaysia
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Date submitted for ethics approval [2]
297049
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Approval date [2]
297049
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21/09/2016
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Ethics approval number [2]
297049
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20166-2609
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Summary
Brief summary
Dialectical behaviour therapy (DBT) has had positive outcomes in correctional settings, especially with adolescents, female inmates and those with Borderline Personality Disorder. Similarly, DBT has also been implemented specifically to reduce self-harming. However, no randomised controlled trials on DBT have been conducted to reduce self-harm in the prison setting among young adults. The purpose of this study is therefore to examine the efficacy of Dialectical Behavioural Therapy (DBT) informed treatment (as compared to treatment as usual, TAU) on young adult prisoners who self-harm or have associated borderline personality disorder symptoms. Specifically, the study aims: 1) To examine efficacy of DBT among prisoners who self-harm 2) To examine if the frequency of self-harming behaviour, thoughts and symptoms would decrease after the implementation of DBT
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
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/AnzctrAttachments/372437-UOW 16-273 Approval 131016.pdf
(Ethics approval)
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Attachments [2]
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/AnzctrAttachments/372437-Arina Main - PIS and CF V3.docx
(Participant information/consent)
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Contacts
Principal investigator
Name
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Prof Brin Grenyer
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Address
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Building 41
School of Psychology
Faculty of Social Sciences
University of Wollongong
Northfields Avenue
WOLLONGONG NSW 2522
AUSTRALIA
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Country
72806
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Australia
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Phone
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+61 2 4221 3474
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Fax
72806
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+61 2 4221 4163
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Email
72806
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[email protected]
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Contact person for public queries
Name
72807
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Brin Grenyer
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Address
72807
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Building 41
School of Psychology
Faculty of Social Sciences
University of Wollongong
Northfields Avenue
WOLLONGONG NSW 2522
AUSTRALIA
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Country
72807
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Australia
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Phone
72807
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+61 2 4221 3474
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Fax
72807
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+61 2 4221 4163
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Email
72807
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[email protected]
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Contact person for scientific queries
Name
72808
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Brin Grenyer
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Address
72808
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Building 41
School of Psychology
Faculty of Social Sciences
University of Wollongong
Northfields Avenue
WOLLONGONG NSW 2522
AUSTRALIA
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Country
72808
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Australia
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Phone
72808
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+61 2 4221 3474
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Fax
72808
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+61 2 4221 4163
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Email
72808
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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