Emotion regulation as mediator of treatment outcome in therapy for deliberate self-harm

This study presents the outcomes of mediator analyses as part of a randomized controlled trial of Cognitive-Behavioural Therapy (CBT) for young people who engage in deliberate self-harm (DSH). The study involved 90 people, aged 15-35 years, who were randomly assigned to CBT in addition to treatment as usual or to treatment as usual only. The findings showed that changes in DSH were partially mediated by changes in emotion-regulation difficulties, particularly difficulties with impulse control and goal-directed behaviours. In addition, the potential mediating role of symptoms of depression, anxiety and suicidal cognitions was examined. Although the CBT intervention significantly reduced depression, anxiety and suicidal cognitions, these measures of symptom severity did not play a mediating role. These findings suggest that interventions for DSH should not primarily focus on mental disorders associated with DSH, but should be DSH-specific and should target specific emotion-regulation difficulties.