{"title":"成人边缘型人格障碍的自杀沟通:临床关联及辩证行为疗法的治疗反应。","authors":"Alma M Bitran, Evan M Kleiman, Shireen L Rizvi","doi":"10.1080/13811118.2025.2512455","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Suicidal communications (SCs)-also known as suicide threats or \"gestures,\" whereby an individual verbally or behaviorally signals suicidal intent-present a serious challenge to clinicians and loved ones, who may struggle to determine the appropriate level of response. Yet, few studies have examined clinical correlates of SCs, partly due to inconsistent operationalization. It is critical to identify mechanisms that maintain SCs and clarify associated suicide risk, especially among individuals with borderline personality disorder (BPD), among whom SCs are relatively common.</p><p><strong>Method: </strong>Adults (N = 108) with BPD receiving a 6-month course of dialectical behavior therapy (DBT) reported on SCs and other suicidal thoughts and behaviors (STBs) at intake, mid-treatment, and end-of-treatment. Participants also completed measures assessing BPD severity, emotion dysregulation, and DBT skills uptake.</p><p><strong>Results: </strong>Participants who endorsed lifetime SCs (53%) reported higher BPD severity and worse emotion dysregulation at baseline. However, dosage of DBT-conceptualized as both skills uptake and length of time in treatment-reduced the incidence of SCs. There were no significant associations between lifetime SCs and engagement in other STBs, both at baseline and during treatment.</p><p><strong>Conclusion: </strong>Current findings support a conceptualization of SCs as an expression of severe emotion dysregulation, which may be alleviated by DBT. Specifically, DBT may protect against SCs by teaching alternative, more adaptive coping strategies, even in the presence of heightened emotion dysregulation. Finally, though results indicate a lack of association between SCs and other STBs, further researcher is needed before clinical recommendations can be made.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-13"},"PeriodicalIF":2.0000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Suicidal Communications in Adults with Borderline Personality Disorder: Clinical Correlates and Treatment Response to Dialectical Behavior Therapy.\",\"authors\":\"Alma M Bitran, Evan M Kleiman, Shireen L Rizvi\",\"doi\":\"10.1080/13811118.2025.2512455\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Suicidal communications (SCs)-also known as suicide threats or \\\"gestures,\\\" whereby an individual verbally or behaviorally signals suicidal intent-present a serious challenge to clinicians and loved ones, who may struggle to determine the appropriate level of response. Yet, few studies have examined clinical correlates of SCs, partly due to inconsistent operationalization. It is critical to identify mechanisms that maintain SCs and clarify associated suicide risk, especially among individuals with borderline personality disorder (BPD), among whom SCs are relatively common.</p><p><strong>Method: </strong>Adults (N = 108) with BPD receiving a 6-month course of dialectical behavior therapy (DBT) reported on SCs and other suicidal thoughts and behaviors (STBs) at intake, mid-treatment, and end-of-treatment. Participants also completed measures assessing BPD severity, emotion dysregulation, and DBT skills uptake.</p><p><strong>Results: </strong>Participants who endorsed lifetime SCs (53%) reported higher BPD severity and worse emotion dysregulation at baseline. However, dosage of DBT-conceptualized as both skills uptake and length of time in treatment-reduced the incidence of SCs. There were no significant associations between lifetime SCs and engagement in other STBs, both at baseline and during treatment.</p><p><strong>Conclusion: </strong>Current findings support a conceptualization of SCs as an expression of severe emotion dysregulation, which may be alleviated by DBT. Specifically, DBT may protect against SCs by teaching alternative, more adaptive coping strategies, even in the presence of heightened emotion dysregulation. Finally, though results indicate a lack of association between SCs and other STBs, further researcher is needed before clinical recommendations can be made.</p>\",\"PeriodicalId\":8325,\"journal\":{\"name\":\"Archives of Suicide Research\",\"volume\":\" \",\"pages\":\"1-13\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Suicide Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/13811118.2025.2512455\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Suicide Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13811118.2025.2512455","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Suicidal Communications in Adults with Borderline Personality Disorder: Clinical Correlates and Treatment Response to Dialectical Behavior Therapy.
Objective: Suicidal communications (SCs)-also known as suicide threats or "gestures," whereby an individual verbally or behaviorally signals suicidal intent-present a serious challenge to clinicians and loved ones, who may struggle to determine the appropriate level of response. Yet, few studies have examined clinical correlates of SCs, partly due to inconsistent operationalization. It is critical to identify mechanisms that maintain SCs and clarify associated suicide risk, especially among individuals with borderline personality disorder (BPD), among whom SCs are relatively common.
Method: Adults (N = 108) with BPD receiving a 6-month course of dialectical behavior therapy (DBT) reported on SCs and other suicidal thoughts and behaviors (STBs) at intake, mid-treatment, and end-of-treatment. Participants also completed measures assessing BPD severity, emotion dysregulation, and DBT skills uptake.
Results: Participants who endorsed lifetime SCs (53%) reported higher BPD severity and worse emotion dysregulation at baseline. However, dosage of DBT-conceptualized as both skills uptake and length of time in treatment-reduced the incidence of SCs. There were no significant associations between lifetime SCs and engagement in other STBs, both at baseline and during treatment.
Conclusion: Current findings support a conceptualization of SCs as an expression of severe emotion dysregulation, which may be alleviated by DBT. Specifically, DBT may protect against SCs by teaching alternative, more adaptive coping strategies, even in the presence of heightened emotion dysregulation. Finally, though results indicate a lack of association between SCs and other STBs, further researcher is needed before clinical recommendations can be made.
期刊介绍:
Archives of Suicide Research, the official journal of the International Academy of Suicide Research (IASR), is the international journal in the field of suicidology. The journal features original, refereed contributions on the study of suicide, suicidal behavior, its causes and effects, and techniques for prevention. The journal incorporates research-based and theoretical articles contributed by a diverse range of authors interested in investigating the biological, pharmacological, psychiatric, psychological, and sociological aspects of suicide.