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Difficulties of Emotion RegulationNCT07021274

DBT Skill Training for Autistic Adults With Difficulties in Emotion Regulation.

A study testing DBT skills training adjusted to autistic needs in people with Difficulties of Emotion Regulation and Self-harm Behavior, run by Helse Møre og Romsdal HF at 1 site in Norway.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

One in 44 has autism, 70% of them have additional mental health challenges. Currently, this patient population does not have access to effective treatment within specialist healthcare services and has struggled to benefit from standard treatments. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
DBT skills training adjusted to autistic needs
Could I receive a placebo?
No, everyone receives an active treatment
How many people
15 participants
Where
1 siteNorway
Study dates
15 Aug 2025to 28 Feb 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Fit general inclusion criteria for the out- patient treatment at the clinic.
  • Have diagnosed autism, and pervasive difficulties in emotion regulation.
  • Speak Scandinavian (Norwegian, Danish and/or Swedish).
  • Manage to commit to participating in the DBT- skills training.
  • Be willing to sign the written informed consent.

Who cannot join

  • Have a clinically significant low linguistic functioning that hinders the patient in understanding and answering the questions on the self-report instruments.
  • Being actively psychotic.
  • Have a Body Mass Index (BMI) under 17.
  • Cognitive disability Intelliganve quotient (IQ) <85

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Johanna Vigfusdottir, Clinical psychologist contact

+4746746154

johannavigfusd@gmail.com

Reidun Hoidal, Clinical psychologist contact

+4795923700

reidun.hoidal@helse-mr.no

Norway1 site, 1 recruiting
  • Outpatient psychiatric unit - More and Romsdal Health Trust

    Molde, 6416

    Johanna Vigfusdottir Vigfusdottir, +4746746154, johanna.vigfusdottir@helse-mr.no

    Recruiting

Other trials in Norway

About this study

Official title: DBT Skill Training for Autistic Adults With Difficulties in Emotion Regulation: a Feasibility Study.

One in 44 has autism, 70% of them have additional mental health challenges. Currently, this patient population does not have access to effective treatment within specialist healthcare services and has struggled to benefit from standard treatments. The goal of this project is to increase access to treatment tailored to their challenges. We will investigate whether a treatment program with an adapted version of Dialectical Behavior Therapy (DBT) is feasible, accepted, and perceived as useful for people with autism. The purpose of the treatment is to improve emotion regulation, function better in relationships, and avoid crises, thereby enhancing their ability to achieve personal goals, reduce suffering, and increase quality of life. Autism is a lifelong neurodevelopmental disorder, presenting with great variation and more widespread than previously thought. Difficulties with emotion regulation are a central challenge for many with autism. These difficulties often manifest as an inability to recognize, understand, and manage emotional responses, leading to destructive strategies, behaviors, and suffering. DBT is developed with a focus on emotion regulation and has shown good effects in other patient populations. The project can increase access to treatment for a patient population that currently stands without.

Read the detailed description

Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition marked by difficulties in social interaction, communication, sensory sensitivities, and repetitive behaviors. ASD varies widely among individuals and has become more recognized over time. The prevalence of ASD has significantly increased, with the U.S Centers for Disease Control and Prevention (CDC) reporting a rise from 1 in 2,222 children in 1968 to 1 in 44 children in 2020. This increase is due to evolving definitions, greater awareness, and differences in study methodologies.

Many individuals with ASD, especially those without intellectual disabilities, often remain undiagnosed until adulthood. Undiagnosed ASD is common in adult clinical populations, with a Swedish study finding that 18.9% of psychiatric outpatients had ASD. Psychiatric comorbidities are frequent in ASD, including anxiety, depression, attention deficit hyperactity disorder (ADHD), obsessive compulsive disorder (OCD), bipolar disorders, and sleep-wake disorders, complicating diagnosis and treatment. Autistic individuals often engage in suicidal behaviors, self-harm, and aggression, impacting daily life.

Autistic women without intellectual disabilities are often underdiagnosed due to less overt symptoms and their ability to camouflage difficulties. Misdiagnosis with personality disorders, particularly borderline personality disorder, is common.

Despite rising diagnosis rates, there is a lack of evidence-based treatment options for autistic adults, especially for those with comorbid mental disorders. Many clinicians lack training to work with autistic adults, and ASD specialists often lack expertise in treating co-occurring conditions. In Norway, there is a significant gap in treatment options for autistic adults without intellectual disabilities.

Emotion regulation difficulties are central challenges for many autistic adults, involving physiological arousal, brain region alterations, and unique ASD mechanisms like cognitive rigidity. Autistic adults often struggle with alexithymia, exacerbating emotion regulation issues. Developing effective emotion regulation strategies can improve quality of life.

Dialectical Behavior Therapy (DBT) helps autistic individuals manage emotions, relationships, and crises. DBT has shown effectiveness in reducing self-harm and suicidal behaviors among autistic adults. A study in North Carolina found DBT skills training feasible and acceptable for autistic adults without intellectual impairment. Similar studies have not been conducted in Nordic countries for outpatient psychiatric settings.

This study is a mixed-method feasibility study without a control group. With measurements pre and post treatment intervention. In the project period approximatly 15 patients will be invited to participate, referred to the project by a therapist form an general outpatient psychiatric clinic.

Primary objectives

If the DBT-skills training is relevant - The severity of difficulties in emotion regulation for the population, and the presences of destructive behaviour such as self-harm and suicide behaviour.

If DBT-skills training is accepted by tracking the dropout rate from DBT skills training, as well as the percentage of DBT-SUD skills sessions participated in, and the percentage completed homework.

Acceptability and Feasibility post treatment by evaluating participants' experiences with the treatment, and use of unhelpful and helpful strategies with self-rapport instruments.

