Wildnerness therapy is becoming increasingly popular as a treatment for adolescents. It has been established as an efficacious treatment in previous literature, but the mechanisms as to why have thus far remained a mystery. This research is looking at the connection between wilderness therapy and DBT, another evidence-based treatment. This study will examine 156 adolescents, comparing the efficacy of wilderness therapy to traditional inpatient and intensive outpatient. Pre-treatment assessments of suicidal ideation, emotional regulation, and distress tolerance will be taken. It is expected that there will be main effects for each of the treatments, but that wilderness therapy will be strongest. Additionally, it is expected that emotion regulation and distress tolerance will act as mediators, and their effect on suicidal ideation will be even greater than that of treatment.

This study was designed to answer two research questions. First, factors associated with placement decisions to three treatment modalities in a university counseling center were examined; the skills training group for dialectical behavior therapy plus individual therapy (DBT), the interpersonal process group plus individual therapy (IP), and individual therapy only (IND). Individual therapy in all three conditions did not follow a specific theoretical orientation. Of 203 participants (55 males, 148 females), 83 were in DBT, 53 were in IP, and 67 were in IND. Client information included demographic variables (e.g., age, gender) and clinical variables (i.e., diagnosis, and scores from Global Assessment of Functioning, the Outcome Questionnaire-45; OQ-45, and the College Adjustment Scale; CAS). As predicted, the results indicated that clinical characteristics played a significant role in referral decision making, with clients in the DBT condition reporting higher clinical severity. Second, the effectiveness of the skills training group (DBT) was examined, testing the hypothesis that people in DBT start out with more clinical problems but make greater progress than those in IP and IND. Treatment outcome was measured by the OQ-45 and the CAS, each collected at multiple time points. Data from 101 people were available for the OQ-45, and 77 people for the CAS. The results did not provide support for the hypothesis. Although significant change was observed over the course of treatment, no clear patterns of superior outcomes for any of the three treatment conditions emerged.

<p>Syftet är att undersöka de teorier och behandlingsmetoder som Nyckelns behandlingshem använder sig av, samt att belysa själva begreppet självskadebeteende och dess orsaker. Vi har gjort en litteraturgenomgång om orsaker och behandling och en kvalitativ intervju med personal på behandlingshemmet Nyckeln, vars målgrupp är unga flickor i åldern 15 till 25 år. Dessa behandlas för självskador enligt vår definition: att skära, rispa eller bränna sig i huden. De metoder vi utgår från är kognitiv terapi, kognitiv beteendeterapi och dialektisk beteendeterapi, vilka Nyckeln grundar sin behandling på. Dessa teorier går ut på att förändra negativa tankesätt och att därmed få till en förändring i beteendet. De resultat vi har fått fram är att orsakerna till självskador i huvudsak är ett sätt att hantera svåra känslor på och att det är ett sätt för flickorna att uttrycka sig. Den kognitiva behandlingen är en fungerande metod just för att den lägger fokus dessa bitar och Nyckeln hjälper därmed flickorna att identifiera sina känslor och att hitta andra sätt att hantera dem på. Efter de resultat vi har fått fram i analysen kan vi dra slutsatsen att Nyckelns arbete fungerar. De lyckas behandla en hel del flickor utifrån de kognitiva modeller de använder sig av.</p>

Syftet är att undersöka de teorier och behandlingsmetoder som Nyckelns behandlingshem använder sig av, samt att belysa själva begreppet självskadebeteende och dess orsaker. Vi har gjort en litteraturgenomgång om orsaker och behandling och en kvalitativ intervju med personal på behandlingshemmet Nyckeln, vars målgrupp är unga flickor i åldern 15 till 25 år. Dessa behandlas för självskador enligt vår definition: att skära, rispa eller bränna sig i huden. De metoder vi utgår från är kognitiv terapi, kognitiv beteendeterapi och dialektisk beteendeterapi, vilka Nyckeln grundar sin behandling på. Dessa teorier går ut på att förändra negativa tankesätt och att därmed få till en förändring i beteendet. De resultat vi har fått fram är att orsakerna till självskador i huvudsak är ett sätt att hantera svåra känslor på och att det är ett sätt för flickorna att uttrycka sig. Den kognitiva behandlingen är en fungerande metod just för att den lägger fokus dessa bitar och Nyckeln hjälper därmed flickorna att identifiera sina känslor och att hitta andra sätt att hantera dem på. Efter de resultat vi har fått fram i analysen kan vi dra slutsatsen att Nyckelns arbete fungerar. De lyckas behandla en hel del flickor utifrån de kognitiva modeller de använder sig av.

