DBT-P Treatment Study

The investigators' observational research with mothers with emotion dysregulation and their infants shows that poor emotion regulation skill use is a mechanism that likely confers risk for self-injurious thoughts and behaviors, depression, and anxiety in the mother and neurobehavioral and co-regulatory challenges in the infant. Emotion dysregulation is an impairing, early-emerging, transdiagnostic vulnerability factor that has intergenerational implications. Treatments have been developed for non-pregnant adults with emotion dysregulation but these are costly, time-intensive, and do not address the unique needs of pregnant people, highlighting an unmet therapeutic need. Through this innovative intervention, researchers will test whether targeting emotion regulation skills use during pregnancy will both improve postpartum emotion regulation, newborn neurobehavior, and mother-infant co-regulation. Early identification of the mechanisms implicated in risk. The researchers will deliver 10 weeks of DBT skills classes selected and adapted to meet the unique needs of pregnancy (DBT-P). The goal of this work is to improve perinatal mental health trajectories.

The premise of this study-that improving emotion regulation in pregnancy may disrupt intergenerational transmission of psychopathology-is informed by our research over the past two decades, including several NIH awards (R01MH119070, R01MH132210, R01DA049755, R21MH1090777, F31MH074196). The investigator' data reveal that maternal emotion dysregulation confers risk for mother. The research also shows that resting respiratory sinus arrhythmia (RSA), a physiological index of emotion dysregulation, can be improved via intervention in non-pregnant adults. The investigators propose that DBT-P will increase emotion regulation skills use or increase RSA in the mother (target engagement) leading to significant reductions in her emotion dysregulation prior to birth.

The primary study objectives are to recruit 100 pregnant women with high emotion dysregulation to receive either: (1) dialectical behavior therapy skills groups or an Assessment only control; and (2) to evaluate whether the treatment improved emotion regulation skills use as well as respiratory sinus arrhythmia.

• Percent of participation [Срок оценки: Baseline (Week 0), mid-treatment (Week 5), and post-treatment (Week 10)]
• Percent of missing data [Срок оценки: Baseline (Week 0), mid-treatment (Week 5), and post-treatment (Week 10)]
• Recruitment rates [Срок оценки: Baseline (Week 0), mid-treatment (Week 5), and post-treatment (Week 10)]
• Reasons for refusal [Срок оценки: Baseline (Week 0), mid-treatment (Week 5), and post-treatment (Week 10)]
• Intervention adherence [Срок оценки: Baseline (Week 0), mid-treatment (Week 5), and post-treatment (Week 10)]
• Number of women who complete all sessions [Срок оценки: Baseline (Week 0), mid-treatment (Week 5), and post-treatment (Week 10)]
• Number of interventionists who can self-monitor for fidelity, assessed by watching segments of video-recorded sessions [Срок оценки: Baseline (Week 0), mid-treatment (Week 5), and post-treatment (Week 10)]
• Participation rates [Срок оценки: Post-treatment (Week 10)]
• Participant satisfaction with the intervention assessed by the Client Satisfaction Questionnaire [Срок оценки: Post-treatment (Week 10)]
• Telehealth acceptability specific to DBT skills training [Срок оценки: Post-treatment (Week 10)]