Secondary objectives

Tracking the change in two target behaviors and four target emotions and use of skills in the treatment period with a diary card.

Assessing goals, hinders, and resources at the start and completion of the DBT skills training, with a qualitative interview.

Strength and limitations

Strength: This is a feasibility study in naturalistic treatment, making the results generalizable.

The result of the study gives relevant information in a population that is often excluded from studies because of ASD diagnosis.

Limitations: With a lack of a randomized control group, one cannot measure the direct effect of the intervention.

Future research: If the intervention fits the progression criteria and proves to be relevant, feasible, acceptable, and of potential benefit for the patients, the future aim is to conduct a Randomized Control Trial (RCT) on the effect of DBT skills training for autistic adults with difficulties in emotion regulation.

Being tested
DBT skills training adjusted to autistic needs
Keywords
Autisim, emotion regulation, DBT skills training, adults, ASD, Feasibility, Autism spectrum disorder
Medical subject headings
Autism Spectrum Disorder, Emotional Regulation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DBT skills training adjusted to autistic needsBehavioural

    Adjustments to fit the specific learning style of people with autism. Simplified skills - fewer words, ,more pictures, autism relevant examples. Hands- on training using props and role play. adjustments so sensory sensitivities.

Study groups in NCT07021274
Study groupRoleWhat they receive
Participate in DBT skills trainingExperimentalThe intervention period will be from August 2025- February 2027. DBT- skills is a group skills training component of Dialectical Behaviour therapy a comprehensive treatment focused on extensive difficulties in emotion regulation. In this project, the investigators will use the standard DBT skill-training model with an addition of Autism specific interventions and adjustments. The DBT-SUD Skills intervention consists of: 2-3 sessions with a DBT therapist focusing on treatment orientation - mapping the patients' goals, obstacles, and resources, DBT- hierarchy, and commitment. Skills training - 28, two-hour sessions - once a week. 1 status and evaluation session half-way through the skills training. 1 summary session with a focus on goals reached and troubleshooting. Two DBT therapists lead the group, and each group consists of approx. 4-6 participants.
Receives: Behavioral: DBT skills training adjusted to autistic needs

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Difficulties in emotion regulation scale (DERS) - 8

    a shortened self-report instrument, developed from the original DERS-36 meant to measure difficulties in emotion regulation. The DERS-8 consists of 8 items prefaced with the phrase "When I'm upset," to provide respondents with a uniform context that elicits thinking about situations requiring regulation of negative emotion; answers to items likely to represent affect, thought, and actions in response to such situations. The scale offers a brief unidimensional measure of difficulties in emotion regulation for adolescents and adults. Higher scores indicate greater levels of difficulties in emotion regulation.

    Measured: From enrollment to the end of treatment at 28 weeks.

  2. participation in treatment

    Dropout rate from DBT skills training, as well as the percentage of DBT-SUD skills sessions participated in, and the percentage completed homework.

    Measured: From enrollment to the end of treatment at 28 weeks.

  3. Dialectical Behavior Therapy- Ways of Coping Checklist (DBT-WCCL)

    It is a 59 item self-rapport questionnaire that assesses both positive and negative methods of coping with stressful situations including problem-focus, seeking social support, blaming self, blaming others, wishful thinking, and avoidance as well as DBT skills use on 4-point likert scale: 0 = Never Used, 1= Rarely Used, 2= Sometimes Used, 3 = Regularly Used. The questionnaire is divided into 2 subscales: 1) DBT skills subscale that consists of Nine items represent emotion regulation skills, seven represent interpersonal effectiveness skills, five depict mindfulness skills, 19 represent crisis survival skills, two depict reality acceptance skills (0-114). and 2) Dysfunctional Coping Subscale that consist of 17 items referring to dysfunctional behavior in general along with items referring more specifically to blaming others (0-63).

    Measured: From enrollment to the end of treatment at 28 weeks.

Secondary outcomes (2)
  1. Diary card

    Tracking the change in two target behaviours and four target emotions and use of skills in the treatment period with a diary card.

    Measured: From enrollment to the end of treatment at 28 weeks.

  2. Qualitative interview guide - DBT skills training ASD

    Qualitative interview focusing on the participants goals, hinders and resources, and how they experienced the treatment interventions in relation to achieving these goals.

    Measured: From enrollment to the end of treatment at 28 weeks.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Jun 2025
  2. Study start15 Aug 2025
  3. Primary completion28 Feb 2027 (estimated)
  4. Study completion28 Feb 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
This study is a mixed-method feasibility study without a control group. With measurements pre and post treatment intervention
Masking
None (open label)
Enrolment
15 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07021274
Sponsor's protocol ID
836937
Status last verified
Oct 2026
First submitted
19 May 2025
Last updated
13 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Bargiela S, Steward R, Mandy W. The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype. J Autism Dev Disord. 2016 Oct;46(10):3281-94. doi: 10.1007/s10803-016-2872-8.

    PubMed 27457364
  • Ritschel LA, Guy L, Maddox BB. A pilot study of dialectical behaviour therapy skills training for autistic adults. Behav Cogn Psychother. 2022 Mar;50(2):187-202. doi: 10.1017/S1352465821000370. Epub 2021 Sep 23.

    PubMed 34553682

Questions about this trial

What is this clinical trial studying?

A study testing DBT skills training adjusted to autistic needs in people with Difficulties of Emotion Regulation and Self-harm Behavior, run by Helse Møre og Romsdal HF at 1 site in Norway.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 13 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Johanna Vigfusdottir, Clinical psychologist (+4746746154, johannavigfusd@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Difficulties in emotion regulation scale (DERS) - 8 (time frame: From enrollment to the end of treatment at 28 weeks.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07021274, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Oct 2026.

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