This thesis examines how perturbing selected adversary capabilities in a design basis threat (DBT) may affect the assessment of a facility's security system performance. We found that using a strictly defined DBT to design and analytically test facility security systems can lead to invalid assessments that security measures are meeting standards. Design Basis Threats are intended to represent the most severe yet realistic attack a facility might face. However, the static nature of the standard DBT makes it unable to test the performance of a facility security system in the case where a specialized adversary may possess different capabilities than defined in the DBT. Our analysis of security system performance for various modeled facilities revealed significant vulnerabilities to certain perturbations of adversary capabilities. These vulnerabilities went undetected when the original strictly defined graded DBT was used in the assessment procedure. By maximizing one adversary capability at the expense of others, a specialized adversary force was able to efficiently defeat each facility. To address this problem, we proposed employing a so-called "point-based" DBT as an alternative to the existing strictly defined DBT. In a point-based DBT, multiple scenarios are assessed that test different sets of adversary capabilities to better uncover and understand any security system vulnerabilities that may exist. We believe the benefit of identifying these site-specific security vulnerabilities will outweigh the additional cost of generating a point-based DBT, especially if the vulnerabilities are identified during the initial design of the security system.

Mental illness is an important and growing problem. In Sweden it is estimated that about 22 percent of the female population, and 15 percent of themale, suffer from anxiety [1]. This thesis examines specifically the borderline personality disorder. It is a serious condition that in a prevalence study, was found to affect 5,4 percent ofthe Swedish population. The disorder is linked to self-harming and about 10 percent with the disorder die of suicide [2]. Continuously, the thesis describes the process of the development of a mobileapplication concept that is created to help the user collect and analyze data about their mental state. The thesis first defines the purpose and the limitationsof the project, as well as what goals the project strives for. It continues by examining various fields of interest; by describing mental illness, similar work and the pros and cons of using applications for this purpose. In order to develop an application suitable for the target group, the projectinvestigated areas such as different development tools, the concept of usabilityand the dialectical behavioral therapy, which is a therapy form created specifi-cally for treating the borderline personality disorder. The project’s method is described; how the structure of the project wasset as well as the process of the design and development of the application. Furthermore, the result of the application is outlined, presenting its functions,layout and underlying database. The thesis additionally discusses the problems with mental illness, and thechallenges the project has faced. Issues such as how to handle sensitive data,further development and other other ways to tackle the problem was consideredin the discussion.Lastly, the project is condensed in a summary.

