Iselin Solerød Dibaj

• Dibaj, Iselin Solerød; Galfalvy, Hanga; Tørmoen, Anita Johanna; Haga, Egil & Mehlum, Lars (2026). Does Dialectical Behaviour Therapy for adolescents affect suicidal ideation and use of coping skills in adulthood? A 12.4-years follow-up study of a Randomized Trial using Ecological Momentary Assessment. Behaviour Research and Therapy. ISSN 0005-7967. 203. doi: 10.1016/j.brat.2026.105091. Fulltekst i vitenarkiv
• Mehlum, Lars; Dibaj, Iselin Solerød; Haga, Egil; Helle, Sofie Egidius; Morken, Katharina Teresa Enehaug & Klungsøyr, Ole [Vis alle 7 forfattere av denne artikkelen] (2026). Adult life outcomes for adolescents 12.4 years after dialectical behavior therapy - a randomized clinical trial. European Child and Adolescent Psychiatry. ISSN 1018-8827. doi: 10.1007/s00787-025-02856-w. Fulltekst i vitenarkiv Vis sammendrag

  Adolescents with suicidal and self-harming behavior run significant risk for suicide. Outcomes in adult life after specialized treatment for this population are unknown. We examined adult life outcomes in adolescents with recurrent suicidal and self-harming behavior and borderline features having participated in a randomized trial of dialectical behavior therapy (DBT-A) or enhanced usual care (EUC). Of the original 77 study participants, 61 (79%) were followed-up at a mean age of 28 years, an average of 12.4 years post-baseline. Primary outcomes were frequency of self-harm episodes and levels of suicidal ideation and depressive symptoms over the follow-up intervals. Secondary outcomes were borderline symptoms, psychiatric morbidity, occupational and psychosocial functioning. Self-harm frequency was consistently lower throughout the 12.4 year follow-up period in participants who had received DBT-A, although differences were not statistically significant at the final follow-up. Whereas suicide attempts were infrequent in both groups, self-harm episodes were more than twice as common in the EUC group compared to the DBT-A group with a mean difference of 90 episodes per person from baseline to 12.4 years follow-up. DBT-A was associated with significantly stronger reductions in suicidal ideation, depressive and borderline symptoms at end of treatment but differences tapered off until not statistically significant at the final follow-up. There were no significant trend differences in current psychiatric morbidity, self-reported depressive symptoms and global functioning. This first study of adult life outcomes of specialized psychosocial interventions for adolescents with recurrent suicidal and self-harming behavior and borderline features suggests that adolescents may have a realistic hope of sustained recovery as adults.

• Dibaj, Iselin Solerød; Tørmoen, Anita Johanna; Klungsøyr, Ole; Morken, Katharina Teresa Enehaug; Haga, Egil & Dymbe, Kine Johansen [Vis alle 7 forfattere av denne artikkelen] (2025). Early remission of deliberate self-harm predicts emotion regulation capacity in adulthood: 12.4 years follow-up of a randomized controlled trial of adolescents with repeated self-harm and borderline features. European Child and Adolescent Psychiatry. ISSN 1018-8827. s. 1–12. doi: 10.1007/s00787-024-02602-8. Fulltekst i vitenarkiv Vis sammendrag

  Emotion regulation capacity, critical for adult functioning and mental health, develops strongly during adolescence in healthy individuals. Deficits in emotion regulation is often referred to as emotion dysregulation [ED] and is associated with various mental health problems, including repeated deliberate self-harm [DSH] which peaks in adolescence. Dialectical Behaviour Therapy for adolescents [DBT-A] systematically targets ED through strategies such as changing coping behaviours and has previously been shown to effectively induce DSH remission in adolescents. However, whether such remission is associated with improved emotion regulation capacity in adulthood, and whether this effect is mediated by changes in use of coping strategies has not been previously studied. Prospective long-term follow-up study of an RCT comparing DBT-A with enhanced usual care [EUC] for adolescents presenting to community child and adolescent psychiatric outpatient clinics with borderline personality features and repeated self-harm. Assessments included both structured interviews and self-report at baseline and 1.6, 3.1 and 12.4 years follow-up. In the final follow-up, adult ED was measured and data were collected for 61 (80%) of the original 77 participants. DSH remission was assessed at 1.6 years follow-up, and use of coping strategies at 3.1 and 12.4 years follow-ups. A mediation analysis was conducted within a causal inference framework. Both treatment groups increased their use of functional coping skills from adolescence to adulthood, while only DBT-A was associated with decreases in dysfunctional coping. There was a direct effect of DSH remission 1 year after treatment on adult ED, particularly for participants who did not receive DBT-A. There was a negative association between reductions in dysfunctional coping and adult ED, however this did not mediate the effect of DSH remission. This is the first study to report that early DSH remission in adolescence predicted lower ED in adulthood. These results highlight the importance of early DSH remission and provides new insight into the long-term relationship between DSH and ED. Clinical trial registration information: “Treatment for Adolescents with Deliberate Self-harm”; http://ClinicalTrials.gov/;NCT00675129

