Reduce Self-Harm and Suicidality in Adolescents with Mindfulness
By John M. de Castro, Ph.D.
“growing evidence supports DBT-A as a likely viable treatment intervention for adolescents who self-harm.” – Kimberly R. Freeman
Around 43,000 people take their own lives each year in the US. The problem is far worse than these statistics suggest as it has been estimated that for every completed suicide there were 12 unsuccessful attempts. In other words, about a half a million people in the U.S. attempt suicide each year. Indeed, suicide is the second leading cause of death in adolescents.
Self-injury is a disturbing phenomenon occurring worldwide, especially in developed countries, such as the U.S. and those in western Europe. Approximately two million cases are reported annually in the U.S. Each year, 1 in 5 females and 1 in 7 males engage in self-injury usually starting in the teen years.
One of the few treatments that appears to be Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic including self-injury. Behavior change is accomplished through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. DBT has been found to reduce self-injurious behaviors. The data is accumulating so there is a need to review and summarize what has been found.
In today’s Research News article “Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188531/ ) Kothgassner and colleagues review, summarize, and perform a meta-analysis of the published research literature on the effectiveness of Dialectical Behavior Therapy (DBT) for the treatment of self-harm and suicidality in adolescents.
They identified 21 published research studies encompassing 1673 adolescents. They report that the published research found that Dialectical Behavior Therapy (DBT) resulted in significant reductions in self-harm and suicide ideation in the adolescents. They further found that the longer the duration of DBT treatment the greater the reductions in suicidal ideation.
This summary of the published research studies suggests that Dialectical Behavior Therapy (DBT) is a safe and effective treatment for the reduction of self-harm and suicidal thoughts in adolescents. Since, suicide is the second leading cause of death in adolescents and has increased substantially over the last decade, a treatment that can help reduce these rates is needed. The present results suggest that DBT with its associated training in mindfulness may be able to address this need.
So, reduce self-harm and suicidality in adolescents with mindfulness.
“the DBT-A group experienced fewer episodes of self-harm. . . as well as statistically significant reductions in suicidal ideation and depression (both of which are risk factors for suicide).” – Suicide Prevention Resource Center
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Kothgassner, O. D., Goreis, A., Robinson, K., Huscsava, M. M., Schmahl, C., & Plener, P. L. (2021). Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis. Psychological medicine, 51(7), 1057–1067. https://doi.org/10.1017/S0033291721001355
Abstract
Background
Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader adolescent psychopathology is critical.
Methods
We conducted a systematic review and meta-analysis of the Dialectical Behaviour Therapy for Adolescents (DBT-A) literature on treating self-injury in adolescents (12–19 years). We searched for eligible trials and treatment evaluations published prior to July 2020 in MEDLINE/PubMed, Scopus, Google Scholar, EMBASE, and the Cochrane Library databases for clinical trials. Twenty-one studies were identified [five randomized-controlled trials (RCTs), three controlled clinical trials (CCTs), and 13 pre-post evaluations]. We extracted data for predefined primary (self-harm, suicidal ideation) and secondary outcomes (borderline personality symptoms; BPD) and calculated treatment effects for RCTs/CCTs and pre-post evaluations. This meta-analysis was pre-registered with OSF: osf.io/v83e7.
Results
Overall, the studies comprised 1673 adolescents. Compared to control groups, DBT-A showed small to moderate effects for reducing self-harm (g = −0.44; 95% CI −0.81 to −0.07) and suicidal ideation (g = −0.31, 95% CI −0.52 to −0.09). Pre-post evaluations suggested large effects for all outcomes (self-harm: g = −0.98, 95% CI −1.15 to −0.81; suicidal ideation: g = −1.16, 95% CI −1.51 to −0.80; BPD symptoms: g = −0.97, 95% CI −1.31 to −0.63).
Conclusions
DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD symptoms was only found in pre-post evaluations.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188531/