MBT-Related Projects. Work Group Heidelberg Svenja Taubner, Jana Volkert, Alessandro Talia, Paul Schröder, Thorsten Gablonski, Christine Bark et al.

Transcription

1 MBT-Related Projects Work Group Heidelberg Svenja Taubner, Jana Volkert, Alessandro Talia, Paul Schröder, Thorsten Gablonski, Christine Bark et al.

2 Current Projects 1. Mentalization-based early day care 2. Implementation of MBT-Lighthouse 3. Epistemic Trust in Adolescents 4. MBT-RCT in Borderline Patients vs. TAU and MBT-DBT (submission second stage BMBF) 5. MBT-RCT in Conduct Disorder vs. TAU

3 Epistemic Trust Assessment (ETA) Situation of uncertainty In the situation the person to be tested has to rely on information from an outside source The information needs to be relevant to the person or he/she will believe it no matter what The information needs to be generalizable

4 Procedure: Valence Question: Was your pulse during the interview fast or slow? (~0% Inherent certainty, physiological) Did your body language appear appropriate or inappropriate during the interview? (~50% Inherent certainty, relational) Did you feel focused during the interview? (~100% Inherent certainty, self-state) Certainty Question: How certain are you in your statement? (Visual Analog Scale from Very uncertain to Very certain ) Trier Social Stress Test Group Version ~0% Certainty (Physiological) -Pulse -Cor+sol -EDA Valence Question ~50% Certainty (Relational) -Body language -Dedica+on -Friendly Certainty Question Expert Feedback Certainty Question 2 ~100% Certainty (Self State) -Emo+ons -Focus -Tension

5 Procedure: Uncertain situation induced by TSST-G 3 distinct question fields with inherent certainties High change in certainty on Self-State questions = Epistemic Naive Low change in certainty on Physiological questions = Epistemic Hypervigilance Trier Social Stress Test Group Version ~0% Certainty (Physiological) -Pulse -Cor+sol -EDA Valence Question ~50% Certainty (Relational) -Body language -Dedica+on -Friendly Certainty Question Expert Feedback Certainty Question 2 ~100% Certainty (Self State) -Emo+ons -Focus -Tension

6 Expert Feedback : Example: Your pulse was very fast during the interview. (Physiological, should always be accepted) Your body language came across as very inappropriate (Relational, 50/50 if accepted or not depending on congruence) You felt angry during the interview. (Self-state, should never be accepted) Certainty Question 2: Repeat

7 RCT: MBT vs. TAU for Conduct Disorder

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9 RCT financed by the Hopp-Foundation Started September 1st 2016 (one week ago) In Cooperation with: Child and Adolescent Psychiatry Heidelberg University Hospital (Prof. Resch, PD Kaess) Child and Adolescent Psychiatry Medical University Innsbruck (Prof. Sevecke, Dr. Bock) Hospital Klagenfurt (Dr. Wladika) University College London und Anna-Freud-Centre London (Prof. Fonagy, Dr. Bateman, Dr. Rosssouw, Tobias Nolte)

10 1st year Appointment 1a Appointment 1b Screening n=100 inclusion criteria, informed consent Study participation n=60 baseline investigation (T 1 ) Enrollment randomization Allocation 2nd year TAU n=30 MBT n=30 Appointment 2 Investigation during therapy (T 2 ) after 6 months Treatment 3rd year Appointment 3 Investigation after therapy (T 3 ) after 12 months Appointment 4 Follow-Up (T 4 ) after 18 months Follow-up Analysis (n=60)

11 Instruments Adolescents Parents Mentalization RF-Q-SF: Reflective Functioning MASC: Movie for the Assessment of Social Cognition BRFI Brief Reflective Functioning Interview PRFQ: Parental Reflective Functioning Questionnaire Attachment RQ-2: Relationship Questionnaire RQ-2: Relationship Questionnaire Relationship Level of functioning Emotion Regulation Behavior Personality CECA-Q: Childhood Experience of Care and Abuse Questionnaire CGAS: Children Global Assessment Scale ERQ: Emotion Regulation Questionnaire STAB: Subtypes of Antisocial Behaviour SDQ-S11-17: Strengths and Difficulties Questionnaire RPQ: Reactive-Proactive-Aggression Approach-Avoidance Task LoPF-Q-12: Levels of Personality Functioning DAPP-BQ: Dimensional Assessment of Personality Pathology YPI: Youth Psychopathy Traits Inventory APQ-A: Alabama Parenting Questionnaire Symptoms/Stress YSR Youth Self Report SIPA: Stress Index for Parents of Adolescents Trust 10 Round Trust Game

12 Next step Finalize the MBT-CD Manual à adjust Adherence measure Adjust MBT-AI Obtain ethical votes Train therapists Organize Supervision (Gerry Byrne, Nick Midgley, German MBT-A supervisors)

13 TREATMENT FOR BPD IN THE GERMAN HEALTH SERVICE BMBF-APPLICATION (2 ND STAGE)

14 1st Year Appointment 1 Screening for eligibility n=960 Inclusion criteria, informed consent Appointment 2 Allocation to trial n=576 Baseline assessment (T 0 ) Enrollment 2nd Year MBT-S n=192 Randomisation to treatment (1:1:1) MBT-I n=192 TAU n=192 Allocation 3rd Year Treatment Treatment Appointment 3 In-Therapy assesment (T 1 ) month 6 4th Year Appointment 4 Appointment 5 Post-Therapy asssessment (T 2 ) month 12 Follow up assessment (T 3 ) month 24 Analysis (n=384) Follow-up

15 Thank you 15