Linehan's biosocial model applied to emotion dysregulation in autism: a narrative review of the literature and an illustrative case conceptualization

From personification abuse to normal expression: emotional treatment for language disorders in schools

Introduction

The escalating prevalence of personification abuse in language disorders among students poses a substantial challenge for autistic students in the domain of language disorders. While prior research has mainly focused on the cognitive hurdles faced by autistic students, ongoing debates persist about the onset, severity, and roots of these challenges in their classroom behavior, with limited exploration of how preconceived notions impact personification abuse. This study aims to delve into emotional treatments for language disorders, specifically targeting personification abuse, to facilitate the shift from distorted perceptions to normative expression. It seeks to pinpoint the primary emotional interventions linked to instances of personification abuse and scrutinize the emotional factors influencing therapeutic approaches for language disorders.

Methods

The research encompassed a cohort of 110 autistic students, aged 2 to 5 years, diagnosed with language disorders, all clinically determined to have autism by developmental pediatricians at a prestigious medical facility. Among these children, 95 were attending specialized schools, while 15 were situated in community settings.

Results

The outcomes disclosed that children across all developmental phases displayed instances of personification abuse in language disorders, showcasing noteworthy enhancements in personification abuse following emotional treatment. Significantly, the discernible disparity in personification abuse performance and emotional treatment can be linked to the simultaneous cognitive advancement of autistic students across four grade levels, with variations noted based on normative expressions.

Discussion

These findings underscore the insufficiency of solely relying on intrinsic trends to comprehend personification abuse within an emotional treatment context. The study accentuates the potential pitfalls associated with emotional treatment for language disorders and stresses the imperative need for additional research and psychiatric intervention strategies.

Transdiagnostic skills training group of dialectical behavior therapy: a long-term naturalistic study

INTRODUCTION

Dialectical Behavior Therapy (DBT) has assembled a large body of evidence for the treatment of emotional dysregulation in borderline personality disorder (BPD), but also in other disorders characterized by emotional dysregulation (e.g., bipolar disorder (BD) and ADHD). Standalone skills learning groups address the problem of limited resources in several clinical settings. Furthermore, transdiagnostic skills groups facilitate the recruitment and decrease the scattering of resources in psychiatric settings. However, few studies have focused on the pertinence of transdiagnostic standalone skills groups in naturalistic settings as well as their long-term outcomes. The goal of this study is to assess the impact of participation in a transdiagnostic DBT skills group one year after its completion.

METHOD

Transdiagnostic DBT skills training groups were provided for BPD, BD and ADHD patients in a University Psychiatric Department (Strasbourg, France), between 2019 and 2020. They consisted of 16 group sessions of 2.5 h and 3 individual sessions. At 1-year follow-up, ad-hoc questionnaires were proposed to all participants to assess the perceived impacts, the changes in symptomatology, and the maintenance of skills learned.

RESULT

22 of the 31 participants were interviewed at the one-year post-group session (64% BPD, 41% ADHD and 27% BD). 73% participants estimated that group impact was important or very important, 64% stated using the skills learned often or very often, mainly emotion regulation skills. An improvement in emotional instability, substance use, impulsivity and suicidal thoughts was reported by respectively 100%, 91%, 86% and 85% of participants. Quality of life improved according to 90% participants. All patients reported an improvement in suicidality during the post-group year, especially in suicide attempts. Psychotropic medication decreased in 59% of participants.

DISCUSSION

Our one-year naturalistic study suggests that transdiagnostic DBT skills training groups are promising for the treatment of emotional dysregulation in people with BPD, BD and/or ADHD. The observational design and the lack of control group are the main limitations. Randomized controlled studies are required to confirm the long-term efficacy of transdiagnostic skills learning groups in naturalistic settings.