Self-injury: Treatment, Assessment, Recovery (STAR): online intervention for adolescent non-suicidal self-injury - study protocol for a randomized controlled trial

Michael Kaess; Julian Koenig; Stephanie Bauer; Markus Moessner; Gloria Fischer-Waldschmidt; Margarete Mattern; Sabine C Herpertz; Franz Resch; Rebecca Brown; Tina In-Albon; Michael Koelch; Paul L Plener; Christian Schmahl; Alexandra Edinger; STAR Consortium

doi:10.1186/s13063-019-3501-6

Self-injury: Treatment, Assessment, Recovery (STAR): online intervention for adolescent non-suicidal self-injury - study protocol for a randomized controlled trial

Trials. 2019 Jul 12;20(1):425. doi: 10.1186/s13063-019-3501-6.

Authors

Michael Kaess^{1

2}, Julian Koenig^{3

4}, Stephanie Bauer⁵, Markus Moessner⁵, Gloria Fischer-Waldschmidt⁶, Margarete Mattern⁷, Sabine C Herpertz⁷, Franz Resch⁶, Rebecca Brown⁸, Tina In-Albon⁹, Michael Koelch¹⁰, Paul L Plener^{8

11}, Christian Schmahl¹², Alexandra Edinger^{4

6}; STAR Consortium

Affiliations

¹ University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. michael.kaess@med.uni-heidelberg.de.
² Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany. michael.kaess@med.uni-heidelberg.de.
³ University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
⁴ Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
⁵ Centre for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany.
⁶ Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
⁷ Department of General Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
⁸ Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany.
⁹ Department of Clinical Child and Adolescent Psychology and Psychotherapy, Faculty of Psychology, University of Koblenz-Landau, Landau, Germany.
¹⁰ Department for Child and Adolescent Psychiatry and Psychotherapy, Medical School Brandenburg, Neuruppin, Germany.
¹¹ Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.
¹² Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Abstract

Background: Non-suicidal self-injury (NSSI) is a clinically significant behavior affecting approximately 18% of adolescents and young adults worldwide. The importance of NSSI is supported by its association with a broad spectrum of mental disorders. Despite its high relevance, evidence-based, specific, time-, and cost-effective treatment approaches are scarce. Cognitive behavioral therapy (CBT) seems effective in reducing the frequency of NSSI in adolescents and young adults. However, young people are often reluctant to seek professional help and effective interventions adressing NSSI are not sufficiently available across all regions of Germany. Research indicates that the majority of youth with risk behavior (including NSSI) prefer technology-based interventions. To date, effective interventions for adolescents and young adults with NSSI that are deliverd online are not available.

Methods: The present project aims to develop and evaluate an online intervention for adolescents and young adults with NSSI based on the content of a recently evaluated face-to-face short-term program that includes elements of CBT and dialectical behavior therapy (DBT): "The Cutting Down Programme" (CDP). The efficacy of the new online CDP intervention will be tested in a randomized controlled trial (RCT) in which n = 700 youths engaging in repetitive NSSI will participate in either an online psychoeducation (n = 350) or online CDP (n = 350). Within a postline assessment four months after baseline (end of treatment; T1), and follow-up evaluations 12 and 18 months after baseline (follow-ups; T2 and T3), NSSI and comorbid symptoms as well as quality of life will be assessed. It is hypothesized that participants receiving online CDP report a greater reduction in the frequency of NSSI within the last three months at T2 (primary endpoint) compared to those receiving online psychoeducation. Exploratory analyses will focus on predictors of treatment outcome.

Discussion: We report on the development and evaluation of an online intervention for adolescents and young adults engaging in NSSI based on the CDP. If supported by empirical evidence, an online-based intervention for NSSI might help to overcome the limited availability of adequate interventions for youth.

Trial registration: German Clinical Trials Register, DRKS00014623 . Registered on 22 May 2018.

Keywords: Adolescents; Internet; Non-suicidal self-injury; Online intervention; Randomized controlled trial.

Publication types

Clinical Trial Protocol

MeSH terms

Adolescent
Adolescent Behavior*
Age Factors
Cognitive Behavioral Therapy / methods*
Dialectical Behavior Therapy / methods*
Female
Germany
Health Knowledge, Attitudes, Practice
Humans
Internet-Based Intervention*
Male
Multicenter Studies as Topic
Patient Education as Topic
Randomized Controlled Trials as Topic
Self-Injurious Behavior / diagnosis
Self-Injurious Behavior / psychology
Self-Injurious Behavior / therapy*
Therapy, Computer-Assisted*
Time Factors
Treatment Outcome
Young Adult

Grants and funding

01GL1747B/Bundesministerium für Bildung und Forschung