Dialectical behavior therapy for nonsuicidal self-injury and depression among adolescents: preliminary meta-analytic evidence

IF 6.8 3区医学 Q1 PEDIATRICS

Child and Adolescent Mental Health Pub Date : 2015-07-08 DOI:10.1111/camh.12112

Nathan E. Cook, Maggie Gorraiz

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引用次数: 47

Abstract

Background

Dialectical behavior therapy (DBT) has proven effective in reducing symptoms and behaviors related to Borderline Personality Disorder. More recently, it has been modified and applied to adolescents struggling with regulating their emotions and who may engage in impulsive, self-destructive behaviors, including nonsuicidal self-injury (NSSI). However, there is limited research evidence regarding the effectiveness of DBT for reducing NSSI behavior and depression among adolescents. Given the high suicide risk associated with NSSI and its association with depression, this is clearly an important focus of clinical and research attention.

Method

This meta-analysis sought to offer preliminary evidence regarding the effectiveness of DBT to treat NSSI and depression in adolescents. Twelve published studies were included; all 12 reported pre- and post-treatment measures of depression and six of these studies reported pre- and post-treatment measures of NSSI.

Results

The weighted mean effect size for NSSI was large (g = 0.81, 95% CI = 0.59–1.03); the weighted mean effect size for depression was small (g = 0.36, 95% CI = 0.30–0.42).

Conclusions

Intervention effects for both outcomes were positive, suggesting decreased NSSI and improvement in depressive symptoms for adolescents following a course of DBT. However, given considerable limitations in the research base available for meta-analysis, these findings are preliminary and tentative. Limitations in the current knowledge base and suggestions for future research are discussed.

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辩证行为疗法治疗青少年非自杀性自伤和抑郁:初步meta分析证据

背景辩证行为疗法(DBT)已被证明在减少边缘型人格障碍的症状和行为方面是有效的。最近，它被修改并应用于难以调节自己情绪的青少年，以及可能从事冲动、自我毁灭行为的青少年，包括非自杀性自伤(NSSI)。然而，关于DBT在减少青少年自伤行为和抑郁方面的有效性的研究证据有限。考虑到自伤的高自杀风险及其与抑郁症的关联，这显然是临床和研究关注的一个重要焦点。方法本荟萃分析旨在为DBT治疗青少年自伤和抑郁的有效性提供初步证据。纳入了12项已发表的研究;所有12项研究都报告了治疗前和治疗后的抑郁测量，其中6项研究报告了治疗前和治疗后的自伤测量。结果自伤的加权平均效应量较大(g = 0.81, 95% CI = 0.59 ~ 1.03);抑郁症的加权平均效应值较小(g = 0.36, 95% CI = 0.30-0.42)。结论两种结果的干预效果均为正，表明在一个疗程的DBT后，青少年自伤减少，抑郁症状改善。然而，考虑到可用于荟萃分析的研究基础的相当大的局限性，这些发现是初步的和试探性的。讨论了现有知识库的局限性和对未来研究的建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child and Adolescent Mental Health PEDIATRICS-PSYCHIATRY

CiteScore

8.30

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： Child and Adolescent Mental Health (CAMH) publishes high quality, peer-reviewed child and adolescent mental health services research of relevance to academics, clinicians and commissioners internationally. The journal''s principal aim is to foster evidence-based clinical practice and clinically orientated research among clinicians and health services researchers working with children and adolescents, parents and their families in relation to or with a particular interest in mental health. CAMH publishes reviews, original articles, and pilot reports of innovative approaches, interventions, clinical methods and service developments. The journal has regular sections on Measurement Issues, Innovations in Practice, Global Child Mental Health and Humanities. All published papers should be of direct relevance to mental health practitioners and clearly draw out clinical implications for the field.