• Dibaj, Iselin Solerød; Neupane, Sudan Prasad & Mehlum, Lars (2025). Brief, pragmatic measure of emotion dysregulation in young people – a preliminary validation of the BER-5. Borderline Personality Disorder and Emotion Dysregulation. 12. doi: 10.1186/s40479-025-00285-4. Fulltekst i vitenarkiv Vis sammendrag

  Background Emotion dysregulation is a transdiagnostic construct associated with mental health problems, including self-harm and borderline personality disorder (BPD). Although often targeted in clinical practice, the majority of psychometric assessment instruments of emotion dysregulation are developed for research purposes, and there is a need for an adapted version to be used in a clinical screening setting. The main aim of this study was to examine psychometric properties of a brief, pragmatic measure of emotion dysregulation, the Brief Emotion Regulation Scale − 5 items (BER-5). Methods The sample consisted of 60 young adults (mean age 28.1 years) who participated in a 12.4 years follow-up study of an RCT of Dialectical Behaviour Therapy’s long-term effect. Cronbach’s alpha was used to calculate internal consistency. Concurrent and convergent validity were examined using Spearman’s correlation in comparison with other measures, and logistic regression as well as area under the curve to examine its ability in terms of differentiating between BPD diagnosis and trait levels. Optimal cut-off points were explored using Receiver Operating Curves. Results Our results indicated adequate internal consistency both in adolescence and in young adulthood, as well as high convergence with a gold-standard measure of emotion dysregulation, and moderate convergence with symptom measures of anxiety and depression. BER-5 was able to differentiate between participants with no BPD from subthreshold or full BPD diagnosis in adulthood, and a cut-off score of 5 was found optimal in terms of sensitivity and specificity in identifying individuals with BPD. Conclusions The BER-5 is a brief, pragmatic measure of emotion dysregulation with good psychometric properties and is potentially a useful screening tool for clinicians working in specialized health care settings.

• Dibaj, Iselin Solerød; Tørmoen, Anita Johanna; Klungsøyr, Ole; Haga, Egil & Mehlum, Lars (2023). Trajectories and Predictors of Change in Emotion Dysregulation and Deliberate Self-Harm Amongst Adolescents with Borderline Features. Clinical Child Psychology and Psychiatry. ISSN 1359-1045. 29(2), s. 407–423. doi: 10.1177/13591045231177374. Fulltekst i vitenarkiv Vis sammendrag

  Background Deliberate self-harm (DSH) and emotion dysregulation (ED) peaks in adolescence, and is associated with an increased risk of psychopathology, suicide and lower functioning in adulthood. DBT-A has been established as an effective treatment for reducing DSH, however less is known about changes in emotion dysregulation. This study aimed to identify baseline predictors of treatment response in outcome trajectories of DSH and emotion dysregulation. Methods Response trajectories of DSH and ED were investigated using Latent Class Analysis on RCT data comparing DBT-A and EUC for 77 adolescents treated for deliberate self-harm and borderline traits. Logistic regression analysis was used to examine baseline predictors. Results Two-class solutions were selected for both indicators, distinguishing between early and late responders in DSH, and responders and non-responders in ED. Higher levels of depression, shorter DSH histories and not receiving DBT-A predicted less favourable response in DSH, while DBT-A was the only predictor of treatment response in ED. Conclusions DBT-A was associated with a significantly faster reduction of deliberate self-harm in the short-term and improved emotion regulation in the long-term.

