Overcontrol is a transdiagnostic cluster of traits associated with excessive psychological, behavioural and social inhibitory control. It is associated with psychiatric diagnoses of depression, restrictive eating disorders and/or obsessive-compulsive personality disorder. Radically Open Dialectical Behaviour Therapy is a transdiagnostic treatment for maladaptive overcontrol. This case series evaluates an adolescent adaption (RO-A) for a transdiagnostic group of adolescents identified as overcontrolled. Twenty-eight adolescents were consecutively referred for RO-A from two different National and Specialist Child and Adolescent Mental Health Services between June 2017 and February 2020. Baseline self-report measures assessed overcontrol characteristics, relationship and attachment quality and mental health symptoms of depression and eating disorders, which were repeated at discharge. Adolescents in this case series reported high rates of depression (78.6%), self-harm (64.3%) and eating disorders (78.6%). Most (85.7%) had two or more mental health diagnoses and all had previous mental health treatments before starting RO-A. The mean number of RO-A sessions attended was 18 group-based skills classes and 21 individual sessions over a mean period of 34 weeks. Significant improvements with medium and large effect sizes were reported in cognitive flexibility (d = 1.63), risk aversion (d = 1.17), increased reward processing (d = .79) and reduced suppression of emotional expression (d = .72). Adolescents also reported feeling less socially withdrawn (d = .97), more connected to others (d = 1.03), as well as more confident (d = 1.10) and comfortable (d = .85) in attachment relationships. Symptoms of depression (d = .71), eating disorders (d = 1.06) and rates of self-harm (V = .39) also significantly improved. Exploratory correlation analyses suggest improvements in overcontrol are moderately to strongly correlated with improvements in symptoms of depression and eating disorders. This case series provides preliminary data that RO-A may be an effective new treatment for adolescents with overcontrol and moderate to severe mental health disorders like depression and eating disorders. RO-A led to improved management of overcontrol, improved relationship quality and reduced mental health symptoms. Further evaluation is indicated by this case series, particularly for underweight young people with eating disorders. More rigorous testing of the model is required as conclusions are only tentative due to the small sample size and methodological limitations.

中文翻译：

---

适用于青少年的彻底开放的辩证行为疗法：案例系列


过度控制是与过度的心理、行为和社会抑制控制相关的一组跨诊断特征。它与抑郁症、限制性饮食失调和/或强迫性人格障碍的精神病学诊断有关。彻底开放的辩证行为疗法是一种针对适应不良过度控制的跨诊断治疗方法。本病例系列评估了被确定为过度控制的跨诊断青少年群体的青少年适应（RO-A）。 2017 年 6 月至 2020 年 2 月期间，有 28 名青少年连续从两个不同的国家和专业儿童和青少年心理健康服务机构转诊至 RO-A。基线自我报告措施评估了过度控制特征、关系和依恋质量以及抑郁症和青少年心理健康症状。饮食失调，出院时再次出现。该病例系列中的青少年抑郁症（78.6%）、自残（64.3%）和饮食失调（78.6%）的发生率很高。大多数人 (85.7%) 有两次或两次以上心理健康诊断，并且所有人在开始 RO-A 之前都接受过心理健康治疗。在平均 34 周内，参加 RO-A 课程的平均次数为 18 门团体技能课程和 21 门个人课程。据报道，中等和大效应的显着改善体现在认知灵活性 (d = 1.63)、风险规避 (d = 1.17)、奖励处理增加 (d = .79) 和情绪表达抑制减少 (d = .72) 方面。青少年还报告称，他们在社交方面的退缩程度有所降低 (d = .97)，与他人的联系更加紧密 (d = 1.03)，并且在依恋关系中更加自信 (d = 1.10) 和舒适 (d = .85)。抑郁症状 (d = .71)、饮食失调 (d = 1.06) 和自残率 (V = .39）也显着改善。探索性相关分析表明，过度控制的改善与抑郁症和饮食失调症状的改善存在中度至强相关性。该病例系列提供的初步数据表明，RO-A 可能是治疗过度控制和中度至重度精神健康障碍（如抑郁症和饮食失调）的青少年的有效新疗法。 RO-A 改善了过度控制的管理，提高了关系质量并减少了心理健康症状。该病例系列表明了进一步的评估，特别是对于患有饮食失调的体重不足的年轻人。由于样本量小和方法学限制，结论只是暂时的，因此需要对模型进行更严格的测试。