Journal article
Dialectical Behavior Therapy for Suicidal Self-Harming Youth: Emotion Regulation, Mechanisms, and Mediators
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, v 60(9), pp 1105-+
Sep 2021
PMID: 33539915
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: This study evaluated mechanisms, mediation, and secondary/exploratory outcomes in our randomized controlled trial evaluating dialectical behavior therapy (DBT) compared to individual and group supportive therapy (IGST). We expand on previously reported results indicating a DBT advantage at posttreatment on planned suicide/self-harm outcomes, and greater self-harm remission (absence of self-harm, post hoc exploratory outcome) during active-treatment and follow-up periods. Method: This was a multi-site randomized trial of 173 adolescents with prior suicide attempts, self-harm, and suicidal ideation. Randomization was to 6 months of DBT or IGST, with outcomes monitored through 12 months. Youth emotion regulation was the primary mechanistic outcome. Results: Compared to IGST, greater improvements in youth emotion regulation were found in DBT through the treatment-period [t(498) = 2.36, p =.019] and 12-month study period (t(498) = 2.93, p =.004). Their parents reported using more DBT skills: posttreatment t(497) = 4.12, p <.001); 12-month follow-up t(497) = 3.71, p <.001). Mediation analyses predicted to self-harm remission during the 6- to 12-month follow-up, the prespecified outcome and only suicidality/self-harm variable with a significant DBT effect at follow-up (DBT 49.3%; IGST 29.7%, p =.013). Improvements in youth emotion regulation during treatment mediated the association between DBT and self-harm remission during follow-up (months 6-12, estimate 1.71, CI 1.01-2.87, p =.045). Youths in DBT reported lower substance misuse, externalizing behavior, and total problems at posttreatment/6 months, and externalizing behavior throughout follow-up/12 months. Conclusion: Results support the significance of emotion regulation as a treatment target for reducing self-harm, and indicate a DBT advantage on substance misuse, externalizing behavior, and self-harm-remission, with 49.3% of youths in DBT achieving self-harm remission during follow-up.
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Details
- Title
- Dialectical Behavior Therapy for Suicidal Self-Harming Youth: Emotion Regulation, Mechanisms, and Mediators
- Publication Details
- JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, v 60(9), pp 1105-+
- Publisher
- ELSEVIER SCIENCE INC; NEW YORK
- Grant note
- This research was supported by grants from the National Institute of Mental Health (NIMH; R01MH090159 and R01MH93898) . The content is solely the re-sponsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000687323100012
- Scopus ID
- 2-s2.0-85104011957
- Other Identifier
- 991021860670404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics
- Psychiatry
- Psychology, Developmental