• Dibaj, Iselin; Halvorsen, Joar Øveraas; Kennair, Leif Edward Ottesen & Stenmark, Håkon Inge (2020). Painful memories: Challenges in trauma-focused therapy for torture survivors with PTSD and chronic pain – a narrative review. Journal on Rehabilitation of Torture Victims and Prevention of Torture. ISSN 1018-8185. 30(2), s. 35–57. doi: 10.7146/torture.v30i2.119788. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: PTSD and chronic pain are disorders that researchers increasingly acknowledge to be risk factors that overlap and their comorbidity is associated with poorer treatment outcomes. This review focuses on torture survivors due to the high prevalence of comorbidity in this group, as well as how PTSD and chronic pain might develop, interact and mutually maintain each other. Methods: A narrative review of empirical studies and theoretical models regarding chronic pain and PTSD in torture survivors, informed by studies conducted in other contexts. Results and discussion: An overview of PTSD and chronic pain studies of torture survivors is presented. Treatment studies for torture survivors with PTSD are scarce and have been discouraging. Studies in other patient populations and theoretical models of maintaining factors within the cognitive-behavioral paradigm are presented, and focused around how interactions between PTSD and chronic pain might mitigate treatment of both disorders. Mutually maintaining factors between chronic pain and PTSD are presented as potential barriers to healing, and clinical implications involve suggestions for clinicians with intention to overcome these barriers in trauma-focused treatment of torture survivors. The knowledge base on how chronic pain and PTSD interact within the context of torture is still very limited. Torture is a potent risk factor in itself for both chronic pain and PTSD. Studies point to complex interactions between pain and PTSD across different trauma-exposed populations, especially when the trauma includes pain. Moreover, the coping strategies that are available and might function as some form of protection during torture [e.g. dissociation, withdrawal], might conversely function to exacerbate symptoms when the survivor is in a safe rehabilitation context. Observations combined with CPPC literature and recent developments in learning theory challenge clinical practice accordingly. Additionally, the limited knowledge base prevents us from providing clear-cut sugges- tions, particularly as the majority of scientific enquiry regarding chronic pain and PTSD has been conducted in other populations outside of the torture survivors group. Furthermore, cultural factors, specific needs and characteristics in this group, the human rights perspective and the socio-political context all need to be acknowledged. Trauma-focused treatment does not appear to specifically target all the mechanisms that are supposedly interacting in maintaining chronic pain and PTSD. Interdisciplinary rehabilitation and close collaboration between physiotherapists and trauma-focused therapists are warranted.

• Dibaj, Iselin; Halvorsen, Joar Øveraas; Kennair, Leif Edward Ottesen & Stenmark, Håkon Inge (2017). An evaluation of combined narrative exposure therapy and physiotherapy for comorbid PTSD and chronic pain in torture survivors. Journal on Rehabilitation of Torture Victims and Prevention of Torture. ISSN 1018-8185. 27(1), s. 13–27. doi: 10.7146/torture.v27i1.26534. Fulltekst i vitenarkiv Vis sammendrag

  INTRODUCTION: Torture is associated with adverse health consequences, with especially high rates of PTSD, depression and chronic pain. Despite increased awareness of the relationship between pain and posttraumaticsymptoms, and the accompanying need for effective treatment strategies, few studies have examined an integrated treatment of comorbid PTSD and pain. METHODS: In this study, using an A-B case series design with three and six month follow-up, six refugee torture survivors with comorbid PTSD, depression and chronic pain received 20 sessions of Narrative Exposure Therapy (NET) and 10 sessions of physiotherapy. Outcome variables included symptoms of PTSD and depression, pain intensity, physical functioning and quality of life. Symptoms of PTSD and pain were also rated after each treatment session. RESULTS: Two patients achieved clinically significant reduction in symptoms of PTSD. Only one patient achieved clinically significant change in depressive symptoms, and two experienced clinically significant reduction in pain intensity. Clinical descriptions of the course of treatment for all patients are provided. DISCUSSION AND CONCLUSIONS: Despite its limitations, the study suggests that some torture survivors who suffer high symptom loads may benefit from a combined treatment of NET and physiotherapy. Appreciating individual differences and how they affect treatment can provide valuable insight and inform clinicians working with torture survivors. Directions for future researchregarding the improvement of rehabilitation strategies of torture survivors are discussed, and highlighted through descriptions from the six therapy cases.

