Treating Self Injurious Behavior: A Novel Brain Stimulation Approach
Self-Injurious Behavior, Self Harm, Self-injury
About this trial
This is an interventional treatment trial for Self-Injurious Behavior focused on measuring Transcranial direct current stimulation, Transcranial electric stimulation, non-invasive brain stimulation, tDCS
Eligibility Criteria
Inclusion Criteria:
- Age 18-60
- Frequent current NSSI (including cutting in which the skin is broken; self-hitting in which there is bruising; or burning in which there is evidence of a burn. Will not enroll if skin-picking or scratching is the only form of self-injury): has engaged in ≥2 episodes of NSSI in the two months prior to enrollment
- Capacity to provide informed consent
- If carries a diagnosis of bipolar I or II disorder, taking a therapeutic dose of a mood stabilizer.
- Normal hearing.
- Physical capacity (e.g., manual dexterity) to set-up and self-administer tDCS. -
Exclusion Criteria:
- Unstable medical conditions based on medical history or physical examination
- Current psychotic disorder, mania, hypomania, intellectual disability
- Dermatologic condition resulting in non-intact skin on the scalp
- Significant suicidal ideation with a plan and intent that cannot be managed safely as an outpatient
- Pregnancy, currently lactating, or planning to conceive during the course of study participation.
- A neurological disease or prior head trauma with evidence of cognitive impairment. Subjects who endorse a history of prior head trauma and score ≥ 1.5 standard deviations below the mean on the Trailmaking A&B will be excluded from study participation.
- Current alcohol or substance use disorder that is moderate or severe
- Individuals who initiated or increased the dose of concurrent psychiatric medications (including antidepressants, anxiolytics, antipsychotic medications, mood stabilizers, and benzodiazepines) within two weeks prior to enrollment
- Individuals who initiated psychotherapy within two weeks prior to enrollment
- Metal implants or paramagnetic objects contained within the body (including heart pacemaker, shrapnel, or surgical prostheses) which may present a risk to the subject or interfere with the MRI scan, according to the guidelines set forth in the following reference book commonly used by neuroradiologists: "Guide to MR procedures and metallic objects," F.G. Shellock, Lippincott Williams and Wilkins NY 2001. Additionally transdermal patches will be removed during the MR study at the discretion of the investigator.
- Claustrophobia significant enough to interfere with MRI scanning
- Weight that exceeds 325 lbs or inability to fit into MRI scanner
- Current seizure disorder.
- Use of anticonvulsant medications that target the GABA system (e.g., gabapentin).
Individuals currently using benzodiazepines who are unwilling or unable to refrain from the use of benzodiazepine medications for at least 72 hours before the first tDCS session and throughout the duration of the 2-week tDCS intervention.
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Sites / Locations
- New York State Psychiatric Institute/Columbia University
Arms of the Study
Arm 1
Arm 2
Active Comparator
Sham Comparator
active anodal tDCS to ventrolateral prefrontal cortex (VLPFC)
sham anodal tDCS to VLPFC
1.5 milliamp (mA) anodal tDCS over right ventrolateral prefrontal cortex; 20-minutes, 6-sessions
Identical electrode montage, sham tDCS over 6 sessions.