Recovery-focused self-help intervention using vodcasts for patients with personality disorder: feasibility randomised controlled trial.

BACKGROUND: Availability of long-term psychological interventions for personality disorders is limited because of their high intensity and cost. Research in evidence-based, low-intensity interventions is needed. AIMS: This study aimed to examine the feasibility, acceptability and potential impact of a low-intensity, digital guided self-help (GSH) intervention that is focused on emotion regulation, recovery-oriented and provides in-the-moment delivery for patients with personality disorders. METHOD: We conducted a single-blind feasibility trial. A total of 43 patients with a personality disorder were recruited and randomly assigned to either a GSH arm (n = 22) or a treatment-as-usual arm (n = 21). The GSH intervention included a series of short videos offering psychoeducation and support, personalised feedback using text messages, and supportive telephone calls, for 4 weeks in addition to treatment as usual. Outcomes of emotional disturbance, emotion dysregulation, self-harm behaviours and decentring ability were measured at baseline, 4 weeks (end of intervention) and 8 weeks (follow-up). RESULTS: All patients who attended the first session continued until the last session. There was an interaction effect between time and group on anxiety (P = 0.027, Δη2 = 0.10), where the GSH group showed a significant reduction in anxiety at follow-up (P = 0.003, d = 0.25). The GSH group increased in decentring ability at the end of intervention (P = 0.007, d = -0.65), and the decrease in self-harm behaviours continued until follow-up (P = 0.02, d = 0.57). CONCLUSIONS: The results suggest that a personalised digital GSH with a focus on recovery could reduce anxiety and self-harm behaviours at short-term follow-up.

Dynamics of family economic hardship and the progression of health problems of husbands and wives during the middle years: a perspective from rural Mid-West.

OBJECTIVE: The objective of this study was to investigate the influence of theoretically important dimensions of stability and change in economic hardship during early middle years on decade-long health problems of husbands and wives. METHOD: The study used prospective data collected from 360 middle-aged husbands and wives during a 12-year period. The variables included self-reported economic hardship (22 items), mental and physical health, and physical impairment. RESULTS: The results supported the hypothesis that the dynamics of family economic hardship (in terms of stability and change) during the early middle years contribute to subsequent onset of health problems of middle-aged husbands and wives. These health problems in turn progress as an interrelated process through intrahealth-domain continuities, cross-health domain proliferations, and dyadic associations as they pass through midlife. DISCUSSION: A better understanding of these processes may aid in the formation and effective implementation of health promotion programs for middle-aged husbands and wives.