Telefonstöd är en behandlingskomponent i dialektisk beteendeterapi (DBT) som innebär att patienten kan kontakta sin individualterapeut mellan sessionerna för hjälp med att generalisera färdigheter, hantera kriser och reparera terapeutisk relation. I litteraturen betonas vikten av att individualterapeuter observerar sina gränser för att förebygga utbrändhet. Få studier har fokuserat på telefonstöd och det saknas tidigare forskning om terapeutupplevelse av telefonstöd, vilket vanligen sker utanför arbetstid. Syftet med den här studien var att undersöka svenska individualterapeuters upplevelse och tillämpning av telefonstöd i DBT utifrån frågeställningarna hur det används och tillämpas, hur terapeuterna upplever tillämpningen samt vilka faktorer som kan vara kopplade till upplevd stress. Metoden var kvantitativ enkätstudie och resultaten beräknades i SPSS. Webbenkäten besvarades av 82 individualterapeuter, varav 69 tillämpade telefonstöd. Majoriteten av deltagarna upplevde inte tillämpningen som särskilt stressande/betungande. Faktorer som korrelerade signifikant med upplevd stress var i vilken utsträckning respondenterna upplevde att patienterna förstod syftet, att konsultationsteamet var hjälpsamt, att de visste hur de skulle agera när patienterna efterfrågade telefonstöd samt hur länge de tänkte på utfört telefonstöd efteråt. Eftersom urvalet i studien skett genom bekvämlighetsurval, är möjligheten till generalisering av resultaten begränsad. Likaså är det inte möjligt att göra uttalanden om orsak-verkan avseende korrelationerna eller påverkan av tredjevariabler, varför vidare forskning behövs. / Phone coaching is a treatment component of dialectical behavioral therapy (DBT) that allows patients to contact their individual therapist between sessions for help in generalizing skills, managing crises and repairing therapeutic relationship. The literature emphasizes the importance of individual therapists observing their limits to prevent burnout. Few studies have focused on phone coaching and previous research about therapist experience of phone coaching application, which usually takes place outside of working hours, is missing. The purpose of this study was to investigate the experience and application of phone coaching in DBT by Swedish individual therapists based on the issues of how it is used and applied, how the therapists experience the application and what factors may be linked to perceived stress. The method was quantitative survey study and the results were calculated in SPSS. The online questionnaire was answered by 82 individual therapists, of which 69 applied phone coaching. The majority did not experience application as particularly stressful/burdensome. Factors that correlated significantly with perceived stress were the extent to which respondents felt that patients understood the purpose, the consultation team was helpful, they knew how to act when patients requested phone coaching and for how long they thought of performed phone coaching afterwards. Since the selection in the study has been made by convenienceselection, the possibility of generalization of the results is limited. Similarly, statements about cause-and-effect regarding the correlations or the influence of third variables is not possible to make, why further research is needed.

Locomotion in vertebrates depends on proper formation and maintenance of neuronal networks in the hind-brain and spinal cord. Malformation or loss of factors required for proper maintenance of these networks can lead to severe neurodegenerative diseases limiting or preventing locomotion. A powerful tool to investigate the genetic and cellular requirements for development and/or maintenance of these networks is a collection of zebrafish mutants with defects in motility. The zebrafish mutant quetschkommode (que) harbors a previously unknown gene defect leading to abnormal locomotor behavior. Here I show that the que mutants display a seizure-like behavior starting around four days post fertilization (dpf) that is characterized by a lack of an initial high amplitude body bend (C-bend) and simultaneous contra-lateral contractions leading to a seizure-like phenotype and paralysis. Peripheral nerve recordings show a significant increase in the number of initiated swimming bouts and overlap between left and right motor neuron activity. These data suggest that the que mutation leads to defects in nervous system function, at the level of motor neurons or central control of motor neurons. I have genetically mapped the que locus to a 0.36cM interval on chromosome 22 using meiotic mapping. I identified a splice mutation in the gene `dihydrolipoamide branched-chain transacylase E2' (dbt) as defective in que mutants. An orthologous mutation in humans lead to Maple Syrup Urine Disease (MSUD), a devastating metabolic disorder leading to seizures, mental retardation, coma and neonatal death if untreated. In zebrafish, dbt is expressed throughout early development and dbt transcripts become enriched in the hind-brain as well as in the gut and liver by 96 hpf. In MSUD patients levels of branched chain amino acids (BCAA) and their keto acids are significantly increased due to the essential role of the dbt enzyme for the BCAA metabolic pathway. The que mutation causes a significant increase of branched chain amino acids in the zebrafish mutant and a strong decrease of neurotransmitters such as glutamate and GABA as well as precursors like glutamine. I hypothesize that reduced neurotransmitter levels in que lead to the observed motility phenotype. Consistent with this hypothesis, I show a tissue specific reduction of glutamate in the hind-brain and spinal cord of que mutants. To evaluate the que mutant's potential as a vertebrate model for MSUD I performed a pilot drug screen using a selection of metabolites of the pathway as well as diet additives currently evaluated in clinical trials. Conversely, application of phenylbutyrate, one of the diet additives, had a beneficial influence on swimming abilities of que mutant embryos, while the keto acid α-ketoisocaproate (KIC), one of the elevated keto acids in human patients, decreased the percentage of larvae capable of swimming. These results help establish the zebrafish que mutant as a new model for MSUD disease that can be used to further the understanding of this disorder and to help identify therapeutic agents.

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