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• Mehlum, Lars & Dibaj, Iselin Solerød (2026). Effective Treatment of Adolescents With Suicidal and Self-Harming Behaviors: What Are the Knowledge Gaps? Journal of the American Academy of Child and Adolescent Psychiatry. ISSN 0890-8567. doi: 10.1016/j.jaac.2026.04.010. Fulltekst i vitenarkiv
• Dibaj, Iselin Solerød; Tørmoen, Anita Johanna; Klungsøyr, Ole; Haga, Egil; Morken, Katharina Teresa Enehaug & Dymbe, Kine Johansen [Vis alle 7 forfattere av denne artikkelen] (2025). Remisjon av selvskading hos ungdommer predikerte bedre emosjonsregulering i voksen alder. Suicidologi. ISSN 1501-6994. 30(1). doi: 10.5617/suicidologi.12350. Fulltekst i vitenarkiv Vis sammendrag

  Emotion regulation capacity, which is critical for adult functioning and mental health, develops strongly during adolescence in healthy individuals, whereas deficits in emotion regulation is often referred to as emotion dysregulation [ED] and is associated with various mental health problems, including repeated deliberate self-harm [DSH], which peaks in adolescence. Dialectical behaviour therapy for adolescents [DBT-A] has previously been shown to effectively induce DSH remission in adolescents. The present study aimed to investigate whether such remission was associated with reduced ED in adulthood, and whether this effect was mediated by reductions in dysfunctional coping. The design was a prospective longterm follow-up study of an RCT comparing DBT-A with enhanced usual care [EUC] for adolescents with borderline personality features and repeated self-harm. The original sample consisted of 77 adolescents, of which 61 were assessed in adulthood, 12.4 years later. The results showed that there was a direct effect of DSH remission one year after treatment on adult ED, although this effect was not mediated by changes in coping. This is the first study to report that early DSH remission in adolescence predicted lower ED in adulthood, and highlights the importance of early DSH remission and provides new insight into the long-term relationship between DSH and ED.

• Mehlum, Lars; Dibaj, Iselin Solerød & Haga, Egil (2024). Skills use and emotion regulation capacity as mechanisms of long-term change after DBT for suicidal and self-harming behaviour. Fulltekst i vitenarkiv
• Dibaj, Iselin; Stenmark, Håkon Inge; Kennair, Leif Edward Ottesen & Halvorsen, Joar Øveraas (2020). Hvordan kan torturutsatte få bedre hjelp? [Journal]. Gemini. Fulltekst i vitenarkiv
• Dibaj, Iselin Solerød; Mehlum, Lars & Tørmoen, Anita Johanna (2025). Long-term change in adolescents treated for deliberate self-harm and borderline features: Exploring the role of emotion dysregulation. Universitetet i Oslo. ISSN 9788234806247. Fulltekst i vitenarkiv Vis sammendrag

  Deliberate self-harm (DSH) peaks during adolescence and is associated with an increased risk of future suicide attempts and mental health problems. DSH can effectively be treated in adolescents, however, the long-term effects of such treatment in adulthood remained unknown when this study was conducted. To date, the treatment that has received the most empirical support in DSH treatment is Dialectical behaviour therapy for adolescents (DBT-A). The main aim of this PhD thesis was to examine adult life outcomes after DBT-A, both when it came to DSH as well as other outcomes, including suicidal ideation, and emotion regulation ability. The specific papers focused on treatment effects, response trajectories, and mechanisms of change. The study was a follow-up study of an RCT conducted 12 years earlier, comparing DBT-A with usual care for adolescents with repetitive DSH and features of borderline personality disorder. The sample was examined with structured interviews and self-report questionnaires at baseline, 1-, 3- and 12-years follow-up. At the final follow-up, participants also reported data through Ecological Momentary Assessment, by receiving short questionnaires six times daily on their phones over a week. DBT-A was associated with earlier and more robust reduction of DSH, however the difference between the groups diminished over time, and DSH was rarely reported in adulthood across the whole sample. As adults, the majority were either working or studying, and suicide attempts were rare. Moreover, DBT-A was associated with less suicidal ideation in adulthood. DBT-A participants also reported lower negative affect after having used coping skills in their daily life. Finally, remission of DSH one year after treatment was associated with better emotion regulation ability in adulthood. Overall, the findings in this thesis highlight the importance of early targeted intervention and suggest an optimistic long-term prognosis for adolescents who are treated for DSH, extending beyond symptom remission.

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